Topical glycopyrrolate should not be overlooked in treatment of focal hyperhidrosis.
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Administration, Cutaneous↗
Biomedical subjects
C Burns
Publications and source records attributed to C Burns.
Measuring safety climate in health care.
AIM: To review quantitative studies of safety climate in health care to examine the psychometric properties of the questionnaires designed to measure this construct. METHOD: A systematic literature review was undertaken to study sample and questionnaire design characteristics (source, no of items, scale type), construct validity (content validity, factor structure and internal reliability, concurrent validity), within group agreement, and level of analysis. RESULTS: Twelve studies were examined. There was a lack of explicit theoretical underpinning for most questionnaires and some instruments did not report standard psychometric criteria. Where this information was available, several questionnaires appeared to have limitations. CONCLUSIONS: More consideration should be given to psychometric factors in the design of healthcare safety climate instruments, especially as these are beginning to be used in large scale surveys across healthcare organisations.
Attitude of Health Personnel↗
Evaluation of agrobacterium-mediated transformation of Agaricus bisporus using a range of promoters linked to hygromycin resistance.
There is interest in establishing genetic modification technologies for the cultivated mushroom Agaricus bisporus, both for improved crop characteristics and for molecular pharming. For these methods to be successful, it is necessary to establish a set of transformation systems that include robust and reliable vectors for gene manipulation. In this article, we report the evaluation of a series of promoters for driving expression of the Escherichia coli hph gene encoding hygromycin phosphotransferase. This was achieved using the Aspergillus nidulans gpdA and the A. bisporus gpdII and trp2 promoters. The Coprinus cinereus beta-tubulin promoter gave contrasting results depending on the size of promoter used, with a 393-bp region being effective, whereas the longer 453-bp fragment failed to yield any hygromycin-resistant transformants. The C. cinereus trp1 and the A. bisporus lcc1 promoters both failed to yield transformants. We also show that transformation efficiency may be improved by careful selection of both appropriate Agrobacterium strains, with AGL-1 yielding more than LBA1126 and by the choice of the binary vectors used to mobilize the DNA, with pCAMBIA vectors appearing to be more efficient than either pBIN19- or pGREEN-based systems.
Agaricus↗
Effect of pramlintide on satiety and food intake in obese subjects and subjects with type 2 diabetes.
AIMS/HYPOTHESIS: Long-term trials in insulin-treated subjects with type 2 diabetes have shown that adjunctive treatment with the amylin analogue pramlintide reduces HbA(1)c levels and elicits weight loss. While amylin reduces food intake in rodents, pramlintide's effect on satiety and food intake in humans has not yet been assessed. METHODS: In this randomised, double-blind, placebo-controlled crossover study, 11 insulin-treated men with type 2 diabetes (age 60+/-9 years, BMI 28.9+/-4.8 kg/m(2)) and 15 non-diabetic obese men (age 41+/-21 years, BMI 34.4+/-4.5 kg/m(2)) underwent two standardised meal tests. After fasting overnight, subjects received single subcutaneous injections of either pramlintide (120 microg) or placebo, followed by a preload meal. After 1 h, subjects ate an ad libitum buffet meal. Energy intake and meal duration were measured, as were hunger ratings (using visual analogue scales), and plasma cholecystokinin, glucagon-like peptide-1 and peptide YY concentrations over time. RESULTS: Compared with placebo, pramlintide reduced energy intake in both the type 2 diabetes (Delta-202+/-64 kcal, -23+/-8%, p<0.01) and obese (Delta-170+/-68 kcal, -16+/-6%, p<0.02) groups, without affecting meal duration. Hunger and hormonal analyte profiles provided evidence that pramlintide may exert a primary satiogenic effect, independently of other anorexigenic gut peptides. CONCLUSIONS/INTERPRETATION: The results indicate that enhanced satiety and reduced food intake may explain the weight loss observed in long-term pramlintide trials.
Adult↗
Efficient GFP expression in the mushrooms Agaricus bisporus and Coprinus cinereus requires introns.
