Search PubMed⌕ Search

Biomedical subjects

S Brooks

Publications and source records attributed to S Brooks.

At least 91 records · Page 5Linked to original sources
PubMed1990

Assessment of community health aides.

A research project funded by the Commonwealth Caribbean Medical Research Council (CCMRC) began in February 1987, to study aspects of the situation in connection with 508 Community Health Aides (CHAs) employed in the Government Service of Jamaica. There were in the service 1,328 CHAs in 1978, reduced to 1,183 in 1982 and to 1,168 in 1984. By 1985/86 the numbers were further reduced, reaching the low figure of 508. This report deals specifically with the responses of 615 members of the community who were interviewed, and questionnaires were returned from all parishes in the four Administrative Health areas in Jamaica. The responses from community members are very important in the assessment of community health aides as members of the community health team. A number of useful and practical suggestions were reflected in their responses regarding service from community health aides.

Community Health Services↗
PubMed1990

Pregnancy outcome of patients with uncorrected uterine anomalies managed in a high-risk obstetric setting.

During an 8-year period, we managed 42 women with 101 pregnancies with previously diagnosed but uncorrected uterine malformations referred to our institution for high-risk obstetric care. All patients were managed under the same standardized protocol requiring weekly visits and decreased physical activity. The population studied consisted of four groups of pregnancies with the following uterine anomalies: unicornuate (five), bicornuate (61), septate (25), and didelphys (ten). Sixty percent of the pregnancies in the unicornuate and didelphys group reached term, 39% in the bicornuate group, and 48% in the septate group. Preterm labor requiring tocolysis occurred in 21% of the pregnancies in the bicornuate group and 15% of the pregnancies in the septate group. Cerclage was placed in 5% of the pregnancies in the bicornuate group. Before our care, the fetal survival rate for pregnancies in the bicornuate and septate groups was 52 and 53%, respectively; with our management protocol, it was 58 and 65%, differences that were not statistically significant. Our experience suggests that high-risk obstetric intervention does not obviate the potential benefit of metroplasty, especially for patients with a bicornuate or septate uterus. We believe that traditional indications for metroplasty should continue to be used.

Abortion, Spontaneous↗
PubMed1989

Internal amino acid sequence analysis of the 80 kDa protein kinase C substrate from rat brain: relationship to the 87 kDa substrate from bovine brain.

We have obtained sequence data from five proteolytic peptides totalling 102 amino acid residues of the 80 kDa protein kinase C substrate purified from rat brain. The amino acid sequences of these five peptides were compared with that deduced from a cDNA encoding the 87 kDa protein kinase C substrate from bovine brain. The overall amino acid sequence identity within the regions covered by our peptides is 54%. Two peptides aligned at the C- and N-termini of the bovine protein kinase C substrate with a very high degree of homology (more than 80% identity). Two other peptides exhibited 62% and 46% identity with two regions located in the C-terminal half of the bovine protein. The fifth peptide which contains the sequence PEQPEQPEQ did not reveal any similarity with the bovine protein. Based on the homologies of our experimentally determined sequences, which represent about 30% of the deduced sequence of the bovine protein, we suggest that although these protein kinase C substrates are not identical, they may belong to a family of related proteins.

Amino Acid Sequence↗
PubMed1989

Effects of epidural analgesia on plasma calcitonin gene-related peptide.

The effects of epidural analgesia on plasma calcitonin gene-related peptide (CGRP) values during and after hysterectomy were investigated in 14 healthy patients. In seven patients who received general anaesthesia alone for pelvic surgery, there were no significant changes in plasma CGRP concentrations. In the remaining patients, who received extensive epidural blockade in addition to general anaesthesia, there were again no significant changes in plasma CGRP values. This was in spite of profound sympathetic blockade, as shown by marked hypotension and a significant decline in plasma catecholamines. The epidural group of patients showed the expected attenuation of the glucose, cortisol and growth hormone responses to surgery. The results show that circulating CGRP is unlikely to be involved in the modulation of peripheral vascular tone during pelvic surgery under either general or epidural anaesthesia.

Adult↗
PubMed1989

Effect of training on muscle metabolism during treadmill sprinting.

