The informed professional: another view of HIV testing: an interview with Dr. Lorraine Day.
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Biomedical subjects
Publications and source records attributed to L Day.
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Two-terminal integrated circuit temperature transducers (Analog Devices' AD 590) were used to fabricate skin and rectal probes for the monitoring of mean body temperature. They are inexpensive, robust, easily constructed and of low mass. The skin sensor system described is capable of being solidly attached regardless of the body contour such that it remains integral throughout profuse sweating and vigorous movement. Both types of probe are stable, accurate to within +/- 0.05 degree C over the physiological range of measurement and exhibit 100% response times of approximately 60 s to a square wave stimulus of 10 degrees C.
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The synthesis of uteroglobin in the rabbit uterus is induced by progesterone and is repressed by estrogen which has an over-riding effect over the inducer. The dual hormonal control system offers an excellent model for studying hormonal regulation of mammalian gene expression. Using a full-length uteroglobin cDNA clone as a specific hybridization probe, recombinant lambda phages containing the entire chromosomal uteroglobin gene have been isolated from a rabbit genomic DNA library. Electronmicroscopic analysis of hybrid molecules formed between the chromosomal uteroglobin gene and uteroglobin mRNA indicated the presence of 2 intervening sequences within this gene. The mosaic structure of the uteroglobin gene has been substantiated by detailed restriction mapping and Southern hybridization. The gene is 3.0 kilobases in length to code for a mature mRNA of 465 nucleotides. Northern hybridization of poly(A)-containing RNA from 4-day-pregnant rabbit uterus with the full-length cDNA clone revealed the presence of uteroglobin mRNA precursors. The size of the largest precursor RNA species detected by the cDNA clone is the same as the entire chromosomal uteroglobin gene. The fidelity of the precursor RNAs was established by their ability to hybridize with specific intervening sequence probes. Thus the entire uteroglobin gene is expressed into primary RNA transcripts, which are subsequently processed into mature mRNA molecules by splicing.
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Twenty-four humeral-shaft fractures with associated radial-nerve injuries in twenty-three patients with adequate follow-up were seen over a fifteen-year period. Initial treatment was closed in all but one patient, in whom débridement of an open fracture revealed a lacerated radial nerve. All patients had complete return of radial-nerve function. Two of the twenty-four nerve lesions were treated by delayed operation: one at fourteen weeks for entrapment in fracture callus, and the other at six weeks for repair of the aforementioned lacerated radial nerve. Thus, only 8 per cent of the patients required exploration of the nerve, all of whom did well after delayed repair. We recommend careful observation for return of nerve function and exploration at three and a half to four months after injury if there is still no clinical or electromyographic evidence of recovery at that time.
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In 11 patients with severe angina pectoris a new beta-blocking drug, atenolol (Tenormin; I.C.I.66082), was found in a double-blind randomized trial to reduce significantly the frequency of anginal attacks (P less than 0-001) and the amount of trinitrin consumed (P less than 0-03) in comparison with practolol and placebo. There was no significant improvement in the patients' ability to exercise on the bicycle ergometer.
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The burden of cardiovascular disease in the elderly has increased interest in lipid profiles which retain associations with outcome except at extreme age and for which management has benefits at least in secondary prevention. The source, clinical and laboratory background of 90 male and 120 female consecutive referrals age >70 years to a specialist cardiovascular lipid service have been analysed. Main sources were vascular surgery 47%, cardiology 9% and general practice 41% with 6% referred through routine health checks. Presenting lipids (mM: mean+/-S.D.) were: males: cholesterol 6.9+/-1.7, triglycerides 2.3+/-1.5, HDL 1.2+/-0.3; females: cholesterol 7.8+/-1.4, triglycerides 2.1+/-1.3, HDL 1.5+/-0.5, consistent with greater awareness of lipid-related problems in males but significant vascular disease in females. Secondary lipemia was defined in 131/210, 62.3% of patients (83 recognised before clinic presentation, 48 found at follow-up, mainly diabetes). Significant vascular disease was identified in 166/210 patients, significant other risk factors in another 35 patients. Levels of lipoprotein(a) were widely distributed for all groups, but elevated against population profiles for all groups with vascular disease. Referrals were monitored and not routinely accepted: reassuringly most then accepted were justified through atheroma-related disease and opportunities for secondary prevention, with little additional burden through untargeted routine health checks. Recognition of and management of secondary lipemia and obesity were however incomplete.
Disseminated intravascular coagulation, whether acute or chronic is usually associated with an underlying causative condition. In this case chronic disseminated intravascular coagulation persisted in one 79 year old man for 3 years with no detectable underlying cause.
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OBJECTIVE: We sought to compare fetal swallowed volume determinations simultaneously by two techniques--amniotic fluid (AF) tracer disappearance and esophageal flow probe measurements. METHODS: Six ovine fetuses (129 +/- 1 days) were chronically prepared with a thoracic esophageal flow probe and vascular and two AF catheters. 125I-labeled albumin was injected into the AF cavity, and samples were withdrawn at timed intervals for 8 hours. The AF volume was calculated by time-0 extrapolation of the semilog of 125I disappearance. Tracer-determined swallowed volume was calculated as the product of AF volume and the slope of isotope disappearance. Flow probe measurement of swallowed volume was determined by computer integration of calibrated flow probe velocity recordings. RESULTS: The AF volume averaged 805 +/- 168 mL. The isotope disappearance rate from the AF was 2.8 +/- 0.4%/hour. Average tracer-determined swallowed volume (547 +/- 113 mL/day) was greater than flow probe volume (366 +/- 81 mL/day), although these values were not significantly different. However, when corrected for estimated swallowed lung fluid, tracer-determined volume was significantly greater than flow probe volume (P < .05). CONCLUSION: Ovine fetal swallowed volume determinations by AF tracer techniques are greater than those determined by esophageal flow probe measurements.
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