Search PubMed⌕ Search

Biomedical subjects

R Briggs

Publications and source records attributed to R Briggs.

At least 19 recordsLinked to original sources
PubMed2006

Tranquilliser use as a risk factor for falls in hospital patients.

This study looked at associations of tranquilliser use and falls risk in a hospital population of confused and nonconfused patients. In a prospective observational study in a rehabilitation hospital for elderly patients, we followed 1025 consecutive patients. The number of fallers, recurrent fallers and total falls was recorded. Confused patients (p < 0.0001) and patients on tranquillisers (p = 0.001) were significantly more likely to fall than nonconfused patients and patients off tranquillisers. Confused patients on tranquillisers were significantly more likely to have recurrent falls (p = 0.026) when compared with confused patients off tranquillisers. The risk was apparent from admission, persisting throughout the first 30 days of stay. This was not noted for nonconfused patients. We identified a stratification of risk for falls with nonsignificant trends for confused and nonconfused patients on tranquillisers to be fallers and to have more falls compared with patients off tranquillisers. These data are associational and do not necessarily imply causality. There is however no evidence to recommend the routine withdrawal of tranquillisers from all patients. Any future research needs to include confused patients.

Accidental Falls↗
PubMed2005

Paraganglioma: the role of genetic counselling and radiological screening.

Paragangliomas are rare tumours of the autonomic nervous system that occur in both sporadic and hereditary forms. They are usually benign tumours with low mortality, but can cause significant morbidity related to mass effect. Genetic predisposition to develop paraganglioma can occur within known tumour syndromes and familial tumours tend to present at a younger age and at multiple sites compared to sporadic tumours. Tumours should be diagnosed and excised as early as possible, as studies have shown morbidity to be directly related to tumour size. We present a case of a 14-year-old boy with multiple paraganglioma and a strong family history of paraganglioma. He suffered significant morbidity at resection of an extra-adrenal retroperitoneal tumour due to late diagnosis and was later unable to undergo excision of a head and neck paraganglioma due to its size and relation to neurovascular structures in the neck. We review the current literature on suggested genetic counselling (psychological counselling and DNA analysis) and radiological screening guidelines and recommend that genetic counselling should be offered to all patients with a family history of paraganglioma from the age of 5 years. Those positive for paternal paraganglioma locus gene should then undergo regular radiological screening with MRI.

Adolescent↗
PubMed2005

The relationship of falls to injury among hospital in-patients.

The need to reduce falls is driven by the need to reduce injury. If patients at risk of injury can be distinguished from the patients at risk of falls, there is the potential for a more effective fall risk management policy by targeting injury prevention measures. We conducted a prospective observational study, with blinded endpoint evaluation of 825 consecutive patients admitted to geriatric rehabilitation wards. We identified 150 fallers (18.2%) contributing 243 falls. Fifty-six patients sustained an injury contributing 73 (30.0%) injurious falls. Only five (6.8%) falls resulted in injury of major severity. We identified no significant differences in demographics between injurious and non-injurious falls. A logistic regression analyses of the independent risk factors of suffering an injurious fall were a history of falls (p=0.036), confusion (p=0.001) and an unsafe gait (p=0.03). However, we identified no significant differences in clinical characteristics between patients suffering injurious and non-injurious falls. None of the characteristics studied can identify patients prone to injury after a fall. Injury is largely unpredictable, and more research is needed to determine how injury can be prevented in patients at risk of falls.

Accidental Falls↗
PubMed2005

TEM/AFM investigation of size and surface properties of nanocrystalline ceria.

A series of ceria nanoparticles were synthesized by using a microemulsion method. The effect of relative concentration of surfactant/water on the size and the surface roughness of ceria nanoparticles was examined using transmission electron microscopy (TEM) and atomic force microscopy (AFM) respectively. The investigation confirmed a relationship between the size and the roughness properties of the nanoceria as a function of the water to surfactant ratio. With increasing dilution of the surfactant, the size distribution became narrow such that average particle size decreased linearly as the ratio increased without affecting lower size threshold of particles (approximately 10 nm). The surface roughness, on the other hand was found to increase with increasing water to surfactant ratio implying diluted surfactant would provide rougher surface of ceria nanoparticles. The information can be used to tailor the adhesion properties of nanoceria by optimizing the size distribution as well as surface roughness as a function of water to surfactant ratio.

