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Holmes S. Justice for women. THE JOURNAL OF THE ROYAL SOCIETY FOR THE PROMOTION OF HEALTH 2000; 120:73-4. [PMID: 10944869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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152
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Abstract
Cancer is commonly complicated by psychiatric comorbidity, particularly depression. However, the effects of panic on cancer treatment and cancer patients' quality of life are not well understood. To examine more closely the occurrence of panic attacks and panic disorder in cancer patients, we retrospectively reviewed charts of 106 consecutive psychosomatic consultations of inpatients with cancer at a regional cancer center. Approximately one-fifth of the patient sample presented with panic attacks or panic disorder at the time of the consultation. We present four case examples to demonstrate the potential effect of panic on cancer patients, including requests for cancer treatment discontinuation. We report resolution of panic with benzodiazepine and selective serotonin reuptake inhibitors.
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Holmes S. Modernisation of prison healthcare? THE JOURNAL OF THE ROYAL SOCIETY FOR THE PROMOTION OF HEALTH 2000; 120:6-7. [PMID: 10918771 DOI: 10.1177/146642400012000104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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154
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Veeramah EK, Holmes S. Complementary therapy: complement or threat to modern medicine? THE JOURNAL OF THE ROYAL SOCIETY FOR THE PROMOTION OF HEALTH 2000; 120:42-6. [PMID: 10918783 DOI: 10.1177/146642400012000117] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Some believe that medicine has lost its holistic perspective as a result of which many people now seek help from 'alternative' practitioners who seem able to devote time to their patients and listen to their concerns. Such practitioners also treat the 'whole person' rather than only their symptoms, a feature which seems to be valued by patients. The use of complementary therapies is, therefore, increasing world-wide. This paper explores this increase, questioning whether this truly reflects dissatisfaction with 'traditional' (allopathic) medicine or rather represents an increased satisfaction with 'alternative' therapies. It also investigates the use of such therapies in mainstream medicine revealing considerable variation in attitudes towards and use of such therapies in current medical practice questioning whether this should be seen as a threat to modern medicine or their use may enhance patient well-being and quality of life.
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Allen HD, Thong IG, Clifton-Bligh P, Holmes S, Nery L, Wilson KB. Effects of high-dose inhaled corticosteroids on bone metabolism in prepubertal children with asthma. Pediatr Pulmonol 2000; 29:188-93. [PMID: 10686039 DOI: 10.1002/(sici)1099-0496(200003)29:3<188::aid-ppul6>3.0.co;2-k] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We studied the effect of inhaled corticosteroids on the increase in bone mineral content in prepubertal children with asthma. Forty-eight asthmatic, prepubertal children receiving either inhaled beclomethasone dipropionate or budesonide were evaluated. Nine children of similar age not receiving inhaled steroids served as controls. The average age of corticosteroid-treated children was 7.8 +/- 2.4 years, and of control children, 8.4 +/- 2.1 years (NS). The average dose of inhaled corticosteroids in the treated children was 0.67 +/- 0.48 mg/m(2)/day, and they were followed over a 9-20-month period. Total bone mineral content (TBMC) was measured at baseline and after 9-20 months. A derived value for 12 months' TBMC was calculated, assuming that changes in TBMC were linear with the passage of time. The change in TBMC over a 12-month period was 264 +/- 68 mg for the corticosteroid-treated children and 330 +/- 84 mg for control children (P < 0.025). In a multiple regression analysis in which adjustments were made for the effects of age, height, and weight, the change in TBMC in corticosteroid-treated children was inversely related to the inhaled steroid dose/m(2)/day (P = 0.016). The increase in the lumbar vertebral bone mineral density in control children was also significantly greater than in the corticosteroid-treated children (P < 0.025). We conclude that inhaled steroids, at an average dose of 0.67 mg/m(2)/day, when used in the treatment of asthma reduce the acquisition of bone mineral in prepubertal children.
