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Biomedical subjects

N Taub

Publications and source records attributed to N Taub.

At least 55 records · Page 3Linked to original sources
PubMed1995

A comprehensive electrophysiological evaluation of phrenic nerve injury related to open-heart surgery.

A prospective electrophysiological study of phrenic nerve was performed in 59 subjects undergoing open-heart surgery. The nerve was stimulated percutaneously at the neck and the diaphragmatic response was recorded with surface electrodes placed over the 8th intercostal space. The latency, amplitude, duration and area of the evoked response were measured before and after the operation. Post-operatively no response was elicited in 2 patients bilaterally, in 5 from the left and in 2 from the right. Comparison of the post-operative with the pre-operative group values in the remaining subjects showed that the amplitude and area of the left phrenic were lower in the post-operative study, indicating that some of the nerve fibres were not conducting. There were no statistically significant differences between pre and post-operative values of latency or duration on the left or any of the parameters on the right. Our findings suggest that the amplitude and area of the diaphragmatic response are more sensitive than latency in detecting phrenic nerve paresis associated with open-heart surgery.

Aged↗
PubMed1995

Patch testing with preservatives at St John's from 1982 to 1993.

We have reviewed our patch test results for preservative allergy from 1982 to 1993. 8 preservatives were included: formaldehyde, 2-bromo-2-nitropropane-1,3-diol (Bronopol(TM)), quaternium-15 (Dowicil 200TM), imidazolidinyl urea (Germall 115TM), diazolidinyl urea (Germall IITM), parabens, 5-chloro-2methyl-isothiazolin-3-one (Kathon CG(TM)) and 1,2-dibromo-2,4-dicyanobutane (one of the constituents of Euxyl K 400TM). Whereas the allergy rate to formaldehyde is quite stable, there is a slight increase in the imidazolidinyl urea allergy rate. Quaternium-15's rate is decreasing and 5-chloro-2-methyl-isothiazolin-3-one plus 2-methyl-isothiazolin-3-one's rate, after a rapid rise, seems to have stabilized. Although very important constituents of cosmetics, preservatives not only induce allergies on the face but also on the hands, and, as expected, the allergy rate in men and women generally differs. Among the 5 formaldehyde-releasers, there are some favoured simultaneous reactions: quaternium-15 and formaldehyde, and diazolidinyl urea and imidazolidinyl urea. Concomitant reactions between 1-bromo-2-nitropropane-1,3-diol and formaldehyde are not common, and those between 2-bromo-2-nitropropane-1,3-diol and diazolidinyl urea, and formaldehyde are not very common. This supports the hypothesis that allergic reactions to the Germalls are directed toward the initial molecule rather than to formaldehyde.

Dermatitis, Allergic Contact↗
PubMed1995

Efficacy of a third coronary angioplasty for a second restenosis: short-term results, long-term follow up, and correlates of a third restenosis.

OBJECTIVE: To report on the short-term and long-term results of patients who underwent a third coronary balloon angioplasty for a second restenosis and to identify the correlates of a third clinical restenosis. DESIGN: A retrospective analysis of clinical, angiographic, and procedure related variables of a consecutive series of patients. PATIENTS: 62 patients (mean (range) age 53 (31-72) years; 84% men) who underwent a third coronary balloon angioplasty of a single coronary artery segment at which restenosis had occurred after two previous angioplasty procedures between 1986 and 1992. RESULTS: Procedure success was achieved in 56 patients (90%). Complications included one myocardial infarction (2%) and one emergency coronary artery bypass surgery (2%). Complete follow up data were available (median (range) 48 (12-94) months). During the follow up period, four patients (6%) died, two (3%) had a non-fatal myocardial infarction, and five (8%) underwent elective coronary artery bypass surgery. Nine patients (14%) underwent a fourth angioplasty for a third clinical restenosis, and three (5%) had a fourth angioplasty procedure for new coronary lesions. The cumulative probability of survival for all 62 patients was 97% and 95% at 1 and 5 years, respectively. The 1 and 5 year freedom from death, infarction, bypass surgery, and repeat angioplasty was 82% and 66.6%, respectively. At census, of the 58 survivors, 31 (53%) were asymptomatic and only eight (14%) complained of angina grade III or IV (P < 0.001). A third clinical restenosis occurred in 22 (39%) of the 56 patients who had initially successful procedures. Multiple stepwise logistic regression analysis identified the interval between the second and third angioplasty procedure as the only independent predictor of a third clinical restenosis (P = 0.004). CONCLUSIONS: A third coronary angioplasty for a second restenosis can be performed safely and effectively and should be considered as an integral part of the overall coronary angioplasty revascularisation strategy. The incidence of a third clinical restenosis remains high, however, and is correlated with the interval between the previous angioplasty procedures.

