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Biomedical subjects

R Taylor

Publications and source records attributed to R Taylor.

At least 325 records · Page 18Linked to original sources
PubMed1995

Labeling revisited: diagnoses in disguise?

The study examines 125 labels central to nursology used by practicing nurses to describe patients. Each nurse described the response pattern identified by each label, organizing and prioritizing its characteristics to produce a diagnostic algorithm. After work-peer affirmation of the chart's accuracy, the response pattern was renamed as a "syndrome." Predominant characteristics of each syndrome were analyzed. Nurses developed treatment protocols that they believed would reduce, control or "cure" defining characteristics. Field testing of these protocols demonstrated that conditions identified by labels (which normally lead to nurse avoidance) could be effectively treated when approached proactively. Some syndromes involved response patterns related to medical diagnosis or treatment, specific units in the hospital or the health care system itself. Nursology also includes less-than-ideal responses to circumstances that threaten personal well-being.

Algorithms↗
PubMed1995

Immunogenicity of the Shigella flexneri serotype Y (SFL 124) vaccine strain expressing cloned glucosyl transferase gene of converting bacteriophage SfX.

The glucosyl transferase gene (gtr) from bacteriophage phage X (SfX) caused partial conversion of serotype Y (group antigen 3, 4) to X (group antigen 7, 8) when introduced into a candidate vaccine strain of Shigella flexneri serotype Y (SFL124). The gtr gene caused conversion of O-antigens but did not eliminate the adsorption of the corresponding phage SfX. The hybrid strain expressing both group antigens 7, 8 and 3, 4 showed 75% protection when immunized guinea pigs were challenged with a wild-type S. flexneri serotype X strain. No protection was observed against serotype Y challenge, although group antigen 3, 4 was detected in the LPS of the hybrid strain. This suggests the importance of O-antigen immunity in the host defense against shigellosis.

Animals↗
PubMed1995

The effect of acute (60 minute) insulin stimulation upon human skeletal muscle glycogen synthase and protein phosphatase-1 in non-insulin-dependent diabetic patients and control subjects.

Previous studies have established that activation of muscle glycogen synthase (GS) is abnormal in non-insulin-dependent diabetes mellitus (NIDDM). Insulin-mediated activation of GS depends upon protein phosphatase-1 (PP1), which dephosphorylates the relevant sites of GS. In order to determine whether defects in PP1 activation cause subnormal activation of GS or whether PP1 activation itself is normal, we administered a short insulin infusion to 8 NIDDM subjects and 8 healthy controls matched for gender, age, and body mass index (BMI). GS fractional activity and PP1 activity were determined in biopsies taken from the gastrocnemius muscle before and after 60 min insulin infusion (0.1 U kg h-1). In the NIDDM group, muscle GS fractional activity was 6.8 +/- 1.6 and 10.0 +/- 1.5% (mean +/- SEM) (p = 0.11) before and after insulin infusion. In the control group, muscle GS fractional activity increased from 7.3 +/- 2.0 to 13.3 +/- 2.7% (p < 0.02). PP1 activity had returned towards basal levels after insulin infusion; NIDDM group 156 +/- 24.7 to 184.1 +/- 28.1 U mg-1; control group 220.8 +/- 30.1 to 233.8 +/- 29.8 U mg-1. In the NIDDM group there was a positive correlation between the increases in GS fractional activity and PP1 activity following insulin stimulation r = 0.77; p < 0.025). These data indicate that in vivo insulin-dependent activation of muscle PP1 is transient in normal subjects but is delayed in NIDDM. The defect in GS activation in NIDDM is likely to be proximal to PP1 in the pathway of transmission of the insulin signal.

Biopsy↗
PubMed1995

Declining blood lead levels in Victorian children.

To investigate the distribution of blood lead levels in a sample of Victorian children, and to compare current levels with those from a similar survey in 1979, blood was tested for lead in 252 children (123 under five years) attending Royal Children's Hospital as outpatients and having venepuncture blood samples for medical reasons. Blood lead levels were determined by graphite furnace atomic absorption spectrophotometer. The mean blood lead level was 0.26 mu mol/L (5.4 mu g/dL). In the under-five age group, the mean was 0.28 mu mol/L (5.7 mu g/dL). Only 1.6 per cent of this group exceeded the National Health and Medical Research Council action level of 0.72 mu mol/L (15 mu g/dL). Levels in this age group have declined significantly since 1979, when the mean was 0.54 mu mol/L (11.1 mu g/dL) and 12.9 per cent exceeded 0.72 mu mol/L (15 mu g/dL). Average blood lead levels have halved since 1979, with likely contributing factors being reduced exposure from lead in diet, reduced access to lead in paint and reduced lead in ambient air. Children with elevated levels had identifiable risk factors such as pica or exposure to lead-based paint, suggesting the need for ongoing pubic health action to prevent exposure in these groups.

