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Biomedical subjects

J McAnulty

Publications and source records attributed to J McAnulty.

At least 19 recordsLinked to original sources
PubMed2001

Acute poststreptococcal glomerulonephritis: public health implications of recent clusters in New South Wales and epidemiology of hospital admissions.

Acute poststreptococcal glomerulonephritis (APSGN) is an inflammatory kidney condition that can complicate Group A streptococcal infections. Two clusters of APSGN occurred recently in New South Wales (NSW), Australia; one in a rural town in December 1999 and the other in a Sydney suburb in January 2000. We interviewed carers of the affected children but found no common exposures except three of the Sydney cases were cousins in frequent contact. To assess the probability of these clusters occurring, we analysed hospital admissions for acute glomerulonephritis, as a proxy for APSGN in younger patients. The incidence of acute glomerulonephritis in NSW during 1989/90-1997/8 in residents aged under 20 years was 2.2/100000/year (95% CI 2.0-2.5). Incidence was highest in children aged 5-9 years, boys and Aboriginal children. We found no evidence for other clusters during that period. The recent clusters highlight the continued potential for unexpected future outbreaks of APSGN.

Acute Disease↗
PubMed2001

Baseline factors predicting early resumption of driving after life-threatening arrhythmias in the Antiarrhythmics Versus Implantable Defibrillators (AVID) Trial.

BACKGROUND: In the Antiarrhythmics Versus Implantable Defibrillators (AVID) Trial, patients with ventricular fibrillation or hemodynamically unstable ventricular tachycardia were randomly assigned to receive either an implantable cardioverter-defibrillator (ICD) or antiarrhythmic drug therapy. As part of the trial, patients were asked to participate in a prospective driving survey. The purpose of the survey was to determine what baseline factors and patient characteristics specifically predicted resumption of driving earlier than advised by current guidelines. METHODS: Patients were surveyed anonymously as to their driving habits in the initial period after random assignment and every 6 months thereafter. AVID study coordinators were independently asked to assess their patients' driving status as well. The relation between baseline factors and time to resumption of driving was explored by means of Kaplan-Meier estimates for univariate analyses and the stepwise Cox proportional hazards regression model for multivariate analyses. RESULTS: There were 802 patients who were eligible for assessment of driving status. The majority of patients (58%) resumed driving an automobile within 6 months of their index arrhythmia regardless of whether they received drug therapy or an ICD. By multivariate analysis, patients who were younger than 65 years of age, male, and college educated were more likely to drive early, as were patients whose index arrhythmia was ventricular tachycardia. CONCLUSIONS: Younger, college-educated men and those whose index arrhythmia is ventricular tachycardia are most likely to resume driving <6 months after the initiation of therapy for a potentially life-threatening ventricular arrhythmia. Patients with an ICD did not appear to resume driving later than those who were discharged on antiarrhythmic drugs alone.

Aged↗
PubMed2000

Surgically treatable upper respiratory disorders.

Diseases of the upper airways and trachea frequently result in inspiratory dyspnea, and surgery is often required to alleviate symptoms arising from these disorders. Although surgery alone may not effectively treat all diseases of the nasal cavity and sinuses, surgery allows removal of foreign bodies that cannot be retrieved endoscopically and may facilitate treatment of other disorders. Indications for surgery are discussed, and principles of surgery of the upper airways are reviewed.

Animals↗
PubMed2000

Advantages and disadvantages of trial designs: a review of analysis methods for ICD studies. AVID Investigators.

General modalities of analyses that have been used for ICD studies are reviewed. Published "typical" examples are briefly described. The historical cohort method is exemplified with previously unpublished data from the Seattle Cardiac Arrest Survivor database. The AVID Study database is used to compare the results obtained from nonrandomized methodologies with randomized methodologies. Particular issues related to the use of the ICD for example, mode of death, inability to blind, selection practice, and treatment decision times make this a natural pedagogic platform.

Bias↗
PubMed1998

A salmonellosis outbreak linked to internally contaminated pork meat.

In August 1995, we investigated an outbreak of salmonellosis among patrons who attended a church camp in southern Sydney. Of the 73 attendees interviewed, 22 reported a gastroenteritis illness within two days of the conclusion of the camp, with one attendee hospitalised. Two stool specimens, one from each of two attendees, were both positive for Salmonella typhimurium phage type 9. A cohort study of 68 attendees established a statistically significant association between illness and the consumption of de-boned roast pork (estimated relative risk infinite, p = 0.03) and between illness and the degree of cooking of the pork meat (chi 2 for trend 5.8, p < 0.02). The outbreak was most likely caused by consumption of roast pork that had been internally contaminated during the de-boning process. Meat and meat products that may be internally contaminated, such as de-boned meats, should be thoroughly cooked. Guidelines about minimum cooking temperatures of meats liable to internal contamination should be developed for commercial food handlers in Australia.

Adolescent↗
PubMed1996

Body mass index and cardiovascular risk factors in Pacific Island Polynesians and Europeans in New Zealand.