Adult↗
PubMed1995

Percutaneous transluminal coronary angioplasty in patients 70 years of age or older: 12 years' experience.

OBJECTIVE: To evaluate the short and long term results of coronary angioplasty in patients aged 70 years and older and identify the determinants of long-term survival. DESIGN: A retrospective analysis of clinical, angiographic, and procedure related variables on a consecutive series of patients. PATIENTS: 163 patients aged 70 years and older (mean (range) age 73 (70-83) years; 63% men) who underwent a first coronary angioplasty procedure between 1981 and 1993. RESULTS: Procedural success was achieved in 82% of patients. Four patients (2%) died, three (2%) had a myocardial infarction, and five (3%) underwent emergency coronary artery bypass surgery. Complete follow up data were available for all patients (median (range) 35 (2-146) months). During the follow up period 16 patients (10%) died, two (1%) suffered non-fatal myocardial infarction, and 12 (7%) underwent elective coronary artery bypass surgery. A second angioplasty procedure was performed in 24 patients (15%). The cumulative probability of survival was 90.7% at 1 year and 83.4% at 5 years. Survival free from myocardial infarction, bypass surgery, and repeat angioplasty at 1 and 5 years was 68.2% and 56.0%, respectively. Proportional hazards regression analyses identified incomplete revascularisation as the only independent predictor of poorer overall survival (P = 0.04) and event free survival (P < 0.001). At census, of the 143 survivors, 75 (52%) were asymptomatic, 58 (41%) had mild angina, and only 10 (7%) complained of grade III or IV angina. Some 112 patients (78%) improved by at least two angina grades. CONCLUSION: Coronary angioplasty can be performed safely in the elderly and provides good symptomatic relief and favourable long-term outcome. Complete revascularisation may not be necessary if the primary goal is to achieve symptomatic relief, but incomplete revascularisation is associated with poorer long-term survival.

Aged↗
PubMed1993

Application of an immortalized human endothelial cell line to the leucocyte:endothelial adherence assay.

This report shows that an immortalized endothelial cell line (EA.hy 926) is able to substitute for secondary cultures of human umbilical vein endothelial cells (HUVEC) in the leucocyte:endothelial adherence assay. Enriched preparations of blood polymorphonuclear leucocytes, monocytes and resting and activated lymphocytes exhibited similar adherence characteristics to HUVEC and the EA.hy 926 cells. Cytokines such as tumour necrosis factor (TNF) act on endothelial cells to increase their adhesiveness for leucocytes and in this study there was no difference between TNF-treated HUVEC and EA.hy 926 cells in supporting the enhanced binding of leucocytes. The adherence promoting effect of TNF-treated EA.hy 926 cells appears to be dependent upon their endothelial properties since TNF treatment of A549 cells, the permanent human cell line used to generate the hybrid EA.hy 926 cells did not augment lymphocyte attachment. Monoclonal antibodies against CD11a and CD18 inhibited the binding of lymphocytes to untreated and TNF-treated HUVEC and EA.hy 926 cells and ICAM-1 expression was increased on both monolayers following treatment with TNF. The availability of a hybrid endothelial cell line whose adhesive properties are similar to those of recently isolated endothelial cells should benefit the study of factors that govern leucocyte-endothelial cell interactions and be advantageous to the longitudinal investigation of leucocyte adherence under static conditions.

Antigens, CD↗
PubMed1993

Assessing long term backache after childbirth.

