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Biomedical subjects

S Wright

Publications and source records attributed to S Wright.

At least 235 records · Page 13Linked to original sources
PubMed1990

Writing and using standards of nursing care.

This paper outlines some of the background to developments in setting nursing standards in the UK. Many nurses are busily engaged in this activity, and this paper offers a case study of the experience of standard setting in one unit. The Care of the Elderly Unit consists of 162 beds and a 50-place day hospital. Four wards accept acutely ill patients of both sexes, and a further five offer a mixture of rehabilitation and respite care. The buildings are a mixture of old workhouse-type wards and modern purpose-built facilities. A total of 170 nurses are employed in the unit which includes a team of clinical specialists and a senior nurse manager with overall responsibility for the nursing services. Staff at all levels on this team were involved in standard setting. The process of standard setting was an accumulation of eight years' work, with a more intense phase of activity in the last year. A variety of tools have been designed to test out the achievement of the standards.

Aged↗
PubMed1990

Multiple familial eccrine spiradenoma with cylindroma.

This report documents an association between multiple eccrine spiradenomata and multiple cylindromata in three generations of one family and provides further evidence to support previous contentions that these tumours are derived from a pluripotential basal cell. We propose that eccrine spiradenoma may be inherited as an autosomal dominant.

Adenoma, Sweat Gland↗
PubMed1990

A survey of tinea capitis in primary school children in Harare, Zimbabwe.

A survey of the prevalence and appearance of tinea infections and associated dermatophytes in schools in Harare is reported. Of 704 children examined, 29% showed clinical evidence of tinea capitis; of these, 86% had mycological evidence of infection. Dermatophytes were isolated from 69% of all the specimens. The most common was Trichophyton violaceum (78% of the isolates), 9% of the dermatophytes were Microsporum audouinii, and other isolates were T. mentagrophytes, T. yaoundei, M. gypseum and M. canis.

Child↗
PubMed1990

Homophobia, stigma and AIDS--an issue for all health care workers.

The AIDS epidemic has brought with it some fairly terrifying images of chronic illness and death among the young. Along with those images are the tremendous feelings of impotence (if that is the right word to use when writing about AIDS) which such an unknown infection creates among health care workers, who are used to dealing with somewhat more manageable entities. Yet, in their everyday work, nurses have to deal with many illnesses which are not particularly easier to cope with than those affecting the AIDS patient. The big difference is that AIDS-related illnesses are less familiar and much more bound up in the moral and political framework of our society.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Analysis of the kinetics, isotype and specificity of serum and coproantibody in lambs infected with Cryptosporidium parvum.

Enteric cryptosporidiosis was studied in colostrum-deprived lambs each infected at five days old with 10(6) oocysts. The prepatent period was three to five days and faecal oocyst concentration fell below detectable levels by day 16 after infection. Specific IgA, the only isotype detected by immunofluorescent assay in faecal extracts from infected lambs, was first evident on day 10 and titres continued to rise until day 16 of infection in association with declining oocyst output. Specific IgM and IgG antibodies were first detected in serum seven days after infection. No specific antibody was detected in uninfected control lambs. Immunoblotting methods showed that serum antibody and faecal IgA had similar profiles of antigen recognition. Antigens with approximate molecular weights of 180,000, 23,000 and 15,000 were consistent features on immunoblots performed with convalescent sera and faecal extracts. The results suggest that specific IgA in intestinal secretions has an important role in immunity to cryptosporidiosis.

Animals↗
PubMed1989

Highly efficient immunoliposomes prepared with a method which is compatible with various lipid compositions.

Monoclonal antibody was conjugated to N-glutaryl-phosphatidylethanolamine in the presence of octylglucoside by using N-hydroxysulfosuccinimide as a carboxyl-activation reagent. The conjugated antibody was then incorporated into liposomes by a simple dialysis method. The method is mild and is compatible with various lipid compositions of the liposomes. We have prepared immunoliposomes containing a lung endothelium-specific monoclonal antibody and showed excellent target binding (approximately 75% injected dose) of the immunoliposomes in mouse. Immunoliposomes can be prepared to contain other acidic lipids such as phosphatidylserine and various amounts of cholesterol. The presence of 20% or more cholesterol in liposomes resulted in high level of target binding. We have used in these experiments a new radioactive lipid-phase marker, 111In-DTPA-SA, which was very stable in vivo. The halflife of clearance in mouse exceeded 3 weeks.

