scispace - formally typeset
Search or ask a question

Showing papers by "University of Salford published in 1992"


Journal ArticleDOI
TL;DR: The nature and basis of nonresponsive celiac sprue require more thoughtful initiatives to elucidate the immunologic mechanism(s) of unresponsiveness and evaluate possible means of reversal.

2,082 citations


Journal ArticleDOI
TL;DR: Fish tissues and body fluids contain naturally occurring proteins or glycoproteins of non-immunoglobulin (Ig) nature that react with a diverse array of environmental antigens and may confer an undefined degree of natural immunity to fish.

530 citations


Journal ArticleDOI
TL;DR: Much drug-related morbidity in the elderly population may be avoidable, as it is due to inappropriate prescribing, which was found to be significantly higher for inappropriate than for appropriate drugs.
Abstract: To determine the extent to which adverse drug reactions (ADRs) in elderly patients admitted to hospital are due to inappropriate prescribing, we examined 416 successive admissions of elderly patients to a teaching hospital. Interacting drug combinations and drugs with relative contra-indications (CIs) were common, but not as important in producing ADRs as drugs with absolute CIs or unnecessary drugs. Forty-eight patients (11.5% of admissions) were taking a total of 51 drugs with absolute CIs (3.8% of prescriptions). One hundred and seventy-five drugs were discontinued on or shortly after admission in 113 (27%) patients because they were deemed to be unnecessary. One hundred and three patients (27.0% of those on medication) experienced 151 ADRs of which 75 (49.7%) were due to drugs with absolute CIs and/or that were unnecessary, a significantly higher rate of ADRs (p less than 0.001) than observed for all prescriptions. Of 26 (6.3%) admissions attributed to ADRs, 13 (50%) were due to inappropriate prescriptions. The admission rate per prescription was significantly higher (p less than 0.001) for inappropriate than for appropriate drugs. We conclude that much drug-related morbidity in the elderly population may be avoidable, as it is due to inappropriate prescribing.

388 citations


Journal ArticleDOI
TL;DR: This study confirms the strong association between prior infection with S pyogenes and guttate psoriasis but suggests that the ability to trigger Guttate Psoriasis is not serotype specific.
Abstract: • Background and Design.— Although the association between streptococcal infection and guttate psoriasis is well known, to date there has been little information on whether only limited groups and/or serotypes of β-hemolytic streptococci are involved. One hundred eleven patients with a sudden onset or deterioration of psoriasis were investigated for evidence of streptococcal infection. Of these patients, 34 had acute guttate psoriasis, 30 had a guttate flare of chronic psoriasis, 37 had chronic plaque psoriasis, and 10 had other types of psoriasis. Results.— Serologic evidence of recent streptococcal infection was present in 19 (58%) of 33 patients with acute guttate psoriasis compared with seven (26%) of 27 patients with guttate exacerbations of chronic psoriasis. Streptococcus pyogenes was isolated from 19(17%) of all 111 patients (9 [26%] of 34 with acute guttate psoriasis, four [13%] of 30 with guttate exacerbations of chronic psoriasis, and five [14%] of 37 patients with chronic psoriasis) compared with seven (7%) of 101 of a control population of patients being seen for treatment of viral warts. Other β-hemolytic streptococci were found with equal frequency in the study and control populations. Thirteen isolates of 10 different streptococcal serotypes were obtained from the 64 patients with guttate psoriasis. These serotypes were similar in distribution and prevalence to those present in the local community. Conclusions.— This study confirms the strong association between prior infection with S pyogenes and guttate psoriasis but suggests that the ability to trigger guttate psoriasis is not serotype specific. ( Arch Dermatol. 1992;128:39-42)

315 citations


Journal ArticleDOI
TL;DR: In this paper, the authors analyse the meaning of home and homelessness in the light of recent contributions on the meanings of home, and explain the political meaning of homelessness as expressed in official definitions, legislation and state provision.
Abstract: This paper has several objectives. These are: (1) to analyse the meaning of homelessness in the light of recent contributions on the meaning of home: (2) to criticize some current perspectives on homelessness as a social problem; (3) to identify and explore a number of different dimensions of the meaning of home and homelessness; (4) to reassess the evidence on the context of home and homelessness, and re-examine the meaning of homelessness in the light of that reassessed evidence; and (5) to explain the political meaning of homelessness as expressed in official definitions, legislation and state provision (or lack of it).

