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Biomedical subjects

J R Kerr

Publications and source records attributed to J R Kerr.

At least 19 recordsLinked to original sources
PubMed1995

Design and production of a target-specific monoclonal antibody to parvovirus B19 capsid proteins.

Native parvovirus B19 was used as antigen to produce a mouse monoclonal antibody, R92F6, which reacted with B19 VP1 and VP2, neutralised the virus in bone marrow culture, and labelled infected cells in paraffin-embedded tissues from cases of B19-related fetal hydrops. The B19 epitope recognised by R92F6 (amino acids 328-344 from the amino terminal region of B19 VP2) appears to be highly conserved, since these tissue specimens were obtained over a 13 year period from widely spaced locations in the UK. This epitope was synthesised as a peptide (S7b) which was used as antigen to produce a mouse monoclonal antibody, 3H8, which specifically reacted with the B19 capsid proteins VP1 and VP2 in immunofluorescence and immunoblot assays. 3H8 was also capable of labelling formalin-fixed, paraffin-embedded, B19-infected fetal tissue and was shown to be of the same isotype as R92F6 (IgG1). Highly conserved epitopes derived from conserved amino acid sequences are valuable in the diagnosis of infectious disease. If these can be recognised and accurately synthesised, the production of specific mouse monoclonal antibodies may be possible for many human pathogens. Considering the vast amount of sequence data available in the literature, this approach seems to be both feasible and of wide potential.

Animals↗
PubMed1995

Genetic diversity in the non-structural gene of parvovirus B19 detected by single-stranded conformational polymorphism assay (SSCP) and partial nucleotide sequencing.

A homologous region in the parvovirus B19 non-structural gene (B19 nt 1399-1682) was examined in 50 samples from patients with a wide variety of B19-related disease from various countries by PCR amplification, single-stranded conformational polymorphism (SSCP) assay and nucleotide sequencing. Five SSCP types were confirmed by nucleotide sequence analysis. Of a total of 6 mutations, all were silent. Types 3 and 4 accounted for 92% of strains. There was no correlation between genome type and either clinical illness or patient age. However, there was a correlation between SSCP type and country of origin. Type 3 strains predominated in Japan (18/26) and the UK (6/8), whereas type 4 predominated in the USA (9/12). Notably, type 3 strains also predominated among females (14/18), whereas there were approximately equal numbers of strain types 3 (7/17) and 4 (8/17) among males; an observation which remains unexplained. Within the Japanese group, although type 3 strains predominated overall, strains isolated from 1981 to 1987 consisted of types 1 (2/15), 2 (1/15), 3 (8/15), and 4 (4/15), whereas strains isolated from 1990 to 1994 consisted almost entirely of type 3 (10/11).

Adolescent↗
PubMed1995

Investigation of a nosocomial outbreak of Pseudomonas aeruginosa pneumonia in an intensive care unit by random amplification of polymorphic DNA assay.

From July to September 1993 in the intensive care unit of the Royal Victoria Hospital there were 10 cases of pneumonia associated with sputum culture of Pseudomonas aeruginosa. The isolates had an identical biotype and pyocine typing profile. The same strain of P. aeruginosa was recovered from the sink plug-hole in two rooms, and the tap handles and ventilator tubing in a third room. All strains were retrospectively typed by the random amplification of polymorphic DNA (RAPD) method using a 26-mer oligonucleotide primer, and were identical in profile. Recommendations to medical and nursing staff included secretion isolation precautions, terminal disinfection after patient discharge, use of disposable vinyl gloves by hospital staff for all body substance contacts, thorough handwashing with 4% chlorhexidine gluconate before and after dealing with all patient contacts, and prompt, appropriate antibiotic treatment for P. aeruginosa pneumonia. RAPD is a simple and effective method to determine the relatedness of P. aeruginosa isolates, and typing results are available within a single working day; thus dramatically increasing its clinical relevance over existing molecular methods.

Bacterial Typing Techniques↗
PubMed1995

A study of the role of parvovirus B19 in rheumatoid arthritis.

