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Biomedical subjects

C Fox

Publications and source records attributed to C Fox.

At least 73 records · Page 4Linked to original sources
PubMed1998

Current microbiological status of 'health foods' sold in Canada.

A follow-up survey was conducted across Canada to evaluate the current status of 'health foods' sold in Canada. A total of 1239 sample units of 'health foods' were analysed for a variety of bacteria, including aerobic colony counts (ACC), coliforms, aerobic and anaerobic sporeformers, Escherichia coli and Bacillus cereus. Results presented indicate that 16.8-18.4% of the 'health foods' exceed ACC guidelines, 16.0-17.8% exceeded coliform guidelines, 35.7% exceeded aerobic sporeformer guidelines, 81.4% exceeded anaerobic sporeformer guidelines, and 9% exceeded B. cereus guidelines. Some ACC were further identified and found to be opportunistic pathogens, including the genera Bacillus, Enterococcus, and Staphylococcus. It was concluded that more extensive surveillance of this industry by health officials is needed.

Bacillus↗
PubMed1998

Comparison of throat swabs with sputum specimens for the detection of Chlamydia pneumoniae antigen by direct immunofluorescence.

AIM: To compare throat swabs with sputum specimens for Chlamydia pneumoniae antigen detection. METHODS: During a one year period, sputum and throat swabs from 50 patients over 15 years of age with acute or persisting lower respiratory tract infection were examined for C pneumoniae antigen by direct immunofluorescence. RESULTS: C pneumoniae antigen was detected in 18/50 patients (36.0%) from sputum, throat swab, or both. Paired sputum and throat swabs were received from 35/50 patients (70.0%). C pneumoniae antigen was detected in either or both specimens from 14/35 patients (40.0%). Of the 14 positive patients, both specimens were positive in nine (64.3%), throat swab only in four (28.6%), and sputum only in one (7.1%). Of the remaining 15 patients from whom only a single specimen was sent, a further three of eight throat swabs and one of seven sputum specimens were positive. There was no statistically significant difference between the results obtained from the two types of specimen. CONCLUSIONS: Throat swabs may be as good as sputum for the detection of C pneumoniae antigen.

Adolescent↗
PubMed1998

Long-term reduction in asthma morbidity following an asthma self-management programme.

The adult "credit card" asthma self-management plan has been shown to be an effective and acceptable system for reducing asthma morbidity when introduced as part of a 6 month community-based asthma programme. The aim of the present study was to assess the effectiveness of the credit card plan 2 yrs after the end of the programme. Markers of asthma morbidity and use of medical services were compared during the 12 months before enrolment, and 2 yrs after completing the 6 month asthma programme. Of the 69 participants who originally enroled in the 6 month asthma programme, 58 were surveyed 2 yrs after completion of the programme. These participants showed a significant improvement in all but one of the asthma morbidity measures. The proportion waking most nights with asthma in the previous 12 months decreased from 29 to 9% (p=0.02), emergency visits to a general practitioner decreased from 43 to 16% (p=0.001), hospital emergency department visits with asthma decreased from 19 to 5% (p=0.02) and hospital admissions decreased from 17 to 5% (p=0.04). Only 24% of patients reported that they usually monitored their peak flow rate daily, but this increased to 73% during a "bad" attack of asthma. A long-term reduction in asthma morbidity and requirement for acute medical services can result following the introduction of the adult credit card asthma self-management plan. Adult patients with asthma are most likely to undertake peak flow monitoring preferentially during periods of unstable asthma, rather than routinely during periods of good control.

Adult↗
PubMed1997

Macrophages as a source of HIV during opportunistic infections.

The source of increasing viremia that characterizes the latter stages of human immunodeficiency virus (HIV) disease has remained a paradox because it occurs at a time when lymphoid tissue is quantitatively and qualitatively impaired, and the patients' CD4 T lymphocytes are steadily declining. Here, macrophages, both infected and uninfected with common opportunistic pathogens of HIV disease such as Mycobacterium avium complex and Pneumocystis carinii, were identified as highly productive sources of HIV in coinfected lymph nodes. These observations indicate that tissue macrophages are not only infected with HIV, but that common pathogens of HIV disease can dramatically increase their production of virus. Thus, prevention or successful treatment of opportunistic coinfections, or both, potentially benefits the patient twofold by limiting the pathology caused by opportunistic infection and by controlling induction of HIV replication.

AIDS-Related Opportunistic Infections↗
PubMed1997

Motor-vehicle crash-injury risk factors among American Indians.