290 citations




Journal ArticleDOI
TL;DR: The impact of premature ovarian failure due to whole abdominal radiotherapy in childhood on uterine physical characteristics and blood flow and measuring the uterine response to exogenous sex steroid replacement in childhood are investigated.

207 citations


Journal ArticleDOI
TL;DR: The probability of rehospitalization following the initial discharge on which a diagnosis of schizophrenia was made is described using data from psychiatric case registers in Victoria, Australia; Maryland, U.S.A.; Denmark; and Salford, England.
Abstract: The probability of rehospitalization following the initial discharge on which a diagnosis of schizophrenia was made is described using data from psychiatric case registers in Victoria, Australia; Maryland, U.S.A.; Denmark; and Salford, England. The percentage eventually rehospitalized, after followup intervals as long as two decades, varies from about 50 to 80 percent in the four service systems. Survival curves for duration in the community without rehospitalization bend sharply in the period between 2 and 3 years following discharge in all four cohorts and are almost flat after 20 years. Early age of onset predicts higher risk for rehospitalization in multivariate proportional hazards models in each cohort. When age of onset is included as a covariate, neither gender nor marital status has consistent or statistically significant effects on risk for rehospitalization.

176 citations


Journal ArticleDOI
TL;DR: The techniques of genetic algorithms are proposed as an alternative means of tuning digital PID controllers for complex multivariable plants with highly interactive dynamics.
Abstract: The techniques of genetic algorithms are proposed as an alternative means of tuning digital PID controllers. This use of genetic algorithms is particularly attractive because the same basic approach can always be readily used, even in the case of digital PID controllers for complex multivariable plants with highly interactive dynamics.

164 citations


Journal ArticleDOI
TL;DR: The high prevalence of human AE in this region of central China is most probably due to semi-domestic transmission of E multilocularis between wild rodents and dogs, together with the poverty and poor hygiene in these rural communities.


Journal ArticleDOI
TL;DR: A prospective analysis of 207 trauma patients, from three internationally recognized trauma centres, showed that trauma teams in which staff carry out allocated tasks simultaneously have the quickest resuscitation times.
Abstract: A prospective analysis of 207 trauma patients, from three internationally recognized trauma centres, showed that trauma teams in which staff carry out allocated tasks simultaneously have the quickest resuscitation times. This finding was further tested by introducing these changes into a fourth centre. A comparison of resuscitation stage times was made in 26 patients before and 24 patients after the introduction of the organizational changes. Significant time reductions were found in all the stages, except the time taken to examine the patient. The time taken to complete the resuscitation was reduced by over half from 122 to 56 min. Significant time reductions applied even when variations in the type of patient, the team size or seniority of the team leader was taken into account. Recommendations for the organization of trauma teams are made.

Journal ArticleDOI
TL;DR: The pharmacokinetics of propofol administered as long term infusions were determined in intensive care unit patients requiring sedation during mechanical ventilation and one patient died during the infusion, from multi-organ failure secondary to a pre-existing septicaemia, and in one other patient no sampling was possible during the first 30 min after infusion.
Abstract: The pharmacokinetics of propofol administered as long term infusions were determined in 12 intensive care unit patients (two female; mean age 58 yr, mean weight 66.9 kg) requiring sedation during mechanical ventilation. Patients were recruited after having been administered propofol for 24 h. Blood samples for analysis of propofol were taken during the infusion (mean duration 85.6 h; mean rate 2.58 mg kg−1 h−1) and for up to about 42 h after its termination. The median propofol total body clearance, derived from the apparent steady state propofol blood concentrations during infusion, was 2.11 litre minr. One patient died during the infusion, from multi-organ failure secondary to a pre-existing septicaemia, and in one other patient no sampling was possible during the first 30 min after infusion; full elimination data were obtained for 10 patients. After termination of the infusion, propofol blood concentrations declined rapidly, with an overall mean decrease of 50% over the first 10 min; thereafter the decline was more gradual. The elimination profile was triphasic in seven patients and biphasic in three patients. Mean half-lives for the three phases were 1.81 (n = 10) min, 70.9 (n = 7) min and 1411 (n = 11) min. There was no apparent trend in the terminal phase half-life with the duration of sampling after infusion.

