The effects of different growth promoters and combinations of growth promoters, on the performance and gut histology of broiler chickens.
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Animal Feed↗
Biomedical subjects
B Owens
Publications and source records attributed to B Owens.
Unusual presentations of spilled gallstones.
Perforation of the gallbladder with resultant spillage of gallstones is not an uncommon occurrence. Spillage is reported to occur in 6% to 40% of laparoscopic cholecystectomies. Although not generally considered a significant problem, retained gallstones may cause serious complications years after the operation, with a clinical presentation that often is confusing. We report two cases of unusual complications from spilled gallstones. The first patient presented with clinical and radiologic findings of acute appendicitis 8 years after the laparoscopic cholecystectomy. The second patient presented with spontaneous erosion of spilled gallstones through the back 2 years and 9 months after the laparoscopic cholecystectomy. The literature is reviewed, and the management of spilled gallstones is discussed briefly. Although the complication rate is low, every effort should be made to retrieve spilled gallstones, and the event should be recorded in detail in the operative record. Obligatory conversion to an open procedure is not necessary.
Abscess↗
Incidence of vomiting in burns and implications for mass burn casualty management.
When faced with large numbers of burn patients and limited resources such as in war or disaster, oral fluids may be used as an alternative to intravenous resuscitation. Vomiting during the first 48 h can limit the usefulness of this method; yet its incidence has not been documented. This study aimed to identify those patients at risk of vomiting following burn injury and who therefore might be suitable for oral resuscitation. A retrospective review of case notes from burn patients between 1990 and 2001 was undertaken. Burns requiring intravenous resuscitation (>10% total body surface area (TBSA) in children, >15% TBSA in adults) were included (n=110). Documentation of vomiting during the first 48 h following burn injury to an extent that prevented commencement of feeding was regarded as significant. Patients that vomited were significantly older (28.3 years compared with 18.5 years, P=0.03), and had sustained significantly larger burns (29.8% compared with 22.9%, P=0.047). Administration of opiates and anti-emetics was similar in both groups and not significant. Although the number of patients in this study excludes a logistic regression analysis, it would seem reasonable to attempt oral resuscitation in patients under 25 years of age and with burns up to 25% TBSA given limited resources.
Adolescent↗
Defining the relationship between obesity and total joint arthroplasty.
OBJECTIVE: The purpose of this study was to examine the relationship between obesity and patient-administered outcome measures after total joint arthroplasty. RESEARCH METHODS AND PROCEDURES: A voluntary questionnaire-based registry contained 592 primary total hip arthroplasty patients and 1011 primary total knee arthroplasty patients with preoperative and 1-year data. Using logistic regression, the relationships between body mass index and the several outcome measures, including Short Form-36 and Western Ontario and McMaster Universities Osteoarthritis Index, were examined. RESULTS: There was no difference between obese and non-obese patients regarding satisfaction, decision to repeat surgery, and Delta physical component summary, Delta mental component summary, and Delta Western Ontario and McMaster Universities Osteoarthritis Index scores (p > 0.05 for all). Body mass index was associated with an increased risk of having difficulty descending or ascending stairs at 1 year (odds ratio, 1.2 to 1.3). DISCUSSION: Obese patients enjoy as much improvement and satisfaction as other patients from total joint arthroplasty.
Adult↗
CHESS: ten years of research and development in consumer health informatics for broad populations, including the underserved.
This paper reviews the research and development around a consumer health informatics system CHESS (The Comprehensive Health Enhancement Support System) developed and tested by the Center for Health Systems Research and Analysis at the University of Wisconsin. The review will place particular emphasis on what has been found with regard to the acceptance and use of such systems by high risk and underserved groups.
Aged↗
Assessing quality of life in patients with head and neck cancer: cross-validation of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Head and Neck module (QLQ-H&N35).
