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Biomedical subjects

M Pearson

Publications and source records attributed to M Pearson.

At least 73 records · Page 4Linked to original sources
PubMed1995

A good man's fault: alcohol and Irish people at home and abroad.

Long-standing stereotypes portray Irish people as prone to use alcohol to excess. This review traces the historical origins of those stereotypes, and examines evidence drawn from a range of secondary sources in Ireland and Britain about alcohol consumption, attributed hospital admissions and mortality. The available data indicate that the 'problem' of Irish drinking and Irish attitudes to alcohol are not as straightforward as traditionally supposed. Far from the stereotypical image of the Irish embodied in the ubiquitous drunk male labourer, rates of abstinence from alcohol are higher in Ireland than in Britain. Amongst migrants, the Irish are no more likely to consume alcohol than the indigenous population. However, those Irish people who do drink alcohol do so at generally higher levels than their British born counterparts. Analysis of combined years' data from the General Household Survey indicates first that people of Irish birth or parentage are no more likely than the British born to use alcohol at all. However, if they make use of alcohol at all, members of the Irish groups were more likely than the British born to consume alcohol at levels greater than 14 or 21 units per week. Both the review and the data presented suggest that a more complex understanding of the dynamics and nature of Irish drinking needs to be developed.

Alcohol Drinking↗
PubMed1994

Respiratory morbidity in Merseyside schoolchildren exposed to coal dust and air pollution.

A cross sectional study was carried out to determine whether schoolchildren in a specific locality exposed to pollution from steam coal dust have an excess of respiratory symptoms compared with children in control areas. A total of 1872 primary schoolchildren (aged 5-11 years) from five primary schools in the Bootle dock area of Liverpool (exposed area), five primary schools in South Sefton (control area), and five primary schools in Wallasey (control area) were studied. A questionnaire was distributed through the schools and was completed by the parents of the children. The questionnaire inquired about respiratory symptoms (cough, wheezing, and shortness of breath), allergy, atopy, smoking, and socioeconomic factors. Height, weight, and peak expiratory flow were measured. Compliance was good (92%) and similar in the three study areas. The children in the three areas were of similar mean age (7.5 years), height (1.24 m), sex ratio, and had a similar prevalence of paternal (6.2%) and maternal (7%) asthma. The exposed zone contained more unemployed parents (41, 29, and 29% respectively), more rented housing (64, 45, 34%), and more smoking parents (71, 60, 59%) than the control areas. Respiratory symptoms were significantly more common in the exposed area, including wheeze (25.0, 20.6, and 17.5%), excess cough (40.0, 23.4, and 25.1%), and school absences for respiratory symptoms (47.5, 35.9, and 34.9%). These differences remained significant even if the groups were subdivided according to whether or not parents smoked or were employed. Multiple logistic regression analysis confirmed the exposed zone as a significant risk factor for absenteeism from school due to respiratory symptoms (odds ratio 1.55, 95% confidence interval 1.17 to 2.06) after adjusting for confounding factors. Standard dust deposit gauges on three schools confirmed a significantly higher dust burden in the exposed zone. An increased prevalence of respiratory symptoms in primary schoolchildren exposed to coal dust is confirmed. Although the association with known coal dust pollution is suggestive a cross sectional study cannot confirm a casual relation and further studies are needed.

Absenteeism↗
PubMed1993

Mutation screening of complete fibrillin-1 coding sequence: report of five new mutations, including two in 8-cysteine domains.

Marfan syndrome (MFS) is an autosomal dominantly inherited connective tissue disorder characterized by cardiovascular, ocular and skeletal manifestations. Previously, mutations in the fibrillin-1 gene on chromosome 15 (FBN1) have been reported to cause MFS. We have now screened 44 probands with MFS or related phenotypes for alterations in the entire fibrillin coding sequence (9.3 kb) by single strand conformation analysis. We report four unique mutations in the fibrillin gene of unrelated MFS patients. One is a 17 bp deletion and three are missense mutations, two of which involve 8-cysteine motifs. Another missense mutation was found in two unrelated individuals with annuloaortic ectasia but was also present in unaffected relatives and controls from various ethnic backgrounds. By using allele-specific oligonucleotide hybridization, we screened 65 unrelated MFS patients, 29 patients with related phenotypes and 84 control individuals for these mutations as well as for a previously reported mutation and two polymorphisms. Our results suggest that most MFS families carry unique mutations and that the fibrillin genotype is not the sole determinant of the connective tissue phenotype.