OBJECTIVES: To examine relationships between body mass index (BMI) and cardiovascular risk factors in 279 Europeans and 231 Polynesian Pacific Islanders in New Zealand. METHODS: Participants were recruited from Seventh-Day Adventist church meetings or camps, and were surveyed by self-administered questionnaire. Blood pressure, weight and height were measured. Fasting blood samples were analysed for lipids, glucose and fructosamine. RESULTS: Age-adjusted BMI was higher in Pacific Islanders than in Europeans: 32.8(0.3) versus 25.6(0.3); means(SE); p = 0.0001). In Europeans, BMI was positively associated with systolic and diastolic blood pressures, triglycerides, total cholesterol, LDL cholesterol and fasting blood glucose, and negatively associated with HDL cholesterol. In Pacific Islanders, BMI was associated only with systolic and diastolic blood pressures, and with HDL cholesterol. These associations were stronger in Europeans than in Pacific Islanders. CONCLUSIONS: In this group of Pacific Islanders, the association between BMI and cardiovascular risk factors was weaker than in Europeans. This suggests that either BMI is a poor measure of adiposity in Pacific Islanders, or that adiposity may be less strongly linked to cardiovascular disease in Pacific Islanders.

Adult↗
PubMed1992

Supraventricular tachyarrhythmias, congenital heart disease, and sudden cardiac death.

The etiologies of sudden cardiac death following the surgical treatment of congenital heart defects remain uncertain. A young patient with prior repair of partial anomalous pulmonary venous return is presented, in whom brief episodes of a supraventricular tachyarrhythmia (rate 170/min) were documented to result in ventricular fibrillation. This unusual sequence may represent a basis for unexplained sudden cardiac death in other patients following atrial surgical procedures for the treatment of congenital heart disease.

Adolescent↗
PubMed1990

Circadian variation in ventricular electrical instability associated with coronary artery disease.

Although sudden cardiac deaths and ischemic cardiac events clearly occur in a circadian pattern, such a pattern has not been shown for primary arrhythmic events. Because primary arrhythmic events are thought to play an important role in sudden cardiac death, a large series of ventricular stimulation studies was analyzed to determine whether circadian variation in ventricular electrical instability exists. If such a circadian variation could be shown, it could have implications for the conduct and interpretation of electrophysiologic testing and the etiology of circadian variation in sudden cardiac death. Results of 2 drug-free ventricular stimulation studies performed 4 to 28 hours apart in each of 162 patients with coronary artery disease were analyzed. Rate and duration of induced arrhythmia, number of extrastimuli required to induce arrhythmia and changes in these factors between the 2 tests in each patient were analyzed. Comparisons were made by half-day, by hour and in a temporally continuous manner to eliminate errors associated with any single method. No significant circadian variation was found in any electrophysiologic measure of ventricular electrical instability despite adequate statistical power. These findings show that the time of day during which ventricular stimulation tests are performed does not affect test results, and therefore does not need to be controlled during electrophysiologic studies. If these findings are parallel to those in ambulatory patients with coronary artery disease, then circadian changes in ventricular electrical instability may not play as important a role in the circadian pattern of sudden cardiac death as had been previously thought.

Cardiac Pacing, Artificial↗
PubMed1990

Cloning, sequence analysis, and expression of genes encoding xylan-degrading enzymes from the thermophile "Caldocellum saccharolyticum".

A lambda recombinant bacteriophage coding for xylanase and beta-xylosidase activity has been isolated from a genomic library of the extremely thermophilic anaerobe "Caldocellum saccharolyticum." Partial Sau3AI fragments of the lambda recombinant DNA were ligated into pBR322. A recombinant plasmid with an insertion of ca. 7 kilobases of thermophilic DNA expressing both enzymatic activities was isolated. The location of the genes has been established by analyzing deletion derivatives, and the DNA sequence of 6.067 kilobases of the insert has been determined. Five open reading frames (ORFs) were found, one of which (ORF1; Mr 40,455) appears to code for a xylanase (XynA) which also acts on o-nitrophenyl-beta-D-xylopyranoside. Another, ORF5 (Mr 56,365), codes for a beta-xylosidase (XynB). The xynA gene product shows significant homology with the xylanases from the alkalophilic Bacillus sp. strain C125 and Clostridium thermocellum.

Amino Acid Sequence↗
PubMed1989

Nucleotide sequence and replication characteristics of RepFIB, a basic replicon of IncF plasmids.

A second autonomous replicon of P307, RepFIB, has been isolated that has significant homology with other replicons in IncFI group plasmids. Eleven homologous repeats of 21 base pairs are present on the sequence and flank an open reading frame capable of coding for a protein of about Mr = 40,000. This protein was identified by maxicell analysis of cloned RepFIB. A series of deletion mutations of RepFIB were inserted into a DNA polymerase I-dependent vector and examined for their replication proficiency in a polA1 strain. These experiments defined a minimal replication region of 1.6 kilobases which includes the three repeats immediately upstream and downstream of the open reading frame. Deletion of a second set of repeats further downstream doubled the copy number of a chimeric plasmid replicating under RepFIB control. It was concluded that these repeats control the copy number of the replicon. Incompatibility tests showed that all three sets of repeats could express incompatibility with a resident RepFIB plasmid.

