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B McDermott

Publications and source records attributed to B McDermott.

At least 19 recordsLinked to original sources
PubMed2005

Phenol red thread test vs Schirmer's test: a comparative study.

AIM: To measure the agreement between Schirmer's and phenol red thread tests in detecting dry eyes. PATIENTS AND METHODS: A total of 103 patients attending preoperative cataract assessment clinic who agreed to be involved in the study were recruited. Each patient had one eye examined by both tests in a random order by two different investigators who were unaware of the results of the other test. Dry eye symptoms were assessed using an interviewer-administered questionnaire. The data were collected after the study period and analysed using kappa statistics to assess the agreement between the two tests. RESULTS: Schirmer's test was positive in 25 patients when a cutoff point of 5 mm was used and positive in 41 patients with a cutoff point of 10 mm. Phenol red thread test was positive in four patients when a cutoff point of 10 mm was used and in 32 patients with a cutoff point of 20 mm. Kappa ranged from 0.067 to 0.3 indicating very weak agreement between the two tests. In all, 27% of the patients had symptoms of dry eyes; however, the agreement between each test and the symptoms was very poor. CONCLUSION: There is very weak agreement between Schirmer's test and phenol red thread tests and between each test and symptoms of dry eyes.

Adult↗
PubMed2003

Analysis of correlated discrete observations: background, examples and solutions.

The goal of this paper is to highlight the use and interpretation of statistical techniques that account for correlation in epidemiological data. A conceptual statistical background is provided, and the main types of regression models for correlated data are highlighted. These models include marginal models, random effect models and transitional regression models. For each model type an example with data from the veterinary literature is provided. The examples are specifically used to highlight estimation procedures for parameters, and the interpretation of the estimated parameters. This paper emphasizes that statistical techniques and software to fit them are more widely available now, but that parameters have different interpretations in different model types. Consequently, we stress the importance of focusing on choosing the most appropriate model for the specific purpose of the analysis.

Animal Diseases↗
PubMed2001

The impact of Theileria parva infections and other factors on calf mean daily weight gains in smallholder dairy farms in Murang'a District, Kenya.

The association between mean daily weight gain, Theileria parva infections, clinical East Coast fever and other possible determinants of weight gain were examined in a longitudinal observational study that was conducted in cohorts of female calves from five agro-ecological zone (AEZ)-grazing strata. The strata were upper-midlands (UM) 1 zero-grazing, UM 1 open-grazing, UM 2 zero-grazing, UM 4 zero-grazing and UM 4 open-grazing. In total, 225 calves on 188 smallholder dairy farms were visited within the first 2 weeks of life and thereafter at biweekly intervals up to the age of 6 months between March 1995 and August 1996. During each visit, the calves were weighed and other calf-management practices in the farm during the visit such as housing, feeding and tick control also were recorded. Other events such as morbidity and mortality between or during the visits were also recorded. The overall mean daily weight gains were 0.24-0.29 kg (S.D.=0.17-0.22 kg) and were lower than the recommended targets for smallholder farms of 0.40-0.50 kg. The major tendency in variability of daily weight gains was due to visit-to-visit variation (especially in calves >3 months old). Differences in mean daily gains were associated with AEZ-grazing strata and calf-level factors that included breed of calf, calf sickness, incidence of ECF, feeding of milk, concentrate feeds and minerals and interaction between calf age and AEZ-grazing strata (P<0.05). ECF and other calf sicknesses exerted a temporal effect on calf-growth at the height of illness and immediately after; calves later recovered the lost growth except where other factors such as poor calf nutrition prevailed. Improvement in calf-growth in Murang'a District is achievable and extension services should continue to target individual-calf-level management practices.

Animal Feed↗
PubMed2000

Positive effect of bumetanide on contractile activity of ventricular cardiomyocytes.

