Search PubMed⌕ Search

Biomedical subjects

M Griffiths

Publications and source records attributed to M Griffiths.

At least 127 records · Page 7Linked to original sources
PubMed1992

Assessing the outcomes of nursing care.

There are many dimensions to outcome measurement for patient care and this study focuses on one aspect of outcome, namely that which is most concerned with the immediate effects of nursing care. Traditionally, outcome studies have been almost exclusively concerned with measuring the clinical outcomes of care with very little attempt being made to assess the effect of the nurses' contributions to that care. One of this study's purposes has been to redress this imbalance. As part of a research project on skill mix and the effectiveness of nursing care, a number of patient-focused standards related to the outcome of nursing care were designed. These were tested, in a case study situation, on 15 wards at seven acute hospitals. Initial testing indicates that these outcome measures show promise as a valid and reliable evaluation instrument with the utility for easy application in the clinical setting. They are being presented as a possible way forward to assessing the outcomes of nursing care.

Humans↗
PubMed1992

Evidence for B-lymphocyte mitogen activity in Borrelia burgdorferi-infected mice.

Borrelia burgdorferi produces a mitogen for murine B lymphocytes which can be measured in vitro by polyclonal stimulation of proliferation and immunoglobulin production (R. Schoenfeld, B. Araneo, Y. Ma, L. Yang, and J. J. Weis, Infect. Immun. 60:455-464, 1992). Sonicated B. burgdorferi cells also stimulated IL-6 production by splenocyte cultures. We have used the murine model for Lyme disease described by Barthold et al. (S. W. Barthold, D. S. Beck, G. M. Hansen, G. A. Terwilliger, and K. D. Moody, J. Infect. Dis. 162:133-138, 1990) to determine whether the B. burgdorferi B-cell mitogen is expressed during active infection. To correlate arthritic changes with immune events, we have studied two strains of mice injected with B. burgdorferi; one of them, C3H/HeJ, developed severe disease, and the other, BALB/c, developed only mild disease. C3H/HeJ mice displayed a persistent 10-fold increase in circulating immunoglobulin G (IgG) levels, a 2-fold increase in IgM levels, and a 15-fold increase in peripheral lymph node B-cell numbers, providing evidence of mitogenic activity. Infected BALB/c mice also had evidence for mitogen activity, since the IgG level in serum increased three- to fourfold. The bulk of the increase in circulating IgG levels was not directed against B. burgdorferi antigens, supporting the occurrence of polyclonal B-cell activation. Analysis of IgG isotypes pointed out a contrast between C3H/HeJ and BALB/c mice in that levels of all isotypes were elevated somewhat in both strains of infected mice but IgG2a levels were much more dramatically increased in the C3H/HeJ mice (28-fold) than in the BALB/c mice (4-fold). In this study, interleukin-6 levels were found to be persistently elevated in the serum of infected C3H/HeJ mice. Interestingly, interleukin-6 levels in serum were much lower in the infected BALB/c mice. These findings indicate that the B. burgdorferi mitogen is active in infected animals and may contribute to the inflammatory and immune response to infection.

Animals↗
PubMed1992

Prevention of collagen induced arthritis in mice by treatment with an antibody directed against the T cell receptor alpha beta framework.

Collagen induced arthritis (CIA) is an animal model of inflammatory polyarthritis. Type II collagen is the major matrix protein of hyaline cartilage. Susceptibility to CIA is linked to the Major Histocompatibility Complex Class II genes but the presence of T cells expressing specific variable beta (V beta) chain of their T cell receptor (TCR) is also required. Pretreatment with the monoclonal antibody H57-597 directed against the TCR alpha beta framework prevented the onset of arthritis in the majority of animals. The depletion of the T cell population did not lead to any apparent health problems. These experiments demonstrate the important role of the alpha/beta T cell and its receptors in the CIA model. Further, anti-TCR alpha beta antibodies may be of value in the therapy of autoreactive disorders.

Animals↗
PubMed1992

An analysis of conditions presenting to a dental hospital emergency clinic.