Journal ArticleDOI
TL;DR: The theory of the parabolic equation method and the manner in which a finite difference numerical solution scheme can be constructed are presented in this paper, where the treatment deals with both narrow and wide angle cases.

Journal ArticleDOI
M A Pollock1, S G Jefferson1, J W Kane1, K Lomax1, G MacKinnon1, C B Winnard1 
TL;DR: This study illustrates the use of a graphical presentation of data, the difference Plot, which can be used as an alternative to least squares regression analysis, and shows that in most cases much more relevant information was obtained from the difference plot.
Abstract: The commonly accepted method of analysing data from method comparison studies is regression analysis, a method which has limitations. This study illustrates the use of a graphical presentation of data, the difference plot, which can be used as an alternative to least squares regression analysis. The data from comparison studies performed on five methods were analysed both by Deming's regression analysis, with calculation of the correlation coefficient, and by the difference plot. The results show that in most cases much more relevant information was obtained from the difference plot.

Journal ArticleDOI
TL;DR: Short‐contact treatment with dithranol (anthralin) is a widely used treatment for chronic plaque psoriasis, although effective, it causes staining and irritation, and is therefore inconvenient.
Abstract: Short-contact treatment with dithranol (anthralin) is a widely used treatment for chronic plaque psoriasis. Although effective, it causes staining and irritation, and is therefore inconvenient. Calcipotriol is a recently developed vitamin D analogue which is effective and easy to use. To evaluate the relative efficacy, safety and acceptability of these treatments a multicentre, open, randomized, parallel-group comparison was performed. Four hundred and seventy-eight patients with chronic plaque psoriasis were randomized to use one of the two treatments for 8 weeks. One group applied calcipotriol ointment (50 micrograms/g) twice daily. The other used a single application for 30 min each day of Dithrocream in the highest concentration tolerated. Severity of psoriasis was assessed by modified PASI score at baseline, and after 2, 4, and 8 weeks of treatment. A five-point scale was used by subjects and by investigators as an additional assessment of overall response, and a similar scale was used by subjects to grade acceptability. Total serum calcium was monitored at baseline and after 2 and 8 weeks on treatment. The mean PASI score fell from 9.1 to 4.7 after 8 weeks on dithranol (P < 0.001), and from 9.4 to 3.4 on calcipotriol (P < 0.001). The difference between the two treatments was significant in favour of calcipotriol at 2 weeks (P < 0.001), and remained so at subsequent assessments. At 8 weeks the difference between mean improvements in scores for the two groups was 1.6 (95% confidence interval 0.5-2.7). Efficacy grading by subjects and investigators, and acceptability grading by subjects, were all significantly better for calcipotriol.(ABSTRACT TRUNCATED AT 250 WORDS)

Journal ArticleDOI
TL;DR: Episodes of hospitalization for schizophrenia tend to cluster earlier rather than later in the treatment career, suggesting a progressive amelioration rather than deterioration.
Abstract: This analysis examines the notion of progressive deterioration in schizophrenia, using long-term followup data on hospital episodes in defined cohorts from psychiatric case registers in Victoria, Australia; Denmark; and Salford, England. The analyses differentiate heterogeneity existing at the first hospitalization for schizophrenia, which produces a widely varying natural course, from heterogeneity that develops over time, as episodes of hospitalization occur. Episodes of hospitalization for schizophrenia tend to cluster earlier rather than later in the treatment career, suggesting a progressive amelioration rather than deterioration. When overall chronicity is adjusted, each additional episode of hospitalization lowers the risk for a further hospitalization by about 10 percent.