OBJECTIVES: To investigate the factors associated with long term backache after childbirth, to assess all women reporting new onset long term backache, and to investigate any relation with pain relief in labour. DESIGN: Data collected from obstetric records and postal questionnaires or telephone interviews on morbidity after childbirth from all women delivering their first baby between March 1990 and February 1991, followed by analysis of data collected from outpatient consultations. SETTING: St Thomas's Hospital, London. SUBJECTS: Questionnaires were sent to 1615 women who had delivered their first baby in the defined period; 1015 either replied by post or were contacted by telephone. RESULTS: 299 women (29.5% of responders) reported backache lasting more than six months and of these 156 (15.4%) said they had had no back problems previously. Those women who had received epidural analgesia in labour were significantly more likely to report new onset backache (17.8%; 95% confidence interval 14.8% to 20.8%) than those who did not (11.7%; 8.6% to 14.8%). Younger women, unmarried women, and those reporting other antenatal symptoms were significantly more likely to report new long term backache. The 156 women reporting new backache were asked to attend an outpatient clinic and 36 (23%) did so. The majority had a postural backache which was not severe. Psychological factors were present in 14 women. CONCLUSIONS: Though new long term backache is reported more commonly after epidural analgesia in labour, it tends to be postural and not severe. There were no differences in the nature of the backache between those who had or had not received epidural analgesia in labour.

Adult↗
PubMed1993

Environmental factors predicting nephritis in systemic lupus erythematosus.

OBJECTIVES: To evaluate social class, ethnic origin, and various endocrine variables as potential risk factors in the development of nephritis in patients with systemic lupus erythematosus (SLE). METHODS: A cross-sectional survey was carried out of all outpatients with SLE attending the lupus Clinic of St Thomas's Hospital from March to October 1992 using retrospective survival data. The main outcome measure was the duration of SLE before the onset of nephritis. RESULTS: Two hundred and ninety six women and 11 men were studied; the male patients were excluded from the analysis. Univariate analysis showed an increased risk of nephritis in patients with SLE of West Indian origin with 54 v 19% with nephritis at five years, in patients of lower social class, in patients who did not drink alcohol, and in those with a history of fetal loss after the onset of lupus. No significant effect of the age of onset of SLE, use of oral contraceptives, normal pregnancy, or smoking was seen. Multivariate analysis showed that ethnic origin did not influence the risk of nephritis independently of social class. CONCLUSIONS: Factors associated with socioeconomic deprivation may increase disease severity in patients with SLE.

Abortion, Spontaneous↗
PubMed1992

The immunogenetics of early nephropathy in insulin-dependent diabetes mellitus: association between the HLA-A2 antigen and albuminuria.

One-hundred and seventy-two normotensive, insulin-dependent diabetic patients without clinical proteinuria (Albustix negative) were typed for the major histocompatibility complex class I (HLA-A, -B) and class II (HLA-DR) antigens. Urinary albumin excretion was measured as the albumin:creatinine ratio (UA/UC, mg/mmol) in an early morning sample. Patients expressing the HLA-A2 antigen had significantly higher UA/UC values than those not expressing the antigen. The observed ratio of geometric means was 1.77 (95 per cent confidence interval (CI) 1.18-2.67; p < 0.01); the relative risk of microalbuminuria (UA/UC > 3.0 mg/mmol) associated with expression of HLA-A2 was 2.52 (95 per cent CI 1.11-5.73; p < 0.05). There was no significant association between UA/UC and HLA-B8, -B15, -DR3, -DR4 or other antigens. Patients were re-studied after a mean period of 5.3 years: multiple linear regression analysis showed that the UA/UC at this time was positively related to the initial glycosylated haemoglobin level (p < 0.01) and expression of the HLA-A2 antigen (p < 0.05), but not to blood pressure or creatinine clearance. Fifteen patients developed macroalbuminuria at follow-up (UA/UC > 45.5 mg/mmol). Compared with a group matched for age, sex, duration of diabetes, and glycosylated haemoglobin who did not develop macroalbuminuria, macroalbuminuric patients had a higher frequency of HLA-A2 (p < 0.01). The odds ratio of progressing to macroalbuminuria associated with HLA-A2 had a 95 per cent CI of 1.71 to infinity. We conclude that an immunogenetic factor may play a role in the development of early diabetic nephropathy and that the risk associated with expression of the HLA-A2 antigen is independent of metabolic control and blood pressure.

Adolescent↗
PubMed1981

The development of serum-free hormone-supplemented media for primary kidney cultures and their use in examining renal functions.