OBJECTIVE: To evaluate the reliability and validity of a new, disease-specific quality-of-life measure for patients with head and neck cancer: the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire--QLQ-H&N35. DESIGN: Cross-sectional study using questionnaire data and medical chart review. SETTING: Academic tertiary care otolaryngology clinic. PARTICIPANTS: One hundred twenty ambulatory patients, including 30 patients with advanced head and neck cancer in each of the following stages of treatment: (1) prior to treatment, (2) during active treatment, (3) within 6 months of completing treatment, and (4) more than 6 months after completing treatment. In addition, (5) a comparison group of 40 patients without malignant disease was included (total sample, N = 160). MAIN OUTCOME MEASURES: Scores on EORTC Quality of Life Core Questionnaire (QLQ-C30) and head and neck module (QLQ-H&N35), Profile of Mood States, and Impact of Events Scale. RESULTS: The QLQ-H&N35 demonstrated acceptable reliability (internal consistency). It successfully discriminated between cancer patients and the comparison group, and among subgroups of cancer patients at different phases of treatment (construct validity). The instrument was sensitive to the effects of radiation treatment and to site of disease. Its low-to-moderate correlations with the EORTC core questionnaire indicated that the QLQ-H&N35 provided unique information (discriminant validity). Scores were significantly associated with a number of demographic variables. CONCLUSION: Results support the use of this disease-specific measure to assess quality of life among patients with advanced head and neck cancer.
Activities of Daily Living↗
An in vitro study of microleakage of occlusal composite restorations polymerized by a conventional curing light and a PAC curing light.
With the increase in usage of bonded dentistry procedures, so comes the development of advanced technology to polymerize it. The purpose of this in vitro study was to evaluate the microleakage of sealants and resin restorations utilizing two different curing lights. The conventional Ortholux curing light (OCL) and the Plasma Arc Curing (PAC) light attached to the KCP air abrasion unit of American Dental Technologies were utilized to polymerize sealants and resin restorations on extracted third molars and premolars. Forty-eight caries-free teeth were divided into 4 groups of 12 specimens. Occlusal sealants were polymerized on groups 1 and 3. Class I composite resin restorations were polymerized on groups 2 and 4. The PAC light polymerized group 2 and the OCL was used for groups 3 and 4. Therefore a comparison between the two light sources' polymerization could be measured by evaluating the microleakage of the two sets of specimens. The PAC light polymerized the Z100 adhesive for 5 seconds and the OCL polymerized it for 10 seconds. The Z100 A-1 composite placed in two 1 mm increments was polymerized with the PAC light for 10 seconds and the OCL for 40 seconds. The teeth were thermocycled 200 times between 5 degrees C and 55 degrees C. The teeth, coated with fingernail polish excluding the occlusal surface, were soaked in 5% methylene blue for 4 hours, removed, and rinsed with water. The teeth were invested in clear resin (Castin Craft) and sectioned longitudinally using an Isomet diamond saw. Microleakage was scored "0" if no leakage was present. Scored "1" if the leakage was present to 1/2 the preparation depth. Scored "2" if the leakage was present past the 1/2 way point but not to the pulpal floor of the preparation. A score of "3" was used if the leakage reached the pulpal floor. Unpaired t-Tests were used to statistically analyze the data. A significant difference (p < 0.05) was found between groups 1 and 3. The PAC light used to polymerize the sealants in group 1 produced no microleakage. A significant difference (p < .005) was found between groups 2 and 4. The OCL produced less microleakage (16 and 20 out of 24 sections) than the resin restorations polymerized with the PAC (only 8 of 24 sections with no microleakage. The 10-second cure by the PAC light appears to be insufficient in polymerizing a class I composite resin restoration. Possibly longer exposures with the PAC would produce less microleakage. Further research needs to be performed to evaluate if the PAC light, with an intensity of 1196 mW/cm2, may be producing high levels of strain within the setting composite. This strain may be responsible for the statistically significant increase in microleakage of the restorations polymerized with the PAC light.). It appears the PAC light would be best utilized to cure sealants and/or possibly polymerize orthodontic brackets. The conventional curing light appears to remain the best choice for polymerizing class I composite restorations.
