Biomedical subjects
Publications and source records attributed to H Miles.
Aristolochic acid I, aristolochic acid II, and D-(+)-raffinose were isolated from Origanum vulgare. Their inhibition of thrombin and activity against leukemia were evaluated. Aristolochic acid I and II have high inhibition of thrombin activity and were confirmed to possess activity against cancer.
OBJECTIVES: The use of league tables has become predominant in the healthcare culture of the United Kingdom. These tables are often based on measures that are viewed with scepticism by clinicians. This study was designed to test the validity of a North American risk of admission score, the PRISA, for use in a United Kingdom population of accident and emergency (A&E) attendees. METHODS: All attendees to a children's A&E department were scored using the PRISA for a single calendar month (November 2000) RESULTS: 701 children were studied in total. The results show that the PRISA applied to this population gives an area under the receiver operator curve of 0.76. Of the 701 patients studied, 206 (29.4%) were admitted. The PRISA predicted a total of 206.10 admissions. Of the 50 patients discharged with the highest PRISA scores (that is, with the highest likelihood of admission), none were admitted in the 48 hours after their original attendance. CONCLUSIONS: These results show that the PRISA is suitable as a measure of paediatric A&E department performance in the United Kingdom and it is highly promising as a future measure of quality.
This study presents the nutrient data collected from women who were being screened for premenstrual syndrome (PMS) for entry into an intervention study. Screening was by the Steiner self-rated questionnaire. One hundred and forty-four overweight women completed the screening process and eighty-eight met the criteria for PMS. All women kept 4 d diet diaries pre- and postmenstrually over two menstrual cycles. The mean energy and macronutrient intakes were compared between the pre- and postmenstrual phases. Energy and macronutrient intake was also calculated according to food categories. Goldberg's cut-off limit for the ratio of energy intake to estimated basal metabolic rate was used to exclude data that was incompatible with predicted energy requirements. The diet diaries were also used to determine the mean number of meals or snacks eaten pre- and postmenstrually. Nutrient analysis of the diet diaries of the women with PMS showed a significant increase (P < 0.001) in total energy and all macronutrients premenstrually when compared to nutrient intake postmenstrually. Women who did not meet the criteria for PMS showed a significant increase in energy and fat intake (P < 0.05) but not in the other macronutrients. When adjusted for energy, data collected from women with PMS showed a premenstrual significant increase in fat, carbohydrate (P < 0.05) and simple sugars (P < 0.001). There was a significant decrease (P < 0.001) in protein premenstrually. Women not meeting the PMS criteria showed no significant difference between pre- and postmenstrual intakes when adjusted for energy. Analysis according to food categories in women with PMS showed a significantly greater intake premenstrually of energy and all macronutrients for cereals, cakes and desserts and high-sugar foods (P < 0.001). In women with PMS there was a significantly greater number of 'episodes of eating' premenstrually (P < 0.001). This study provides further evidence, to support the very limited number of earlier studies, that there is a group of women with PMS who increase their nutrient intake during the premenstrual phase. This could potentially be a contributing factor for some women experiencing difficulties adhering to suggested dietary modification and should be considered when counselling premenopausal women.
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This is an unusual case of a 37-year-old male whose initial presentation to medical care was for dyspnea. A transthoracic echocardiogram was suspicious for cor triatriatum, which was confirmed by transesophageal echocardiography. Since the resting transmembrane gradient was low, a cardiac catheterization with exercise hemodynamics was performed and demonstrated a marked increase in pulmonary capillary wedge and pulmonary artery pressures. The cor triatriatum was successfully resected at surgery. We have reviewed the English literature and find this to be a unique approach to diagnosis and management.
