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Biomedical subjects

J Goulding

Publications and source records attributed to J Goulding.

11 recordsLinked to original sources
PubMed2000

Tracing the source of illicit drugs through plastic packaging--a database

Common plastic drug packaging material available in Australia and in Asia was analyzed using a standard protocol including optical examination, UV-visible and Fourier transform infrared spectrometry. The aims were to determine whether there are significant differences between different sources, to establish the evidential value of these examinations, and to build a database of common packaging material. Visual examination was the most effective means for discriminating samples. Thickness and weight measurements provided useful information. Visualization of machining marks using crossed polarized light was found to be useful in the comparison process. UV-visible spectrophotometry has some value for distinguishing samples. Fourier transform infrared analysis was a good technique for determination of the polymer composition of the packaging. Significant differences were observed between Australian and overseas samples. The "Australian Database of Drug Packaging Materials" was created to systematically collate all of the collected data for application on personal computers. It is concluded that the properties of plastic packaging materials can be excellent indicators for identifying the specfic brand or origin of the packaging.

Journal Article↗
PubMed1999

Nursing rotas. Shift up.

Trusts may wish to consider more flexible, staggered daytime shifts, which accommodate married nurses--for instance, 9.30 am-3.30 pm on weekdays with longer hours at weekends/on nights to ensure that contractual requirements are met. For larger trusts, creche/nursery facilities may solve the problem. After-school clubs on site on a voluntary basis may also mean that more married women and unmarried women with children could more easily accommodate standard shifts. The tribunal decision seems to condone the provision of somewhat ad hoc training and supervision, whereas in professional practice continuous supervision and participation in professional developments are essential elements in the provision of safe, high-quality clinical practice.

Contract Services↗
PubMed1998

Intravenous vs subcutaneous naloxone for out-of-hospital management of presumed opioid overdose.

OBJECTIVE: To determine whether naloxone administered i.v. to out-of-hospital patients with suspected opioid overdose would have a more rapid therapeutic onset than naloxone given subcutaneously (s.q.). METHODS: A prospective, sequential, observational cohort study of 196 consecutive patients with suspected opioid overdose was conducted in an urban out-of-hospital setting, comparing time intervals from arrival at the patient's side to development of a respiratory rate > or =10 breaths/min, and durations of bag-valve-mask ventilation. Subjects received either naloxone 0.4 mg i.v. (n = 74) or naloxone 0.8 mg s.q. (n = 122), for respiratory depression of <10 breaths/min. RESULTS: Mean interval from crew arrival to respiratory rate > or =10 breaths/min was 9.3 +/- 4.2 min for the i.v. group vs 9.6 +/- 4.58 min for the s.q. group (95% CI of the difference -1.55, 1.00). Mean duration of bag-valve-mask ventilation was 8.1 +/- 6.0 min for the i.v. group vs 9.1 +/- 4.8 min for the s.q. group. Cost of materials for administering naloxone 0.4 mg i.v. was $12.30/patient, compared with $10.70/patient for naloxone 0.8 mg s.q. CONCLUSION: There was no clinical difference in the time interval to respiratory rate > or =10 breaths/min between naloxone 0.8 mg s.q. and naloxone 0.4 mg i.v. for the out-of-hospital management of patients with suspected opioid overdose. The slower rate of absorption via the s.q. route was offset by the delay in establishing an i.v.

Adult↗
PubMed1998

Effect of host Lewis and ABO blood group antigen expression on Helicobacter pylori colonisation density and the consequent inflammatory response.

The Lewis(b) blood group antigen has been implicated as a putative receptor for Helicobacter pylori in the gastric mucosa. Furthermore, an increased prevalence of duodenal ulcer was found in non-secretors and it has been suggested that secretor status may influence bacterial colonisation density. Other investigators have hypothesised that severity of antral gastritis may be related to colonisation density of the bacterium alone, and that a critical bacterial load is necessary for the development of duodenal ulcer. Our objectives were to investigate whether a relationship existed between host Lewis and ABO blood group phenotype and prevalence of H. pylori infection. In addition we investigated whether bacterial colonisation density and the ensuing inflammatory response was influenced by secretor status and ABO blood group phenotype. The Lewis and ABO blood group phenotype of 207 patients undergoing upper endoscopy was determined. Of these, 136 were secretors and 62 were nonsecretors. Forty-five percent of patients were infected with H. pylori. No significant association was found between H. pylori infection and expression of Lewis(a) or Lewis(b) blood group antigen. The mean histological density of H. pylori was 1.8 +/- 0.2 among non-secretors and 1.51 +/- 0.13 among secretors (P = 0.209), with a mean grade of lymphocytic infiltration significantly greater in H. pylori-infected non-secretors (2.23 +/- 0.123 vs 1.8 +/- 0.074; P = 0.003). In addition, blood group O non-secretors had a significantly higher grade of lymphocyte infiltration of their gastric mucosa compared to non-O non-secretors (2.53 +/- 0.133 vs 1.93 +/- 0.181, P = 0.027). These results suggest that although no in vivo relationship exists between H. pylori and preferential adhesion to the putative Lewis(b) receptor, bacterial colonisation and the ensuing inflammatory response may be influenced at least in part by host expression of ABO and Lewisa blood group antigens.

