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Biomedical subjects

E Douglas

Publications and source records attributed to E Douglas.

At least 19 recordsLinked to original sources

Is occupational dermatitis being taken seriously by UK industries?

Occupational dermatitis is a considerable burden but little is documented concerning industry response to this. A postal questionnaire survey of 1,100 UK companies was conducted to investigate skin care provision. The response rate was 51%. The person primarily responsible for health and safety had a professional qualification in only 34% of responding companies. In all, 75% of companies responded that they were required to conduct COSHH risk assessments and, of these, 71% mentioned skin hazards. Only 27% of companies had a skin care policy but 71% had procedures requiring glove use. Seventy-seven per cent of companies did not conduct regular skin checks. Twenty-six per cent had either been aware of a skin problem in the workforce in the last 12 months or had had to modify work practices. Improvement of skin care in UK industry could be facilitated by the establishment of a minimum recommended training qualification; assistance with compliance with COSHH legislation; and guidelines to design and implement a skin policy, provide worker protection and detect skin problems.

Cross-Sectional Studies↗

Truncated structural variants of lipoarabinomannan in ethambutol drug-resistant strains of Mycobacterium smegmatis. Inhibition of arabinan biosynthesis by ethambutol.

The anti-tuberculosis drug, ethambutol (Emb), was previously shown to inhibit the synthesis of arabinans of both the cell wall arabinogalactan (AG) and lipoarabinomannan (LAM) of Mycobacterium tuberculosis and other mycobacteria. However, an Emb-resistant mutant, isolated by consecutive passage of the Mycobacterium smegmatis parent strain in media containing increasing concentrations of Emb, while synthesizing a normal version of AG, produced truncated forms of LAM when maintained on 10 microg/ml Emb (Mikusová, K., Slayden, R. A., Besra, G. S., and Brennan, P. J. (1995) Antimicrob. Agents Chemother. 39, 2482-2489). We have now isolated and characterized the truncated LAMs made by both the resistant mutant and a recombinant strain transfected with a plasmid containing the emb region from Mycobacterium avium which encodes for Emb resistance. By chemical analysis, endoarabinanase digestion, high pH anion exchange chromatography, and mass spectrometry analyses, truncation was demonstrated as primarily a consequence of selective and partial inhibition of the synthesis of the linear arabinan terminal motif, which constitutes a substantial portion of the arabinan termini in LAM but not of AG. However, at higher concentrations, Emb also affected the general biosynthesis of arabinan destined for both AG and LAM, resulting in severely truncated LAM as well as AG with a reduced Ara:Gal ratio. The results suggested that Emb exerts its antimycobacterial effect by inhibiting an array of arabinosyltransferases involved in the biosynthesis of arabinans unique to the mycobacterial cell wall. It was further concluded that the uniquely branched terminal Ara6 motif common to both AG and LAM is an essential structural entity for a functional cell wall and, consequently, that the biosynthetic machinery responsible for its synthesis is the effective target of Emb in its role as a potent anti-tuberculosis drug.

Antigens, Bacterial↗

The C.B.17 scid mouse strain as a model for human disseminated leukaemia and myeloma in vivo.

Using the C.B.17 scid mouse strain, we have developed a model of disseminated leukaemia and myeloma using five human cell lines, CCRF-Cem, Molt-4, Raji, IM9 and HS-Sultan. Introduction of any of these cell lines by either an intravenous or an intraperitoneal route eventually kills the mouse due to leukaemia or myeloma cell load. Neoplastic cells can be found in the blood, liver and bone marrow. Intraperitoneal transfer produces a local solid tumour whereas intravenous transfer produces foci of neoplastic cells in the spine and brain. A single dose of melphalan is able to increase survival time from infection of a lethal dose of the T-cell leukaemia cell line, CCRF-Cem.

Animals↗

Identification of Bordetella pertussis in nasopharyngeal swabs by PCR amplification of a region of the adenylate cyclase gene.

The polymerase chain reaction (PCR) was used to amplify a 522-bp region of the adenylate cyclase toxin (cyaA) gene of Bordetella pertussis. As few as 100 cfu from a suspension of B. pertussis could be detected by this procedure when the amplified PCR product was detected by ethidium bromide staining of agarose gels. However, simulated clinical specimens, prepared from swabs impregnated with known numbers of B. pertussis cells, only yielded a positive reaction with > or = 10(4) cfu. Hybridisation of a Southern blot of the PCR products from the swab samples with a cya-specific probe gave a positive reaction with as few as 8 cfu, but the hybridisation signal was uniformly weak with fewer than 10(4) cfu. Nevertheless, three of 13 nasopharyngeal swabs, taken from suspected clinically defined cases of whooping cough and stored frozen for up to 18 months, gave a positive PCR reaction.

Adenylate Cyclase Toxin↗

Neuropsychiatric rehabilitation for persistent mental illness.

