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Biomedical subjects

P Carey

Publications and source records attributed to P Carey.

At least 19 recordsLinked to original sources
PubMed1996

Memory for conversation.

Memory for conversation is treated as a source of coherence in social encounters and its connections with social competence are tested in a study of problem-solving conversations. As predicted, accurate recall is found to correlate positively with social competence and negatively with social anxiety. Partners have better memory for their own contributions than for each other's, and this difference is exacerbated by topic importance. Differences in recall are also found for differing amounts of involvement in the conversations. Results are explained in terms of resource allocation during conversation.

Analysis of Variance↗
PubMed1995

Toxoplasmosis masking non-Hodgkin's lymphoma: a case report.

A 39-year-old female with persistent cervical lymphadenopathy is reported. Initial investigations resulted in a diagnosis of toxoplasmosis, but subsequently the patient proved to have high grade immunoblastic non-Hodgkin's lymphoma. This paper highlights the difficulties in accurately diagnosing some cases of either toxoplasmosis or lymphoma, and briefly mentions some of the ongoing technical advances which will increase diagnostic specificity and sensitivity by early detection of genetic mutations.

Adult↗
PubMed1995

Cancer education and the primary school teacher in England and Wales.

Many adult behaviors and attitudes develop in early childhood. There is a growing acceptance of the need for health education of children of primary school age. Cancer is an important topic within health education, and this study was designed to assess the level of cancer education in schools. Data were collected from a randomly selected sample of over 1,000 teachers of children in primary school years 3-6 (ages 7-11 years). Cancer had been taught about by 18% of the sample, and their pupils' ages had no significant effect on whether they had taught about cancer. Cancer was most often taught about in response to a real-life situation, and the majority of the teachers did not use cancer education resources to help them. The study sought to ascertain why so many teachers had taught about cancer. It appears that concerns over their own lack of personal knowledge, and a perceived lack of resources, were the most common reasons. The young age of the pupils was also a deterrent to cancer education, especially among the teachers of the younger pupils. The results indicate various interventions that may increase the level of primary-school-based cancer education. These include improving teachers' awareness of cancer education issues and providing appropriate cancer education resources.

Attitude to Health↗
PubMed1995

Is health locus of control related to health education activity.

Analysis of responses of 1922 teachers indicated that Multidimensional Health Locus of Control scale was a suitable instrument for assessing their health beliefs. The results suggest that health belief is not linked to whether teachers teach about cancer and, by implication, health generally.

Adolescent↗
PubMed1995

Effect of atrial natriuretic hormone on vasopressin and thirst response to osmotic stimulation in human subjects.

To evaluate the effect of systemically administered atrial natriuretic hormone (ANH) on osmotically induced secretion of arginine vasopressin (AVP) and thirst sensation, 11 healthy men, aged 18 to 28 years, were studied on four occasions. The intravenous infusions of placebo (P) or one of three doses of ser-tyr28 human ANH (0.6 [LD], 1.8 [MD], and 5.4 [HD] pmol/kg/min) were given in random order over 2 hours. During the second hour, subjects also received a 5% saline (HS) infusion (0.1 ml/kg/min). The baseline parameters were similar on each of the study days. Plasma ANH levels increased approximately twofold, eightfold, and 25-fold during LD, MD, and HD infusions, respectively. HS infusion caused increases in serum sodium level (5 to 7 mEq/L) and osmolality (14 to 15 mOsm/L) (p < 0.001). During HS infusion on P day, ANH levels almost doubled (p < 0.001). AVP levels remained stable during the first hour of ANH infusions. An addition of HS caused a significant increase in AVP levels (p < 0.001). The magnitude of this increase was similar on each of the study days. Similarly, thirst perception increased significantly (p < 0.01) and to the same extent during HS infusion on all study days. Both AVP levels and thirst showed a very good correlation with serum osmolality on each of the study days, and there were no significant differences between any of the slopes or intercepts. We conclude that short-term elevation of plasma ANH levels up to 25-fold affects neither the osmotically stimulated secretion of AVP nor thirst perception.

