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Biomedical subjects

S Blair

Publications and source records attributed to S Blair.

At least 37 records · Page 2Linked to original sources
PubMed1996

Patient educational material in the management of low back pain in primary care.

Distributing educational material about low back pain to patients is increasingly seen as a possible adjunct to clinical management and a potential means of reducing the risk of the progression of the disorder toward chronic disability. Most back pain is managed in the primary care setting, where such material could save time and support the efforts of these practitioners. Recent evidence-based clinical guidelines for acute low back pain in U.S. and U.K. have advocated the use of educational material, but most of the available booklets are based on traditional biomedical theory about back pain and are neither evidence-based nor in line with recent guidelines. The few of these booklets that have been tested have had inconsistent effects. A new booklet has been developed which is evidence-based, in line with recent guidelines, and states its messages in a firm, uncluttered, and unambiguous manner. Preliminary studies show that it is readily accepted by patients, that they understand the messages, and that it creates a positive shift in beliefs about low back pain. Further studies regarding the use of this booklet are required to determine its effect on clinical outcomes.

Humans↗
PubMed1995

Hepatitis B transmission from contaminated cryopreservation tank.

Over a 25-month period, six multiply transfused patients undergoing cytotoxic treatment for haematological or other malignant disorders developed icteric acute hepatitis B virus (HBV) infection. Bone marrow or peripheral-blood stem cells had been harvested from all six patients and stored in the same cryopreservation tank for possible future transplantation. Human DNA, HBsAg, and HBV DNA with sequences identical to those from four patients with related infections were subsequently found in the liquid nitrogen. Leakage of the cryopreservation bags used to store bone marrow harvested from the first patient when acutely infected with HBV led to contamination of the tank and its contents with HBV and subsequent transmission to patients after transplantation. This incident emphasises the continuing need to screen donors of tissue to be cryopreserved for bloodborne virus infections. It also reinforces the requirement for primary containers used to cryopreserve human tissue to be sealed in a way which prevents exchange of material between the specimen and the liquid nitrogen.

Acute Disease↗
PubMed1995

Expression of E6/E7 or SV40 large T antigen-coding oncogenes in human corneal endothelial cells indicates regulated high-proliferative capacity.

PURPOSE: Human corneal endothelial cells are thought to have limited capacity for proliferation. Little is known about the mechanisms that regulate the proliferation of these cells. The authors introduced oncogenes into human corneal endothelial cells to modulate proliferation. In addition, they sought to establish cell lines to facilitate study of human corneal endothelial cells. METHODS: Early-passage human corneal endothelial cells were transduced with disabled retrovirus (pLXSN16E6/E7) coding for the human papilloma virus type 16 transforming oncoproteins E6 and E7. Early-passage cells were also stably transfected by electroporation with the pMTV-D305 plasmid vector, in which SV40 large T antigen (SV40 LTAg) mRNA expression is positively regulated by the mouse mammary tumor virus promoter. Expression of E6/E7 mRNA or SV40 LTAg mRNA in cell lines was monitored with the polymerase chain reaction. SV40 LTAg protein expression was detected by immunocytology and Western blot analysis. RESULTS: Human corneal endothelial cells were efficiently infected with disabled retrovirus coding for E6/E7, and seven strains of cells have continued active proliferation for more than 50 population doublings (PD) (< 8 control PD). E6/E7 mRNA was expressed by each cell strain. E6/E7 transformed cells proliferate rapidly and form a monolayer of cells with a high degree of contact inhibition. Transfection with pMTV-D305 is less efficient, and only a single strain was developed. pMTV-D305-transfected endothelial cells (dexamethasone induced) proliferated at a lower rate than E6/E7-transduced cells or cells transfected with a vector (pSV3neo) in which SV40 LTAg is constitutively regulated. In the absence of dexamethasone, the proliferation of pMTV-D305-transfected cells was even slower, but cells continued to produce SV40 LTAg mRNA and protein. The latter results indicated that SV40 LTAg mRNA continued to be synthesized at significant levels in pMTV-D305-transfected cells in the absence of the inducer dexamethasone. CONCLUSIONS: This study suggests that human corneal endothelial cells have a high capacity for proliferation. Thus, cell division is normally controlled in human corneal endothelial cells by poorly characterized, but efficient, mechanisms. Because the E6 and E7 proteins, as well as the SV40 large T antigen, specifically bind to and interfere with the activity of the retinoblastoma (RB) and p53 tumor suppressor proteins, our results suggest that these proteins have critical roles in regulating the proliferation of human corneal endothelial cells.

