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Biomedical subjects

S Bell

Publications and source records attributed to S Bell.

At least 109 records · Page 6Linked to original sources
PubMed1992

A pilot study of screening for neuroblastoma in the north of England.

A pilot study has been carried out to assess the feasibility of screening for neuroblastoma in 6-month-old infants in the north of England. A total of 20,829 infants were screened. Two true-positive cases were found, along with eight false-positive and three false-negative cases. It was shown that the concentrations of catecholamine metabolites in the urine are dependent on the creatinine content; centiles have been established to allow this relationship to be taken into account. Five of the eight false-positive cases would have been correctly assessed as normal if the new centiles had been used. Preliminary results lend support to the need for a well-designed study of neuroblastoma screening to be carried out, with death from this disease as the only end point.

England↗
PubMed1992

[Toxic oil syndrome--an example of an exogenously-induced autoimmune disease].

In 1981 epidemic poisoning with adulterated cooking oil occurred in Spain, affecting more than 20,000 people. The condition caused has since become known as the toxic oil syndrome (TOS). About 10-15% of the patients with acute symptoms developed a chronic disease with scleroderma-like skin manifestations, polyneuropathy and myositis. While the acute phase of the TOS was characterized by eosinophilia and elevated IgE, the chronic stage involved humoral autoimmune phenomena, such as antinuclear and antinucleolar antibodies, in many cases. In women with the chronic phase of TOS there was a possible prevalence of HLA-DR3 and HLA-DR4. The recently characterized eosinophilia-myalgia syndrome (EMS), which is thought to have been induced by contaminated L-tryptophan preparations, is similar to the TOS in some particulars. Understanding of the toxicological, immunological and genetic pathways leading to these diseases might give us some insight into the pathogenesis of spontaneously occurring autoimmune diseases, such as systemic scleroderma.

Animals↗
PubMed1990

Interpractice visits by general practitioners: implications of a pilot project for quality assurance in general practice.

This article describes a pilot study involving 25 general practitioners who agreed to undertake interpractice visits. Decisions regarding the nature, length and documentation of the interpractice visit were made by consensus during a 5-h workshop. Participants met again as a group after the visits were completed and discussed the acceptability of the visits and their potential to improve standards of care. Reactions included a high level of enthusiasm to develop further the rigour of these visits.

Australia↗
PubMed1990

Effect of ranitidine on acetaminophen-induced hepatotoxicity in dogs.

The effect of ranitidine administration upon the hepatotoxic effect produced by a multidose acetaminophen administration regimen was examined. Seventy-two dogs received three subcutaneous injections of acetaminophen (750, 200, 200 mg/kg body wt) in DMSO (600 mg/ml) at time zero, 9 hr later, and 24 hr after the first dose. Ten control animals (group I) were not given ranitidine, the remaining 62 dogs received an intramuscular injection of ranitidine 30 min before each acetaminophen dose. Three different doses of ranitidine were used (mg/kg body wt): 50 mg, group II (33 dogs); 75 mg, group III (14 dogs); 120 mg, group IV (15 dogs). Ranitidine reduced the expected acetaminophen-induced hepatoxicity in a dose-response manner. Moreover, a significant correlation was found between the ranitidine dose and the survival rate, as evidenced by transaminase levels in the serum and histology of the liver. This model of fulminant hepatic failure induced by acetaminophen and its modulation with ranitidine provides clinical investigators with a research tool that will be useful in the future investigation of putative medical and surgical therapies being investigated for use in the clinical management of fulminant hepatic failure. Because of the size of the animal used in this model, frequent and serial analyses of blood and liver were available for study to determine the effect of therapy within a given animal as opposed to within groups of animals.

Acetaminophen↗
PubMed1990

Rhabdomyolysis associated with severe hyponatremia after prostatic surgery.

Transurethral resection of the prostate gland (TURP) has long been associated with disturbances of plasma sodium concentration. Relatively recent substitution of isotonic irrigation solutions has transformed the predominant laboratory abnormality reported from one of hypotonic hyponatremia to one of nearly isotonic hyponatremia with infrequent clinically significant manifestations. We report the unique association of acute and very severe isotonic hyponatremia with rhabdomyolysis and acute renal failure in the post-TURP setting. The mechanism for rhabdomyolysis is postulated to be an impairment of normal maintenance of cellular integrity by virtue of the acuteness and severity of hyponatremia, in the absence of a disturbance of tonicity. Survival after hyponatremia of this severity has not, to our knowledge, been previously reported.