Animals↗
PubMed1989

DNA sequences that mediate attenuation of transcription from the mouse protooncogene myc.

Expression of the protooncogene myc is regulated by multiple mechanisms and is probably involved in the control of cellular proliferation. Modulation of transcriptional elongation by attenuation within exon 1 of the myc gene is thought to play an important role in determining levels of myc RNA in both normal and tumor cells. We show that the first exon of mouse myc contains specific DNA sequences that may mediate transcriptional attenuation. A 180-nucleotide DNA fragment derived from the 3' end of exon 1 reduced transcriptional elongation by polymerase II when placed within an intron of the human alpha 1-globin gene and assayed by transfection into HeLa cells. A 36-nucleotide sequence that resembles a variety of transcriptional termination signals was located within this myc fragment but was by itself insufficient to cause attenuation when placed within the alpha-globin gene. Modulation of transcriptional elongation through specific DNA sequences within a gene may thus provide a mechanism for regulating its expression.

Animals↗
PubMed1989

Breast milk fatty acids in mothers of children with atopic eczema.

The total lipid fatty acid composition of mature breast milk has been analysed in a group of twenty-five mothers of children with atopic eczema, and compared with breast milk from twenty-two controls. Total lipids were extracted into chloroform-methanol (2:1, v/v) and the methyl esters prepared by alkalicatalysed trans-esterification were separated by gas-liquid chromatography and identified by comparison with standard fatty acid methyl esters. Results show that mothers of children with atopic eczema have a significantly greater proportion of linoleic acid, and a smaller proportion of dihomo-gamma-linolenic acid in their total breast milk lipid than the controls. Proportions of total derived fatty acids were similar between groups and there were no differences in the principal saturated and monounsaturated fats. It was concluded that mothers of children with atopic eczema have an abnormal breast-milk fatty acid composition. This supports previous evidence of a defect of conversion of linoleic acid into its long-chain polyunsaturated metabolites in the condition.

Adult↗
PubMed1989

Monoclonal antibody Tor 23 binds a subset of neural cells in the human cortex and displays an altered binding distribution in Alzheimer's disease.

Recent evidence suggests that alterations in molecules of the external neuronal surface may be pivotal factors in Alzheimer's disease (AD) either as primary or secondary lesions. We are studying neuronal surface components with a library of monoclonal antibodies (MAbs) made to highly purified, exclusively cholinergic nerve terminals of the Torpedo ray. The most extensively characterized of the Tor MAbs. Tor 23, binds the external membrane of some human neuronal cells in culture. Our present findings demonstrate that Tor 23, in situ, binds the apparent limiting membrane of rare neurons of the human isocortex. Tor 23 binds, in addition, internally within a subpopulation of subcortical white matter astrocytes, as identified by colocalization with glial fibrillary acidic protein. Neuronal surface binding of Tor 23 parallels our findings in other species: astrocyte staining was not observed in other species and may be unique to human. Immunoblot analysis of white matter reveals one polypeptide band with a relative mobility of 115,000 +/- 15,000 daltons. In the mid-frontal cortex from cases of AD. Tor 23 immunopositive neurons are greatly reduced in number and immunopositive astrocytes are completely absent. The reduction of the neuronal surface epitope defined by Tor 23 supports the recent hypothesis that surface molecules are altered in AD. The absence of Tor 23 positive astrocytes opens an area for specific investigation: namely, the role subcortical astrocytes may play in the pathogenesis of AD.

Aged↗
PubMed1989

Posterior lumbar interbody fusion with facet-screw fixation.

