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Biomedical subjects

P Morgan

Publications and source records attributed to P Morgan.

At least 91 records · Page 5Linked to original sources
PubMed1992

Are elderly people living alone an at risk group?

OBJECTIVE: To test the hypothesis that elderly people living alone are an at risk group with a high level of morbidity that makes high demands on health and social services. DESIGN: Secondary analysis of data from a community survey of 239 people aged 75 and over, identified from general practitioners' age-sex registers. SETTING: Nine practices in the London boroughs of Brent and Islington. MAIN OUTCOME MEASURES: Scores on the mini-mental state examination; stated satisfaction with life; assessment of mobility; numbers of diagnoses of major physical problems; numbers of prescribed drugs taken; urinary incontinence; alcohol consumption; contacts with general practitioners and hospital outpatient and inpatient services; contact with community health and social services. RESULTS: There were significantly more women among those living alone (93/120 (78%) v 63/119 (53%); p < 0.0005) and the median age of elderly people living alone was higher (81 v 80; p < 0.04). Those living alone and those living with others showed no significant differences in measures of cognitive impairment, numbers of major physical diagnoses, impaired mobility, or use of general practitioner or hospital services. Stated satisfaction with life was somewhat higher in those living alone. Elderly people living alone were significantly more likely to have contact with chiropody, home help, and meals on wheels services and less likely to have someone they could contact in an emergency or at night. Living alone increased the likelihood of contact with one or more community health professionals (district nurses, health visitors, or chiropodists) considered as a group and also increased the likelihood of contact with social services as a whole. There was a tendency for more of those living alone than those living with others to have home visits from their general practitioners, but there were no significant differences in contact with hospital services between the two groups. CONCLUSIONS: Elderly people living alone do not have an excess of morbidity compared with those living with others and do not seem to be an at risk group requiring specifically targeted assessments. More help is needed to provide elderly people living alone with a point of contact in case of emergency.

Aged↗
PubMed1992

The metabolism of 2- and 4-fluoro-17 beta-oestradiol in the rat and its implications for oestrogen carcinogenesis.

2-Fluoro-[6,7-3H]17 beta-oestradiol([3H]2-FE2) and 4-fluoro-[6,7-3H]17 beta-oestradiol([3H]4-FE2) were synthesized by the fluorination and reduction of [3H]oestrone and purified by HPLC. [3H]2-FE2 and [3H]4-FE2 (72.5 micrograms/kg; 0.25 mumol/kg) were administered i.v. to anaesthetized female and male Wistar rats (N = 4) with biliary cannulae. Bile was collected for 6 hr. Female rats administered [3H]2-FE2 excreted 85% of the dose into bile over 6 hr whilst male rats excreted 77%. After the administration of [3H]4-FE2, female and male rats excreted 72 and 83% of dose into bile over 6 hr, respectively. The biliary metabolites were glucuronides in all cases. The principal metabolite of [3H]2-FE2 liberated from biliary conjugates by beta-glucuronidase was 2-fluoroestrone in both female rats (64% of dose) and male rats (57%). No 2-hydroxylated, i.e. oxidatively defluorinated, metabolites were detected in either sex. In contrast, 2-hydroxylation of [3H]4-FE2 did occur, but only in female rats: 2-hydroxy-4-fluoro-oestrone (22%) and 2-methoxy-4-fluoroestrone (17%) were identified as biliary aglycones. However, the major metabolite was 4-fluoroestrone (4FE1; 38%). In male rats, 4-FE1 and 4-fluoro D-ring-oxygenated products were the principal biliary aglycones. The differences in metabolism between the two fluoro analogues and oestradiol are discussed with particular reference to the possible involvement of 2- and 4-hydroxy (catechol) oestrogens in oestrogen toxicity.

Animals↗
PubMed1992

Anaerobic degradation of trans-cinnamate and omega-phenylalkane carboxylic acids by the photosynthetic bacterium Rhodopseudomonas palustris: evidence for a beta-oxidation mechanism.