Journal ArticleDOI
TL;DR: The value of TP as a marker of corticosteroid hypersensitivity is reinforced by this study, but no satisfactory marker was found for the 9·2% of cases not detected by TP.
Abstract: Topical corticosteroids are increasingly recognized as relatively common contact sensitizers. Between July 1988 and December 1991 2687 patients undergoing routine patch testing were also tested with tixocortol pivalate (TP). Over the same time period 528 patients were selected for testing with a series of 18 steroids. One-hundred and thirty-one cases (4.9%) of corticosteroid hypersensitivity were detected and 119 (90.8%) of these cases were positive to TP. Thirty-seven patients reacted to one or more steroids in the steroid series, the most frequent sensitizers being hydrocortisone, budesonide (3.6%) and hydrocortisone 17-butyrate (2.5%). Of these 37 cases, 20 (54%) reacted to more than one steroid simultaneously, but the patterns of cross-reaction were not consistent with previously suggested groupings. Screening for steroid allergy should be performed as part of standard patch testing. The value of TP as a marker of corticosteroid hypersensitivity is reinforced by this study, but no satisfactory marker was found for the 9.2% of cases not detected by TP. There remains a need for further markers of corticosteroid hypersensitivity. A prevalence of 4.9% of corticosteroid allergy amongst our patients suggests that the frequency of this finding is generally underestimated.

Journal ArticleDOI
TL;DR: A finite element method has been used to investigate the contract stresses due to elastic indentation of coating/substrate systems consisting of a high modulus surface coating on a low modulus substrate as discussed by the authors.

Journal ArticleDOI
TL;DR: This work generalizes several results to the case of an arbitrary prime power q as well as introducing new results and a detailed methodology to enable the problem of finding nq(k, d) to be tackled over any finite field.
Abstract: Let n q (k, d) denote the smallest value of n for which there exists a linear [n, k, d]-code over GF(q). An [n, k, d]-code whose length is equal to n q (k, d) is called optimal. The problem of finding n q (k, d)has received much attention for the case q = 2. We generalize several results to the case of an arbitrary prime power q as well as introducing new results and a detailed methodology to enable the problem to be tackled over any finite field. In particular, we study the problem with q = 3 and determine n 3(k, d) for all d when k ≤ 4, and n 3(5, d) for all but 30 values of d.

Journal ArticleDOI
TL;DR: In this article, the authors address the modelling of a problem of growing interest to production engineers, namely the appropriate and cost-effective way of condition monitoring of a production plant, which checks the state of wear of a component and records a (0, 1) signal depending upon all being well or that wear is below a critical level with the possibility of imminent failure.
Abstract: This paper addresses the modelling of a problem of growing interest to production engineers, namely the appropriate and cost-effective way of condition monitoring of a production plant. Here a condition monitoring test is assumed which checks the state of wear of a component and records a (0,1) signal depending upon all being well or that wear is below a critical level with the possibility of imminent failure. Decision variables are the critical warning level and frequency of monitoring inspections. Consequence variables are the cost of maintaining plant and the availability of plant for production.

Journal ArticleDOI
TL;DR: There were significant differences in the time taken to resuscitate 257 trauma patients from four internationally recognized trauma centres, the fastest unit completed resuscitation in 15 min while the slowest took 105 min, and the average post-qualification time of the team leader at the fastest units was 2 years.
Abstract: There were significant differences in the time taken to resuscitate 257 trauma patients from four internationally recognized trauma centres. The fastest unit completed resuscitation in 15 min while the slowest took 105 min. This variation was not explained by differences in the type of patient dealt with, seniority of the team leader, or the number of personnel in the trauma team. Although there were significant differences between the units with regard to these parameters, they did not account for the resuscitation time variations. The average post-qualification time of the team leader at the fastest unit was 2 years. Although the slowest unit had the smallest trauma team (two people), larger numbers of personnel did not shorten resuscitation times. The time taken to carry out the ABC of the primary survey was significantly correlated with patient's physiological change in the resuscitation room (R = 0.63, P

