Biomedical subjects
Publications and source records attributed to S Lane.
Acute anterior dislocation of the peroneal tendons from behind the peroneal groove is uncommon but not rare. The injury must be evaluated carefully to determine whether conservative treatment will suffice or surgical intervention is required. Choice of a surgical procedure depends on the fibular groove, the nature of the retinaculum, and the amount of damage to the area.
The therapeutic effect of transfer factor (TF) from healthy donors was investigated in two children with extensive intractable atopic dermatitis, recurrent pyogenic skin infections, hyperimmunoglobulinaemia E, defective neutrophil chemotaxis and depressed cell-mediated immunity. Striking clinical improvement was noted in both patients with disappearance of skin infections, pruritus and eczema. No new lesions have occurred 13 months after the completion of therapy in the first patient but a few new atopic lesions have reappeared after 8 months in the second. Both patients are off steroids and antibiotics. Transfer factor administration did not influence the T cell rosette number or the lymphocyte blastic transformation response, but it did cause conversion of the skin-test reactivity in both patients and correction of polymorphonuclear chemotaxis in one of them. Non clinical side-effects were noted but marked and persistent rise of serum IgE was observed in both patients. Our data suggest that patients with hyper-IgE syndrome may be benefited by TF therapy and they lend further support to the notion that T lymphocyte deficiency may be the basis of the eczema in this syndrome.
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Polyamines are small cationic molecules necessary for growth and differentiation in all cells. Although mammalian cells have been studied extensively, particularly as targets of polyamine antagonists, i.e. antitumor agents, polyamine metabolism has also been studied as a potential drug target in microorganisms. Since little is known concerning polyamine metabolism in the microsporidia, we investigated it in Encephalitozoon cuniculi, a microspordian associated with disseminated infections in humans. Organisms were grown in RK-13 cells and harvested using Percoll gradients. Electron microscopy indicated that the fractions banding at 1.051-1.059/g/ml in a microgradient procedure, and 1.102-1.119/g/ml in a scaled-up procedure were nearly homogenous, consisting of pre-emergent (immature) spores which showed large arrays of ribosomes near polar filament coils. Intact purified pre-emergent spores incubated with [1H] ornithine and methionine synthesized putrescine, spermidine, and spermine, while [14C]spermine was converted to spermidine and putrescine. Polyamine production from ornithine was inhibitable by DL-alpha-difluoromethylornithine (DFMO) but not by DL-alpha-difluoromethylarginine (DFMA). Cell-free extracts from mature spores released into the growth media had ornithine decarboxylase (ODC), S-adenosylmethionine decarboxylase (AdoMetdc), and spermidine/spermine N1-acetyltransferase (SSAT) activities. ODC activity was inhibited by DFMO, but not by DFMA. AdoMetdc was putrescine-stimulated and inhibited by methylglyoxal-bis(guanylhydrazone); arginine decarboxylase activity could not be detected. It is apparent from these studies that Encephalitozoon cuniculi pre-emergent spores have a eukaryotic-type polyamine biosynthetic pathway and can interconvert exogenous polyamines. Pre-emergent spores were metabolically active with respect to polyamine synthesis and interconversion, while intact mature spores harvested from culture supernatants had little metabolic activity.
AIM: The aim of this pilot evaluation was to assess whether changing a nursing shift pattern to incorporate 12-hour shifts would have positive effects for patients and staff in a ward environment. METHOD: All nurses, night sisters and therapists in contact with the ward during the trial were asked to complete a questionnaire. Data on sickness, agency use, 'untoward incidents' and spread of unsocial hours were also analysed to see what effects a change in shift pattern had. RESULTS: The new shift pattern offered benefits for patients through improved communication, increased continuity of care and more content staff. In addition, staff complied to the Working Time Regulations (DTI 1998) with no change to their unsocial hour pay. There was also a reduced need for agency nurses. CONCLUSION: This study illustrated the potential a new nursing shift pattern involving 12-hour shifts has for patient care, as well as for staff job satisfaction and efficient management of the ward. Twelve-hour shifts are infamous in nursing and many studies cite exhausted and dissatisfied staff as a reason for the negative press (Fitzpatrick et al 1999, Todd et al 1993). In particular, Todd et al (1989) claimed that the quality of patient care was negatively affected on wards that used a 12-hour shift pattern. The study reported here challenges Todd et al's work (1989, 1993) by demonstrating the benefits a change in shift pattern to 12-hour shifts can have for patients and staff in a ward environment.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.