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Biomedical subjects

R Beard

Publications and source records attributed to R Beard.

At least 19 recordsLinked to original sources
PubMed2005

Cyclooxygenase-1 gene polymorphisms in patients with different asthma phenotypes and atopy.

Cyclooxygenase-1 (COX-1) regulates the biosynthesis of prostaglandins, which are important mediators in asthma. The possible association of COX-1 gene polymorphisms with asthma has not been investigated. The allele frequencies of 20 COX-1 polymorphisms were determined in a random Australian Caucasian population using MassARRAY technology. Informative and potentially functional promoter (c.8592C > T, c.1676C > T) and coding region (c.22C > T, c.50C > T) polymorphisms were investigated in carefully phenotyped patients with mild (n = 316), moderate (n = 241), severe (n = 86) or aspirin-intolerant asthma (AIA) (n = 58), and in nonasthmatic subjects (n = 477). There were no allelic, genotypic or haplotypic associations between these four polymorphisms and asthma or asthma severity. Over-representation of the c.50TT genotype among AIA patients (3.4%) compared with aspirin-tolerant patients (0.8%), and a global haplotype association with AIA did not reach statistical significance. The c.22TT genotype was less frequent among atopic (0.1%) rather than nonatopic individuals (1.2%; odds ratio = 9.05, 95% confidence interval 1.01-81.29). In conclusion, the present investigation of cyclooxygenase-1 polymorphisms in asthma indicates that they do not appear to play a substantial role in genetic pre-disposition for asthma or asthma severity. However, the c.22TT genotype confers a small protective effect against atopy. Potential associations with aspirin-intolerant asthma were identified and warrant further investigation in a larger population of aspirin-intolerant asthma patients.

Adult↗
PubMed2004

Urinary leukotriene E4 and 9 alpha, 11 beta-prostaglandin F concentrations in mild, moderate and severe asthma, and in healthy subjects.

BACKGROUND: Airway inflammation in asthma is associated with cysteinyl leukotriene and prostaglandin D(2) production. Measurement of urinary metabolites of these eicosanoids may be useful for monitoring asthma patients. However, the influence of asthma phenotype and severity on basal urinary excretion of these metabolites is unknown. OBJECTIVE: To compare urinary leukotriene (LT)E(4) and 9 alpha, 11 beta-prostaglandin (PG)F(2) concentrations in large groups of mild, moderate and severe asthmatic patients and healthy control subjects. METHODS: Asthma severity, treatment and aspirin sensitivity were assessed by questionnaire in 168 asthmatic patients. Basal LTE(4) and 9 alpha, 11 beta-PGF(2) concentrations were measured in urine samples from these patients and from 175 control subjects using enzyme immunoassays. RESULTS: Urinary LTE(4) was correlated with 9 alpha, 11 beta-PGF(2) in both control subjects and asthmatic patients (P<0.002). Median LTE(4) and 9 alpha, 11 beta-PGF(2) concentrations in patients with severe asthma were significantly reduced compared with mild asthmatic patients (P<0.05 and <0.001, respectively). Urinary 9 alpha, 11 beta-PGF(2), but not LTE(4) was lower in asthmatic patients using inhaled corticosteroids (P<0.02). Multiple regression analysis indicated that urinary 9 alpha, 11 beta-PGF(2) concentration was negatively correlated with asthma severity (P=0.003) and also with % predicted FEV(1) (forced expiratory volume in 1 s) (P=0.005). CONCLUSIONS: Baseline urinary LTE(4) and 9 alpha, 11 beta-PGF(2) concentrations are of limited value in discriminating between patients with different severities of asthma. Reduced urinary LTE(4) and 9 alpha, 11 beta-PGF(2) in patients with severe asthma suggest that direct or indirect effects of high-dose corticosteroid therapy combined with other factors associated with severe asthma may influence eicosanoid production. However, the negative association of urinary 9 alpha, 11 beta-PGF(2) with lung function suggests an adverse effect of chronic PGD(2) production on lung function in asthma, irrespective of severity.

