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Biomedical subjects

R Jenkins

Publications and source records attributed to R Jenkins.

At least 199 records · Page 11Linked to original sources

A comparison of the prescriptions received by the elderly in long-term care in New York and London.

A comparison of medication prescribed for elderly residents in long-term care institutions in London and New York shows that New York residents are prescribed more drugs. The contrast is sharpest for those suffering from dementia who are much more likely to receive neuroleptic medication than their counterparts in London. Analysis indicates that the differences may reflect the greater emphasis in New York on the nursing-medical model of care, rather than any differences between the residents themselves.

Activities of Daily Living↗

Immunohistochemical demonstration of leucocyte elastase in human tissues.

A polyclonal antiserum, produced in sheep and reactive against purified human leucocyte elastase, has been applied to paraffin sections from a range of human tissues by means of the indirect immunoperoxidase method. Striking and consistent results have been obtained. Normal or inflammatory granulocytes were intensely positive, the reaction being "blocked" by pure elastase. Activity was not seen in other sites, including histiocytic reticulum and lymphoid cells, although some weaker reaction was present in gastric and ileal lining epithelium. Strong reactivity was also seen in the cells of acute and chronic myeloid leukaemia and in extramedullary haemopoiesis. The advantages of this technique are compared with those for muramidase (lysozyme), alpha 1-antitrypsin, and naphthol-AS-D-chloroacetate esterase.

Granulocytes↗

A quantitative study of histiocytic reticulum cells in diffuse and follicular non-Hodgkin's lymphomas.

Histiocytic reticulum cells have been counted in 160 lymph nodes, comprising 50 high grade non-Hodgkin's lymphomas, 90 lymphomas of low grade histology, and 20 specimens exhibiting reactive follicular hyperplasia. The histiocytes were shown immunohistochemically by virtue of their content of the cysteine proteinase cathepsin B. A consistent and striking finding was that high grade lymphomas contain many more histiocytes than low grade lymphomas. Immunoblastic neoplasms contain up to 24.2% of these cells, whereas low grade diffuse lymphomas possess only up to 3.6% histiocytes. Histiocytic reticulum cells were also counted in benign or malignant follicular lesions in standard areas from follicle centres only. No significant differences were found between low grade lymphomas and hyperplastic nodes. These findings are discussed in relation to previous, more limited studies.

Cathepsin B↗

Glutamic dehydrogenase activity in rat heart: demonstration of two forms of enzyme activity.

Glutamic dehydrogenase (GDH) activity in rat heart was found to be 2.1 U/g of heart (wet wt). The mitochondrial glutamic dehydrogenase activity accounted for only 18% of the total. This percentage of the total activity in heart mitochondria was not altered by nagarse treatment, acetone extraction, sonication in Triton X-100, and extraction with buffer containing a protease inhibitor. The remainder of the activity was present in the cytosol. Cytosolic GDH activity differed from mitochondrial GDH activity by its pH curve, stability to heat, Arrhenius plot, and the effect of different nucleotides. Acetone extraction of the mitochondria resulted in GDH that was stable to heat and had a shallow temperature activation curve resembling cytosolic GDH. Acetone extraction of cytosolic GDH inactivated it. The cytosolic activity was purified 288-fold and the mitochondrial activity 100-fold. Purified cytosolic and mitochondrial GDH enzymes had different monomeric molecular weights on sucrose density gradient centrifugation. Gel filtration of cytosolic and mitochondrial GDH also showed different monomeric molecular weights. We conclude that rat heart GDH exists in two forms with different physical and kinetic characteristics. The majority of GDH activity in rat heart is cytosolic. The mitochondrial enzyme has a lipid-soluble component that can be removed with acetone without destroying its activity.

Animals↗

Surgical repair of extratemporal facial nerve: a comparison of suture repair and microfibrillar collagen repair.

The extratemporal portion of the facial nerve is often severed by various forms of surgical and non-surgical trauma. A commonly accepted method of repair is with monofilament nylon suture, using microsurgical techniques to approximate the epineurium. A study was designed to compare the clinical and histologic success of repair using microfibrillar collagen hemostat (Avitene) with that of suture repair of the epineurium. Although the success rates of these two methods of repair of peripheral facial nerves in rabbits appear to be functionally equivalent, the histologic results show the suture repair to be superior.

Animals↗

The development and use of standardized assessment of abnormal personality.

A standardized assessment of personality (SAP) based on interview with an informant has been developed to classify a patient's premorbid personality in clinical terms for use for research purposes in or out of a hospital setting. Three preliminary investigations of its use are reported. These indicate that an informant's account of personality can be rated reliably by psychiatrists and is consistent over time. The addition of two extra descriptive types to the schema of ICD Section 301, the anxious and the self-conscious personalities, is found to contribute usefully to a taxonomy of personality in two series of patients investigated with the SAP. Further investigations are indicated to determine the accuracy of an informant's account before epidemiological studies with this instrument can be considered.

Humans↗

The twelve-month outcome of patients with neurotic illness in general practice.

