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Biomedical subjects

C A Lewis

Publications and source records attributed to C A Lewis.

At least 19 recordsLinked to original sources
PubMed2006

Short-burst oxygen therapy for COPD patients: a 6-month randomised, controlled study.

Short-burst oxygen therapy (SBOT) remains widely advocated for patients with chronic obstructive pulmonary disease (COPD), despite a lack of supporting evidence. The aim of this randomised, double-blind, placebo-controlled, parallel group study was to determine whether SBOT improves health-related quality of life (HRQL) or reduces acute healthcare utilisation in patients discharged following an acute exacerbation of COPD. Consecutive patients were screened; 78 of 331 were eligible for randomisation to cylinder oxygen, cylinder air or usual care following discharge. Patients were elderly with high acute healthcare utilisation, forced expiratory volume in one second of <1 L and had dyspnoea limiting daily activity but were not hypoxaemic at rest. Over the 6-month study period, there were no significant differences between patient groups in HRQL (Chronic Respiratory Questionnaire (CRQ), 36-item Short-Form Health Survey, Hospital Anxiety and Depression Scale) except for CRQ emotion domain. There were no significant differences in acute healthcare utilisation. Time to readmission was greatest in the usual care group. Cylinder use was high initially, but rapidly fell to very low levels within weeks in both cylinder oxygen and air groups. In conclusion, the availability of short-burst oxygen therapy for chronic obstructive pulmonary disease patients discharged from hospital following an acute exacerbation did not improve health-related quality of life or reduce acute healthcare utilisation. These results provide no support for the widespread use of short-burst oxygen therapy.

Acute Disease↗
PubMed2005

Development of educational image databases and e-books for medical physics training.

Medical physics education and training requires the use of extensive imaging material and specific explanations. These requirements provide an excellent background for application of e-Learning. The EU projects Consortia EMERALD and EMIT developed five volumes of such materials, now used in 65 countries. EMERALD developed e-Learning materials in three areas of medical physics (X-ray diagnostic radiology, nuclear medicine and radiotherapy). EMIT developed e-Learning materials in two further areas: ultrasound and magnetic resonance imaging. This paper describes the development of these e-Learning materials (consisting of e-books and educational image databases). The e-books include tasks helping studying of various equipment and methods. The text of these PDF e-books is hyperlinked with respective images. The e-books are used through the readers' own Internet browser. Each Image Database (IDB) includes a browser, which displays hundreds of images of equipment, block diagrams and graphs, image quality examples, artefacts, etc. Both the e-books and IDB are engraved on five separate CD-ROMs. Demo of these materials can be taken from www.emerald2.net.

Biomedical Engineering↗
PubMed2005

Chest radiography: a comparison of image quality and effective dose using four digital systems.

Image quality (IQ) and effective dose for chest radiography was compared for four digital imaging systems that used three different detector technologies: a-Si/TFT flat-panel detector (FPD), scanning-slot/charge-coupled device (CCD) and photostimuable phosphor (PSP). On each system a phantom was exposed at 125 kV(p) for automatic exposure control (AEC) and 2, 4 and 8 Gy receptor dose using identical geometrical conditions. All images were scored as softcopy images by three observers. The effective dose was calculated for each exposure condition. For AEC, superior IQ was observed for the GE FPD compared with all the other systems, which showed similar IQ performance. For all systems the entrance surface dose associated with AEC was within the European recommendations but variations in the effective dose were observed between the four systems. For identical receptor dose levels superior IQ was observed with the FPDs. Thorascan was noted for its low effective dose and Agfa CR was associated with the highest effective dose. FPD systems showed a better overall performance, followed by the CCD and PSP systems.

Computers↗
PubMed2003

Short-burst oxygen immediately before and after exercise is ineffective in nonhypoxic COPD patients.

Short-burst oxygen therapy (SBOT) remains an unproven treatment for reduction of exertional dyspnoea in chronic obstructive pulmonary disease (COPD). This study aimed to assess whether SBOT before exercise reduces dyspnoea or improves performance, and whether SBOT after exercise reduces dyspnoea during recovery. Twenty-two clinically stable COPD patients (mean forced expiratory volume in one second 34% predicted, mean resting saturation 94%) attended a respiratory gymnasium and undertook four 6-min walk (6MW) tests at each of two sessions, 1 week apart. Cylinder air or oxygen was administered single-blind in random order for 5 min prior to the first two 6MW and during recovery following the final two 6MW. Dyspnoea was self-rated by subjects using the modified Borg scale. There was no significant difference in mean 6MW distance or final Borg score for air and oxygen given before exercise. There was also no significant difference in mean time-to-resting Borg score for air and oxygen given after exercise. Only two subjects demonstrated a clinically significant and consistent reduction in dyspnoea for oxygen compared with air either before or after exercise. Overall, short-burst oxygen therapy neither reduced dyspnoea nor improved performance. This study does not support the use of short-burst oxygen therapy either immediately before or after exercise.

Aged↗
PubMed2001

Ca(2+)/calmodulin-dependent protein kinase mediates the phosphorylation of CD44 required for cell migration on hyaluronan.