A retrospective analysis of 1,000 consecutive patients was undertaken to determine the frequency and types of common dental problems presenting to the Emergency and Oral Medicine Clinic at Bristol Dental Hospital. The results show that most attenders presented with problems readily manageable by dental practitioners, but providers of emergency dental services should be aware that rare, but serious, conditions can occur. Information presented in this paper should be incorporated into the design of undergraduate curricula and emergency dental services.

Dental Service, Hospital↗
PubMed1991

Evidence that patients presenting with dyskaryotic cervical smears should be screened for genital-tract infections other than human papillomavirus infection.

One hundred and fifty-four women with dyskaryotic cervical smears were referred for colposcopy from two distinct population groups, namely those who initially had attended a sexually transmitted disease (STD) clinic, and those who came from general practitioners and family planning and gynaecology clinics (non-STD group). They were investigated to determine the prevalence and pattern of concomitant lower genital-tract infections. The mean age in each group was 25 years. Microbiological studies revealed that 79 (51%) of the women were infected, more than one infection occurring in 16 (10%) of them. Infection was present in 40% of the non-STD group and 66% of the STD group. The pattern of infection was remarkably similar in each group. Bacterial vaginosis was the most common disease in each group and accounted for more than one-third of all infections detected. Six patients had genital warts, 15 harboured Chlamydia trachomatis and 4 had gonorrhoea. Two-thirds of those with C. trachomatis and half of those with gonorrhoea were asymptomatic. We conclude that an abnormal cervical smear is frequently a marker of concomitant lower genital tract infection. Comprehensive microbiological investigations in order to effect appropriate treatment are easily achieved on women in the STD group, but the cost may be seen as prohibitive for those in the non-STD group. For these women we suggest a less comprehensive microbiological approach that provides a compromise strategy of management.

Chlamydia Infections↗
PubMed1991

The differential diagnosis of epithelial-type mesothelioma from adenocarcinoma and reactive mesothelial proliferation.

Three monoclonal antibodies (mAbs) have been applied to 14 adenocarcinomas, eight mesotheliomas, and nine reactive mesothelial proliferations. One of these, AUA1, is a novel antibody in this context. It was found in 13/14 of the adenocarcinomas but not in benign or malignant mesothelial tissue, making it a potential substitute for carcinoembyronic antigen (CEA) in the differential diagnosis of mesotheliomas from adenocarcinomas. In addition, the lesions were stained using an argyrophil technique to identify nucleolar organizer regions. The results of counting these showed a small but significant overlap in their numbers between malignant and benign mesothelial proliferations. Although there was a difference overall in the numbers of nucleolar organizer regions in adenocarcinomas and mesotheliomas, on the one hand, and benign hyperplasias, on the other, this overlap considerably reduces their value in assessing individual difficult cases.

Adenocarcinoma↗
PubMed1991

Some monotreme milk "whey" and blood proteins.

1. Electrophoretic studies are made of mature phase milk "whey" proteins and blood serum proteins of echidna (Tachyglossus aculeatus) and platypus (Ornithorhynchus anatinus). The echidna milk bands are designated A-M, those of platypus A-G. Some of the proteins are isolated and characterized. 2. Echidna band A protein has some similarity to high cystine "whey" proteins. Band E protein (apparent Mr 21,000) may be a beta-lactoglobulin-like protein. Band M is lysozyme. Band C is serum albumin. Bands G-K are transferrins. 3. Platypus milk bands A, C, D, F and G are isolated. Bands F and G are transferrins. 4. Lactose synthase and lytic activities are examined.

Amino Acid Sequence↗
PubMed1991

The effects of a leukaemia-controlling dose of acivicin on murine splenic lymphocytes in vitro and in vivo.

