Regulatory peptides in the heart and major vessels of man and mammals

Studies on the distribution of peptides in human tissues have been made either by measuring responses to localized stimuli or by subjecting extracts of different regions to radioimmunoassay (RIA). Attempts at isolating regulatory peptides from the mammalian tissues have resulted in the isolation of many bioactive fragments. Later, modification of initial isolation methods led to the identification of the native molecules in various tissues and body fluids. The present study examined atrial natriuretic peptide (ANP) and several other peptides in cardiac tissues of several species of laboratory mammal and human beings; using a sensitive and highly specific radioimmunoassays.In all the species studied, ANP-like immunoreactivity appeared to be highest in the heart tissue of rat. The peptide was highest in the right atrium (RA) of rat and lowest in the RA of guinea pig (P< 0.002). Neuropeptide Y (NPY) another abundant cardiac peptide was present in the cardiac tissues of all species but was more in the left atrium (LA) than the RA of all species (P<0.05). Calcitonin gene-related peptide (CGRP) was present throughout the cardiovascular system of the rat and guinea pig. Small but detectable amount of Neurotensin (NT) immunoreactivity was found in the rat but was consistently negative in the guinea pig cardiac tissues (P< 0.05). Substance P (SP) immunoreactivity was detected in the rat and higher quantities being in the Aorta but no trace of the peptide was detected in the left ventricle, aorta nor the pulmonary vein of post mortem human.Though the structure of most of the species studied has been elucidated, the primary structure of guinea pig ANP has not been fully generated. Thus the data obtained may suggest that in keeping with these mammalian peptides, the primary structures may be variant. With most of the peptides studied (e.g. ANP, Neuropepdide Y), immunoreactivity occurs predominantly in the atrial tissues, but is also present in vessels outside the heart, a finding which may be of functional significance.     

Re-engineering operating theatres: the perspective assessed

Refers to the widely experienced and appreciated difficulties in scheduling hospital operating theatres to make effective use of resources, and to avoid delays and overruns that can adversely affect patient care and staff morale. Reports the findings and recommendations of a project based in the Surgical Directorate of Leicester General Hospital NHS Trust which sought to address these problems from a business process re-engineering perspective. Covering the whole patient trail, from referral to discharge describes the project's progress through four phases concerning process mapping, the collection of staff opinions and ideas through a combination of interviews and surveys, collection of data on patient flows and procedure times, and a final "handover" phase in which broad recommendations were passed back to the Surgical Directorate for implementation with staff involvement. Details the recommendations which include a shift to cross-functional teamworking in a number of areas, along with the development of a revised theatres policy and a strengthened theatres co-ordination function. In view of recent substantial and harsh criticisms of the re-engineering perspective, seeks to offer a balanced assessment of the perspective applied to a health care setting, exploring both the problems and benefits.     

Feasibility of using Travenol sets in an IVAC 230 controller

The feasibility of using Travenol regular and minidrip sets to deliver intravenous solution with IVAC 230 controllers was investigated. Intravariability within Travenol regular sets proved to be negligible. Likewise, intervariability among IVAC controllers is negligible. The least squares fit obtained from drops per minute (dpm) versus flow rate (ml/hr) for Travenol regular sets using dextrose 5% in water was y = 4.50x + 0.8 (r greater than 0.99). Similarly, the least squares fit for sodium chloride 0.9% was y = 4.50x - 0.6 (r greater than 0.99). Therefore, the calculated dpm for the required flow rate for both solutions is similar using Travenol regular sets. Also, no significant difference is found between the drip rate of dextrose 5% in water and sodium chloride 0.9% with Travenol minidrip at 5, 30, and 60 dpms. This study shows that interchangeability of IVAC administration sets with Travenol regular and minidrip sets is possible for dextrose 5% in water and sodium chloride 0.9% solutions.     

The clinical manifestations of systemic lupus erythematosus: a Cairo-Glasgow co-operative study.

The clinical features of 78 patients with SLE seen in Cairo and Glasgow are reviewed. Raynaud's phenomenon was recorded more frequently here than in previous series. The value of serial measurements of anti-DNA antibodies, C3 and C4 in the management of SLE is discussed. Although antibodies to native DNA paralleled the disease course in only a minority of SLE patients anti-DNA antibodies were present during all major SLE exacerbations and could be diagnostically useful. Serious systemic infections complicating the management of SLE patients could occur and their diagnosis is discussed.     

Growth monitoring with the British 1990 growth reference

AIM: To provide a simple method for assessing centile change based on the British 1990 growth reference. STATISTICAL METHOD: The change in SD score over a period of time has SD square root of 2(1-r), where r is the correlation between the first and second SD score. This leads to an SD score for centile change. DATA: Annual height measurements from 2 to 9 years for 318 children from the French longitudinal growth study. RESULTS: The correlations between heights at different ages are higher for shorter measurement intervals and at older ages. The chance of a child's height centile falling one centile band width is correspondingly smaller for shorter measurement intervals and at older ages. An increase in height measurement error reduces the correlations and dramatically increases the chances of centile crossing. CONCLUSIONS: Quantitative height monitoring based on centile change is provided for whole year periods between 2 and 9 years of age. Effective monitoring requires the measurement error to be as small as possible.     

Adult height in patients with childhood onset atopic dermatitis

Cross sectional studies have reported impaired growth in children with atopic dermatitis. If this growth impairment is irreversible, it would be expected to adversely influence final height attainment. The standing heights and other anthropometric parameters were assessed in 35 adults with onset of atopic dermatitis before 5 years of age and a control group of 35 adults with adult onset contact dermatitis or psoriasis. There was no significant difference in the standing height SD score, mid-parental height SD score, sitting height SD score, subischial leg length SD score, nor body mass index between the atopic dermatitis and control groups. The standing height SD score was not significantly different among: (a) patients with atopic dermatitis affecting less than 50% of their body surface area and those with greater than 50% affected; (b) patients using the four different potency topical corticosteroids; and (c) patients with atopic dermatitis without asthma and those with coexisting asthma. It is concluded that short stature is not a feature of our group of adult patients with onset of atopic dermatitis before 5 years of age, continuing into adulthood, and severe enough to require specialist care. This suggests that if growth impairment occurs in childhood, it is likely to be temporary and reversible.