The rates of motor-vehicle crash mortality are highest among American Indians and Alaska Natives, compared to other ethnic groups. The aim of this study was to compare risk factors for motor-vehicle crashes and occupant injuries between rural and urban American-Indian (AI) drivers, and between rural AI and non-AI rural drivers. A statewide traffic-accident database was linked to the Indian Health Service patient-registration database to identify crashes that involved American-Indian drivers. Using a cross-sectional design, crashes occurring in a two-county region during 1989 and 1990 were studied. A total of 9329 motor-vehicle crashes involving 16,234 drivers and 6431 passengers were studied. Two percent of drivers were American Indian. Compared to American-Indian drivers in urban crashes, rural crashes involving American-Indian drivers were more likely to result in injury or death (38% vs 64% p < 0.001). The difference in risk for crashes between urban and rural non-AI drivers was not as high (42% vs 33%). Only 44 percent of rural American-Indian motor-vehicle occupants reported wearing seat belts, compared to 70 percent of urban American-Indian occupants (p < 0.05). Rates of driver alcohol impairment, as assessed by the police, were much higher among AI drivers and highest among rural AI drivers. We conclude that, compared to non-American-Indian drivers, AI drivers are less likely to be restrained and more likely to be alcohol-impaired at the time of the crash. These risks are higher among rural AI drivers than urban AI drivers.

Accidents, Traffic↗
PubMed1997

An open trial of moclobemide in the treatment of post-traumatic stress disorder.

Traditional monoamine oxidase inhibitors have shown efficacy in the treatment of post-traumatic stress disorder, but their use is limited by some serious drug and food interactions. Moclobemide, which is a reversible inhibitor of monoamine oxidase-A, is relatively free of these limitations and is therefore potentially useful in the treatment of post-traumatic stress disorder. Twenty patients who met Diagnostic and Statistical Manual of Mental Disorders, Third Edition Revised (DSM-III-R) criteria for post-traumatic stress disorder were entered into a 12-week open study with moclobemide. Assessments were completed every 4 weeks. Eleven participants no longer met DSM-III-R criteria for post-traumatic stress disorder by week 12. The severity of post-traumatic stress disorder reduced by 2.09 SD (95% confidence interval 1.49-2.69; p < 0.001) and functional impairment improved by 1.08 SD (95% confidence interval 0.46-1.69; p < 0.01). Adverse events were minimal. Controlled, double-blind studies should be considered to confirm these findings.

Adult↗
PubMed1997

Development and validation of a computerized screening test for personality disorders in DSM-III-R.

The available self-report instruments designed to measure personality disorder (PD) are time-consuming to administer and/or score and can be impractical for routine clinical use. There is a need for a computerized method of personality assessment based on contemporary systems of classification. A computerized DSM-III-R-based questionnaire was developed and validated against the structured clinical interview for DSM-III-R Axis-II disorders on a sample of 60 subjects. The computerized test showed moderate validity as a diagnostic instrument (mean kappa coefficient = 0.47). With adjusted cut-off scores it was valid as a screening instrument (mean sensitivity = 0.87). Antisocial, borderline and avoidant PD scores were strongly correlated across measures and not subject to significant observer bias.

Adult↗
PubMed1997

Lancefield grouping and smell of caramel for presumptive identification and assessment of pathogenicity in the Streptococcus milleri group.

AIM: To evaluate Lancefield grouping and caramel smell for presumptive identification of the Streptococcus milleri group, and to find whether Lancefield group, species, or protein profile correlated with virulence or infection site. METHODS: Prospective studies were made of 100 consecutive streptococcal isolates in blood cultures or pus from 100 patients in whom the severity of infection was categorised as serious, moderate, or not significant. The usefulness of Lancefield group and the caramel smell for presumptive identification was examined, and the relation of the S milleri species, Lancefield group, and SDS-PAGE protein analysis to severity of infection and infection site was investigated. Lower respiratory tract and genital tract specimens, strict anaerobes, group D streptococci, and strains identified as Streptococcus pneumoniae, Streptococcus pyogenes, or Streptococcus agalactiae were excluded. RESULTS: Most streptococci occurring in pure or significant growth density were S milleri group (87/100; 87%, 95% confidence interval 0.81-0.93). Of these, 89.7% (78/87; 0.84-0.96) were associated with infection. Lancefield group F antigen predominated (41/87; 47.1%, 0.38-0.56). Lancefield group F alone or accompanied by the caramel smell had a specificity of 100%, but a sensitivity of only 47.3% for group F alone, and 19.5% for group F accompanied by the caramel smell. There was no significant association between species, Lancefield group, and severity of infection, site of infection, or pathogenicity. SDS-PAGE analysis failed to discriminate between strains. CONCLUSIONS: Neither species nor Lancefield antigen was related to the site of infection. The presence of Lancefield group F antigen alone or accompanied by a caramel smell was a useful indicator for the S milleri group when present, but was too insensitive to use as a screening test. Most streptococci occurring in pure culture or in significant growth density were of clinical importance. Such organisms should be identified to species level to detect the S milleri group.

