Publications by authors named "David R Woods"

39 Publications

Managing endocrine dysfunction following blast injury to the male external genitalia.

J R Army Med Corps 2013 Mar;159 Suppl 1:i45-8

Department of Endocrinology and Diabetes, Northumbria and Newcastle NHS Trusts, University of Newcastle, Newcastle upon Tyne, UK.

Blast injury to the external genitalia is associated with considerable morbidity, including the risk of primary hypogonadism due to insufficient testosterone. It is of the utmost importance that, prior to any testosterone replacement being commenced, serious consideration is given to sperm retrieval. The clinical and biochemical picture of hypogonadism allows a relatively straightforward diagnosis in most cases although it is important to be alert to the possibility of hypogonadism in the context of partial testicular tissue preservation. It is also prudent to consider the possibility of secondary hypogonadism especially in patients with chronic pain or those on opiate medication. Therapeutic options for testosterone replacement are diverse but relatively simple. This article aims to give guidance to the non-specialist in the consideration, diagnosis, and treatment of hypogonadism, with particular reference to blast injury of the external genitalia.
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http://dx.doi.org/10.1136/jramc-2013-000022DOI Listing
March 2013

The effects of prolonged acute hypobaric hypoxia on novel measures of biventricular performance.

Echocardiography 2013 May 11;30(5):534-41. Epub 2013 Jan 11.

Department of Cardiology, Poole Hospital NHS Foundation Trust, Dorset, United Kingdom.

Background: There are limited data on the effects of prolonged acute hypoxia on individual and global measures of biventricular function.

Aims: The aim of this study was to assess its effects on conventional and novel measures of biventricular function, including the recently defined E'/(A'×S') (EAS) index, obtained using pulsed-wave tissue Doppler Imaging (PWTDI) and associated blood brain natriuretic peptide (BNP) levels.

Methods: In this study, 14 healthy subjects aged 30.5 years were assessed at baseline and at >150 minutes following hypobaric hypoxia (HH) to the equivalent altitude of 4800 m for a total of 180 minutes. The combined EAS index (E'/(A' × S')) was calculated at the mitral and tricuspid annulus using data from the peak systolic (S') early (E') and late (A') diastolic filling.

Results: It was seen that HH increased resting heart rate (63.4 ± 8.4 vs. 85.2 ± 10.2/min; P < 0.0001), cardiac output (4.6 ± 0.7 L/min vs. 6.1 ± 1.2 L/min; P < 0.0001), peak pulmonary artery systolic pressure (PASP) (26.3 ± 2.0 mmHg vs. 37.2 ± 6.3 mmHg; P < 0.0001), and reduced SpO2 (98.5 ± 1.1 vs. 72.9 ± 8.1%; P < 0.0001). There was a significant reduction in mitral (0.19 ± 0.06 vs. 0.11 ± 0.03; P < 0.0001) and tricuspid (0.12 ± 0.04 vs. 0.09 ± 0.03; P = 0.03) EAS indices, but no change in left or right ventricular myocardial performance (Tei) indices, global left ventricular (LV) longitudinal systolic strain, BNP levels, or estimated filling pressures (E/E'). Only reducing SpO2 remained as an independent predictor of PASP on multivariate analysis (overall R(2) = 0.77; P < 0.0001). The right and LV EAS indices were significantly correlated (r = 0.45; 95% CI: 0.07-0.7; P = 0.02).

Conclusion: The conclusion from this study was that acute prolonged HH does not adversely affect resting global biventricular function and there is evidence of linked right and LV responses.
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http://dx.doi.org/10.1111/echo.12088DOI Listing
May 2013

Management of amiodarone-related thyroid problems.

Ther Adv Endocrinol Metab 2011 Jun;2(3):115-26

Department of Endocrinology, Poole Hospital NHS Foundation Trust, Poole, UK.

