Search PubMed⌕ Search

Biomedical subjects

M Wallace

Publications and source records attributed to M Wallace.

At least 127 records · Page 7Linked to original sources
PubMed1995

The new OPCS area classifications.

This article introduces the OPCS area classifications based on the 1991 Census. It illustrates the methodology and results in terms of local authority districts. It follows earlier articles in Population Trends that described the production of similar classifications after the 1971 and 1981 Censuses. Each district in Great Britain is classified as both the centre of a small cluster of districts which correspond closely to it and as a member of a cluster within a division of all districts. The list of corresponding districts is set out in full. Information is also given on how to obtain further details of the classification.

Data Interpretation, Statistical↗
PubMed1994

Smith-Lemli-Opitz syndrome in a female with a de novo, balanced translocation involving 7q32: probable disruption of an SLOS gene.

A 3-month-old infant girl had manifestations of the Smith-Lemli-Opitz syndrome (SLOS) including typical positional anomalies of the limbs, apparent Hirschsprung disease, cataracts, ptosis, anteverted nares, cleft of the posterior palate, small tongue, broad maxillary alveolar ridges, and abnormally low serum cholesterol levels. Chromosomal analysis showed a de novo balanced translocation interpreted as 46,XX,t(7;20)(q32.1;q13.2). We hypothesize that the translocation breakpoint in this case interrupts one SLOS allele and that the other allele at the same locus has a more subtle mutation that was inherited from the other parent. This case, as well as cytogenetic observations in other SLOS cases, suggests that SLOS could be due to autosomal recessive mutation at a gene in 7q32.

Abnormalities, Multiple↗
PubMed1994

Circulatory response of young adult trauma victims with alcohol intoxication.

Young adults are a subgroup particularly susceptible to traumatic injury; alcohol intoxication is a major risk factor for trauma in young adults. During the first hours following multiple trauma, however, little is known about the specific effects of alcohol intoxication on the circulatory response of critically injured young adults. The purpose of this prospective study was to compare the circulatory response of 5 severely injured young adults (15-40 years old) with acute alcohol intoxication to the circulatory response of 5 severely injured, nonintoxicated young adults. Data were collected every hour for the first 8 hours after admission to a surgical intensive care unit. Subjects with alcohol intoxication had significantly higher heart rates (t = 2.8176, p < .05) than their nonintoxicated counterparts. Heart rate and blood pressure, however, showed no statistically significant (p < .05) Group x Time interaction between the two groups. Subjects with alcohol intoxication also had injuries that caused more blood loss, more invasive monitoring, more operative procedures, more fluid replacement, and higher oxygen requirements.

Adolescent↗
PubMed1994

FPTT is a low-incidence Rh antigen associated with a "new" partial Rh D phenotype, DFR.

BACKGROUND: Several Rh D phenotypes with partial D antigens are recognized. Some partial D antigens are associated with low-incidence Rh antigens. New partial D antigens are revealed by an atypical pattern of reactions with anti-D. STUDY DESIGN AND METHODS: The reactions of D variant cells with panels of monoclonal anti-D and with antibodies to low-incidence antigens were compared to those of known D categories to identify a new Rh D phenotype. The inheritance of partial D antigens was studied by Rh phenotyping of the families of the probands. Standard serologic methods were used and family data were analyzed. RESULTS: A new Rh D phenotype, to be called DFR, was identified in 17 probands, two of whom had made anti-D. The partial D antigen carries epD3, epD4, and epD9 and lacks epD8. The presence of other D epitopes is ambiguous; different answers were obtained for the same sample with different monoclonal anti-D of the same apparent epitope specificity. The immunoglobulin class of the anti-D was important: IgG were more successful than IgM monoclonal anti-D in detecting the partial D of DFR. Family studies showed that DFR traveled with Ce more frequently than with cE. The low-incidence antigen FPTT (International Society of Blood Transfusion number 700048) was found on all DFR samples. Family studies demonstrated that FPTT is, as suspected, part of the complex Rh system. CONCLUSION: The partial D of the Rh D phenotype, DFR, is recognized by its pattern of reactions with monoclonal anti-D and its association with the low-incidence antigen FPTT, FPTT has now been numbered Rh50.

