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Biomedical subjects

R Dodds

Publications and source records attributed to R Dodds.

At least 19 recordsLinked to original sources
PubMed2006

Incidence of trampoline related pediatric fractures in a large district general hospital in the United Kingdom: lessons to be learnt.

AIM: To test the observation that the incidence of trampoline related pediatric fractures is increasing-both nationally and in a large district general hospital. METHOD: A retrospective analysis was undertaken of patient records establishing mechanism of injury of pediatric fractures over three consecutive summers from 2000-03. Theatre records of fractures treated operatively were used as the initial data source. RESULTS: A statistically significant increase in trampoline related injuries was discovered. This reflects the rising incidence of injuries from national data and furthermore corresponds to the growing popularity of domestic use trampolines in the UK. CONCLUSION: The incidence of injuries is increasing. There are lessons to be learnt from existing work from countries where trampoline prevalence has been greater for longer. The authors recommend various safety measures that may reduce children's injuries.

Child↗
PubMed1999

Antiretroviral therapy in HIV infection: are we using resources appropriately and cost effectively?

The provision of antiretroviral therapy to HIV-positive patients attending the Department of Genitourinary Medicine at the Royal Infirmary of Edinburgh was assessed, to examine whether clinicians were offering treatment in line with the departmental protocol. A total of 195 patients attended in 1998, of whom 169 fulfilled the protocol criteria for treatment. Although only 115 of these were on therapy, no patient who fulfilled treatment criteria and wished to be treated was denied treatment. Of the 26 patients not fulfilling any treatment criteria, 9 had transferred in from another unit already on treatment. The remaining 17 were not on treatment.

Anti-HIV Agents↗
PubMed1999

Cathepsin K knockout mice develop osteopetrosis due to a deficit in matrix degradation but not demineralization.

Cathepsin K is a cysteine protease expressed predominantly in osteoclasts. Activated cathepsin K cleaves key bone matrix proteins and is believed to play an important role in degrading the organic phase of bone during bone resorption. Mutations in the human cathepsin K gene have been demonstrated to be associated with a rare skeletal dysplasia, pycnodysostosis. The degree of functional activity of the mutated forms of cathepsin K in these individuals has not been elucidated, but is predicted to be low or absent. To study the role of cathepsin K in bone resorption, we have generated mice deficient in the cathepsin K gene. Histologic and radiographic analysis of the mice revealed osteopetrosis of the long bones and vertebrae, and abnormal joint morphology. X-ray microcomputerized tomography images allowed quantitation of the increase in bone volume, trabecular thickness, and trabecular number in both the primary spongiosa and the metaphysis of the proximal tibiae. Not all bones were similarly affected. Chondrocyte differentiation was normal. The mice also had abnormalities in hematopoietic compartments, particularly decreased bone marrow cellularity and splenomegaly. The heterozygous animals appeared normal. Close histologic examination of bone histology revealed fully differentiated osteoclasts apposed to small regions of demineralized bone. This strongly suggests that cathepsin K-deficient osteoclasts are capable of demineralizing the extracellular matrix but are unable to adequately remove the demineralized bone. This is entirely consistent with the proposed function of cathepsin K as a matrix-degrading proteinase in bone resorption.

Animals↗
PubMed1999

Supporting breastfeeding of babies in neonatal units.

Breastmilk is invaluable for premature and sick babies. Recognition of the unique qualities of breastmilk has led to increasing encouragement to women to express breastmilk for their babies, if they are unable to feed directly from the breast. The National Childbirth Trust (NCT) had become increasingly concerned about the shortcomings in some areas in the practical and professional support available to women wanting to breastfeed when their babies are in neonatal units. The NCT therefore funded an investigation of the provision of facilities to express breastmilk in hospitals, including the availability of electric breast pumps for loan to mothers at home. We found that facilities for mothers in hospital were patchy, with only a third of neonatal units providing a separate room where mothers could express breastmilk or breastfeed in private. More than half the units on which we collected information had no specialist breastfeeding professional available. A quarter of units loaned out free electric breast pumps and a further 28% were able to provide some free breast pumps. 24% of hospitals did not provide any pumps to mothers who needed to express breastmilk at home while their babies were in hospital.

Adult↗
PubMed1997

Induction and expression of human cartilage glycoprotein 39 in rheumatoid inflammatory and peripheral blood monocyte-derived macrophages.

Human cartilage glycoprotein 39 (HC gp-39) has been described as a major secreted product of cultured articular chondrocytes, synovial fibroblasts, and the osteosarcoma line MG63. However, its expression in these cells types has not been directly linked to corresponding cell types in vivo. In this report, expression of HC gp-39 is demonstrated from peripheral blood-derived macrophages in association with their differentiation from monocytes to macrophages. Consistent with macrophage specificity, HC gp-39 expression is also induced upon selective stimulation of the pluripotent promyelocytic leukemia cell line HL-60 toward the monocyte/macrophage lineage with vitamin D3 or phorbol 12-myristate 13-acetate (PMA), while treatments stimulating granulocyte and eosinophilic pathways do not induce expression. Furthermore, HC gp-39 expression levels correlate with the degree of morphological differentiation induced by PMA and vitamin D3 treatments. PMA-induced mRNA expression occurs by 36 h and is a secondary transcriptional response since its synthesis is inhibited by cycloheximide. Apparently, HC gp-39 expression is tied to later events in the differentiation of monocytes into macrophages. The in vivo significance of these results is validated by the in situ detection of HC gp-39 mRNA in inflammatory macrophages associated with rheumatoid synovium. Thus, macrophages appear to be an important source of HC gp-39, which has been shown to be present at elevated levels in the blood and synovium of rheumatoid arthritis patients. The implications of this extend well beyond the previously restricted observations in cell types associated with the joint and suggest a potential involvement of macrophage-derived HC gp-39 in other aspects of inflammation, tissue remodeling, and host defense.

