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Biomedical subjects

R England

Publications and source records attributed to R England.

34 records · Page 2Linked to original sources
PubMed1992

Reassessment of lead exposure in New Jersey using GIS technology.

In order to prevent children's exposure to lead, a variety of sources must be controlled. The New Jersey Department of Environmental Protection and Energy (NJDEPE) is using its Geographic Information System to identify areas within Newark, East Orange, and Irvington, New Jersey, where there may be greater environmental exposure to lead. Sensitive populations are identified through the U.S. Bureau of the Census information. Blood screening data provided by the New Jersey Department of Health (NJDOH) provide reported patterns of elevated blood lead in the study area. Comparisons of these spatial patterns will assist the NJDEPE in its soil sampling activities and lead exposure research, will provide information for public education, and will provide valuable information on sections of the study area where further screening and public education may be needed.

Air Pollutants↗
PubMed1992

Quantitative analysis of Langerhans' cells in epidermis at irritant contact reactions using confocal laser scanning microscopy.

Confocal laser scanning microscopy (CLSM) was used for quantitative analysis of CD1a+ cells in epidermis at irritant reactions. Sodium lauryl sulphate (2% and 4%) or non-anoic acid (20% and 80%) were applied to the skin of healthy volunteers under occlusion for 24 h. Skin biopsy specimens were taken after additional 24 h and were snap frozen. Freeze-sections, 25 microns thick, were stained with anti-CD1a antibodies (Leu-6) followed by FITC-labelled rabbit anti-mouse IgG. The sections were viewed and optically sectioned in the CLSM at four depth levels. The data was analysed using a threshold value for the fluorescence. The obtained result is presented as the proportion of specimen area having a fluorescence intensity above the threshold. The result demonstrates that the CLSM is a useful tool for obtaining not only structural information but also quantitative information from a defined tissue volume. In the present investigation it was possible to demonstrate variations in CD1a+ reactivity in epidermis at detergent-induced irritant reactions with a marked decrease in CD1a+ after 80% non-anoic acid exposure and only minor differences in the CD1a+ after 2% and 4% sodium lauryl sulphate exposure.

Cell Count↗
PubMed1991

Pulmonary artery catheter introducers: do the component parts affect flow rate?

Arrow sheath introducers are useful during massive transfusion as well as during catheter insertion. However, each component (sheath, side port, and obturator/catheter) probably progressively impedes maximum flow. This study quantitates these flow changes. Six configurations (C) were tested: (C1) sheath; (C2) sheath, side port; (C3) sheath, side port, obturator; (C4) C3 with 1.5-in obturator; (C5) C3 with 0.25-in obturator; (C6) no components. Flow was measured five times with each configuration and compared. Flows (mL/min) (mean +/- SE) were: (C1) 838.1 +/- 11.2, (C2) 283.4 +/- 9.2, (C3) 149.9 +/- 7.9, (C4) 176.0 +/- 14.0, (C5) 232.5 +/- 5.5, (C6) 1030.5 +/- 11.6. Flow decreased progressively with C2 and C3 (P less than 0.0001). C4 did not increase flow, but C5 did (P less than 0.0001). C5 flow was comparable to C2 but less than C1 (P less than 0.0001). C6 flow was larger than any other configuration (P less than 0.0001). Flow increases in C2 and C5 over C3 and C4 were modest (25%-50%) compared with C1 (250%). Therefore, we do not recommend removing or cutting the obturator to improve flow. During massive transfusion, we recommend removal of the side port until smaller flows suffice.

Catheterization↗
PubMed1990

Synthesis and characterization of soluble dextran-adenosine phosphate complexes: kinetic effects of coenzyme loading.

Soluble dextran-ATP complexes have been synthesized using a bifunctional oxirane as the coupling agent. The degree of coupling is time-dependent, allowing materials of varying coenzyme loadings to be produced very simply. Characterization studies have shown that at the maximum coenzyme loading obtained (34 molecules per complex) all coenzyme moieties were coenzymically active with hexokinase. The extent of coenzyme loading was shown to have a considerable influence on the values of Km and Vmax of the complex as a substrate for hexokinase. Enzyme activity was also found with acetate kinase and myokinase, and coenzyme recycling (ATP, ADP) was demonstrated in an ultrafiltration reactor.

Acetate Kinase↗
PubMed1989

Do subjects with stiff arteries have high blood pressure?