Child↗
PubMed1995

Cognitive estimation in neurological disorders.

The Cognitive Estimation Test (CET) was devised by Shallice & Evans (1978) in an attempt to quantify the tendency observed in some patients with frontal lobe lesions to produce bizarre estimates in response to questions to which people do not usually know exact answers (e.g. 'what is the height of a double-decker bus?'), despite performing normally on standard intelligence tests. In the present study, the CET performance of a large number of patients suffering from head injury, brain tumour, ruptured aneurysm (anterior communicating artery and other), multiple sclerosis, dementia, encephalitis, Korsakoff's syndrome and anxiety/depression were compared with CET scores from 150 healthy controls. Patients with Korsakoff syndrome demonstrated significantly impaired CET performance. A subgroup of patients with discrete frontal lesions was compared with a group with localized non-frontal lesions. No significant difference in CET performance was observed between anterior and posterior lesioned patients. The sensitivity of the CET to anterior brain dysfunction is called into question by the present findings.

Adult↗
PubMed1995

Health plans and providers: how new partnerships are evolving in a volatile environment.

As the fee-for-service health system dwindles, organized provider structures and mutually beneficial relationships are forming between providers and payers. Providers and payers--united by shared goals of efficiency and effectiveness of care--are beginning to work together to identify and achieve their financial and quality objectives. In this article, the author discusses the evolution of these relationships in health care delivery, addresses the challenges of integration, and reveals the winners in this new delivery system.

Capitation Fee↗
PubMed1995

The heavy eye phenomenon: orthoptic and ophthalmic characteristics.

A series is presented of nine patients who demonstrate the heavy eye phenomenon. Illustrations of these patients show the salient features of the phenomenon, including hypotropia, exotropia and pseudoproptosis. The condition is summarized and the pathogenesis of the eye and lid positions are discussed. The indications for surgery and some examples with results are shown. The correct diagnosis may prevent unnecessary investigation of pseudoproptosis and pseudo third-nerve palsy.

Adult↗
PubMed1995

A survey of environmental and occupational health needs of GPs.

OBJECTIVE: To investigate general practitioners' experience of the nature and frequency of patient consultations about environmental health matters, and about preferred sources of information to assist in designing continuing medical educational programs in environmental and occupational health. STUDY DESIGN/PARTICIPANTS: 491 randomly selected Victorian GPs were mailed a 16-item questionnaire. RESULTS: 80% of GPs responded to the survey questionnaire. GPs reported that between 1% and 4% of consultations were environmental health related in their average caseload. The commonest environmental health concerns expressed by patients were allergy or chemical sensitivity, outdoor and indoor air quality, asbestos, and fears about exposure to environmental carcinogens. Significant differences in concerns were observed between rural, large town and urban GPs, reflecting the types of exposures encountered in those environments. Seventy-two per cent of GPs said they did not have enough access to information of environmental health, and 55% were prepared to undertake further educational activities. Preferred methods of education included journal articles, CHECK programs and clinical meetings. CONCLUSIONS: Most GPs see a need for further education and improved access to information and resources to manage patients' environmental health concerns. It is suggested a variety of avenues be utilised to meet the range of preferred ways of learning expressed by GPs.

Data Collection↗
PubMed1994

A multileaf collimator field prescription preparation system for conventional radiotherapy.

PURPOSE: The purpose of this work is to develop a prescription preparation system for efficient field shaping using a multileaf collimator that can be used in community settings as well as research institutions. The efficiency advantage of the computer-controlled multileaf collimator, over cerrobend blocks, to shape radiation fields has been shown in conformal treatments, which typically require complete volumetric computerized tomographic data for three-dimensional radiation treatment planning--a utility not readily available to the general community. As a result, most patients today are treated with conventional radiation therapy. Therefore, we believe that it is very important to fully use the same efficiency advantage of multileaf collimator as a block replacement in conventional practice. METHODS AND MATERIAL: The multileaf collimator prescription preparation systems developed by us acquires prescription images from different sources, including film scanner, and radiation treatment planning systems. The multileaf collimator angle and leaf positions are set from the desired field contour defined on the prescription image, by minimizing the area discrepancies. Interactive graphical tools include manual adjustment of collimator angle and leaf positions, and definition of portions of the field edges that require maximal conformation. Data files of the final leaf positions are transferred to the multileaf collimator controller via a dedicated communication link. RESULTS: We have implemented the field prescription preparation system and a network model for integrating the multileaf collimator and other radiotherapy modalities for routine treatments. For routine plan evaluation, isodose contours measured with film in solid water phantom at prescription depth are overlaid on the prescription image. Preliminary study indicates that the efficiency advantage of the MLC over cerrobend blocks in conformal therapy also holds true for conventional treatments. CONCLUSION: Our model of computer-controlled prescription, evaluation, and treatment using multileaf collimators can be effectively implemented in both community settings and research institutions. The resultant increase in treatment efficiency and accuracy is now available for conventional radiotherapy.

