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Biomedical subjects

D Allen

Publications and source records attributed to D Allen.

At least 109 records · Page 6Linked to original sources
PubMed1996

Surgical treatment of subchondral cyst-like lesions in the tibia of an adult pony.

A 13 year-old pony was evaluated because of right hind limb lameness of acute onset. Radiographs of the right tarsus obtained shortly after the onset of lameness were normal, but results of nuclear scintigraphy were abnormal. Two radiolucent subchondral cyst-like lesions of the distal part of the tibia were seen on radiographs obtained 9 months later. The lesions were surgically decompressed, and the pony was sound 1 year later. It is hypothesized that a traumatic insult created a crack or split in the articular cartilage that allowed subsequent development of the cyst-like lesions.

Animals↗
PubMed1996

Laparoscopy during pregnancy.

OBJECTIVE: To compare the safety and efficacy of laparoscopic surgery with that of open laparotomy in pregnant patients. DESIGN: Six-year case-control study. SETTING: Tertiary care, university and community hospitals. PATIENTS: Population-based sample. From 1990 through 1995, 16 pregnant patients underwent laparoscopic surgery (study group) and 18 underwent open laparotomy (control group) during the first or second trimester. Follow-up ranged from 1 month to 6 years. INTERVENTION: In the study group, 4 patients underwent appendectomies and 12 underwent cholecystectomies. The control group included 7 appendectomies and 11 cholecystectomies. MAIN OUTCOME MEASURES: The 2 groups were compared for age, trimester, surgical time, oxygen saturation, end-tidal carbon dioxide, return of gastrointestinal tract function, duration of intravenous or intramuscular narcotics, postoperative stay, gestational age of delivery, 1- and 5-minute Apgar scores, birth weights, and complications. RESULTS: Age, trimester, oxygenation, end-tidal CO2, gestational age at delivery, Apgar scores, and birth weights were not different between the 2 groups. The patients who underwent laparoscopy had significantly longer operative times 82 vs 49 minutes), shorter stay (1.5 vs 2.8 days), earlier resumption of regular diet (1.0 vs 2.4 days), and shorter duration of intravenous or intramuscular narcotics (1.2 vs 2.6 days) (all P < .01). Four complications were found in the laparotomy group vs 6 in the laparoscopy group. CONCLUSIONS: Laparoscopic surgery in pregnant women significantly decrease hospitalization, decreases narcotic use, and quickens return to a regular diet when compared with open laparotomy in pregnant women. No significant differences between the 2 groups in perioperative morbidity or mortality were present. These data suggest that therapeutic laparoscopy during pregnancy in the first or second trimester is safe.

Adolescent↗
PubMed1996

Diagnosis and classification in autism.

This study compared four systems for the diagnosis of autism (DSM-III, DSM-III-R, DSM-IV, and ICD-10) with two empirically derived taxa of autism, and with three social subgroups of autism (Aloof, Passive, and Active-but-Odd) in 194 preschool children with salient social impairment. There were significant behavior and IQ differences between autistic and other-PDD groups for all four diagnostic systems, and a significant association was found (a) for Taxon B, diagnoses of autism, and the Aloof subgroup, and (b) for Taxon A, other-PDD, and the Active-but-Odd subgroup. Findings offer support for two major overlapping continua within idiopathic Pervasive Developmental Disorder.

Algorithms↗
PubMed1996

Development of grating acuity and contrast sensitivity in the central and peripheral visual field of the human infant.

Central and peripheral visual functions were measured simultaneously in 39 infants from 10 to 39 weeks old using a dual-frequency VEP technique. Central acuity and contrast sensitivity over a 4 deg circular field were measured at 6 or 8 Hz. Peripheral acuity and contrast sensitivity were measured simultaneously at the other rate with a semi-circular stimulus extending from 8 to 16 deg. The EEG was analyzed at 12 and 16 Hz to determine the separate responses for the central and peripheral fields. Both central and peripheral VEP acuity developed over the age range tested. Central acuity improved by about a factor of 2.6 over the age range tested, while peripheral acuity improved by about a factor of 2.2. Central acuity was always higher by an average factor of about 2.3. Contrast sensitivity showed similar development for the central and peripheral fields with an early rapid rise in sensitivity.

Adult↗
PubMed1996

Assessing risk in families affected by substance abuse.

A new instrument assessing risk in substance abuse-affected families is presented. The instrument assesses those dimensions of substance abuse that make it more difficult for parents to meet the basic needs of their children. It also assesses those components of the parent's environment that may increase risk to the family's well-being. Information is presented on the instrument's reliability and validity. The article concludes with a discussion of the issues involved in assessing the risk for child abuse and neglect in families where there is an identified substance abuse problem.

Adult↗
PubMed1996

Instrumentation and techniques in equine gastrointestinal surgery.

