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Biomedical subjects

C Potter

Publications and source records attributed to C Potter.

At least 19 recordsLinked to original sources
PubMed2005

Patients treated by dental students in outreach: the first year of a pilot project.

This paper describes the patients treated by 4th year undergraduate students during the first year of a pilot outreach course to teach Restorative Dentistry in community clinics in 2001-02. Data were collected from 908 summaries of patient treatment completed by the students, and from 139 patient questionnaires. Some 75% of patients were aged between 16 and 64, 58% were female, and 16% had dental phobia or anxiety. Most lived locally to the clinic and 41% made their initial contact as an emergency or drop-in. Some 37% made only a single visit (including children treated as emergencies) but 22% made six or more visits. Did not attend (DNA) was a problem and 18% of patients DNA to complete their treatment. Students undertook the full range of restorative procedures, with the emphasis on direct restorations, preventive treatment and advice, scaling, extractions and emergency treatment. Patients' main reasons for attending the clinic were lay recommendation, the need for treatment, convenience, free treatment, or the lack of access to a dentist. Some 30% said they did not have or did not know of an alternative source of dental care, and half had not seen a dentist for at least 2 years. The study demonstrates that despite difficulties related to attendance, a suitable patient base can be established offering students the opportunity to provide comprehensive care for adults in a primary care setting.

Adolescent↗
PubMed2001

Thirteen UDPglucuronosyltransferase genes are encoded at the human UGT1 gene complex locus.

The original novel UGT1 complex locus previously shown to encode six different UDP-glucuronosyltransferase (transferase) genes has been extended and demonstrated to specify a total of 13 isoforms. The genes are designated UGT1A1 through UGT1A13p with four pseudo ones. UGT1A2p and UGT1A11p through UGT1A13p have either nucleotide deletions or flawed TATA boxes and are therefore pseudo. In the 5' region of the locus, the 13 unique exons 1 are arranged in a tandem array with each having its own proximal TATA box element and, in turn, are linked to four common exons to allow for the independent transcriptional initiation to generate overlapping primary transcripts. Only the lead exon in the nine viable primary transcripts is predicted to undergo splicing to the four common exons generating mRNAs with identical 3' ends and transferase isozymes with an identical carboxyl terminus. The unique amino terminus specifies acceptor-substrate selection, and the common carboxyl terminus apparently specifies the interaction with the common donor substrate, UDP-glucuronic acid. In the extended region, the viable TATA boxes are either A(A)TgA(AA)T or AT14AT; in the original locus the element for UGT1A1 is A(TA)7A and TAATT/CAA(A) for all of the other genes. UGT1A1 specifies the critically important bilirubin transferase isoform. The relationships of the exons 1 to each other are as follows: UGT1A2p through UGT1A5 comprises a cluster A that is 87-92% identical, and UGT1A7 through UGT1A13p comprises a cluster B that is 67-91% identical. For the two not included in a cluster, UGT1A1 is more identical to cluster A at 60-63%, whereas UGT1A6 is identical by between 48% and 56% to all other unique exons. The locus was expanded from 95 kb to 218 kb. Extensive probing of clones beyond 218 kb with coding nucleotides for a highly conserved amino acid sequence present in all transferases was unable to detect other exons 1. The mRNAs are differentially expressed in hepatic and extrahepatic tissues. This locus is indeed novel, indicating the least usage of exon sequences in specifying different transferase isozymes that have an expansive substrate range.

Base Sequence↗
PubMed2000

The use of hypnosis in dentistry: a review.

Hypnosis is a valuable technique in patient management. With appropriate training, general dental practitioners can widen the treatment options they can offer to patients, especially those who are dentally anxious. This article provides a brief theoretical and historical overview, and a review of the literature pertaining to the clinical uses of hypnosis in dentistry.

Analgesia↗
PubMed1999

Squamous cell metastasis from the tongue to the myocardium presenting as pericardial effusion.

Cardiac metastasis from head and neck cancer is rarely encountered. We present a base-of-tongue squamous cell carcinoma with metastasis to the heart that was diagnosed antemortem. Autopsy series indicate that tongue cancer may metastasize more frequently to the heart than from other head and neck sites. However, none of these studies was controlled. Most importantly, cardiac metastasis should be suspected in any patient with cancer in whom new cardiac symptoms develop. The diagnosis is best confirmed with two-dimensional echocardiography or cardiac MRI. A myocardial or endocardial biopsy specimen can be obtained with angiographic guidance. Despite the improvement in diagnostic capability, available treatments are only palliative. All patients eventually die of their metastatic disease.

