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Biomedical subjects

R Horton

Publications and source records attributed to R Horton.

At least 397 records · Page 22Linked to original sources
PubMedDate not supplied

Conversion of dihydrotestosterone to androstanediol glucuronide by female sexual skin.

Sexual skin biopsies from 13 normal women were obtained and minces/3-h studied after adding either [3H]dihydrotestosterone (DHT) or [3H]androstanediol (3 alpha diol) to RPMI-1640 medium in a Dubnoff apparatus. Unconjugated or conjugated androgens (after hydrolysis) were purified by three chromatography steps. Formation of 3 alpha diol and 3 alpha diol glucuronide (3 alpha diolG) was linear with time. The conversion of DHT to DHT17 beta G was only 4.4 +/- 0.5%/200 mg/3 h, while conversion to 3 alpha diol was 32 +/- 1.7%. The back conversion of 3 alpha diol to DHT was 30 +/- 3% and conversion to 3 alpha diolG was 4.5 +/- 1.25%. The product of the conversion separately measured of DHT to 3 alpha diol and 3 alpha diol to 3 alpha diolG was 1.5%, which is not very different than the overall conversion rate of DHT to 3 alpha diolG of 1.4%. This study indicates that the predominant path in this tissue is DHT in equilibrium 3 alpha diol----3 alpha diolG, rather than formation of DHT17 beta G and then 3 alpha reduction to 3 alpha diolG.

Adult↗
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Ghana: defining the African challenge.

In 1957, Ghana became the first African nation to achieve independence from its colonial ruler. But since then Ghana has suffered mixed political and economic fortunes. The health of Ghana's people and the country's progress in modernising its health-care system have fluctuated according to peaks and troughs in West African history. Some critics see Ghana's course since independence as a promise unfulfilled. Others view Ghana as a model for North-South cooperation, which could be rolled out across the whole of Africa. In November, 2001, I visited hospitals and health centres in both rural and urban settings to investigate the present state of Ghanaian medicine. The picture I saw was one of a country clear about what it wants to do but divided about how it should achieve its goals. If Ghana is to be a model for Africa, it is more a model of problems to be faced than solutions discovered.

Academic Medical Centers↗
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The Wakley Prize.

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Awards and Prizes↗
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Data-proof practice.

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Clinical Trials as Topic↗
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Simulating conservative tracers in fractured till under realistic timescales.

Discrete-fracture and dual-porosity models are infrequently used to simulate solute transport through fractured unconsolidated deposits, despite their more common application in fractured rock where distinct flow regimes are hypothesized. In this study, we apply four fracture transport models--the mobile-immobile model (MIM), parallel-plate discrete-fracture model (PDFM), and stochastic and deterministic discrete-fracture models (DFMs)--to demonstrate their utility for simulating solute transport through fractured till. Model results were compared to breakthrough curves (BTCs) for the conservative tracers potassium bromide (KBr), pentafluorobenzoic acid (PFBA), and 1,4-piperazinediethanesulfonic acid (PIPES) in a large-diameter column of fractured till. Input parameters were determined from independent field and laboratory methods. Predictions of Br BTCs were not significantly different among models; however, the stochastic and deterministic DFMs were more accurate than the MIM or PDFM when predicting PFBA and PIPES BTCs. DFMs may be more applicable than the MIM for tracers with small effective diffusion coefficients (De) or for short timescales due to differences in how these models simulate diffusion or incorporate heterogeneities by their fracture networks. At large scales of investigation, the more computationally efficient MIM and PDFM may be more practical to implement than the three-dimensional DFMs, or a combination of model approaches could be employed. Regardless of the modeling approach used, fractures should be incorporated routinely into solute transport models in glaciated terrain.

Alkanesulfonic Acids↗
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Introducing high quality infection control in a hospital setting.

Hospital infection is a quality issue and as such has become an important topic in the current health care debate. Quality assurance and resource management are becoming integral to the measurement of nursing standards in clinical practice. Quality assurance is, in many ways, inseparable from effective infection control. This article outlines the development of such a high profile demonstration unit named Quality Infection Control (QIC) and discusses its strengths and weaknesses.