Although the beneficial effects of loop-diuretics in relieving congestive heart failure and essential hypertension are well established, there has been limited investigation into the direct cardiac effect of these drugs. The aim of the present study was to investigate mechanical and electrophysiological effects of three loop-diuretics, namely, frusemide, bumetanide and torasemide, in ventricular cardiomyocytes isolated from rabbit myocardium. Contractile performance was assessed using a video edge detection method and effects on L-type Ca(2+) currents were determined using a 'perforated' patch-clamp technique. Unlike frusemide and torasemide, bumetanide produced concentration-dependent (3x10(-8) to 10(-5) M) increases in cell shortening and velocity of cell shortening. Neither frusemide, bumetanide nor torasemide exerted any action on peak Ca(2+) current amplitudes. In summary, the present investigation provides evidence for a direct contractile effect of the loop diuretic, bumetanide, in contrast to absence of effects by frusemide and torasemide, in ventricular cardiomyocytes isolated from rabbit myocardium.

Animals↗
PubMed1998

Power evaluation of small drug and vaccine experiments with binary outcomes.

Power analysis based on the Fisher exact test is used to evaluate the usefulness of alternative designs for small drug and vaccine experiments with a binary, success or failure, outcome. The emphasis is on the comparison between designs with equal and unequal allocations of animals to treated and control groups having the same total sample size, and between designs with equal and unequal allocations but with one or two fewer animals in the control than the treated group. Designs with unequal allocation can sometimes be more powerful at a given level of statistical significance alpha than designs with equal allocation. Graphs and a table are presented to aid the choice of suitable designs for (1-beta) = 0.80 and alpha = 0.05.

Animal Welfare↗
PubMed1998

Paediatric assessment in a residential child and adolescent psychiatry unit.

OBJECTIVE: To document the health status, comorbidity and functional impairments experienced by a group of psychiatrically disturbed children and adolescents. METHODOLOGY: A detailed study of consecutive admissions to a residential unit over a two-year period was undertaken. All admissions had a comprehensive paediatric, speech pathology and psychiatric assessment. RESULTS: Compared to the general population, there was a significant history of developmental delay and low birthweight, but only a slightly greater prevalence of antenatal problems. Clumsiness (37%), severe speech and language disorder (32%), and hearing loss (15%) were prominent. Only 25% had no history of comorbid medical or neurological disorders. CONCLUSION: Children and adolescents presenting with moderate to severe mental health morbidity may have pre-existing comorbid medical problems, as well as unrecognised difficulties and impairments in other skills areas. Multidisciplinary assessment and intervention should be an integral part of the residential programme.

Adolescent↗
PubMed1998

Heterogeneity of the psychoses: is there a neurodegenerative psychosis?

Whereas etiological heterogeneity of the various types of schizophrenia has been repeatedly proposed, relatively few attempts have been made to separate the component diseases. Using a strategy focusing on bimodal distributions within several relevant domains of schizophrenia, we demonstrate that currently available data on schizophrenia patients are consistent with the hypothesis that some of these patients have an ongoing neurodegenerative disease, whereas others do not. We review studies (longitudinal and cross-sectional) documenting progressive increases in ventricular size, accelerated loss of brain tissues, progressive delays in treatment response, and neurochemical (magnetic resonance spectroscopy) and neurophysiological (P300) indices, all of which are consistent with ongoing cerebral degeneration in a significant subgroup of schizophrenia patients. These lines of evidence converge on a conceptualization of schizophrenia as being composed of several etiologically distinct processes, with one subset of psychotic patients evidencing progressive brain degeneration. We conclude with a discussion of possible etiologies for this condition.

Antipsychotic Agents↗
PubMed1997

Psychiatric findings among child psychiatric inpatients grouped by public and private payment.

OBJECTIVE: The study compared school-age psychiatric inpatients whose care was publicly funded with those whose care was privately funded to determine whether the public patients presented with more psychiatric risk factors and more psychiatric problems. METHODS: Retrospective chart review was used to collect data on the demographic and personal characteristics, behavior in the hospital, and response to milieu treatment of 40 public patients and 40 private patients. Half of each group were admitted during 1985-1986, and half during 1991-1993. Characteristics of the two groups were compared, and trends over time were examined. RESULTS: The public group presented for hospitalization with significantly more risk factors and psychiatric problems. Public status predicted the use of certain interventions, such as time-outs and physical holding. Public patients responded less positively to the treatment program. They had three times the number of bed-days as the private group during 1991-1993. CONCLUSIONS: Public patients require more intensive and extensive inpatient treatment and will be more profoundly affected by the restrictions on psychiatric inpatient care in the current climate of fiscal restraint.

