Determining priority for long-term care.
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Activities of Daily Living↗
Biomedical subjects
P Hayes
Publications and source records attributed to P Hayes.
Characterization and regulation of the receptor tyrosine kinase Tie-1 in platelets.
The receptor tyrosine kinase Tie-1 is expressed predominantly on endothelial cells where it has an essential role in blood vessel formation. Targeted disruption of the Tie-1 gene results in a lethal phenotype with severe disruption to the normal integrity of the vasculature. In an examination of Tie-1 in vivo, we observed a significant pool of the receptor present in the circulation associated with the platelet fraction. Western blotting reveals the platelet form of Tie-1 to be a protein of approximately 110 kDa, this contrasts with the 135/125-kDa doublet found in endothelial cells. Platelet activation results in increased surface expression of Tie-1. The closely related receptor tyrosine kinase Tie-2/Tek is not present in platelets. Endothelial Tie-1 undergoes metalloprotease-mediated ectodomain cleavage in response to phorbol ester and other agonists. Tie-1 cleavage leads to release of the extracellular domain and generation of a cell-associated intracellular domain with signalling capacity. The potential for cleavage was investigated in platelets. In contrast to endothelial Tie-1, phorbol ester does not stimulate truncation of the platelet receptor, suggesting these cells lack one or more components of the regulated metalloprotease system controlling Tie-1. These data demonstrate the Tie-1 receptor tyrosine kinase is present on platelets and its surface expression is regulated. Furthermore, platelet Tie-1 differs significantly from the endothelial receptor. Platelet Tie-1 has the potential to modulate endothelial function by competing for any Tie ligands and may have signalling roles important in controlling aspects of platelet behaviour.
Adenosine Diphosphate↗
The role of risk and benefit perception in informed consent for surgery.
BACKGROUND: Informed consent relies on patients' ability to understand risk information. Evidence suggests that people may extract the gist of any risk information to make medical decisions. Existing evidence also suggests that there is an inverse relationship between the perception of risk and the perception of benefit. METHOD: Seventy-one patients on the waiting list for carotid endarterectomy (CEA) were surveyed regarding their understanding and recall of the risk and benefit to health of undergoing CEA. Patients were surveyed 1 month after their initial consultation, and a subgroup was surveyed again on the day before their operation. RESULTS: Patients' estimates of their baseline risk of stroke without surgery were significantly different from what they had been told by the surgeon. Patients' estimates of stroke risk due to surgery ranged from 0% to 65% (actual local risk 2%). Patients also had unreasonable expectations about the benefit of the operation for their health. Estimates of stroke risk correlated positively with the degree of expected benefit from the operation (r = 0.29, P = 0.05). When resurveyed the day before the operation, patients' perceptions of both risk and benefit had increased significantly. The risk perception data from some patients appeared to contradict some of the predictions of the fuzzy-trace theory. CONCLUSIONS: Most patients failed to understand the risks and benefits associated with CEA. Some patients' estimates of stroke risk were actually greater than the perceived potential benefit of surgery in terms of risk reduction. The data also suggested a positive correlation between the degree of perceived benefit and the degree of perceived risk.
Cognitive Dissonance↗
Emerging quinolone-resistant Salmonella in the United States.
We conducted a national survey of antimicrobial resistance in human clinical isolates of Salmonella between July 1, 1994, and June 30, 1995. Every tenth nontyphoidal Salmonella isolate received at state public health laboratories in the United States during this period was tested for resistance to 12 antimicrobial agents, including two quinolones, nalidixic acid, and ciprofloxacin. Emerging quinolone resistance was detected; of 4,008 isolates tested, 21 (0.5%) were resistant to nalidixic acid, and one (0.02%) was resistant to ciprofloxacin. Continued surveillance for quinolone-resistant Salmonella is necessary, particularly after the recent approval of a fluoroquinolone for use in animals intended for food in the United States.
Animal Feed↗
Family atmosphere in a nursing unit.
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Aged↗
Reduction of bioavailability of aluminium in neonatal parenteral nutrition solutions by prior complexation in the dosage form.
Aluminium (Al ) is abundant in our environment and is a contaminant of electrolyte solutions used in the manufacture of Total Parenteral Nutrition (TPN) solutions administered to neonates, who are unable to tolerate oral feeding. Previous studies by McHalsky et al. (1) have shown concern over the levels of aluminium in parenteral products, and there are special considerations needed with regard to neonatal TPN solutions, (2). It is felt that neurotoxicology and abnormalities of bone histology may be seen with aluminium deposition in the tissues. In the present study it was shown that the average aluminium contamination in TPN solutions was in the order of 205 micrograms/L. It is well documented that aluminium is chelated successfully in dialysis solutions by desferrioxamine (DFO), Allain et al. (3). Using an AA spectrophotometer equipped with a graphite furnace, the average amount of aluminium in compounded neonatal TPN solutions was determined. Equimolar amounts of DFO to aluminium were added to various neonatal TPN formulations, and the physical stability of each solution was determined using microscopic and electronic particle counting analysis. This study suggests that aluminium can be irreversibly chelated with DFO and stable TPN solutions can be prepared.
Aluminum↗