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Biomedical subjects

R Crawford

Publications and source records attributed to R Crawford.

At least 73 records · Page 4Linked to original sources
PubMed1994

The effects of labor on maternal and fetal levels of insulin-like growth factor binding protein-1.

OBJECTIVE: Our purpose was to determine the effects of labor and fetal hypoxia on the levels of insulin-like growth factor binding protein-1 in the maternal and fetal circulation. STUDY DESIGN: Serum levels of insulin-like growth factor binding protein-1 were determined in maternal and umbilical blood at delivery in two groups. The first group included 43 vaginal deliveries and 23 elective cesarean sections. The second group consisted of 44 women; in 24 the liquor was meconium stained and in 20 it was clear. RESULTS: Levels of insulin-like growth factor binding protein-1 in the neonate were lower in deliveries occurring before onset of labor (p < 0.001), Mann-Whitney U test) and higher in cases with severe meconium staining (p = 0.01). There were no differences in maternal levels of insulin-like growth factor binding protein-1 between subjects in labor and not in labor or those with or without meconium staining. CONCLUSION: The process of labor leads to an increase in fetal levels of insulin-like growth factor binding protein-1. This increase may well be associated with the relative fetal stress that occurs during labor. This suggestion is supported by the finding of the highest levels in labors in which there was thick staining of the liquor.

Adolescent↗
PubMed1994

Gonadal tumors in disorders of sexual differentiation.

OBJECTIVE: To study the prevalence and distribution of gonadal tumors in patients with disorders of sexual differentiation. METHODS: Retrospective review of pathologic materials and clinical data on all patients diagnosed with mixed gonadal dysgenesis, pure gonadal dysgenesis, androgen insensitivity, and true hermaphroditism between 1982 and 1990. RESULTS: Twenty-one patients were identified and all underwent bilateral gonadectomy at the time of diagnosis. Nine of 21 patients had a gonadal tumor for a prevalence of 44 percent. Those at greatest risk for tumor were patients with mixed gonadal dysgenesis (6 of 11 patients) and pure gonadal dysgenesis (2 of 3 patients). There were four gonadoblastomas, two dysgerminomas, and one each of teratocarcinoma, seminoma, cystadenofibroma, and juvenile granulosa cell tumor. CONCLUSIONS: The high prevalence of gonadal tumors in children with mixed and pure gonadal dysgenesis warrants consideration of early, bilateral, prophylactic gonadectomy once the diagnosis is established with certainty.

Adolescent↗
PubMed1994

The boundaries of the self and the unhealthy other: reflections on health, culture and AIDS.

Most accounts of the cultural stigmas associated with AIDS have not adequately considered the meanings through which the stigmatizing self imagines his/her difference from the stigmatized other. This paper argues that 'health' is a key concept in the fashioning of identity for the modern and contemporary middle class and that the 'unhealthy' come to be represented as the other of this self. 'Healthy' and 'unhealthy,' however, must be understood both in their biomedical meanings and in their implicit metaphorical meanings. The 'unhealthy,' 'contagious,' 'sexually deviant,' and 'addicted-minority' other--all condensed in the negative symbolism of AIDS--have become images which are mobilized as part of a cultural politics of reconstructing the self in conformity with intensified mandates for self-control. The expulsion of 'unhealthy' meanings from the self, an act of patrolling the borders of identity, finds its projected physical location in the figure of the person with HIV-AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Regulation of steroid hydroxylase gene expression in the ovine fetal adrenal gland at 0.4 gestation.