Adolescent↗
PubMed1997

A profile of children and adolescents in a psychiatric unit: multidomain impairment and research implications.

OBJECTIVE: The scientific literature has not kept pace with the evolution of child and adolescent psychiatric inpatient units, including their nature, patient profile, philosophical orientation and efficacy. This study aims to establish a comprehensive, multimodal description of the population served by an inpatient psychiatric treatment facility for children and adolescents. METHOD: A multidisciplinary assessment regime including psychiatric, medical, speech and language examination, observer rating and patient self-report of psychopathology was used to assess 58 consecutive patients over a 20-month period. RESULTS: In addition to a prevalence of disruptive behaviour disorders of 67% and a high rate of comorbidity with other psychiatric conditions, a breadth of impairment was demonstrated in many areas. Significantly decreased measures of socialisation, communication, daily living skills, self-esteem, intelligence and physical health are reported. Moderate to severe language handicap was found in 40% of patients. CONCLUSIONS: The inpatient population of children and adolescents exhibited not only a high rate of disruptive behaviour disorders, frequently comorbid with other psychiatric conditions, but also high levels of physical, speech, language and living skills impairment. This finding supports the need for multimodal, multidisciplinary evaluation and treatment in this population. Outcome research evaluating treatment effectiveness must also account for the wide-ranging disabilities of these children and adolescents.

Activities of Daily Living↗
PubMed1996

Dual effects of endothelin-1 on the L-type Ca2+ current in ventricular cardiomyocytes.

The effects of endothelin-1 on the L-type Ca2+ current were studied in rabbit ventricular cardiomyocytes, using both the 'perforated' and the conventional 'ruptured' whole-cell patch-clamp techniques. Endothelin-1 exerts a dual effect on ventricular cardiomyocytes using experimental conditions which minimize intracellular dialysis; endothelin-1 produced both an increase (10(-9) M) and a decrease (10(-8) M) in the L-type Ca2+ current using the perforated patch-clamp technique. However, using the ruptured patch-clamp technique, endothelin-1 produced a similar decrease in L-type Ca2+ current at 10(-8) M, but no effect was observed at a concentration of 10(-9) M. These effects suggest multiplicity in the receptor-effector coupling mechanism.

Animals↗
PubMed1996

Marketing nursing.

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Health Services Needs and Demand↗
PubMed1996

Homomeric interactions between transmembrane proteins of Moloney murine leukemia virus.

We have studied homomeric interactions between transmembrane proteins (TM) of the Moloney murine leukemia virus envelope using the Saccharomyces cerevisiae two-hybrid system. TM interacts strongly with itself but not with various control proteins. Deletional and mutational analyses indicated that the putative leucine zipper motif in the extracellular domain of TM is essential and sufficient to mediate the binding. The first three repeats of the leucine zipper-like motif are the most important in mediating the interaction. The TM-TM interaction detected in this system may play a role in several stages of viral replication.

Amino Acid Sequence↗
PubMed1996

Phase I/II trial of biweekly paclitaxel and cisplatin in the treatment of metastatic breast cancer.

PURPOSE: To determine the maximum-tolerated dose of escalating doses of paclitaxel (Taxol; Bristol-Myers Squibb, Princeton, NJ) administered biweekly with a fixed dose of cisplatin, to assess the toxicity, and to evaluate the activity of this combination in a phase I/II trial in metastatic breast cancer. PATIENTS AND METHODS: Twenty-nine women with metastatic breast cancer were enrolled; 27 were assessable for response and 29 for toxicity. All but two of the women had received prior adjuvant chemotherapy, with 23 receiving anthracyclines and six previous cisplatin. RESULTS: The initial starting dose of paclitxel 90 mg/m2 and cisplatin 60 mg/m2 became the phase II dose due to dose-limiting neutropenia. Responses were seen in 85% of assessable patients, with three patients (11%) achieving a complete response (CR) and 20 patients (14%) a partial response (PR), for an overall response rate of 85% (95% confidence interval [CI], 66% to 96%). The time to disease progression for patients who achieved a CR was 110 to 200 days, and for those with a PR, it was 96 to 377+ days, with a median time to progression of 7.1 months and a median response duration of 7.9 months. Sites of CR were skin, soft tissue, and lung, and all occurred in women with previous exposure to anthracyclines. Septic events were rare, with two grade 3 infections (7%), only one of which required hospital admission. There were no grade 4 nonhematologic toxicity and minimal grade 3 toxicity. A total of 251 chemotherapy cycles were given -- 16 with paclitaxel alone in five patients. Forty-five percent of patients required dose reductions, while 52% had delays due to neutropenia. CONCLUSION: Biweekly paclitaxel and cisplatin is an active combination in the treatment of metastatic breast cancer, including for patients with previous exposure to anthracyclines.

