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Biomedical subjects

S M Hunt

Publications and source records attributed to S M Hunt.

At least 55 records · Page 3Linked to original sources
PubMed1986

Immunochemical analysis of normal and mutant forms of human pyruvate dehydrogenase.

Pyruvate dehydrogenase (PDH) deficiency has been described in many patients with primary lactic acidosis. However, there are very few cases in which a structural defect in the complex has been clearly demonstrated. Measurement of the activity of the PDH complex in cultured human cells has proved unreliable, and a combination of structural and functional studies are required to make a definitive diagnosis. For this reason, an immunochemical strategy has been developed to complement direct enzyme assay in the detection and further characterization of PDH deficiency. We illustrate the usefulness of this approach by describing defects in the alpha-subunit of the pyruvate decarboxylase component of the PDH complex in two patients with primary lactic acidosis. In one patient, there is no immunologically cross-reacting material corresponding to this subunit. In the second patient, there appears to be an intrinsic structural defect in the subunit which restricts dephosphorylation (and hence activation) of the inactive phosphorylated complex.

Acidosis, Lactic↗
PubMed1986

Cross-cultural issues in the use of socio-medical indicators.

Socio-medical indicators for the assessment of physical, psychological and social conditions have become increasingly popular as adjuncts to traditional clinical and epidemiological measures. Most such indicators have been developed in the U.S.A. or Great Britain and considerable problems may arise from attempts to use them in other cultures. The ambiguity inherent in the terms "health" and "illness" is compounded cross-culturally by differences in the meaning system of cultures, their values, expectations and historical development. Consideration of cultural differences must precede any attempt to adapt already existing instruments for use in a culture or within a sub-group whose members were not included in the development process. Reliability and validity of socio-medical measures can only be assumed after the closest attention has been paid to the technical, conceptual and linguistic issues which arise from translation. This paper details some of the issues involved together with an account of the practical problems arising from the translation of the Nottingham Health Profile into Arabic and Spanish.

Cross-Cultural Comparison↗
PubMed1986

Health needs in a London district.

The hospital admission rate in Inner London is higher than for the country as a whole. This could be because more beds are available or because the local population has special needs. This paper considers admission rates by electoral wards within one Inner London District. The paper shows that the high admission rates are characteristic of electoral wards which exhibit severe social deprivation and that the more affluent wards do not have high hospitalization rates despite the fact that residents of all electoral wards have equal access to hospital. Our conclusion is that the high hospitalization rates in Inner London are at least in part due to social deprivation and that any allocation of health resources needs to make adequate and additional provision for the health needs of communities which are socially deprived.

Aged↗
PubMed1985

Social inequalities and perceived health.

The association between morbidity and mortality indicators and low socio-economic status has been observed for many centuries. In 1980 the publication of the Black Report in Britain drew attention to the failure of the National Health Service to close the gap between rich and poor in relation to health status. The gradients of morbidity and mortality which are linked to social class have been observed throughout Europe, in the U.S.A. and Australia. However, information on how people feel, as opposed to how they become ill, and the cause of their death, is scarce. Measures of perceived need can provide important additions to routinely collected data because they give access to the experiential status of respondents and thus provide vital data on which to base planning, provision and evaluation of health services. A standard reliable and valid measure of perceived health, the Nottingham Health Profile, was used to conduct a postal survey of differential status in subjective health between social classes in England. The results showed statistically significant differences between social classes in the age group 20-44 years only. For both men and women these were in their experience of sleep problems, emotional problems and lack of energy. In all cases the lower the social class the greater the amount and severity of perceived distress. After the age of 45 these differences, although still present, were not so marked, perhaps because of the excess mortality rates in lower socio-economic groups and the lowering of expectations with age. It is suggested that younger people from unskilled and semi-skilled occupations and, of course, the unemployed, are more vulnerable than their better off compatriots because of a kind of psychic susceptibility which is a consequence of social circumstances and the inability to cushion the effects of ill health. A type of Marxian "immiseration' may occur whereby in contemporary society health status is undermined by spiritual and social impoverishment rather than by the gross poverty and grinding labour of the past. The results of this study indicate that changes in the allocation of health care resources may have only a minor influence on inequalities in health. Remedial action would, rather, need to take the more radical form of providing fulfillment for aspirations and enhancing well-being by introducing fundamental social, economic and environmental reforms.

