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Biomedical subjects

H Dunn

Publications and source records attributed to H Dunn.

At least 19 recordsLinked to original sources
PubMed2004

Delivering cognitive therapy to people with psychosis in a community mental health setting: an effectiveness study.

OBJECTIVE: Cognitive therapy (CT) has been shown to be an efficacious treatment for persistent psychotic symptoms. However, there is some debate regarding whether this is transportable to real life clinical settings. This study aimed to evaluate the effectiveness of CT for psychosis in a community mental health team (CMHT) setting. METHOD: Patients referred for CT for psychosis were naturalistically allocated (determined by the availability of a therapist) to CT or waiting-list (WL)/treatment-as-usual (TAU). Outcome assessments were performed at WL, pre-CT, post-CT and 1-year follow-up. Data from 59 patients were analysed. RESULTS: Random effects regression analyses showed there was a significant improvement, attributable to CT, on most outcome measures, and that many of the symptomatic improvements were maintained at follow-up. Wilcoxon signed ranks tests indicated that there was a significant reduction in psychiatric hospital use following CT. CONCLUSION: These results confirm that CT is an effective treatment for psychosis that is generalizable to a community setting.

Adolescent↗
PubMed2002

Imagery and psychotic symptoms: a preliminary investigation.

Recent cognitive accounts of psychotic symptoms have suggested that processes involved in the maintenance of emotional disorders may also be implicated in the maintenance of hallucinations and delusions, and particularly emphasise the appraisals of such symptoms as important. Imaginal appraisals have been identified in emotional disorders, and many studies have reported spontaneously occurring images in patients with anxiety disorders. Such images appear to be linked to affect, beliefs and memories. This study examined the occurrence of imagery, using a semi-structured interview, in 35 patients who were experiencing hallucinations and/or delusions and receiving cognitive therapy. The majority of patients (74.3%) reported images, and most of these were recurrent and associated with affect, beliefs and memories. Common themes included images about feared catastrophes associated with paranoia, traumatic memories, and images about the perceived source or content of voices. The theoretical and clinical implications of these findings are discussed and directions for further research considered.

Adolescent↗
PubMed2001

Structural characterisation of the exopolysaccharide produced by Streptococcus thermophilus EU20.

Streptococcus thermophilus EU20 when grown on skimmed milk secretes a high-molecular-weight exopolysaccharide that is composed of glucose, galactose and rhamnose in a molar ratio of 2:3:2. Using chemical techniques and 1D and 2D-NMR spectroscopy (1H and 13C) the polysaccharide has been shown to possess a heptasaccharide repeating unit having the following structure: [chemical structure: see text]. Treatment of the polysaccharide with mild acid (0.5 M TFA, 100 degrees C for 1 h) liberates two oligosaccharides; the components correspond to the repeating unit and a hexasaccharide equivalent to the repeating unit minus the terminal alpha-L-Rhap.

Carbohydrate Sequence↗
PubMed2001

Exopolysaccharide-producing strains of thermophilic lactic acid bacteria cluster into groups according to their EPS structure.

AIMS: To compare galactose-negative strains of Streptococcus thermophilus and Lactobacillus delbrueckii subspecies bulgaricus isolated from fermented milk products and known to produce exopolysaccharides (EPSs). METHODS AND RESULTS: The structures of the EPSs were determined using nuclear magnetic resonance (NMR) and their genetic relationships determined using restriction endonuclease analysis (REA) and random amplification of polymorphic DNA (RAPD). Similar groupings were apparent by REA and RAPD, and each group produced an EPS with a particular subunit structure. CONCLUSION: Although none of the strains assimilated galactose, all inserted a high proportion of galactose into their EPS when grown in skimmed milk, and fell into three distinct groups. SIGNIFICANCE AND IMPACT OF THE STUDY: This information should help in an understanding of genetic exchanges in lactic acid bacteria.

Carbohydrate Sequence↗
PubMed2001

Removal and fate of Cryptosporidium in dissolved air drinking water treatment plants.