We have developed a "Molecular Toolkit" comprising interchangeable promoters and marker genes to facilitate transformation of homobasidiomycete mushrooms. We describe the evaluation of a range of promoters in the homobasidiomycetes Agaricus bisporus and Coprinus cinereus using green fluorescent protein (GFP) as a reporter gene; the C. cinereus trp1 promoter and A. bisporus trp2 and gpdII promoters proving successful in driving expression in C. cinereus, with the gpdII promoter also functioning in A. bisporus. Our investigations demonstrate that a prerequisite for GFP expression in C. cinereus and A. bisporus is the presence of an intron. This is the first reported expression of GFP in either C. cinereus or A. bisporus.
Agaricus↗
Identifying predictors of high quality care in English general practice: observational study.
OBJECTIVES: To assess variation in the quality of care in general practice and identify factors associated with high quality care. DESIGN: Observational study. SETTING: Stratified random sample of 60 general practices in six areas of England. OUTCOME MEASURES: Quality of management of chronic disease (angina, asthma in adults, and type 2 diabetes) and preventive care (rates of uptake for immunisation and cervical smear), access to care, continuity of care, and interpersonal care (general practice assessment survey). Multiple logistic regression with multilevel modelling was used to relate each of the outcome variables to practice size, routine booking interval for consultations, socioeconomic deprivation, and team climate. RESULTS: Quality of clinical care varied substantially, and access to care, continuity of care, and interpersonal care varied moderately. Scores for asthma, diabetes, and angina were 67%, 21%, and 17% higher in practices with 10 minute booking intervals for consultations compared with practices with five minute booking intervals. Diabetes care was better in larger practices and in practices where staff reported better team climate. Access to care was better in small practices. Preventive care was worse in practices located in socioeconomically deprived areas. Scores for satisfaction, continuity of care, and access to care were higher in practices where staff reported better team climate. CONCLUSIONS: Longer consultation times are essential for providing high quality clinical care. Good teamworking is a key part of providing high quality care across a range of areas and may need specific support if quality of care is to be improved. Additional support is needed to provide preventive care to deprived populations. No single type of practice has a monopoly on high quality care: different types of practice may have different strengths.
Chronic Disease↗
Adhesion molecules in lymphocyte trafficking and colitis.
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Cell Adhesion Molecules↗
Pesticides and fetal death due to congenital abnormalities.
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Abnormalities, Drug-Induced↗
Intranasal sumatriptan in post-ECT headache: results of an open-label trial.
BACKGROUND: Significant headaches occur in up to 45% of patients receiving electroconvulsive therapy (ECT) as a result of treatment. Headaches may at times be severe and affect patient compliance with this treatment modality. The 5-HT(1B/1D) receptor agonist sumatriptan has been reported to be effective for post-ECT headache in several case reports. The aim of the present open-label study was to assess the efficacy and tolerability of intranasal sumatriptan for post-ECT headache. METHOD: Patients undergoing ECT who experienced moderate-to-severe post-ECT headache were enrolled in the study. Patients were asked to rate their headache severity and describe headache characteristics using a standard headache diary. Headaches rated as severe or moderate were treated with 20 mg of intranasal sumatriptan. Additional headache ratings were recorded at 0.25, 0.5, 1.0, 1.5, and 2 hours after sumatriptan administration and compared with baseline values. RESULTS: Eight female patients (ages 34-45 years old) participated in the trial and experienced a total of 13 post-ECT headaches, which were treated with intranasal sumatriptan. Of the headaches treated, six (46.2%) were described as severe and seven (53.8%) were characterized as moderate in severity. Twelve (92.3%) of the treated headaches responded by the 2 hour posttreatment time point and 11 (84.6%) had responded within 1 hour. Comparisons made at the 1- and 2-hour time point revealed a statistically significant improvement from baseline (p = 0.002). Of the 12 headaches that responded, 6 (50%) were reported as no pain and 5 (38.5%) were reported as only mild pain at 1 hour following treatment. At the 2-hour assessment, an additional headache, which had previously not responded, was rated at mild resulting in six (50%) headaches with complete resolution of pain and six (50%) with a decrease in pain symptoms from moderate or severe to mild. Overall, sumatriptan treatment was well tolerated, and no significant adverse effects or changes in vital signs were recorded. In no case was a second dose of sumatriptan given. The most common complaint was the taste of the medication (n = 4), which was not treatment limiting. No patient withdrew from the study due to an adverse event. CONCLUSION: Intranasal sumatriptan spray may be an effective, well-tolerated, and prompt treatment for patients experiencing moderate-to-severe post-ECT headache. Preventing post-ECT headache may contribute to patient compliance with the ECT treatment modality. Additionally, the known pharmacologic effects of sumatriptan and the generally positive results found in the present study suggest that ECT-induced headache is vascular in origin. Further placebo-controlled, double-blind studies are needed to confirm our open-label results.