Adult↗
PubMed1994

Autologous bone marrow transplantation in poor-risk high-grade non-Hodgkin's lymphoma in first complete remission. Newcastle and Northern Lymphoma Group.

We report the safety and efficacy of autologous bone marrow transplantation (ABMT) in 30 patients with high-grade non-Hodgkin's lymphoma (NHL) in first complete remission (CR1) following remission induction chemotherapy. Two patients relapsed prior to ABMT. All patients were conditioned with high-dose melphalan. In Addition, ten received fractionated total body irradiation, one hemi-body irradiation and four high-dose etoposide. Unmanipulated non-cryopreserved autologous marrow was reinfused within 56 h of harvesting. Engraftment occurred in all patients with a median of 11 days of neutropenia (< 0.5 x 10(9) l-1), a median requirement for platelet transfusion of 3 days and packed red cell transfusion of 2 units, with a median hospital stay of 18 days post transplant. There was no procedure-related mortality and only minor morbidity was observed. Two patients relapsed at 1 and 2 months post transplantation, and one patient died of carcinoma of the lung 33 months after transplantation. The remaining 25 patients remain alive, well and in CR1 with a median follow-up of 44 months. The event-free survival at 3 years for all patients considered for ABMT was 83%. We conclude that ABMT for high-grade NHL in CR1 with non-cryopreserved marrow results in rapid haematological recovery without growth factor support. It is safe and is associated with high survival when used as consolidation of CR in high-risk patients.

Adolescent↗
PubMed1994

Zidovudine phosphorylation in HIV-infected patients and seronegative volunteers.

OBJECTIVES AND DESIGN: Measurement of phosphorylated zidovudine (ZDV) inside infected cells is more likely to provide satisfactory dose response relationships than serum concentrations. This study provides information on ZDV phosphorylation in HIV-seronegative volunteers (n = 5) and in patients with HIV infection (n = 12). METHODS: Intracellular ZDV phosphate metabolites were measured in peripheral blood mononuclear cells isolated from whole blood by density cushion centrifugation. Cells were washed and extracted overnight with 60% methanol prior to analysis by high performance liquid chromatography. Fractions eluted from the column corresponding to ZDV, ZDV monophosphate (ZDV-MP), ZDV diphosphate (ZDV-DP) and ZDV triphosphate (ZDV-TP) were collected, hydrolysed by acid phosphatase and ZDV levels quantified by radioimmunoassay. RESULTS: The area under the plasma ZDV concentration-time curve (AUC0-6 h) was similar in seronegative volunteers and patients [mean +/- SD, 4.64 +/- 2.50 versus 5.56 +/- 2.67 mumoles/l h; 95% confidence interval (CI), -4.39-2.23; P = 0.646, Mann-Whitney U test]. However, ZDV phosphorylation was greater in patients, with the AUC0-6 h for total phosphate metabolites being 5.91 +/- 3.42 pmoles/10(6) cells h compared with seronegative volunteers (0.66 +/- 0.48 pmoles/10(6) cells h; 95% CI, -8.35 to -2.32; P = 0.0003). The concentration of ZDV-TP was similar in both groups, the increase in total phosphates in patients being due primarily to ZDV-MP. ZDV-MP AUC0-6 h and total ZDV phosphate AUC0-6 h were closely correlated (r2 = 0.94). The relationship between total ZDV phosphate AUC0-6 h and the CD4 count demonstrates that patients with a count < 100 x 10(6)/l have much higher ZDV phosphate levels, predominantly ZDV-MP. CONCLUSION: ZDV is phosphorylated to a greater extent in patients than in healthy volunteers. The increased ZDV-MP in patients with low CD4 counts may explain the well known occurrence of increased ZDV toxicity in patients with more advanced disease. The ability to measure ZDV phosphorylated metabolites (without the administration of radiolabelled nucleoside) represents a significant advance in our understanding of the clinical pharmacology of the drug.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Laparoscopic varicocelectomy.