The effect of 100 polar and 100 nonpolar plant extract materials obtained from Southeast Asia were evaluated for amebicidal activity in vitro against three species of Acanthamoeba. A. culbertsoni, A. castellanii, and A. polyphaga, the causative agents of granulomatous amebic encephalitis and amebic keratitis, were studied in vitro to determine whether the plant extracts exhibited amebicidal activity or induced encystment of the amebae. Of the 200 plant extracts tested, extracts obtained from three plants (Ipomoea sp., Kaempferia galanga, and Cananga odorata) were amebicidal for all three species of Acanthamoeba and a fourth extract prepared from Gastrochilus panduratum was lytic for A. polyphaga and growth-inhibitory for A. castellanii and A. culbertsoni. Three plant extracts induced encystment of all three species of Acanthamoeba. Select plant extracts were tested as well for tumoricidal activity against B103 neuroblastoma cells. Some plant extracts that exhibited tumoricidal activity for B103 cells were not amebicidal for Acanthamoeba spp. Additionally, the polar and nonpolar extracts that exhibited amebicidal activity were also tested for activity against primary murine peritoneal macrophage cultures. Plant extracts that demonstrated tumoricidal or amebicidal activity were not lytic for normal macrophage cultures.
The authors report their clinical experience with VRCTC-310 in two patients suffering with advanced cancer in which the skin was severely compromised. VRCTC-310 is a combination of the snake venoms crotoxin (CT) and cardiotoxin (CD). The local (peritumoral) treatment with the drug (0.O14 mg/kg/week during 6 weeks) provoked the complete disappearance of a relapsed skin squamous cell cancer in one patient. The other patient was an aged woman with local-advanced breast cancer (carcinoma en cuirasse) who was inoculated intra-and-peritumoral with VRCTC-310. After 6 weekly courses (0.014 mg/kg/week) with the drug a > 80% tumor reduction was seen. A 133 days follow-up demonstrated not only an objective complete response of the primary tumor mass, but the disappearance of supraclavicular tumor mass as well a significant reduction in lymphangitis. To our knowledge, this is the first communication about the in vivo antitumoral activity of VRCTC-310 when injected locally to humans. Further studies are now in progress.
Thirty patients with advanced squamous cell carcinoma of the cervix were included in a phase II study with cisplatin (DDP) and ifosfamide (IF)/mesna. They received a median of 4 courses of chemotherapy and were all evaluable for response and toxicity. Each cycle consisted of 2,500 mg/m2 IF i.v. days 1-5; mesna 500 mg/m2 i.v. at hours 0 and 2, and 1,000 mg/m2 per os at hours 6 and 10, days 1-5; DDP 20 mg/m2 i.v., days 1-5. Cycles were repeated every 4 weeks. One patient obtained CR and 14 PR giving an overall response rate of 50%. Mean duration of response was 21 months. Anemia grade 3 developed in 7 patients, leukopenia grade 3 in 9 patients and grade 4 in one patient; thrombopenia grade 3 in 2; creatinine clearance grade 3 in one; CNS grade 3 in one and cystitis grade 3 in one patient. Overall median survival time was about 25+ months (3-63+); after a follow-up of 70 months, 11 patients (37%) are still alive with a median survival of 31+ months. IF plus DDP seems to be a good combination for treatment of advanced cervical cancer, with acceptable tolerance and response rate.
BACKGROUND: This study sought explanations for the proneness to respiratory events in young Australian children. METHODS: Prospective respiratory symptom diaries on 836 children collected data on respiratory symptoms and episodes. Questionnaires to mothers and birth and pregnancy records provided 56 known and possible predictors which were tested against two summary respiratory outcomes in each of the first and second years of life. RESULTS: The two summary respiratory variables recorded for first and second year of life give four outcome variables. In fitting multivariate regression models to predict outcomes, use of child care in early childhood and mothers' experience of respiratory illness in the 12 months before birth were significant predictors for all four outcomes. Number of siblings was a predictor for three of the four outcomes. Sleep difficulty during pregnancy in the mother, and respiratory hospitalization of the infant in the first year, were significant predictors for both first-year outcomes. Unexpected and unexplained findings emerged for alcohol intake during pregnancy, passive smoking and breastfeeding in relation to the second year respiratory outcomes. Less than 9% of variance in outcome scores was explained in any of the four multiple regression models but this rose to between 24% and 31% when a corresponding score from the other year was added to the model. CONCLUSIONS: Proneness to respiratory illness is an important entity; its determinants are largely unknown and events in pregnancy or the perinatal period explain only a small proportion of the between-infant variability.
