PubMed Health⌕ Search

Biomedical subjects

G Brook

Publications and source records attributed to G Brook.

At least 19 recordsLinked to original sources
PubMed2004

An association between HIV/HCV co-infection and diabetes mellitus--is there a need for routine blood glucose monitoring?

We describe two cases of HIV/HCV co-infected patients developing adult onset diabetes mellitus. Neither was taking a protease inhibitor based regimen. We review the current recommendations for diabetes screening in this subset of patients and suggest that those managing co-infected patients pay particular attention to screening for abnormal glucose metabolism and elicit a full family history of metabolic disorders.

Adult↗
PubMed2004

Ethical and legal issues in caring for asylum seekers and refugees in the UK.

Inward migration to the UK remains topical and controversial as numbers continue to increase. Many immigrants have specific health care needs and may shoulder a large burden of infectious disease. Imposition of legal constraints can have a huge impact on the medical care afforded to immigrants. Currently UK policy is to treat, free of charge and with NHS resources, those who fulfil specific criteria. However an increasing number are being asked to pay for their treatment. Many health care professionals are confused as to current legal restrictions and require guidance on the associated ethical issues. We concentrate on provision of care to HIV positive individuals and use cases to illustrate some of the issues. However these issues are equally pertinent to practitioners in all branches of medicine.

Antiretroviral Therapy, Highly Active↗
PubMed2001

Effect of salicis cortex extract on human platelet aggregation.

The bark of Salix species contains several prodrugs of salicylate, mainly salicin. The aim of this study was to investigate if during pain treatment with Salicis cortex extract platelet aggregation was affected. A total of 51 patients were enrolled in the study. Thirty-five patients suffering from acute exacerbations of chronic low back pain received randomly and double-blind either Salicis cortex extract with 240 mg salicin/day (n = 19) or placebo (n = 16). Further sixteen patients with stable chronic ischemic heart disease were given 100 mg acetylsalicylate per day. Platelet aggregation was studied using an aggregometer. As aggregating agents, arachidonic acid (500 micrograms/ml), adenosine di-phosphate (2 x 10(-5) M) and collagen (0.18 microgram/ml) were used. The mean maximal arachidonic acid induced platelet aggregation was 61%, 78% and 13% in the Salicis cortex extract, placebo and acetylsalicylate groups. Acetylsalicylate had a significant inhibitory effect on platelet aggregation compared to Salicis cortex extract (p = 0.001) and placebo (p = 0.001). There was also a significant difference between the placebo and the willow bark-treated groups in the maximal platelet aggregation induced by arachidonic acid (p = 0.04) and ADP (p = 0.01). No statistical difference was found between the groups when collagen was applied to the human platelets. Daily consumption of Salicis cortex extract with 240 mg salicin per day affects platelet aggregation to a far lesser extent than acetylsalicylate. Further investigation needs to clarify if this finding is of clinical relevance in patients with impaired thrombocyte function.

Adenosine Diphosphate↗
PubMed2001

Computer-assisted quantification of axo-somatic boutons at the cell membrane of motoneurons.

This paper presents a system for computer-assisted quantification of axo-somatic boutons at motoneuron cell-surface membranes. Different immunohistochemical stains can be used to prepare tissue of the spinal cord. Based on micrographs displaying single neurons, a finite element balloon model has been applied to determine the exact location of the cell membrane. A synaptic profile is extracted next to the cell membrane and normalized with reference to the intracellular brightness. Furthermore, a manually selected reference cell is used to normalize settings of the microscope as well as variations in histochemical processing for each stain. Thereafter, staining, homogeneity, and allocation of boutons are determined automatically from the synaptic profiles. The system is evaluated by applying the coefficient of variation (Cv) to repeated measurements of a quantity. Based on 1856 motoneuronal images acquired from four animals with three stains, 93% of the images are analyzed correctly. The others were rejected, based on process protocols. Using only rabbit anti-synaptophysin as primary antibody, the correctness increases above 96%. Cv values are below 3%, 5%, and 6% for all measures with respect to stochastic optimization, cell positioning, and a large range of microscope settings, respectively. A sample size of about 100 is required to validate a significant reduction of staining in motoneurons below a hemi-section (Wilcoxon rank-sum test, alpha = 0.05, beta = 0.9). Our system yields statistically robust results from light micrographs. In future, it is hoped that this system will substitute for the expensive and time-consuming analysis of spinal cord injury at the ultra-structural level, such as by manual interpretation of nonoverlapping electron micrographs.