Ceramics↗
PubMed2004

Serum ovalbumin-specific immunoglobulin G responses during pregnancy reflect maternal intake of dietary egg and relate to the development of allergy in early infancy.

BACKGROUND: The value of allergen elimination diets during pregnancy for primary prevention of infant allergy has been questioned. However, dietary compliance may influence effectiveness. OBJECTIVES: To monitor egg intake during a randomized controlled trial of egg avoidance throughout pregnancy and lactation by serial measurements of serum ovalbumin (OVA) IgG concentration in conjunction with dietary diary record and also, to analyse specific IgG concentrations at birth in relation to infant allergic outcome. METHODS: Pregnant women, with personal or partner atopy, were randomized to complete dietary egg exclusion or an unmodified healthy diet before 20 weeks gestation. The infants were evaluated for atopy at 6 months of age. Serum food-specific IgG concentrations were determined by ELISA in maternal samples collected at study recruitment and during labour, and in infant samples at birth (umbilical cord). RESULTS: Serum-specific IgG to OVA, but not the unrelated allergen, cow's milk beta-lactoglobulin, decreased over pregnancy in egg-avoiding women only (P<0.001). Cord OVA IgG concentration correlated with maternal IgG at delivery (r=0.944; P<0.001), and for infants born to atopic women, cord concentration was higher than that of their mother's (P<0.001). Infants with the lowest and highest cord IgG concentrations were the least likely, and those with mid-range concentrations were the most likely, to be atopic by 6 months of age (P=0.008). CONCLUSION: Serum OVA IgG concentration reflects egg consumption, thereby indicating dietary allergen doses to which the developing immune system might be exposed. Trans-placental maternal IgG must be considered among early life factors that regulate infant atopic programming.

Adult↗
PubMed2003

Somatization among older primary care attenders.

BACKGROUND: The importance of somatization among older primary care attenders is unclear. We aimed to establish the prevalence, persistence and associations of somatization among older primary care attenders, and the associations of frequent attendance. METHOD: One hundred and forty primary care attenders over 65 years were rated twice, 10 months apart, on measures of somatization, psychiatric status, physical health and attendance. RESULTS: The syndrome of GMS hypochondriacal neurosis had a prevalence of 5% but was transient. Somatized symptoms and attributions were persistent and associated with depression, physical illness and perceived poor social support. Frequent attenders (top third) had higher rates of depression, physical illness and somatic symptoms, and lower perceived support. CONCLUSION: Somatization is common among older primary care attenders and has similar correlates to younger primary care somatizers. Psychological distress among older primary care attenders is associated with frequent attendance. Improved recognition should result in benefits to patients and services.

Aged↗
PubMed2002

Polymorphism of the IGF2 gene, birth weight and grip strength in adult men.

BACKGROUND: Grip strength is a simple measure of skeletal muscle function but a powerful predictor of disability, morbidity and mortality. Recent evidence has shown that prenatal and infant growth influence grip strength in later life; this may reflect genetic influences on muscle size and function, although strong candidate genes have not been identified. IGF II has proliferative effects in adult muscle and is one of the major determinants of fetal growth; polymorphism in the IGF2 gene could therefore link early growth to adult grip strength. OBJECTIVES: To determine whether polymorphism of the IGF2 gene influences adult grip strength and mediates the association between size at birth and grip strength in later life. METHODS: Polymorphism of the ApaI marker in the IGF2 gene was determined for 693 Hertfordshire men and women born between 1920 and 1930 who had taken part in a study linking early growth to ageing. Grip strength was measured using isometric dynamometry. Genotyping assay development was undertaken in Southampton Genetic Epidemiology Laboratories (http://www.sgel.humgen.soton.ac.uk). RESULTS: In univariate analyses, IGF2 genotype and birth weight were both significant predictors of adult grip strength in the men after adjustment for age and current height. Significant associations were not seen in the women. When IGF2 genotype and birth weight in men were studied simultaneously, both contributed significantly to grip strength after adjustment for age and adult height. CONCLUSIONS: These results show that polymorphism of the IGF2 gene and birth weight have independent effects on adult grip strength in men and suggest that IGF2 polymorphism does not explain the association between size at birth and grip in later life. This study provides preliminary evidence for independent genetic and early environmental programming of adult muscle strength.