Serum and synovial tissue from 26 patients with rheumatoid arthritis (RA) (according to the diagnostic criteria of the American Rheumatism Association) and 26 patients with osteoarthritis (OA) were examined. Among the RA group, the female to male ratio was 4.2:1, and the age range was 44-82 yr with a mean of 64.0 yr; joints from which synovium was sampled were hip (n = 12), knee (n = 9), ankle (n = 3) and shoulder (n = 2). The duration of rheumatoid disease ranged from 6 to 24 yr with a mean of 13.9 yr. Among the OA group, the female to male ratio was 2.25:1, and the age range was 51-88 yr with a mean of 68.2 yr; joints from which synovium was sampled were hip (n = 18) and knee (n = 8). Twenty-one patients from the RA group and 20 patients from the OA group had evidence of previous parvovirus B19 infection (serum anti-B19 IgG), and all patients from both groups were serum anti-B19 IgM negative. Synovial sections from all 52 patients were stained with mouse monoclonal antibodies, 3H8 (to B19 capsid proteins) and alpha-P (to blood group P antigen). All tissue sections examined were found to be negative for both B19 capsid proteins and blood group P antigen. Using a nested polymerase chain reaction (PCR) assay, all patients were negative for serum B19 DNA. However, B19 DNA was demonstrated in the synovium of 10 of 26 RA patients and 9 of 26 OA patients; uncorrected chi 2 value = 0.08; degrees of freedom = 1; P = 0.77. All 19 patients testing positive for synovial B19 DNA had evidence of prior exposure to B19 infection (serum anti-B19 IgG). In conclusion, although there is published evidence of chronic rheumatoid-like arthropathy following acute parvovirus B19 infection, our findings do not support the involvement of B19 in the aetiopathogenesis of RA.

Adult↗
PubMed1995

Satisfaction and cardiac lifestyle.

A descriptive, correlational approach was used to examine the relationship between success with a recommended cardiac lifestyle and satisfaction with a cardiac rehabilitation programme 1 year following completion. The Cardiac Lifestyle Questionnaire (CLQ) and the Programme Satisfaction Questionnaire (PSQ) evaluated success in eight lifestyle dimensions and four satisfaction areas. Seventy-two participants (85.7%) returned questionnaires. Successful lifestyle dimensions included exercise, tobacco, alcohol and weight; diet, stress and hypertension were unsuccessful. Two open-ended programme satisfaction questions revealed that 'caring' and 'individualized' approaches were most favoured by participants. These provide direction for high-quality care in cardiac rehabilitation programmes. Discriminant analysis did not yield a statistically significant separation of groups relative to cardiac lifestyle on the basis of programme satisfaction areas.

Adult↗
PubMed1994

An outbreak of parvovirus B19 infection; a study of clinical manifestations and the incidence of fetal loss.

Eighty-five cases of B19 infection were diagnosed in Northern Ireland from 1984 to 1989; 65 of these occurred during 1989, the outbreak year. Of the total 85 cases, 15 had a rash, 21 had arthralgia, 47 had a rash and arthralgia, and 2 had aplastic crisis. The age range was 4-63 years with a mean of 26.9 years. Thirty cases (35%) were referred to hospital; 25 of these had arthralgia and 2 had aplastic crisis. Two thousand four hundred pregnant women at 12 weeks gestation in 1989 were screened for anti-B19 IgM; 8 were positive. Of these 8 patients, 7 progressed to delivery of a normal fetus and one had an intra-uterine death at 26 weeks gestation; no congenital abnormalities were noted in any fetus. The incidence of fetal involvement in maternal B19 infection in this study was therefore 12.5%.

Adolescent↗
PubMed1994

A comparison of oral, axillary, rectal and tympanic-membrane temperatures of intensive care patients with and without an oral endotracheal tube.