Acute Disease↗
PubMed1990

Extraction of DNA from exfoliative cytology specimens and its suitability for analysis by the polymerase chain reaction.

The extraction of DNA from archival exfoliative cytology samples would allow the molecular biological analysis of this readily available material using the polymerase chain reaction (PCR). We have quantitatively and qualitatively studied the extraction of DNA from a variety of cytological preparations. For both fresh and archival cervical smears, overnight incubation with proteinase K produces high yields of high molecular weight DNA, but simply boiling the samples produces DNA suitable for PCR amplification of a single copy gene. Increasing the proteinase K incubation to several days allows the extraction of DNA from fixed and stained archival cytology slides from a variety of sites. The extracted DNA was again suitable for PCR analysis. Fresh and archival cytological material can be utilized for molecular biological study of disease processes using PCR. Archival cytological material is probably the best source of DNA and RNA after stored frozen tissue.

DNA↗
PubMed1990

Induction of immunoglobulin G Fc receptors by recombinant vaccinia viruses expressing glycoproteins E and I of herpes simplex virus type 1.

Glycoprotein E (gE) of herpes simplex virus type 1 (HSV-1) will bind immunoglobulin G (IgG) (Fc) affinity columns (R. B. Bauke and P. G. Spear, J. Virol. 32:779-789, 1979), but recent evidence suggests that the HSV-1 Fc receptor is composed of a complex of gE and glycoprotein I (gI) and that both gI and gE are required for Fc receptor activity (D. C. Johnson and V. Feenstra, J. Virol. 61:2208-2216, 1987; D. C. Johnson, M. C. Frame, M. W. Ligas, A. M. Cross, and N. D. Stow, J. Virol. 62:1347-1354, 1988). We have expressed gE and gI, either alone or in combination, on the surface of HeLa cells by using recombinant vaccinia viruses and have measured Fc receptor activity by Fc-rosetting or IgG-binding assays. Expression of gE alone resulted in the induction of Fc receptor activity, while expression of gI alone gave no detectable Fc binding. Coexpression of gE and gI resulted in higher levels of IgG binding than did expression of gE alone, despite the fact that under conditions of coexpression, the levels of surface gE were reduced. We propose that gE and gI together form a receptor of higher affinity than gE alone and that HSV-1 therefore has the potential to induce two Fc receptors of different affinities.

Animals↗
PubMed1990

Evaluation of N-acetylcysteine and methylprednisolone as therapies for oxygen and acrolein-induced lung damage.

Reactive oxidizing species are implicated in the etiology of a range of inhalational pulmonary injuries. Consequently, various free radical scavengers have been tested as potential prophylactic agents. The sulfydryl compound, N-acetylcysteine (NAC) is the only such compound clinically available for use in realistic dosages, and it is well established as an effective antidote for the hepatic and renal toxicity of paracetamol. Another approach in pulmonary injury prophylaxis is methylprednisolone therapy. We evaluated NAC and methylprednisolone in two rat models of inhalational injury: 40-hr exposure to greater than 97% oxygen at 1.1 bar and 15-min exposure to acrolein vapor (210 ppm). For oxygen toxicity, NAC (80 mg) or methylprednisolone (10 mg) were given IP every 2 or 6 hr, respectively. For acrolein, single doses of NAC (1 g/kg) and methylprednisolone (30 mg/kg) were given intravenously 15 min before exposure. In sham-exposed control animals, neither treatment favorably effected mortality, lung wet/dry weight ratios, or pulmonary histology. The increases in lung wet/dry weight ratios, seen with both oxygen and acrolein toxicity were reduced with both treatments. However, with oxygen, NAC therapy was associated with considerably increased mortality and histological changes. Furthermore, IP NAC administration resulted in large volumes of ascitic fluid. With acrolein, IV, NAC had no significant effect on mortality or pulmonary histological damage. Methylprednisolone had no beneficial effects on either the mortality or histological damage observed in either toxicity model. We caution against the ad hoc use of NAC in the management of inhalational pulmonary injury.

Acrolein↗
PubMed1989

Antibodies to Ro/SSA detected by ELISA: correlation with clinical features in systemic scleroderma.

