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Biomedical subjects

S Quinn

Publications and source records attributed to S Quinn.

At least 37 records · Page 2Linked to original sources
PubMed1996

Paracetamol prescribing--an epidemic?

BACKGROUND: Although we are uncertain of its therapeutic mechanism, paracetamol is seen as a safe drug, especially for children. However, adult fatalities from overdose and its association with hepatotoxicity have cast doubt on its safety. OBJECTIVE: We aimed to establish the prescribing patterns of paracetamol in the United Arab Emirates (UAE). METHOD: The prescribing patterns in the UAE for paracetamol were studied by obtaining information on national utilization and recording in detail the pattern of prescribing in one primary health care centre. RESULTS: Paracetamol was included in 35.5% of all prescriptions from the study practice. Of these, 58.5% were for children under 12 years of age and overall 13.5% were for those infants under one year of age. CONCLUSIONS: National prescribing utilization is in keeping with the prescribing patterns of the index practice. Paracetamol prescribing is reaching epidemic proportions and the potential dangers of hepatotoxicity and the inhibition of the immune response in children are discussed.

Acetaminophen↗
PubMed1996

Influence of saddle type upon the incidence of lower back pain in equestrian riders.

OBJECTIVE: To investigate the possible influences of saddle type on the incidence of "lower back pain" in a cross section of equestrian riders. METHODS: 108 equestrian riders completed a questionnaire concerning their riding habits and whether they suffered from lower back pain. In particular they were asked whether they used a traditional style/general purpose saddle (GP) or a deep seated/Western style saddle (W). RESULTS: 48% of the riders reported suffering from lower back pain, the incidence being higher in the GP saddle users (66%) than in W saddle users (23%) (P < 0.001). Female riders had a higher incidence of lower back pain than males, 58% v 27% (P < 0.005). When the genders were analysed separately for the effect of saddle type, males using the GP and W saddles had a 33% and 6% incidence of lower back pain respectively, while females using the GP and W saddles had a 72% and 33% incidence. The highest incidence of lower back pain occurred in the GP saddle users who had been riding for more than 15 years (P < 0.07). The data also indicated a possible tendency for there to be more low back pain among riders using a short stirrup length. No other factors were found to affect the incidence of lower back pain. CONCLUSIONS: The difference in the incidence of lower back pain between the users of the two saddle types may be due to the additional comfort, cushioning, postural positioning, and stability offered by the design of the deep seated saddle. The results suggest that, while a deep seated saddle is not suited to all equestrian activities, where possible its use should be considered because of its effect in reducing the risk of lower back pain.

Adolescent↗
PubMed1994

Thrombolysis versus thrombectomy for occluded hemodyalisis grafts.

Graft thrombosis is the most frequent complication of polytetrafluoroethylene grafts for hemodialysis. Many of these patients arrive at the dialysis unit with fluid and metabolic abnormalities that require prompt dialysis. Rapid declotting of the graft is important to avoid having to create temporary access. Thrombolysis with urokinase has been evaluated by recent retrospective studies and found to be successful in 60% to 90% of cases. Our prospective, randomized trial was initiated to compare thrombolysis with standard surgical thrombectomy; and to evaluate the safety, effectiveness, efficiency, and durability of these modalities. In this study, 15 patients underwent thrombolysis and 16 had thrombectomy. The success rate was 67% for the thrombolysis group compared with 94% for the surgical group. Patency rates were similar for both modalities, but the complication rates were higher and the time to completion longer with thrombolysis. Although both treatments can be used successfully, surgical thrombectomy remains the optimal choice for treating occluded dialysis grafts.

Adult↗
PubMed1993

Diabetes and diet. We are still learning.

A diagnosis of diabetes mellitus can be overwhelming at first to any patient who faces it. Although most patients initially feel that learning to administer insulin by injection is diabetes' most difficult aspect, altering life-time eating habits to provide ideal nutrition is in actuality more challenging. Despite this, dieting is becoming easier every day. Research now tells us that caloric restriction to maintain normal weight improves glucose tolerance as well as weight control. Complex carbohydrates should comprise 50% to 60% of total calories. Concentrated sweets and simple sugars are to be avoided. Dietary protein should account for no more than 20% of total calories although some individuals may require further protein restriction or increased protein in the case of catabolic states. The Recommended Daily Allowance of protein is 0.8 g/kg per day. The remaining calories are ingested as fat and make up 20% to 30% of the total. Further fat restriction may be necessary in diabetics with dyslipidemias. Saturated fats are to be avoided with a polyunsaturated:saturated fat ratio of at least 0.8 and preferably 1.0. Though specifically designed for the diabetic, these recommendations provide good nutrition for healthy people as well. The many low-fat, low-cholesterol, and low-calorie alternatives provided by today's food industry provide ample variety making compliance easier all the time. After mastering the basics of glucose control and diabetic nutrition, most patients can expand their skills to include restaurant dining and travel by anticipating potential problems and preparing ahead.(ABSTRACT TRUNCATED AT 250 WORDS)