Amiodarone is a highly effective and well-established antiarrrhythmic drug. It can be used to treat supraventricular and ventricular tachyarrhythmias and has the added advantage of being well tolerated in patients with impaired left ventricular systolic function with a low incidence of arrhythmic events, such as torsades de pointes. However, owing to its marked lipid affinity, it is highly concentrated in tissues and is linked to a number of adverse effects, including thyroid dysfunction. Amiodarone can lead to both hypothyroidism (amiodarone-induced hypothyroidism) and less commonly hyperthyroidism (amiodarone-induced thyrotoxicosis) and relates to high iodine content within the molecule as well as to several unique intrinsic properties of amiodarone. Dronedarone is a recently approved antiarrhythmic drug. It is structurally very similar to amiodarone, however the iodine moiety, present with amiodarone has been removed and replaced with a methylsulfonamide group to reduce fat solubility and adverse effects. We present an overview of the effects of amiodarone on thyroid function and the treatment options available, as well as a brief insight into dronedarone and its potential as an alternative to amiodarone.
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http://dx.doi.org/10.1177/2042018811398516DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3474631PMC
June 2011

An outbreak of human external ophthalmomyiasis due to Oestrus ovis in southern Afghanistan.

Clin Infect Dis 2008 Jun;46(11):e124-6

United Kingdom Joint Force Medical Group, Camp Bastion, Afghanistan.

Oestrus ovis is the most common cause of human ophthalmomyiasis, and infection is often misdiagnosed as acute conjunctivitis. Although it typically occurs in shepherds and farmers, O. ovis ophthalmomyiasis has also been reported in urban areas. We report the first case study of O. ovis infection from Afghanistan.
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http://dx.doi.org/10.1086/588046DOI Listing
June 2008

Lack of change in serum angiotensin-converting enzyme activity during the menstrual cycle.

J Renin Angiotensin Aldosterone Syst 2006 Dec;7(4):231-5

Rayne Institute, UCL Centre for Cardiovascular Genetics, 5 University Street, London, UK.

Introduction: The Deletion (D) rather than Insertion (I) variant of the angiotensin-converting enzyme (ACE) gene is associated with higher circulating ACE activity. Meanwhile, coronary risk rises with the menstrual nadir in oestrogen levels, exogenous oestrogen reduces serum ACE activity (with a greater reduction the higher the baseline ACE activity), and pharmacological reduction in ACE activity is cardioprotective. Alterations in coronary risk associated with the menstrual cycle may thus be mediated through (genotype-dependent) changes in ACE activity. We have examined this hypothesis.

Materials And Methods: Twenty-three healthy female subjects (12 II, 11 DD genotype) were studied. None were taking oral contraceptive agents. Blood was assayed for oestrogen, follicle stimulating hormone (FSH), luteinising hormone (LH), progesterone and ACE activity every three days throughout their menstrual cycle.

Results: ACE activity was unrelated to oestrogen, FSH or LH during the menstrual cycle, irrespective of ACE genotype.

Conclusions: The increase in myocardial ischaemia during low oestrogen phases of the menstrual cycle does not appear mediated through a fall in serum ACE activity.
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http://dx.doi.org/10.3317/jraas.2006.043DOI Listing
December 2006

Skeletal muscle RAS and exercise performance.

Int J Biochem Cell Biol 2003 Jun;35(6):855-66

Department of Cardiovascular Genetics, 3rd Floor, Rayne Institute, University College London, 5 University Street, London WC1E 6JJ, UK.

A local renin-angiotensin system (RAS) may be suggested by evidence of gene expression of RAS components within the tissue as well as physiological responsiveness of this gene expression. This review will focus on the evidence supporting the existence of the constituent elements of a physiologically functional paracrine muscle RAS. The effect of local skeletal muscle RAS on human exercise performance will be explored via its relation with pharmacological intervention and genetic studies. The most likely configuration of the muscle RAS is a combination of in situ synthesis and uptake from the circulation of RAS components. A reduction in angiotensin-converting enzyme (ACE) activity reverses the decline in physical performance due to peripheral muscle factors in those with congestive heart failure and may halt or slow decline in muscle strength in elderly women. Genetic studies suggest that increased ACE and angiotensin II (Ang II) mediate greater strength gains perhaps via muscle hypertrophy whereas lower ACE levels and reduced bradykinin (BK) degradation mediate enhanced endurance performance perhaps via changes in substrate availability, muscle fibre type and efficiency.
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http://dx.doi.org/10.1016/s1357-2725(02)00342-4DOI Listing
June 2003

Human performance: a role for the ACE genotype?

Exerc Sport Sci Rev 2002 Oct;30(4):184-90

Department of Cardiovascular Genetics, Rayne Institute, University College London, UK.