Antibodies, Monoclonal↗
PubMed1994

Optimum dose of neostigmine at two levels of atracurium-induced neuromuscular block.

There is controversy about the optimum dose of neostigmine for antagonizing neuromuscular block. We have studied 57 patients undergoing gynaecological surgery to establish a dose-response relationship when neostigmine was given to antagonize atracurium-induced block. Anaesthesia was induced with thiopentone and fentanyl and maintained with nitrous oxide and enflurane in oxygen and neuromuscular block was produced with a bolus of atracurium 0.5 mg kg-1. At the time of antagonism of block, three groups received neostigmine 20, 40 or 80 micrograms kg-1 at 5-10% recovery of the compound muscle action potential of the adductor pollicis (profound block) and three groups received one of these doses at 40-50% neuromuscular recovery (light block). At profound block, antagonism was prolonged by reducing the dose of neostigmine from 40 micrograms kg-1 to 20 micrograms kg-1, but not shortened by increasing the dose from 40 micrograms kg-1 to 80 micrograms kg-1. At light block, there was no significant difference between the three groups in the time taken to reach a train-of-four ratio of 0.7. There was little benefit in increasing the dose of neostigmine from 40 micrograms kg-1 to 80 micrograms kg-1 when antagonizing profound neuromuscular block. When light block was antagonized, neostigmine 20 micrograms kg-1 was the optimum dose. We suggest that smaller doses of neostigmine than are given commonly produce adequate antagonism of atracurium-induced neuromuscular block.

Adult↗
PubMed1994

Monitoring neuromuscular block by acceleromyography: comparison of the Mini-Accelograph with the Myograph 2000.

The precision of the compact Mini-Accelograph (M-A) was compared with the Myograph 2000 (MYO). Neuromuscular block resulting from atracurium was measured simultaneously by the MYO and the M-A applied to contralateral thumbs. During onset, the M-A frequently underestimated the extent of block (maximal at approximately 50% twitch depression). The M-A control train-of-four (TOF) ratio was characteristically > 1.0 and remained greater than the MYO ratio during the onset of atracurium. During recovery, the difference between the MYO and the M-A was maximal at approximately 50% twitch depression, but the M-A frequently overestimated the extent of block. The mean differences between the MYO and the M-A were small in respect of the recovery index (RI) and the TOF. However, the limits of agreement were unacceptably wide for both TOF and RI. When the MYO TOF was 0.7, the corresponding M-A TOF varied between 0.4 and 1.0. The M-A was more susceptible to drift than the MYO.

Adult↗
PubMed1994

Threat of hepatitis E virus infection in Somalia during Operation Restore Hope.

In support of Operation Restore Hope, the United States military established a diagnostic laboratory for infectious diseases, the Joint Forward Laboratory, in Mogadishu, Somalia. Because sporadic hepatitis due to unknown causes was a frequent problem, staff members of the Joint Forward Laboratory evaluated 31 Somalis, five displaced Ethiopians, and three Western relief workers who had acute clinical hepatitis. Patients lived in multiple locations in Somalia--Mogadishu, Baidoa, and Merca--and became ill between December 1992 and February 1993. IgM antibody to hepatitis A virus was found in one English relief worker, and IgM antibody to hepatitis E virus was found in 20 (65%) of 31 Somalis, two (40%) of five Ethiopians, and two (67%) of three Western relief workers. No patient had evidence of acute hepatitis B, malaria, yellow fever, or other arbovirus infections. These data indicate that hepatitis E virus--the major cause of enterically transmitted non-A, non-B hepatitis--was a common cause of acute sporadic hepatitis in Somalia during the initial stages of Operation Restore Hope.