Animals↗
PubMed2001

Management of chronic prostatitis in Genitourinary Medicine clinics in the United Kingdom's North Thames Region 2000.

Twenty-two Genitourinary Medicine (GUM) clinics in North Thames participated in a survey of policies and case notes audit of chronic prostatitis managed within the past 2 years, compared with the UK National Guideline. For 32/33 cases notes reviewed (97%) chronic abacterial prostatitis/chronic pelvic pain syndrome (CAP/CPPS) were diagnosed. Of these, 14/32 cases (44%) were following non-chlamydial non-gonococcal urethritis (NGU), 1/32 cases (3%) followed Chlamydia trachomatis infection and for 17/32 cases (53%) no predisposing cause was identified. The single case of chronic bacterial prostatitis (CBP) was caused by prostatic infection with Staphylococcus spp. All cases were prescribed antibiotics, initial follow-up appointments coinciding with completion of antibiotics. Fourteen cases (42%) were discharged following GUM clinic management; only 7 of these cases (50%) were asymptomatic, the others having residual problems. Nine cases (27%) were referred to a specialist. Ten cases (30%) defaulted follow-up appointments; 7 of these did not attend their first follow-up appointments.

Adult↗
PubMed2000

An audit of antiretroviral medication offered to patients with HIV attending a district general hospital for outpatient care.

In order to determine if antiretroviral prescribing for patients with HIV infection attending the Central Middlesex Hospital is according to current UK guidelines and effective at reducing the serum HIV viral load, 71 case notes were reviewed. All patients eligible for treatment according to the British HIV Association (BHIVA) guidelines were currently being offered triple therapy. The most recent serum HIV viral loads of patients taking at least 3 antiretrovirals were undetectable in 75% of the 20 patients on their first established regimen and 36% of 14 patients who had failed at least one drug according to previous surrogate marker results. Such work allows an individual clinic to monitor its antiretroviral prescribing practices in the face of constantly updated information and guidelines.

Ambulatory Care↗
PubMed2000

Minimal change glomerulonephritis associated with hydatid disease.

A 63-year-old man presented to our department with dyspnea and peripheral edema. A cystic mass in the right upper abdomen, consistent with echinococcal disease was discovered. Proteinuria was also present, and a nephrotic syndrome was diagnosed. The kidney biopsy revealed minimal change glomerulonephritis. Treatment with the antiechinococcal drug albendazole induced complete remission of the nephrotic syndrome, suggesting an etiopathogenic role for a hydatid antigen in the development of an immune-mediated glomerulonephritis.

Albendazole↗
PubMed1998

Quality of life issues: parenteral nutrition to small bowel transplantation--a review.

Parenteral nutrition (PN) has given life to patients with chronic intestinal failure who would otherwise have died. Home parenteral nutrition has improved the quality of life for many children. However, morbidity from this therapy remains significant with complications of line sepsis, lack of venous access, hepatic dysfunction, and pulmonary embolism. These complications are common in younger children. Detailed discussion must take place with the family regarding risks and benefits of PN. In those children developing complications of PN, intestinal transplantation is a logical extension of treatment. Early referral of patients for assessment is vital because significant mortality occurs when liver disease is established. Time is needed to counsel families on the potential benefits and risks of this treatment, including the physical and emotional demands made on the child and family. Overall worldwide survival for isolated small bowel transplantation is currently 50% and for combined small bowel and liver transplantation 40%. Significant complications are rejection, sepsis, and lymphoproliferative disease. Postoperative management can be complex and prolonged; child and parents require a great deal of physical and emotional support. The burden of care for parents decreases significantly after the first year. Small bowel transplantation offers a realistic alternative to PN. The choice of treatments is influenced by expected quality of life, which is just beginning to be evaluated.

Child↗