Base Sequence↗
PubMed1987

Determinants of induced sustained arrhythmias in survivors of out-of-hospital ventricular fibrillation.

We prospectively studied 196 consecutive survivors of out-of-hospital ventricular fibrillation (VF) not associated with acute myocardial infarction and 46 consecutive, control patients without prior ventricular arrhythmias. Programmed stimulation included two extrastimuli (S3 protocol) in all patients and three extrastimuli (S4 protocol) in the last 140 study patients and in all control patients. Sustained ventricular tachycardia (VT) or VF was not induced in any control patient. In study patients, logistic regression identified two independent predictors of induced, sustained VT for both S3 and S4 protocols: prior spontaneous, sustained VT (37 patients; p less than or equal to .001) and prior myocardial infarction (113 patients; p = .005). With the S3 protocol, sustained VT was induced in 54% of patients with both prior myocardial infarction and prior sustained VT vs 4% without either; with the S4 protocol, sustained VT was induced in 91% vs 13%, respectively. Eighty-three percent of induced VT episodes had a cycle length less than 300 msec, and all required termination by cardioversion or pacing. VF was induced only in survivors of out-of-hospital VF without prior, spontaneous, sustained VT (S3 protocol, 9%; S4 protocol, 24%) but not in study patients with prior sustained VT (S3, p = .10; S4, p = .05) or control patients (S3, p = .06; S4, p = .01). The mean coupling intervals of extrastimuli that induced VF were not significantly different from the intervals that induced sustained VT.(ABSTRACT TRUNCATED AT 250 WORDS)

Arrhythmias, Cardiac↗
PubMed1985

Location of rep and inc sequences in the F secondary replicon.

Miniplasmids derived by deletion of DNA from the F plasmid secondary replicon have been tested for the ability to replicate and to express incompatibility with the IncFI plasmid, ColV3-K30. The results demonstrate that the minimal rep region of the secondary replicon lies within a 1.9-kb sequence (33.7F-35.6F kb), and that an inc region, presumably involved in replication control, is present in a 0.45-kb portion of the rep region (33.7F-34.15F kb). In addition, the secondary replicon was found not to require DNA polymerase I activity.

Chromosome Mapping↗
PubMed1983

Myocardial infarction following an acute viral illness.

A 24-year-old man was admitted to our coronary care unit with a transmural lateral wall myocardial infarction 48 hours after the onset of a viral illness. Coronary angiography two months following the patient's discharge from the hospital disclosed normal left ventricular wall motion and coronary anatomy. The pathophysiologic mechanisms of myocardial infarction in the setting of normal coronary arteries are reviewed. The possibility of a viral-induced myopericarditis is raised.

Acute Disease↗
PubMed1982

Serial electrophysiologic studies in patients with chronic bundle branch block.

Serial His bundle recordings were obtained during 1:1 atrioventricular (AV) conduction in 90 patients with chronic bundle branch block over a mean interval of 30 months. Atrioventricular conduction time (AH) increased greater than or equal to 10 msec in 25 (28%) and infranodal conduction time (HV) increased greater than or equal to 8 msec in 29 (32%), but only 10 patients had parallel increases in AH and HV intervals. Increases in conduction times were independent of age, time interval between studies, cause of heart disease or initial AH or HV intervals. Women were significantly more likely than men to show an increased HV interval and spontaneous trifascicular block. Spontaneous progression to second- or third-degree AV block occurred at the AV node in seven patients and below the node in 12 patients. The initial AH interval was prolonged in five of seven patients (71%) with AV nodal block and had increased further in only two at restudy. The initial HV interval was abnormal in eight of 12 patients (67%) who progressed to infranodal block and was prolonged further in eight at restudy. We conclude that in patients with chronic bundle branch block, (1) approximately 33% show progressive AV conduction system disease and AV nodal and infranodal disease progress independently; (2) progression of infranodal disease is more common in women; (3) AV nodal disease progress independently; (2) progression of infranodal disease is more common in women; (3) AV nodal disease is a common cause of AV block and can occur without further prolongation of the AH interval once a critical level of disease is attained, whereas infranodal block is usually accompanied by progressive lengthening of the HV interval; and (4) progression of AV conduction disease is not readily predictable from clinical and electrophysiologic variables.

Aged↗
PubMed1981

Prognosis in bundle branch block.

Chronic bundle branch block is common and is a marker for associated heart disease. In the asymptomatic patient no diagnostic studies or treatment are required. In the patient with symptoms suggestive of a bradyarrhythmia, attempts to document complete heart block should be made and if this rhythm is demonstrated a permanent pacemaker should be inserted. If no arrhythmia is documented, close clinical follow-up is warranted but insertion of a permanent pacemaker has not been shown to be useful in preventing symptoms or prolonging life.

Bundle-Branch Block↗