This study was designed to test the hypothesis that ACTH from the fetal pituitary is a major regulator of adrenocortical steroid hydroxylase gene expression in the ovine fetus at 0.4 (60-70 days) of gestation. Pregnant ewes at 0.4 gestation received intravenous infusions of dexamethasone (0.76 mg/h, n = 13) for 48 h. The rationale for this regime was that some of the infused dexamethasone would cross the placenta and act on the fetal pituitary to suppress ACTH release. Control animals received infusions of saline (0.38 ml/h, n = 12) for 48 h. At the end of the infusion period, the animals were killed, umbilical vessel blood taken for ACTH and cortisol analyses, and the fetal adrenal glands taken for assessment of P-450scc, P-450(17 alpha) and P-450c21 levels using the techniques of hybridization histochemistry and RNase protection assay. Dexamethasone treatment decreased maternal and fetal concentrations of ACTH to 29 +/- 10 and < 20 pg/ml, respectively and cortisol concentrations to 3.5 +/- 0.6 and 3.2 +/- 0.8 nmol/l respectively. The adrenal glands from the dexamethasone-treated fetuses exhibited significantly lower levels of mRNA for P-450scc (11% of control) and P-450(17 alpha) (2% of control). These results suggest that ACTH is a major regulator of steroid hydroxylase gene expression and subsequent cortisol biosynthesis in vivo in the ovine fetus at 0.4 gestation.

Adrenal Glands↗
PubMed1994

Site-specific transgene insertion: an approach.

Methods to improve the production of transgenic animals are being developed. Conventional transgenesis, involving microinjection of DNA into fertilized eggs, has a number of limitations. These result from the inability to control both the site of transgene insertion and the number of gene copies inserted. The approach described seeks to overcome these problems and to allow single copy insertion of transgenes into a defined site in animal genomes. The method involves the use of embryonic stem cells, gene targeting and the FLP recombinase system.

Animals↗
PubMed1994

Pseudomonas aeruginosa bacteremia in immunocompromised children: analysis of factors associated with a poor outcome.

We identified 98 children and adolescents with cancer who were treated for Pseudomonas aeruginosa bacteremia over a 27-year period. The most common underlying disease was leukemia (lymphoblastic in 63 cases and myeloblastic in 17); in addition, 12 episodes were associated with solid tumors and 6 with other diagnoses. There were 29.5 episodes of P. aeruginosa bacteremia/1,000 cases of acute lymphoblastic leukemia, with a mortality of 27%, and 29.8 episodes/1,000 cases of acute myeloblastic leukemia, with a mortality of 24%; patients with solid tumors had an incidence of 5.0/1,000 cases and a mortality of 58% (P = .01 for mortality in leukemia vs. mortality in solid tumors, logistic regression analysis). Mortality was lower among children who developed bacteremia during remission therapy or induction therapy than among children who were being treated for relapse (P = .001). The majority (78%) of the 76 evaluated cases developed during periods when the absolute neutrophil count (ANC) was < 0.1 x 10(9)/L; mortality was higher among patients with such counts than among those with higher ANCs (36% vs. 14%, P = .04). Logistic regression analysis showed that perineal skin lesions were associated with higher mortality than were lesions at other sites of skin involvement (54% vs. 23%, P = .04).

Adolescent↗
PubMed1994

Influence of needle gauge in Mantoux skin testing.

STUDY OBJECTIVE: To determine the influence of needle gauge in Mantoux skin testing for tuberculosis. DESIGN: Randomized selection of either a 27- or 30-gauge needle for Mantoux skin test placement; observer-blinded. SETTING: Annual hospital employee screening. PARTICIPANTS: Six hundred twenty-five employees working in clinical and laboratory research environments. RESULTS: Blinded observers found that the use of 27-gauge needles caused increased bleeding and bruising compared with 30-gauge needles (p < or = 0.007 for each). However, the 27-gauge needle produced larger blebs and less leakage of tuberculin solution (p < or = 0.0003). CONCLUSION: Smaller gauge needles could potentially cause false-negative screening results because of decreased antigen delivery. Use of needle gauges smaller than 27 gauge should be avoided until their reliability is validated.

Evaluation Studies as Topic↗
PubMed1993

The management of dental problems presenting to an accident and emergency department.

