Microchipping horses.
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Biomedical subjects
Publications and source records attributed to S Ware.
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BACKGROUND: Increased variation in peak expiratory flow (PEF) is characteristic of poorly controlled asthma, and measurement of diurnal variability of PEF has been recommended for assessment of asthma severity, including during exacerbations. We aimed to test whether asthma exacerbations had the same PEF characteristics as poor asthma control. METHODS: Electronic PEF records from 43 patients with initially poorly controlled asthma were examined for all exacerbations that occurred after PEF reached a plateau with inhaled corticosteroid treatment. Diurnal variability of PEF was compared during exacerbations, run-in (poor asthma control), and the period of stable asthma before each exacerbation. FINDINGS: Diurnal variability was 21.3% during poor asthma control and improved to 5.3% (stable asthma) with inhaled corticosteroid treatment. 40 exacerbations occurred in 26 patients over 2-16 months; 38 (95%) of exacerbations were associated with symptoms of clinical respiratory infection. During exacerbations, consecutive PEF values fell linearly over several days then improved linearly. However, diurnal variability during exacerbations (7.7%) was not significantly higher than during stable asthma (5.4%, p=0.1). PEF data were consistent with impaired response to inhaled beta2-agonist during exacerbations but not during poorly controlled asthma. INTERPRETATION: Asthmatics remain vulnerable to exacerbations during clinical respiratory infections, even after asthma is brought under control. Calculation of diurnal variability may fail to detect important changes in lung function. PEF variation is strikingly different during exacerbations compared with poor asthma control, suggesting differences in beta2-adrenoceptor function between these conditions.
The human fibrinogen gamma-chain C-terminal segment functions as the platelet integrin binding site as well as the Factor XIIIa cross-linking substrate and thus plays an important role in blood clot formation and stabilization. The three-dimensional structure of this segment has been determined using carrier protein driven crystallization. The C-terminal segment, gamma-(398-411), was attached to a linker sequence at the C-terminus of glutathione S-transferase and the structure of this fusion protein determined at 1.8 A resolution. Functional studies of the chimeric protein demonstrate that the fibrinogen sequence in the presence of the carrier protein retains its specific functions as ligand for platelet integrin alpha(IIb)beta3 (gpIIb/IIIa) and as a cross-linking substrate for Factor XIIIa. The structure obtained for the fibrinogen gamma-chain segment is not affected by crystal packing and can provide the missing links to the recently reported model of cross-linked fibrin.
To determine whether cutaneous blood vessels in subjects with psoriasis possess a generalized inherently abnormal response to neuropeptides, the effect of three doses of intradermally injected calcitonin gene-related peptide (CGRP) on skin blood flow in normal subjects (n = 10), and on clinically normal skin (greater than 5 cm from psoriatic lesions) in subjects with psoriasis (n = 9) was measured using a laser Doppler technique. Calcitonin gene-related peptide caused a dose-dependent increase in local blood flow in both psoriatic and normal subjects, which was not statistically different between the two groups. This study has shown that the cutaneous vasculature at sites distant from lesions of psoriasis (> 5 cm) is not inherently different from normal skin in its response to CGRP.
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Sudorometry of the finger was carried out using the ventilated capsule method, the aim being to use the level of relative humidity within the sudorometer as an indirect measure of the sudomotor drive. Subjects inserted a finger through a diaphragm of a finger-shaped, temperature-controlled chamber which also contained the humidity sensor. Manoeuvres known to alter the sudomotor drive produced changes in chamber humidity. The relative humidity within the sudorometer became constant after local anaesthesia of the digital nerves and after upper limb sympathectomy, suggesting that fluctuations in the sudorometer output were dependent upon an intact autonomic nervous system. In an environment in which temperature was controlled and arousal effects from the process of measurement were minimised, chamber humidity always increased during a Stroop test, providing a rapid means of indirectly assessing sudomotor drive mechanisms.
Illicit substance abuse among pregnant women has been documented in many large metropolitan areas. However, there has been limited documentation in smaller, more traditional cities of America. The urine of 105 viable newborns delivered within a 30-day period was tested for illicit drugs in a blind study. Positive results were obtained in 9.5% of the subjects. The following demographic data were compiled about the subjects: (a) type of identified substance; (b) age of mother; (c) timing of mother's entry into prenatal care; (d) maternal complications; (e) newborn complications; (f) newborn gestational age; and (g) mother's economic status.
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Fourteen patients with anaplastic seminoma were analyzed retrospectively. At the time of presentation anaplastic seminoma has similar prognosis stage for stage as the classic seminoma. However, the distinctive histologic findings and the high rates of local invasion and of elevations of serum beta-subunit human chorionic gonadotropin serve to distinguish anaplastic seminoma from the classic seminoma. These features, suggesting a possibly greater metastatic potential for anaplastic seminoma, warrant its continued identification as a distinct pathologic subtype.
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Five patients, four of them children, had acute liver disease after treatment with sodium valproate. Three died. The liver disease began 3-6 months after the start of treatment and was often associated with other side-effects of sodium valproate such as thrombocytopenia and hair loss.
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Six of 57 children under 4 years old became hypoglycaemic during postoperative recovery from various surgical procedures. Fluids either by mouth or intravenously did not always prevent this. Children at risk could not be predicted on the basis of age or weight-for-age. Small children should be fed as soon as practicable after operations, preferably with milk.
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