Antigens, Polyomavirus Transforming↗
PubMed1995

Compliance issues in adolescence: practical strategies.

Understanding the process of adolescent development is crucial to engendering good compliance. Successful outcomes can be achieved by approaching adolescents with respect and negotiating with them shared treatment goals. A few simple interventions can help make the issue of compliance in adolescents less problematic.

Adolescent↗
PubMed1994

Detection and significance of bone marrow infiltration at the time of autologous bone marrow transplantation in Hodgkin's disease.

Bilateral iliac crest biopsies were performed at the time of bone marrow (BM) harvest in patients with poor-risk Hodgkin's disease (HD) undergoing autologous bone marrow transplantation (ABMT). 67 consecutive patients with normal trephine biopsies (58 unilateral; nine bilateral) taken 2 weeks prior to harvest were studied. Nine (13%) of patients had BM infiltration with HD on the harvest biopsies. These patients had all previously had only unilateral biopsies. Three patients did not proceed to ABMT because disease progression became clinically apparent, but the remaining six patients were infused with involved marrow. One patient died 6 weeks post ABMT, with no evidence of disease at post-mortem. One patient showed no response to ABMT and four patients either had a partial or complete response to ABMT. Of the responders, three patients are now in complete remission at 53, 39 and 33 months past ABMT.

Adolescent↗
PubMed1993

LH pulsatility, biopotency, and clearance during undernutrition in orchidectomized mature rats.

The effect of food restriction on circulating luteinizing hormone (LH) levels in orchidectomized rats is controversial. The present study demonstrates that decreasing food intake by 50% for 3-10 days in orchidectomized rats increases LH pulse amplitude, length, area under pulse curve, and mean levels but decreases LH pulse frequency compared with ad-lib fed, orchidectomized controls. The effects on pulsatile LH secretion of food reduction by 50% with or without dilution by cellulose to maintain food volume in orchidectomized rats were also examined. Food volume influences pulsatile LH secretion independent of macronutrient effect after 3 days of food restriction, but subsequently macronutrient deprivation predominates. The exaggerated increase in LH levels in orchidectomized rats subject to food restriction for 7 days was not due to immunochemical or chromatographic heterogeneity or alteration in biopotency of circulating LH molecules. Intravenously injected 125I-labeled rat LH analyzed by noncompartmental modeling revealed that neither LH clearance nor mean residence time was reduced by food restriction. We conclude that during food restriction in orchidectomized rats, increases in LH pulse amplitude exceed and precede the decreases in LH pulse frequency, although the early changes in pulse amplitude are predominantly due to reduced food volume rather than macronutrient deprivation.

Aging↗
PubMed1992

Mini-BEAM followed by BEAM and ABMT for very poor risk Hodgkin's disease.

High dose chemotherapy and autologous bone marrow transplantation (ABMT) is an effective form of salvage therapy in patients with relapsed or resistant Hodgkin's disease. Patients with large tumour masses at the time of ABMT have a poorer prognosis and we have therefore administered intermediate dose BCNU, etoposide, cytarabine and melphalan (mini-BEAM) prior to high dose therapy with the same agents (BEAM) and ABMT in such patients. In addition we have used the same strategy in patients with bone marrow infiltration at the time of relapse in an attempt to clear the bone marrow for transplant. A total of 23 patients received mini-BEAM and 21 proceeded to BEAM and ABMT. Platelet engraftment was delayed compared to BEAM recipients who had not received mini-BEAM (P = 0.008) but there was only one procedure related death. Responses to BEAM and ABMT were not predicted by the response to mini-BEAM indicating a dose response effect at the upper end of the dose intensity spectrum. At 2 years, the overall survival and progression free survival are 61% and 46% respectively for this group of Hodgkin's patients with extremely poor prognosis.

Adult↗
PubMed1992

von Willebrand factor as a marker of endothelial cell activation following BMT.