The mechanism responsible for the initial steps in the anaerobic degradation of trans-cinnamate and omega-phenylalkane carboxylates by the purple non-sulphur photosynthetic bacterium Rhodopseudomonas palustris was investigated. Phenylacetate did not support growth and there was a marked CO2 dependence for growth on acids with greater side-chain lengths. Here, CO2 was presumably acting as a redox sink for the disposal of excess reducing equivalents. Growth on benzoate did not require the addition of exogenous CO2. Aromatic acids with an odd number of side-chain carbon atoms (3-phenylpropionate, 5-phenylvalerate, 7-phenylheptanoate) gave greater apparent molar growth yields than those with an even number of side-chain carbon atoms (4-phenylbutyrate, 6-phenylhexanoate, 8-phenyloctanoate). HPLC analysis revealed that phenylacetate accumulated and persisted in the culture medium during growth on these latter compounds. Cinnamate and benzoate transiently accumulated in the culture medium during growth on 3-phenylpropionate, and benzoate alone accumulated transiently during the course of trans-cinnamate degradation. The transient accumulation of 4-phenyl-2-butenoic acid occurred during growth on 4-phenylbutyrate, and phenylacetate accumulated to a 1:1 molar stoichiometry with the initial 4-phenylbutyrate concentration. It is proposed that the initial steps in the anaerobic degradation of trans-cinnamate and the group of acids from 3-phenylpropionate to 8-phenyloctanoate involves beta-oxidation of the side-chain.

Anaerobiosis↗
PubMed1992

The sexually differentiated metabolism of [6,7-3H]17 beta-oestradiol in rats: male-specific 15 alpha- and male-selective 16 alpha-hydroxylation and female-selective catechol formation.

The oxygenated-metabolite profiles of exogenous 17 beta-oestradiol (E2) in adult male and female Wistar rats have been characterized and major sex-dependent biotransformations observed which correlate with the regioselectivities of known sexually differentiated hepatic P450. [6,7-3H]E2 (27 micrograms/kg) was given i.v. The metabolites of E2 were rapidly and extensively excreted in bile (46 and 78% of the dose over 1 and 6 h, respectively). Female rats metabolized E2 by one major pathway: oxidation to oestrone (E1) followed by C-2 hydroxylation and O-methylation; the principal aglycones (0-1 h bile collections) were E1 (14%), 2-hydroxyE1 (2-OHE1) (42%) and 2-methoxyE1 (24%). Male rats metabolized E2 principally by two parallel composite pathways of E1 hydroxylation which yielded a complex mixture of mono- and di-oxygenated compounds: 15 alpha-OHE1 (33%), 2,15 alpha-diOHE1 (7%), and 2-methoxy-15 alpha OHE1 (14%); 16 alpha-OHE1 (13%), 2,16 alpha-diOHE1 (4%) and 2-methoxy-16 alpha-OHE1 (2%). 15 alpha-Hydroxylation was unique to males. The balance of aromatic and alkyl hydroxylation in males was dose-dependent: at 3 mg/kg, 15 alpha-hydroxylation was decreased approx. 50% in favour of 2-hydroxylation whilst 16 alpha-hydroxylation was largely unaffected. The male-specific 15 alpha-hydroxylation and male-predominant 16 alpha-hydroxylation of E1 derived from E2 in vivo may be ascribable to the male-specific isoforms P450IIC13 and P450IIC11, respectively.

Animals↗
PubMed1992

Left atrial ball thrombus in combined mitral-aortic valve disease.

This report describes a patient with left atrial ball thrombus which was detected during echocardiographic evaluation of combined mitral-aortic valve disease. Surgical correction was performed entirely on the basis of the echocardiographic diagnosis.

Aortic Valve Insufficiency↗
PubMed1992

The inhibition of long-chain fatty acyl-CoA synthetase by enoximone in rat heart mitochondria.

The mechanism by which enoximone, a reported phosphodiesterase inhibitor, inhibits the oxidation of long-chain fatty acids was studied in isolated rat heart mitochondria using a series of 14C-labeled substrates. Enoximone decreased palmitate oxidation in a time- and concentration-dependent manner. Fifty percent inhibition of palmitate oxidation was achieved with 250 microM of enoximone. In contrast to its effect on palmitate, enoximone (250 microM) increased octanoate oxidation by 30%, whereas pyruvate oxidation was unaffected by enoximone. At that dose there was no effect on the oxidation of palmitoyl-CoA and palmitoyl carnitine. The degree of palmitate oxidation inhibited by enoximone was parallel to the inhibition of acyl-CoA synthetase in both rat heart mitochondria and microsomes. These results suggest that enoximone is a reversible inhibitor of long-chain fatty acyl-CoA synthetase. Moreover, the reaction, which is catalyzed by this enzyme, is a rate-limiting step in the pathway of fatty acid oxidation in rat heart mitochondria.