The development of successful chemotherapy for cancers, including leukaemia, is based on the exploitation of significant toxic differentials of the agents, between the cancer cells and their normal counterparts. A concentration of 0.1 mumol/L of the amino acid analogue acivicin (L-(alpha S,5S)-alpha-amino-3-chloro-4,5-dihydro-5-isoxazoleacetic acid) was sufficient to inhibit [3H]-DNA synthesis in mitogen stimulated murine splenic lymphocytes and WEHI 7.1 murine leukaemic cells in vitro, at glutamine concentrations up to 0.5 mmol/L. However, at concentrations of glutamine of 1.0 mmol/L and above, more acivicin was required to inhibit WEHI 7.1 cells than to inhibit the splenic lymphocytes. At 1.0 mmol/L glutamine, 18 h of exposure to an optimal inhibitory concentration of acivicin (0.5 mumol/L) in vitro was sufficient to inhibit [3H]-DNA synthesis in the mitogen stimulated lymphocytes, whereas 24 h of exposure to an optimal inhibitory acivicin concentration of 2.0 mumol/L was required for inhibition of [3H]-DNA synthesis in the WEHI 7.1 leukaemic cells. When an acivicin inoculation regime that was sufficient to control the growth of intraperitoneally (i.p.) implanted WEHI 7.1 leukaemic cells was administered to Balb/c mice, the primary immune response was significantly inhibited to an antigen given either during or after the acivicin treatment. These results indicate that lymphocytes replicating in vivo in a specific primary immune response could be as sensitive to acivicin as leukaemic cells.

Animals↗
PubMed1991

Psychobiology of the near-miss in fruit machine gambling.

Explanations involving the etiology of pathological gambling have tended to emphasize psychosocial factors. However, the possibility that psychobiological factors may be important in the development of pathological gambling behavior should not be ruled out. Psychobiological approaches are becoming ever more prominent with the three main lines of research being (a) a search for a physiological disposition and/or underlying biological substrate in pathological gamblers, (b) an examination of the role of arousal in gambling, and (c) speculation about endorphin-related explanations. The data from questionnaires and interviews with fruit machine gamblers suggest that both physiological and cognitive factors (e.g., the psychology of the near-miss) may be important in the explanation of excessive fruit machine gambling. Thus, if a gambler becomes physiologically aroused when he or she wins or nearly wins, it will stimulate further play, here termed the psychobiology of the near-miss.

Adolescent↗
PubMed1991

Insidious loss of renal function in patients with anticardiolipin antibodies and absence of overt nephritis.

Circulating anticardiolipin antibodies are associated with recurrent thrombosis, fetal loss and thrombocytopenia. We have identified four patients with SLE or lupus-like disease who have high circulating levels of ACLA, repeated thrombosis and evidence of renal disease. Their clinical signs and symptoms of lupus activity were minimal, yet all had renal insufficiency with GFR 50 ml/min or less despite no history nor evidence of overt nephritis (proteinuria less than 0.5 g/day and no haematuria). Renal biopsy specimens showed focal ischaemic lesions with no evidence of active lupus nephritis. We describe a new lesion of renal ischaemia secondary to non-inflammatory vascular pathology associated with circulating ACLA.

Adult↗
PubMed1991

Detection of human and murine common idiotypes of DNA antibodies in tissues and sera of patients with autoimmune diseases.

The expression in tissue and serum of a panel of murine and human common DNA antibody idiotypes (Ids) (BEG 2, PR 4, F-423, I-402, II-28, IV-228, V-88) has been investigated. The murine V-88 Id was detected in eight out of 10 and the human BEG 2 Id in five out of 10 labial biopsies from patients with Sjögren's syndrome. The murine F-423, I-402 and IV-228 Ids were identified in one out of 10 biopsies. In each case the pattern of staining was similar with staining of the acinar basement membrane and a cell population. Using double-labelling immunohistochemistry this cell population were identified as plasma cells. No staining was seen in four normal labial biopsies. The V-88 Id was detected on the epithelial aspect of the thickened basement membrane in three out of nine renal biopsies from patients with systemic lupus erythematosus (SLE). None of the other Ids (BEG 2, PR4, IV-228, F-423 or I-402) could be detected in renal tissue. None of the Ids were found in skin biopsies from SLE patients. Id V-88 may, like the 16/6 Id to which it is phenotypically related, play a role in the pathogenesis of renal lesions in SLE. The BEG 2 Id could be detected in the serum of patients with rheumatoid arthritis (RA) and active untreated tuberculosis. Ids II-28, V-88 and I-402 were elevated in serum from patients with Sjögren's syndrome and II-28 Id in serum from patients with myositis and RA. None of the Ids were elevated in serum from patients with SLE. Apart from the BEG 2 Id, none of the Ids were elevated in serum from patients with tuberculosis or Gram-negative infections. The presence of murine Ids in human tissue and serum suggests that they are cross-species idiotypes and have been conserved through evolution.