Journal ArticleDOI
10 Oct 1992-BMJ
TL;DR: This case shows that, although papaverine is a relatively safe coronary vasodilator for measuring coronary flow reserve, all patients should be closely monitored while receiving intracoronary papaverines, as well as appropriate antiarrhythmic preparations.
Abstract: Drs A CHAUHAN, P A MULLINS, S T THURAISINGHAM, and P M SCHOFIELD (Papworth Hospital, Cambridge CB3 8RE) write: Papaverine administered by the intracoronary route in humans produces a brief maximal hyperaemic response in the coronary circulation that has little systemic effect and is used to measure coronary flow reserve in cardiac disease. 2 Intracoronary papaverine is known to produce changes in cardiac electrophysiological variables and ST-T configuration and prolongation of the QT interval.3 Isolated cases of ventricular tachycardia and ventricular fibrillation have also been described.46 We describe a case of complete atrioventricular block after intracoronary papaverine administration. A 53 year old man was undergoing investigations for chest pain with a positive response on exercise electrocardiography and normal coronary arteries on angiography. He was readmitted for further investigations, including coronary flow reserve studies. He had been taking nifedipine for several months and this was stopped 24 hours before cardiac catheterisation. His only other medication was dipyridamole, which was continued. Baseline pulse rate, blood pressure, electrocardiogram, and serum electolyte concentrations were normal. Resting coronary blood flow was measured with a 3F 20 mHz intracoronary Doppler flow probe. Incremental doses of intracoronary papaverine were given after a 2 mg test dose. After administration of a 12 mg dose the patient developed complete atrioventricular block lasting five seconds. He remained asymptomatic and was haemodynamically stable. The study was terminated because of this unexpected side effect. This case shows that, although papaverine is a relatively safe coronary vasodilator for measuring coronary flow reserve, all patients should be closely monitored while receiving intracoronary papaverine. A temporary pacemaker should also be available as well as appropriate antiarrhythmic preparations.

Journal ArticleDOI
TL;DR: Urea production and disposal Urea production is used by the body to remove potentially toxic products of nitrogen metabolism and may also have evolved for the disposal of hydrogen ions.
Abstract: Urea production and disposal Urea production is used by the body to remove potentially toxic products of nitrogen metabolism and may also have evolved for the disposal of hydrogen ions. Ammonia is a product of amino acid metabolism and the major source of circulating ammonia is the gastrointestinal tract. 2 It is neurotoxic, possibly due to its effect on the glutamate dehydrogenase pathway causing a reduction in the a-ketoglutarate available to the citric acid cycle." Other mechanisms are possible, but the overall effect is interference with preand post-synaptic function. Animals must therefore remove ammonia from the body. This may be direct (ammonotelic) as in fish, via uric acid (uricotelic) as in frogs, or via urea (ureotelic) as in mammals. Urea accounts for 80-90010 of nitrogen excretion in man; assuming a diet containing 100 g protein/day, this amounts to 25-35 g urea daily." Urea exceeds creatinine as a component of urinary nitrogen by a factor of up to 30. Urea synthesis from ammonia occurs only in the liver, by means of a cyclical process in which