Recent advances in abdominal surgical techniques in the horse have resulted in improved survival rates and reduced postoperative morbidity. The development of abdominal surgical procedures in horses has paralleled the development of safe anesthetic protocols and innovative technological advancements in humans. Irrespective of the species, the application of sound surgical principles is still the foundation of surgical intervention. This article describes recent advances in equine gastrointestinal surgical techniques. The availability and application of innovative intestinal surgical devices and their specific uses in equine gastrointestinal surgery are also described.

Anastomosis, Surgical↗
PubMed1996

Generation of a panel of related human scFv antibodies with high affinities for human CEA.

BACKGROUND: A human single chain Fv (scFv) specific for human carcinoembryonic antigen (CEA) has been isolated from a 2.0 x 10(9) phage display library from unimmunised human donors. The dissociation constant of the scFv has been measured by surface plasmon resonance (SPR) and found to be 7.7 x 10(-9) M, with an off-rate component of 6.2 x 10(-3) s-1. In order to investigate directly whether increased affinity leads to improved targeting of CEA-positive tumours, this scFv has been affinity matured by both targeted mutagenesis of the CDRs of heavy and light chains, and by light chain shuffling. STUDY DESIGN: A partial randomisation scheme, biased towards amino acids commonly found as somatic mutations of germline antibody sequences, was used for directed diversification of VH and VL CDR3s. Diversification of the entire VL region was also introduced by light chain shuffling of the parental anti-CEA scFv. Selection of the mutagenised repertoires was carried out to enrich for antibodies with a reduced koff. RESULTS: Sequencing the selected clones identified a number of amino acid changes in the VH CDR3, one of which gave a four-fold reduction in koff. Stringent selection of the light chain shuffled library resulted in several clones with a two- to three-fold reduction in koff. It has been possible to combine the selected changes from both mutagenesis approaches by using the mutagenised heavy chain and a light chain derived by shuffling to give a human scFv with a dissociation constant for human CEA of 6.0 x 10(-10) M. CONCLUSION: A panel of human anti-CEA scFvs has been generated with differing dissociation constants for antigen, which will allow the correlation between tumour targeting efficiency in relation to binding affinity to be assessed directly. The scFv panel will be valuable in the optimisation of human antibodies for immunotherapy.

Amino Acid Sequence↗
PubMed1996

Surfactant therapy prior to the interhospital transport of preterm infants.

The risk-to-benefit ratio of surfactant treatment of outborn preterm infants prior, as opposed to after, transportation to a perinatal center is not known. The objective of this study was to document current practice and to examine clinical outcomes in North America. In phase I (December, 1991 to January, 1992) questionnaires were distributed to 114 perinatal centers in the United States and Canada. The centers returned 98 surveys. Over half (50.5%) of the centers report giving surfactant rescue prior to infant transport, but only a minority (9.5%) of the centers report doing so for prophylaxis. In phase II (January, 1992 to December, 1992), clinical outcomes of surfactant-eligible babies requiring interhospital transport at a university hospital were evaluated to determine which infants ultimately received surfactant and when. The infants were compared between groups and did not differ significantly in gestational age, birthweight, sex type, number of multiple births, five-minute Apgar scores, or whether antenatal steroids were used. In phase II, the 66 consecutive, ventilator-dependent, outborn infants with average, and median, gestational age of 28 weeks were compared. The infants receiving surfactant prior to transport, when compared to the infants that got it after transport (9 hours later), did not do any better. There was 6% more survival without bronchopulmonary dysplasia in the group receiving surfactant after transport (65.2% versus 59.3%, p = 0.665). The infants receiving surfactant after transport were off the ventilator sooner (95% C.I. 6.0-28.7 versus 11.8-25.9 days) and discharged from the perinatal center earlier (95% C.I. 37.8-70.8 versus 47.9-69.0 days). Furthermore, arterial blood gases before and after transport reveals that there were no short-term advantages in administering surfactant prior to transport when compared to waiting for reevaluation at the perinatal center. These findings suggest that surfactant can be used safely prior to the interhospital transport of preterm infants, but this treatment does not seem to confer benefit over waiting for reevaluation, and possible surfactant treatment, at the tertiary perinatal center.

Administration, Inhalation↗
PubMed1996

Are alcoholic women more likely to drink premenstrually?

A retrospective questionnaire study of alcoholic women attending a clinic for abstaining alcoholics, a voluntary agency and a drop-in centre for people with alcohol problems was conducted over a 2-year period. The women were asked whether they experienced premenstrual symptoms based on Halbreich et al.'s Premenstrual Assessment Form (PAF) [Halbreich et al. (1982) Acta Psychiatrica Scandinavica 65, 46-65] and were also administered the severity of Alcohol Dependence Questionnaire (SADQ). The results showed that one-third of women drank more premenstrually than at other times of the month. It is concluded that knowledge of high-risk times of the month can aid counselling for this group of women.