Aged↗
PubMed2001

Sphenoid sinus mucocoele presenting as complete ophthalmoplegia.

Sphenoid sinus mucocoeles represent 1% of all paranasal sinus mucocoeles. We describe a case of a sinus mucocoele with an atypical presentation comprising the sudden onset of a complete ophthalmoplegia. There was good recovery following drainage of the mucocoele.

Aged↗
PubMed2001

Long-term care in rural West Virginia: managed care and future roles for the aging network.

The managed care movement emphasizes the rationalization of health care delivery through fixed price or capitation of service and the utilization of a preferred physician or health gatekeeper. These features are advanced as measures of cost control in health care delivery. This approach presents the aging network, established under the Older Americans Act, with a number of daunting challenges which are particularly acute to service providers in rural areas. How this network responds will determine its future efficacy in the delivery of health and long-term care services. This article examines these concerns among eight rurally based senior centers and two Area Agencies on Aging in Southern West Virginia. Issues of management capacity, present and future positioning, and receptivity to managed care are emphasized. These providers stand on the strengths of a long tradition of serving clients, knowledge of their needs and face-to-face interactions with them--capabilities managed care organizations do not have. However, little outreach to managed care in these areas has occurred.

Aged↗
PubMed1999

Do all systems age together?

BACKGROUND: Aging changes in different body system are well described, but few studies have considered the relationship between them. OBJECTIVE: The purpose of this study was, therefore, to investigate the interrelationships between markers of aging in different parts of the body. METHODS: A cross-sectional study design was used. Structural and functional markers of aging were measured in a number of different body systems. RESULTS: Conditional independence analysis demonstrated that the aging markers selected clustered into two groups, either related to chronological age or adult height. Visual acuity, lens opacity, hearing threshold, cognitive decline, and the number of teeth were associated with age, while systolic blood pressure and skin thickness were related to height. Grip strength was associated with both. CONCLUSIONS: The differential associations of the aging markers with chronological age and adult height suggest that different systems do not age together. This may have relevance for understanding what underlies aging, and these preliminary findings now require replication in other aging cohorts.

Aged↗
PubMed1999

Biochemical characteristics of beta-adrenoceptors in rats after an 18-day spaceflight (LMS-STS78).

BACKGROUND: To ascertain whether there was autonomic adaptation with the development of adrenoceptor hypersensitivity under microgravity, the biochemical properties of the beta-adrenoceptors were determined using (125I)iodocyanopindolol (ICYP) binding in rats flown for 18 d onboard the space shuttle. METHODS: This study was performed on heart and kidneys of 3 groups of 12 animals: the flight and 2 ground control (vivarium and AEM) groups. To distinguish the possible role of the corticosteroids, half of each animal group was bilaterally adrenalectomized (ADX rats) with an aldosterone and corticosterone supplementation while the other half was SHAM operated. RESULTS: The Scatchard analysis of the ICYP-binding in both organs revealed no significant alterations in the dissociation constant (Kd) and in the maximal binding capacity (Bmax) between SHAM flight and control groups. The Kd of the beta-adrenoceptors in the cardiac atria of the SHAM flight rats (74 +/- 5 pm) was significantly higher (p < 0.05) than in those of the ADX flight rats (60 +/- 3 pm) while the Bmax was nonsignificantly higher (1925 +/- 370 in SHAM flight rats vs. 1482 +/- 283 fmol x mg(-1) protein in ADX flight rats). No significant change was determined for the Bmax and Kd values in the kidneys of the ADX and SHAM flight rats. CONCLUSIONS: This work performed on animals did not show any obvious effect of microgravity on the beta-adrenergic function in the heart and kidneys. Inflight rodent sacrifice protocols should definitely ensure assessment of the influence of microgravity on the animals.

