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Biomedical subjects

R J Spooner

Publications and source records attributed to R J Spooner.

At least 37 records · Page 2Linked to original sources
PubMed1989

Incidence of AIDS and excess of mortality associated with HIV in haemophiliacs in the United Kingdom: report on behalf of the directors of haemophilia centres in the United Kingdom.

OBJECTIVE--To estimate the cumulative incidence of AIDS by time since seroconversion in haemophiliacs positive for HIV and to examine the evidence for excess mortality associated with HIV in those who had not yet been diagnosed as having AIDS. DESIGN--Analysis of data from ongoing national surveys. SETTING--Haemophilia centres in the United Kingdom. PATIENTS--A total of 1201 men with haemophilia who had lived in the United Kingdom during 1980-7 and were positive for HIV. INTERVENTION--None. END POINTS--Diagnosis of AIDS; death in those not diagnosed as having AIDS. MEASUREMENTS AND MAIN RESULTS--Estimation of cumulative incidence of AIDS and number of excess deaths in seropositive patients not diagnosed with AIDS. Median follow up after seroconversion was 5 years 2 months. Eight five patients developed AIDS. Cumulative incidence of AIDS five years after seroconversion was 4% among patients aged less than 25 at first test positive for HIV, 6% among those aged 25-44, and 19% among those aged greater than or equal to 45. There was little evidence that type or severity of haemophilia or type of factor VIII or IX that had caused HIV infection affected the rate of progression to AIDS. Mortality was increased among those who had not been diagnosed as having AIDS, especially among those with "AIDS related complex." Thirteen deaths were observed among 36 patients diagnosed as having AIDS related complex against 0.65 expected, and 34 deaths in 1080 other patients against 22.77 expected; both calculations were based on mortality rates observed in haemophiliacs in the United Kingdom in the late 1970s. CONCLUSIONS--Rate of progression to AIDS depended strongly on age. There is a substantial burden of fatal disease among patients positive for HIV who have not been formally diagnosed as having AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1989

On-call service: the role of chemical pathologists.

The workload of the chemical pathology advisory on-call service was investigated. Over three years 317 calls were recorded, giving a mean of nine calls a month. Seasonal variation in the number of calls was observed, with an increase in calls during December, January, and February. Requests for the arrangement of analysis accounted for 231 calls, while there were 98 requests for advice. Authorization of a request for analysis was the outcome of 156 calls. Advice with respect to investigation, treatment, or interpretation of results was offered during 173 calls. The acute medical and surgical wards, the accident and emergency department, renal unit and intensive care unit accounted for 198 of the calls. The two analyses most frequently requested, through the advisory on-call service, were serum digoxin and blood ethanol, with 51 and 33 requests, respectively. The "acute" wards and accident and emergency department had the greatest request rate, accounting for 35 of the requests for digoxin and 26 of the requests for blood ethanol. The acute care areas were responsible for the major part of the workload, and a clinical requirement for the services of chemical pathologists out of hours, was observed.

Blood Chemical Analysis↗
PubMed1988

Glycemic control and raised serum alanine aminotransferase activity in treated diabetes mellitus.

The prevalence of raised serum liver-associated enzyme activity in stabilised, treated diabetic outpatients without concurrent hepatobiliary disease was investigated using a retrospective computer search of biochemical data. The frequency of raised alanine aminotransferase, aspartate aminotransferase, or gamma glutamyl transferase activity found among diabetic, general medical and respiratory outpatients was compared with that found in apparently healthy controls. It was established that a raised activity of any of the three enzymes occurred with a similar frequency in each outpatient group. However, only with alanine aminotransferase did the frequency of elevation (7.1%) in the patients with previously diagnosed hepatobiliary disease exceed that of healthy controls. A raised alanine aminotransferase activity in diabetic outpatients was associated with good glycemic control (hemoglobin A1 less than 8%, p less than 0.02) and treatment with oral hypoglycaemic agents (p less than 0.001).

Alanine Transaminase↗
PubMed1988

Nosocomial dysnatremia.

Patients who exhibited both hyponatremia and hypernatremia during a single admission were identified by a review of their biochemistry data. The mortality of patients who developed either hypernatremia or hyponatremia, followed by the opposite abnormality within less than or equal to 10 days, was 42%. This was greater than the 8.2% mortality for an age-, sex-, and admission-matched normonatremic control group (P less than 0.01, chi 2). Eight of the 10 patients who died had had a change in the sodium concentration in serum greater than 20 mmol/L. The interval (days) between the maximum and minimum sodium concentrations in the survivors and those who died was not statistically different. We found no specific clinical features that could be used to predict the development of this biochemical abnormality.

Adult↗
PubMed1987

Detection of microalbuminuria in diabetic patients using a simple latex agglutination test.

The adaptation of an immunoturbidimetric assay to quantitatively measure urinary albumin is described and this was used to evaluate a commercial latex agglutination slide test, Albuscreen, with a sensitivity of 25 mg/l. Excellent agreement was observed between the two methods, and in clinical studies an acceptable classification of patients was made using Albuscreen, an albumin: creatinine ratio of less than or equal to 2.5 being used to indicate possible microalbuminuria. A small number of false negative and false positive results occurred in some dilute and concentrated urine samples, respectively.

Albuminuria↗
PubMed1986

Selenium depletion and its correction in a child with homocystinuria.

A child of 10 months with proven homocystinuria was found to be selenium depleted and we report the serial monitoring of replacement therapy. Selenium, as an enriched yeast preparation, equivalent to 50 mug on alternate days was required for maintenance. Indices of selenium status returned to normal in varying times. The child initially demonstrated an abnormality of an in vitro challenge by hydrogen peroxide to her erythrocytes, that returned to within normal limits with selenium therapy alone, the serum vitamin E concentration being normal.