In the first part of the paper, data from pilot plant studies are used to evaluate Cryptosporidium removal by dissolved air flotation (DAF) clarification and dual media filters under challenge conditions. Oocyst removals were investigated for design detention times and hydraulic loadings for winter and spring seasons. Coagulation was optimized for turbidity and removal of natural organic matter. DAF performance was better for spring water temperatures achieving 2.5 +/- 0.3 log removal of oocysts compared to 1.7 +/- 0.3 log removal in the winter. Cumulative log removal across DAF and filtration exceeded 5.4, and was not affected by water temperature. Low turbidities and particle counts are indicators of good treatment and good removals of Cryptosporidium. The second part of the paper uses a mathematical model to predict the fate of Cryptosporidium through a DAF plant and the impact of filter backwash recycle on oocyst build-up in the plant influent. Model predictions show that the fate of Cryptosporidium and the build-up of oocysts in the plant influent depend on: DAF performance, the percent of filtered water production used for backwashing, and the percent of filter backwash recycle flow. A DAF plant with 2.5% filtered water production for backwashing and that achieves 1.6 log removal or greater of oocysts by DAF clarification will not have a build-up of oocysts in the plant influent regardless of the recycle rate. This is because the oocysts are concentrated in the DAF floated sludge and not within granular filters.

Air↗
PubMed2001

Evaluation of the performance of full-scale packed saturators.

An evaluation of the performance of full-scale packed saturators was made. Measurements of saturator effluent air concentrations, saturator efficiency and precipitated are reported for both cold water and warm water operating conditions. Packed saturators were analyzed over a full range of operating pressures and loading rates. Measured results compared to predicted results based on a comprehensive model for the performance of packed saturators prove the model to be a useful tool in designing efficient and cost effective saturation systems.

Air↗
PubMed1998

Cytomegalovirus pp65 antigenaemia as an indicator of end-organ disease in AIDS.

We aim to assess the usefulness of the cytomegalovirus (CMV) pp65 antigenaemia test, also called the CMV direct antigen test (DAT), in the management of patients with advanced human immunodeficiency virus (HIV) infection; we studied all patients who had pp65 assays between 8 September 1995 and 30 August 1996. Twenty-three patients had 31 tests. The mean CD4 cell count was 20/mm3. The tests were negative in 16 patients, of whom 12 have not developed CMV end-organ disease after a mean follow up of 114 days (range 14-269 days), whilst the remaining 4 patients had previously treated CMV disease. Eleven patients had positive tests: 4 had active CMV disease, 2 subsequently developed CMV retinitis, 2 died within a fortnight of multi-drug resistant tuberculosis (MDR-TB), one was lost to follow up and 2 have remained disease-free. This test has a positive predictive value of 43% and a negative predictive value of 94%, Fisher's exact test P=0.03. The pp65 antigenaemia assay can be performed in a standard virology laboratory avoiding the problems associated with polymerase chain reaction (PCR), a result is available within 5 h, and it is semi-quantifiable. However, a large prospective study is required to determine the comparative value and roles of the pp65 antigenaemia assay and DNA PCR in the management of CMV disease, especially with regard to the use of primary prophylaxis and pre-emptive therapy.

AIDS-Related Opportunistic Infections↗
PubMed1997

Blastic transformation of hairy cell leukemia.

OBJECTIVE: To report blastic transformation of hairy cell leukemia, an uncommon lymphoproliferative disorder of B-cell lineage. DESIGN: Routine histology, cytochemistry, and ultrastructural analysis were used to study this case. Immunoperoxidase studies for leukocyte common antigen (CD45), pan B-cell marker L26 (CD20), and hairy cell leukemia marker DBA.44 were performed. In addition, cell surface marker analysis for CD19, CD20, CD5, CD25, CD11c, and kappa and lambda light chains by flow cytometry was performed. RESULTS: The patient presented with typical clinical, morphologic, cytochemical, immunophenotypic, and ultrastructural features of hairy cell leukemia. Following splenectomy and prior to institution of any other therapy, he developed a blastic lymphoproliferative malignancy with loss of tartrate-resistant acid phosphatase activity, expression of cell surface markers CD11c and CD25, and immunoreactivity for DBA.44. CONCLUSION: We believe this to be the first report of such a transformation and recommend that the differential diagnosis of blastic transformation of chronic lymphoproliferative disorders include such a possibility.

