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Biomedical subjects

J Ward

Publications and source records attributed to J Ward.

At least 19 recordsLinked to original sources
PubMed2006

Late results of mesh wound closure after elective open aortic aneurysm repair.

INTRODUCTION: Incisional hernia is a common late complication after abdominal aortic aneurysm (AAA) repair. We examined the outcome after prophylactic placement of a pre-peritoneal polypropylene mesh during abdominal closure in consecutive patients having elective AAA repair. REPORT: At least 30 months after surgery, 28 patients underwent clinical and ultrasound examination of their surgical wound for incisional hernias. Only one patient had a hernia in the original surgical scar. No patients had late mesh-related wound problems. DISCUSSION: Pre-peritoneal polypropylene mesh placement is a simple, safe and effective method to decrease the incidence of incisional hernia after AAA repair.

Aortic Aneurysm, Abdominal↗
PubMed2006

Salmonella surveillance in raw and cooked meat and meat products in the Republic of Ireland from 2002 to 2004.

The food industry, under the regulation of the Department of Agriculture and Food (DAF) in the Republic of Ireland, is required to undertake all microbiological testing in relation to zoonoses control, in laboratories approved by DAF. These laboratories submit a monthly report of all tests undertaken, together with all presumptive Salmonella isolates for confirmation, typing and storage to the Central Veterinary Research Laboratory (CVRL). Details of Salmonella tests on 110,229 raw and 25,189 cooked meat samples from 25 laboratories were recorded over the 3-year period 2002-2004. Salmonella spp. were isolated from 1.0% of the 110,229 raw meat samples and 0.1% of the 25,189 cooked meat samples tested. The percentage of raw meat samples contaminated with Salmonella decreased over the three-year period from 1.2% to 0.9%. There was no seasonal trend in the isolation of Salmonella from any of the meats or meat products. Recoveries of the organism were highest for turkey and chicken meats at 3.1% and 2.8%, respectively, followed by porcine meats at 2.1%. The recoveries were much lower for ovine meats and meat products at 0.2% and bovine meat and meat products at 0.16%.

Animals↗
PubMed2006

Patient safety, systems design and ergonomics.

The complexity of the health care environments necessitates an holistic and systematic ergonomics approach to understand the potential for accidents and errors to occur. The health service is also a socio-technical system, and design needs must be met within this context. This paper aims to present the design challenges and emphasises the specialised needs of the health care sector, when dealing with patient safety. It also provides examples of approaches and methods that ergonomists can bring to help inform our knowledge of these systems and the potential towards improving their safety. Mapping workshops provide an example of such methods. Results from these are used to illustrate how the knowledge base required for better design requirements can be generated. The workshops were developed specifically to help improve the design of medication packaging and thereby reduce the probability of medication error. The issues raised are now the subject of further research, design requirements guidance and new design concepts. The paper illustrates the need to engage with the design community and, through the use of robust scientific methods, to generate appropriate design requirements.

Delivery of Health Care↗
PubMed2006

New MR techniques for the detection of liver metastases.

It is well established that hepatic resection improves the long-term prognosis of many patients with liver metastases. However, incomplete resection does not prolong survival, so knowledge of the exact extent of intra-hepatic disease is crucially important in determining patient management and outcome. MR imaging is well recognised as one of the most sensitive methods for detecting metastases. Recent developments in gradient coil design, the use of body phased array coils and the availability of novel MR contrast agents have resulted in MR being recognised as the pre-operative standard in this group of patients. However, diagnostic efficacy is extremely dependent on the choice and optimisation of pulse sequences and the appropriate use of MR contrast agents. This article reviews current MR imaging techniques for the detection and characterisation of metastases and discusses the relative capability of different techniques for detecting small lesions.

Adenocarcinoma↗
PubMed2006

HLA Cw*06 is not essential for streptococcal-induced psoriasis.

BACKGROUND: Streptococcal throat infections and HLA Cw6 (Cw*06) have been implicated in the pathogenesis of psoriasis, particularly in the guttate form. OBJECTIVES: To study 105 Irish patients with psoriasis to investigate the relationship between streptococcal infections and Cw*06. METHODS: The patients were divided into two groups: those with guttate psoriasis or guttate flare (guttate group, GG, n=64) and those with chronic plaque psoriasis (chronic plaque group, CPG, n=41). RESULTS: The incidence of Cw*06 was 86% in the GG and 73% in the CPG, which was not significantly different (P=0.1725) but the incidence in both groups was significantly higher than in an Irish control group (18%) (P<0.0001 vs. GG and P<0.0001 vs. CPG). Evidence for streptococcal infection was higher in the GG (56%) than in the CPG (32%) (P=0.0231). Of those patients with evidence of streptococcal infection, 30 of 36 GG (83%) and nine of 13 CPG (69%) patients possessed the Cw*06 genotype. CONCLUSIONS: Thus, not all patients with streptococcal-related psoriasis carry Cw*06. The role of Cw*06 in psoriasis, if any, has yet to be determined.