Adult↗
PubMed1995

Health, just world beliefs and coping style preferences in patients of complementary and orthodox medicine.

This study was designed to compare health and Just World Beliefs, coping style preferences and the mental health of a group of patients that utilize complementary medicine (CM), a group that exclusively use orthodox medicine (OM) and a mixed group who use both. Each participant filled out a questionnaire consisting of four sections: a measure of health beliefs which attributed certain factors to the state of their current health and to their capacity to become healthier in the future; a measure of the extent of their Belief in a Just World; a measure of coping style preference when faced with a threatening situation; and a measure of mental health. The results, co-varying out demographic factors, showed differences between the group yielded significant differences on the beliefs about future health, with the CM group scoring higher than the OM group. There were no differences in coping styles, Just World Beliefs or mental health between the three groups. The results were discussed in relation to explanations for differences in illness behaviour, specifically the reasons for choosing complementary therapies against orthodox therapies for the treatment of illness.

Adaptation, Psychological↗
PubMed1994

Comparative hospital databases: value for management and quality.

OBJECTIVES: To establish an accurate and reliable comparative database of discharge abstracts and to appraise its value for assessments of quality of care. DESIGN: Retrospective review of case notes by trained research abstractors and comparison with matched information as routinely collected by the hospitals' own information systems. SETTING: Three district general hospitals and two major London teaching hospitals. PATIENTS: The database included 3905 medical and surgical cases and 2082 obstetric cases from 1990 and 1991. MAIN MEASURES: Accessibility of case notes; measures of reliability between reviewers and of validity of case note content; application of high level quality indicators. RESULTS: The existing hospital systems extracted insufficient detail from case notes to conduct clinical comparative analyses for medical and surgical cases. The research abstractors at least doubled the diagnostic codes extracted. Interabstractor agreement of about 70% was obtained for primary diagnosis and assignment to diagnosis related group. These data were sufficient to create a comparative database and apply high level quality indicators designed to flag topics for further study. For obstetric-specific indicators the rates were comparable for abstractors and the hospital information systems, which in each case was a departmentally based system (SMMIS) producing more detailed and accessible data. CONCLUSIONS: Current methods of extracting and coding diagnostic and procedural data from case notes in this sample of hospitals is unsatisfactory: notes were difficult to access and recording is unacceptably incomplete. IMPLICATIONS: Improvements as piloted in this project, are readily available should the NHS, hospital managers, and clinicians see the value of these data in their clinical and managerial activities.

Data Collection↗
PubMed1994

1994 Architectural Design awards. Windemere Nursing & Rehabilitation Center, Martha's Vineyard; Harold & Patricia Toppel Center for Life Enhancement, Miami; Westminster Place, Oakmont, Pa.

At the 11th annual Architectural Design Awards, sponsored by Contemporary Long Term Care, the following projects were singled out for their innovative designs: New nursing home with 130 beds or less: Windemere Nursing and Rehabilitation Center on Martha's Vineyard. New nursing home with more than 130 units: Harold & Patricia Toppel Center for Life Enhancement, Miami, Fla. Renovated retirement center with 150 beds or less: Westminster Place, Oakmont, Pa. No awards were given in one nursing-home and three retirement-center categories. The competition was held on March 20 in the offices of Backen Arrigoni & Ross of San Francisco. Following is an overview of the competition and a narrative on each of the three entries honored for notable innovations in design.

Aged↗
PubMed1993

Management of the third stage of labour in women at low risk of postpartum haemorrhage.

