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Biomedical subjects

S Robinson

Publications and source records attributed to S Robinson.

At least 253 records · Page 14Linked to original sources
PubMed1992

Skin lesion removal: practice by general practitioners in Grampian Region before and after April 1990.

The introduction of new GP contracts in April 1990 incorporated a financial incentive to undertake minor surgical procedures. Previous reports have noted large increases in the number of GP-derived skin specimens after April 1990. Our present study intended to address whether similar changes have occurred in Grampian Region as well as, more specifically, noting whether there have been changes in the quality of practice following the 1st April 1990. A retrospective study of skin biopsies removed by general practitioners in Grampian Region was undertaken. Cases were selected from four periods of six months (1st April to end of September) in 1987, 1988, 1989 and 1990. All skin specimens sent by general practitioners to the Department of Pathology, Aberdeen Royal Infirmary, were included. Following April 1990 there was a two-fold increase in skin specimen numbers--an increase significantly greater than increases observed over previous years (p < 0.01). Of particular note was the contribution made to this increase by Aberdeen City GPs whose contribution rose five-fold (p < 0.0001). Non-benign lesions (ie malignant plus carcinoma-in-situ-) represented 6% of lesions excised. A non-benign clinical diagnosis or an indication of suspicion was written on only one third of request forms for histopathologically diagnosed non-benign lesions. The proportion of histologically incompletely excised lesions rose over the four years (p < 0.01); moreover the increase in total numbers of lesions resulted in a striking increase in the actual numbers of incompletely excised lesions after April 1990.

Biopsy↗
PubMed1992

Bronchodilating efficacy of an open-spacer device compared to three other spacers.

BACKGROUND: Spacers devices are commonly used in aerosol therapy; however, they are bulky and require regular cleaning. A compact open spacer (OS, Synchroner, Fisons, UK) has been developed to overcome this problem. We compared bronchodilator efficacy associated with its use to efficacy of same dose via three other spacers: Volumatic (Glaxo Laboratories), Nebuhaler (Astra Laboratories), Inspirease (Key Pharmaceuticals). MATERIALS & METHODS: Sixteen asthmatics (greater than 20% reversibility of FEV1) took part in the study. In random order, they used a different device on each of the 4 study days to inhale 2 puffs of a combination aerosol (1 mg reproterol and 2 mg sodium cromoglycate, Aarane). We recorded results of spirometry before and 5, 30, and 60 minutes after bronchodilator inhalation. RESULTS: At each time, we found no significant difference in bronchodilation. CONCLUSION: OS is as efficient as other commonly used spacers to produce bronchodilation resulting from a conventional dose of reproterol.

Administration, Inhalation↗
PubMed1992

The Glasgow Coma Scale: a critical look.

Today much of our knowledge about a patient's level of consciousness is given to us by his or her score on the Glasgow Coma Scale (GCS). Since its development at the University of Glasgow in 1974, it has been widely adopted, become an integral component of the hourly "neuro assessment", and is typically incorporated into the graphic assessment portion of the patient's medical record. Once the information has been documented, the pure data itself is lost as the documented form takes on an interpretative meaning or a reality that is different from the clinical state experienced by the patient. The formation of this "new" reality occurs in two separate phases: in the completion of the scale and in its reading. There are various factors or forces that affect the completion and use of the scale. These are important as they are not visible in the scale itself; however, their effects are evident in the coma score obtained. These forces include the design of the GCS and the manner in which the tool is taught and used. The purpose of this paper is to discuss these factors and to delineate how they create a reality that may not accurately depict the patient's level of consciousness.

Glasgow Coma Scale↗
PubMed1991

Medium effects in antibody-catalyzed reactions.

Catalytic antibody technology has been used to explore the contribution of medium effects to the overall rate of an enzyme-catalyzed reaction. An antibody generated against a derivative of 2-acetamido-1,5-napthalenedisulfonate efficiently catalyzes the decarboxylation of 5-nitro-3-carboxybenzisoxazole. This unimolecular reaction is not susceptible to general acid-base catalysis but is highly sensitive to microenvironment; thus, it provides a simple chemical model for biologically important decarboxylations. The 10(4)-fold rate acceleration observed for the antibody reflects the kinetic advantage of the low-dielectric environment of the binding pocket acting to destabilize the substrate by desolvation and to stabilize the charge-delocalized transition state through dispersion interactions. These results are pertinent to an understanding of solvent effects in enzymic reactions in general and suggest approaches for developing antibody catalysts for numerous other reactions that involve large changes in charge distribution as the reaction coordinate is traversed.

Anilino Naphthalenesulfonates↗
PubMed1991

Impedance measurement of absolute blood flow using an angioplasty catheter: a validation study.

