Biomedical subjects
Publications and source records attributed to S J Hampson.
Adult Wilms tumour is an uncommon entity, with fewer than 200 cases reported in the world literature. Strict criteria for the definition of this tumour have been specified, amongst which was the need for it to be a primary renal neoplasm. We present radiological and histological evidence of this tumour occurring at an extrarenal site, and make the case for relaxation of these criteria to include this eventuality.
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Strains of the Mycobacterium avium intracellulare complex (MAIC) have become important colonisers of patients with acquired immunodeficiency syndrome (AIDS). Restriction fragment length polymorphisms were used to study the DNA from 88 MAIC isolates, including 51 derived from 47 AIDS patients. MAIC isolates from 33 of 45 AIDS patients were identical at the molecular level and distinct from the mycobacteria isolated from the stools of healthy subjects. The study also showed that serotyping correlates poorly with the genetic identity of these organisms. Mycobacterium paratuberculosis, which has been implicated in Crohn's disease, was not identified in any of the cultures studied.
Twenty patients with active Crohn's disease, the majority refractory to conventional therapy, were treated with rifampicin, ethambutol, isoniazid, and pyrazinamide or clofazamine for 9 months. After this period, 10 were in remission (Crohn's disease activity index less than 150). Of the 10 not in remission, three had been at 6 months, but had relapsed on treatment. Nine of 10 patients on steroids at the beginning were off steroids at 9 months. Six patients came to surgery during the period, five for stricture formation without evidence of florid Crohn's disease outside the strictured segment. Three young patients with severe Crohn's disease facing total colectomy were spared surgery. No serious drug-related side-effects were encountered. The results of this pilot study suggest that controlled trials of antimycobacterial chemotherapy, using four or more of the best agents available, are worthy of assessment in Crohn's disease.
Serial blood samples were taken at two-hour intervals over a 24-hour period from 25 premenopausal vegetarians (12 vegans and 13 ovolactovegetarians) and from 21 omnivorous controls. All members of the former group had been on a vegetarian diet for a minimum of three years. The mean proportion of estradiol unbound to blood proteins was similar in both vegetarians (1.26%) and meat eaters (1.16%). However, the amount bound to albumin was significantly raised in vegetarians (50.1% vs. 43.1%, p less than 0.009), whereas that bound to sex hormone-binding globulin (SHBG) was correspondingly lower (48.7% vs. 55.8%, p = 0.01). Mean levels of SHBG were similar in vegetarians (59.9 nmole/l) and omnivores (62.0 nmole/l), as was the total amount of free fatty acid (0.42 mmole/l for both). Within the vegetarian group, no differences were detected between vegans and ovolactovegetarians.
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Diurnal levels of plasma prolactin and growth hormone were measured in 47 normal premenopausal women, 26 of whom were established vegetarians and 21 of whom were omnivorous controls. There were no differences between the median prolactin levels of the two groups during a 24-hour period of investigation. When the groups were further subdivided into ovolactovegetarians and vegans, still no differences were found in prolactin secretion. In contrast, the vegetarian women exhibited elevation of growth hormone levels during the period of study, which was particularly marked at midnight and 10 A.M.
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The transition to parenthood has been viewed as a crisis, yet families often have little contact with health-care professionals during the early postpartum months. What factors influence adaptation to parenthood and what nursing interventions facilitate the transition? A selective literature review is presented of the more commonly recognized interventions, including home visits, group support, and telephone support. Recommendations follow.