OBJECTIVE: To compare active management with physiological management of the third stage of labour in women at low risk of postpartum haemorrhage. DESIGN: Randomised allocation of women in labour at low risk of postpartum haemorrhage to either physiological or active management of the third stage. SETTING: Labour ward in a district general hospital. PATIENTS: 193 Women with spontaneous vaginal delivery at term completed the study. Exclusion criteria were induction or augmentation of labour, antepartum or previous postpartum haemorrhage, premature rupture of membranes, previous caesarean section, raised blood pressure, cervical lacerations and third degree tears. INTERVENTIONS: Active management with syntometrine and controlled cord traction; or physiological management, where the cord was not clamped and the placenta was delivered by maternal effort. MEASUREMENTS: Blood loss was measured subjectively at delivery and estimated objectively by comparing the haemoglobin in labour with that on the third postpartum day. The duration of the third stage was also measured as was the incidence of retained placenta and blood transfusion. RESULTS: There was no significant difference in the estimated blood loss or haemoglobin drop between the two groups (P > 0.5). In addition the duration of the third stage was significantly longer in the physiological group (P < 0.001). Out of 90 women having physiological management, 7 received oxytocics for presumed postpartum haemorrhage. Only one case in the active group required further oxytocics and one other case in this group required a manual removal of placenta. CONCLUSIONS: This preliminary study confirms that active management results in a reduction in the length of the third stage of labour. However, it suggests that active management does not reduce blood loss when compared to physiological management in the woman at low risk of postpartum haemorrhage.

Delivery, Obstetric↗
PubMed1990

Chlamydia trachomatis in the fallopian tubes of women without laparoscopic evidence of salpingitis.

23 women with lower abdominal pain and Chlamydia trachomatis in the cervix, urethra, or both sites were studied. Laparoscopy was done with sampling of the endometrium and fallopian tubes for detection of C trachomatis. 11 women had laparoscopic evidence of pelvic inflammatory disease (PID); C trachomatis was detected in the upper genital tract of 8, but not in the upper tract of 5 who had laparoscopy again after treatment. The organism was also found in the upper genital tract of 9 of the 12 women without laparoscopic evidence of PID. Most of the women with abdominal pain or tenderness had tubal or endometrial C trachomatis infection, although only half had laparoscopic evidence of salpingitis. This finding suggests that antibiotic treatment should be given as soon as chlamydial infection is detected in the cervix and that pain does not necessarily point to C trachomatis in the upper genital tract. Laparoscopy may miss important pathogens in the upper genital tract, unless the procedure is complemented with detailed microbiological investigation.

Anti-Bacterial Agents↗
PubMed1989

HIV testing in antenatal clinics: the impact on women.

One hundred and fifty-five women attending antenatal clinics in an inner city area where the rate of AIDS reporting is high were interviewed to examine the acceptability of different modes and purposes of antenatal HIV testing. Eighty-two per cent of women felt the test should be available in antenatal clinics, but only 48% reported that they themselves would take the test. Seventy-four per cent would accept anonymous testing. Potential anxiety levels surrounding the HIV test were significantly higher than for other (currently routine) tests in antenatal clinics. The implications of these findings for policy are discussed.

AIDS Serodiagnosis↗
PubMed1989

Local oral immunization with synthetic peptides induces a dual mucosal IgG and salivary IgA antibody response and prevents colonization of Streptococcus mutans.

A small cell surface antigen of Streptococcus mutans was partially sequenced and the amino terminal peptides of 11, 15 and 20 amino acid residues and a dimer of the 15 and 20 residues peptides were synthesized. The synthetic peptides (SP) were used in topical oral immunization of the gingivomucosal epithelium of macaque monkeys. Sequential examination for antibodies over a period of up to 30 weeks revealed that six applications of the linear or cyclized SP11 and a random SP11 induced negligible or very low antibody levels. In contrast, the SP17 (SP15 with added cysteine at each terminus), SP21 (SP20 with one cysteine) and the dimer (SP35) induced significant anti-SP as well as anti-native streptococcal antibodies in the gingival fluid and in saliva. The functional significance of this immune response was examined by studying its effect on oral colonization of S. mutans following feeding of a carbohydrate-rich diet. Whereas control animals, sham-immunized with a random SP of 11 residues, showed increased colonization of the teeth by S. mutans, there was no colonization or a significant reduction in colonization of animals immunized with the cyclized SP17, linear SP21 or dimerized SP35. These experiments suggest that local immunization with SP derived from the sequences of a streptococcal cell surface antigen induce a dual local immune response of gingival IgG and salivary IgA antibodies against the SP and native SA. These antibodies may be involved in preventing colonization of S. mutans, which is the principal agent in the development of dental caries.