Monitoring rectal temperatures (RTs) in orally intubated, critically ill patients is common practice, as they are generally believed to be more accurate than oral temperatures (OTs). This study was designed to compare OTs of critically ill patients, with and without an endotracheal tube, using patients as their own control. Axillary (AT), tympanic membrane (TMT) and RTs of patients were also studied. Sixty-five orally intubated patients ready for extubation, ranging in age from 17 to 96 years (17 female and 48 male), were included in the study. OT, AT, RT and TMTs were taken before and after extubation. Using a t-test for paired samples, significant differences were found between both ATs and OTs measured with and without an oral endotracheal tube (P < 0.01); the differences (-0.12 and 0.08 degrees C, respectively) were not considered clinically important. Further t-tests for paired samples revealed no significant difference between TMTs and RTs pre and post extubation. Respiratory rate, presence or absence of teeth, and mouth position were shown to have no effect on OT (t-tests, P < 0.01). Analysis of variance showed no difference in OT dependent on room temperature or temperature within the endotracheal tube. It was concluded that OTs are accurate when taken in patients who are orally intubated and ready for extubation.

Adolescent↗
PubMed1994

Suppression of fungal growth exhibited by Pseudomonas aeruginosa.

Three surgery patients were monitored postoperatively, with particular reference to lung infection. In each case there was a clinical impression that Pseudomonas aeruginosa suppressed the growth of Candida albicans in patients with clinically significant lung infections from whom both of these organisms were isolated from serial sputum samples. Regrowth of C. albicans after P. aeruginosa eradication occurred in two patients, despite fluconazole therapy, to which both C. albicans isolates were susceptible. In all three patients, the strain of P. aeruginosa was found to inhibit the growth of the corresponding C. albicans strain in vitro. Further in vitro susceptibility studies revealed significant inhibition by 10 strains of P. aeruginosa of 11 strains of fungi known to infect humans; these were Candida krusei, Candida keyfr, Candida guillermondii, Candida tropicalis, Candida lusitaniae, Candida parapsilosis, Candida pseudotropicalis, Candida albicans, Torulopsis glabrata, Saccharomyces cerevisiae, and Aspergillus fumigatus.

Candida↗
PubMed1993

Computerised calculation of the true costs of antibiotic therapy.

A system for computerised calculation of the drug costs and hidden costs of antibiotic therapy is described. A previously developed method for costing antibiotic therapy was used to quantify hidden costs arising from intravenous administration, labour, serum antibiotic assays, monitoring of haematological and biochemical indices, and disposal of sharp instruments. These calculations were installed into a software system using spreadsheets (Microsoft Excel/Windows). Cost calculations were simplified as a result of automated calculation with centralised cost updating, a facility for new antibiotics, a facility for atypical regimens, availability to a number of users, password protection and a facility for multiple courses of intravenous antibiotic therapy.

Anti-Bacterial Agents↗
PubMed1992

Technique for calculation of the true costs of antibiotic therapy.

An in-house method for costing antibiotic therapy is presented which quantifies hidden costs including costs arising from intravenous administration, labour, serum antibiotic assay, monitoring of haematological and biochemical indices and disposal of sharp instruments. A study of various hospital procedures relating directly to antibiotic therapy was undertaken in an acute medical ward, which involved determination of staff members performing various procedures, consumables used and time taken. Results of this study facilitated accurate quantification of hidden costs of i.v. antibiotic therapy in this ward. Using these results, the cost of five-day courses of gentamicin, cefuroxime, penicillin G, flucloxacillin and erythromycin were calculated. The costing of adverse effects was not attempted. It is recommended that a costing technique of this sort is used in cost-benefit analysis of antibiotic use, as the cost of the drug alone is misleading.

Anti-Bacterial Agents↗
PubMed1992

Five cases of Alcaligenes pseudobacteraemia.

A cluster of five cases of pseudobacteraemia due to the organism Alcaligenes denitrificans occurred in three hospital medical wards over a four week period. The same organism was isolated from four of twelve commercially prepared bottles for erythrocyte sedimentation tests. The most likely explanation for the outbreak is that the ESR bottles were filled prior to inoculation of blood culture bottles. The outbreak was brought to an end by advising on correct procedure.

Alcaligenes↗