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Biomedical subjects

C J Murray

Publications and source records attributed to C J Murray.

At least 19 recordsLinked to original sources
PubMed1992

Tuberculosis: commentary on a reemergent killer.

Tuberculosis remains the leading cause of death in the world from a single infectious disease, although there is little knowledge of the mechanisms of its pathogenesis and protection from it. After a century of decline in the United States, tuberculosis is increasing, and strains resistant to multiple antibiotics have emerged. This excess of cases is attributable to changes in the social structure in cities, the human immunodeficiency virus epidemic, and a failure in certain major cities to improve public treatment programs. The economic costs of not adequately addressing the problem of tuberculosis in this country are estimated from an epidemiological model.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Cost effectiveness of chemotherapy for pulmonary tuberculosis in three sub-Saharan African countries.

The value of programmes to control pulmonary tuberculosis in developing countries remains the subject of debate. We have examined the cost-effectiveness of chemotherapy programmes for the control of pulmonary sputum-smear-positive tuberculosis in Malawi, Mozambique, and Tanzania. Effective cure rates of 86-90% were achieved with short-course chemotherapy and of 60-66% with standard chemotherapy. The average incremental costs per year of life saved were US $1.7-2.1 for short-course chemotherapy with hospital admission, $2.4-3.4 for standard chemotherapy with hospital admission, $0.9-1.1 for ambulatory short-course chemotherapy, and $0.9-1.3 for ambulatory standard chemotherapy. Chemotherapy for smear-positive tuberculosis is thus cheaper than other cost-effective health interventions such as immunisation against measles and oral rehydration therapy. Because the greatest benefit of chemotherapy is reduced transmission of the bacillus, treating HIV-seropositive, tuberculosis smear-positive patients would be only slightly less cost-effective than treating HIV-seronegative, tuberculosis-smear-positive patients.

Ambulatory Care↗
PubMed1991

Cockroaches (Blatta and Periplaneta species) as reservoirs of drug-resistant salmonellas.

A total of 221 cockroaches (Blatta and Periplaneta spp.), collected in hospitals, houses, animal sheds, grocery stores and restaurants, in various parts of South Kanara District, a south-west coastal region of India, were studied bacteriologically for the presence of various salmonellas. Salmonellas were isolated from 4.1% of these cockroaches. Nine strains of salmonellas were recovered, belonging to five serotypes--Salmonella bovismorbificans, S. oslo, S. typhimurium, S. mbandaka and S. braenderup, the former two being the commonest serotypes. All salmonellas were resistant to one or other of 11 antibacterial drugs used in the susceptibility test. Isolation of salmonellas from cockroaches collected from the livestock premises and human dwellings suggested that they may act as significant reservoirs of salmonella in nature. Recovery of serotypes, phage types and R-types that were commonly isolated from humans and animals of this locality, suggested a transmission role for cockroaches. By harbouring potentially pathogenic, drug-resistant salmonellas, these wandering arthropods may pose dangerous infective hazards to humans and animals.

Animals↗
PubMed1991

Epidemiology of Salmonella sofia in Australia.

In recent years, the incidence of isolation of Salmonella sofia in Australia has risen from 33% of all poultry isolates in 1982 to a peak of 49% of isolates in 1988. A parallel rise has not been seen in S. sofia isolated from humans. In Israel, however, S. sofia has been commonly isolated from both humans and poultry. We investigated the possibility that the Israeli strains may belong to a different clonal group and express virulence determinants not seen in the Australian isolates, accounting for the apparent differences in the virulence seen within this species. A number of S. sofia isolates from Australian chickens and humans, as well as from Israeli humans and chickens, were compared by using sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis of outer membrane proteins, plasmid profiles, and restriction fragment length polymorphism analysis. No reproducible differences could be detected by analysis of outer membrane proteins. A small 6.4-kb plasmid, pIMVS2, was detected in all Australian isolates from chickens but not in the Israeli isolates. Restriction fragment length polymorphism studies with cosmid clones as probes provided the most discrimination among isolates, allowing us to divide them into seven groups. This technique revealed that significant differences exist between Australian and Israeli isolates and provided additional insights into the epidemiology of these Salmonella isolates.

Animals↗
PubMed1991

Social, economic and operational research on tuberculosis: recent studies and some priority questions.