Humans↗
PubMed1994

Human cytotrophoblast invasion is up-regulated by epidermal growth factor: evidence that paracrine factors modify this process.

Formation of the human placenta requires a subset of cytotrophoblast stem cells to acquire an invasive phenotype. We examined the effect on cytotrophoblast invasiveness of growth factors that control the differentiation of other cells. Exogenous TGF-beta 1, PDGF-AA, PDGF-BB, and TNF-alpha affected neither cell morphology nor the rate of cytotrophoblast invasion in vitro. In contrast, addition of EGF to first trimester cytotrophoblast cultures produced dramatic changes in morphology and a severalfold increase in invasive capacity. The effects of EGF on later gestation cytotrophoblasts, whose invasive capacity is diminished, were much less pronounced. Next we investigated whether cytotrophoblasts themselves produce ligands that interact with the EGF receptor. A radioimmunoassay and a radioreceptor assay failed to detect EGF receptor ligands in cytotrophoblast-conditioned medium. Likewise, by RT-PCR cytotrophoblasts expressed neither EGF nor TGF-alpha mRNA. In contrast, EGF receptor mRNA was expressed and its protein levels remained constant during the experiment. Immunolocalization using F(ab') fragments of an anti-human EGF antibody failed to detect this growth factor in the chorionic villus. We conclude that maternal ligands that interact with the EGF receptor could play an important role by up-regulating trophoblast invasion, particularly during the early stages of pregnancy.

Becaplermin↗
PubMed1994

Conformational properties of pyrethroids.

X-ray database searches and theoretical potential-energy calculations indicate that the acid moieties of pyrethroid cyclopropanecarboxylate esters adopt a well-defined, relatively inflexible conformation. In contrast, the alcohol moieties can exist in many low-energy geometries. One of the least conformationally flexible pyrethroid alcohols is 4-phenylindan-2-ol. The approximate overall conformation adopted at the biological binding site by insecticidal esters of this alcohol can be deduced with reasonable confidence by molecular modelling. Graphics superposition of a variety of pyrethroid acids suggests the existence of a large but rather narrow pocket at the binding site, in which substituents at the 3-position of the cyclopropane ring can be accommodated. This pocket is asymmetric with respect to the plane of the cyclopropane ring, extending further on the side remote from the ester group. The effects of alpha-substitution on the insecticidal activity of pyrethroid esters may be due to the influence of substituents on the preferred conformations of the molecules. This hypothesis rationalises the paradoxical dependence on absolute stereochemistry of the activities of various allylbenzyl and cinnamyl alcohol derivatives.

Computer Graphics↗
PubMed1994

Erythrocyte sodium-lithium countertransport activity is related to membrane fluidity in IDDM patients.

Sodium-lithium countertransport (SLC) activity at a standard physiological sodium concentration is raised in uncomplicated IDDM, for which the kinetic mechanism is a raised maximum velocity (Vmax). Diabetic patients with nephropathy do not have raised values for Vmax but a low Michaelis constant (km). Transporter activity could be influenced by its membrane lipid environment. This was assessed in 21 control subjects, 32 uncomplicated diabetic patients, 17 patients with diabetic nephropathy and 11 patients with non-diabetic nephropathy by measuring the fluorescence anisotropy of DPH and TMA-DPH to assess different membrane regions. Standard SLC was higher in all the patient groups compared to the control subjects: 0.307 +/- 0.020 mmol Li/h x 1 cells in uncomplicated IDDM; 0.300 +/- 0.032 in diabetic nephropathy patients and 0.276 +/- 0.019 in non-diabetic nephropathy patients vs 0.216 +/- 0.011 mmol Li/h x 1 cells in control subjects (p < 0.001, p < 0.05, p < 0.05, respectively). This was due to raised Vmax values in the uncomplicated group: 0.528 +/- 0.035 vs 0.385 +/- 0.022 mmol Li/h x 1 cells in control subjects (p = 0.001) and low values for km in the diabetic nephropathy group: 58 (27-170) vs 106 (81-161) mmol/l in control subjects (p < 0.001). Raised SLC in the non-diabetic nephropathy group was largely due to raised Vmax: 0.460 +/- 0.030 mmol Li/h x 1 cells; p = 0.053, with no difference in km: 99.5 (74-137).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Epidemiology of behavioral and emotional problems among children of Jamaica and the United States: parent reports for ages 6 to 11.

Research on child behavior problems requires standardized methodology in order to identify similarities and differences between societies. The present study compared parent-reported behavior problems of 360 Jamaican and 946 U.S. children aged 6 to 11. It revealed few differences in individual, total, internalizing (e.g., depression), and externalizing (e.g., fighting) problem scores as a function of nationality, gender, or age. Findings from this and other studies indicate the feasibility of a common methodology in cross-national studies of children's problems, but also the need for further refinement.

Affective Symptoms↗