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Biomedical subjects

R Tobin

Publications and source records attributed to R Tobin.

14 recordsLinked to original sources
PubMed2006

A review of policy change regarding how patients access their HIV test results at two genitourinary medicine services in Central London.

A retrospective note audit was carried out across two genitourinary (GU) medicine services in Central London to review a radical change in policy one year after its implementation that allows patients assessed as low risk for HIV infection to receive their HIV result by post. Sixteen patients tested positive across the two clinics but had arranged to receive their results by post. Their recall management and outcomes are discussed.

Communication↗
PubMed2002

An urban epidemic--an audit of an inner city young persons' clinic.

In 1996 a young persons' clinic was set up at the Archway Sexual Health Clinic. A retrospective case note review of all attendees for 7 months in 1999 was performed to assess the demography and incidence of sexually transmitted infections (STIs) amongst attenders of the clinic. There were 567 attendances, comprising 364 individuals (331 women and 33 men). Ten per cent of attendees were less than 16 years of age, and 48% were 16-18 years. Fifty-eight per cent were from ethnic minorities. Chlamydial and gonococcal infection was identified in 21.3% and 8.4%, respectively. Thirty-five per cent of new presentations by women involved pregnancy testing, 28.6% were positive. The introduction of the clinic has been successful judged both by the amount of attendances and diseases diagnosed. Specific provision of services for this group needs to be addressed by all sexual health providers.

Adolescent↗
PubMed2001

A novel condom policy for young attenders at a sexual health clinic.

OBJECTIVES: To review the uptake of a new service for condom provision in the under 16s. METHODS: A retrospective case note review of attenders at an inner London sexual health clinic. RESULTS: The service was audited over a 3 month period in the spring of 2000. There were 97 individual attendances, 94% (92) male and 6% (5) female. 89% (87) had never attended a sexual health service before. When asked how they had heard of the clinic 88% (86) said a friend had told them about the clinic. 66% (64) claimed not to be sexually active. CONCLUSIONS: A novel policy of condom distribution to groups of boys has been successfully piloted at an inner London sexual health clinic. This policy appears to be overcoming the reluctance of teenage boys to access sexual health services.

Adolescent↗
PubMed1995

Lead poisoning: low rates of screening and high prevalence among children seen in inner-city emergency departments.

Of 254 children who were 1 to 6 years of age and were tested at two major inner-city emergency departments, 65% had no record of previous lead screening in the previous 30 months, and 71% (97/137) and 50% (58/117), respectively, had blood lead levels > or = 0.48 mumol/L (10 micrograms/dl). The emergency department may be an appropriate resource for lead screening of selected inner-city children.

Child↗
PubMed1993

The effect of intravenous saline loading on plasma levels of brain natriuretic peptide in man.

OBJECTIVE: Recent evidence suggests the presence of a dual natriuretic peptide system consisting of atrial natriuretic factor (ANF) from the atrium and brain natriuretic peptide (BNP) from the ventricle. Discrete roles have been postulated for these two natriuretic peptides in the control of circulatory homeostasis. We have therefore compared the release of ANF and BNP in response to an acute saline load to explore a differential pattern of release for the two natriuretic peptides in man. DESIGN: The effects of an acute saline infusion on plasma ANF and BNP concentrations were studied in 10 normal male volunteers. METHODS: Subjects were studied on two study days in the semirecumbent position. An acute intravenous saline infusion (250 ml/min) of 18 ml/kg isotonic sodium chloride-potassium chloride solution was administered on one of the two study days. No infusion was administered on the other day as a control. RESULTS: Plasma ANF concentrations increased significantly (P < 0.01) with saline loading without any detectable changes in plasma BNP concentrations up to 60 min following infusion. Heart rate and systolic and diastolic blood pressure were unchanged after saline loading. CONCLUSIONS: We have shown that an acute intravenous saline load causes an increase in plasma ANF concentrations with no detectable increase in plasma BNP at least up to 60 min after the acute saline load in man. These results support the view that the release of ANF and BNP may be regulated differently, especially with regard to the time required for the acute release of each peptide.

Adult↗
PubMed1984

Serial echocardiograms in patients with congestive cardiomyopathies: lack of evidence for thrombus formation.