An angioplasty catheter was developed to allow measurement of absolute coronary blood flow during interventional procedures. This method uses electrical impedance changes induced by a 0.5 ml bolus of 5% dextrose solution and indicator-dilution principles. The indicator is injected through a port located just proximal to the dilating balloon and the resulting changes in blood impedance are measured by electrodes at the catheter tip. Excellent linear correlations were found between known flow in 2 to 4 mm to diameter plastic tubes and catheter measurements (r = 0.99) and between timed collection canine femoral artery flow and catheter measurements (r = 0.97). Final validation was performed in canine coronary arteries using electromagnetic flowmeter data as the standard (r = 0.94). Thus accurate clinical determination of absolute coronary blood flow can be accomplished using this relatively inexpensive and simple catheter technique.

Angioplasty, Balloon, Coronary↗
PubMed1991

Basal metabolic rate, body composition and whole-body protein turnover in Indian men with differing nutritional status.

1. Three groups of adult men were studied in Bangalore, India: two groups were controls who had been receiving an adequate diet. Of these, one group, designated 'normal weight controls', had a mean body mass index of 22; the other group, 'underweight controls', had a mean body mass index of 16.7. The third group consisted of poor labourers, whose daily food intake had been less than 10 MJ and whose mean body mass index was 16.6. Previous studies had shown that such men had a lower basal metabolic rate than well-nourished Indian control subjects. 2. The object of the present study was to find out whether a reduced rate of protein turnover, measured after a single dose of [15N]glycine, contributed to a lower basal metabolic rate. It was found, however, that after adjusting for body weight and fat-free mass by analysis of co-variance there was no significant difference in basal metabolic rate between the three groups. Adjusted rates of protein synthesis were higher in the underweight controls and the undernourished labourers than in the normal weight controls, but not significantly so. 3. Estimates based on creatinine excretion showed that within the fat-free mass the underweight groups had a higher proportion of non-muscle to muscle mass. This may explain the somewhat higher rates of protein turnover in these groups. 4. Nitrogen flux (Q) was determined from 15N abundance in two end products, urea (QU) and ammonia (QA). In the underweight and undernourished groups the ratio QU/QA was increased compared with the normal weight group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

High-level viremia in adults and children infected with human immunodeficiency virus: relation to disease stage and CD4+ lymphocyte levels.

Sixty-eight adults and nine children infected with human immunodeficiency virus type 1 (HIV-1) were evaluated consecutively for the presence and amount of cell-free infectious virus in their plasma. Viremia was detected in 18 of 68 adults and in five of nine children; titers ranged from 10 to 100,000,000 TCID/ml plasma. Among the adults, none of 19 asymptomatic patients, 4 of 34 AIDS-related complex patients, and 14 of 15 AIDS patients had cell-free infectious virus in their plasma. None of 35 adult subjects with CD4+ lymphocyte counts greater than 400/mm3 were viremic, whereas 3 of 17 with 200-400 CD4+ lymphocytes/mm3 and 15 of 16 individuals with less than 200 CD4+ lymphocytes/mm3 were plasma viremic. In contrast to adults, each of five children infected with HIV-1 in utero or during the perinatal period were plasma viremic regardless of their CD4+ lymphocytes counts (range, 42-2227/mm3), duration of infection, or clinical stage; however, children infected by HIV-1 at older ages were less frequently plasma viremic. Therapy with zidovudine led to a 10- to 10(6)-fold decline in plasma HIV-1 TCID in all eight subjects studied before and after treatment.

Adult↗
PubMed1991

Wound infiltration of local anaesthetic after lower segment caesarean section.

The analgesic efficacy of subcutaneous wound infiltration with 20 ml of 0.5% bupivacaine after elective lower segment section Caesarean section was studied in 28 patients in a double-blind randomised controlled manner using a patient-controlled analgesia system. The mean 24-hour morphine consumption of the placebo group and the bupivacaine group was similar (76 mg and 68 mg respectively). Analysis of the cumulative hourly morphine consumption failed to show any statistically significant differences between the groups. However, on a weight-adjusted basis statistically significant differences in morphine consumption were demonstrated, although these may not be clinically important. Subjective experiences of pain, nausea and drowsiness assessed by linear analogue scoring were similar in both groups.

Administration, Topical↗
PubMed1991

Serum melatonin levels in schizophrenic and schizoaffective hospitalized patients.

Conflicting results on changes of the diurnal melatonin rhythms of patients with affective disorders have been reported in the literature. The heterogeneous data may derive from the great discrepancy in the diagnostic criteria of different authors. A study of 12 schizoaffective and chronic schizophrenic psychotic patients found a constant pattern of an obliterated nocturnal melatonin rise only in the latter group. The presence or absence of the nocturnal melatonin rise was determined in drug-free hospitalized patients and remained unchanged despite 2 months of drug treatment including large doses of neuroleptics. This finding, when confirmed in a larger number of patients, could possibly serve as a marker for the type of mental disorder, drug to be applied and response expected.

Adult↗
PubMed1991

The effects of severe behavior problems in children on the teaching behavior of adults.