We report our initial experience of laparoscopic ligation of varicocele in 13 patients with a mean age of 34 years (range 18-39). Eight patients were subfertile, and the rest complained of dragging pain and discomfort in the left scrotum. At laparoscopy the peritoneum overlying the spermatic vessels was divided, and the spermatic veins were mobilized, clipped, and divided. The spermatic artery was identified and preserved in 11 of the 13 cases. The patients were discharged within 24 h of hospital admission. Semen quality improved in seven of the eight subfertile patients studied with a mean follow-up of 8 months. Four patients who were operated on for pain and discomfort had symptomatic improvement by the time of their first outpatient visit at 3 months. One patient complained of paresthesia along the anterior aspect of his thigh, which resolved in 6 weeks. There were no other complications. Laparoscopic varicocelectomy is a safe and effective minimally invasive procedure for treatment of clinical varicocele.

Adolescent↗
PubMed1993

Randomized phase I chemoprevention dose-seeking study of alpha-difluoromethylornithine.

BACKGROUND: alpha-Difluoromethylornithine (DFMO) is an irreversible inhibitor of ornithine decarboxylase (ODC), the key enzyme in mammalian polyamine biosynthesis. Levels of ODC are closely related to tumor promotion, and inhibition of ODC is associated with suppression of tumor development in laboratory animals. DFMO has shown a dose-response effect in tumor inhibition in mice. PURPOSE: A randomized phase I study of DFMO was conducted to determine the lowest daily oral dose that can achieve at least 50% inhibition of ODC activity induced by 12-O-tetradecanoylphorbol-13-acetate (TPA) in human skin, with minimal clinical toxicity (grade 1 or lower; Eastern Cooperative Oncology Group [ECOG]). METHODS: Cancer patients entered in steps 1 and 2 of the study had been treated and had no clinical evidence of cancer. In step 1, 13 patients received 0.125, 0.25, 0.5, or 0.75 g/m2 DFMO four times a day. In step 2, 13 patients received 0.125 or 0.25 g/m2 four times a day or 0.5 or 1.0 g/m2 every day. The 26 patients treated in steps 1 and 2 (range, < 1-6 months) had colon, prostate, or bladder cancer. In step 3, six cancer-free subjects at risk for colorectal cancer received 0.5 g/m2 every day for 5-12 months. To evaluate the effectiveness of DFMO in reducing TPA-induced ODC activity, we calculated the percent change from pretreatment ODC levels in skin biopsy specimens and the percentage of subjects with at least a 50% reduction in ODC levels. RESULTS: In step 1 of the study, treatment-limiting audiotoxicity was observed at the three highest doses. Because the only dose with no major toxic effects in step 2 was 0.5 g/m2 every day, that dose was administered in step 3, with no major toxic effects. Seven subjects treated with 0.5 g/m2 every day had pretreatment ODC levels in the normal range; five averaged a reduction in ODC activity of at least 50%. DFMO had linear pharmacokinetics over the entire dose range. When 0.5 g/m2 was given every day, the peak plasma concentration was 47.1 +/- 5.1 microM at 3-4 hours (monthly mean +/- SE, 14.5 +/- 5.2 microM); half-life was 3.5 hours; and area under the curve for plasma concentration x time for a single dose of DFMO was 311 +/- 39 microM x hour. CONCLUSIONS: These data support phase II chemoprevention studies with DFMO given at a dose of 0.5 g/m2 every day. IMPLICATIONS: Studies investigating prevention of cancers with DFMO are under consideration.

Adult↗
PubMed1993

Follow-up of abnormal Papanicolaou smears among women of different races.

BACKGROUND: Current information about racial differences in the rate of cervical abnormalities is incomplete, and there are few data about racial differences in compliance with follow-up and treatment. The purpose of this study was to investigate the frequency and follow-up of abnormal Pap smear findings in white, black, and Southeast Asian women. METHODS: The charts of women who attended a St Paul family practice residency clinic and who had abnormal Papanicolaou (Pap) smear results between January 1, 1989, and September 1, 1992, were reviewed, and information about age, race, insurance, Pap smear findings, diagnostic studies, and treatment procedures was recorded. RESULTS: Of 1794 women who had Pap smears during this period, 190 (10.6%) had abnormal results, with a diagnosis of atypia, dysplasia, or carcinoma. The rate of abnormality was greater for black women (16.4%) than for Southeast Asian (6.1%) and white women (11.6%); however, the proportion of abnormal Pap smears that showed moderately severe or worse changes was greater for Southeast Asians than for whites (30.6% vs 14.3%, P < .05). Southeast Asian women with abnormal Pap smears were also less likely than whites and blacks to follow through with recommended diagnostic and treatment procedures. CONCLUSIONS: Southeast Asian women in this study were less likely than white and black women to comply with recommended follow-up diagnostic and treatment procedures for cervical disease.