The I allele of the angiotensin I-converting enzyme (ACE) gene is associated with lower ACE activity and endurance performance; an excess occurs in elite distance runners, rowers, and mountaineers, perhaps secondary to enhanced muscle efficiency. Conversely, the D allele is associated with training-related strength gain and elite power-oriented performance secondary to increased ACE and angiotensin II, a growth factor.
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http://dx.doi.org/10.1097/00003677-200210000-00008DOI Listing
October 2002

Insertion/deletion polymorphism of the angiotensin I-converting enzyme gene and arterial oxygen saturation at high altitude.

Am J Respir Crit Care Med 2002 Aug;166(3):362-6

UCL Centre for Cardiovascular Genetics, Rayne Institute, St. Bartholomew's and the Royal London MDS, London, UK.

There is a significant genetic influence on arterial oxygen saturation (Sa(O(2))) in high-altitude (HA) residents. It is not known whether this is true of lowlanders ascending to HA. The I allele of the angiotensin-converting enzyme (ACE) gene is associated with low ACE activity and elite endurance performance. An excess of the I allele has also been reported in South American natives living over 3,000 m and among elite HA mountaineers who demonstrate extreme endurance in a hypoxic environment, where maintenance of Sa(O(2)) is crucial to performance. We postulated that the I allele may confer an advantage at HA through genotype-dependent alterations in Sa(O(2)). Rapid ascent (n = 32) and slow ascent groups (n = 40), ascending to approximately 5,000 m over 12.0 and 18.5 days, respectively, had their Sa(O(2)) assessed throughout and compared with their ACE genotype. Resting Sa(O(2)) was independent of the ACE genotype and remained so for the slow ascent group, in whom the fall in Sa(O(2)) with ascent was genotype independent. However, Sa(O(2)) with ascent was significantly associated with the ACE genotype in the rapid ascent group (p = 0.01) with a relatively sustained Sa(O(2)) in the II subjects. These data are the first to report an association of the I allele with the maintenance of Sa(O(2)) at HA.
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http://dx.doi.org/10.1164/rccm.2103060DOI Listing
August 2002

Cloning and Expression of a Clostridium acetobutylicum Alcohol Dehydrogenase Gene in Escherichia coli.

Appl Environ Microbiol 1988 Mar;54(3):676-682

Department of Microbiology, University of Cape Town, Rondebosch 7700, South Africa.

An alcohol dehydrogenase (ADH) gene from Clostridium acetobutylicum was cloned on a recombinant plasmid, pCADH100. Escherichia coli HB101, and an allyl alcohol-resistant mutant, HB101-adh1, containing this plasmid were unable to grow aerobically or anaerobically on agar media containing sublethal concentrations of allyl alcohol. E. coli HB101 and HB101-adh1 transformed with the plasmid pCADH100 produced increased levels of ethanol when grown anaerobically under alkaline conditions in the absence of nitrate. Cell extracts from aerobically and anaerobically grown E. coli HB101(pCADH100) and HB101-adhl(pCADH100) cells exhibited increased levels of NADP-dependent ADH activity with either ethanol or butanol as the substrate. The inability of E. coli HB101(pCADH100) to grow in the presence of allyl alcohol correlated with the appearance of an NADP-dependent ADH activity band on nondenaturing polyacrylamide gel electrophoresis with either ethanol or butanol as the substrate. The position of the cloned NADP-dependent ADH activity bands in E. coli HB101(pCADH100) cell extracts with either ethanol or butanol as the substrate coincided with the position of a single NADP-dependent ADH activity band in extracts of C. acetobutylicum cells. E. coli HB101(pCADH100) cell extracts prepared from both aerobically and anaerobically grown cells exhibited an additional protein band with an apparent M(r) of approximately 33,000 on sodium dodecyl sulfate-polyacryl-amide gel electrophoresis which was absent in cell extracts of E. coli HB101. A protein band with a similar apparent M(r) was observed in cell extracts of C. acetobutylicum, and in vitro transcription and translation experiments with pCADH100 produced a major protein product with a similar apparent M(r).
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC202524PMC
http://dx.doi.org/10.1128/aem.54.3.676-682.1988DOI Listing
March 1988