Adult↗
PubMed1996

Recent trends, future needs: management training for consultants.

Describes the results of a postal questionnaire survey of all 1,383 hospital consultants in the North Western Region of the UK in 1994; updating a similar survey conducted in 1987. In both surveys, consultants were asked to describe their current management role, management training received and any perceived future training needs. A series of open questions in the 1994 survey explored barriers and incentives to the take-up of management training. The results show that in 1994 more doctors were taking on greater management responsibility and from an earlier age. Consequently, the proportion of consultants expressing a need for management training had risen from 62 per cent in 1987 to 73 per cent in 1994. The most useful courses were local budgeting and business planning. However, many consultants described problems in accessing training. Concludes by highlighting policy implications arising from the surveys which will need to be addressed if consultants are to fulfil their management potential.

Education, Medical, Continuing↗
PubMed1996

Characterization of major depression symptoms in multiple sclerosis patients.

Retrospective review of affective disturbances in 238 patients with multiple sclerosis (MS) seen over a 6-month period revealed: 1) 51 patients (22%) received pharmacologic treatment for depressive symptoms during or within 4 years of the study period, and 17 (7%) received treatment for rapid mood swings; 2) among the 51 depressed patients, response rate to medication was extremely high; 3) relapse of depressive symptomatology after discontinuation of medication was also high (17/29); 4) first episodes of major depression frequently occurred during periods of MS progression or exacerbation, but first episodes also occurred during periods of relative clinical stability; 5) suicidal ideation was common (12 patients), but only 1 patient had a history of attempted suicide; and 6) side effects were tolerable in most patients.

Adult↗
PubMed1996

A community collaboration: the dental emergency assistance program.

The Dental Emergency Assistance Program is a collaboration between Michigan dentists and a United Way agency. The program's goal is to provide timely, accessible dental care to underserved people in a large metropolitan area. The authors analyzed the program's 1993 activities to determine sources of patient referrals, patients' demographic characteristics, and the types and value of services provided by participating dentists. The evaluation indicated that the Dental Emergency Assistance Program was successfully addressing the emergency dental needs of an underserved portion of the community.

Adolescent↗
PubMed1996

Occupational therapy in full-inclusion classrooms: a case study from the Moorpark model.

This article provides a historic review of the movement toward integrated classroom placements as well as the characteristics of full-inclusion classrooms relevant to occupational therapy school-based practice. A full-inclusion model adopted by the Moorpark Unified School District is described. This model incorporates occupational therapy as a vital and integral component of the school's inclusive education efforts.

Child↗
PubMed1995

Evidence that CD4+, but not CD8+ T cells are responsible for murine interleukin-2-deficient colitis.

Mice deficient in interleukin-2 production (IL-2null mice) develop colonic inflammation closely resembling ulcerative colitis in humans. Although this disease is marked by substantial infiltration of the colon by CD8+ and CD4+ T lymphocytes, no function has yet been assigned to these T cell subsets in the development of colitis in the IL-2null mouse. For the present study, we investigated the involvement of T lymphocytes in the onset of colitis in IL-2null mice, and examined the possible role played by cytotoxic T cells. Both lamina propria lymphocytes (LPL) and intraepithelial lymphocytes (IEL) of the colon of IL-2null mice were potently cytotoxic ex vivo in short-term redirected cytotoxic lymphocyte (CTL) assays. In contrast, colonic T cells of wild-type animals showed little or no constitutive cytotoxic T cell activity. Colonic CTL were detectable prior to the appearance of disease in IL-2null animals and CTL activity was confined to the TcR alpha beta, rather than to the TcR gamma delta IEL subset. IL-2null animals crossed with major histocompatibility complex class I-deficient mice [IL-2null x beta 2 microglobulin (beta 2mnull) mice] also developed colitis, which appeared even earlier than in most IL-2null mice. These findings suggest that neither CD8+ IEL nor LPL were causal in the onset of colitis in IL-2null animals. In IL-2null x beta 2mnull mice, an ulcerative colitis-like disease was evident from histological studies and immunohistological staining which showed very large numbers of CD4+ lymphocytes within the intestinal mucosa. Significant ex vivo killing by CD4+ T cells was observed in IL-2null x beta 2null animals, although this required an extended incubation time compared to colonic CD8+ T cells. Peripheral as well as colonic CD4+ T cells in IL-2null and IL-2null x beta 2mnull animals, were activated as judged by their cell surface phenotype (CD45RBlo, L-selectinlo and CD69+). In light of these findings, we propose that infiltrating CD4+, but not CD8+ T cells are central to the inflammation observed in the intestinal mucosa in IL-2null colitis.

Animals↗