Search PubMed⌕ Search

Biomedical subjects

S Nichols

Publications and source records attributed to S Nichols.

At least 55 records · Page 3Linked to original sources
PubMed1988

Predictive value of clinical, laboratory, pathologic, and treatment variables in steroid/immunosuppressive resistant lupus nephritis.

Twenty-seven patients with lupus nephritis and nephrotic syndrome had persistent disease activity despite an adequate trial of corticosteroids and immunosuppressive drugs; 30% were Asians, compared with 7% of our overall SLE population. Two years later, seven had a very good outcome and seven a poor outcome. Thirty clinical, pathological, laboratory, and treatment variables were analyzed in a good versus poor responder subset comparison in an effort to determine which factors were associated with favorable outcome. Administration of pulse steroids (P = .069) and a low biopsy chronicity index (P = .048) were associated with the good responder subset. Serum creatinine, biopsy class, blood pressure, complement, and anti-DNA values at entry as well as the choice of immunosuppressive drug were not helpful in predicting outcome. All seven good responders were plasmapheresed (P = .026). Patients with refractory lupus nephritis who have a low biopsy chronicity index may benefit from the use of pulse steroids or plasmapheresis, and controlled studies are suggested.

Adult↗
PubMed1987

Women's preferences for sex of doctor: a postal survey.

A random sample of 512 women were sent a questionnaire to determine whom they see and whom they would prefer to see for primary and preventive health care, including screening for breast and cervical cancer. The response rate was 86%.The majority of women had had at least one cervical smear test, most of them carried out by a general practitioner. Two thirds of the women had had a physical breast examination, but only one third had been shown breast self-examination techniques - again the general practitioner was the health professional most often involved.The women's preferences for who to see for primary and preventive health care were problem/procedure specific. Less than one in 10 said they would prefer to see a female general practitioner for general health problems, compared with nearly six out of 10 for women's health problems. Similarly, almost 60% would prefer to see a female health professional for cervical screening and for breast screening by physical examination and instruction in self-examination. Just under half of all the respondents - two fifths of the over 45 years age group and half of the younger women - said they would prefer a female doctor for breast screening by mammography.A female general practitioner was the first choice for cervical screening for the highest proportion of women (41%) and the proportion was even higher among women from the manual classes and among older women from the nonmanual classes. More women general practitioners might increase compliance rates for cervical screening among these high risk groups.

Attitude to Health↗
PubMed1986

Randomised trial of compliance with screening for colorectal cancer.

A randomised trial of compliance with screening for colorectal cancer by means of the haemoccult test was conducted in Farnborough and Basingstoke districts. In each of the 14 participating practices (41 general practitioners) 25 852 men and women aged between 40 and 70 years were randomly allocated by household to one of six groups. The group determined the method of invitation to screening: a letter and the test were sent to the patient, or a letter with an appointment to attend the surgery was sent, or during a routine consultation the general practitioner invited patients to participate, and some patients received an educational booklet about bowel disorders and screening. Of the 17 824 people who were offered screening, 7545 (42%) complied. Compliance was significantly affected by the method of invitation, but not by whether an educational booklet was received, and was highest (57%) in the group that was offered the haemoccult test during a routine consultation (the "opportunistic" approach). In this group the compliance rate achieved by individual general practitioners ranged from 26% to 82%. Compliance was significantly higher in Farnborough, in the older (55-70) age group, in women, and in households in which two or more people were offered screening. The higher compliance in Farnborough may be explained by the higher proportion of older people and by the higher proportion of people living in households of two or more in the population that was offered screening. The fact that the screening programme in Farnborough was offered to the whole community and that the researcher may have acted as a facilitator were probably also important. One per cent of the patients screened had a positive test, and 24 (38%) of the 63 patients who were positive and were investigated in hospital had neoplastic disease. The yield was 1.2 cancers and 1.2 benign adenomas (1 cm or larger in size) per 1000 people screened. This low yield is likely to be a consequence of the relatively young age group screened.

Adult↗
PubMed1986

General practitioners' awareness of colorectal cancer.

A survey was carried out in Portsmouth to find out what general practitioners knew about colorectal cancer and what their views were on screening. A random sample of general practitioners was interviewed by questionnaire and the remainder asked to complete the questionnaire themselves. The overall response rate was 62%. There was a higher response rate from women doctors and from the group that was interviewed. For some questions there was a difference in the pattern of responses given by the interview group and the group who completed the questionnaire themselves.The level of knowledge of colorectal cancer varied according to which aspect was questioned. The general practitioners knew the symptoms well but were less aware of the vital statistics and risk factors. Most doctors were not in favour of screening by testing for faecal occult blood.

Adult↗
PubMed1985

Evaluation of breast self-examination teaching materials in a primary care setting.

A study was designed to determine the effectiveness of breast self-examination teaching materials in a primary care setting. The Women's National Cancer Control Campaign tape/slide programme and leaflets were displayed in a health centre, both independently and in combination. Women leaving the health centre were interviewed about breast cancer and the information on breast self-examination contained in the educational material.Both the leaflet and tape/slide programme, independently, increased knowledge about breast cancer and self-examination, but only to a small extent. They were more effective in combination, mainly in increasing knowledge of breast self-examination, rather than knowledge of breast cancer or breast abnormalities.

Adolescent↗
PubMed1984

Plasmapheresis versus lymphoplasmapheresis in rheumatoid arthritis: immunologic comparisons and literature review.

