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Biomedical subjects

A Hunt

Publications and source records attributed to A Hunt.

At least 37 records · Page 2Linked to original sources
PubMed1999

Cryptosporidiosis in the immunocompromised: weighing up the risk.

Cryptosporidiosis has been increasingly recognised as a cause of diarrhoeal illness in both immunocompetent and immunocompromised people. Massive outbreaks have been linked to municipal drinking water supplies in North America and Europe, but so far none have been reported in Australia. There is evidence that modes of transmission other than drinking water are more important. There can be no guarantee that infective Cryptosporidium oocysts will not contaminate an Australian water supply. Therefore, a permanent "boil water" warning may be warranted on medical advice in severely immunocompromised people, for whom cryptosporidiosis could be persistent and life threatening.

Cryptosporidiosis↗
PubMed1999

Aroclor 1242 inhalation and ingestion by Sprague-Dawley rats.

PCBs have been considered to be almost nonvolatile and insoluble in water. However, recent studies have shown the importance of their slight solubility in water and capability to enter the atmosphere and disperse throughout the global environment. This preliminary study was designed to measure uptake and observe any physiological changes in Sprague-Dawley rats. The PCB product Aroclor 1242 is the major pollutant of the Hudson River, NY, and New Bedford Harbor, MA. The rats were exposed for 30 d to 0.9 microg/m3 via inhalation and 0.436 microg/g (ppm) in the food. The inhalation of PCBs gave a greater PCB uptake than ingestion. Both routes of administration caused significant serum thyroid hormone elevations. Histopathologic changes were observed in the urinary bladder, thymus, and the thyroid after both exposure regiments. Rearing and ambulation were significantly decreased in both exposure regiments in an open field behavior test.

Administration, Inhalation↗
PubMed1999

Population pharmacokinetics of oral morphine and its glucuronides in children receiving morphine as immediate-release liquid or sustained-release tablets for cancer pain.

OBJECTIVES: (1) To determine the pharmacokinetics of morphine, morphine-6-glucuronide (M6G), and morphine-3-glucuronide (M3G) in children with cancer receiving morphine as immediate-release morphine liquid or sustained-release tablets. (2) To determine differences with age within the group and from adults. (3) To explore relationships between plasma concentration and pain measurements. STUDY DESIGN: Blood samples were collected and plasma analyzed by high-performance liquid chromatography with electrochemical and fluorescence detection. Population pharmacokinetic parameters were derived with the program P-PHARM. RESULTS: Forty children with a median age of 11.4 years (range 1.7 to 18.7 years) received a median dose of 1.4 mg/kg/d (range 0.4 to 24.6 mg/kg/d). A median of 4 blood samples per child was collected. Plasma clearance of morphine was 23.1 mL/min per kg body weight. The volume of distribution was 5.2 L/kg. Molar ratios of M3G/morphine, M6G/morphine, and M3G/M6G were 21.1, 4.7, and 4.2, respectively. Children <11 years had significantly higher clearance and larger volume of distribution for morphine and its glucuronides than older children and adults. Regression analysis indicated average plasma morphine concentration equal to dose (mg/kg/d) x 8.6 (95% confidence interval 7.4 to 9.9). Significant pain was present in 30% of the children. Higher pain scores were recorded in children with average morphine concentrations <12 ng/mL (P <.01 MW). CONCLUSION: Age differences in morphine pharmacokinetics exist within children and compared with adults. The study supports a starting dose of 1.5 to 2. 0 mg/kg/d to provide plasma morphine concentrations >12 ng/mL in children with cancer pain unrelieved by mild to moderate strength analgesia.

Adolescent↗
PubMed1999

Use of melatonin to treat sleep disorders in tuberous sclerosis.