Bicuspid↗
Shorter survival in advanced human immunodeficiency virus type 1 infection is more closely associated with T lymphocyte activation than with plasma virus burden or virus chemokine coreceptor usage.
To define predictors of survival time in late human immunodeficiency virus type 1 (HIV-1) disease, long- and short-duration survivors were studied after their CD4+ T cells fell to </=50/mm3. Immune activation of CD4+ and CD8+ T cells, as measured by elevated cell surface expression of CD38 antigen, was strongly associated with shorter subsequent survival (P</=.002). The naive CD45RA+CD62L+ T cell reserve was low in all subjects and did not predict survival (P=.34 for CD4+ and.08 for CD8+ cells). Higher virus burden correlated with CD8+ but not CD4+ cell activation and, after correcting for multiple comparisons, was not associated with shorter survival (P=.02). All of the patients' viruses used CCR5, CXCR4, or both, and coreceptor usage did not predict survival (P=. 27). Through mechanisms apparently unrelated to higher virus burden, immune activation is a major determinant of survival in advanced HIV-1 disease.
ADP-ribosyl Cyclase↗
Treatment of recurrent glioma with intracavitary alloreactive cytotoxic T lymphocytes and interleukin-2.
For a single-dose toxicity assessment, five patients with recurrent malignant glioma (ages 29-46 years) were treated with intracavitary alloreactive cytotoxic T lymphocytes (CTL) and interleukin-2 (IL-2). The trial tested the hypothesis that alloreactive CTL, sensitized to the major histocompatibility complex (MHC) proteins of the patient, offer selective, targeted killing of glioma cells that express MHC. Patient lymphocytes, which also express MHC, were irradiated and placed into CellMax artificial capillary systems with lymphocytes from MHC-disparate donors and CTL developed over a 2- to 3-week period with a low concentration of IL-2. The CTL largely expressed CD3 and CD11a/CD8 markers and lysed targets displaying patient MHC. CTL were implanted into the tumor bed at surgery and a catheter was used for subsequent infusions. Patients received one to five treatment cycles every other month; one cycle generally consisted of two or three CTL infusates administered within a 1- to 2-week period. Different unrelated donors were used for each cycle. Treatment was well tolerated; transient toxicity at grades 1-3 was recorded by NCI Common Toxicity Scale criteria. Two glioblastoma patients have died; one from tumor recurrence locally and the other from recurrence at a site distant from the treatment. Two of the five patients completed five cycles; one anaplastic oligodendroglioma patient shows no evidence of tumor 30 months from the start of immune therapy and an anaplastic astrocytoma patient shows stable disease 28 months after initiation of therapy. One anaplastic oligodendroglioma patient, who dropped the protocol during her second treatment cycle, has no evidence of tumor 28 months after recurrence.
Adult↗
Interaction between the breast cancer patient and the health care system: demands, constraints and options for the future.
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Adaptation, Psychological↗
In vitro and in vivo effects of leukotriene B4 antagonism in a primate model of asthma.
To test the hypothesis that leukotriene (LT) B4 antagonists may be clinically useful in the treatment of asthma, CP-105,696 was evaluated in vitro, using chemotaxis and flow cytometry assays, and in vivo, using a primate asthma model. CP-105,696 inhibited LTB4-mediated monkey neutrophil chemotaxis (isolated cells, LTB4 = 5 nM) and CD11b upregulation (whole blood, LTB4 = 100 nM) with IC50 values of 20 nM and 16.5 microM, respectively. Using a modification of a previously described in vivo protocol (Turner et al. Am. J. Respir. Crit. Care Med. 1994. 149: 1153-1159), we observed that treatment with CP-105,696 inhibited the acute increase in bronchoalveolar lavage (BAL) levels of IL-6 and IL-8 by 56.9 +/- 13.2% and 46.9 +/- 14.5%, respectively, 4 h after challenge with Ascaris suum antigen (Ag). CP-105,696 tended to reduce the increase in BAL protein levels 0.5 h after Ag challenge by 47.5 +/- 18.3%, but this was not statistically significant. In addition, CP-105,696 prevented the significant 11-fold increase in airway responsiveness to methacholine after multiple Ag challenge. These results suggest that LTB4 partially mediates acute and chronic responses to antigen in an experimental primate asthma model and support the clinical evaluation of LTB4 antagonists in human asthma.