Adult↗
PubMed1985

Measuring health status: a new tool for clinicians and epidemiologists.

The development and validation of a short and simple measure of perceived health problems is described. Extensive testing with selected groups, including the elderly, the chronically ill, pregnant women, fracture victims, and a random sample of the community has established the face, content and criterion validity, and the reliability of the instrument. The Nottingham Health Profile is intended as a standardized tool for the survey of health problems in a population, but is equally valid and useful as a means of evaluating the outcome of medical and/or social interventions and as an adjunct to the clinical interview.

England↗
PubMed1984

Subjective health assessments and the perceived outcome of minor surgery.

A simple and standardised measure of perceived health status, the Nottingham Health Profile, was used to assess the effect on perceived health status of surgical intervention in a variety of non-acute medical disorders. Patients were assessed a few days before their operation and again two months later and were compared with a control group who had not undergone surgery. Results showed very little change in subjective health from before to after surgical intervention. The experimental group had similar perceived health scores to the control group on the pre- and post-tests. It is suggested that the period allowed to elapse after surgical intervention was too short, or that the level of problems experienced by patients prior to surgery was too low to show significant change. It is also possible that the particular presenting disorders were only one possible somatic representation of general feelings of minor ill-health in the group. The findings of this study point to the need to look at the differences between doctors and patients expectations of the outcome of surgery, the decision to seek care and the factors that govern wellbeing.

Adolescent↗
PubMed1984

Perceived health: age and sex comparisons in a community.

The need to find accurate and reliable indicators on which to base the planning, provision, and evaluation of health services gave impetus to the attempt to develop reliable and valid measures of the perceived health status of the consumers of health care. Subjective measures can provide an important complement to traditional statistics by giving direct access to the personal feelings of discomfort or distress that influence the use of health services. Such measures also give meaningful criteria for the evaluation of the efficacy of such services. Self assessments of health obtained from surveys and interviews have consistently found age and sex differences in the tendency to report symptoms, ill-health, disability, visits to doctors, and sickness absence. Many of these data, however, may have been misleading in using instruments of unknown or uncertain validity and reliability. Nevertheless, subjective assessments of health have been shown to have value and to add a dimension to objective measurements of health. They have been considered to be one of the better predictors of mortality and of adjustment to major episodes of illness.

Adult↗
PubMed1983

The two molecular weight forms of rat phenylalanine hydroxylase are encoded by different messenger RNAs.

Immunoprecipitation of the phenylalanine hydroxylase formed by translation of rat liver RNA in a rabbit reticulocyte cell-free protein synthesis system was used to examine the origin of the molecular weight heterogeneity of the enzyme. Sodium dodecyl sulfate-polyacrylamide electrophoresis of the immunoprecipitated products showed that in most cases a single specifically immunoprecipitated polypeptide was produced which corresponded to the higher molecular weight (H) form of phenylalanine hydroxylase (Mr = 50,000). The identity of the product was confirmed by immunological competition and peptide mapping. RNA from other rats, however, coded for both the H-form and the lower molecular weight (L) form of phenylalanine hydroxylase or for only the L-form. The evidence suggests that the L-form derives from a different mRNA, rather than by proteolysis of the H-form, an interpretation which is supported by the isolation of the lower form of phenylalanine hydroxylase from livers of some rats.

Animals↗
PubMed1983

Clinical studies of color vision with Gunkel's chromagraph.