CD44 is the principal cell surface receptor for the extracellular matrix glycosaminoglycan hyaluronan, and binding to this ligand underlies CD44-mediated cell attachment and migration. As would be expected for a widely expressed adhesion receptor, CD44 is subject to complex regulatory events, and mis-regulation of the receptor has been associated with a number of disease pathologies, including chronic inflammatory conditions and the progression of metastatic tumours. In previous studies we have demonstrated that a key control point for this receptor is the phosphorylation of CD44 on a conserved cytoplasmic serine residue, Ser(325). This modification is not required for efficient ligand binding, but is an essential component of CD44-dependent cell migration on a hyaluronan substratum. To understand better the mechanism regulating CD44 phosphorylation on Ser(325), we have generated a monoclonal antibody that specifically recognizes CD44 phosphorylated on Ser(325), and have developed assays to identify the Ser(325) kinase. We demonstrate here that CD44 is phosphorylated to high stoichiometry in resting cells and that Ca(2+)/calmodulin-dependent protein kinase II is a CD44 Ser(325) kinase.

Amino Acid Sequence↗
PubMed2001

Fluoroscopically guided Norplant removal.

The Norplant contraceptive implant system is a commonly used method of contraception worldwide. Implant placement and removal are usually simple office-based outpatient procedures. Norplant removal can occasionally become difficult, usually secondary to improper insertion. In these instances, we describe a method of Norplant removal that can easily be performed with use of high-resolution fluoroscopy with associated digital subtraction imaging.

Arm↗
PubMed2001

Convergent validity of the Depression-Happiness Scale with the Memorial University of Newfoundland Scale of Happiness.

The Depression-Happiness Scale and the Memorial University of Newfoundland Scale of Happiness were administered to 52 Northern Irish university students. Higher scores on the Depression-Happiness Scale were significantly associated with higher scores on the Memorial University of Newfoundland Scale and the subscale scores of Positive Affect and Positive Experiences and with lower scores on Negative Affect and Negative Experiences. These data provide further support for the convergent validity of the Depression-Happiness Scale.

Adult↗
PubMed2001

Cultural stereotype of the effects of religion on mental health.

To examine if the religious are more likely to be rated as having a poorer mental health than the non-religious, 48 Northern Irish undergraduate students completed self-report measures of religious attitude and mental health under four counter-balanced conditions: 'control' (present yourself 'as you really are') and as how 'religious', 'nonreligious', and 'mentally ill' respondents might be thought to answer. The 'religious' condition provided significantly higher scores for both the Obsessional Symptom Scale and the Obsessional Personality Trait Scale and significantly lower Psychoticism Scale scores than the 'non-religious' condition. Moreover, significant associations were found between higher scores on the religiosity scale and higher scores on the Obsessional Personality Trait Scale in two of the four conditions ('religious' and 'mentally ill') and lower scores on the Psychoticism Scale in three of the four conditions ('control', 'religious', and 'mentally ill'). These results suggest that the religious are viewed paradoxically as having both aspects of better (i.e. lower psychoticism scores) and poorer mental health (i.e. higher obsessional scores) than the non-religious. As such, the present findings provide some support for the existence of a powerful cultural stereotype of the religious.

Adult↗
PubMed2000

Configurations of polyunsaturated sesterterpenoids from the diatom, Haslea ostrearia.

The partial configurations of C25 isoprenoid alkenes isolated from the diatom Haslea ostrearia Gaillon (Simonsen) have been established. A combination of NMR spectroscopy studies of the alkenes with chiral shift reagents in conjunction with soluble silver beta-diketonate complexes and enantioselective gas chromatography of oxidation products of the alkenes was used. Unexpected differences in highly branched isoprenoid isomer configurations were observed between different laboratory cultures of the alga.

Alkenes↗
PubMed1999

Sedation with xylazine and lumbosacral epidural administration of lidocaine and xylazine for umbilical surgery in calves.

OBJECTIVE: To determine whether anesthesia consisting of sedation induced by intramuscular administration of xylazine hydrochloride and lumbosacral analgesia induced by epidural administration of lidocaine and xylazine is useful for umbilical surgery in neonatal calves. DESIGN: Prospective study. ANIMALS: 6 neonatal male dairy calves. PROCEDURE: Calves were sedated with xylazine (0.1 mg/kg [0.045 mg/lb] of body weight, i.m.), and 5 minutes later a 2% solution of lidocaine (0.18 to 0.24 ml/kg [0.08 to 0.11 ml/lb]) and xylazine (0.05 mg/kg [0.022 mg/lb]) were administered into the lumbosacral epidural space. Calves were positioned in dorsal recumbency, and the umbilical structures were resected. Local infusion of lidocaine, cranial to the umbilicus, was required in 5 of 6 calves to provide adequate analgesia. Xylazine sedation was reversed with tolazoline (1 mg/kg [0.45 mg/lb], i.v.). RESULTS: Calves maintained adequate cardiac output and oxygen delivery throughout the procedure but were hypotensive. Reversal of xylazine-induced sedation with tolazoline caused transient sinus bradycardia and sinus arrest, accompanied by severe systemic arterial hypotension. All calves regained a suckle reflex within 10 minutes and were able to stand within 90 minutes. CLINICAL IMPLICATIONS: Intramuscular administration of xylazine for sedation and epidural administration of lidocaine and xylazine for analgesia failed to provide satisfactory analgesia for umbilical resection without supplemental local infiltration of lidocaine. The anesthetic protocol is most useful when respiratory compromise or cost are concerns and the surgical procedure can be completed in < 1 hour. Caution should be exercised when tolazoline is administered intravenously to reverse xylazine-induced sedation in calves.

Adrenergic alpha-Agonists↗