Administration, Intranasal↗
Array-based ELISAs for high-throughput analysis of human cytokines.
In this report, we describe the development of a mini-array system suitable for high-throughput quantification of proteins. This mini-array is a multiplexed, sandwich-type ELISA that measures the concentration of seven different human cytokines--TNF-alpha, IFN alpha, IFN gamma, IL-1 alpha, IL-1 beta, IL-6, and IL-10--from a single sample in each well of a 96-well plate. The mini-array is produced by spotting monoclonal antibodies (mAbs) in a 3 x 3 pattern in the bottom of the wells of 96-well polystyrene plates. Cytokines that are captured by the arrayed mAbs are detected by using biotinylated mAbs, followed by the addition of a streptavidin-horseradish peroxidase (HRP) conjugate and a chemiluminescent substrate. The light produced from the HRP-catalyzed oxidation of the substrate is measured at each spot in the array by imaging the entire plate with a commercially available CCD camera. Here, we demonstrate that these 96-well-plate format mini-arrays have performance characteristics that make them suitable for the high-throughput screening of anti-inflammatory compounds.
Anti-Inflammatory Agents↗
Redefining critical incidents: a preliminary report.
This pilot study was conducted to describe how some traumatic events become "critical incidents" and to generate a new understanding of the term critical incident. The qualitative research design utilized content analysis of structured interviews of six emergency nurses. The nurses were interviewed regarding the ways they think about certain patient care events, the reasons that specific events are remembered and the changes that occurred following the experience of an event they considered to be critical. The definitions of a critical incident as described in the literature--as an event, as a professional's reaction and as a professional's performance--are included in the nurses' comments. None of them, however, offers a comprehensive way of describing a critical incident. The results of this pilot study suggest one, two or all three elements may be present when a traumatic event is experienced. The interaction of these elements helps to produce a fourth "critical" component, the meaning a nurse gives to an event, which can trigger cognitive, affective and/or behavioral changes. This study acknowledges the importance of all the definitions of a critical incident and proposes a more comprehensive definition that results from the interaction among the other components and the generation of personal meaning and change.
Crisis Intervention↗
'of Mice and men' (John steinbeck)-How do we determine the potential for immunotoxicity in humans?
PURPOSE: Immunotoxicology is most simply defined as the study of adverse effects on the immune system resulting from exposure to drugs, environmental and industrial chemicals, and in some instances, biological materials. The science of immunotoxicology has validated animal models to conduct risk assessment. However, approaches to characterize immunotoxicity in humans are poorly defined. Animal models have indicated that a primary immune response is most predictive of immunotoxicity. Because vaccines can trigger a primary immune response, this approach may have utility in humans. The purpose of this project was to determine if the response to the influenza vaccine can be validated as an objective measurement of immune status in the workplace.METHODS: We randomly selected employees to receive the influenza vaccine and employees, matched according to age and gender, to receive the placebo. The participants (32 test group and 19 placebo group) completed a brief questionnaire to identify potential confounding factors. Specific anti-influenza antibodies were measured in the serum via an ELISA 30 days after administering the vaccine or placebo.RESULTS: Only 50% (16 of 32 subjects) produced a positive response which is defined by the Centers for Disease Control as a four-fold increase in serum titers. Not unexpectedly, all samples contained antibody to influenza prior to vaccination, and a number of the participants who did not achieve a positive response started with high serum titers.CONCLUSIONS: The influenza vaccine was originally selected for this study because of costs, acceptability to the population and proven safety and efficacy. However, the results of the present investigation suggest that this approach will have little utility as a workplace monitor of human immunotoxicity because most individuals would not be making a primary antibody response. Other technical limitations with the influenza vaccine will be presented; and the alternatives for other biomonitors of human immunotoxicity will be discussed.