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156
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Seager JM, Cullen DJ, Pearson G, Holmes S, Doherty M, Wilson JV, Garrud P, Garner S, Maynard A, Logan RF, Hawkey CJ. Ibuprofen versus other non-steroidal anti-inflammatory drugs: use in general practice and patient perception. Aliment Pharmacol Ther 2000; 14:187-91. [PMID: 10651659 DOI: 10.1046/j.1365-2036.2000.00699.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Abstract
OBJECTIVE To investigate whether ibuprofen was as well-regarded by patients as other non-steroidal anti-inflammatory drugs (NSAIDs). DESIGN Questionnaire sent to 1137 consecutive recipients of an NSAID prescription from 21 doctors in six general practices with computerized records. Patient responses were subsequently linked to data held on the practice records. SETTING General practices in and around Nottingham, selected to reflect local variations in number of partners, list size, geographical location, deprivation, prescribing burden and prescribing rate. SUBJECTS Unselected patients receiving NSAIDs prescribed for all indications for use. MAIN OUTCOME MEASURES Effectiveness of ibuprofen and other NSAIDs, possible drug related adverse events, patients' overall satisfaction with ibuprofen and other NSAIDs, factors associated with choice of ibuprofen, drug costs of ibuprofen and other NSAIDs. RESULTS The main NSAIDs used were ibuprofen, diclofenac and naproxen. Ibuprofen use ranged from 1.0% of prescriptions in one practice to 69.1% in another. Although ibuprofen was generally prescribed in low doses, it was perceived by patients as being as effective as the other NSAIDs used, even after allowing for severity of the pre-treatment condition. Overall, 50.5% of patients rated their NSAID the best treatment they had received for their condition with no differences between individual drugs. CONCLUSIONS Ibuprofen is as highly regarded as other NSAIDs when used in similar circumstances. Switching patients to ibuprofen may be a realistic way of reducing financial and medical costs associated with NSAIDs.
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Cullen DJ, Seager JM, Holmes S, Doherty M, Wilson JV, Garrud P, Garner S, Maynard A, Logan RF, Hawkey CJ. Pharmacoepidemiology of non-steroidal anti-inflammatory drug use in Nottingham general practices. Aliment Pharmacol Ther 2000; 14:177-85. [PMID: 10651658 DOI: 10.1046/j.1365-2036.2000.00700.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Abstract
AIM To investigate the pharmacoepidemiology of NSAID usage in Nottingham general practices. DESIGN Questionnaire sent to 1137 consecutive recipients of an NSAID prescription from 21 doctors in six general practices with computerized records. Patient responses were subsequently linked to data held on the practice records. SETTING General practices in and around Nottingham, selected to reflect local variations in number of partners, list size, geographical location, deprivation, prescribing burden and prescribing rate. SUBJECTS Unselected patients receiving NSAIDs prescribed for all indications. MAIN OUTCOME MEASURES Indication for treatment, differences in prescribing to different age groups, compliance and overall scheme drug exposure, drug effectiveness and tolerability, possible drug-related adverse events, patients' overall satisfaction with treatment and estimated costs of care. RESULTS NSAIDs were used for a wide range of conditions and only a small number of patients had rheumatoid arthritis. The main drugs used were ibuprofen, diclofenac and naproxen. Patients making short-term use of NSAIDs had low compliance if they experienced adverse drug effects, whilst conversely in long-term users, those with high compliance reported more adverse drug effects. Calculated compliance did not vary with age although older patients (over 65 years) claimed in their questionnaires to be more compliant than younger patients. Half the patients reported good or complete symptom relief. Half of those questions (and two thirds of those with good or complete symptom relief) rated their NSAID as the best treatment they had received for their current condition. The frequency of gastrointestinal adverse events was higher in the young and the old, which correlated with the use of anti-ulcer drugs, and increased with the total number of medications used. CONCLUSIONS NSAIDs are used for a wide-range of conditions. They give symptom relief to, and are perceived as effective by, most patients taking them.
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Abstract
Male sexual dysfunction is a prevalent condition in the population, is a major health problem and has previously been both under diagnosed and under treated. There are now a number of treatments available that are safe and easy to use which provide an effective solution for most presenting patients. Oral drugs have recently become the first-line option for many men with about 60-70% of new presentations achieving success. Those who fail a trial of oral treatments have a number of other options available, which are able to provide erections sufficient for intercourse in many of the oral drug failures. All these options, their indications, side-effects and complications are outlined in this chapter.
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160
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Cutler DJ, Morris R, Sheridhar V, Wattam TA, Holmes S, Patel S, Arch JR, Wilson S, Buckingham RE, Evans ML, Leslie RA, Williams G. Differential distribution of orexin-A and orexin-B immunoreactivity in the rat brain and spinal cord. Peptides 1999; 20:1455-70. [PMID: 10698122 DOI: 10.1016/s0196-9781(99)00157-6] [Citation(s) in RCA: 186] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The orexins are recently identified appetite-stimulating hypothalamic peptides. We used immunohistochemistry to map orexin-A and orexin-B immunoreactivity in rat brain, spinal cord, and some peripheral tissues. Orexin-A- and orexin-B-immunoreactive cell bodies were confined to the lateral hypothalamic area and perifornical nuclei. Orexin-A-immunoreactive fibers were densely distributed in the hypothalamus, septum, thalamus, locus coeruleus, spinal cord, and near the ventricles, but absent from peripheral sites investigated. In contrast, orexin-B-immunoreactive fibers were distributed sparsely in the hypothalamus. Orexin cells are strategically sited to contribute to feeding regulation, but their widespread projections suggest that orexins have other physiological roles.