Endothelial cell activation may play a role in thrombotic complications of BMT such as hepatic veno-occlusive disease (VOD), right atrial line thrombosis and microangiopathic haemolysis. To assess this, von Willebrand factor antigen (vWF:ag) was measured in 72 patients (25 allografts, 46 autografts and one syngeneic) during the first 6 weeks post-transplant. There was a significant rise in vWF:ag in both allografts and autografts but a greater increase was seen in the allografts. The changes in vWF:ag did not correlate with changes in C reactive protein showing that this was not merely an acute phase response. vWF multimers were normal in a subgroup of uncomplicated transplants showing that there was no large scale endothelial cell disruption. Patients with VOD did not have changes in vWF:ag that were consistently different from uncomplicated controls. Three of four patients who developed line thrombosis had higher levels of vWF:ag compared with control groups; multimeric structure of the vWF was again normal. These results show that there is endothelial cell activation post-BMT and that this is greater in allografts compared with autografts, thus suggesting a possible mechanism for the higher incidence of VOD in this group. There were no useful predictive markers of VOD or thrombosis in individual patients.

Adolescent↗
PubMed1991

Liposomal amphotericin B (AmBisome) in the treatment of fungal infections in neutropenic patients.

The use of high-dose chemotherapy and the subsequent prolonged neutropenia in patients with haematological diseases has resulted in an increased incidence of fungal infections. The diagnosis and treatment of these infections in neutropenic patients pose major therapeutic problems. The only drug with proven efficacy in the treatment of deep-seated fungal infections, including invasive aspergillosis, is amphotericin B. Unfortunately, this drug has adverse side effects, most importantly dose-dependent nephrotoxicity; furthermore, some patients fail to show a response to amphotericin B. We have treated 20 patients undergoing myeloablative chemotherapy and/or bone marrow transplantation for haematological diseases with liposomal amphotericin (AmBisome) for proven or suspected aspergillosis. Eighteen patients had diffuse interstitial pneumonitis and two patients had suspected fungal liver abscesses. Five patients had mycologically proven fungal infection and of these, three patients (60%) showed a complete response to liposomal amphotericin. Eleven patients received liposomal amphotericin because of the failure of conventional amphotericin B to eradicate proven or suspected fungal infection. Five of these 11 patients (45%) showed a complete clinical response to liposomal amphotericin. Eight patients received liposomal amphotericin because of pre-existing renal impairment or nephrotoxicity caused by conventional amphotericin B. Four of these patients (50%) showed a response to liposomal amphotericin. Recovery from probable fungal infection in this group of patients occurred when there was complete remission of underlying disease and recovery of neutrophil counts, when they were concurrently treated with liposomal amphotericin.

Adolescent↗
PubMed1990

Toe the line: a nurse-run well foot care clinic.

1. Adequate foot inspection requires good vision and joint mobility, both of which tend to decline with age. In addition, medical records suggest that health-care workers typically do not consider foot care a priority. 2. A major focus of discharge planning is functional status and mobility, of which the feet play a major role. Nurses must endeavor to look at the total person and address the client's primary concern. 3. Foot care assessment, intervention, and teaching is a unique opportunity for nurses to independently and positively affect the specialized health-care system toward viewing and caring for the client as a whole.

Aged↗
PubMed1989

Effects of treadmill running on plasma beta-endorphin, corticotropin, and cortisol levels in male and female 10K runners.

Reports of plasma beta-endorphin (B-EN) levels in response to submaximal exercise have been highly disparate. Variations in experimental design have complicated interpretation of previous research. The present study was designed to determine whether a sequential change in plasma beta-endorphin (B-EN), corticotropin (ACTH), and cortisol levels occurs in response to a 30-min submaximal run. Twenty-three subjects were divided into four groups: male runners, female runners, sedentary males and sedentary females. Subjects ran on a treadmill at 80% of previously determined maximum heart rate. Five plasma samples were obtained through an indwelling catheter before exercise (-30 and 0 min), at 15 and 30 min of exercise, and after 30 minutes of recovery. The run resulted in no rise in B-EN, ACTH, and cortisol despite an elevated rectal temperature. B-EN values were significantly higher in males than in females (p less than 0.01). No sex or training differences were seen with respect to change of hormone concentrations over the course of the run. Three male runners developed symptoms of vasovagal syncope after the catheter placement and had high initial B-EN, ACTH, and cortisol concentrations which decreased throughout the run. These data indicate that gender and training do not affect ACTH and cortisol concentrations before, during, and after 30 min of treadmill running at 80% of maximum heart rate, whereas B-EN concentrations are higher in males under these conditions.

Adrenocorticotropic Hormone↗
PubMed1986

The toxicity of D-penicillamine in systemic sclerosis.