Journal Article↗
The public's response to the obesity epidemic in Australia: weight concerns and weight control practices of men and women.
OBJECTIVE: : To assess weight perceptions, weight concerns and weight control behaviours and related beliefs in a representative sample of adults. DESIGN: : Cross-sectional postal survey. SETTING: : The survey was conducted between October and December 1997 in the state of Victoria, Australia. SUBJECTS: : A total of 2500 subjects were selected at random from the Australian electoral roll; 900 provided usable responses. RESULTS: : At the time of the survey, 2.7% of respondents were trying to gain weight, 26.6% were trying to avoid gaining weight, 22.9% were trying to lose weight and 47.9% were not doing anything for their weight. Men (47.2%) were less likely than women (55.3%) to be attempting any form of weight control. Watching the type of food eaten (95.6%), reducing dietary fat intake (87.3%) and engaging in physical activity or exercise (84.4%) were the most common weight control strategies used. Potentially harmful strategies, such as self-induced vomiting and smoking, were used by relatively few respondents. Many adults believed that vigorous activity (26.8%) and total omission of fat from the diet (35.3%) are necessary in order to lose weight. CONCLUSIONS: : Attempts at weight control are common in the community. However, many men, including men who are already overweight, appear to be unconcerned about their weight. Obesity prevention initiatives should attempt to influence individuals' weight-related beliefs and behaviours, as well as seeking to change policies and environments to better support weight control.
Adult↗
Physical activity beliefs and behaviours among adults attempting weight control.
OBJECTIVE: To compare the frequency and duration of varying intensities of physical activity performed by adults trying to lose weight, avoid gaining weight and not actively trying to control their weight, and to compare these groups' beliefs about the physical activity they should perform. METHOD: Random postal survey of 2500 Victorian adults selected from the Australian electoral roll (response rate=42%). MEASURES: One-week physical activity recall (frequency and duration of walking, other moderate activity and vigorous activity), BMI (based on self-reported height and weight) and weight-control behaviour. RESULTS: At the time of the survey, 27% of respondents were actively trying to avoid gaining weight, 23. 9% trying to lose weight and 49.1% undertaking no weight control. Respondents spent a mean time of 4.0 (+/-7.1) h walking, 5.5 (+/-7. 9) h in moderate activity and 3.1(+/-5.9) h in vigorous activity during the week prior to the survey. Women trying to lose weight or avoid gaining weight engaged in vigorous activity more often than women not trying to control their weight. After adjusting for age, education and BMI, women trying to avoid gaining weight were 2.4 times more likely, and women trying to lose weight 2.5 times more likely, to have met current physical activity guidelines than women undertaking no weight control. On average, respondents believed they should spend 5.2 (+/-6.9) h walking, 6.5 (+/-8.2) h in moderate activity and 4.3 (+/-6.5) h in vigorous activity each week. Women trying to lose weight felt they should perform vigorous activity more often than other women. Weight-control behaviour was not associated with physical activity beliefs and behaviours of men. CONCLUSION: Walking is a common activity among adults attempting weight control. However, many men and women do not fully recognize the value of moderate-intensity physical activity. Future efforts should be directed at promoting the role of moderate-intensity activity in weight control, particularly activity that can be performed outside of planned activity sessions. International Journal of Obesity (2000)24, 81-87
Adult↗
Effect of some electrical stimulation variables on wing flapping, post-mortem glycolysis and eating quality characteristics of broiler pectoralis major muscle.