Biopsy, Needle↗
PubMed1999

Taste changes experienced by patients receiving chemotherapy.

PURPOSE/OBJECTIVES: To increase knowledge about the nature, frequency, and quality-of-life (QOL) effects associated with taste changes after chemotherapy. DESIGN: Cross-sectional, descriptive. SETTING: 11 outpatient urban and suburban oncology centers. SAMPLE: 284 adults who had received at least two chemotherapy cycles. METHODS: Patients completed a taste change questionnaire and the Functional Assessment of Cancer Therapy-General, and nurses collected demographic and disease-related information. Descriptive statistics, Spearman correlations, chi-square, Mann-Whitney, and Kruskal-Wallis one-way analysis of variance were calculated. FINDINGS: Taste changes were frequent and at least moderately severe for many patients, who often reported dry mouth, decreased appetite, nausea, and vomiting. Cisplatin and doxorubicin were the agents most likely to be related to severe taste changes and to have caused greater distress from taste changes, which also were associated with decreased QOL. Oncology nurses and physicians rarely discussed taste changes with patients, who often tried changing the ways they seasoned their food. CONCLUSIONS: Taste changes are a frequent and significant problem for patients receiving chemotherapy and have negative effects on patients' QOL. Oncology nurses and physicians typically do not offer self-management suggestions to patients. IMPLICATIONS FOR NURSING RESEARCH AND PRACTICE: Repeated-measures research may provide a clearer understanding of chemotherapy-associated taste changes over time. Studies to examine strategies suggested from this and other research as well as clinical literature may determine which self-care interventions are most useful. Nurses should inform patients that taste changes may occur following chemotherapy, provide self-management information, and assess for related problems that could increase chemotherapy morbidity.

Adult↗
PubMed1997

No effect of timing of biopsy in the menstrual cycle on incidence of bone marrow micrometastasis in patients with breast cancer.

BACKGROUND: The timing of breast cancer excision relative to the menstrual cycle has been debated to be of significant prognostic value. The differences in survival relative to the timing in the menstrual cycle have been attributed to the incidence of micrometastasis. METHODS: All patients underwent bone marrow aspiration after the diagnostic surgical biopsy, immediately before definitive surgery. The timing of the diagnostic surgical biopsy in the menstrual cycle was calculated according to Senie. Monoclonal antibodies to epithelium-specific antigens were used to detect bone marrow micrometastasis (BMM). RESULTS: This study reports on the effect of the phase of the menstrual cycle on incidence of BMM after surgical biopsy. Ninety-two patients with regular cycles underwent bone marrow aspiration an average of 12 days (range 0-32 days) after biopsy. Thirty-nine patients had undergone biopsy during the follicular phase and 53 patients during the luteal phase. BMM were detected in 31% of patients (29 of 92). We observed BMM in 33% of patients (13 of 39) in the follicular phase and in 30% of patients (16 of 53) in the luteal phase. This difference is not significant (p > 0.70). The mean number of cells detected and the presence of clumps of cells is similar in the two groups. CONCLUSIONS: The incidence and characteristics of bone marrow micrometastases are independent of the timing of diagnostic excision biopsy in the menstrual cycle.

Adult↗
PubMed1997

Genetic polymorphism in the human UGT1A6 (planar phenol) UDP-glucuronosyltransferase: pharmacological implications.

Two missense mutations were uncovered in the UGT1A6 (HLUG P1) cDNA which codes for a human phenol-metabolizing UDP-glucuronosyltransferase. The mutant and a wild-type UGT1A6 cDNAs were isolated from a custom synthesized human liver lambda Zap cDNA library. Both an A to G transition at nucleotide 541 (T181 A) and an A to C transversion at nucleotide 552 (R184S) occurred in exon 1 of the UGT1A6 (UGT1F) gene at the UGT1 locus. The two mutations on a single allele created a heterozygous genotype. Newly created BsmI and BsoFI sites at the T181 A and R184S locations, respectively, were confirmed by endonuclease treatment of PCR-generated DNA using the donor-liver genomic DNA as template. Screens with endonuclease treatment showed that 33/98 DNA samples were heterozygous with both mutations on one allele. One other individual also carried the R184S mutation on the second allele. Wild-type UGT1A6 generated a broad plateau of activity from pH 5.0 to pH 8.0 with certain experimental phenols, while activity was 1.3-2.5-fold higher at pH 6.4 than at pH 7.2 for others. UGT1A6*2 (181 A+ and 184S+) metabolized 4-nitrophenol, 4-tert-butylphenol, 3-ethylphenol/4-ethylphenol, 4-hydroxycoumarin, butylated hydroxy anisole and butylated hydroxy toluene, with the pH 6.4 preference, at only 27-75% of the rate of the wild-type isozyme whereas 1-naphthol, 3-iodophenol, 7-hydroxycoumarin, and 7-hydroxy-4-methylcoumarin were metabolized at essentially the normal level. Furthermore, UGT1A6*2 metabolized 3-O-methyl-dopa and methyl salicylate at 41-74% of that of the wild-type, and a series of beta-blockers at 28-69% of the normal level. This evidence suggests that the UGT1A6 enzyme activity is affected by different amino acids depending upon the substrate selection.