The results of a therapeutic trial of the use of melatonin in patients with tuberous sclerosis complex who also have severe sleep problems are reported. We used a randomized double-blind placebo-controlled crossover design. Seven patients with confirmed diagnoses of tuberous sclerosis and significant sleep disorder were recruited. We employed three outcome measures: total sleep time, time to sleep onset, and number of awakenings. Patients treated with melatonin had a small but clinically significant improvement in total sleep time (mean improvement 0.55 hours, P<0.05). They also tended to have an improvement in sleep-onset time but this did not reach statistical significance. Melatonin, in this trial, had no discernible effect on sleep fragmentation. We conclude that melatonin does have a beneficial effect in prolonging the total sleep time of patients with tuberous sclerosis and sleep disorder and that further trials are necessary to investigate the issues of optimal dosage, tolerance, and possible interactions with other medications.

Adolescent↗
PubMed1999

Shyness and sociotropy: additive and interactive relations in predicting interpersonal concerns.

Sociotropy (an aspect of interpersonal dependence) and sociability (affiliative need) were examined as moderator variables of the relationship between shyness and interpersonal concerns in two studies. In Study 1, sociotropy, but not sociability, predicted unique variance in three indices of interpersonal concerns through both direct and interactive relations with shyness. An initial analysis in Study 2 showed that sociotropy, but not sociability, was predictive of participants' perceived competence in situations that involved initiation of conversations and assertion. In the second part of Study 2, sociotropy accounted for significant increments in variance when predicting cognitive and affective manifestations of distress related to simulated conversation and assertion situations, while sociability did not. Study 2 results suggest that sociotropy operates primarily in an additive manner with shyness in predicting interpersonal concerns, rather than moderating the relation between shyness and interpersonal concerns. Differences in the results of the two studies and implications for future research are discussed.

Adolescent↗
PubMed1999

Medial longitudinal arch of the foot: stationary versus walking measures.

We describe the characteristics of the medial longitudinal arch (MLA) of the right foot in 19 healthy men while sitting/partial bodyweight, standing/full bodyweight, and during the stance phase of walking. Three measurements were selected as representative of the MLA, including: height of the arch, length of the arch, and supranavicular angle. Mean values were calculated in three dimensions for each measure in the sitting and standing conditions and for the minimum value of each measure in the walking condition. Patterns measured during walking had high association (r = 0.999) and could be related to phases of stance. In the stationary conditions, the MLA varied significantly (P<0.001). No significant relationship of arch height, arch length, or supranavicular angle was found between sitting and standing or between stationary and walking conditions. It was concluded that none of the static variables could be used to predict others and that static measures of the MLA do not predict the dynamic motion of the MLA. The MLA may not be a reasonable indicator of behavior or motion of the foot.

Adult↗
PubMed1999

Antimicrobial activity of selected cyclic dipeptides.

Cyclic dipeptides are products of rational drug design, which may exhibit both antimicrobial and antitumor properties. The aim of this study was to investigate both the antimicrobial effects of the cyclic dipeptides cyclo(L-phenylalanyl-L-prolyl), cyclo(L-tyrosyl-L-prolyl), cyclo(L-tryptophanyl-L-prolyl) and cyclo(L-tryptophanyl-L-tryptophanyl) and the effects of these cyclic dipeptides on the gastrointestinal epithelium in vitro. Furthermore, a relevant solvent for the possible pharmaceutical application of the products was sought concurrently. The antimicrobial effect of the cyclic dipeptides was assayed using the Kirby-Bauer disc diffusion assay against Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus, Bacillus subtilis, Streptococcus pneumoniae, Candida albicans, Aspergillus niger and Penicillium notatum. The effect of the cyclic dipeptides on the gastrointestinal epithelium was assessed by changes in alkaline phosphatase expression of HT-29 cells. Cyclo(Pro-Trp) and cyclo(Phe-Pro) show broad spectrum antibacterial properties and cyclo(Trp-Pro) and cyclo(Trp-Trp) show broad spectrum antifungal properties. The maturation of the gastrointestinal cells was enhanced by cyclo(Phe-Pro), cyclo(Tyr-Pro), cyclo(Trp-Trp) and cyclo(Trp-Pro). The activity of these cyclic dipeptides thus indicates potential application of these compounds as pharmacological agents.