Sixteen subjects volunteered for the study and were divided into a control (4 males and 4 females) and experimental group (4 males and 4 females, who undertook 8 wk of sprint training). All subjects completed a maximal 30-s sprint on a nonmotorized treadmill and a 2-min run on a motorized treadmill at a speed designed to elicit 110% of maximum oxygen uptake (110% run) before and after the period of training. Muscle biopsies were taken from vastus lateralis at rest and immediately after exercise. The metabolic responses to the 110% run were unchanged over the 8-wk period. However, sprint training resulted in a 12% (P less than 0.05) and 6% (NS) improvement in peak and mean power output, respectively, during the 30-s sprint test. This improvement in sprint performance was accompanied by an increase in the postexercise muscle lactate (86.0 +/- 26.4 vs. 103.6 +/- 24.6 mmol/kg dry wt, P less than 0.05) and plasma norepinephrine concentrations (10.4 +/- 5.4 vs. 12.1 +/- 5.3 nmol/l, P less than 0.05) and by a decrease in the postexercise blood pH (7.17 +/- 0.11 vs. 7.09 +/- 0.11, P less than 0.05). There was, however, no change in skeletal muscle buffering capacity as measured by the homogenate technique (67.6 +/- 6.5 vs. 71.2 +/- 4.5 Slykes, NS).

Adult↗
PubMed1989

Recent sexual behaviors among homosexual men seeking primary medical care.

We studied the sociodemographic characteristics, knowledge, and beliefs about acquired immunodeficiency syndrome transmission and sexual practices of 823 gay or bisexual men seeking primary care. During the previous 2 months, 64% had engaged in at least one sexual behavior considered unsafe. These patients compared with those having safer sex, were younger, of lower socioeconomic status, and from a racial minority, especially Latino. The unsafe group also had more sexual partners, engaged in sexual acts more often, felt less in control over their sexual behavior, used recreational drugs more frequently, and were less likely to talk about safe sex with partners. The unsafe group had less adequate knowledge about human immunodeficiency virus transmission but felt safer from the risk of acquired immunodeficiency syndrome even when engaging in unsafe sex. Educational programs dealing more directly with belief systems and the potential addiction to recreational drugs and sexual behaviors need to be developed for primary care settings.

Acquired Immunodeficiency Syndrome↗
PubMed1988

The responses of the catecholamines and beta-endorphin to brief maximal exercise in man.

The responses to brief maximal exercise of 10 male subjects have been studied. During 30 s of exercise on a non-motorized treadmill, the mean power output (mean +/- SD) was 424.8 +/- 41.9 W, peak power 653.3 +/- 103.0 W and the distance covered was 167.3 +/- 9.7 m. In response to the exercise blood lactate concentrations increased from 0.60 +/- 0.26 to 13.46 +/- 1.71 mmol.l-1 (p less than 0.001) and blood glucose concentrations from 4.25 +/- 0.45 to 5.59 +/- 0.67 mmol.l-1 (p less than 0.001). The severe nature of the exercise is indicated by the fall in blood pH from 7.38 +/- 0.02 to 7.16 +/- 0.07 (p less than 0.001) and the estimated decrease in plasma volume of 11.5 +/- 3.4% (p less than 0.001). The plasma catecholamine concentrations increased from 2.2 +/- 0.6 to 13.4 +/- 6.4 nmol.l-1 (p less than 0.001) and 0.2 +/- 0.2 to 1.4 +/- 0.6 nmol.l-1 (p less than 0.001) for noradrenaline (NA) and adrenaline (AD) respectively. The plasma concentration of the opioid beta-endorphin increased in response to the exercise from less than 5.0 to 10.2 +/- 3.9 p mol.l-1. The post-exercise AD concentrations correlated with those for lactate as well as with changes in pH and the decrease in plasma volume. Post-exercise beta-endorphin levels correlated with the peak speed attained during the sprint and the subjects peak power to weight ratio. These results suggest that the increases in plasma adrenaline are related to those factors that reflect the stress of the exercise and the contribution of anaerobic metabolism.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Long-term pancreatic-biliary diversion in the rat: persistent loss of mucosal enterokinase, with reinduction by delayed oral pancreatic biliary supplementation.