The benefits of new knowledge on the psychobiology and neuropsychology of serious mental illnesses have been slow to impact on psychiatric rehabilitation technology. A literature review reveals that, at least in the case of schizophrenia, enough is known about neurobiological deficits and their impact on neurocognitive functioning to justify a more informed approach to psychiatric rehabilitation. Essential elements for a program of research are presented and preliminary data are reported examining the prevalence of executive deficits, correlations between neuropsychological deficits and social adjustment, and the nature of socially stigmatizing neuromotor deficits and their reliable assessment. In addition, early experience with the remediation of executive deficits is described and suggestions are made for future developments in this area. The authors conclude that barriers to the integration of knowledge from biological psychiatry and psychiatric rehabilitation have been largely related to academic "cultural" isolation, and that active cross fertilization of ideas is clearly justified by the present state of knowledge.

Adult↗

Remediation of neuropsychological deficits in psychiatric populations: rationale and methodological considerations.

The authors provide a literature review and methodological description of the emerging field of neuropsychiatric rehabilitation. Part I reviews literature that reveals compelling reasons for considering neuropsychological (NP) rehabilitation methods in patients with mental illness. NP deficits are prevalent in these patients and in contrast to psychopathology are predictive of social and occupational dysfunction, the most costly aspect of mental illness in both human and financial terms. NP deficits may explain the relatively poor outcomes from traditional vocational rehabilitation programs and there is evidence that they may be remediable. Part II summarizes methodological considerations required for research in this field. Methods for selecting optimal neuropsychiatric rehabilitation intervention techniques are reviewed and some suggestions are offered along with a brief theoretical discussion concerning their potential neural basis. Finally, design issues are reviewed, some tools for the measurement of outcome are offered, and methods are suggested for controlling for medications and environmental factors.

Humans↗

The alkalinisation of bupivacaine for intercostal nerve blockade.

A double-blind randomised study was performed to investigate the effect of pH adjustment of bupivacaine, with adrenaline 1:200,000, on the duration of block and pain relief after intercostal nerve blockade following thoracotomy. One group (n = 10) received bupivacaine with adrenaline 1:200,000 (pH = 4.1) and the other (n = 10) received alkalinised bupivacaine with adrenaline 1:200,000 (pH = 6.9). There was no significant difference in block duration (mean 23.9 and 26.4 hours respectively) visual analogue pain scores or morphine usage. Patients were more likely to have a block during the first 12 hours if they received alkalinised bupivacaine (p less than 0.01, Chi-squared test). A progressive regression of block, not previously described, was observed, explicable by means of spread of local anaesthesia to adjacent intercostal nerves. Alkalinisation of bupivacaine with adrenaline for intercostal nerve blockade has little clinical benefit.

Bupivacaine↗

Comparison of i.m. ketorolac trometamol and morphine sulphate for pain relief after cholecystectomy.

I.m. ketorolac trometamol 30 mg was compared with morphine sulphate 10 mg after cholecystectomy in a double-blind, multiple dose, randomized study of 100 patients. Assessments of pain were made immediately after operation (day 1), and the next morning (day 2). Pain intensity (verbal response score and visual analogue scale) was recorded before injection and then over a 6-h period. Pain relief was assessed also. The effect of ketorolac on operative blood loss and platelet function was examined. Time to commencing oral intake and the duration of administration of i.v. fluids were recorded. Adverse events were noted. Ketorolac produced significantly less analgesia than morphine on day 1, but on day 2 the two drugs produced a similar effect. Blood loss was not increased by ketorolac, although platelet function was impaired. Repeated i.m. administration of ketorolac did not produce any serious adverse effects.

Anti-Inflammatory Agents, Non-Steroidal↗

The nonsteroidal anti-inflammatory analgesics.

The NSAID's are exciting and interesting new analgesics; diclofenac and ketorolac seem to be especially promising for post-operative use. Perhaps the real potential of the NSAID's is that they are an additional way of interrupting the pain pathway to produce analgesia.

Anti-Inflammatory Agents, Non-Steroidal↗

Pragmatics in the measurement of family functioning: an interpretive framework for methodology.

The issue of the cross-method comparison of concepts that describe family functioning is addressed by means of an empirical investigation of two methods of family assessment. The examination focuses on a consideration of the functional, or pragmatic, aspects of subjects' responses through a comparison of a self-report and an observational method whose associated concepts appear to be similar. Little predicted association based on conceptual similarity is noted. An interpretive framework is developed suggesting that the outcomes of empirical method comparisons may be usefully considered in terms of the pragmatic aspects of subjects' responses or the way in which subjects may be using their responses, based on their inferences regarding the interpersonal context associated with each method.

Adolescent↗

Gastric infarction: a complication of selective vasopressin infusion.

This report describes a case of massive gastric hemorrhage, initially controlled by selective arterial vasopressin infusion. Infusion was followed by extensive necrosis of the gastric wall which necessitated subtotal gastrectomy. Gastric necrosis following arterial infusion is rare and in this case appears to be due to migration of the infusion catheter into a peripheral branch of the left gastric artery in a patient whose gastric circulation had been compromised by prior surgery. The complications related to the use of arterial infusion for the control of gastric hemorrhage are discussed and the literature is reviewed.

Angiography↗