Alleles↗
PubMed1995

Activated protein C resistance in a neonate with venous thrombosis.

A term infant had a life-threatening inferior venal caval thrombosis during the first 24 hours of life. The plasma from the infant and his mother was found to be resistant to activated protein C and to be heterozygous for the factor V mutation (FV Leiden) associated with this disorder. The presence of this hereditary disorder should be considered in infants with thrombosis and in infants with conditions predisposing them to thrombosis.

Antithrombin III↗
PubMed1994

Sedation with meperidine and midazolam in pediatric patients undergoing endoscopy.

We conducted a randomized, double-blind trial evaluating the efficacy and safety of meperidine 2 mg.kg-1 (M) and meperidine 2 mg.kg-1 plus midazolam 0.05 mg.kg-1 (M + M) in 40 pediatric outpatients (age 1 to 17 years) undergoing upper endoscopy procedures. The physician and nurse performing the procedure were asked to rate cooperation, emotional status, drowsiness, and overall efficacy. A blinded observer recorded the frequency of negative behaviors indicating distress, vital signs, and oxygen saturation before, during, and after the procedure. No significant differences were noted in the overall efficacy of the regimens. Good or excellent efficacy was noted in 15 of 21 children (71%) in the M group and 15 of 19 children (79%) in the M + M group by physicians; nurses assigned a good or excellent rating for 14 of 21 (67%) and 13 of 19 (68%) in the M and M + M groups, respectively. Immediately following the procedure, amnesia was noted in 4 of 17 (23%) patients who received M versus 14 of 18 (78%) patients who received M + M (P = 0.002). Of the children who received M + M, the amnesia tended to occur more frequently in older children (> 11 years, 8 children, rate of amnesia 100%) than in younger children (< or = 11 years, 6 of 10 evaluable children, rate of amnesia 60%). There was no significant difference between the frequency of negative behaviors, rate of adverse effects, or changes in vital signs or oxygen saturation noted with the two drug regimens.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Deficiency of the human mitochondrial transcription factor h-mtTFA in infantile mitochondrial myopathy is associated with mtDNA depletion.

Recent studies show that patients presenting with cytochrome oxidase (COX) deficiency in infancy may have reduced mitochondrial DNA (mtDNA) in muscle. The human mitochondrial transcription factor A (h-mtTFA) may be an important regulator of both transcription and replication of mtDNA. h-mtTFA levels were investigated in cell lines which were either free of mtDNA (rho 0) or temporarily depleted by treatment with dideoxycytidine (ddC), and in tissue from three patients with mtDNA depletion and cytochrome oxidase deficiency. h-mtTFA was compared with other mitochondrial proteins such as pyruvate dehydrogenase and porin by Western blotting. The ratio of mtDNA and h-mtTFA mRNA to reference nuclear probes was measured by dual labelling of dot blots. The ratio of mtDNA to nuclear DNA in skeletal muscle was low in muscle in the three patients and in other tissues in one. h-mtTFA was low in cells depleted either permanently or transiently of mtDNA, and this reduction in h-mtTFA roughly paralleled mtDNA levels. Similarly, treatment of rho 0 cell lines with ddC induced a reduction in mtDNA as well as h-mtTFA protein. The relationship between h-mtTFA and mtDNA levels suggests that they may be causally linked. MtDNA depletion was accompanied by an increase in the level of h-mtTFA RNA in the cell lines but low levels in the patient. This suggests that either h-mtTFA regulates mtDNA levels, or that h-mtTFA expression may be regulated by a feedback mechanism initiated by MtDNA Depletion.

Base Sequence↗
PubMed1994

Cytokine response to respiratory syncytial virus stimulation of human peripheral blood mononuclear cells.