Acyl Coenzyme A↗
PubMed1992

Twin pregnancies: accuracy of first-trimester abdominal US in predicting chorionicity and amnionicity.

A first-trimester transabdominal ultrasound (US) study was performed on twin pregnancies to determine the utility of US in predicting chorionicity and amnionicity. Among 85 dichorionic-diamniotic (DC-DA) twin pairs, a thick membrane was present in 78 (92%). Four of the DC-DA cases without a thick membrane had two distinct placental sites, allowing 82 DC-DA pregnancies (96%) to be predicted. Among 16 monochorionic-diamniotic (MC-DA) twin pairs, a thin membrane was present in 14 (88%). None of the four monochorionic-monoamniotic (MC-MA) cases had an identifiable membrane. The lambda sign had no value in this evaluation and was actually misleading, while a thick membrane or the identification of two separate placentas was always predictive of DC-DA twinning. However, a thin membrane, while usually predictive of an MC-DA pregnancy, did not exclude a DC-DA gestation. When no membrane is present, an MC-MA gestation is probable; however, a diamniotic pregnancy may still be present, and further evaluation is suggested.

Amnion↗
PubMed1991

Alcohol consumption by elderly people: a general practice survey.

A random sample of 241 patients from General Practice registers in London were interviewed to assess alcohol consumption, cognitive impairment, depression and other factors. Fifty-one per cent of men and 22% of women reported use of alcohol in the previous 3 months. No significant association was found between reported drinking status and age, score on a depression scale, falls in the previous 3 months, attendance at outpatient clinics or inpatient care in the previous year. In the men abstainers were significantly more likely to show cognitive impairment than were drinkers. Amongst those respondents who admitted to drinking within the previous 3 months, total stated weekly alcohol consumption was not associated with age, cognitive impairment and scores on the depression scale, and there was no association with falls, or with outpatient or inpatient care. Only three men (3.6%) and five women (3.2%) admitted consuming more than 21 and 14 units of alcohol per week, respectively.

Aged↗
PubMed1991

[Acute and long-term effects of pimobendan (UD-CG 115) in NYHA II and III heart failure. Results of a randomized multicenter double-blind study].

The effects of pimobendan (UD-CG 115) on hemodynamics and exercise capacity after acute (single dose) and chronic (6 month) oral treatment, as well as acute treatment after 6 months were investigated in 67 patients with chronic heart failure of NYHA classes II or III, which had persisted in spite of treatment with diuretics and digitalis. They were treated with pimobendan (2.5 mg bid or 5 mg) or placebo in a randomized, double-blind multicenter trial. With a single administration before and after 6 months' treatment there was-compared to placebo-a significant fall in pulmonary capillary pressure (PCP) at rest (R) and during exercise (E) of 7% to 24%. Right atrial pressure (R) and pulmonary arterial pressure (PAP) (R, E) decreased after pimobendan on day 1; cardiac index (E) increased significantly. All other parameters were not influenced. After chronic therapy, PCP (E), PAP (E), LV stroke work index (E), and pulmonary resistance (R and E) values were significantly lowered by pimobendan when compared to day 1. Exercise duration was prolonged after 6 months by 83 s and 47 s after 5 and 10 mg/day, resp., compared to the placebo group (group difference not significant). Subjective wellbeing was improved in all three groups (no group difference). Clinical symptoms were not altered; six patients (two in each group) died suddenly. Another nine patients discontinued the trial prematurely because of poor efficacy or adverse events (no group difference). Overall, pimobendan was well-tolerated and had favorable effects on both acute and chronic hemodynamics and on exercise capacity. There was no evidence of any tolerance development.

Adult↗
PubMed1991

Assessment of elderly people in general practice. 1. Social circumstances and mental state.