One hundred patients, selected to be representative of those attending general practitioners with non-psychotic psychiatric disorders were followed up for one year. Standard assessments of mental state, personality, social stresses and supports were carried out for each patient at the outset and after a year. The outcome for this cohort determined both by the level of psychiatric morbidity at interview after one year and by the pattern of the psychiatric morbidity during the year has been analysed with reference to the assessment measures. Discriminant function analysis indicates that the initial estimate of the severity of the psychiatric morbidity and a rating of the quality of the social life at the time of follow-up are the only factors that significantly predict the psychiatric state after one year. Social measures also predict a pattern of illness characterized by a rapid recovery after the initial assessment. Patients who reported continuous psychiatric morbidity during the year were older, physically ill and very likely to have received psychotropic drugs. Receipt of this medication during the year was associated with initial assessments of abnormality of personality, older age, and a diagnosis of depression. The findings of this study are seen to support a triaxial assessment and classification of non-psychotic psychiatric disorders, with symptoms, personality and social state being rated independently.

Adolescent↗

Pacemaker syndrome: a non-invasive means to its diagnosis and treatment.

Vertigo, lightheadedness, syncope, and hypotension occurring after implantation of a ventricular pacemaker has become known as pacemaker syndrome. In one patient with this syndrome we have demonstrated an associated decrease in the pulse amplitude of the ophthalmic arteries during ventricular pacing by utilizing ocular pneumoplethysmography (O.P.G.). This non-invasive technique was subsequently used intra-operatively to test the presence of ophthalmic artery pulse amplitude changes after implantation of the ventricular electrode. An A-V sequential pacemaker was then implanted and eliminated all symptoms of pacemaker syndrome.

Bradycardia↗

Minor psychiatric morbidity in employed men and women and its contribution to sickness absence.

A pilot study is described on 41 men and women of similar age, social and educational backgrounds, in 2 working environments. The use of psychiatric interviews in such occupational settings is demonstrated to be acceptable to both management and employees. Preliminary coefficients of validity for the General Health Questionnaire are found to compare favourably with those in clinical or community settings. Though the prevalence of minor psychiatric morbidity in these small samples did not differ between the sexes, the women had twice as many spells of absence as the men. Considering women separately, minor psychiatric morbidity was found to be significantly correlated with absence. However, psychiatric illness was a less important predictor of absence in men.

Absenteeism↗

In-vitro inactivation of aminoglycoside antibiotics by piperacillin and carbenicillin.

Clinical microbiology laboratory experiences wherein aminoglycoside serum assay results appeared inconsistent with the amount of the compound given when administered in combination with a semisynthetic penicillin led us to compare the interaction of three currently available aminoglycoside antibiotics with carbenicillin, as a representative semisynthetic penicillin given in large doses, and with piperacillin, a new broad-spectrum semisynthetic penicillin. Amikacin, gentamicin, and tobramycin were incubated in serum in vitro with various concentrations of carbenicillin and piperacillin. In the presence of very high concentrations of the two penicillins, tobramycin was the most rapidly inactivated aminoglycoside, gentamicin was next, and amikacin was only slightly inactivated. With low concentrations of the two penicillins, the rates of aminoglycoside inactivation were negligible. Carbenicillin, in high concentration, inactivated the aminoglycosides more rapidly than piperacillin. In patients experiencing renal failure, the maintenance of moderate serum levels of carbenicillin and piperacillin may be important in attempting to maintain adequate aminoglycoside serum levels.

Amikacin↗

Significance of Aspergillus species isolated from respiratory secretions in the diagnosis of invasive pulmonary aspergillosis.

To determine the significance of Aspergillus species isolated from sputum or other respiratory secretions with respect to the diagnosis of invasive pulmonary aspergillosis, the clinical records and radiographs of all patients whose respiratory secretion cultures yielded an Aspergillus species between 1972 and 1978 were reviewed. All known predispositions to invasive aspergillosis, e.g., presence of cancer or granulocytopenia, and therapy with corticosteroids, antibiotics, and cytotoxic drugs, were significantly associated with proven or probable invasive pulmonary aspergillosis. Most notable were patients with acute leukemia and granulocytopenia. Prolonged duration of hospitalization between initial isolation (greater than 2 weeks) and multiple isolates (greater than three isolates) were also significantly associated with a high frequency of proven or probable disease. Isolation of A. niger was only rarely associated with proven or probable disease (one of eight patients). The isolation of A. fumigatus and A. flavus from respiratory secretions does not usually represent laboratory contamination and must be interpreted in the light of known predispositions to aspergillosis. In some situations, e.g., granulocytopenic patients with acute leukemia, even a single isolation carries a high likelihood of invasive aspergillosis.

Adrenal Cortex Hormones↗

A cross-national comparison of the institutionalized elderly in the cities of New York and London.

Two random samples, each constituting 0.5% of the institutionalized elderly (over 65) in the cities of New York and London have been compared. This preliminary report of a collaborative study demonstrates the similarity of the 2 samples. Institutions in the 2 cities are shown to differ in size, type of ownership and the frequency that skilled nursing is provided. Some implications of these 2 findings are raised now, and will be discussed later when the full data for the study are presented.

Aged↗