A key impediment to developing respiratory syncytial virus (RSV) vaccines is a lack of understanding of enhanced disease that occurred in children who received a formalin-inactivated RSV (FI-RSV) vaccine. Studies in mice have suggested that the FI-RSV vaccine induces a TH2 and live RSV induces a TH1 memory T cell response. In this study, the cytokine mRNA response of peripheral blood mononuclear cells (PBMC) from adults and children with and without previous RSV infection was characterized using a semiquantitative polymerase chain reaction (PCR). PBMC from 22 subjects previously infected with RSV usually had RSV-specific increases in TH1 cytokine-specific mRNA (interferon-gamma [IFN-gamma] mRNA, 20; interleukin [IL]-2 mRNA, 12; IL-5 mRNA, 6; and IL-4 mRNA, 0). PBMC from RSV antibody-negative children had no RSV-specific increases in IFN-gamma, IL-2, or IL-4 mRNA; 1 of 7 had an increase in IL-5 mRNA. These data indicate that naturally acquired RSV induces a TH1 memory T cell response.

Adolescent↗
PubMed1994

Continuous quality improvement in an acute hospital: a report of an action research project in three hospital departments.

Describes an action research project to improve quality in three hospital departments including operating theatres, X-ray, and medical records. The approach combined quality assurance (QA) or audit methods with those of continuous quality improvement (CQI) or TQM. The intention was to bring about improved organizational performance through an emphasis on bottom-up rather than top-down methodology, and to assess the relative effectiveness of different quality strategies being used within the hospital. Baseline studies of organizational climate and of patient perceptions enabled evaluation of effectiveness. Provides a description of the background to various health-care quality strategies, and argues that several perspectives are required if all stakeholders (e.g. policy makers, professionals, patients, and managers) are to be satisfied. Describes the responses of staff, superiors and professionals and recommendations offered for more effective quality strategy implementation.

Attitude of Health Personnel↗
PubMed1993

A method to quantify binding of unlabeled peptides to class I MHC molecules and detect their allele specificity.

A general method has been developed for measuring the stabilization of class I MHC molecules in extracts of the mutant cell lines .174/T2 and RMA-S. 35S-Met-labeled class I molecules which have been stabilized by peptides in vitro are immunoprecipitated with conformation dependent monoclonal antibodies and electrophoresed on polyacrylamide gels. The heavy and light chains are excised from the dried gel and quantified on a flat bed scintillation counter. The stabilizing effect of peptides on class I molecules in vitro correlates well with peptide binding measured by direct methods and can be therefore used to assess peptide binding affinity. We show that a peptide from HIV-1 gag (which has a high affinity for Db) is a CTL epitope restricted through Db, and also use the assay to analyse the effects of amino acid substitution on peptide affinity. In addition, the effect of a given peptide on a class I molecule within a mixture of human class I molecules can be distinguished by immunoprecipitation with the monomorphic antibody W6/32 and separation by 1-D isoelectric focussing. The technique therefore requires neither labeled peptide ligands nor allele-specific antibodies. It can be used to identify the peptide ligand of any human class I molecule, and gives a measure of peptide binding affinity. The technique should be of value in identifying epitopes recognized by CTL since we have found that these tend to bind with the highest affinities.

Alleles↗
PubMed1993

Left ventricular mass index and coronary artery disease in hypertensive black males.

Thallium-201 stress scintigraphy (TSS) and echocardiography were performed on 60 consecutive black male hypertensives and compared to 60 sex-, race-, and age-matched controls. We found a higher prevalence of left ventricular hypertrophy with repolarization abnormality in the hypertensive group; 32 of 60 (53%), compared to 10 of 60 (17%) of the controls, P < .05. Echocardiographically determined left ventricular mass index revealed a significantly higher mean value in the hypertensive group of 147 +/- 57 compared to 124 +/- 34 in the control group, P < .001. Thirty-one of 60 (52%) of the hypertensive group had a normal TSS compared to 22 of 60 (37%) of the controls. A total of 68 (38 fixed and 30 reversible) perfusion defects were noted in the hypertensive group compared to 74 (55 fixed and 19 reversible) in the controls. The severity of clinical syndromes associated with myocardial ischemia were noted in increased incidence in the presence of left ventricular hypertrophy and left ventricular mass index was noted to be predictive of severity of coronary disease independent of the standard risk factors.

Adult↗
PubMed1992

Heparin-induced thrombocytopenia in a child.

We describe a case of thrombocytopenia and deep venous thrombosis in a boy who received heparin to maintain patency of a central venous catheter. Measurement of the release of serotonin labeled with carbon 14 confirmed the presence of heparin-induced thrombocytopenia. Children receiving heparin therapy should be monitored for the possibility of heparin-induced thrombocytopenia.

Adolescent↗