Adolescent↗
PubMed1993

Primary immunisations in Liverpool. I: Who withholds consent?

The association between parents in Liverpool consenting to their children being invited for primary immunisations and five sociodemographic factors, namely sex, position of child in the family, family type, migration into Liverpool since birth, and local deprivation was examined. Rates of consent to invitation were over 97% for each antigen except pertussis, which had a consent rate of 83%. Consent to invitation for pertussis vaccine was least likely to have been given for boys, children with older siblings, those recorded as living with a single parent, and those in the most deprived areas. Local deprivation also had an effect on consent to the measles, mumps, and rubella vaccine. Migration into Liverpool had a significant effect on consent to invitation for all antigens except pertussis. The child's sex, family type, and local deprivation had no effect on consent to diphtheria, tetanus, and polio immunisations. Maximising pertussis vaccine uptake will require more attention to be paid to those parents who have been identified as being less likely to give consent. It is particularly important that consistent and clear advice about immunisations is made available to parents with two or more children, lone parents, and those living in materially deprived areas. Our findings challenge some of the assumptions underlying the principles of 'first parent visiting', at least so far as pertussis is concerned.

Attitude to Health↗
PubMed1993

Primary immunisations in Liverpool. II: Is there a gap between consent and completion?

The association between completion of primary dipht eria, tetanus and pertussis, measles, mumps, and rubella and polio immunisation courses in Liverpool and five sociodemographic factors, namely the child's sex, position in the family, family type, migration into Liverpool since birth, and local deprivation was examined. Only 68% of children were fully immunised by their second birthday. The immunisation rate for pertussis was 74%, compared with 85-89% for the other antigens. Children who had older siblings, were recorded as living with one parent, had moved into Liverpool or who lived in areas of high deprivation were less likely to complete the full set of antigens and individual courses. Boys were significantly less likely than girls to be fully immunised against pertussis. Differences in the completion of pertussis immunisation associated with the child's sex and with local deprivation were a direct reflection of differences in rates of parental consent. Parental consent did not wholly account for significantly lower rates among children with older siblings, those living with a lone parent, and those who had moved into Liverpool, however. This may reflect the practical difficulties of attending immunisation clinics. To achieve immunisation targets, a more flexible and targeted approach is required of health professionals. This may include the careful targeting of efforts to increase consent and the improvement of access to immunisations by providing domiciliary services or by opportunistic immunisation of infants when they are in contact with primary and community health care services.

Attitude to Health↗
PubMed1993

Food intolerance and Crohn's disease.

It has been claimed that prolonged remissions of Crohn's disease can be achieved after enteral or parenteral nutrition, by identifying and excluding foods that exacerbate a patient's symptoms. The occurrence of food intolerances were assessed after induction of remission with elemental diet in 42 eligible patients to whom single foods were introduced over five days. Suspect foods were reinvestigated with open and if possible, double blind rechallenge. Fourteen patients (33%) dropped out of the study because of relapse of disease unrelated to food (n = 8) or because of difficulties in complying with the regimen (n = 6). Twenty (48%) of the patients identified food sensitivities whereas eight (19%) did not. Seventeen of the patients who identified food sensitivities had an open rechallenge with recurrence of symptoms in 10 (24% of total). Food sensitivity was confirmed in three patients on double blind challenge. There was no significant difference in the duration of remission between patients who did or did not identify food sensitivities. During the study three cases of intolerance to the formula diet, and one of severe salicylate sensitivity were encountered. In conclusion food sensitivities are evident after treatment of Crohn's disease with elemental diet but are variable, often do not persist, and are of insufficient importance to warrant putting all patients through elimination diets.