Adolescent↗
PubMed2006

Evidence-based clinical policy: case report of a reproducible process to encourage understanding and evaluation of evidence.

We report within a case study a reproducible process to facilitate the explicit incorporation of evidence by a multidisciplinary group into clinical policy development. To support the decision-making of a multidisciplinary Intersectoral Advisory Group (IAG) convened by the Royal Australasian College of Physicians Health Policy Unit, a systematic review of randomized controlled trials about environmental tobacco smoke and smoking cessation interventions in paediatric settings was first undertaken. As reported in detail here, IAG members were then formally engaged in a transparent and replicable process to understand and interpret the synthesized evidence and to proffer their independent reactions regarding policy, practice and research. Our intention was to ensure that all IAG members were democratically engaged and made aware of the available evidence. As clinical policy must engage stakeholder representatives from diverse backgrounds, a process to equalize understanding of the evidence and 'democratize' judgment about its implications is needed. Future research must then examine the benefits of such explicit steps when guidelines, in turn, are implemented. We hypothesize that changes to future practice will be more likely if processes undertaken to develop guidelines are transparent to clinicians and other target groups.

Advisory Committees↗
PubMed2006

Identification of erythrobactin, a hydroxamate-type siderophore produced by Saccharopolyspora erythraea.

AIMS: To investigate the production of siderophores by Saccharopolyspora erythraea SGT2 and how this production is affected by the inoculum. METHODS AND RESULTS: When grown in a low-iron, chemically defined medium (CDM), the soil dwelling actinomycete S. erythraea secretes a substance that is reactive in the nonspecific chrome azurol S (CAS) assay. Importantly, the production of CAS-reactive substance is highly reduced upon the addition of 0.925 micromol l(-1) iron to the cultures and has a peak of production in the late-log to early stationary growth phase. In addition, the culture supernatants tested were negative in the Arnow and Rioux assays but positive in the Csáky procedure. Interestingly, we also found evidence that the production of this CAS-reactive substance in CDM was highly reduced, when inoculated with cells that had been previously grown to late-stationary phase. Conversely, inocula derived from late-log to early stationary cultures presented high levels of CAS activity. CONCLUSIONS: These results indicate that S. erythraea produces a hydroxamate-type siderophore that we have generically designated as erythrobactin. Additionally, the inocula growth stage plays a key role in siderophore production in S. erythraea. SIGNIFICANCE AND IMPACT OF THE STUDY: It is the first evidence for siderophore synthesis in S. erythraea and one of the first examples of non-polyketide secondary metabolite production by this organism.

Culture Media↗
PubMed2006

Smart tool for force measurements during knee arthroscopy: in vivo human study.

This paper describes the magnitude and patterns of forces obtained by using a probe, equipped with a six-axis force torque sensor, in knee arthroscopy. The probe was used by orthopaedic surgeons and trainees, who performed 11 different tasks in 10 standard knee arthroscopies. The force magnitude and patterns generated are presented; which can support the development of virtual arthroscopy systems with realistic haptic feedback. The results were compared across both groups of surgeons. A difference in the force patterns generated by senior versus junior surgeons was noted which can aid in the development of an objective assessment system for arthroscopy skills. The results could potentially be useful to assess future performance in real arthroscopy.

Arthroscopy↗
PubMed2005

An anomaly in the isotopomer shift of the hyperfine spectrum of LiI.

A high-precision examination of the hyperfine spectrum of 6LiI in comparison with 7LiI shows a shift in the iodine nuclear electric quadrupole moment that cannot be accounted for by a model in which the electric field gradient at the iodine site is assumed to depend only upon the internuclear distance between Li and I. The other hyperfine interactions are consistent between the two isotopomers, including the previously reported electric hexadecapole interaction of the iodine nucleus.

Journal Article↗
PubMed2005

A molecular identification system for grasses: a novel technology for forensic botany.

