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Biomedical subjects

A Cole

Publications and source records attributed to A Cole.

At least 19 recordsLinked to original sources
PubMed2005

Modified electrode placement must be recorded when performing 12-lead electrocardiograms.

BACKGROUND: Local observation has suggested that placing limb leads on the torso when recording the standard 12-lead resting electrocardiogram (ECG) has become commonplace. This non-standard modification has the important advantages of ease and speed of application, and in an emergency may be applied with minimal undressing. Limb movement artefact is also reduced. It is believed that ECGs obtained with torso electrodes are interchangeable with standard ECGs and any minor electrocardiographic variations do not affect diagnostic interpretation. STUDY DESIGN: The study compared 12-lead ECGs in 100 patients during routine electrocardiography, one being taken in the approved way and one taken with modified limb electrodes. RESULTS: It was found that the use of torso leads produced important amplitude and waveform changes associated with a more vertical and rightward shift of the QRS frontal axis, particularly in those with abnormal standard ECGs. Such changes generated important ECG abnormalities in 36% of patients with normal standard ECGs, suggesting "heart disease of electrocardiographic origin". In those with abnormal standard ECGs, moving the limb leads to the torso made eight possible myocardial infarcts appear and five inferior infarcts disappeared. Twelve others developed clinically important T wave or QRS frontal axis changes. CONCLUSIONS: It is vital that ECGs should be acquired in the standard way unless there are particular reasons for not doing so, and that any modification of electrode placement must be reported on the ECG itself. Marking the ECG "torso-positioned limb leads" or "non-standard" should alert the clinician to its limitations for clinical or investigative purposes, as any lead adaptation may modify the tracing and could result in misinterpretation.

Adult↗
PubMed2004

Cortical thickness in a case of congenital unilateral perisylvian syndrome.

In congenital perisylvian syndrome, there is polymicrogyric cortex distributed in variable extensions around the sylvian fissure. Unilateral cases usually present with congenital hemiparesis, while bilateral cases have pseudobulbar paralysis of the oropharingoglossal region. Both unilateral and bilateral cases have a high rate of epilepsy. Polymicrogyric cortex is characterized by too many small convolutions. Often there are no intervening sulci, and almost no white matter can be seen under them. On MRI they appear to have increased thickness. Bilateral and symmetric polimycrogiria can be hard to recognize on standard MRIs. Accurate and automated methods for measuring the thickness of cerebral cortex are available. They have mainly been used to study a variety of disorders with diminished cortical thickness. We studied a case of right perisylvian polymicrogyria, who presented in adult life with epilepsy and had a normal neurological exam. Fischl and Dale's automated cortical thickness analysis rendered a very clear picture of increased cortical thickness with values up to 9 mm in the affected areas (normal cortical thickness varies between 1 and 4.5 mm). The thickest areas were seen over grossly abnormal gyri on the reconstructed cerebral cortex. On MEG he presented a prominent and monotonous 9 Hz activity that was located within the limits of a thick gyrus. There was a significant difference of thickness between homologous hemispheric areas. To our surprise some areas of the left hemisphere also appeared to have increased thickness, raising the question of a bilateral asymmetric case.

Cerebral Cortex↗
PubMed2004

Prevalence of diabetic eye disease in Tayside, Scotland (P-DETS) study: methodology.

AIMS: To describe the use of a validated diabetes register for sampling frame generation and assessment of the representative nature of participants in a fieldwork study of diabetic eye disease. METHODS: We performed an observational, cross-sectional fieldwork study of diabetic retinal disease using reference standard eye examination. We sampled the entire diabetic population using the Diabetes Audit and Research in Tayside Study (DARTS) diabetes register. RESULTS: The study population comprised 4825 diabetic patients aged over 16 years registered with one of 166 general practitioners (GPs) in 41 practices in Tayside in October 1999. This represented 61.1% of the Tayside diabetic population (7903). A total of 586 (66%; 95% confidence interval 63, 70) patients were examined from a sampling frame of 882 living patients registered with a Tayside GP. Demographic and disease parameters recorded on the DARTS patient register allowed comparison between participants and non-participants. CONCLUSIONS: This study shows the clear benefit of using a complete diabetic population as a sampling frame. This allows potential selection bias and external validity to be evaluated using routine data sources. Studies performed and reported in this way will aid the critical appraisal process.

Adult↗
PubMed2003

Inducibility of HBD-2 in acute burns and chronic conditions of the lung.

The respiratory tract produces a number of molecules that act in the first line of host defense to protect against pathogenic colonization and tissue invasion. Most of the innate antimicrobial activity can be attributed to airway fluid proteins, such as lysozyme, lactoferrin, and secretory leukoproteinase inhibitor, and peptides, such as defensins. Human beta-defensins are cationic antimicrobial peptides with broad and potent microbicidal activity that have been shown to play a role in protecting the healthy lung from infection. To determine the effect of thermal injury on the production of the inducible beta-defensin, human beta-defensin-2 (HBD-2), we measured the concentration of HBD-2 by Western blot analysis in bronchoalveolar lavage samples from the lungs of burned patients with and without inhalation injury. Our data demonstrates an increased amount of HBD-2 in the pulmonary airways with thermal injury compared to normal lung. A further substantial increase in levels was noted in chronic lung conditions.