Adaptation, Physiological↗
PubMed1999

Hindlimb-suspension and spaceflight both alter cGMP levels in rat choroid plexus.

Effects of actual and simulated weightlessness on choroidal guanylate cyclase activity were evaluated by assaying the production of cyclic guanosine monophosphate (cGMP), a second messenger involved in mechanisms regulating the secretion of cerebrospinal fluid (CSF) in choroid plexus. Cyclic cGMP was measured, using radio-immunoassay, in choroidal extracts of hindlimb-suspended rats (HLS rats), adapted to an anti-orthostatic restraint for 30 min., or for 3, 9 or 14 days and after a 17-day spaceflight (Life and Microgravity SpaceLab experiment; LMS). Basal cGMP levels were slightly but significantly decreased in the first 30 min. of the HLS experiment, whereas they were significantly increased in rats adapted to longer anti-orthostatic restraints. LMS flight rats demonstrated a similar increase in the choroidal cGMP baseline. After natriuretic peptide stimulation, i.e. using ANP (atrial natriuretic peptide) or BNP (brain natriuretic peptide), choroidal cGMP contents were typically increased (by 1.5-2 times; p<0.05) in control rats (LMS and HLS experiments), but not significantly elevated in suspended rats, except for those adapted to HLS for 14 days. In these animals the ANP-dependent cGMP production was significantly increased (by about 3 times; p<0.005). The ANP- or BNP-dependent responses were similarly abolished in LMS flight rats, which were dissected 4-6 hours after return to Earth's gravity. The role of corticosteroids was also investigated during the LMS experiment. Results on choroidal functions revealed a lack of significant change of cGMP levels between adrenalectomized and sham-operated rats. For the first time, it is reported that both basal and ANP- stimulated cGMP levels are dramatically changed over the first 14 days of suspension, i.e. with experiments known to simulate some effects of weightlessness. Basal choroidal cGMP levels are also increased after 17 days in space, suggesting that space adaptation also impacts choroidal guanylate cyclase activities. However, the absence of ANP-dependent cGMP increase, observed in LMS flight animals, suggests that HLS could not simulate all the spaceflight effects. Thus, these preliminary results seem to show that a natriuretic peptides-independent s stem is involved in choroidal adaptation to spaceflight.

Adaptation, Physiological↗
PubMed1998

A methodologic issue for ophthalmic telemedicine: image quality and its effect on diagnostic accuracy and confidence.

BACKGROUND: The possibility of ophthalmic telemedicine raises questions as to the quality of images displayed on a video display terminal and its effect on a doctor's accuracy and confidence of diagnosis. This study compares diagnostic accuracy and confidence levels of subjects observing two formats of retinal imaging. METHODS: Test images included 90 conventional 4- x 6-inch retinal fundus photographs and the same set of photographs after they had been scanned, digitized, modified in brightness and contrast, and displayed on a video display terminal. Fifty-six of the images demonstrated one or more retinal anomalies; the remaining 34 were of normal fundi. Abnormalities were selected on the basis of estimates of prevalence in the general population. Twenty optometrists affiliated with the Southern California College of Optometry participated as subjects. One group of 10 was shown the photographs; the remaining ten subjects were shown the digitized images. Both groups were asked if the pictures were "healthy" or "unhealthy," how confident they were of their decision, and, if abnormal, what was the ocular disease. RESULT: T-tests were used to compare the results of the two groups. There was a statistically significant difference in the confidence of a specific diagnosis between the two groups (p = 0.018), as well as tendencies toward significance on other measures. CONCLUSION: Viewing digitally reconstructed photographic images of the retina on a video display caused doctors to lose confidence in making a diagnosis before they lost accuracy.

Adult↗
PubMed1997

Conventional haemofiltration during routine coronary bypass surgery.