Animals↗
Replacement therapy: arginine vasopressin (AVP), growth hormone (GH), cortisol, thyroxine, testosterone and estrogen.
Replacement therapy is routinely used to treat hormone deficiencies of patients who have had surgery or radiation therapy that damages the hypothalamus or pituitary gland. Hormones commonly replaced include: arginine vasopressin (AVP), growth hormone (GH), cortisol, thyroxine (T4), testosterone and estrogen. AVP, synthesized in the hypothalamus, is stored in and released by the posterior lobe of the pituitary gland. GH is synthesized and released by the anterior pituitary gland. The other hormones are produced and released by target glands each of which is stimulated by a specific anterior pituitary hormone, which in turn is controlled by release of a specific hypothalamic hormone. Feedback control by a high circulating concentration of the target gland's hormone regulates hypothalamic hormone release. Deficiency of AVP, important for water balance in the body, is restored with the synthetic analogue, 1-desamino-8-D-arginine vasopressin (DDAVP); it is given as a nasal spray or by injection. GH is required for normal growth in the developing child; recombinant GH, produced in bacteria, is injected subcutaneously. Adrenocorticotropic hormone (ACTH) controls release of cortisol which is produced by the adrenal cortex and enables the body to cope with stress; cortisol is replaced with prednisolone given orally. Thyroid stimulating hormone (TSH) controls release of the thyroid hormones, T4 and triiodothyronine (T3), which promote growth and development, and regulate energy metabolism; for replacement of T4, oral synthetic L-thyroxine is given. Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) control release of testosterone, which promotes maturation of sperm and development of male sexual characteristics; replacement testosterone is administered intramuscularly. In females, FSH and LH control release of estrogens and progesterone which prepare the reproductive tract for release of the ovum, fertilization, implantation and development of the embryo, replacement by estrogen and progesterone preparations which are orally effective is given in a cyclic manner. A transdermal delivery system is available. Nursing implications include cautions and contraindications, potential problems of over-replacement, drug interactions as well as patient teaching points.
Arginine Vasopressin↗
A comparison of Culture-Free Self-Esteem Scale means from different child and adolescent groups.
The Culture-Free Self-Esteem Inventory (CFSEI-2) was administered to 7 groups of children: 84 White Catholic school students from a New Orleans suburb, 78 White rural public school students from Virginia, 62 Hispanic Migrant student from Florida, 90 Aboriginal and White students from an isolated Canadian community, 199 African American students attending an inner city school, 60 Hispanic and White international students from Venezuela, and 61 Innuit students from isolated community in Labrador. The four elder groups also wrote three words to describe themselves (the Adjective Generation Technique [AGT]). Significant differences in responding between groups were found on all CFSEI-2 scales and for AGT favorability means. Although several possible reasons for these results are discussed, we conclude that the CFSEI-2 is not culture-free. Recommendations are: change the title of the test to avoid misrepresentation, limit test usage to elementary school children, develop an adolescent version with age appropriate language, and construct local norms before using the CFSEI-2 to make decisions about a child's self-esteem. To determine relevance of scores, a team of professionals and lay persons should review items from this or any test given to children who may be different from the normative or standardization group.
Adolescent↗
Medical complications following successful pediatric dental treatment.
Dental treatment is usually performed without any development of medical sequela. However, patients can acquire serious, life threatening complications, even though successful dental treatment is completed. This paper presents four case reports of medical complications following routine pediatric dental treatment. The cases include: Ludwig's angina, endocarditis, brain abscess, and anesthetic toxicity. Many of the medical complications were caused by pre-existing conditions and were not necessarily direct result of dental treatment. Although medical complications following dental treatment cause grave concern, the dental practitioner can learn much from these occurrences.