This study was conducted to determine job availability for athletic trainers in school and/or clinic settings in western Kansas, western Nebraska, western Oklahoma, and eastern Colorado. A survey was sent to 109 physical therapy (PT) clinics and 194 public schools to determine the major factors associated with job marketability. Of the 194 questionnaires mailed to the public schools, 119 were returned for a 61% response rate. Of the 109 questionnaires mailed to PT clinics, 57 were returned for a 52% response rate. Very few school districts (13%) hired their own trainer due to financial restrictions; therefore, the National Athletic Trainers' Association (NATA) athletic trainer would increase his/her likelihood of being hired if he/she was also teacher-certified. Most of the clinics responding would hire an NATA-certified athletic trainer if that individual was also licensed as a physical therapist, whereby, the trainer without PT licensure could be used for outreach programs for the local high schools. Essential factors identified by both the public school and clinic personnel for increasing the marketability of athletic trainers were: 1) NATA certification, 2) acquisition of an additional certification such as a teaching endorsement or a PT degree, and 3) willingness to provide services jointly to the schools and/or clinic with either being the primary hiring agent.
This paper estimates the cost of mastitis for the New York dairy sector. The average cost is found to be $125 per cow from reduced milk production, treatment, and increased culling. At the 1988 cow inventory, this translates to approximately $100 million annually for the entire dairy farm sector. When quality and production losses for the processing sector are added, the cost to the New York industry alone is nearly $150 million annually. Two promising new treatments, a bacteriocin and a vaccine, are evaluated. Both have shown effectiveness in preliminary trials against Staphylococcus aureus. Assuming that further development will allow the treatments to be effective against the major bacterial sources of mastitis infections, the treatments are projected to increase the annual income of the New York dairy industry by $18.8 to $39.7 million. The bacteriocin could replace antibiotic usage, a desirable goal in the opinion of many, and the vaccine promises to immunize cows against mastitis very effectively.
OBJECTIVE: To test the hypothesis that children attending child care centres are more likely to be prone to acute respiratory illness. DESIGN: A case-control study. SETTING: A community-based study in the Adelaide metropolitan area. PARTICIPANTS: A randomly selected sample of Adelaide children whose births were registered in 1983. MAIN OUTCOME MEASURE: A respiratory illness score was calculated for each child, based on parents' reports of acute respiratory illness in the previous 12 months. RESULTS: Information was obtained by postal survey for 2618 children (mean age at time of study, 26 months). Eight hundred and nineteen of these children (31%) were reported to be regular or occasional attenders of child care centres or crèches. Home interviews were carried out with parents of children whose respiratory illness scores fell in the top 20% of the range and those whose score was in the bottom 20%. Children prone to respiratory illness were more likely to be users of child care centres or crèches than the children who were not prone (odds ratio = 2.28; 95% confidence interval, 1.53-3.40). The risk of being prone to respiratory illness increased with the frequency of use of child care, and tended to be greater the younger children were when they first attended child care centres. Adjustment in multivariate analysis for confounding factors made little difference to the strength of the association of proneness to respiratory illness with the use of child care (adjusted odds ratio = 2.23; 95% confidence interval 1.38-3.61). CONCLUSION: Use of child care centres is an important cause of acute respiratory illness among Australian children.