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161
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Dickinson RA, Holmes S. Identify the best value proposition for your organization & market. THE HEALTHCARE STRATEGIST 1999; 3:8-12. [PMID: 10623067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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162
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Hagan JJ, Leslie RA, Patel S, Evans ML, Wattam TA, Holmes S, Benham CD, Taylor SG, Routledge C, Hemmati P, Munton RP, Ashmeade TE, Shah AS, Hatcher JP, Hatcher PD, Jones DN, Smith MI, Piper DC, Hunter AJ, Porter RA, Upton N. Orexin A activates locus coeruleus cell firing and increases arousal in the rat. Proc Natl Acad Sci U S A 1999; 96:10911-6. [PMID: 10485925 PMCID: PMC17982 DOI: 10.1073/pnas.96.19.10911] [Citation(s) in RCA: 877] [Impact Index Per Article: 35.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
The localization of orexin neuropeptides in the lateral hypothalamus has focused interest on their role in ingestion. The orexigenic neurones in the lateral hypothalamus, however, project widely in the brain, and thus the physiological role of orexins is likely to be complex. Here we describe an investigation of the action of orexin A in modulating the arousal state of rats by using a combination of tissue localization and electrophysiological and behavioral techniques. We show that the brain region receiving the densest innervation from orexinergic nerves is the locus coeruleus, a key modulator of attentional state, where application of orexin A increases cell firing of intrinsic noradrenergic neurones. Orexin A increases arousal and locomotor activity and modulates neuroendocrine function. The data suggest that orexin A plays an important role in orchestrating the sleep-wake cycle.
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Holmes S. Nutrition: a necessary adjunct to hospital care? THE JOURNAL OF THE ROYAL SOCIETY FOR THE PROMOTION OF HEALTH 1999; 119:175-9. [PMID: 10518357 DOI: 10.1177/146642409911900308] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Good nutrition is undoubtedly central to optimum health and to the recovery from illness yet research and clinical surveys repeatedly demonstrate an unacceptably high incidence of malnutrition in hospital patients in whom it delays recovery, increases the incidence of complications and significantly increases the cost of treatment; the human cost is inestimable.
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164
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Holmes S, Fallowfield M, McHenry P. Bleeding nodule on the forehead. ARCHIVES OF DERMATOLOGY 1999; 135:1115, 1118. [PMID: 10490120 DOI: 10.1001/archderm.135.9.1113-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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165
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Jackson G, Betteridge J, Dean J, Hall R, Holdright D, Holmes S, Kirby M, Riley A, Sever P. A systematic approach to erectile dysfunction in the cardiovascular patient: a consensus statement. Int J Clin Pract 1999; 53:445-51. [PMID: 10622072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
Sexual activity is no more stressful to the heart when compared with a number of other natural daily activities, e.g. walking one mile on the level in 20 minutes. The cardiac risk of sexual activity in patients diagnosed with cardiovascular disease is minimal in properly assessed and advised patients. Erectile dysfunction (ED) is common, affecting 10% of men aged 40-70 years and increases in frequency with age. ED and cardiovascular disease share many of the same risk factors and often coexist. ED in the diagnosed cardiovascular patient should be identified by routine questioning in general practice. Modern therapies can restore a sexual relationship in the majority of patients with ED and can lead to a substantial improvement in quality of life. The majority of patients assessed to be at low or intermediate cardiac risk, as defined later in this paper (Table 4), can be effectively managed in primary care. Primary care treatment for ED in patients defined as high risk can be initiated following a specialist opinion and/or confirmation that the patient's cardiovascular condition is stabilised. There is no evidence that currently licensed treatments for ED add to the overall cardiovascular risk in patients with or without diagnosed cardiovascular disease.
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166
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Malek AM, Halbach VV, Holmes S, Phatouros CC, Meyers PM, Dowd CF, Higashida RT. Beating aneurysm sign: angiographic evidence of ruptured aneurysm tamponade by intracranial hemorrhage. Case illustration. J Neurosurg 1999; 91:517. [PMID: 10470834 DOI: 10.3171/jns.1999.91.3.0517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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167
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Hardee P, Holmes S, Carter J, Coghlan K, Bradley P, Ali N, Songra A, Cannell H, Hutchison I. Re: Planning the consultant workforce in oral & maxillofacial surgery. Br J Oral Maxillofac Surg 1999; 37:245-6. [PMID: 10454036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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168
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Gordon M, Holmes S, McGrath K, Neil A. Benchmarking pathology services: implementing a longitudinal study. Pathology 1999; 31:133-41. [PMID: 10399169 DOI: 10.1080/003130299105322] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
This paper details the benchmarking process and its application to the activities of pathology laboratories participating in a benchmark pilot study [the Royal College of Pathologists of Australasian (RCPA) Benchmarking Project]. The discussion highlights the primary issues confronted in collecting, processing, analysing and comparing benchmark data. The paper outlines the benefits of engaging in a benchmarking exercise and provides a framework which can be applied across a range of public health settings. This information is then applied to a review of the development of the RCPA Benchmarking Project. Consideration is also given to the nature of the preliminary results of the project and the implications of these results to the on-going conduct of the study.