Diversion of pancreatic-biliary (PB) secretions in rats for 23 days led to loss of enterokinase (EK) activity in bypassed segments of the small intestine. Simultaneous oral trypsinogen and bile salt (TB) supplements prevented the loss of EK activity. To study the temporal course of events after PB diversion and to determine if the loss of EK is reversible, PB diversion was performed in rats by surgical transposition of the 4-cm segment of duodenum including the ampulla of Vater to a point 30 cm distal to its original site. Bypassed and control (sham- and nonoperated) rats fed standard rat chow were sacrificed at 10, 23, and 45 days after surgery. One bypassed group was fed standard chow for 23 days and then chow supplemented with TB until sacrifice at 45 days. At sacrifice, the intestines were divided into segment 1 (the bypassed proximal 30 cm) and segment 2 (the 30 cm distal to the bypass). In segment 1, EK disappeared almost completely by 10 days and remained at the same low levels at both 23 and 45 days (p less than 0.05). No significant changes in EK levels were found at any time in segment 2 distal to the bypass. Mucosal disaccharidase activity in segment 1 increased or showed no change. In rats with delayed TB supplementation, EK activity in segment 1 returned almost to control levels at the time of sacrifice. The results confirm the importance of PB secretions in the maintenance of EK activity. The effects of bypass on EK are both enzyme- and site-specific.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

Node-negative breast cancer treated by modified radical mastectomy without adjuvant therapies: variables associated with disease recurrence and survivorship.

The present study attempts to identify poor prognosis subgroups of women with node-negative breast cancer that might benefit from systemic adjuvant therapy. The cases were collected through a cooperative effort of 57 surgeons at eight hospitals in the Detroit area and coordinated by the Michigan Cancer Foundation where data collection and analyses were completed. The primary treatment of all patients was a modified radical mastectomy. Of the 1,078 cases accessioned between October 1975 and April 1983, 537 were found to have no microscopic lymph node involvement and 462 of these cases received no adjuvant antineoplastic therapy. The period of follow-up of these cases (alive, n = 358) has been 78.75 +/- 24.6 months (mean +/- SD). Overall, the cumulative 6-year recurrence rate as calculated by life table analysis was 26%, with 16.8% dying of their disease. Tumor size was an important prognostic factor; the recurrence rate was 16.2% for those with primaries measuring less than or equal to 1 cm, with only a 6.3% mortality. Patients with tumors measuring greater than 5 cm also did well: 13.7% recurrence and 13.7% mortality rates at 6 years. The premenopausal women did slightly, but not statistically significantly, better than those who were postmenopausal. The presence or absence of quantifiable estrogen receptor protein (ER) was of little predictive value as far as rates of recurrence were concerned, but patients with an ER-positive tumor survived significantly longer. In postmenopausal women, those whose tumor lacked ER (n = 112) fared poorly: 30.4% experienced a recurrence by 6 years and 28% died of their disease. Recurrence rates and death rates were also high in a small group (n = 35) of postmenopausal women with ER+ tumors exhibiting nuclear pleomorphism (nuclear grade [NG]3) (38% and 24.3%, respectively). No poor prognosis group of premenopausal women was identified.

Actuarial Analysis↗
PubMed1987

Enzyme binding to detect carbohydrate expression in tissue sections. 1. Native and cross-linked glucose oxidase.

Enzymes may be useful as highly specific histochemical probes to identify and localize macromolecular substrates in tissue sections. We have used glucose oxidase, a double-headed enzyme, to demonstrate beta-glucosyl groups in paraffin sections. Native glucose oxidase has two active sites per molecule. Soluble polymers formed by glutaraldehyde combine many active binding sites on to one molecule. Some of these bind to glucose in tissue sections, leaving others free to react with chromogenic substrate. The intensity of staining is directly related to the concentration of enzyme, duration of incubation with enzyme, temperature and pH. Polymeric forms of enzyme are about 100 times more effective than native. Glucose oxidase, particularly in a polymeric form, appears a simple reagent for the identification of glucose-containing structures. The use of native and polymerized enzymes as a histochemical probe has enormous potential in the analysis of normal tissues and in the detection of aberrant carbohydrate deposition in pathological tissues; this system serves as a useful model.

Animals↗
PubMed1987

The role of trochanteric wire revision after total hip replacement.