A survey of patients aged 75 years and over registered with general practitioners in north and north west London was carried out by trained interviewers to investigate cognitive impairment. A random sample of 239 patients was selected for the more detailed home assessment. General practitioners had seen nearly two thirds (65.3%) of their patients aged 75 years and over in the three months prior to the study, the majority of these consultations (82.1%) being initiated by the patient and occurring at the surgery. Half of the patients lived alone (50.2%), nearly one in three had no living siblings (31.9%), a similar proportion had no living children (29.5%), and contact with neighbours and relatives was relatively infrequent. One in five elderly patients had evidence of depression (22.0%) although this appeared to be severe in only two cases, and 36 participants (15.1%) had scores on the mini-mental state examination suggesting cognitive impairment. General practitioners underdiagnosed both dementia and depression. The population contained a small group of people who consumed alcohol on a daily basis (10.5%). This study showed that an annual assessment of elderly people as required by the new general practitioners' contract would yield much new evidence of depression and dementia and assist in the identification of heavy drinkers. Up to 30% of patients aged 75 years and over are likely to require further assessment on the basis of screening tests for depression and cognitive impairment, although it remains unclear to what extent identification of these patients will lead to improvements in outcome for them or their carers.

Aged↗
PubMed1991

Assessment of elderly people in general practice. 2. Functional abilities and medical problems.

A random sample of 239 patients aged 75 years and over registered with general practitioners in north and north west London was selected for home assessment to determine the functional abilities and medical problems of this group of patients. Nearly one in five of the patients were incontinent of urine (18.4%), although this was on a daily basis for only 4.1%. Around one in 20 patients were incontinent of faeces (5.9%), yet only one patient had laundry service support. Unassisted mobility outdoors was reported as possible by 81.2% of the patients. Fourteen different types of aids were present in the participants' homes, the commonest being walking sticks, bath aids and stair rails. Only a small proportion of aids seemed to be currently unused. The major functional problems were bathing, housework, shopping, washing and ironing, and cooking main meals, but the level of demand for extra help was low. One in five patients had a hearing aid (19.8%) but for only 30% of these patients was it in continuous use. Polypharmacy was common, with 29.7% of patients taking three or more prescribed medicines. The workload implications of this approach to anticipatory care of elderly people are considerable. In an average practice of 2000 patients with 130 patients aged 75 years and over the primary care team would need over 150 hours of face-to-face contact per year with these patients to fulfil the new contractual obligation and the yield of new information leading to effective medical or social intervention is limited.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMed1991

Illicit drugs.

Explore the source record for details and available documents.

Drug and Narcotic Control↗
PubMed1990

Physiology of aliphatic hydrocarbon-degrading microorganisms.

This paper reviews aspects of the physiology and biochemistry of the microbial biodegradation of alkanes larger than methane, alkenes and alkynes with particular emphasis upon recent developments. Subject areas discussed include: substrate uptake; metabolic pathways for alkenes and straight and branched-chain alkanes; the genetics and regulation of pathways; co-oxidation of aliphatic hydrocarbons; the potential for anaerobic aliphatic hydrocarbon degradation; the potential deployment of aliphatic hydrocarbon-degrading microorganisms in biotechnology.

Anaerobiosis↗
PubMed1990

The metabolism of 2,4-dibromo-17 alpha-ethynyl[6,7-3H]oestradiol in the rat.

1. The metabolism of 2,4-dibromoethynyloestradiol (2,4-DBEE2) in the rat was studied in order to determine the influence of ring-A substituents on the phase I biotransformations of oestrogens. 2. 2,4-Dibromo-17 alpha-ethynyl[6,7-3H]oestradiol was synthesized by the one-stage bromination of 17 alpha-ethynyl[6,7-3H]oestradiol (EE2) with N-bromoacetamide, and administered (30 micrograms/kg, i.v.) to anaesthetized male and female rats. 3. A single metabolite, identified as a glucuronide of 2,4-DBEE2, was rapidly and extensively eliminated in bile by male rats (83% of the dose over 6 h). Females excreted additional minor conjugated metabolites. Neither unchanged 2,4-DBEE2 nor EE2 was detected in bile. 4. The hepatic residues after 6 h (percentage of dose) were 2.7% and 3.4% in male and female rats, respectively, whilst less than 0.1% per organ(s) was found in kidneys, heart, spleen, lungs and brain. 5. 2,4-Dibromo substitution of EE2 effectively blocked all phase I biotransformations whilst not limiting glucuronylation in male rats, but did not entirely preclude phase I metabolism in females. The inertness of 2,4-DBEE2 to ring-A hydroxylation in male rats conforms with the insignificant debromination of 2,4-dibromoestradiol by hepatic microsomes.

Animals↗