Alkaline Phosphatase↗
PubMed1999

Preparing for the workplace: fostering generic attributes in allied health education programs.

Allied health curricula need to extend beyond the learning of discipline-specific skills to encompass broader learning goals. In particular, the acquisition of generic skills is necessary to enable graduates to function more competently and confidently within their rapidly changing work, professional, and societal environments. In health sciences education particularly, the rate of change in practice and education is rapid and unprecedented. If educators focus on components of the curriculum rather than the entire learning experience, they are likely to significantly limit the students' acquisition of such generic skills. To achieve the desired generic skills outcomes, an overarching, integrated, and consistently applied curriculum strategy is advocated. This article considers a number of such strategies relevant to allied health education.

Allied Health Personnel↗
PubMed1998

IL-10-mediated suppression of TNF-alpha production is independent of its ability to inhibit NF kappa B activity.

IL-10 has a well-characterized anti-inflammatory role that includes the suppression of inflammatory cytokine (e.g. TNF-alpha) production by monocytic/macrophage cells. Both transcriptional and post-transcriptional/translational mechanisms have been proposed to explain this process. In this study we observed that IL-10 inhibited nuclear NF kappa B DNA binding activity without affecting I kappa B degradation or translocation of NF kappa B subunits to the nucleus. While the suppression of NF kappa B in 70Z/3 pre-B cells correlated with suppression of NF kappa B transcriptional activity and expression of surface IgM, it did not correlate with the production of TNF-alpha mRNA or protein in RAW 264.7 macrophages. Similar observations in the macrophages were made with a second anti-inflammatory cytokine, IL-4. Therefore we conclude that although IL-10 or IL-4 can suppress NF kappa B activity, this appears to have little effect on the expression of the TNF-alpha gene and is unlikely to be the basis of the anti-inflammatory effects of these cytokines.

Animals↗
PubMed1998

Nitrate therapy is an alternative to furosemide/morphine therapy in the management of acute cardiogenic pulmonary edema.

BACKGROUND: Nitrates are superior to furosemide in the management of acute pulmonary edema associated with myocardial infarction; however, their role in the absence of infarction is unclear. METHODS AND RESULTS: A randomized comparison was undertaken of the relative effectiveness of primary therapy with either intravenous morphine/furosemide (men/women; n = 32) or nitroglycerin/N-acetylcysteine (NTG/NAC; n = 37) in consecutive patients with acute pulmonary edema. The primary end point was change in PaO2/FIO2 over the first 60 minutes of therapy. Secondary end points were needed for mechanical respiratory assistance (ie, continuous positive airway pressure via mask or intubation and ventilation) and changes in other gas exchange parameters. Both treatment groups showed improvement in oxygenation after 60 minutes of therapy; however, this reached statistical significance only with NTG/NAC therapy. There was no significant difference between groups in the assessed parameters (95% CI for differences in Pao2/FIO2: furosemide/morphine -12 to 23 and NTG/NAC 4 to 44), a finding also confirmed in 32 patients presenting with respiratory failure. Only 11% of the study group required mechanical ventilatory assistance (continuous positive airway pressure in 4 patients and intubation and ventilation in 3 patients). CONCLUSIONS: NTG/NAC therapy is as effective as furosemide/morphine in the initial management of acute pulmonary edema, regardless of the presence or absence of respiratory failure. The necessity for mechanical ventilatory assistance is infrequent in these patients, regardless of the initial medical treatment regimen.

Acetylcysteine↗
PubMed1997

Poisoning of dairy heifers by mercurous chloride.