Color thresholds in a series of patients with local or systemic diseases were determined by a chromagraph method and subjected to computer analysis. When compared with normal persons, those with optic nerve disease (multiple sclerosis, optic neuritis, and optic atrophy) showed an overall weakness for all colors (enlarged neutral areas), with an additional specific defect in the orange-cyan (greenish blue) axis. Those with the two retinal diseases studied (macular degeneration and retinitis pigmentosa) also showed threshold elevation for all colors, but with a special defect in the yellow-blue axis. The general elevation was greater for patients with retinitis pigmentosa than for those with macular degeneration, regardless of the visual acuity. In patients undergoing treatment for systemic lupus erythematosus and rheumatoid arthritis, there was a mild elevation of the color threshold, especially for yellow.

Arthritis, Rheumatoid↗
PubMed1982

beta-hydroxyisobutyryl coenzyme A deacylase deficiency: a defect in valine metabolism associated with physical malformations.

An infant, born to parents who were first cousins had multiple physical malformations. An associated biochemical abnormality was suggested by the urinary excretion of cysteine and cysteamine conjugates of methacrylic acid. The coenzyme A (CoA) ester of this compound is an intermediate in the pathway of valine oxidation. Subsequent investigation revealed a deficiency of beta-hydroxyisobutyryl-CoA deacylase, an enzyme unique to valine metabolism. The enzyme defect results in accumulation of methacrylyl-CoA, a highly reactive compound, which readily undergoes addition reactions with free sulfhydryl groups. Tissue damage due to reactions between methacrylyl-CoA and important sulfhydryl-containing enzymes and cofactors may account for the teratogenic effects seen in this patient.

Abnormalities, Multiple↗
PubMed1981

Detection of tones in band-reject noise.

Three experiments were conducted to investigate the detectability of tonal signals simultaneously presented with computer-generated, long duration (.5 sec), band-reject maskers. In Experiment 1, detectability of a tone of 500, 1000, or 2000 Hz presented at 50 dB SPL was measured as a function of the width of a spectral "notch" symmetrically placed around the tone. A narrow notch resulted in decreased detectability relative to the wide band (zero-notch width) control condition. Further increases in notch width resulted in increased detectability until subjects approached errorless performance. In Experiment 2, psychometric functions were obtained for a 1000-Hz tone presented in four notch-noise conditions. The slopes of the psychometric functions were consistently steeper in the band-reject conditions relative to the zero notch-width condition. These slope differences result in relationships between threshold and notch width that depend upon the region of the psychometric function from which the threshold estimates are obtained. In Experiment 3, the decrease in performance associated with the notch was found to increase in proportion to notch depth. The data suggest that spectral edges placed in the immediate vicinity of a tone reduce the detectability of the tonal signal. This "edge effect" is discussed in relation to two-tone inhibition that has been observed in the auditory nerve.

Acoustic Stimulation↗
PubMed1981

Weighting the seriousness of perceived health problems using Thurstone's method of paired comparisons.

An exercise carried out to weight the seriousness of perceived health problems using Thurstone's method of paired comparisons is reported. For the purposes of illustration, the sleep section of the Nottingham Health Profile containing 5 statements is used. The calculation of the scale values associated with each statement is described and a new method of deriving weights from the scale values is proposed. The judgement of comparisons was found acceptable to interviewees. The applicability of the paired comparison techniques of the field of health is discussed.

Attitude to Health↗
PubMed1981

Reliability of a population survey tool for measuring perceived health problems: a study of patients with osteoarthrosis.

A study is described which tested the reliability of the Nottingham Health Profile, a standardised measure of perceived health status suitable for use with both large groups and individual patients. Patients with osteoarthrosis, uncomplicated by other diagnosed conditions, were given the questionnaire to fill in on two separate occasions four weeks apart. Analysis of data showed that all sections of the profile achieved a high level of reliability with coefficients of correlation ranging from 0.77 to 0.85 on part I and from 0.44 to 0.86 on part II. Patients reported many problems in the areas of physical mobility, pain, sleep, and energy, but rather fewer in the areas of social isolation and emotional reactions. With the exception of family relationships, most respondents reported a high level of disruption of their daily activities. Patients were very consistent in the number and type of problems which they affirmed.

Adult↗