Social, economic and operational research has already contributed to the growing global awareness of the neglected burden of tuberculosis on individuals, families and communities. These studies have also illustrated that short-course chemotherapy for smear-positive pulmonary tuberculosis is a highly cost-effective tool for combatting tuberculosis. In the present work, the author examines the costs and effectiveness of the national tuberculosis programmes in Malawi, Mozambique and Tanzania. Chemotherapy for smear-positive tuberculosis is found to be among the most cost-effective health interventions known, costing 1-4 US dollars per year of life saved. In all situations, short-course chemotherapy is found to be more cost-effective than standard 12-month chemotherapy. General conclusions about the role of hospitalization are difficult to make; its cost-effectiveness depends on local patterns of compliance and the cost of hospitalization. Because more than three-quarters of the benefits of chemotherapy for smear-positive tuberculosis are due to transmission reduction, treating HIV sero-positives, smear-positives is probably cost-effective.

Adolescent↗
PubMed1991

Salmonellae in the environment.

Salmonellae are part of the bacterial flora normally found in Man and animals, although the frequency of occurrence is variable, reflecting the general level of Salmonella in food, water and the environment. They are widely disseminated into environments which have been disturbed by human activities. Wildlife may harbour the organisms but do not appear to be a major conduit by which the organisms enter the human and animal food chain. In areas associated with Man, salmonellae in wild animals and birds reflect the serovars disseminated into the environment. Seasonal changes in infection occur, and the capacity of the organisms to survive in nature varies. Water plays an important role in the spread of the organisms to Man and animals. Control of salmonellae must start with a significant decrease in the number of organisms which are discharged into the environment.

Animal Feed↗
PubMed1991

Salmonella carriage rate amongst school children--a three year study.

As a part of three-years epidemiological survey of salmonellosis in South Kanara District, a southwest coastal region of India, an attempt was made to determine the human Salmonella carriage rate during the period between 1981 to 1983. One thousand and two asymptomatic school children 5 to 15 years of age, 42 restaurant employees and 17 dairy workers formed the subjects of this bacteriological study. The Salmonella carriage rate among healthy school children from a single fecal sampling was 1% and no Salmonellae were recovered from the feces of restaurant and dairy workers. Ten school children excreted Salmonellae which belonged to 6 different serotypes-Salmonella oslo, S. ohio, S. typhimurium, S. urbana, S. cerro and S. derby; S. oslo and S. ohio were the most frequent serotypes. No-S. typhi, S. paratyphi A or S. paratyphi B were recovered. All Salmonella strains recovered during this study were dual or multiple drug resistant, sulfadiazine and tetracycline resistance being commonly observed. The significance of excretion of potentially pathogenic, drug resistant Salmonellae by symptomless school children is discussed from public health point of view.

Adolescent↗
PubMed1990

Treatment adherence and risk of death after a myocardial infarction.

The relation of treatment adherence to mortality after a myocardial infarction was investigated among 2175 participants in the Beta Blocker Heart Attack Trial, which had data for measures of treatment adherence, clinical severity, and the psychological and social features that may influence post-infarction mortality. Overall, patients who did not adhere well to treatment regimen (ie, who took less than or equal to 75% of prescribed medication) were 2.6 times more likely than good adherers to die within a year of follow-up (95% confidence interval, 1.2, 5.6). Poor adherers had an increased risk of death whether they were on propranolol (OR = 3.1) or placebo (OR = 2.5). Furthermore, this increased risk of death for poor adherers was not accounted for by measures of the severity of myocardial infarction, sociodemographic features (eg, race, marital status, education), smoking, or psychological characteristics (high life-stress or social isolation).

Adult↗
PubMed1990

A study of financial resources devoted to research on health problems of developing countries.

The Commission on Health Research for Development is an independent, international commission composed of 12 leaders from the fields of health research, social science research and development policy. Chaired by John Evans, the other Commissioners are Gelia Castillo, vice-chair, F. H. Abed, Sune Bergstrom, Doris Calloway, Esmat Ezzat, Demissie Habte, Walter Kamba, Adetokumbo Lucas, Adolfo Martinez-Palomo, Saburo Okita and V. Ramalingaswami. The Commission began its work in November 1987, charged with analysing the strengths, weaknesses and gaps in current research on health problems of developing countries, and making proposals and promoting action for improvement. The Commission is sponsored by a variety of foundations, bilateral donor agencies, and international organizations. The Commission's report was published in the spring of 1990. As part of the work of the Commission Secretariat, we have undertaken a study of financial resources devoted to research on the health problems of developing countries. The study which began in May 1988 has three objectives: (i) To describe the current pattern of funding for research on the health problems of developing countries. (ii) To provide a baseline against which future trends and/or new programmes can be measured. (iii) To explore the possibility of an ongoing information system on research on health problems of developing countries.