STUDY OBJECTIVE: The aim was to investigate the relation between passive smoking and childhood acute respiratory illness. DESIGN: The study involved an initial postal survey on a random sample of children followed by a case-control study based on the survey. A respiratory illness score was calculated from maternal reports of episodes of illness in the previous 12 months. SETTING: The study was a population survey based on Adelaide metropolitan area in South Australia. PARTICIPANTS: The reference population (n = 13,996) was all live born children registered in South Australia in 1983 whose parents lived in Adelaide metropolitan area. Of these, 4985 families were contacted by post and from 2125 respondents, 1218 (58%) gave consent for home interview. "Cases" were children with respiratory illness scores in the top 20%, controlling for age and time of year (n = 258); "controls" were taken in the bottom 20% (n = 231). MEASUREMENTS AND MAIN RESULTS: Maternal smoking in the first year of life was associated with a doubling in relative odds of respiratory proneness in the child (odds ratio = 2.06, 95% CI 1.25-3.39) after adjustment for confounding by parental history of respiratory illness, other smokers in the home, use of group child care, parent's occupation, and levels of maternal stress and social support. There was no evidence that this association was attributable to differences in the way smoking and non-smoking parents perceived or managed childhood acute respiratory illness. Maternal smoking in the first year, without smoking in pregnancy, was also associated with increased risk of respiratory proneness (odds ratio 1.75, 95% CI 1.03-3.0), showing an effect of passive smoking independent of any in utero effect. There was a strong negative effect modification by breast feeding: relative odds of respiratory proneness with maternal smoking were seven times higher among children who were never breast fed than among those who were breast fed. CONCLUSIONS: The results suggest a relatively small but real effect of passive smoking on childhood acute respiratory illness. Effect modification by breast feeding may be due to a combination of behavioural and biological mechanisms.
Although left ventricular diastolic filling patterns can be examined by both Doppler velocity recordings and gated blood pool scintigraphy, few data exist regarding a comparison of these techniques. Therefore, Doppler echocardiography and scintigraphy were compared in 25 patients. Pulsed Doppler echocardiography was performed using an apical four chamber view with the sample volume at the level of the mitral anulus. Doppler measurements included peak velocity of the early diastolic filling wave, time to peak early diastolic velocity from both end-systole and end-diastole, diastolic time period and diastolic integrated velocity (early, atrial and total). The cross-sectional area of the mitral anulus and the left ventricular end-diastolic volume were estimated from measurements made on the apical four chamber view. Scintigraphic measurements included normalized peak filling rate, time to normalized filling rate from both end-diastole and end-systole, diastolic time period and relative diastolic filling during early and atrial filling. Doppler echocardiography and scintigraphy compared favorably in assessment of fractional filling during early diastole (r = 0.84) and atrial systole (r = 0.85), ratio of early to atrial filling (r = 0.83), diastolic filling period (r = 0.94) and interval from end-diastole to peak early diastolic flow (r = 0.88). Normalized peak filling rate and time to normalized peak filling rate from end-systole did not correlate closely by these two techniques. The differences in normalized peak filling rate may be explained by difficulties in estimating mitral anulus cross-sectional area and left ventricular end-diastolic volume.(ABSTRACT TRUNCATED AT 250 WORDS)
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Tonsil swabs were collected from 248 children (1 through 10 yr) who presented with acute tonsillitis. A beta-hemolytic streptococcus was grown from 129 (53%) of 244 cases and as the sole pathogen from 83 (47%) of 178 cases. Beta-Hemolytic streptococci were especially common over the age of 6 yr (68% of children) relatively uncommon under the age of 4 yr (18%); most (90%) streptococci belonged to group A; 18 streptococcal T types were represented amongst 88 group A strains; the potentially nephritogenic serotypes 4 and 12 were prominent and accounted for 42 (47%) of typable isolates. Eight (8%) of 96 unmatched children (1 through 10 yr) who served as controls were found to be carrying beta-hemolytic streptococci, 5 of which belonged to group A. A virus was grown from 52 (29%) of 182 children and as the sole pathogen from 40 (22%) of 178 children. Only echoviruses (8 serotypes) and adenoviruses (5 serotypes) were common; younger children showed a higher isolation rate of viruses. The clinical picture in children yielding a virus was indistinguishable from that of cases who yielded a beta-hemolytic streptococcus.
Minimum inhibitory concentrations of erythromycin were determined, in the absence of CO2, for 256 strains of anaerobic microorganisms recently isolated from clinical practice. Of 126 strains of Bacteroides fragilis, 93% were inhibited by 6 mg/L, or less, of erythromycin. Of the remaining 130 isolates, 92% were inhibited by 6 mg/L, or less, of erythromycin. These findings suggest that the majority of anaerobic microorganisms would be inhibited by the serum levels achieved by administering 1 g of erythromycin intravenously, every six hours.