Adult↗
PubMed1993

Familial differences between rapid neuroleptic response psychosis and delayed neuroleptic response psychosis.

Recent data suggest that latency of neuroleptic response may be used to separate distinct subtypes of psychotic disorders. In this preliminary study we contrast family patterns of illness of rapid neuroleptic response psychotics and delayed neuroleptic response psychotics. The data show that first-degree relatives of delayed neuroleptic response psychotics evidence higher levels of psychiatric disorder than rapid responders: relatives of delayed neuroleptic response psychotics evidenced a morbid risk for schizophrenic-spectrum disorder that was more than twice as high as the morbid risk for such disorders among relatives of rapid neuroleptic response psychotics. Relatives of delayed neuroleptic responders that received a diagnosis of schizophrenia, schizoaffective, or schizophreniform disorder evidenced significantly more residual impairment than schizophrenic-spectrum relatives of rapid neuroleptic responders. These preliminary data indicate the possibility that latency of therapeutic response to neuroleptic medication may be used to discriminate two familially distinct psychotic disorders and they suggest that delayed neuroleptic response may characterize a familially transmitted poor-outcome disease.

Adult↗
PubMed1993

The course of DSM-III-R schizophreniform disorder.

This study compared the course of illness of 36 patients who received a diagnosis of either DSM-III-R schizophreniform disorder or schizophrenia. Approximately 3.5 and 4.0 years after their index hospitalization, the two groups were compared for differences in positive and negative symptoms of psychosis, interpersonal and occupational role functioning, and other aspects of the deficit state. Multivariate data analyses indicate that the course of illness of the two groups is significantly different (p < .007), and the data also indicate that patient symptoms and functioning changed significantly over time (p < .008). The schizophreniform patients showed a low level of negative symptoms at both follow-ups; schizophrenics initially showed a higher level of negative symptoms, but these symptoms decreased significantly over time (p < .04). These data indicate that the course of DSM-III-R schizophreniform disorder is distinct from the course of schizophrenia.

Activities of Daily Living↗
PubMed1988

Continuous vincristine infusion as part of a high dose chemoradiotherapy regimen: drug kinetics and toxicity.

A 5-day continuous infusion of vincristine (VCR; total dose 4 mg/m2) has been given as part of a high-dose chemoradiotherapy regimen with bone marrow transplantation. Evidence of neurotoxicity, such as weakness, paraesthesia and intestinal hypomotility, was evaluated prospectively in nine patients. Five patients had advanced neuroblastoma and four, relapsed sarcomas, and all had responded to initial conventional-dose therapy. VCR was combined with high-dose melphalan (180 mg/m2) and fractionated total-body irradiation. Plasma concentrations of VCR were measured by radioimmunoassay during and up to 24 h after the infusion. Serum and urine electrolytes and liver function tests were measured during VCR treatment and at regular intervals thereafter. VCR concentration at 1 h ranged from 1.8 to 10.9 (median 6.6) ng/ml, and a steady state was achieved by 13-30 h (median 16 h). Levels above 1 ng/ml were maintained throughout the 5-day period with a mean steady-state concentration of 1.7 ng/ml (range 1.3-2.15). After cessation of the infusion, serum concentrations fell to below 0.25 ng/ml within 24 h. Abdominal pain occurred in one patient, but neither constipation nor ileus was seen. In two patients severe muscle pain occurred in the lower limbs towards the end of the infusion. Significant electrolyte problems did not occur and, in particular, there was no evidence of inappropriate ADH secretion. Transient increases in liver enzymes were common but bilirubin was not elevated during the period of monitoring. This regimen allows a two-fold escalation in the dose of VCR to be administered, producing sustained high serum drug levels without major toxicity.

Adolescent↗