Adolescent↗
Coupling between gamma irradiation, p53 induction and the apoptotic response depends upon cell type in vivo.
The accumulation of p53 protein following whole body irradiation of adult mice was studied using a new polyclonal antibody to mouse p53. While dramatic accumulation of the protein was apparent in splenocytes, thymocytes and osteocytes no p53 protein accumulation was detected in the hepatocytes of the irradiated mouse. Thus, the upstream initiating signals that control the induction of p53 are controlled in a tissue specific manner. While massive apoptosis accompanies p53 induction in thymocytes and splenocytes it is not seen in the osteocytes. Thus the downstream consequences of p53 induction are also tightly controlled. These results have profound significance for an understanding of the role of the p53 tumour suppression pathway in different tissues.
Animals↗
Formal clinical evaluation of the CADD-Micro system for circadian delivery of FUDR in patients with metastatic renal cell cancer.
The CADD-Micro System (Sims Deltec, St. Paul, MN) was formally evaluated in patients with metastatic renal cell cancer, participating in a phase-III study comparing a 2-week circadian versus flat infusion of FUDR. Ten patients participated, 2 receiving five cycles of FUDR by a flat infusion, and 8 receiving 12 cycles of FUDR by circadian infusion. A total of 235 treatment days were evaluated. All patients had a Port-A-Cath in place for venous access. The patients completed a structured evaluation survey for each week of treatment regarding their interaction with the pump and an overall evaluation of the system and the patient information guide at the end of each 2-week course. Nurses from our home infusion program completed a separate evaluation. Overall patient and clinician perception of this pump was excellent. The main drawback had to do with the design of the battery compartment cover and the handling of the drug reservoir. The small size of the drug reservoir (10 mL) limits the usability of this pump to low-volume tasks.
Antimetabolites, Antineoplastic↗
The protection against gentamicin nephrotoxicity in the streptozotocin-induced diabetic rat is not related to gender.
Since gender can influence the renal toxicity of a drug in a given species, the present study was undertaken to evaluate the role of sex in the protection against gentamicin (G)-induced nephrotoxicity afforded by diabetes mellitus (DM) in the rat. We have compared the effects of administration of G (40 mg/kg/day, for 14 days) on male and female DM Sprague-Dawley rats. Non-diabetic animals of both sexes receiving identical doses of G served as controls. At the end of the experiment on day 14, both female (F) and male (M) control groups had similar and marked evidence of nephrotoxicity: elevation of plasma creatinine (F 1.7 +/- 0.7; M 2.8 +/- 0.6 mg/dl), decrease in endogenous 24-h creatinine clearance (Ccr) (F0.3 +/- 0.1; M 0.2 +/- 0.1 ml/min/100 g BW), and histological evidence of severe acute tubular necrosis. In marked contrast, the DM rats showed no functional or morphological evidence of renal damage throughout the study regardless of their gender (day 14: plasma creatinine: F 0.2 +/- 0.03; M 0.2 +/- 0.02; Ccr: F 1.2 +/- 0.1; M 1.6 +/- 0.1 ml/min/100 g BW), and they also accumulated less G in their kidney cortex than the C rats. The male controls exhibited higher renal cortex accumulation of G than the female controls (p < 0.05), whereas the opposite occurred in the DM groups (p < 0.01). Because the validity of using Ccr for the evaluation of GFR changes in experimental nephrotoxicity has been questioned, we have compared, in a separate experiment, three different methods of estimation of GFR (simultaneous short clearances of inulin and Ccr, and 24-h Ccr) in conscious female Sprague-Dawley rats undergoing the same treatment with G described above. At no time during the study did the method used for estimation of the GFR influence the results. We conclude that male and female Sprague-Dawley rats with diabetes are functionally and morphologically equally protected against G. Furthermore, no gender-related differences in the magnitude of G-induced nephrotoxicity was demonstrated in the non-diabetic control animals.
Animals↗
L.A. hospitals: "I've never seen anything like this before".
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Disaster Planning↗