Adipokines↗
PubMed1996

Management of lung cancer in South East Scotland.

BACKGROUND: There are few reports which describe the management of unselected groups of patients with lung cancer. This study was undertaken to audit prospectively the presentation, diagnosis, management, and outcome of patients presenting with lung cancer in South East Scotland. METHODS: Data were recorded on all patients with newly diagnosed lung cancer who presented to a multidisciplinary group of clinicians over a 12 month period. Subsequent follow up data on treatment and survival were collected. RESULTS: Six hundred and twenty two patients were registered, 80% of whom were referred from primary care. There was a considerable variation in the length of history, but the diagnosis was rapidly made after referral (87% within two weeks). In 82% of patients the pathological examination was positive; 70% were treated with palliative intent. Only 36% of patients who underwent surgery had computed tomographic scanning and 55% had sampling of mediastinal nodes. A wide variety of regimens was used for treatment with radiotherapy and chemotherapy, and follow up data were difficult to obtain in these patients. Survival was poor in all patients treated with palliative intent. CONCLUSIONS: This audit confirms the importance of previously noted prognostic factors. Significant variation in referral practice, diagnostic and management evaluation has been shown. The data serve as a useful background for the formation of local management guidelines.

Adult↗
PubMed1996

Low blood glucose--an NCT investigation.

Babies are being tested for hypoglycaemia and treated unnecessarily. Inaccurate blood glucose testing strips are still being used. In many units research evidence is not being followed. Differences in care between hospitals means that some babies are not receiving the most appropriate care. Mothers receive conflicting advice. Some health professionals do not have confidence in breast feeding. Formula milk is being given to breast fed babies, interfering with the establishment of lactation.

Bias↗
PubMed1993

Expression of osteopontin mRNA by osteoclasts and osteoblasts in modelling adult human bone.

Over recent years several non-collagenous matrix proteins of bone have been isolated and characterized. One of these proteins, osteopontin, has been shown to be synthesized by osteoblasts and deposited in the bone matrix where it is thought to bind to hydroxyapatite. However much of the functional evidence is circumstantial, and the precise function of osteopontin has not been fully elucidated. We have used in situ hybridization techniques to investigate the expression of osteopontin mRNA in a variety of human bone tissues. Cryostat sections of human osteophyte and osteoclastoma tissue were hybridized with an antisense RNA probe for osteopontin. Sense transcripts were used as a negative control to assess non-specific binding. There was a very distinct pattern of osteopontin mRNA expression in these tissues. Plump osteoblasts adjacent to the osteoid matrix expressed high levels of osteopontin mRNA, whilst flattened osteoblasts demonstrated weaker expression. The most striking feature of osteopontin mRNA expression was the high levels detected in osteoclasts. Osteoclasts in resorption lacunae and those distant from resorption sites both expressed osteopontin mRNA, suggesting that attachment was not a prerequisite for osteopontin expression. A population of mononuclear cells in resorption lacunae was also observed to express high levels of osteopontin mRNA. The whole population of osteoclasts in the osteoclastoma tissue expressed high levels of osteopontin mRNA, indicating that expression is not restricted to osteoclasts involved in bone resorption. This study confirms that human osteoblasts are capable of synthesizing osteopontin.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Protein intake and blood glucose as modulators of GFR in hyperfiltering diabetic patients.

Glomerular hyperfiltration has been claimed to be a risk factor for the development of diabetic nephropathy. Protein intake and hyperglycemia can both increase GFR in diabetic and normal subjects. Our study was designed to explore the relative importance of short-term changes in protein intake and glycemia on the modulation of renal hemodynamics in insulin-dependent diabetic (IDDM) patients with and without glomerular hyperfiltration. The renal hemodynamic response to a protein challenge was studied in eight hyperfiltering (HF) and eight normofiltering (NF) patients after a three week period of low or normal protein diet (LPD, NPD), each study being conducted twice, in random order, under conditions of prevailing hyperglycemia (H) and euglycemia (E). In HF patients GFR failed to increase significantly in response to protein challenge during NPD under conditions of either H or E (Baseline vs. 2 hr H: 151 +/- 4 vs. 155 +/- 6, NS; E 147 +/- 4 vs. 157 +/- 7 ml/min/1.73 m2, NS). A more normal response was restored following LPD with GFR increasing in all but one patient after challenge during H and in all patients during E (Baseline vs. 2 hr H: 130 +/- 7 vs. 145 +/- 8, P less than 0.07; E: 127 +/- 7 vs. 143 +/- 7 ml/min/1.73 m2, P less than 0.01). Changes in RPF paralleled the changes in GFR and filtration fraction remained stable under all study conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

The ability of deaf students to understand text. A comparison of the perceptions of teachers and students.

Sixteen deaf high school students and nine of their teachers, two deaf and seven hearing, were interviewed for their perceptions of the interest and difficulty of three types of text. Students read and retold the texts and reported on their use of metacognitive strategies and comprehension monitoring and assessment. In this paper, we compare the perceptions of the teachers and students. The teachers in this study underestimated the extent to which their students could comprehend independently, often based on insubstantial evidence. The text perceived to be most difficult by both teachers and students was also considered the most interesting to students, but not to teachers. This text also fostered the greatest use of a variety of metacognitive strategies, suggesting that difficult materials should not be avoided or simplified for deaf students.

Adolescent↗