Mercury poisoning was diagnosed in four dairy heifers, three of which died. The clinical signs were variable and included salivation, excessive thirst, extreme depression and severe diarrhoea. Postmortem examinations revealed inflammation and ulceration of the alimentary tract, pulmonary and cardiac haemorrhages, pallor of the kidney cortices and perirenal oedema. The kidney mercury concentrations were in the range 58 to 91 micrograms/g wet tissue. It is believed that the animals were poisoned by the ingestion of soil contaminated with mercurous chloride.

Animals↗
PubMed1996

Three-dimensional kinematics of the rearfoot during the stance phase of walking in normal young adult males.

Three-dimensional video analysis was used to quantify three-dimensional motion of the rearfoot in 14 normal young adult males during the stance phase of walking. A stringent calibration procedure enabled standardization of the neutral position of the rearfoot. Surface markers were placed on the calcaneus and lower tibia, and a joint coordinate system was used to determine the relative displacement between the calcaneus and lower leg as representative of rearfoot motion. Confirmation was made of the assumption of a mechanical coupling between the rearfoot displacements of abduction/adduction and eversion/inversion. However, there were several findings which contrasted with commonly held assumptions. For example, the rearfoot was found to evert gradually, rather than rapidly, from heel contact to just prior to heel rise. Also the conventional descriptions of the composite movements of pronation and supination were not applicable to rearfoot movement in this study, and it was therefore concluded that pronation and supination are not valid descriptors of three-dimensional rearfoot motion during the stance phase of walking.

Journal Article↗
PubMed1996

A prospective audit of wound infection rates after caesarean section in five West Yorkshire hospitals.

A three month prospective audit of wound infection following emergency and elective caesarean section was carried out in five West Yorkshire hospitals. Among 4076 women undergoing delivery in the five obstetric departments, the caesarean rate was 15.4%. The overall infection rate was 45/628 (7.2%) with a range of 2.5-17.2% between the five centres. The infection rate was 14/226 (6.2%) when antibiotics were used compared with 31/402 (7.7%) without antibiotics. The use of prophylactic antibiotics made no significant difference to the infection rate, which did not correlate with duration of labour or of ruptured membranes. The number of vaginal examinations correlated with the infection rate. In conclusion, the caesarean section rate observed was higher than that estimated for the UK as a whole, but was distorted by one centre with a high rate. For the other four hospitals the caesarean rate was unexceptional. The ratio of emergency to elective operations was comparable with recently reported values in the UK and the wound infection rate was within the widely varying limits found in previous studies. In view of the relatively low infection rate recorded without antibiotics, in the interests of cost effectiveness, prophylaxis may be limited in future to selected women at high risk. Because this was an audit rather than a randomized study we cannot exclude that this is already happening on an empirical basis.

Antibiotic Prophylaxis↗
PubMed1996

An electromyographic marker for neuroleptic-induced akathisia: preliminary measures of sensitivity and specificity.

Previous polysomnographic (PSG) investigations have reported a rhythmic electromyographic (EMG) pattern (0.5-3.0 cps) of leg movement activity in a subset of patients with neuroleptic-induced akathisia (NIA). It has been suggested that this EMG pattern may represent a pathophysiological correlate of NIA and thus have clinical utility as an objective marker for this condition. We present preliminary measures of sensitivity and specificity for this EMG pattern as a diagnostic marker for NIA for 26 neuroleptic-treated patients. The EMG marker yielded a diagnostic sensitivity of 68.9% and a specificity of 70.0%, falling just short of statistical significance (Fisher's exact test p = 0.06). Quantitative analysis of the EMG pattern revealed a significant positive correlation between the percentage of time the NIA marker occurred during wakefulness and corresponding chlorpromazine equivalent levels. Clinical demographic findings for true-positive, false-positive, true-negative, and false-negative groups are discussed. Overall findings suggest that this particular pattern of EMG marker activity observed in neuroleptic-treated patients during PSG and EMG studies is valuable in facilitating the diagnosis and monitoring treatment.

Adolescent↗