Adolescent↗
PubMed1993

The nurse, the elderly caregiver, & stress.

The benefits of home care can carry a hefty price for the overburdened elderly caregiver, typically the patient's spouse, in terms of stress, deteriorating health, even burnout. The home care nurse can watch for warning signs and intervene to prevent situations that could endanger the caregiver and patient from escalating.

Caregivers↗
PubMed1992

Structural diversity in the extracellular faces of peptidergic G-protein-coupled receptors. Molecular cloning of the mouse C5a anaphylatoxin receptor.

The mouse C5a receptor gene was isolated using the human C5a receptor cDNA probe recently described (Gerard, N. P., and C. Gerard. 1991. Nature 349:614). By analogy with the human gene, the mouse homolog contains two exons with the 5' untranslated region and initiating methionine codon present in exon 1 and the remainder of the molecule in exon 2. Generation of an expressible cDNA for the mouse C5a receptor was accomplished using the polymerase chain reaction and a sense oligodeoxynucleotide primer which included an initiation codon just 5' to the sequence encoding the N-linked glycosylation site. When transfected into human 293 kidney epithelial cells the cloned cDNA directs expression of a binding site for human C5a anaphylatoxin with a binding constant of 2.5 +/- 0.3 nM; the human C5a receptor expressed under identical conditions has a Kd of 1.7 +/- 0.2 nM. Overall, the deduced amino acid sequences of the receptors are 65% identical given the analogous gene structures. Alignment of the sequences as seven transmembrane segment receptors reveals that the greatest structural diversity (approximately 70%) exists in the putative extracellular domains. In contrast, species differences among other members of this family of seven membrane-spanning receptors is generally only 10 to 20%, even for receptors whose ligands are relatively small and not expected to interact with sites on the extracellular surfaces. A high degree of structural identify is observed for the C5a receptors in the transmembrane segments and in all but one of the loops predicted to exist in the cytoplasm. Inasmuch as critical structures responsible for high affinity binding of the 74 amino acid polypeptide to both C5a receptors involve features conserved between species, these data provide the starting point for mutagenesis studies to determine the nature of the binding and activation sites for the chemotactic receptors. Additionally, these data provide a reagent for immunologic and molecular genetic studies on the role of C5a receptors in inflammatory models.

Amino Acid Sequence↗
PubMed1992

The Autographa californica baculovirus genome: evidence for multiple replication origins.

The Autographa californica multinucleocapsid nuclear polyhedrosis virus (AcMNPV), which is used for the overexpression of eukaryotic genes and is being engineered for possible use as a viral insecticide, has a circular, supercoiled genome of approximately 128 kilobases. Despite its widespread use, little is known about the mechanism by which AcMNPV replicates. Evidence is presented in this report that AcMNPV origins of DNA replication are repeated sequences each containing several closely related imperfect palindromes that are present in six regions distributed around the genome. Although AcMNPV infection-dependent plasmid replication was initiated by a single complete palindrome, the amount of replication was substantially increased in plasmids containing six or eight palindromes.

Baculoviridae↗
PubMed1991

The effect of elemental diet on intestinal permeability and inflammation in Crohn's disease.

This study examines whether treatment of acute Crohn's disease with an elemental diet improves intestinal integrity and inflammation as assessed by a 51Cr-labeled ethylenediaminetetraacetatic acid (EDTA) permeability test and the fecal excretion of 111In-labeled autologous leukocytes, respectively. Thirty-four patients with active Crohn's disease completed a 4-week treatment course with an elemental diet. Active disease was characterized by increased intestinal permeability [24-hour urine excretion of orally administered 51Cr-EDTA, 6.4% +/- 0.6% (mean +/- SE); normal, less than 3.0%] and by high fecal excretion of 111In-labeled leukocytes (14.2% +/- 1.1%; normal, less than 1.0%). Twenty-seven (80%) went into clinical remission, usually within a week of starting treatment. After 4 weeks of treatment, there was a significant decrease in both the urine excretion of 51Cr-EDTA (to 3.4% +/- 0.5%; P less than 0.01) and the fecal excretion of 111In (to 5.7% +/- 1.0%; P less than 0.001), indicating that such treatment is not just symptomatic. A framework for the mechanism by which elemental diet works, centering around the importance of the integrity of the intestinal barrier function, is proposed, and also appears to provide a logical explanation for some relapses of the disease.