Hospitals↗
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Handwashing: the fundamental infection control principle.

This article examines the evidence linking handwashing practices with hospital-acquired infections, the basis for the selection of an appropriate handwashing agent, and ways in which health-care workers may be encouraged to comply with handwashing.

Cross Infection↗
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Infection control and the bedside nurse.

Safe infection control practice implies that caregivers have an insight into the factors that contribute to hospital-acquired infections which enables them to provide informed care and examine patient treatment outcomes. However, results of recent studies suggest that this is far from the case. This article examines why this area of nursing knowledge and practice has remained unquestioned and urges for an examination of how nurses are prepared for safe, informed infection control practice.

Humans↗
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Nurses' knowledge of infection control.

The article is based on a research study examining infection control in nurse education and practice. A survey of a large population was carried out to establish the perceived importance of microbiological knowledge to nurses and to ascertain whether this knowledge was present. The results suggest that although microbiological knowledge is considered necessary for safe infection control practice, nurses' actual knowledge falls far short of the level required for 'informed' practice. What this implies in relation to patient care, and recommendations regarding education and practice, are discussed.

Aged↗
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A brief educational intervention for patients with rheumatic disease chosen to be presented in a clinic conference.

Being presented in a case conference can be anxiety-provoking and intimidating for the patient. We observed that patients, at times, would show signs of apparent discomfort. A structured interview of the patient was designed to assess, address, and clarify concerns the patient might have beforehand. The patients' concerns were communicated to the staff. The structured interview was given to 31 patients before they were presented. An additional 14 patients were interviewed after the conference about their experience without the prior interview. One year later, we followed up by interviewing another 15 patients who had been selected for clinic conference cases. The structured interview revealed confusion on the patient's part about the purpose of the conference, and a desire for information about the physical setting and who would be there. Patients wanted to be introduced formally when entering the room and to be thanked when leaving, and preferred to be questioned directly about their symptoms. Of the 31 patients interviewed before the conference, 23 (74%) reported that the conference was a positive experience when questioned afterward, compared with only 9 of 14 (64%) of those who were not interviewed before the conference. The results of this study were presented to the clinic staff, and education of the patients was stressed as a primary responsibility. At the follow up, 12 of the 15 patients reported real understanding of the clinic conference purpose. The only patient who reported being uncomfortable with the clinic conference and unwilling to attend another was the only patient who reported not being informed about what the conference entailed. It can be too easy for medical staff to forget that what is routine to them is very unusual and can be very stressful to the patient.

Adult↗
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Dihydrotestosterone is a peripheral paracrine hormone.

Androgen action in sexual tissues, especially skin and the prostate, is expressed by dihydrotestosterone (DHT) acting at the nuclear level. Dihydrotestosterone in the circulation and target tissues is almost solely derived from the peripheral conversion of secreted testosterone (T) in men and androstenedione in women. The general pathway is testosterone----DHT in equilibrium with androstanediol (3 alpha diol). However, a number of studies suggest that blood DHT or 3 alpha diol are not reliable indicators of peripheral DHT formation. This is particularly suggested by discrepancies in the specific activity of DHT in blood and urine following infusion of labeled DHT, suggesting that total body DHT formation is not reflected by blood levels. Thus, DHT should be thought of as a paracrine hormone formed and acting primarily in target tissues. 3 alpha androstanediol glucuronide (3 alpha diol G) is a major metabolite of DHT. An important site of its formation is the skin. Levels in blood and urine are increased in hirsutism and acne, and blood levels closely parallel pubertal development. 3 alpha diol G levels are especially increased in adrenal disorders of androgenicity such as andrenogenital syndrome; it is also a good marker of response to therapy. Levels are reduced in various forms of male pseudohermaphroditism. 3 alpha androstanediol glucuronide appears to be the best marker available of DHT formation in target tissues such as skin.

Dihydrotestosterone↗