Anti-Ro/SSA antibodies were determined by a newly developed enzyme-linked immunosorbent assay in serum specimens from 114 patients with systemic scleroderma in order to examine the relationship between Ro/SSA antibodies and clinical subsets of scleroderma. Sera of 42 patients (37%) were positive for Ro/SSA antibodies. Clinical investigations, including Schirmer's test and enzymatic profiles, demonstrated that 60% (16 of 27) of scleroderma patients with sicca syndrome and 63% (10 of 16) with polymyositis (PM) were Ro/SSA positive. In these patients there was a significant association between Ro/SSA antibodies and rheumatoid factor. HLA-antigens DR2, DR3 and B8 showed an increased frequency in anti-Ro/SSA positive patients.

Antibodies, Antinuclear↗
PubMed1989

Correlation of asphyxia and other risk factors with outcome: a contemporary view.

The relationships between 14 maternal/prenatal, 24 perinatal and 12 asphyxia-related variables and outcome at 40 weeks, nine, 18 and 36 months were evaluated in a sample of 608 children enrolled in the multi-center National Heart, Lung and Blood Institute Collaborative study. Correlations were weak generally, although they tended to be stronger for perinatal variables and neurological outcome at 36 months. When the maternal/prenatal and perinatal variables (medical/biological), the SES-Composite Index (environmental/psychosocial) and the Early Neuropsychologic Optimality Rating Scale-9 (behavioral/developmental) were used as optimality scales, prediction was enhanced; however, it appeared that the environmental/psychosocial and behavioral/developmental scales were more predictive of 36-month outcome than were medical/biological variable groupings.

Aging↗
PubMed1988

Complicated mania. Comorbidity and immediate outcome in the treatment of mania.

In a case-control study, 57 manics with antecedent or coexisting nonaffective psychiatric disorders (n = 38) or serious medical illnesses (n = 19) ("complicated mania") were compared with 114 age-, sex-, and year-of-admission-matched controls with no other disorder ("uncomplicated mania"). Significant differences emerged between the three groups in age, marital status, age at onset, number of prior hospitalizations and prior suicide attempts, organic features, and outcome measures (recovery and death rates). Patients were divided into four treatment groups based on primary mode of therapy during index admission; the groups included electroconvulsive therapy, adequate lithium carbonate, inadequate lithium carbonate, and neither treatment. Uncomplicated manics were significantly more likely to receive adequate lithium carbonate and less likely to receive inadequate lithium carbonate than were complicated manics. The latter patients had a significantly poorer immediate response to treatment overall, and to adequate lithium carbonate specifically. Seventy-eight (68.4%) uncomplicated manics had recovered ad discharge, compared with 26 (45.6%) complicated manics. Logistic regression suggested that the influence of comorbidity on outcome was more important for women than men. We conclude that complicated mania is a useful clinical construct.

Adult↗
PubMed1988

The Early Neuropsychologic Optimality Rating Scale (ENORS-9): a new developmental follow-up technique.

The development and application of the Early Neuropsychologic Optimality Rating Scale (ENORS-9) is described. This 24-item technique, scored in an optimal/nonoptimal fashion, enables assessment of posture, tone, and movement, as well as developmental delays. The ENORS-9 was compared with the Bayley Mental and Psychomotor Developmental indexes and a neurologic examination administered at 9 months, in terms of sensitivity and specificity of cognitive, motor, and neurologic outcome at 36 months. Using an ENORS-9 cut-off score of 85% for cognitive and motor, and 75% for neurologic outcome, sensitivity values were more than three times greater than more traditional assessment techniques. This instrument meets many needs in developmental follow-up because of straightforward scoring, decreased personnel requirements and cost, and flexibility in regard to missing data and cut-off scores. The implications of these findings are discussed.

Child Development↗
PubMed1987

A computer simulation program to facilitate budgeting and staffing decisions in an intensive care unit.

ICUs have unique problems in choosing their best staffing levels for direct patient care because each unit's total patient needs per shift, quantitated in acuity points, vary widely. We devised a computer program to simulate our 12-bed medical/cardiac ICU workload and staffing system. Nursing staffing policies, costs, and availabilities, and a table of past patient acuities per shift were input; total overstaffing, understaffing, and cost per year for full-time nursing equivalents (FTEs) for direct patient care were output for different staffing levels. Using the model, we considered financial concerns, quality of care issues, and staff working preferences and determined that our best staffing level would be based on 5.5 direct FTEs per shift. The stimulation analysis is straightforward, flexible, adaptable, and easy to update and use.

Budgets↗