Animals↗
PubMed1988

Psychological and somatic factors in women with pain due to pelvic congestion.

Chronic pelvic pain in association with dilated pelvic veins and polycystic ovaries is a common complaint in women in the reproductive years, regardless of whether or not they have been pregnant. These women have a higher incidence of deaths and illnesses amongst family members and close relatives which makes them pay more attention to physical complaints such as pain which may make them more susceptible to environmental "stress" of daily life. A hypothesis is put forward which would link the effects of stress to the somatic changes observed in women with what is here described as the pelvic pain syndrome.

Adult↗
PubMed1985

An obstetric microcomputer information system.

A systems analysis has been done to determine how computer technology can provide an information system to improve the care of the mother and her baby. A minimum data base was established complying with the recommendations of the Körner Committee and designed to meet the needs of the health personnel looking after the mother and baby. An ICL DRS 20/50 network of four microcomputers has been installed in the obstetric unit of a district teaching hospital with a link to the regional mainframe. There have been no significant software or hardware faults since the system became fully operational in January 1984. All women are registered on the system at their first visit allowing the pregnancy to be followed prospectively. Subsequently midwives enter data on line at delivery and at discharge. The on line validation and range checks improves the accuracy of the data allowing a reliable perinatal audit to be obtained routinely. The system has been accepted by the staff since much of the routine pregnancy documentation is produced automatically. This includes booking letters and summaries for general practitioners, admission slips, birth notification forms, registers and forms for the community midwives and health visitors. Immediate production of reports for community health staff allows better communication and improved patient care. No additional staff are needed in the obstetric unit and one job which was mainly of a clerical nature has been saved and the salary transferred to provide one more midwife for the postnatal wards.(ABSTRACT TRUNCATED AT 250 WORDS)

Computers↗
PubMed1983

Dorsal column stimulation in multiple sclerosis: effects on bladder and long term findings.

The effect of dorsal column stimulation on bladder function in 15 patients with established multiple sclerosis was analysed by urodynamic tests. Significant improvement in flow rate and urethral sphincter pressure was recorded in about two thirds. Of 31 patients examined over five years only 13 showed initial benefit from stimulation and were given permanent stimulators; of these, only three appeared to receive lasting benefit. Early complications occurred in nine patients and five had a relapse of their disease. These results suggest that at present stimulation of the dorsal column does not have a place in the routine management of multiple sclerosis.

Adult↗
PubMed1982

Ultrasonic hyperthermia and drugs as therapy for human tumor xenografts.

Ultrasonic energy can generate controlled, local hyperthermia (42 degrees C--43 degrees C), and ultrasonic hyperthermia results in increased cytotoxicity of chemotherapeutic drugs for the treatment of cancer. Human breast (MX-1) and lung (LX-1) tumors implanted subcutaneously in athymic nude mice were treated with a single application of ultrasonic (670 kHz, peak intensity of 5 watts/cm2) hyperthermia (43.0 degrees C +/- 0.5 degrees C) for 30 minutes in combination with suboptimal doses of cyclophosphamide, melphalan, or procarbazine. Delays in the tumor growth rate and temporary tumor regression were observed. Comparison of the tumor growth rate with single modalities, ie, drug or hyperthermia alone, shows evidence of synergistic effects of the combination of ultrasonic hyperthermia and melphalan on MX-1 and of hyperthermia and procarbazine on LX-1 tumors.

Animals↗