Acute Disease↗
PubMed1991

Postoperative protein metabolism: effect of nursing elderly patients for 24 h after abdominal surgery in a thermoneutral environment.

We have studied the effect of intraoperative body heat conservation and 24-h thermoneutrality on postoperative whole body protein turnover using stable isotope methodology in a group of elderly patients undergoing colorectal surgery for rectosigmoid adenocarcinoma. Two groups of eight patients were studied. One group (control, or cold) received routine intraoperative and postoperative care. All patients in the second group (warmed) were maintained at normothermia during anaesthesia and surgery; these patients were nursed after surgery in a warm room (ambient temperature 28-30 degrees C) for a period of 24 h. General anaesthesia, surgical care and nutritional support were similar in both groups. A constant nutritional intake, based on nitrogen 0.1 g kg-1 day-1 and energy 20 kcal kg-1 day-1, was provided orally for 7 days before surgery and i.v. after operation for 4 consecutive days. Whole body protein breakdown and synthesis, as assessed by stable isotope methodology, increased significantly 2 and 4 days after surgery in both groups (P less than 0.01), but the increase in protein breakdown in the warmed group on day 2 was significantly less than that in the cold group (P less than 0.05). The increase in leucine oxidation in the warmed group on the 2nd day after surgery was not significant, and was less than the increase observed in the cold group (P less than 0.05). However, by the 4th day, leucine oxidation was enhanced significantly in both groups (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗
PubMed1991

Protein metabolism after abdominal surgery: effect of 24-h extradural block with local anaesthetic.

We have studied the effect of intraoperative and postoperative (24 h) extradural block with local anaesthetic on whole body protein turnover (stable isotope methodology) and urinary excretion of urea nitrogen, adrenaline, noradrenaline and cortisol in a group of well nourished elderly patients undergoing colorectal surgery who received a constant nutritional intake before (7 days) and after (4 days) surgery. One group (control, n = 8) received routine anaesthetic and surgical care. Patients in the test group (extradural, n = 9) received extradural bupivacaine, and sensory block (T4-S5) was maintained during and after surgery for a period of 24 h. Whole body protein breakdown and amino acid oxidation increased significantly after surgery in both groups (P less than 0.05), but the increase in protein breakdown in the extradural group was significantly less than that in the control group. Urinary excretion of urea nitrogen, adrenaline and noradrenaline increased in the control group after surgery, whilst the increase in the extradural group was very small. In contrast, urinary excretion of cortisol increased significantly in both groups after surgery. We conclude that extradural block maintained for 24 h after surgery significantly minimized postoperative protein breakdown without compromising whole body protein synthesis.

Abdomen↗
PubMed1991

Patterns of uptake and problems presented at Well Woman clinics in Liverpool.

Well Woman clinics, at which all the staff are women, are provided on an open-access basis by Liverpool Health Authority. In 1986, uptake was low by women over the age of 55, by women from semi-skilled and unskilled manual households, and by women who did not have any formal employment. These, however, are the women who are at greatest risk of ill health. Almost half of the women attending had a vaginal problem or infection, and 40% were anxious or depressed. The clinics, however, are unable to treat any problems diagnosed, and over a third of women using the clinics were referred back to their general practitioner. The findings have important implications for the provision and continuity of primary and preventive care, not least because many women may be reluctant to take the problem which they present to Well Woman clinic doctors to their own (often male) general practitioner in a busy general surgery.

Adolescent↗