Applied behavior analysts have focused on how adults can influence the problem behavior of children using a variety of behavior modification strategies. A related question, virtually unexplored, is how the behavior problems of children influence adults. This child-effects concept was explored empirically in a study involving 12 adults who were asked to teach four pairs of children in which one member of the pair exhibited problem behavior and the other typically did not. Results demonstrated that problem children displayed tantrums, aggression, and self-injury contingent on adult instructional attempts but not at other times, whereas nonproblem children showed little or no problem behavior at any time. Importantly, from a child-effects perspective, adults engaged in teaching activities with nonproblem children more often than with problem children. Also, when an adult worked with a problem child, the breadth of instruction was more limited and typically involved those tasks associated with lower rates of behavior problems. The implications of these results are discussed with respect to theories of escape behavior, current assessment practices, and intervention issues related to maintenance. The existence of child effects suggests that problem behavior may be better understood when it is conceptualized as involving a process of reciprocal influence between adult and child.

Adult↗
PubMed1991

The impact of the Demjaniuk trial on the psychotherapeutic process in Israel.

The Demjaniuk trial was a national experience and people showed great interest in it, more than the organizers of the trial had expected. Many therapists expressed interest in the trial. They stressed the importance of the trial and their identification with it. In some questionnaires, therapists reported dramatic reactions and revival of survivors syndrome. Therapists who were sensitive and perceptive to the subject of the Holocaust reported definite reactions in their patients. On the other hand, therapists who were inclined to isolation, denial and avoidance of this subject, reported that their patients did not react or that their reactions were only superficial. Therapists reported that second generation patients tended to stronger identification with their parents following the trial. The trial served as a catalyst for the treatment and also made them more interested in knowing more about their parents. It broke down a barrier between survivors and those who did not experience the Holocaust, according to one of the therapists. In our opinion, it also broke down a barrier between first and second generation. Many therapists reported strong identification with their patients, especially when both therapist and patient were of the same generation in relation to the Holocaust. Some patients reacted strongly to the trial and needed more frequent treatment sessions, more drugs and sometimes even hospitalization, but in many cases the trial had a positive influence on the therapeutic process and important content emerged in treatment. The trial enabled many patients to work through the mourning process, which previously they did not allow themselves to experience.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude↗
PubMed1991

Ultrastructural quantification of collagen fibrils in chordae tendineae of the sheep and rabbit.

Collagen fibril diameters and the volume occupied by collagen were quantified at the ultrastructural level in the chordae tendineae of the rabbit and the sheep. Collagen fibril diameter distribution was unimodal and significant differences were found between values on the left and right sides, those on the left being greater than those on the right. The differences are discussed in terms of mechanical loading and compared with results obtained from other tendinous structures subjected to continuous loading.

Animals↗
PubMed1991

A pre-eclamptic-like syndrome associated with hypothyroidism during pregnancy.

Hypothyroidism presenting during pregnancy is rare, probably due to the lower incidence of hypothyroidism during the reproductive years, and because myxoedema causes anovulatory cycles. We report an unusual case of hypothyroidism during a 34-year-old woman's fifth pregnancy, complicated by hypertension, oedema, pericardial effusion and severe nephrotic syndrome. This is the first report of renal biopsy abnormalities under these circumstances. Review of the literature regarding hypothyroidism presenting during pregnancy leads us to suggest that hypothyroidism during pregnancy may mimic pre-eclampsia.

Adult↗
PubMed1991

Haematopoietic stem cell proliferation regulators investigated using an in vitro assay.

The in vivo CFU-S murine haematopoietic transplantation assay has allowed haematopoietic stem cell behaviour and regulation to be investigated; however, the in vivo nature of the CFU-S assay restricts its use. Recent use of combinations of haematopoietic colony-stimulating factors (CSFs) in vitro has cloned a population of colony-forming cells from haematopoietic tissue, characterised by high proliferative potential and proposed to be a component of the haematopoietic stem cell compartment. A high proliferative potential colony-forming cell (HPP-CFC) population was assayed from murine haematopoietic tissue using a combination of WEHi 3B myelomonocytic leukaemic cell line conditioned medium (a crude source of interleukin 3 (IL3)/multi-CSF) and L929 fibroblast cell line conditioned medium (a crude source of M-CSF/CSF-1). The proportion of HPP-CFC in S-phase was determined following incubation with an S-phase specific, cytotoxic agent. In normal bone marrow from CBA/H mice, 9% of HPP-CFC were in S-phase, while in sublethally X-irradiated, regenerating bone marrow, 50% of HPP-CFC were in S-phase, a close correlation with in vivo CFU-S kinetics. The kinetic state of appropriate HPP-CFC populations can be modified in vitro by incubation with stem cell specific regulators (inhibitor and stimulator). Both inhibitor and stimulator were titratable against the appropriate target HPP-CFC population. Results obtained showed a close correlation between the in vivo CFU-S and in vitro HPP-CFC titration data, reinforcing the belief that the HPP-CFC population is a developmentally early haematopoietic precursor, possibly a component of the haematopoietic stem cell compartment.

Animals↗