Bacterial Proteins↗
PubMed1997

A confirmatory factor analysis of the structure of tacit knowledge in nursing.

The purpose of this study was to examine the structure of tacit knowledge in the nursing profession. Using research in implicit learning and practical intelligence as a theoretical framework, a paper-and-pencil measure of tacit knowledge for nurses was developed and refined. Five models, each representing an established theory of traditional intelligence, were compared in terms of fit to the data. The results of the confirmatory factor analysis suggest that Model 3, a hierarchical model of intelligence, was the most plausible representation of tacit knowledge in nursing. The results indicate that the portion of managerial decision making learned implicitly on the job is mainly accounted for by managing tasks and others. Suggestions for nursing education include teaching effective strategies for managing tasks, such as handling increased workloads, establishing priorities, and delegating responsibility.

Decision Making↗
PubMed1996

Dopaminergic regulation of progesterone receptors: brain D5 dopamine receptors mediate induction of lordosis by D1-like agonists in rats.

To characterize the signaling pathway by which the neurotransmitter dopamine modulates progesterone receptor (PR) activation, the steroid-dependent behavior lordosis was used in estrogen-primed ovariectomized Sprague-Dawley rats with stereotaxic implanted third ventricle cannulas. Lordosis was observed in response to solicitous males in females after central administration of the D1-like agonist SKF38393 and three of its analogs (SKF77434, SKF75640, and SKF85174). In contrast, D1-like antagonist SCH23390 and D1-like/D2 repopulation inhibitor EEDQ blocked behavior inducible by the D1-like agonists. Further, antisense oligonucleotides to D5, but not D1, dopamine receptor mRNA suppressed reproductive behavior associated with D1-like stimulation. This finding provides strong evidence that dopaminergic modulation of lordosis is mediated by the novel D5 dopamine receptor. Although D1, but not D5, dopamine receptor mRNAs were detected in the ventromedial nucleus (VMN) by in situ hybridization, agonists microinjected into the VMN, but not into the arcuate nucleus or preoptic area, induced lordosis, suggesting the functional presence of D5 dopamine receptors in the VMN. Also in support, D5 receptor mRNA antisense microinjected into the VMN blocked the subsequent induction of lordosis by D1-like agonists. Finally, facilitation of sex behavior by D1-like agonists was blocked by the antiprogestin RU38486 and PR antisense oligonucleotide. Collectively, the data provide strong evidence for dopaminergic modulation of reproductive behavior through D5 dopamine receptor-mediated modulation of PR-dependent behavior in rat CNS.

Animals↗
PubMed1996

Comparison of virus burden in blood and sequential lymph node biopsy specimens from children infected with human immunodeficiency virus.

BACKGROUND: Lymph nodes serve as reservoirs for the replication of human immunodeficiency virus (HIV) type 1. Comparison of serial measurements of virus burden in lymph nodes and peripheral blood after a change in antiretroviral therapy may provide insights into pathogenic mechanisms and permit a more accurate assessment of a therapeutic response. STUDY DESIGN: Nevirapine was added to the drug regiment of eight children with HIV infection treated with the combination of zidovudine and didanosine who had increasing levels of serum p24 antigen. Lymph node biopsies were performed at entry and after 12 weeks of therapy. RESULTS: Neither CD4 counts nor p24 antigen level correlated with the degree of viremia as measured by ribonucleic acid copy numbers in plasma. Correlations were found between HIV DNA copy number in peripheral blood mononuclear cells and HIV DNA copy number in lymph nodes (p = 0.02), as well as between peripheral blood CD4 counts and lymph node architecture. The HIV signals in the lymph nodes conformed to the anatomic organization of apical light zones in the germinal centers; however, in more advanced disease stages, organized germinal centers disappeared as evidence by a decline in the extent of the follicular dendritic network. CONCLUSIONS: Lymph node biopsies in this small number of HIV-infected children revealed a progressive loss of an organized architecture, especially of the follicular dendritic network. This correlated with a progressive loss of CD4+ cells but not with other measures of disease stage, including viral load, as measured by ribonucleic acid copy numbers.

Antiviral Agents↗
PubMed1996

Health-related quality of life as an outcome for patients with heart failure.

The Agency for Health Care Policy and Research Clinical Practice Guidelines on heart failure recommends that providers assess patients' health-related quality of life (HRQOL) and recommends using HRQOL information to modify treatment and guide patient and family teaching to facilitate adaptation to heart failure. This research column reviews eight studies that measured HRQOL as an outcome for patients with medically managed heart failure.

Activities of Daily Living↗