Journal ArticleDOI
01 Mar 1992-Pain
TL;DR: It is concluded that the occurrence of nerve fibre degeneration and regeneration is in itself unlikely to be sufficient to account fully for diabetic neuropathic pain, however, it is conceivable that events occurring during certain stages in the pathological cycle of degenerations and regeneration create the necessary circumstances which lead to pain.
Abstract: The cause of the neuropathic pain that is experienced by some patients with diabetic neuropathy remains to be established. Early neuropathological reports, based on comparisons between diabetic patients and non-diabetic control subjects, emphasised associations between pathological changes in specific classes of peripheral nerve fibre and the presence of pain. By making comparisons with more appropriate control subjects, namely diabetic patients without neuropathic pain, more recent studies have found that there are few clear morphological correlates for this type of pain. To investigate this further, we have conducted a detailed morphometric study of sural nerve biopsies from six diabetic patients, four with active acute painful neuropathy and two with recent remission from the same condition. Normal values for the neuropathological parameters were obtained from six non-diabetic control subjects. Teased fibre analysis showed that similar axonal and Schwann cell abnormalities were present in both groups of diabetic patients. Electron microscopical studies revealed that evidence of both myelinated and unmyelinated fibre degeneration and regeneration was also present in the nerves of all diabetic patients, irrespective of whether they had pain. Within the constraints of interpreting results from small numbers of patients, our observations suggested that remission from pain might be associated with a less abnormal axon/Schwann cell calibre ratio, more successful myelinated fibre regeneration and less active unmyelinated fibre regeneration. However, the inescapable finding of this study was, in fact, the similarity in the nerve fibre pathology in diabetic patients with active and remitting painful neuropathy. We conclude that the occurrence of nerve fibre degeneration and regeneration is in itself unlikely to be sufficient to account fully for diabetic neuropathic pain. However, it is conceivable that events occurring during certain stages in the pathological cycle of degeneration and regeneration create the necessary circumstances which lead to pain.

Journal ArticleDOI
TL;DR: For example, this article argued that the Second World War radicalized the public, turning an unprecedented number of enthusiastic Labour voters into enthusiastic Conservative voters, and that voters who did not want to see the return of a Conservative government had no choice but to vote straight left.
Abstract: Labour's victory at the general election of 1945, the first in which the party won an absolute majority in the house of commons, had fundamental implications for Britain's post-war history. Despite this, historians have failed to examine the popular political temper which made Labour's term of office possible. Instead, they have largely assumed that the Second World War radicalized the public, turning an unprecedented number into enthusiastic Labour voters. Whilst not denying that the war had a profound impact on the politics of some sections of society this article proposes a rather different perspective to that normally offered. Instead of promoting pro-Labour sentiment it seems that the conflict left many members of the public disengaged from the political process and cynical about the motives of all politicians. As a consequence, rather than have Labour hold office by itself the generally favoured outcome appears to have been the formation of a progressive coalition committed to the implementation of the Beveridge report. However, in reality, electors who did not want to see the return of a Conservative government had no choice but to vote ‘straight left’.

Journal ArticleDOI
TL;DR: In this paper, the application of this type of reaction to a variety of nitriles and β-methylazines (pyridines, quinolines, pyridine, pyrimidine and quinoxalines) is described.

Journal ArticleDOI
TL;DR: In this article, the authors examined the relationship between the competitiveness of contract bids entered by individual bidders through the variables of bidder size, contract value and project type and found that, in terms of competitiveness, there is a relationship between size of bidder and size of contract.
Abstract: This paper examines the relationship between the competitiveness of contract bids entered by individual bidders through the variables of bidder size, contract value and project type. The analysis indicates that, in terms of competitiveness, there is a relationship between the size of bidder and size of contract. This concurs with previous work in the field. Bidders having competitiveness affinities towards particular types of projects, although apparent, appear to be weaker for the private sector than found in previous work concerning the public sector.

Journal ArticleDOI
TL;DR: It is shown how searches may be extended to codes whose length is a multiple of some integer which is greater than the dimension.
Abstract: Quasi-cyclic codes have provided a rich source of good linear codes. Previous constructions of quasi-cyclic codes have been confined mainly to codes whose length is a multiple of the dimension. In this paper it is shown how searches may be extended to codes whose length is a multiple of some integer which is greater than the dimension. The particular case of 5-dimensional codes over GF(3) is considered and a number of optimal codes (i.e., [n, k, d]-codes having largest possible minimum distance d for given length n and dimension k) are constructed. These include ternary codes with parameters [45, 5, 28], [36, 5, 22], [42, 5, 26], [48, 5, 30] and [72, 5, 46], all of which improve on the previously best known bounds.