Developing Countries↗
PubMed1989

Rapid freeze- and chemical-quench studies of dopamine beta-monooxygenase: comparison of pre-steady-state and steady-state parameters.

The copper-containing enzyme dopamine beta-monooxygenase has been studied with regard to pre-steady-state kinetics of tyramine hydroxylation and reduction of enzyme-bound Cu2+ by chemical- and freeze-quench EPR techniques. The bulk of the enzyme-bound copper (approximately 70%) is reduced in a single-exponential process with a limiting rate constant of 250 s-1, Km = 0.9 mM, consistent with participation of both copper ions in the redox events of catalysis. The remaining copper is reduced much more slowly (k approximately 2 s-1) or not at all, attributed to a distribution of copper into inhibitory binding sites and the presence of some inactive enzyme. Knowledge of the Cu2+ reduction rate, together with rate constants calculated from steady-state isotope effects [Miller, S. M., & Klinman, J. P. (1985) Biochemistry 24, 2114-2127], has allowed prediction of pre-steady-state product formation transients. Measurement of these transients under conditions of excess ascorbate shows close agreement with prediction, supporting the validity of individual rate constants obtained from steady-state data. Kinetic modeling shows further that the predominant steady-state enzyme form is the enzyme-product complex (E-P), which is expected to show a correspondingly large (approximately 70% of total copper) EPR signal for bound Cu2+. Surprisingly, the steady state is characterized by a low (19% of total copper) EPR signal. This lack of correlation between the anticipated and observed steady-state EPR signal suggests either antiferromagnetic coupling in binuclear copper centers or reduction of Cu2+ in this enzyme form by ascorbic acid.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

Hydrogen tunneling in enzyme reactions.

Primary and secondary protium-to-tritium (H/T) and deuterium-to-tritium (D/T) kinetic isotope effects for the catalytic oxidation of benzyl alcohol to benzaldehyde by yeast alcohol dehydrogenase (YADH) at 25 degrees Celsius have been determined. Previous studies showed that this reaction is nearly or fully rate limited by the hydrogen-transfer step. Semiclassical mass considerations that do not include tunneling effects would predict that kH/kT = (kD/kT)3.26, where kH, kD, and kT are the rate constants for the reaction of protium, deuterium, and tritium derivatives, respectively. Significant deviations from this relation have now been observed for both primary and especially secondary effects, such that experimental H/T ratios are much greater than those calculated from the above expression. These deviations also hold in the temperature range from 0 to 40 degrees Celsius. Such deviations were previously predicted to result from a reaction coordinate containing a significant contribution from hydrogen tunneling.

Alcohol Dehydrogenase↗
PubMed1988

The infant mortality rate, life expectancy at birth, and a linear index of mortality as measures of general health status.

The infant mortality rate is not a good indicator of overall mortality or health status. Based on new empirical life tables from the UN Population Division, it can only predict life expectancy with 95% confidence to within a 14-year range. Two infant mortality rates must be nearly 80 units apart to be 95% confident that life expectancy in the two communities is different. Life expectancy itself is not an ideal general measure of mortality, because it implicitly weights deaths at different ages in an inconsistent fashion. A measure of potential years of life lost is preferable because it is ethically more consistent.

Adolescent↗
PubMed1987

A critical review of international mortality data.

Mortality data have become increasingly important not only in health related studies but also in development studies as a whole. The demand for data on life expectancy and the infant mortality rate is met by five publications-the UN Demographic Yearbook, World Population Prospects, World Development Report, World Population Trends and Policies Monitoring Report, and World Population. Within these statistical publications, life expectancy and the infant mortality rate are available for nearly every country each year. However, recent empirical information on mortality in most developing exists only for a handful of countries. The estimates published in the World Development Report and World Population Prospects are based on old empirical data updated with assumed rates of improvement in mortality. Neither of these sources provide technical notes explaining the original data source, estimation technique, and updating model used. Fortunately, two sources, the World Population Trends and Policies Monitoring Report and World Population, publish only empirically based data clearly identifying source, year of applicability, and estimation technique. The work in the World Development Report and the World Population Prospects could be made more useful if they provided adequate technical documentation for each estimate. At present, the Monitoring Report and World Population are the only appropriate sources for quantitative analysis of mortality or of change in mortality.

Developing Countries↗