ABO Blood-Group System↗
PubMed1996

Secretor status and human leucocyte antigens in coeliac disease.

BACKGROUND: The ability to secrete blood group antigens into body fluids and secretions is controlled by a single gene on chromosome 19. By means of erythrocyte Lewis (Le) antigen phenotype secretor status can be inferred. An increase prevalence of non-secretors of blood group antigens among coeliac patients has recently been described. METHODS: Blood was collected from 112 coeliac patients and 103 controls and tested for secretor status. Secretor status was correlated with human leucocyte antigens (HLA) in coeliac patients, thus evaluating a proposed interaction of susceptibility genes--that is, the secretor gene on chromosome 19 and HLA-linked genes on chromosome 6. Case notes for coeliacs were reviewed with regard to clinical outcome. RESULTS: Of 112 coeliacs who had either Le(a) or Le(b) antigens, 36 (32%) were non-secretors Le(a+, b-), compared with 27% (28) of 103 disease-free controls (P = 0.313). Recessive Lewis phenotype Le(a-, b-) was found in 9% of coeliacs versus 2% of controls. Prevalence of HLA-A1, B8, DR3, and DQ2 was unrelated to secretor status in coeliac versus patients. An increased prevalence of complications and coeliac-associated abnormalities was found in the non-secreting and recessive coeliac groups. CONCLUSIONS: This study shows no firm relationship between the non-secretor state and coeliac disease, nor any difference in the distribution of HLA markers among secretor and non-secretor coeliacs. It is unlikely, therefore, that the secretor gene is the much sought-after second coeliac gene.

Celiac Disease↗
PubMed1994

Refining the genetic map for the region flanking the X-linked hypophosphataemic rickets locus (Xp22.1-22.2).

We have screened fourteen kindreds with X-linked hypophosphataemic rickets with four microsatellite markers, viz AFM163yh2, DXS999 (AFM234yf12), DXS443 and DXS365, in order to refine the genetic map flanking the gene, and to define a close flanking interval for the construction of a yeast artificial chromosome (YAC) and cosmid contig. The genetic data were enhanced after the isolation of a large 1.2-megabase YAC derived from AFM163yh2, in which marker DXS274 was present but not DXS365 or DXS443. Against HYP, DXS365, AFM163yh2 and DXS443 showed no recombinants (Zmax = 18.1, Zmax = 9.9, and Zmax = 16.0 respectively). DXS999 gave Zmax = 9.6 at 4% recombination and lies distal to HYP but proximal to DXS197 and DXS43. The disease gene and markers AFM163yh2 and DXS365 are flanked by DXS443 and DXS274. Combining the genetic and physical data, we are able to propose the following gene marker order: Xptel-DXS43-DXS197-DXS999-DXS443-[(DXS3 65-AFM163yh2), HYP]-DXS274-DXS41-Xcen.

Base Sequence↗
PubMed1993

New markers for linkage analysis of X-linked hypophosphataemic rickets.

Three polymorphic markers have been used to improve the genetic map of the region Xp22.1-p22.2, which contains the HYP (hypophosphataemic rickets) locus. DXS365 gave no recombinants with HYP, with a peak Lod score of 5.4 at theta = 0.0. A microsatellite marker mPA274 was derived for the DXS274 locus; it detects five alleles with a polymorphism information content of 0.55. Combining information from this microsatellite and the original DXS274 marker, probe CRI-L1391, the peak Lod score for DXS274 against HYP was 9.6 at theta = 0.02. A microsatellite associated with the DXS207 locus (mPA207) gave a peak lod score against HYP of 4.7 at theta = 0.14. A consideration of key recombinants and multilocus analysis suggests the gene order. Xpter-DXS207-DXS43-DXS197-(DXS365,HYP)- DXS274-DXS41-Xcen.

Base Sequence↗
PubMedDate not supplied

Ceftriaxone versus cefazolin with probenecid for severe skin and soft tissue infections.

To evaluate the hypothesis that a single daily administration of cefazolin and probenecid and a single daily administration of ceftriaxone and probenecid would be equally effective, in combination with oral antibiotics, for the outpatient treatment of skin and soft tissue infections, a randomized, double-blind study was completed. Patients presenting to the Emergency Department with the primary diagnosis of cellulitis or soft tissue infection, excluding patients requiring immediate hospital admission, received either 2 g of ceftriaxone or 2 g of cefazolin, each with 1 g of probenecid, on a daily basis as outpatients from the Emergency Department. The patients were given a prescription for oral penicillin and cloxacillin for independent procurement. Outcome was assessed based on reduction in the size of the infected area, and the need for additional treatment (other antibiotics or hospital admission). A total of 194 patients were randomized to receive ceftriaxone (96) or cefazolin (98). There was no statistical difference in cause of infection, site of infection, duration of treatment, noncompliance or need for incision or drainage of the wound. The outcome, as determined by the ratio of the involved infected area on initial and last treatment day, and the frequency of failure were similar. The single daily administration of 2 g of either cefazolin, in combination with probenecid, or ceftriaxone are equivalent in efficacy in the outpatient treatment of skin and soft tissue infections. There is the potential for significant cost savings in utilizing outpatient cefazolin therapy over ceftriaxone for treatment of these infections.

Ambulatory Care↗