We have demonstrated the primary kidney cultures and defined medium can be used for several purposes. First, primary kidney cultures can be examined in defined medium to evaluate the physiological significance of studies made with established kidney cell lines. Secondly, new kidney epithelial cell culture systems can be developed, using primary cultures and defined medium. The studies presented here have demonstrated several possible approaches towards these ends. First, a hormone-supplemented serum-free medium (Medium K-1) developed for an established dog kidney epithelial cell line (MDCK) was used to grow primary cultures of baby mouse kidney epithelial cells without fibroblast overgrowth. The primary cultures of baby mouse cells not only grew in response to each of the five supplements in Medium K-1, but also possessed several of the differentiated kidney functions observed in the MDCK cell line. Secondly, defined media were developed for primary cultures of rabbit kidney epithelial cells directly. The rabbit cells were shown to require a different set of supplements than MDCK cells to attain optimal growth. Furthermore primary cultures derived from purified rabbit proximal tubules required a different set of supplements than primary cultures derived from unpurified rabbit kidney tissue. These new primary culture systems should prove invaluable in examining renal transport functions in vitro.

Alprostadil↗
PubMedDate not supplied

A randomized, controlled, a single-blind trial of nutritional supplementation after acute stroke.

BACKGROUND: Although stroke patients who do not have difficulty swallowing may be at risk of undernutrition and worsening nutritional status during hospitalization, optimum methods for nutrition intervention in stroke patients have not been established. AIM: To examine the feasibility of enteral sip feeding as an effective nutrition intervention after acute stroke. METHODS: Forty-two acute ischemic stroke inpatients with impaired nutritional status who did not have difficulty swallowing within 1 week after the stroke were entered into a single-blind, randomized, controlled, prospective study of enteral sip feeding. Twenty-one patients were randomized to receive daily oral food supplements for 4 weeks in addition to the hospital food, and 21 patients received only the hospital food for the same period. Main outcome measures were energy and protein intakes during the intervention period, change in nutritional status, disability, infective complications, length of stay, and mortality during hospitalization and at 3 months. RESULTS: Two patients, one from each group, were lost to follow-up immediately after randomization. Twenty patients received oral nutritional supplementation. The energy intake was significantly greater in the supplemented group: 1807 +/- 318 vs 1084 +/- 343 kcal/d (mean +/- SD; p < .0001) (estimated treatment effect, 723 kcal/d; 95% confidence interval [CI], 498 to 947), as was protein intake: 65.1 +/- 13.8 vs 44.1 +/- 12.8 g/d (p < .001) (estimated treatment effect, 21.0 g/d; 95% CI, 11.7 to 30.3). There also were significant differences between the two groups in the changes in serum albumin and serum iron concentrations between randomization and at follow-up. There was a trend to lower mortality at 3 months in the supplemented group with two deaths (10%) compared with seven deaths (35%) in the control group (p = .127, relative risk, 0.29; 95% CI, 0.07 to 1.21). CONCLUSIONS: This study suggests that enteral sip feeding is effective in improving nutritional intake and status in stroke patients who do not have swallowing difficulties. There also may be some beneficial effects on clinical outcome, but larger studies are required to confirm this observation and define more precisely the magnitude of any favorable effects.

Brain Ischemia↗
PubMedDate not supplied

Increased risk of infection with Helicobacter pylori in spouses of infected subjects: observations in a general population sample from the UK.

BACKGROUND/AIMS: To investigate risk factors for infection with Helicobacter pylori in a general population sample who accepted an invitation to be screened. In particular, to determine whether being the spouse of an infected subject is an independent risk factor for infection after adjustment for other risks. METHODOLOGY: A serological screening test for Helicobacter pylori was offered to 4015 randomly selected subjects registered at a single general practice in Market Harborough, UK. Those invited were also asked to complete a questionnaire if attending for screening; this included information relating to possible risk factors for infection. Results were analyzed in the overall sample of attenders and a subset of married couples, using univariate and multivariate analyses. RESULTS: Complete results were obtained for 1431 (36%) subjects. Age, childhood social class and household crowding in childhood were independent risk factors after adjustment for other variables. Positive status of spouse was an independent risk factor in a subset of 389 married couples (P = 0.005, Odds Ratio: 2.65, 95% Confidence Interval: 1.34-5.25). CONCLUSIONS: Our study confirmed the correlation between childhood living conditions and infection with Helicobacter pylori. In the study population, having a Helicobacter pylori-positive spouse was associated with a significant increased risk of being infected.

Adult↗