Journal Article↗
PubMed1984

Observed activities of serum creatine kinase: total and B subunit activity and other enzymes in young persons abusing solvents.

Serum enzymes (aspartate transaminase, alanine transaminase, alkaline phosphatase (ALP), gamma-glutamyltransferase, and creatine kinase (CK] were measured in 296 young persons who admitted to recent inhalation of solvents, usually toluene based glues. In general, results fell within expected adult reference ranges except for ALP and CK. About 60% of subjects had CK activities above the upper reference limit and these activities were investigated in terms of their isoenzyme composition. CK B subunit activity was measured in 90 subjects with raised total CK activities. In five instances the CK B subunit activity was judged abnormal and in two subjects the presence of CK BB was confirmed. These two subjects were thought to have a circulating macro CK, type 1. It is concluded that the increased total CK activity found in this group of solvent abusers was due to physical activity, but a contribution from specific muscle toxicity by solvents cannot be excluded.

Adolescent↗
PubMed1983

Treatment of haemophilia and related disorders in Britain and Northern Ireland during 1976-80: report on behalf of the directors of haemophilia centres in the United Kingdom.

A five year survey of the treatment of patients in the United Kingdom suffering from haemophilia and related disorders was carried out on behalf of the directors of haemophilia centres. The survey showed an increase in the number of patients receiving treatment from the centres, a substantial increase in the total amount of therapeutic materials used, and an increase in the average amount of factor VIII or factor IX used yearly per patient. Home treatment became established for severely affected patients and accounted for roughly half of the total amount of material used. Study of the acquisition of factor VIII or factor IX antibodies (inhibitors) in patients with haemophilia A or haemophilia B showed no increase in antibodies during the survey period, despite the increased use of factor VIII and factor IX concentrates. The occurrence of acute hepatitis in treated patients was also studied and no increased incidence was observed. A near normal median expectation of life in patients with severe haemophilia A was found.

Adolescent↗
PubMed1982

Serum gamma-glutamyltransferase and alkaline phosphatase in rheumatoid arthritis.

Serum gamma-glutamyltransferase (GGT) and alkaline phosphatase (AP) were assayed in 98 consecutive patients with rheumatoid arthritis. Twenty-three patients had increased GGT activities and 45 an increased AP activity. Twelve patients showed an increase in both enzyme activities and AP isoenzyme studies were performed on seven of this group. In three subjects an increase in the bone isoenzyme was observed and in three others the increase in activity was attributed to the liver isoenzyme. The remaining patient, who probably suffered from coexistent primary biliary cirrhosis, showed an increase in both bone and liver isoenzymes. The liver involvement, suggested by the alkaline phosphatase isoenzyme results, was largely confirmed by the butanol extraction of GGT. The changes in these enzymes in this small series could not be related definitely to drug therapy. It is concluded that though increases in GGT and AP are common in rheumatoid arthritis, this does not necessarily indicate hepatic involvement. Further isoenzyme studies are needed to define the extent to which organs other than the liver bring about increases in these serum enzymes in rheumatoid disease.

Adult↗
PubMed1981

Serum glutamate dehydrogenase as a marker of hepatocyte necrosis in alcoholic liver disease.

Serum glutamate dehydrogenase concentration was assessed as a marker of the degree of hepatocyte necrosis found at liver biopsy in 95 patients suspected of having alcoholic liver disease. Although the serum concentration was raised in 54 patients, no relation between it and the severity of hepatocyte necrosis could be established. Glutamate dehydrogenase was therefore not confirmed to be a useful indicator of hepatocyte necrosis in patients with chronic alcoholism.

Glutamate Dehydrogenase↗
PubMed1979

Serum enzymes in colorectal cancer.

A study of the value of serum enzymes in 184 patients with colorectal cancer has been performed. The enzymes studied were gamma glutamyltransferase (gammaGT), alkaline phosphatase (AP), lactate dehydrogenase (LDH), 5'-nucleotidase (5'-NT), glutathione reductase (GR), alanine and aspartate transaminases. In patients without liver metastases, elevated enzyme levels were found in 11-55% preoperatively. 5'-NT showed the least number of elevated activities, while gammaGT activities were increased in 29% and LDH in 55%. The percentage of elevated enzyme levels rose significantly in the early postoperative period. Patients with liver metastases showed increased enzyme activities in 40-60% preoperatively: gammaGT was the most sensitive indicator. Increased enzyme activity was related to the degree of liver involvement with secondary tumor. With extensive liver metastases, gammaGT levels were increased in 82%. It is concluded that serum enzymes are of limited value in the preoperative detection of liver metastases, and particularly when tumor involvement of the liver is small.

Alanine Transaminase↗
PubMed1979

Home treatment in haemophilia: clinical, social and economic advantages.

Twenty-eight severely affected haemophiliacs were observed for 3 months under treatment as hospital out-patients and for the subsequent 9 months while treating themselves at home. Delay in receiving treatment and financial costs were both clearly reduced by home treatment, the patients recovered from individual bleeds more quickly and reported a greater sense of personal freedom and independence. The amount of treatment required did not materially change and no untoward effects were noted; the use of analgesics tended to be less.

Adolescent↗
PubMed1979

A bichromatic method for total bilirubin with a CentrifiChem 400.

We describe a method for the bichromatic determination of total bilirubin with a CentrifiChem 400 centrifugal analyzer with the Boehringer DPD kit. After reading the blank at 620 nm, we read the test at 550 nm. Because only one rotor is required, the analytical time for bilirubin estimations is halved. The proposed method is no more prone to interference by hemoglobin or turbidity than a conventional approach or a reference continuous-flow method and has performed well over several months of routine use.

Autoanalysis↗