We studied 90 patients with congestive myocardial disease documented at cardiac catheterization (46 idiopathic, 39 ischemic, and 5 hypertensive) who underwent M-mode and two-dimensional echocardiograms every 2-3 months for up to 7 years (mean 3.4 +/- 1.6 years, +/- 1 S.D.). All had angiographic evidence of severe left ventricular dysfunction (left ventricular ejection fraction less than 40%), and were on a variety of inotropic, diuretic, and vasodilating drugs. Only 9 were ingesting anticoagulants (5 warfarin and 4 aspirin), those on warfarin had documented pulmonary emboli or deep venous thrombosis. All but 4 patients were in normal sinus rhythm. Only one subject in this group was found to have a myocardial (left ventricular) thrombus. Postmortem examinations of 27 patients confirmed the ultrasound data. Thus, we conclude that cardiac thrombi are unusual in patients with congestive cardiomyopathies and rarely develop over the course of the illness even in the absence of chronic anticoagulation.

Adult↗
PubMedDate not supplied

Amylose-iodine complex. I. Sedimentation behavior.

Sedimentation measurements are reported on solutions of blue amylose-iodine complexes in the range of 0.001 to 0.007% amylose. Amylose fractions B and F2, of weight average molecular weight average molecular weight 4.0 X 10(5) and 3.4 X 10(4), respectively, were used in this study. Iodine complexes of these fractions formed polydisperse solutions of limited solubility and stability. Sedimentation coefficients increased as a function of potassium iodide concentration. Values for fraction B complexes varied from (16.3 +/- 1.0) X 10(-13) at 1.2 X 10(-3) M KI to (57.2 +/- 7.5) X 10(-13) at 8.3 X 10(-3) M KI; values for fraction F2 complexes varied from (10.0 +/- 1.2) X 10(-13) at 1.2 X 10(-13) M KI to (24.8 +/- 3.9) X 10(-13) at 9.5 X 10(-3) M KI. At constant potassium iodide concentration, sedimentation coefficients, within our experimental error of 10 to 15% standard deviation, are independent of amylose concentration. Time dependence of sedimentation coefficient values was observed for solutions either saturated or unsaturated with respect to the iodine-binding capacity of amylose. For iodine-saturated complex solutions, sedimentation coefficients extrapolated to zero potassium iodide concentration were two to three times greater than for the parent amylose. Measurements are evaluated in terms of possible polyelectrolytic charge effects and aggregation. Under conditions used in these experiments, aggregation of amylose-iodide complexes appears to be the mechanism responsible for the large increase in sedimentation coefficients.

Amylose↗
PubMedDate not supplied

Amylose-iodine complex. II. Molecular weight estimates.

Ultracentrifugation measurements made by the Archibald method on solutions of amylose-iodine-iodide (AI) complexes, containing 0.003% amylose of weight average molecular weight 4.0 X 10(5) at 3.6 X 10(-3) M KI, yield an apparent molecular weight at the meniscus of 8 X 10(5) when measurements are extrapolated to 1200 rpm. Sedimentation equilibrium measurements at 1200 rpm yield apparent molecular weight at the meniscus of 6 X 10(5) and at the cell bottom of 2.4 X 10(6). Heterogeneity and aggreagation are major features of AI complex solution behavior. Apparent molecular weights increase as a function of increasing potassium iodide concentration and with time. This behavior directly correlates with AI complex sedimentation coefficient behavior previously reported. Molecular weight estimates are of the same order for AI complex solutions saturated and 65-70% saturated with respect to the iodine-binding capacity of amylose. Qualitative estimates of net macroion charge effects upon apparent molecular weights are presented.

Amylose↗
PubMedDate not supplied

Metachondromatosis and avascular necrosis of the femoral head: a radiographic and histologic correlation.

We report the case histories, radiographic and computed tomographic studies, and histologic findings of two children with metachondromatosis who developed avascular necrosis (AVN) of the femoral ossific nucleus. The first was a 9-year-old boy with involvement of both femoral heads; the second was an 8-year-old girl with involvement of her right femoral head. The changes were associated with either exostoses or enchondromalike lesions of the femoral neck. Interference with the integrity of the lateral epiphyseal vessels by these lesions would explain the avascular changes that occurred. The findings in these cases and other reports associating AVN with skeletal dysplasia should encourage treating physicians to analyze carefully a sudden increase in hip pain or rapid radiographic development of femoral head collapse in a child with a skeletal dysplasia. Recognition of true AVN, in contrast to the gradual evolution of head shape change in typical skeletal dysplasia, may change treatment recommendations and prognosis.

Child↗