Asian People↗
PubMed1993

Serum inhibitors precede the development of SAIDS.

Rhesus macaque monkeys infected with the simian immunodeficiency virus develop a syndrome mimicking AIDS in humans. We have demonstrated previously that sera from individuals infected with human immunodeficiency virus type 1 inhibit the proliferation of lymphocytes from healthy noninfected subjects and that this phenomenon is associated with the development of clinical AIDS. We have also shown that sera from monkeys infected with SIV also have such inhibitors. In this body of work, we attempted to document the onset of these inhibitors in relation to the time of SIV infection. Twenty rhesus macaques were injected with one of two tissue strains of SIV or media. Blood was drawn on a set schedule and the serum samples frozen at -70 degrees C. The animals were monitored and observed for up to 42 weeks. All test animals were autopsied. Sera from all the draws were assayed against the same populations of human peripheral blood mononuclear cells in the same experiment using suboptimal amounts of phytohemagglutinin (PHA). Sera from those animals that subsequently developed SAIDS were more likely to demonstrate serum inhibition. This inhibition could be seen as early as 8-10 weeks after infection. By week 14, the assay could differentiate animals into SAIDS or healthy groups with a sensitivity of 67% and a specificity of 89%.

Analysis of Variance↗
PubMed1992

Continuous-infusion 5-fluorouracil combined with doxorubicin and cyclophosphamide: feasibility study.

Previous studies have demonstrated continuous-infusion 5-fluorouracil (CI 5-FU) to be an active single-agent treatment for breast cancer without significant myelotoxicity. These qualities made CI 5-FU an attractive agent for combination with other effective but myelosuppressive agents. In this study we attempted to determine the maximal doses of CI 5-FU that could be added to a combination of agents known to be dose limited by myelotoxicity, doxorubicin 50 mg/m2 day 2 and cyclophosphamide 150 mg/m2 days 3-12 of a 28-day cycle. Patients who received doxorubicin and cyclophosphamide alone developed significant myelotoxicity but did not develop stomatitis. The addition of 5-7 days of CI 5-FU at 200-300 mg/m2 was associated more closely with increased stomatitis (P = .11) than with increased granulocytopenia (P = .57). The stomatitis observed for low doses of CI 5-FU given with doxorubicin and cyclophosphamide would not have been expected for these low doses of CI 5-FU given as a single agent. We conclude that the addition of CI 5-FU to myelotoxic doses of doxorubicin and cyclophosphamide is not a promising therapeutic strategy for significantly increasing the effectiveness of this combination of agents.

Adenocarcinoma↗
PubMed1992

Teachers' attitudes to cancer education: a discussion in the light of a recent English survey.

Various attempts have been made at encouraging cancer education in British schools, and while some have had limited success, there is still a reluctance amongst teachers to adopt this subject in the classroom. The study discussed in this paper was an attempt to ascertain the current status of cancer education in English secondary education. Over 1,200 English secondary (11-16 years olds) schools took part and the data were collected between February and June 1990. Although there is evidence to suggest an element of self-selection, results from this sample indicate a growing commitment and enthusiasm for cancer education, in comparison to previous, similar studies. Over half the teachers had taught about cancer and 68.8% rated it an important health education topic. However, cancer did rate lowest out of a variety of health issues. Several reasons for this are discussed and all appear to relate to teachers' negative attitudes toward cancer, apparently based on preconception and misinformation. These must be overcome if cancer education is to achieve its true potential in English schools.

Adolescent↗