Disease Outbreaks↗
PubMed1994

Schizophrenia--a national emergency: preliminary observations on SANELINE.

In May 1992 the British mental health charity SANE inaugurated a telephone helpline for people suffering from or copying with severe mental illness. From its first days the line has been inundated by people needing information and help about their illness. The line is open from 1400 to midnight every day of the year, and is manned by almost 100 trained volunteers supervised by professional staff. In total more than 100,000 people have called the SANELINE number since it opened. For every call taken, a detailed log is written up immediately. The service is, of course, confidential. We recognized even before the line was opened that these logs would provide unique information on which a wide range of research could be based. One of the most frequent problems about which callers told us was dissatisfaction with the medication they were given. Many callers complained about the negative symptoms of schizophrenia. We have been working on a pilot study to determine the problems sufferers find with their medication, which may throw light on the concept of the neuroleptic-induced deficit syndrome.

Antipsychotic Agents↗
PubMed1994

Efficacy of breathing and coughing exercises in the prevention of pulmonary complications after coronary artery surgery.

One hundred twenty patients undergoing coronary artery surgery completed a randomized controlled study designed to investigate whether prophylactic chest physiotherapy affected the incidence of postoperative pulmonary complications. Group 1 patients received no preoperative or postoperative chest physiotherapy. Group 2 patients received preoperative education and instruction in breathing and coughing exercises and postoperative supervision and assistance in performing the same. These exercises were supervised by a physiotherapist twice per day on the first 2 postoperative days and once per day on the 3rd and 4th postoperative days. Physiotherapy for group 3 patients was the same as for group 2 patients except that patients were seen by a physiotherapist 4 times per day on the first 2 postoperative days and twice per day on the 3rd and 4th postoperative days. Group 2 and 3 patients were instructed to practice breathing and coughing exercises every hour. Overall, an incidence of clinically significant postoperative pulmonary complications of 7.5 percent was demonstrated. In general, these patients demonstrated lower levels of preoperative pulmonary function and very low early postoperative oxygenation compared with those who did not develop pulmonary complications. There was no indication that the incidence or severity of fever, hypoxemia, chest roentgenologic abnormalities or clinically significant postoperative pulmonary complications was different between groups. These results suggest that the necessity for prophylactic chest physiotherapy after routine coronary artery surgery should be reviewed.

Breathing Exercises↗
PubMed1994

Assessment and management of pain in the elderly.

Due to the high prevalence of musculoskeletal disorders, cancer, and other medical conditions in elderly patients, pain is a significant concern for this age group and their caregivers. Despite the frequent experience of pain in this population, few assessment and management techniques have been developed and tested to treat pain in the elderly. To provide effective pain relief, medical-surgical nurses must know how to adapt assessment and management techniques for elderly patients.

Age Factors↗
PubMed1993

Allelic loss on a chromosome 17 in ductal carcinoma in situ of the breast.

Multiple tumor suppressor genes are implicated in the oncogenesis and progression of invasive carcinoma of the breast. To investigate the chronology of genetic changes we studied loss of heterozygosity on chromosome 17 in ductal carcinoma in situ, a preinvasive breast cancer. A microdissection technique was used to separate tumor from normal stromal cells prior to DNA extraction and loss of heterozygosity was assayed mainly using simple sequence repeat polymorphism markers and the polymerase chain reaction. Loss of heterozygosity on 17p was observed in 8 of 28 tumors (29%) when compared with normal control DNA, whereas no loss was seen on 17q, suggesting that at least one locus on 17p is involved early in the development of breast cancer.

Alleles↗
PubMed1993

Delayed angiography in the investigation of intracerebral hematomas caused by small arteriovenous malformations.

