Limits on Canadian dermatologists.
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Canada↗
Biomedical subjects
Frank Murphy
Publications and source records attributed to Frank Murphy.
The comparison and validity of troponin I assay systems in diagnosing myocardial ischemic injury after surgical coronary revascularization.
OBJECTIVE: A prospective observational study was conducted to test the agreement between 2 commercially available automated cardiac troponin-I immunoassay systems (Opus Plus, Behring Diagnostics UK Ltd, Hounslow, UK; AxSYM, Abbott Laboratories, Abbott Park, IL) and to determine a normal reference range and threshold value indicative of perioperative myocardial infarction (PMI) after elective coronary artery bypass graft (CABG) surgery for the Opus Plus system. DESIGN: Prospective, observational study. Setting : Single institution, cardiothoracic specialty hospital. PARTICIPANTS: Seventy patients undergoing elective CABG surgery. INTERVENTIONS: After institutional review board approval, patients received standardized anesthetic, surgical, and myocardial preservation techniques. Serial electrocardiographs, creatine kinase-MB, troponin-I, and perioperative outcome data were collected. Correlation between the immunoassay systems was tested using 124 duplicate samples from the first 18 patients. The normal reference range and threshold value indicative of PMI were tested for the Opus Plus system using duplicate samples from all 70 patients. MEASUREMENTS AND MAIN RESULTS: Peak troponin-I concentrations (median [interquartile range]) differed significantly when measured by the Opus Plus and AxSYM immunoassay systems (5.61 [3.20-22.35] microg/L v 46.50 [14.55-70.95] microg/L, respectively; p < 0.001). There was clear proportional bias that was corrected with log transformation of the raw data. By using confidence interval and receiver operating characteristic curve analysis, the authors showed that a value > or =15 mug/L was indicative of PMI (Opus Plus system) and accordingly report a 35.7% (2.9% Q-wave) overall incidence of PMI in this study population (n = 70). CONCLUSIONS: These data highlight differences between commercially available troponin-I assay systems. The authors recommend that each institution establish a local reference range and threshold indicative of perioperative myocardial infarction for its specific patient population and assay system and provide sample methodology.
Biomarkers↗
N-Cadherin cleavage during activated hepatic stellate cell apoptosis is inhibited by tissue inhibitor of metalloproteinase-1.
Apoptosis of hepatic stellate cells (HSC) has previously been shown to occur during spontaneous resolution of experimental liver fibrosis. TIMP-1 has also been shown to have a key role because of its ability to inhibit apoptosis of HSC via matrix metalloproteinase (MMP) inhibition. This has led to further study of novel substrates for MMPs that might impact on HSC survival. N-Cadherin is known to mediate cell-cell contacts in fibroblasts. In this study we demonstrate that N-Cadherin is expressed by activated rat HSC. Furthermore, during apoptosis of HSC, the N-Cadherin is cleaved into smaller fragments. Apoptosis of HSC may be inhibited by TIMP-1. This is associated with reduced fragmentation of N-Cadherin. N-Cadherin may have an important role in supporting HSC survival while N-Cadherin cleavage may play a part in promoting HSC apoptosis in recovery from liver fibrosis.
Journal Article↗
The telomere hypothesis for progressive liver cirrhosis.
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Animals↗
A case-control study of childhood environmental risk factors for the development of inflammatory bowel disease.
OBJECTIVE: To clarify the relationship between childhood environment and the risk of subsequent development of Crohn's disease or ulcerative colitis. DESIGN AND OUTCOME MEASURES: A case-control study, assessing the risk of inflammatory bowel disease in relation to a series of historical and serological markers of childhood circumstance, analysed using the maximum likelihood form of conditional logistic regression. SETTING: District general hospital (secondary care institution). PARTICIPANTS: Subjects with Crohn's disease (n = 139) or ulcerative colitis (n = 137) aged between 16 and 45 years, each matched for sex and age with an outpatient control. RESULTS: Helicobacter seroprevalence was substantially reduced in Crohn's disease (OR 0.18; 95% CI, 0.06-0.52) but not in ulcerative colitis (OR 0.91; 95% CI, 0.38-2.16). In ulcerative colitis, a strong negative association with childhood appendectomy was confirmed (OR 0.05; 95% CI, 0.01-0.51). Crohn's disease was associated with childhood eczema (OR 2.81; 95% CI, 1.23-6.42) and the frequent use of a swimming pool (OR 2.90; 95% CI 1.21-6.91). There was no association between hepatitis A seroprevalence and either disease. CONCLUSION: The findings are consistent with the hypothesis that improved childhood living conditions are associated with increased risk of Crohn's disease. The study confirms that the negative association between appendectomy and ulcerative colitis relates primarily to events in childhood. Overall, the findings strongly support the assertion that childhood environment is an important determinant of the risk of inflammatory bowel disease in later life, with quite distinct risk factors for ulcerative colitis and Crohn's disease.
Adolescent↗
Developing strategies for liver fibrosis treatment.
Liver fibrosis represents a major worldwide healthcare burden. Current therapy is limited to removing the causal agent. This approach is successful in some diseases; particularly haemochromatosis and chronic viral hepatitis. However, for many patients treatment is not possible, while other patients present to medical attention at an advanced stage of fibrosis. There is therefore a great need for novel therapies for liver fibrosis. The hepatic stellate cell has been recognised to be responsible for most of the excess extracellular matrix observed in chronic liver fibrosis. The detailed understanding of hepatic stellate cell biology has allowed the rational design of novel antifibrotic therapies. This review describes for the general reader the novel emerging therapies for liver fibrosis.
Animals↗
Comparison of the efficacy and safety of the 308 nm excimer laser for the treatment of localized psoriasis in adults and in children: a pilot study.
The 308-nm excimer laser has been shown to be safe and efficacious in the treatment of localized mild-to-moderate plaque-type psoriasis in adults. However, the laser's safety and efficacy has not yet been demonstrated in children. Four of seven children with a mean age of 11.0 years and 12 of 18 adults with a mean age of 48.8 years completed the full protocol. The most common reason for incompletion was noncompliance unrelated to side effects. Both the children (p=0.0200) and the adult groups (p=0.0009) yielded a significant decrease in psoriatic severity scores of their respective target lesions. The children group had a greater reduction (p=0.008) from a mean baseline target (PSS) of 5.75+/-1.71 to final of 0.50+/-0.58 (91.3% reduction) as compared to the adult treatment group from a mean baseline psoriatic severity score of 5.00+/-1.15 to final of 1.92+/-1.11 (61.6% reduction). However, there was no statistical difference between the mean total treatments required to achieve this result (p=0.112). Side effects were common, albeit minor and well tolerated. In conclusion, the 308 nm excimer laser appears to be a safe and effective treatment for localized psoriasis in children as well as in adults.
Adolescent↗