Our present inability to rapidly, accurately and cost-effectively identify trace botanical evidence remains the major impediment to the routine application of forensic botany. Grasses are amongst the most likely plant species encountered as forensic trace evidence and have the potential to provide links between crime scenes and individuals or other vital crime scene information. We are designing a molecular DNA-based identification system for grasses consisting of several PCR assays that, like a traditional morphological taxonomic key, provide criteria that progressively identify an unknown grass sample to a given taxonomic rank. In a prior study of DNA sequences across 20 phylogenetically representative grass species, we identified a series of potentially informative indels in the grass mitochondrial genome. In this study we designed and tested five PCR assays spanning these indels and assessed the feasibility of these assays to aid identification of unknown grass samples. We confirmed that for our control set of 20 samples, on which the design of the PCR assays was based, the five primer combinations produced the expected results. Using these PCR assays in a 'blind test', we were able to identify 25 unknown grass samples with some restrictions. Species belonging to genera represented in our control set were all correctly identified to genus with one exception. Similarly, genera belonging to tribes in the control set were correctly identified to the tribal level. Finally, for those samples for which neither the tribal or genus specific PCR assays were designed, we could confidently exclude these samples from belonging to certain tribes and genera. The results confirmed the utility of the PCR assays and the feasibility of developing a robust full-scale usable grass identification system for forensic purposes.

Botany↗
PubMed2005

Somatosensory activations during the observation of touch and a case of vision-touch synaesthesia.

In this study, we describe a new form of synaesthesia in which visual perception of touch elicits conscious tactile experiences in the perceiver. We describe a female subject (C) for whom the observation of another person being touched is experienced as tactile stimulation on the equivalent part of C's own body. Apart from this clearly abnormal synesthetic experience, C is healthy and normal in every other way. In this study, we investigate whether C's 'mirrored touch' synesthetic experience is caused by overactivity in the neural system that responds to the observation of touch. A functional MRI experiment was designed to investigate the neural system involved in the perception of touch in a group of 12 non-synesthetic control subjects and in C. We investigated neural activity to the observation of touch to a human face or neck compared with the observation of touch to equivalent regions on an object. Furthermore, to investigate the somatosensory topography of the activations during observation of touch, we compared activations when observing a human face or neck being touched with activations when the subjects themselves were touched on their own face or neck. The results demonstrated that the somatosensory cortex was activated in the non-synesthetic subjects by the mere observation of touch and that this activation was somatotopically organized such that observation of touch to the face activated the head area of primary somatosensory cortex, whereas observation of touch to the neck did not. Moreover, in non-synesthetic subjects, the brain's mirror system-comprising premotor cortex, superior temporal sulcus and parietal cortex-was activated by the observation of touch to another human more than to an object. C's activation patterns differed in three ways from those of the non-synesthetic controls. First, activations in the somatosensory cortex were significantly higher in C when she observed touch. Secondly, an area in left premotor cortex was activated in C to a greater extent than in the non-synesthetic group. Thirdly, the anterior insula cortex bilaterally was activated in C, but there was no evidence of such activation in the non-synesthetic group. The results suggest that, in C, the mirror system for touch is overactive, above the threshold for conscious tactile perception.

Adult↗
PubMed2005

Reproductive performance of pubertal red deer (Cervus elaphus) hinds: effects of genetic introgression of wapiti subspecies on pregnancy rates at 18 months of age.

Low reproductive productivity of young red deer (Cervus elaphus) hinds on New Zealand deer farms appears to reflect high incidences of puberty failure at 16 months of age. This is despite the general attainment of average liveweights 15-25 kg in excess of the accepted minimum threshold for puberty in subspecies of western European origin (scoticus, elaphus and hippelaphus) that form the basis of the national herd. The present study tests the hypotheses that introgression of the larger North American wapiti subspecies (nelsoni, manitobensis and roosevelti) into breeding herds (1) can be assessed from morphological features of individuals, (2) that there is a relationship between the level of wapiti parentage and non-pregnancy rate at 18 months of age (a proxy for puberty failure) and (3) that minimum liveweight thresholds for puberty increase with increasing levels of wapiti parentage. A total of 4329 18-month-old hinds across four "red" deer farms in southern New Zealand were scanned for pregnancy status. Each hind was assigned a wapiti score (WS) as a subjective assessment of the obviousness of wapiti features. Various body measurements were additionally recorded for each hind. A hair sample was collected for DNA analysis (14 markers) to objectively assign subspecies pedigree (i.e. "Elkmeter") on a subset of 1258 individuals. A total of 506 (11.7%) hinds were not pregnant at 18 months of age with rates varying between 4.1 and 37.3% between farms and years. Mean WS differed significantly between farms and reflected the genetic management policy of each farm. WS was positively correlated to Elkmeter for each farm/year (<0.05) although regression slopes varied significantly. WS was able to be adjusted for these differences to assign a corrected WS (CWS) for all 4329 individuals that estimated the proportion wapiti parentage. Discriminant analysis of morphological variables relative to Elkmeter supported the first hypothesis and showed that shoulder height and body length were good indicators of the degree of wapiti parentage within individuals. This enabled the development of an objective estimate of wapiti parentage (EWP). The actual level of such parentage within herds ranged from <5 to >55%. There was a significant negative association between wapiti parentage and pregnancy, which was strongly influenced by liveweight, supporting the second and third hypotheses. This was manifest as marked displacement of pregnancy probability curves in relation to liveweight between genotype groups, particularly for those groups with >20% wapiti parentage. For example, predicted threshold liveweights required to achieve a 90% pregnancy rate for EWP values that represent 0, 10, 20, 30, 40 and 50% wapiti parentage were 81, 81, 85, 106, 127 and approximately 137 kg, respectively. Within the study herds, the majority of hinds of 0-20% wapiti parentage exceeded the predicted 90% threshold liveweights for their genotype cohort. However, hinds with higher levels of wapiti parentage generally fell below the predicted threshold for their genotype group. The data strongly suggest that under liveweight performance levels measured for red deer, hinds with >20% wapiti parentage are at high risk of puberty failure.