It has been argued that age-related increases in arterial stiffness could lead to spuriously high indirect blood pressure measurements, with consequent overdiagnosis of hypertension in older patients. To study the relationship between arterial stiffness and blood pressure, we identified patients with 'arterial stiffness', using Osler's manoeuvre, and compared their blood pressure levels with patients of a similar age. A total of 250 hospital inpatients were assessed independently by two doctors. In the 198 patients (79%) where both observers agreed on Osler's manoeuvre status, positive Osler's manoeuvre was uncommon under the age of 50 years but became more common thereafter, rising to 58% of patients aged over 75 years. However, blood pressure levels were similar in each age group, irrespective of Osler's manoeuvre status. We conclude that increased arterial stiffness as measured by Osler's manoeuvre is not necessarily associated with raised blood pressure levels in the elderly.

Adolescent↗
PubMed1975

How barefoot? Next steps for the medical auxiliary.

The arguments for and against medical auxiliaries are over and interest must now shift to ways of maximising their effectiveness. An important issue is to what extent the findings of high-technology medicine can be successfully combined with the barefoot concept of delivery. An important question for the future is to what extent they can be applied by the individual to himself.

Community Health Workers↗
PubMedDate not supplied

Expandable metal stents for the palliation of malignant gastroduodenal obstruction.

PURPOSE: Gastric outlet obstruction is a debilitating complication of upper gastrointestinal malignancy. We present our experience with insertion of self-expanding metal stents (SEMS). METHODS: Twenty-eight patients were referred, stenting being attempted in 23. Two patients had esophageal Wallstents inserted through a gastrostomy; 21 had an endoscopic approach with enteral Wallstents. RESULTS: One stent insertion failed, ten patients (45%) returned to a normal diet, ten patients (45%) managed semi-solid food and two patients (9%) had no significant improvement. No immediate complications were seen. One patient subsequently developed pancreatitis. Reintervention (4 stents, 1 jejunostomy, 1 gastrojejunostomy) was required in six of 22 patients (27%) for inadequate stent expansion (1), second stricture (2), stent migration (1), and tumor ingrowth (2). The mean survival was 95.4 days (SD 78.8 days, range 3-230 days). The mean follow-up time was 98.9 days (SD 86.7 days, range 3-309 days). CONCLUSIONS: SEMS are effective in palliating malignant gastric outlet obstruction. A combined endoscopic/fluoroscopic approach allows the most complete assessment of the stricture and removes the need for gastrostomy insertion. Careful assessment of the gastrointestinal tract distal to the lesion is important.

Adult↗
PubMedDate not supplied

Musculosketal symptoms and non-REM sleep disturbance in patients with "fibrositis syndrome" and healthy subjects.

In sleep studies of (a) patients with the "fibrositis syndrome" and (b) healthy subjects undergoing stage 4 sleep deprivation, we observed in both groups the anomalous presence of alpha-rhythms in the non-rapid-eye-movement (NREM) sleep EEG. This phenomenon has been termed alpha-delta sleep. In the healthy subjects stage 4 deprivation was accompanied by the temporary appearance of muscoloskeletal and mood symptoms comparable to the symptoms seen chronically in the patients. It is suggested that the external arousing stimulus, which induced alpha-delta sleep in the subjects, is paralleled in the patients by an internal arousing mechanism. Such a mechanism, acting in competition with the NREM sleep system, would impair the presumed restorative function of NREM sleep and lead to the development of symptoms. It is proposed that the "fibrositis" symptom complex be considered a "non-restorative sleep syndrome". Evidence froms presented in support of the hypothesis that a disorder of serotonin metabolism serves as a basis for both the EEG sleep disturbance and the symptoms.

Adult↗
PubMedDate not supplied

Reporting of communicable diseases by university physicians.

Billing records from the outpatient clinics of the University of Arizona were compared to case reports of communicable diseases received by the local health department. Of 286 cases of reportable diseases found, 183 (64 percent) were reported to the local health department. Sexually transmitted diseases were more likely to be reported than other diseases [risk ratio (RR) = 1.97; 95 percent confidence interval (CI), 1.62-2.39]. Diseases of residents of Pima County were more likely to be reported than those of residents of other Arizona counties (RR = 1.40; 95 percent CI, 1.11-1.77), and diseases in Arizona residents were more likely to be reported than those of residents of other States (RR = 2.37; 95 percent CI, 1.35-4.15). Diseases of citizens of other countries were never reported. The only significant difference found among the specialty clinics of the medical center was that pediatricians reported less frequently than others (RR = 0.75; 95 percent CI, 0.58-0.98).

Ambulatory Care Facilities↗