Fifty-nine cases of trochanteric wire revision following hip arthroplasty with trochanteric osteotomy and reattachment were identified and their outcome was studied. Two were infected and were excluded. Five were revised for instability: four became stable while one continued to have persistent dislocation. Fifty-two were revised for pain, 36 by removal of the trochanteric wire and 16 by reattachment of the greater trochanter. Successful relief of pain was obtained in less than half the cases. There was no difference in the incidence of back pain, wiring technique, trochanteric advancement, previous surgery to the same hip, trochanteric size or the pattern of wire breakage in the successfully treated group and the unsuccessful group. Neither was the removal of intact wire from a united trochanter any more certain of relieving pain than removal of broken wire from an un-united trochanter. Six patients later required revision for loosening or infection. These results indicate the need for full radiological and haematological investigation before exploration of the greater trochanter. At exploration for pain the wires should simply be removed as we could show no successful union after late reattachment of the trochanter in the absence of instability.

Adult↗
PubMed1986

The use of an oral prostaglandin inhibitor following splintage in fractures of the distal radius--a prospective trial.

A prospective, double-blind, controlled trial is reported in which oral diclofenac, a prostaglandin inhibitor, was given for 1 week immediately following the removal of splintage for fracture of the distal end of the radius. The patients who received the prostaglandin inhibitor had less pain, a more rapid recovery of range of movement and a stronger grip than those who received a placebo.

Adolescent↗
PubMed1986

Human muscle metabolism during sprint running.

Biopsy samples were obtained from vastus lateralis of eight female subjects before and after a maximal 30-s sprint on a nonmotorized treadmill and were analyzed for glycogen, phosphagens, and glycolytic intermediates. Peak power output averaged 534.4 +/- 85.0 W and was decreased by 50 +/- 10% at the end of the sprint. Glycogen, phosphocreatine, and ATP were decreased by 25, 64, and 37%, respectively. The glycolytic intermediates above phosphofructokinase increased approximately 13-fold, whereas fructose 1,6-diphosphate and triose phosphates only increased 4- and 2-fold. Muscle pyruvate and lactate were increased 19 and 29 times. After 3 min recovery, blood pH was decreased by 0.24 units and plasma epinephrine and norepinephrine increased from 0.3 +/- 0.2 nmol/l and 2.7 +/- 0.8 nmol/l at rest to 1.3 +/- 0.8 nmol/l and 11.7 +/- 6.6 nmol/l. A significant correlation was found between the changes in plasma catecholamines and estimated ATP production from glycolysis (norepinephrine, glycolysis r = 0.78, P less than 0.05; epinephrine, glycolysis r = 0.75, P less than 0.05) and between postexercise capillary lactate and muscle lactate concentrations (r = 0.82, P less than 0.05). The study demonstrated that a significant reduction in ATP occurs during maximal dynamic exercise in humans. The marked metabolic changes caused by the treadmill sprint and its close simulation of free running makes it a valuable test for examining the factors that limit performance and the etiology of fatigue during brief maximal exercise.

Adult↗
PubMed1986

Enteral feedback control of pancreatic hypertrophy: the role of pancreatic biliary secretions.

Chronic diversion of pancreatic and biliary secretions away from the proximal small intestine resulted in rapid increases in pancreatic size and protein content in adult rats. The effect was detectable as early as 10 days postsurgery. Differential changes in pancreatic enzymes were evident after bypass. The concentration of trypsinogen remained stable while amylase concentrations showed a marked decrease. Total pancreatic trypsinogen content, however, was increased, while amylase content remained similar to controls. Feeding bypassed rats with chows containing various pancreatic and biliary supplements had no effect on the hyperplastic response of their pancreata. Trypsinogen and amylase levels in supplemented groups remained similar to the bypassed group fed nonsupplemented chow, with the exception of increases in trypsinogen concentration and content in the groups supplemented with bile and cotazyme plus bile acids. The adequacy of oral refeeding of pancreatic biliary components was supported by its effectiveness in restoring mucosal enterokinase activity and trypsin levels in segment 1. However, there was no correlation between tryptic activity in the contents of the bypassed segment and the eventual pancreatic weight. These results indicate that factors other than those supplemented in this study are required in maintaining the steady state of pancreatic growth in normal rats.

Ampulla of Vater↗