1. The influence of different rates of wing flapping on the rate of post-mortem glycolysis in the Pectoralis major (PMI) muscles of commercially-processed broilers was investigated. This was achieved by applying 300 pulses of low voltage electrical stimulation (ES) shortly after slaughter at various frequencies and pulse widths. The rate of post-mortem glycolysis was assessed by measuring muscle pH values at 20 min post mortem (pH(20 min)). 2. ES gave a mean pH(20 min) value of 6.01, significantly lower than that of the control carcases which had a mean value of 6.45. Within ES treatments, variation in pulse frequency between 1/s and 10/s and in pulse width from 5 to 20 ms had no influence on pH(20 min) values as measured by direct probe. However, differences between mean pH(20 min) values attributable to pulse frequency were detected when measured by the iodoacetate method. 3. A further experiment was carried out to determine how different rates of wing flapping would affect the eating quality of PM muscles from commercially-processed broilers stored at chill temperatures for 24 h post mortem. This was achieved by using pulse frequencies of 1/s, 5/s and 10/s, all other ES variables being standardised. Pulse frequency had no effect on ultimate pH, sarcomere length, cooking loss or tenderness of PM muscle compared to controls. 4. We concluded that the rate of wing flapping post-slaughter has no effect, per se, on the extent of post-mortem glycolysis in broiler PM muscle or on its subsequent meat quality assessed after holding the carcases under chill storage conditions for 24 h.
Animals↗
Xplore mRNA assays for the quantification of IL-1 beta and TNF-alpha mRNA in lipopolysaccharide-induced mouse macrophages.
Because the accurate measurement of a number of cytokine mRNA transcripts provides valuable knowledge about cytokine gene regulation, we have developed the Xplore assay for the quantification of cytokine mRNA. This microplate-based assay is rapid (under four hours), quantitative over three orders of magnitude and carries no risk of false-positive values from contamination with amplified target. Here, we describe the use of Xplore assays to measure the steady-state mRNA levels of TNF-alpha and IL-1 beta produced by mouse WEHI and J774 macrophage-like cell lines.
Animals↗
The measurement of IgA and IgG transglutaminase antibodies in celiac disease: a comparison with current diagnostic methods.
Celiac disease (CD) is an inflammatory disorder of the small intestine induced by cereal prolamins. The demonstration of IgA endomysial antibodies (EMA) is currently the most reliable serological screen for CD. The antigenic target is transglutaminase. The aim of this study was to develop an ELISA assay for the detection of antibodies to transglutaminase (TGA), and to assess the sensitivity and specificity of TGA for the detection of celiac disease against the benchmarks of jejunal biopsy, antigliadin antibodies (AGA) and EMA. Sera from 57 patients with celiac disease were tested for IgA and IgG TGA, IgA EMA, IgA and IgG AGA, and the total IgA level. The sensitivity, specificity, predictive value and concordance of AGA, EMA and TGA were assessed against the gold-standard biopsy result. IgG plus IgA TGA offered 100% sensitivity in CD patients for whom no dietary intervention had been commenced, with a specificity of 61%. The sensitivity of TGA dropped from 100 to 79% after dietary restriction. In patients on no gluten restriction, there was 100% agreement between TGA and EMA, and 100% agreement between TGA and AGA for the IgA isotype. The false-positive rate for TGA was 53% in Down's syndrome patients and 25% in patients with systemic autoimmune disorders. We conclude that testing for TGA is a reliable diagnostic serology for celiac disease, with improved sensitivity compared with established methods. The results suggest that serial TGA measurements may be a more and accurate marker for dietary compliance than AGA, but prospective studies are required.
Autoantibodies↗
Renal function in chronically catheterized conscious diabetic rats using constant and servo-controlled infusion.
1. Infusion experiments were performed on chronically catheterized conscious rats to assess kidney function before and after the induction of diabetes mellitus with streptozotocin. 2. Two infusion regimens were used, a conventional constant-infusion protocol and a novel computer-driven, servo-controlled fluid replacement technique. The latter enables body fluid status to be maintained throughout a study occasion by servo-controlled replacement of spontaneous urinary fluid losses. 3. The chronically catheterized conscious rat infused using a servo-controlled system appears to be the optimum model for a study of diabetic renal function. The conscious preparation circumvents problems associated with anaesthesia and acute surgery. The servo-controlled infusion protocol maintains the altered fluid status of the diabetic condition. Both hyperfiltration and polyuria, characteristics of human diabetes often absent in anaesthetized and/or constantly infused diabetic rats, were seen in all conscious servo-controlled diabetic animals. 4. The new regimen enables a more accurate assessment of renal function in experimental diabetes than with previous protocols. It should prove useful in future studies, particularly those assessing the role of anti-diabetic drugs on the kidney.
Animals↗