Eight patients with Functional Class III, seropositive, erosive rheumatoid arthritis unresponsive to remittive drugs each underwent nine aphereses over 3 weeks. Four had a 40-ml/kg plasma exchange and four others had a 40-ml/kg plasma exchange plus a mean 5.67 X 10(9) lymphocyte depletion. Both groups appeared to improve clinically. T and B cell counts and OK T4 and OK T8 ratios decreased in the lymphoplasmapheresis group. Phytohemagglutinin stimulation decreased in lymphoplasmapheresis and increased in plasmapheresis patients with significant comparisons (p = 0.02). These findings confirm and extend previous work. Plasmapheresis and lymphoplasmapheresis appear to have fundamentally different actions on lymphocyte function.

Adult↗
PubMed1984

Kinetics of intestinal calcium transport during maturation in rats.

Young animals absorb and retain more calcium (Ca) than their older counterparts. The mechanism(s) for this age-related difference and the kinetics of intestinal calcium transport during maturation are not known. We determined, therefore, the unidirectional uptake and the transmural flux of [45Ca] in everted duodenal and jejunal sacs of suckling, weanling, adolescent, and adult rats using [3H] dextran as a marker of adherent mucosal volume. These measurements were carried out over a wide range of Ca concentrations (0.5-30 mM). Results indicate an evolving pattern of intestinal calcium transport with different kinetic characteristics emerging as the animals matured. The active component of transport became more pronounced with increasing age. In adult rats Km and Jmax of [45Ca] duodenal and jejunal uptake were several-fold greater than corresponding values for suckling rats. Transport at higher calcium concentrations (10-30 mM) was non-saturable, and the permeability coefficient decreased with age. The transition to a more saturable process occurred around the time of weaning. These findings suggest that intestinal calcium transport is characterized by a maturation pattern that starts with a predominantly passive system during infancy and changes to a saturable active mechanism during maturation.

Aging↗
PubMed1983

Resolution-limiting factors in 2-deoxyglucose autoradiography. I. Factors other than diffusion.

We measured the extent to which factors other than the diffusion of the radioactive label during tissue preparation limits the spatial resolving power of 2-deoxyglucose (2-DG) autoradiography. Radioactive swept frequency gratings were created using microcircuit lithography. The gratings consisted of alternating equal width radioactive and non-radioactive bars in groups of narrowing bar width (effective range 500-20 mum). The vertical thickness of the gratings ranged from 2.25 to 20 mum. The isotope in the radioactive bars was either 14C or 3H. A variety of X-ray films were exposed to these gratings and the resulting images scanned with microdensitometers or video digitizers to determine the fall off in image contrast (dark-bar values minus light-bar values) as a function of the number of dark bars (lines) per millimeter. The power of the isotope was the resolution limiting factor. Grating thickness and type of film made little difference. The limit of resolution with 14C was 10 lines/mm; with 3H, it was 25 lines/mm. The microdensitometer itself is apt to be a resolution limiting factor; the resolving power of those commonly used in autoradiography is unlikely to exceed 10 lines/mm. From measurements of the steepness of gray-matter to white-matter transitions in the image from a tissue section, we conclude that the resolution in the image is no worse than 1.6-3.2 lines/mm. Either the isotope or diffusion of the 2-DG during tissue preparation must be the factor that limits resolution.

Absorptiometry, Photon↗
PubMed1983

Immunologic dynamics in cryapheresis for rheumatoid arthritis.

Five patients with erosive rheumatoid arthritis (RA) who had previously experienced a favorable response to lymphoplasmapheresis were treated with cryapheresis. Cryapheresis was performed 9 times in 3 weeks using a membrane filtration device that selectively removes plasma proteins with molecular weights greater than 100,000 daltons. Four of the 5 patients so treated improved clinically. The membranes selectively removed more immunoglobulins and complement components that were part of circulating immune complexes than those that were not. Plasma or albumin replacement was not necessary in these patients. Cryapheresis might be a safe and effective technology in treating patients with refractory RA.

Adult↗
PubMed1983

Developmental kinetics of colonic calcium transport.

Young animals absorb and retain more calcium (Ca) than their older counterparts. Our previous studies on small intestinal calcium transport indicated an evolving pattern with a change in the kinetics of calcium uptake. Whether the lower intestine also mirrors and participates in calcium transport is not known. Therefore, the unidirectional uptake of 45Ca was determined in everted colonic sacs of suckling, weanling and adolescent rats using 3H dextran as a marker of adherent mucosal volume. These measurements were carried out over a 0.5-30 mM Ca2+ concentrations. Results indicate an evolving pattern of intestinal calcium transport with different kinetic characteristics emerging as the animals matured. The mediated component of transport became more pronounced with increasing age. Actual Km and Jmax values for mediated colonic 45Ca uptake showed an evolving pattern. A steady rise in both Km and Jmax was noted with increasing age. Transport at higher concentrations (10-30 mM) was non-saturable. The transition to a more saturable process occurred around the time of weaning. These findings suggest that colonic calcium transport is characterized by a maturation pattern that starts with a predominately passive system during infancy and changes to a saturable mechanism during maturation.

Animals↗
PubMed1983

Reluctance to seek medical advice about breast symptoms.

A third of a sample of women with breast symptoms referred by general practitioners to a hospital clinic said they had been reluctant to consult their doctor. Fear, being a nuisance to the doctor, and embarrassment were the three most frequently mentioned reasons for their reluctance. Nearly half of those questioned were prompted to seek medical advice either solely, or partly, because of the thought of breast cancer.

Breast Diseases↗