Animals↗
PubMed1991

Skill mix in nursing: a selective review of the literature.

The issues surrounding skill mix are often highly contentious and, not surprisingly, various interest groups either welcome or reject attempts to examine the different combinations of staff, qualified and unqualified, experienced and inexperienced, in relation to costs, outcomes and quality of nursing care. Despite the strong passions aroused by the debate, other factors, most notably demographic changes and the possible shortage of nurses, new demands on health care services and the call for more cost-effective use of resources, have kept skill mix foremost on the policy agenda. The review covers manpower planning, an area where considerable efforts have been made to determine the number but rarely the mix of nurses required to provide the necessary care for patients. In addition, previous work on staff turnover, and the possibility of substituting less qualified for more qualified staff, are examined in relation to cost-containment, recruitment and demography, and the creation of a new single level of nurse. These factors, along with the introduction of health care assistants, will have an important influence on the future shape and structure of nursing and, of course, the composition of the skills available. While calling for further work on skill mix, the review provides a timely reminder that the issues are complex and often highly political.

Humans↗
PubMed1991

'Nuns, virgins, and spinsters'. Rigoni-Stern and cervical cancer revisited.

The view that nuns have a very low risk of cervical cancer is questioned. The historical evidence for this view is reviewed, from the beginning of the eighteenth century to the present. An estimate of the actual mortality rate from cervical cancer suggests that risk of death from this neoplasm among nuns is little different from that among the general female population. It is recommended that nuns should not be excluded from cervical cytology screening. When symptoms which might suggest cervical cancer arise in such women, full gynaecological assessment is necessary.

Adult↗
PubMed1991

Hypoxic pulmonary vasoconstriction in systemic sclerosis and primary pulmonary hypertension.

Reduction of pulmonary vascular resistance by a high inspired oxygen concentration is a common, but not universal phenomenon in patients with pulmonary vascular disease of varying etiology that may determine their response to long-term domiciliary oxygen therapy. We therefore determined changes in PVR during oxygen therapy in two patient populations not previously studied: systemic sclerosis (n = 8, mean age +/- SEM, 44.5 +/- 5.4 years) and primary pulmonary hypertension (n = 7, mean age +/- SEM 38 +/- 7.8 years). All patients were hypoxemic (arterial oxygen tension, on air 9.5 +/- 1.2 kPa for SSc and 8.3 +/- 0.6 kPa for PPH, p greater than 0.05). Right atrial pressure, pulmonary artery pressure, pulmonary artery occlusion pressure, systemic arterial pressure, PaO2 and cardiac output by thermodilution were measured at three, 20-min intervals while inspiring air and again after inspiring 60 percent oxygen for 30 min. The PVR fell significantly with oxygen in patients with SSc from 797.6 +/- 179.2 to 610 +/- 151.6 dynes/s/cm-5 (p less than 0.01), and this fall correlated with baseline PAP and PaO2 prior to oxygen therapy (r = 0.86, p less than 0.025; r = 0.77, p less than 0.05, respectively). In patients with PPH, there was no significant fall in PVR with oxygen (from 969 +/- 80.2 to 851.9 +/- 91.2 dynes/s/cm-5, p greater than 0.05) and no predictor of a vasodilator response in individual patients. In SSc, hypoxic pulmonary vasoconstriction contributes more consistently to elevated PVR than in patients with PPH.

Adult↗