Acute Disease↗
PubMed2002

Molecular basis of osteoarthritis: biomechanical aspects.

The unique biomechanical properties of healthy cartilage ensure that articular cartilage is able to transmit force between the joints while maintaining almost friction-free limb movement. In osteoarthritis, the biomechanical properties are compromised, but we still do not understood whether this precedes the onset of the disease or is a result of it. This review focuses on the physical changes to cartilage with age, disease, and mechanical loading, with specific reference to the increased collagen cross-linking that occurs with age (nonenzymatic glycation), and the response of chondrocytes to physiological and pathological loads. In addition, the biomechanical properties and matrix biosynthesis of cartilage from various joint surfaces of the knee and ankle are compared to elucidate reasons why the ankle is less affected by progressive osteoarthritis than the knee.

Aging↗
PubMed2001

Survey of stakeholders' opinions of community psychiatric nursing services.

The paper describes a telephone survey of the views of representatives of users, purchasers and providers of community psychiatric nursing services on services in Scotland. The telephone interview protocol was based on seven themes derived from interviewing 63 users, purchasers and providers throughout the UK. Descriptive statistics were used to present the responses in the survey to the forced choice questions. Responses to the open ended questions were coded, categorized and computed. The paper describes the responses by the major stakeholders to each of the themes. Overall, the quality of the existing services was placed in the 'good' category. However, criticism was directed at the insufficient numbers of Community Psychiatric Nurses in the service, the inadequate amount of time spent with clients and their poorly organized method of working. Other findings and stakeholders' recommendations are discussed.

Attitude of Health Personnel↗
PubMed2001

Metaperception in cyberspace.

Knowing how others perceive us is an important aspect of social life. "Impression meta-accuracy" is the extent to which we are correct in our assumptions about the impressions others have formed of us. The goal of this study was to compare meta-accuracy of WWW homepage creators to meta-accuracy of people in face-to-face interactions. Because creators of WWW pages have a high degree of control over the information they make available online, they may believe that they accurately know the nature of the impressions they give to other people. However, perceivers of homepages must form impressions without many of the social and context cues that influence judgments in a face-to-face setting, including body language and speaking qualities, and thus their impressions may not match those assumed by the creators of the pages. Our results showed a general tendency for homepage creators to believe the impression they gave to those who viewed their pages was more positive than was actually the case, and this discrepancy was greater than in face-to-face interactions. The source of online inaccuracy seems to lie in people's belief that others develop the same impression of them in both online and offline contexts. In fact, perceivers are significantly influenced by whether the information they are receiving is based on face-to-face interaction or on cues obtained from a WWW homepage. Our data demonstrate that one of the challenges of social life in cyberspace is managing one's online persona to take into account the limitations of metaperception.

Female↗
PubMed2001

Crossing over is rarely associated with mitotic intragenic recombination in Schizosaccharomyces pombe.

Chromosomal rearrangements can result from crossing over during ectopic homologous recombination between dispersed repetitive DNA. We have previously shown that meiotic ectopic recombination between artificially dispersed ade6 heteroalleles in the fission yeast Schizosaccharomyces pombe frequently results in chromosomal rearrangements. The same recombination substrates have been studied in mitotic recombination. Ectopic recombination rates in haploids were approximately 1-4 x 10(-6) recombinants per cell generation, similar to allelic recombination rates in diploids. In contrast, ectopic recombination rates in heterozygous diploids were 2.5-70 times lower than allelic recombination or ectopic recombination in haploids. These results suggest that diploid-specific factors inhibit ectopic recombination. Very few crossovers occurred in ade6 mitotic recombination, either allelic or ectopic. Allelic intragenic recombination was associated with 2% crossing over, and ectopic recombination between multiple different pairing partners showed 1-7% crossing over. These results contrast sharply with the 35-65% crossovers associated with meiotic ade6 recombination and suggest either differential control of resolution of recombination intermediates or alternative pathways of recombination in mitosis and meiosis.

Alleles↗
PubMed2001

Three-dimensional quantitative echocardiographic assessment of ventricular volume in healthy human fetuses and in fetuses with congenital heart disease.

The purpose of this study was to evaluate the feasibility of three-dimensional freehand echocardiographic assessment of ventricular volumetry in healthy fetuses and in fetuses with congenital heart disease. The study was approved by the hospital institutional review board. After echocardiographic examination by conventional ultrasonographic equipment interfaced with a magnetic tracking system, three-dimensional cardiac data were collected prospectively in 57 fetuses. Ventricular volumes were determined from three-dimensional data sets, and 22 fetuses with congenital heart disease were compared with 29 healthy fetuses. A multiple regression analysis of covariance was performed to assess between-group differences. Gated three-dimensional volume data sets enabled assessment of ventricular volumes in 51 of the 57 fetuses. Both fetuses with and without congenital heart disease had exponential increases in cardiac volumes during gestation. In fetuses with congenital heart disease and a marked inequality of ventricular size but no heart failure, the combined end-diastolic and stroke volumes of both ventricles were found to be significantly reduced compared with controls with no disease and fetuses with other types of congenital heart disease. Three-dimensional imaging can provide estimates of ventricular volume changes in fetal hearts with abnormal ventricular morphology that cannot easily be performed by two-dimensional echocardiography, and it may provide insight into evolving congenital heart disease.

Echocardiography, Three-Dimensional↗