Diabetes Mellitus↗
PubMed1992

Growth hormone-binding proteins of human serum: developmental patterns in normal man.

The binding of GH by a low affinity binding protein (LA-BP) was measured from birth into adulthood and compared with binding of a high affinity binding protein (HA-BP) in human serum. Pooled serum samples for each year of age from birth to 16.5 yr were formed from 2500 separate samples and assayed for both binding proteins using a Sephadex chromatographic method. Individual samples in this age range and those from adults were assayed in a similar manner. Binding of [125I]GH was minimal by both binding proteins in cord blood (binding by LA-BP, 2.77 +/- 0.32%; binding by HA-BP, 2.58 +/- 0.35% mean +/- SEM). A 4-fold increase to maximal binding for LA-BP occurred by the age of 5 yr and remained relatively constant through adolescence, except for a transient decrease at puberty. From 16.5-20 yr of age, binding by LA-BP decreased to a level no greater than that seen at birth. Binding by the HA-BP, which increased 6- to 8-fold reached maximal binding between 23-25 yr of age. Binding by HA-BP did not decrease in adults between the ages of 20-30 yr. Whereas pregnancy increased LA-BP activity, GH binding by HA-BP was unaltered.

Adolescent↗
PubMed1991

The growth hormone-insulin-like growth factor I axis: studies in man during growth.

Several major differences are noted between males and females in their patterns of growth at puberty. Accelerated pubertal growth in both males and females depends upon the integrity of the GH-receptor system. In males, acceleration of growth results primarily from enhanced sensitivity of the GH-receptor-IGF I system to GH brought about by testosterone. Whether testosterone itself is responsible for this observation is still unclear. Perhaps the initial GH, IGF I peak present in males and absent in females occurs at the time when sleep-related rises of gonadotropins and testosterone begin just prior to puberty. Though the pygmy data certainly supports a relationship between testosterone and the GH-receptor-IGF I axis, the undisputed tall stature of eunuchs remains a puzzle. It is possible that the maturing male gonad secretes another growth factor and/or growth inhibitor in conjunction with testosterone and that it is this unidentified factor which modulates growth. At any rate, acceleration of growth in males results from sensitization or the GH-receptor-IGF I system while growth acceleration in females results almost solely from increased secretion of GH and not sensitization of the system.

Adolescent↗
PubMed1991

Hormone and receptor studies: relationship to linear growth in childhood and puberty.

Preliminary data suggested different patterns of hormonal control of linear growth in males and females. To better define these patterns, serum samples were collected from 75-125 boys and a similar number from girls for each year of age between 3-16 yr (n = 2416). Fewer samples were collected from 2-yr-olds, newborns, and adults (n = 151). Samples for each age were aliquoted, combined, and assayed for GH, GH-binding protein (GHBP), insulin-like growth factor-I, and testosterone. GHBP, expressed as a percentage of the [125I]GH bound, increased yearly in males and females, with no relationship to the secretion of sex hormones. The increase in binding of [125I]GH and, by inference, GH receptors occurred at a greater rate between the ages of 2-10 yr than between 10-16 yr (in terms of absolute binding, 1.2 +/- 0.11% vs. 0.38 +/- 0.04% yearly; P less than 0.001). In each age group, however, the increase in GHBP exhibited a strong positive correlation with linear height (r = 0.96-0.98 in males; r = 0.92-0.99 in females). Before puberty, GH and insulin-like growth factor-I concentrations were consistently greater in females. Between 10-16 yr of age, height velocity (centimeters of growth per yr) correlated strongly with GH in girls (r = 0.86), but did not correlate with GH in boys of a similar age (r = -0.13). The major pubertal growth spurt in males strongly correlated with a rise in serum testosterone concentration beginning at age 11 yr (r = 0.92). Small peaks of GH secretion before and after the major period of accelerated growth in males possibly prolonged the major growth phase, but did not initiate it.

Adolescent↗