Aging↗
PubMed2005

High IGFBP-3 levels in marrow plasma in early-stage MDS: effects on apoptosis and hemopoiesis.

The pathophysiology of the myelodysplastic syndromes (MDS) is incompletely understood. Tumor necrosis factor (TNF)alpha levels are elevated, particularly in early-stage MDS, and apoptosis in marrow cells is upregulated. Observations in other models have shown a role for insulin-like growth factor binding protein 3 (IGFBP-3) in TNFalpha-mediated apoptosis. We observed increased levels of IGFBP-3 in the marrow plasma of patients with MDS (P = 0.005) and hypothesized that altered IGFBP-3 levels contribute to the dysregulation of hemopoiesis in MDS by affecting proliferation and apoptosis. Western analysis of marrow plasma from MDS patients revealed an increase in the ratio of intact vs fragmented IGFBP-3 in early-stage MDS (relative to controls) that decreased with MDS disease progression, suggesting increased proteolysis with more advanced disease. Thus, these results provide evidence for dysregulation of IGFBP-3 in patients with MDS. While the data are complex, they are consistent with a modulatory effect of IGFBP-3 on hemopoiesis in MDS. Conceivably, understanding these mechanisms may allow for the development of novel therapeutic strategies.

Adult↗
PubMed2005

Comparison of olanzapine and risperidone in 367 first-episode patients with non-affective or affective psychosis: results of an open retrospective medical record study.

INTRODUCTION: Previous studies comparing olanzapine (OLZ) and risperidone (RIS) have tended to focus on multiple-episode patients, with no studies examining their comparative efficacy in a non-selective sample of first-episode psychosis. METHODS: The Early Psychosis Prevention and Intervention Centre in Australia had admitted 786 first-episode psychosis (FEP) patients between 1998-2000. Data were collected from the medical records (MR) of 367 patients, which met inclusion criteria. The primary objective was to evaluate the efficacy of OLZ vs. RIS as measured by CGI-S, CGI-BP (symptomatic level), GAF and SOFAS (functioning level). RESULTS: 367 FEP patients were entered into the study, 278 in the RIS- (2.7 mg/day) and 89 in the OLZ group (10.2 mg/day). No between-group differences were found in non-affective FEP (n = 273). In affective FEP patients (n = 94), mainly treated for acute mania (86.7 %), OLZ treatment was related to better response on the symptomatic (CGI-S; p = .002), but not on the functioning level (GAF and SOFAS; ns). There were trends in the OLZ group towards a higher rate of remission of positive symptoms ( p = .054) and a shorter treatment duration to reach this remission in affective FEP patients ( p = .077). More extrapyramidal side effects ( p <.001) were related to RIS and more weight gain to OLZ-treatment ( p <.001). DISCUSSION: Despite the limitations of a retrospective MR design, study results suggest equal therapeutic efficacy of OLZ and RIS in non-affective FEP and some therapeutic advantages of OLZ compared to RIS in affective FEP patients, especially in those with acute mania. Results may serve as hypotheses for future randomised controlled trials.

Adolescent↗
PubMed2005

A review of an anaesthetic led vascular access list.

The demand for insertion of long-term central venous (Hickman type) catheters is thought to be increasing. Organisation is required to meet this demand in a safe and efficient manner. This report reviews the results from a dedicated, anaesthetic led vascular access list over the initial 61-month period. One thousand procedures were performed. Nine hundred and twenty catheters were inserted under local anaesthesia, with or without intravenous sedation and analgesia. Eighty catheters were removed. All procedures were performed during a dedicated once weekly, morning list. A total of 53% of all procedures were performed on a day-case basis, 43% on in-patients. Only 1.5% of patients required an unexpected overnight stay (usually medically unfit patients). There were 81 (9%) cancellations on the day of procedure due to neutropaenia, pneumonia or urinary tract infections. