Search PubMed⌕ Search

Biomedical subjects

R Baker

Publications and source records attributed to R Baker.

At least 343 records · Page 19Linked to original sources

Synthesis and muscarinic activity of quinuclidinyl- and (1-azanorbornyl)pyrazine derivatives.

The synthesis and cortical muscarinic activity of a novel series of pyrazine-based agonists is described. Quinuclidine and azanorbornane derivatives were prepared either by reaction of lithiated pyrazines with azabicyclic ketones, followed by chlorination and reduction, or by reaction of the lithium enolate of the azabicyclic ester with 2-chloropyrazines followed by ester hydrolysis and decarboxylation. Substitution at all three positions of the heteroaromatic ring has been explored. Optimal muscarinic agonist activity was observed for unsubstituted pyrazines in the azanorbornane series. The exo-1-azanorbornane 18a is one of the most efficacious and potent centrally active muscarinic agonists known. Studies on the 3-substituted derivatives have provided evidence of the preferred conformation of these ligands for optimal muscarinic activity. Substitution at C6 gave ligands with increased affinity and reduced efficacy. Moving the position of the diazine ring nitrogens to give pyrimidine and pyridazine derivatives resulted in a significant loss of muscarinic activity.

Animals↗

Hardware to hard hats: training workers for action (from offices to construction sites).

A university-based labor education program provides training to unionists, emphasizing the skills needed by workers and their representatives in order to promote their rights to health and safety on the job. The article describes two examples of this training approach. The first example is a training program for video display terminal (VDT) operators which prepares them to take a leadership role in advancing policies to regulate working conditions for VDT users. The second is a program designed to improve the quality of safety, or "tailgate" meetings in the construction industry by promoting an approach that encourages active worker participation in identifying potential hazards and developing solutions. The methodologies used to achieve action-oriented outcomes are described.

Accident Prevention↗

Clozapine for the treatment of adolescents with schizophrenia.

Despite recent reports that clozapine is useful for the treatment of chronic schizophrenics resistant to neuroleptics, no studies have been reported in adolescents with schizophrenia. Despite the risk of potentially fatal agranulocytosis, clozapine's use in adolescents may become important because of its lack of extrapyramidal side effects or association with tardive dyskinesia, and reports that suggest that schizophrenic adolescents resemble chronic adult schizophrenics. The authors report three successful trials of clozapine in adolescents with schizophrenia who did not respond to conventional neuroleptic treatment.

Adolescent↗

Measuring patient satisfaction: a test of construct validity.

OBJECTIVE: To establish the validity of two patient satisfaction questionnaires (surgery satisfaction questionnaire (SSQ) and consultation satisfaction questionnaire (CSQ)) developed for use in general practice. DESIGN: Prospective study of performance of SSQ and CSQ in patients selected for their predicted levels of satisfaction. SETTING: Avon Family Health Services Authority (FHSA); general practices in Bristol (practice A) and in Cheltenham (practice B). PATIENTS: 400 patients selected by Avon FHSA who had changed practices but not their home address and whose original practice had not changed its services (group 1); 869 randomly selected patients (221 from practice A, 648 from practice B) (group 2). MAIN MEASURES: Median difference in satisfaction scores for each questionnaire between groups 1 and 2 and between subgroups of group 2 patients according to assessed level in continuity of care (< 50%, > or = 50%) in the past 12 consultations. RESULTS: 272 (68.0%) patients in group 1 completed the SSQ and CSQ. 711 (81.2%) patients in group 2 (178/221 (80.5%) in practice A, 533/648(82.3%) in practice B) completed the SSQ and 374(88/106(83.0%), 286/335(85.4%)) completed the CSQ. Both questionnaires classified patients in groups 1 and 2 according to the construct of satisfaction; thus the difference in median scores for every component of satisfaction in each questionnaire was significant and occurred in the direction predicted by the construct. Each questionnaire also discriminated between patients grouped according to their assessed level of continuity of care. CONCLUSION: SSQ and CSQ are valid measures of satisfaction for these types of patients. IMPLICATIONS: Valid measures of patient satisfaction can be developed; untested instruments should no longer be used.

Adult↗

Characterization and adaptive modification of the goldfish vestibuloocular reflex by sinusoidal and velocity step vestibular stimulation.

1. The normal and adapted vestibuloocular reflex (VOR) of goldfish was characterized by means of sinusoidal, velocity step, and position step head rotations about the vertical axis. VOR adaptation was induced by short-term, 1- to 4-h, presentation of visual and vestibular stimuli that altered the ratio of eye to head velocity. 2. The VOR response measured with sinusoidal oscillations in the dark was close to ideal compensatory values over 2 decades (1/32-2 Hz). Gain approximated unity, and phase, in relation to the head, was nearly 180 degrees. The VOR was linear within the range of head velocity tested (4-64 degrees/s). 3. Head velocity steps from 1/8 to 1 Hz produced steplike eye velocity profiles that could be divided into an early acceleration-related "dynamic" component and a later constant-velocity "sustained" period frequently separated by a sag at approximately 0.1-0.15 s from the initiation of eye movement. The sustained response exhibited no decay during the constant-velocity component of the step. 4. Higher temporal resolution of the dynamic response showed the adducting eye movement to have a shorter latency, faster rise time, and larger peak gain than the abducting eye movement. The characteristics of this directional asymmetry were similar for position steps and electrical stimulation of the vestibular nerve. However, the asymmetry was not observed during sinusoidal head rotation, the sustained component of the step response, or after electrical stimulation of the VIth and IIIrd nerves. We conclude that this directional asymmetry is of central origin and may be largely due to the parallel vestibular and abducens internuclear neuron pathways onto medial rectus motoneurons. 5. The VOR adaptation process for both higher and lower eye velocity exhibited an exponential time course with time constants of 55 and 45 min, respectively. After continuous sinusoidal training for 4 h, VOR gain reached an asymptotic level 5% away from perfect suppression in the low-gain training, but 19% away from the actual performance in the high-gain paradigm. The time constant for VOR gain reversal was 5 h, and an asymptotic level 40% less than performance was reached within 10 h. 6. Adapted VOR gain was symmetrical for both directions of eye movement measured either during sinusoidal rotation or the sustained part of the velocity step. VOR adaptation also produced a comparable gain change in the nasal and temporal directions of the dynamic component, but this reflected the asymmetric characteristics observed in the preadapted condition.(ABSTRACT TRUNCATED AT 400 WORDS)

Acoustic Stimulation↗

Functional expression of an inactivating potassium channel cloned from human heart.

Recently a putative K+ channel with homology to the Shaker family of potassium channels has been cloned from human ventricular myocardium. However, proof that the cDNA encodes a K+ channel requires appropriate translation and expression of a functional ion-selective channel. Therefore, expression of this putative human K+ channel DNA was attempted by cytoplasmic injections of in vitro transcribed cRNA into Xenopus laevis oocytes and screening by two-electrode voltage-clamp methods. This resulted in expression of voltage-gated channels that rapidly inactivated (time constant of inactivation, 47.6 +/- 3.6 msec; 0 mV; n = 10) and were at least 50 times more selective for K+ than Na+ (Na+/K+ permeability ratio of 0.02). The channels showed voltage-dependent activation (half-maximal voltage, -34 +/- 0.7 mV; n = 5), and 50% of the channels were inactivated within 2 seconds when the membrane potential was clamped near -60 mV (half-maximal voltage, -62 +/- 7 mV; n = 10). The expressed protein resulted in a K+ current that had many properties similar to the 4-aminopyridine-sensitive calcium-insensitive component of the cardiac transient outward current that is observed in native cardiac myocytes and thus may serve as one molecular substrate for this current.

Animals↗

Comparison of controlled-release ketoprofen and diclofenac in the control of post-surgical dental pain.

Preoperative treatment with controlled-release ketoprofen or diclofenac was compared in 56 out-patients, for control of postoperative dental pain, following unilateral or bilateral surgical removal of lower third molars. Six patients were excluded due to non-compliance, leaving 50 evaluable patients. Patients were assessed by the dental surgeon, on the day of the operation and one week later, prior to removal of sutures. Additionally, patients completed a daily diary during the postoperative week. Following surgery, scores for graded dental pain, consumption of paracetamol, incidence of dental bleeding, dysphagia, sleep disturbance and trismus were similar for the two treatment groups. However, median pain scores were consistently elevated in the diclofenac group over those seen with the ketoprofen group. The four adverse events reported were all minor and posed no problem to patient management.

Adult↗

Triage and equality: an historical reassessment of utilitarian analyses of triage.

We distinguish and review aspects of the history of two models of triage: egalitarian and utilitarian. Egalitarian triage is widely and successfully practiced in battlefield medicine, as well as in the emergency room and the ICU. Utilitarian triage has been sporadically practiced and typically collapses under the pressure of public scrutiny. Unfortunately, the two models tend to be conflated, confusing our understanding of the past and confounding our ability to plan for the future.

Emergency Service, Hospital↗

General practice in Gloucestershire, Avon and Somerset: explaining variations in standards.

Variations in standards are found in all health services. The method and amount of funding are thought to be important reasons for these variations. A cross sectional survey of all general practices in three counties in south west England was undertaken in order to explain variations in the level of development. A development score for each practice was calculated. There was wide variation in standards as described by the level of development. Multiple regression analysis showed that being a training practice, having a practice manager, the partners having a younger mean age, a larger total number of patients registered with the practice and a lower Jarman underprivileged area score were all independently related to a higher level of practice development. In addition, the responsible family health services authority was also related to the level of development. A combination of professional factors such as the decision to become a training practice, environmental factors such as the family health services authority or the underprivileged area score and economic factors reflected in the total list size determine the level of practice development. The most easily corrected factor is the employment of a practice manager. It is suggested that differences in standards in general practice may be increased rather than decreased by the fundholding scheme.

Cross-Sectional Studies↗

Behavior of cat abducens motoneurons following the injection of toxic ricin into the lateral rectus muscle.

The aim of this investigation was to study the behavior of identified abducens motoneurons in the chronic cat following a single injection of toxic ricin into the lateral rectus muscle. Lateral rectus electromyographic potentials induced by VIth nerve stimulation disappeared, and abducens antidromic field potentials decreased by 90% 3 days following ricin injection. Several abnormalities and a significant decrease in eye position and velocity sensitivities were observed in motoneuron activity up to 8-10 days following ricin injection. Contrary to a previous report for axotomized abducens motoneurons, no functional sign of recovery was observed. Histological analysis showed a survival of 10-15% of the abducens motoneuron population 10 days following ricin injection. From this time on, recorded motoneurons behaved like controls, but showed a specific retraction signal suggesting an exclusive projection onto the retractor bulbi muscle. Although intermingled in the nucleus with motoneurons, no recorded abducens internuclear interneuron was affected by the ricin during one month following the injection.

Abducens Nerve↗

Micronuclei in mouse skin cells following in vivo exposure to benzo[a]pyrene, 7,12-dimethylbenz[a]anthracene, chrysene, pyrene and urethane.

Detection of micronuclei (MN) in skin cells from HRA/Skh hairless mice treated with chemical or physical agents may prove informative in qualitative and quantitative studies of skin carcinogenesis. MN induction and cell survival were estimated in cytokinesis-blocked keratinocytes, cultured for 4 days in vitro, after a single topical dose of various organic compounds. Treatment with 2.56 micrograms (10 nmol) 7,12-dimethylbenz[a] anthracene (DMBA) resulted in maximal MN induction in cells removed from skin 12-24 hr after topical administration (79-88 MN/1,000 cells compared with 10-16 MN/1,000 cells in acetone-treated controls). Even in cells removed only 1 hr after DMBA treatment, a significant increase in MN was evident. However, to allow sufficient time for metabolic activation, a sampling time for of 24 hr was adopted for all test substances. Dose-dependent increases in MN were observed with DMBA, benzo[a]pyrene, chrysene, and urethane. Increased numbers of micronucleated cells were detected at the lowest doses administered in the present study (0.128, 0.5, 50, and 50 micrograms, respectively). Although reduced cell recovery occurred following exposure of mice to acetone, pyrene, and other chemicals, there was no evidence that cytotoxicity contributed to MN scored in keratinocytes. Moreover, the probable noncarcinogen, pyrene, failed to induce MN at doses from 2.5 micrograms to 2.5 mg/mouse. These results show that it is possible to assess chemical exposure in skin by measuring cell survival and skin genotoxicity by measuring MN induction in cultured keratinocytes. The available data suggest that MN induction may be a useful indicator of the carcinogenic potential of chemicals applied to the skin.

9,10-Dimethyl-1,2-benzanthracene↗