We studied D-penicillamine toxicity in 259 patients with systemic sclerosis treated since 1972. The average daily dose of 635 mg was given for a mean of 1.8 years. Of patients with systemic sclerosis, 47% has side effects from D-penicillamine treatment, similar to the 56% of 807 patients with rheumatoid arthritis in seven separate series. Individual manifestations of toxicity included rash, proteinuria, gastrointestinal symptoms, dysgeusia, oral ulcers, thrombocytopenia, and neutropenia. Four episodes each of myasthenia gravis and pemphigus occurred in our patients; both were reported rarely in patients with rheumatoid arthritis. Adverse effects occurred more frequently after rapid increases in dosage. Treatment had to be discontinued due to toxicity in 29% of patients with systemic sclerosis and in 33% of those with rheumatoid arthritis. Although toxic, with a high frequency of adverse effects, D-penicillamine can be used safely in the treatment of systemic sclerosis. Pemphigus and myasthenia gravis may occur more frequently with therapy for systemic sclerosis than with that for rheumatoid arthritis.

Arthritis, Rheumatoid↗
PubMed1985

Measles matters, but do parents know?

Two hundred and one parents attending three child health clinics were questioned about both measles and immunisation against measles. Most parents were unaware of the symptoms and possible complications of measles and did not believe immunisation to be effective in preventing measles. They did not remember having talked to health professionals about immunisation.

Attitude to Health↗
PubMed1985

Changing knives a wasteful and unnecessary ritual.

The use of two knives for making a surgical incision is a deeply ingrained practice of British surgery and a postal survey of the theatre superintendents in the South-West Thames Region revealed that out of 143 surgeons all but one use this technique. Therefore we undertook a bacteriological study of the knife blades used on a general surgical unit. This showed that under normal conditions pathogenic organisms do not contaminate the knife blade and are not carried into the wound by it. The use of only one knife to make an incision does not increase the incidence of wound infection. A survey of the world literature confirms these findings. The wasteful and unnecessary ritual of using two knives to make an incision through normal skin has no theoretical, scientific or clinical basis and can be discontinued.

Bacteria↗
PubMed1982

Tooth-brushing-induced epilepsy.

A case report of a 12-year-old male with tooth-brushing-induced epilepsy is presented. The partial elementary seizures began several weeks after placement of a palatal expansion appliance which led to local irritation of the upper gums. Although other oral stimulation occasionally precipitated the seizures, they were consistently induced by tooth brushing. The case is another example of how specific stimuli can trigger epileptic seizures.

Adolescent↗
PubMed1981

Modification of the macaque's vestibulo-ocular reflex by picrotoxin.

The vestibulo-ocular reflex (VOR) in the macaque was tested by a modified Bárány spinning test before and after subcutaneous administration of 1 mg/kg of picrotoxin. The drug caused a decrease in the nystagmus time constant to a value near that of the cupula and a decrease in mystagmus asymmetry. Picrotoxin prevented diazepam from increasing the time constant of vestibular nystagmus. Furthermore, picrotoxin reduced the nystagmus time constant after vermisectomy, a lesion that increases the nystagmus time constant and prevents some VOR modifications. Because picrotoxin and diazepam interact antagonistically in the gamma-aminobutyric acid (GABA) neurotransmitter system, these results show a role of GABA in the neural network that transforms a short cupula time constant into a longer nystagmus time constant.

Animals↗
PubMed1980

News of risk for early heart disease as a stressful event.

Modern prevention includes efforts to reduce the frequency of coronary heart disease by screening populations for certain risk factors, and then advising persons high in risk on how to alter their vulnerability. But what is the effect of telling persons they are at increased risk for such threatening events as heart attacks? Without such information they may not be motivated to change such behavior as cigarette smoking or to comply with blood pressure reducing regimens. With it, worry about their health status may increase. The present study examined such variables in 575 men with no previous symptoms of heart disease who were informed of increased risk and followed for three years. The men were divided at random into two groups of equal size. A Special Intervention group received repeated reminders of risk and procedures for cessation of smoking, reduction of blood pressure, and dietary alteration to lower serum cholesterol. A contrast group received usual medical care, as they saw fit, in response to the news of risk. At yearly intervals, scores on level of subjective distress, avoidance, and coping were obtained. One-third of the men reported intrusive or avoidance experiences one year after receipt of the news of increased risk. The Special Intervention group, with its more frequent reminders, had significantly higher levels of intrusive ideas and feelings about the news of risk than the Usual Care group, and significantly higher levels of coping experiences.

Adult↗