The use of conventional ultrafiltration during cardiopulmonary bypass (CPB) has been well recognized as an efficient modality of therapy to reverse the effects of deliberate haemodilution. Routine use of the haemofilter was prospectively studied on 60 patients undergoing coronary artery bypass surgery. Group A consisted of 30 patients on whom the ultrafiltrator was used and compared to group B who did not receive the ultrafiltration technique. The COBE 1200 ultrafiltration device was used. The results of the study demonstrated that, in group A, the mean total amount of ultrafiltrate collected during bypass was 2510 +/- 804 ml per patient. The mean 24-h postoperative blood loss was 440 +/- 192 ml in group A and 451 +/- 136 ml in group B. The average bank blood transfused was 0.6 +/- 1.3 units per patient in group A and 0.75 +/- 1.5 units per patient in group B. Postoperative weight gain in group A averaged 3.5 +/- 3.45 lb per patient, compared to 4.8 +/- 3.7 lb per patient in group B. Postoperative length of stay averaged 6.4 +/- 1.5 days per patient in group A and 6.4 +/- 2.1 days per patient in group B. Overall patient charges averaged $33,706 +/- 8348 per patient in group A and $33,041 +/- 7674 per patient in group B. It was concluded that routine use of ultrafiltration during routine coronary artery bypass surgery with CPB offers no improvement in the quality of care nor does it decrease the patient's overall charges.

Blood Cell Count↗
PubMed1996

Postoperative incision complications after cesarean section in patients with antepartum syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP): does delayed primary closure make a difference?

OBJECTIVE: Our purpose was to evaluate wound complications between patients with antepartum HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome with primary closure versus delayed closure and Pfannenstiel versus midline skin incisions. STUDY DESIGN: Medical records of patients with antepartum HELLP syndrome undergoing cesarean section were examined for type and timing of skin closure: Pfannenstiel versus midline skin incision and primary versus delayed closure. The immediate (before hospital discharge) and late (2-week postoperative check) wound complications were analyzed with respect to timing of wound closure and type of skin incision. RESULTS: A total of 104 patients were identified; 75 had a primary skin closure and 29 had a delayed closure 48 to 72 hours postoperatively. Immediate wound complications (wound infection, hematoma), occurred in 18 (26%) patients who had primary closure versus 8 (24%) who had a delayed closure, odds ratio 1.13 (95% confidence interval 0.39 to 3.27). A late wound breakdown was seen in only 1 patient with primary closure but in none with delayed closure. There were no fascial wound dehiscences. No statistical difference in wound complication was found between midline (primary, delayed) and Pfannenstiel (primary, delayed) incisions, odds ratio 0.65 (95% confidence interval 0.23 to 1.88). CONCLUSION: In women with antepartum HELLP syndrome delivered by cesarean section the frequency of wound complications is not influenced by type of skin incision or time of skin closure (primary or delayed).

Adult↗
PubMed1994

Interferon alpha selectively affects expression of the human myeloid cell nuclear differentiation antigen in late stage cells in the monocytic but not the granulocytic lineage.

The human myeloid cell nuclear differentiation antigen (MNDA) is expressed constitutively in cells of the myeloid lineage, appearing in myeloblast cells in some cases of acute myeloid leukemia and consistently being detected in promyelocyte stage cells as well as in all later stage cells including peripheral blood monocytes and granulocytes. The human myeloid leukemia cell lines, HL-60, U937, and THP-1, express similar levels of immunochemically detectable MNDA. Although, the level of MNDA mRNA in primary monocytes is very low it was up-regulated at 6 h following the addition of interferon alpha. The effect of interferon alpha on the MNDA mRNA is also observed in the cell lines HL-60, U937, and THP-1. The MNDA mRNA level in primary granulocytes was unaffected by addition of interferon alpha and other agents including interferon gamma, endotoxin, poly (I).poly (C), and FMLP. The MNDA mRNA level in the myeloid cell lines was also unaffected by the latter four agents. Induction of differentiation in the myeloid cell lines with phorbol ester induces monocyte differentiation which was accompanied by a decrease in MNDA mRNA level. This reduced level of mRNA could then be elevated with subsequent interferon alpha treatment. The effects of phorbol ester on MNDA mRNA appeared to be associated with induced differentiation since inhibiting cell proliferation did not alter the level of MNDA mRNA and cell cycle variation in MNDA mRNA levels were not observed. The ability of interferon alpha to up-regulate MNDA mRNA in phorbol ester treated myeloid cell lines is consistent with the observations made in primary monocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens, Differentiation, Myelomonocytic↗