The optimal surgical construct for lumbar fusion remains controversial. The posterior lumbar interbody fusion (PLIF) operation offers advantages including total nuclear disc excision, restoration of disc-space height, root decompression, limited muscle retraction and injury, and solid mechanical arthrodesis. Major disadvantages have included graft displacement, neurologic injury and nonunion. The use of posterior fixation as an adjunct to PLIF reduces the probability of these complications and increases the chances of fusion. This study examines 35 patients who underwent PLIF and facet-screw fixation. Indications for surgery included disabling low-back pain with discographic/MRI-demonstrated disc derrangement, recurrent disc herniation, and failed inter-transverse process fusions. Follow-up ranged from 6 to 18 months. There were no patients with significant neurologic injury or functional root loss. One patient developed graft displacement and failure of fixation (laminar fracture in markedly obese patient). Three patients had subcutaneous hematomas (no surgical treatment required). None of the cases required blood replacement. The authors have concluded that the addition of facet fixation/fusion to the PLIF operation substantially reduces the complication rate of the procedure.

Bone Screws↗
PubMed1989

Meta-analysis of placebo-controlled studies of the efficacy of Epogam in the treatment of atopic eczema. Relationship between plasma essential fatty acid changes and clinical response.

Gamma-linolenic acid in the form of a particular variety of evening primrose oil (Epogam) has been reported of value in the treatment of atopic eczema. Nine controlled trials of evening primrose oil were performed in eight centres. Four of the trials were parallel and five cross-over. Doctors and patients assessed the severity of eczema by scoring measures of inflammation, dryness, scaliness, pruritus and overall skin involvement. Individual symptom scores were combined to give a single global score at each assessment point. In the analysis of the parallel studies, both patient and doctor scores showed a highly significant improvement over baseline (P less than 0.0001) due to Epogam: for both scores the effect of Epogam was significantly better than placebo. Similar results were obtained on analysis of the cross-over trials, but in this case the difference between Epogam and placebo in the doctors' global score, although in favour of Epogam, failed to reach significance. The effects on itch were particularly striking. There was no placebo response to this symptom, whereas there was a substantial and highly significant response to Epogam (P less than 0.0001). When the improvements, or otherwise, in clinical condition were related to changes in plasma levels of dihomogammalinolenic and arachidoni acids, it was found that there was a positive correlation between an improvement in clinical score and a rise in the fatty acid levels.

Adolescent↗
PubMed1989

Intra-epidermal neutrophilic IgA dermatosis with colitis.

We report the association of an intra-epidermal blistering disease of the skin with colitis. Both the skin and large bowel epithelium were infiltrated by neutrophils and eosinophils, and showed intra-epithelial deposition of IgA in an intercellular pattern. The colitis and the blisters responded well to treatment with dapsone.

Aged↗
PubMed1989

Flow-volume curves in snoring patients with and without obstructive sleep apnea.

To examine the usefulness of flow-volume curves as a screening test for the diagnosis of obstructive sleep apnea (OSA), we studied 405 consecutive patients referred for evaluation of possible OSA. All patients had full pulmonary function studies, which included measurements of maximal inspiratory and expiratory flow-volume curves, and nocturnal polysomnography, including continuous monitoring of snoring sounds. When the results were analyzed, of the 405 patients studied, 207 had OSA (apnea/hypopnea index [AHI] greater than 10) and 198 did not. Flow-volume curves were examined for the presence of upper airway obstruction defined as midvital capacity flow ratio (MVCFR = ratio of the maximal expiratory flow at 50% of vital capacity to maximal inspiratory flow at 50% of vital capacity) greater than 1.0. We found no significant difference in the values of MVCFR between the two groups: MVCFR was equal to 0.69 +/- 0.31 for nonapneic snorers, and 0.68 +/- 0.29 for the apneic snorers. Furthermore, we redefined the apneic and nonapneic groups using different cutoff values of AHI: 20, 30, 40, and 50. Independently of the AHI cutoff used, we found no significant difference in the MVCFR between the two groups. Linear regression analysis for the entire group of 405 patients revealed no significant correlation between MVCFR and the AHI or the snoring indices. We calculated the sensitivity, specificity, and predictive values of MVCFR for the diagnosis of OSA. We found that this test had 12% sensitivity, 86% specificity, 47% positive predictive value, and 46% negative predictive value.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