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Biomedical subjects

R Samuel

Publications and source records attributed to R Samuel.

51 records · Page 3Linked to original sources

Glycine pools and turnover rates in leukaemia patients measured with [15N]glycine.

Turnover parameters for plasma glycine were measured by administration of a single dose of [15N]glycine to overnight fasted healthy volunteers, nine patients with chronic leukaemia, one patient with acute monocytic leukaemia and one patient with chronic myeloid leukaemia before and after chemotherapy. Gas chromatography-mass spectrometry was used to determine plasma [15N]glycine enrichment. Pool sizes and turnover rate constants were estimated from time-decay curves for isotope enrichment. Turnover rate constants and metabolic clearance rates of plasma glycine in leukaemia patients were elevated in comparison with data for healthy volunteers. The increased rates of glycine disappearance from the circulation were not accompanied by a depletion in glycine pool size. Turnover rate constants fell during chemotherapy and were within the normal range during remission. There was a significant positive correlation between glycine turnover rate constants and leucocyte counts. The increase in glycine turnover rate constants may be related to proliferation of the neoplastic cells.

Female↗

End-organ resistance to 1,25-dihydroxycholecalciferol.

A 13-year-old girl with total alopecia who in infancy had rickets unresponsive to large doses of vitamin D2 is described. She had profound hypocalcaemia which was resistant to treatment with high doses of dihydrotachysterol, 1 alpha-hydroxycholecalciferol, and 1,25-dihydroxycholecalciferol. Serum concentrations of 25-hydroxyvitamin D were normal but those of 1,25-dihydroxycholecalciferol were markedly raised (674 and 745 pg/ml). In addition, 24,25-dihydroxyvitamin D was undetectable in serum. Administration of synthetic 24,25-dihydroxycholecalciferol was followed by normocalcaemia which persisted long after treatment was stopped. Her sister, who died at the age of 10 months, also had had total alopecia, rickets, and hypocalcaemia resistant to vitamin-D2 therapy. In this familial syndrome there seems to be end-organ resistance to the action of 1,25-dihydroxycholecalciferol, possibly as a result of changes at the receptor sites.

Adolescent↗

Secondary pituitary insufficiency: report of three cases of ectopia or hemiagenesis of the thyroid gland.

Three patients with clinical and laboratory manifestations suggestive of pituitary insufficiency due to the presence of a pituitary tumor were found to have long-standing myxedema. The insidious appearance of the signs of hypothyroidism was explained by the cause of their disease--an ectopic thyroid gland in two patients and hemiagenesis of the thyroid in the third. Early recognition and treatment of such cases is important.

Adult↗

Cases of pulmonary tuberculosis among the out-patients attending general health institutions in an Indian city.

A study was undertaken in Bangalore City, India, to find out whether people with chest symptoms, including tuberculosis patients, attend general health institutions or report directly to tuberculosis clinics. The attendance for one day at 19 general dispensaries was investigated. Of the total of 2506 eligible persons who were questioned about the presence of chest symptoms, 1170 admitted having symptoms suggestive of pulmonary tuberculosis and 20 cases and 31 suspected cases of pulmonary tuberculosis were diagnosed. The findings indicate that tuberculosis patients do not by-pass the city health institutions. On the other hand, if these institutions take an active part in the tuberculosis programme and undertake diagnostic functions, or refer persons with chest symptoms to a central clinic, they can contribute substantially to case-finding.

Adolescent↗

Community empowerment in the control of lymphatic filariasis in Misima, Milne Bay Province using diethylcarbamazine in combination with albendazole.

We report the successful implementation of a community-based lymphatic filariasis control program using annual single-dose treatment with diethylcarbamazine (DEC) in combination with albendazole. The target population included over 28,000 people in the Samarai Murua District, Milne Bay Province, Papua New Guinea. A community-based delivery model was as effective as the standard health services delivery model. The number of people tested in 1998 before mass drug administration (MDA) and in 1999, one year after treatment, were 1644 and 942 respectively; the number who received mass treatment was 29,883 in 1998 and 28,965 in 1999. The prevalence of antigenaemia decreased significantly from 19% to 12%. The cost of running the program also decreased by 50%. The total number of trained health staff required to conduct the MDA program declined from 62 in 1998 to 12 in 1999, a reduction of 81%, with a cost saving in salary and allowances. A salient organizational initiative that surfaced was the use of local expertise in the private sector as a catalyst for obtaining funds from external sources to manage and facilitate the program which was conducted with locally available resources.

Albendazole↗

Spherulite crystals in synovial tissue of a patient with recurrent monoarthritis.

Frozen, unstained sections of synovial tissue of a 38-year-old man with recurrent monoarthritis and hyperuricemia were studied. Negatively birefringent crystals in a spherulite form were detected by using a compensated polarized light microscope. It is postulated that in some cases of gout the first stage of crystallization is in the spherulite form.

Adult↗

Measuring the quality of service in the community.

This paper describes a joint project carried out by clinical psychologists and senior trusts managers to identify and measure consumer outcomes across a range of community services. The outcomes identified have been written into service contracts, and the outcome data are collected on a regular basis and used to inform management decisions.

Community Health Services↗