Antigens, CD19↗
PubMed1996

Serological and molecular evidence of enterovirus infection in patients with end-stage dilated cardiomyopathy.

OBJECTIVE: To study the relative diagnostic value of enterovirus-specific molecular biological and serological assays in patients with end-stage dilated cardiomyopathy, and to investigate the possible role of other cardiotropic viruses in dilated cardiomyopathy. DESIGN: Analysis of recipient myocardial tissue and serum from patients with dilated cardiomyopathy and controls undergoing cardiac transplantation for end-stage cardiac disease. SETTING: University virology department and transplantation unit. METHODS: Reverse transcriptase-polymerase chain reaction and nucleotide sequence analysis of myocardial RNA and DNA; enterovirus-specific in situ hybridization; enterovirus-specific immunoglobulin M detection. RESULTS: Enterovirus RNA was detected in myocardial tissue from only a small proportion of (five of 75) hearts. However, although enterovirus-specific immunoglobulin M responses were detected in 22 (28%) of 39 controls patients, a significantly higher prevalence was observed among patients with dilated cardiomyopathy (22 (56%) of 39 patients; P < 0.005). All enteroviruses detected in myocardium showed greatest nucleotide sequence homology with coxsackievirus type B3. Detection of enterovirus RNA in myocardium by the polymerase chain reaction and by in situ hybridisation gave comparable results. Other potentially cardiotropic virus genomes, including human cytomegalovirus, influenzaviruses, and coronaviruses were not detected in myocardium. CONCLUSION: This study found that enterovirus-specific immunoglobulin M responses provided the strongest evidence of enterovirus involvement in patients with end-stage dilated cardiomyopathy. However, the high background prevalence of these responses limits their diagnostic value. The finding that enteroviruses detected in myocardium were coxsackievirus type B3 accords with recent findings in patients with acute myocarditis, and indicates that this serotype is the major cardiotropic human enterovirus.

Antibodies, Viral↗
PubMed1989

Luque fixation to the sacral ala using the Dunn-McCarthy modification.

The Galveston-Luque technique of fixation to the pelvis requires solid bone and a strong pelvis. Because the majority of neuromuscular patients who require fixation to the pelvis have a weak and thin illum, an alternative to the Galveston technique was sought. A technique of rod contouring was developed that takes advantage of the reliable, stout bone of the sacral ala for fixation. Twenty-four patients have been instrumented with Luque rods and fused to the sacrum over the past 4 years using the technique. There have been no complications in this short follow-up.

Follow-Up Studies↗
PubMed1985

Immunisation of nurses with a live varicella vaccine.

34 nurses who had no previous history of chickenpox and were seronegative to varicella zoster virus (VZV) were immunised with a live attenuated varicella vaccine (OKA-RIT strain) and followed up for up to 36 months. No major vaccine reactions were observed. At 5 months and at 1 year, 94% of the nurses had seroconverted but at 3 years only 64% had detectable antibody. Lymphocyte transformation to VZV antigen tested in seven nurses in whom antibody was no longer detectable gave positive stimulation indices. 2 of 13 vaccinated nurses who looked after children with chickenpox became infected but 1 of them had not seroconverted after vaccination. Chickenpox developed in 6 out of 7 unvaccinated seronegative nurses who looked after children with chickenpox. This study shows that the OKA-RIT strain VZV vaccine is safe and immunogenic in adults and may therefore be considered for use in susceptible health care workers. The investigations also show that both cell-mediated and antibody tests are needed for long-term assessment of immunity to chickenpox after vaccination.

Adolescent↗