We reviewed the clinical and radiological features of ten patients with small arteriovenous malformations that caused intracerebral hematomas. In six patients, angiography showed a small nidus (less than 1 cm in diameter) with a shunt at the site of the hematoma, and in four only an early-filling vein was evident. Six patients had only delayed angiography (4 weeks or more after the ictus). In three, angiography within 2 days of the ictus failed to reveal the cause of the bleed, but repeat angiography showed an early-filling vein in two, and a nidus with shunting in one. In only one patient did early angiography reveal the malformation. MRI was obtained in eight patients, and in two prominent vessels were evident in the wall of the hematoma cavity. In investigation of an unexplained intracerebral hematoma, MRI may be useful to exclude a neoplasm or cavernoma, although the latter may be not be evident in the presence of a recent hematoma. We suggest early MRI and angiography for investigation of an unexplained, nonhypertensive intracerebral bleed, with follow-up MRI and delayed angiography if the initial studies fail to reveal the cause.

Adult↗
PubMed1993

Primary radiotherapy for treating all laryngeal cancer: a district hospital experience.

We report our experience of long-term follow-up of all patients treated during a ten-year period with primary radiotherapy irrespective of the disease stage of their laryngeal carcinoma. This policy was adopted in order to allow all patients the opportunity to save their larynx and to preserve their voice. In the present literature, surgery is favoured for treating advanced disease.

Adult↗
PubMed1993

Allele loss from 5q21 (APC/MCC) and 18q21 (DCC) and DCC mRNA expression in breast cancer.

Thirty-four primary, untreated sporadic breast cancers were examined for loss of heterozygosity (LOH) at tumour suppressor loci involved in colorectal cancer: APC/MCC at 5q21 and DCC at 18q21. LOH was identified in 28% informative patients at 5q21 and 31% at 18q21. LOH at 5q21 and 18q21 was compared with allele loss at 17p13 and concurrent LOH at two or more of the loci was noted in 24% of tumours. Expression of a 12 kb DCC mRNA was demonstrated in 14/34 (42%) of the cancers and in all five tumours with LOH at the DCC locus there was an additional 11 kb DCC mRNA. Abnormalities of three loci involved in colorectal cancer (5q21, 17p13 and 18q21) therefore also occur in sporadic breast cancer. The accumulation of such genetic abnormalities may confer a growth advantage important in the development of breast cancer.

Alleles↗
PubMed1993

Virologic markers of human immunodeficiency virus type 1 in cerebrospinal fluid. The HIV Neurobehavioral Research Center Group.

As part of a longitudinal study, 265 cerebrospinal fluid (CSF) specimens from 204 human immunodeficiency virus type 1 (HIV-1)-seropositive subjects and 43 seronegative controls were evaluated. Of the 204 seropositive persons, 78 (38%) had > or = 1 CSF culture positive for HIV-1; the probability of being culture positive increased as the number of CSF samples obtained increased (P = .0018). Significantly correlated with culture positivity were elevations in CSF protein level (P = .014) and CSF white blood cell count (P = .001). Virus was more readily cultured from clarified CSF (89%, 42/47) than from the cellular fraction (30%, 14/47; P < .00001). Amplification of HIV-1 DNA by polymerase chain reaction (PCR) from 25 seropositive persons was positive in 9 (82%) of 11 culture-positive and in 4 (29%) of 14 culture-negative specimens, while amplification of viral RNA detected all 11 culture-positive and 9 (64%) of the 14 culture-negative CSF specimens. These data support the hypothesis that the development of HIV-1-associated neurocognitive disorders are not dependent solely on the presence of HIV-1 within the central nervous system.

Adult↗
PubMed1993

Creutzfeldt-Jakob disease: assessment and management.

1. Creutzfeldt-Jakob disease (CJD) is a progressive neurologic disease that occurs in approximately one in one million individuals annually. 2. CJD affects late middle-aged and elderly individuals, with a peak occurrence between the ages of 55 and 75. 3. The disease is thought to be caused by an unknown virus that enters the central nervous system, causing neuron destruction and replacing the destroyed neurons with plaques. 4. There is no known cure or treatment for CJD, and the time span from onset of symptoms until death is 6 to 12 months.

Creutzfeldt-Jakob Syndrome↗