Patients with dental diagnoses, not necessarily traumatic, often present to accident and emergency departments and general medical practitioners. Few doctors have received much, if any, education in the management of these patients. A 6 month prospective study revealed 107 patients (0.3% of new attenders) attending the accident and emergency department of Glasgow Royal Infirmary. Only 19 of these had suffered trauma. Medical staff in the department were only rarely able to make any diagnosis, and management of these patients took place on an empirical, symptomatic basis. Management could be improved by better education of medical students and doctors. Use of an algorithm may be appropriate.

Adolescent↗
PubMed1992

Urinary tract metastasis from renal carcinoma.

Five patients with urinary tract metastases from renal carcinoma are presented. In 4, urinary tract metastasis occurred in the absence of spread elsewhere. The initial presentation in 1 patient was ureteric obstruction; 3 others re-presented with haematuria and the fifth patient was diagnosed post mortem. Metastatic sites included ipsilateral ureter, contralateral ureter, ureteric stump, bladder and prostatic fossa. After previous nephrectomy for renal carcinoma, urinary metastases, although rare, should be considered and investigation of unexplained haematuria should include the ureteric stump. Useful palliation and possibly cure can be achieved by resection of these lesions.

Aged↗
PubMed1992

Intracardiac therapy following emergency thoracotomy in the accident and emergency department: an experimental model.

For a select group of patients with penetrating chest trauma, immediate thoracotomy in the accident and emergency department offers the only chance of survival. Foley catheters have been used to achieve haemostasis in cardiac wounds but are not widely used for intracardiac fluid and drug administration during resuscitation. In an anatomical model designed to assess this procedure an average flow rate of 275 ml min-1 was achieved. The equipment required is readily available and easily assembled.

Animals↗
PubMed1991

Trauma audit: experience in north-east Scotland.

The management of 125 patients with trauma treated at Aberdeen Royal Infirmary from 1 January 1988 has been analysed using a microcomputer-based hospital trauma registry incorporating trauma and injury severity scores (TRISS) methodology. These patients fulfilled the North American Major Trauma Outcome Study (MTOS) inclusion criteria and were the first for whom data were available. Sixty-six patients had multiple injuries, of whom 52 were suffering from major trauma (defined as an injury severity score of 16 or greater). There were 14 deaths in the series, three (21 per cent) of which were considered to be preventable. Surgery was required in 84 (67.2 per cent) patients, of whom 59 (70 per cent) were operated on by a consultant or senior registrar. Five of six critically injured patients who died from their injuries were operated on by a consultant.

Adolescent↗
PubMed1991

Evaluation of tartar control dentifrices in in vitro models of dentin sensitivity.

The effects of anticalculus dentifrices were compared with other commercially available dentifrices in in vitro models of dentin sensitivity. Changes in the hydraulic conductance of dentin discs were measured with and without a smear layer before and after treatment and also after a post-treatment acid etch. The capacity of dentifrices to occlude open dentinal tubules in vitro was also assessed by scanning electron microscopy (SEM). There was good correlation (R = 0.98) between our test and values reported in the literature. Tartar control dentifrices gave reductions in fluid flow rates through the dentin discs comparable to those obtained with Promise, Sensodyne, Thermodent and Denquel. Additionally, tartar control dentifrices did not remove microcrystalline debris (smear layers) from the surfaces of dentin in vitro. These results were confirmed by SEM. Thus, according to the hydrodynamic theory of dentin sensitivity, these in vitro results suggest that pyrophosphate-containing dentifrices should reduce dentinal sensitivity.

Dental Calculus↗
PubMed1990

Dermoid cyst of the scalp: intracranial extension.

Intracranial dermoids are rare and are usually associated with cutaneous scalp lesions. Five hundred forty-two scalp lesions were treated in a 22-year period, and were associated with intracranial lesions in three cases. High-risk cases can be identified by clinical and radiological features, confirmed by a computed tomography scan, and then referred for neurosurgical treatment.

Brain Neoplasms↗