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Holmes S. Government relations report: tobacco settlement. NASNEWSLETTER 1999; 14:4, 6. [PMID: 10568926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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170
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Holmes S. Nutritional status: a priority of care. PROFESSIONAL NURSE (LONDON, ENGLAND) 1999; 14:449. [PMID: 10347522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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171
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Holmes S. The weak link in the food chain. NURSING TIMES 1999; 95:55. [PMID: 10349018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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172
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Flanagan J, Holmes S. Facing the issue of dependence: some implications from the literature for the hospice and hospice nurses. J Adv Nurs 1999; 29:592-9. [PMID: 10210455 DOI: 10.1046/j.1365-2648.1999.00927.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Research and clinical practice suggest that dependence upon others causes distress to those with a life-threatening illness and that the hospice may serve to reinforce feelings of loss of autonomy. Hospice nurses can contribute to good care and act therapeutically to maximize an individual's potential for independent activity where this is possible and desirable. However, literature from other contexts demonstrates variability in the extent to which this is achieved. This paper outlines the problem of dependence in those with a life threatening illness. Therapeutic nursing is explored in relation to issues which may arise in a hospice context, potential relationships between therapeutic nursing and partnership are noted, particularly with regard to the possible meanings of dependence which for some individuals comes to be apprehensively associated with impending death.
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173
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Halleen JM, Karp M, Viloma S, Laaksonen P, Hellman J, Käkönen SM, Stepan JJ, Holmes S, Väänänen HK, Pettersson K. Two-site immunoassays for osteoclastic tartrate-resistant acid phosphatase based on characterization of six monoclonal antibodies. J Bone Miner Res 1999; 14:464-9. [PMID: 10027912 DOI: 10.1359/jbmr.1999.14.3.464] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Tartrate-resistant acid phosphatase (TRAP), an enzyme expressed in bone-resorbing osteoclasts, is secreted into the circulation during bone resorption. We used six monoclonal antibodies (MAbs) to optimize direct two-site fluoroimmunoassays for determining serum TRAP concentrations. Four of the MABs, 1F1, 2H1, 4E6, and 5C1, were raised against recombinant human TRAP, and the other two, O1A and J1B, against human bone TRAP. 2H1, J1B, and O1A appeared to be highly specific for TRAP. 1F1 and 4E6 were poor in recognizing bone TRAP and were not useful in the assay. 5C1, while having a good affinity for the bone enzyme, was not specific. Serum TRAP is relatively stable, because 7 days of storage of serum samples at 4 degreesC and -20 degreesC or five thawing-freezing cycles, did not change the TRAP concentration detected using the two-site assays. All studied assays detected an increase in serum TRAP concentrations of postmenopausal women compared with premenopausal women, the difference being highest with MAB pairs 2H1-5C1 and O1A-J1B. These results suggest that serum TRAP may be a useful bone resorption marker, and the MAB pairs 2H1-5C1 and O1A-J1B may be useful in determining the bone resorption rate.
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175
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Jones BR, Kirkman JH, Hogan J, Holmes S. Analysis of uroliths from cats and dogs in New Zealand, 1993-96. N Z Vet J 1998; 46:233-6. [PMID: 16032055 DOI: 10.1080/00480169.1998.36095] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIMS Canine and feline uroliths were analysed to determine the prevalence of particular types of urolith and the dog breeds at risk. METHODS Three hundred and sixty-nine uroliths recovered from 316 dogs and 53 cats between November 1993 and December 1996 were analysed by X-ray diffraction, and by infrared spectrometry where X-ray diffraction alone was non-diagnostic. RESULTS Bitches of small breeds especially Welsh corgi and Bichon frise, were most frequently affected. Struvite was the most common urolith (204 dogs). Oxalate (60 dogs) was the second most prevalent urolith identified, followed by cystine (24 dogs). The breeds producing cystine calculi were: Dalmatian, Bassett hound, Borzoi, Newfoundland, Shetland sheepdog, Labrador, Chihuahua, Fox terrier, English bulldog, Bichon frise, Doberman pinscher, Border collie. Silica uroliths were identified for the first time in New Zealand. All feline uroliths were struvite. CONCLUSION The results are useful in determining the prevalence of specific types of urolith in New Zealand and the breeds at risk of forming them.
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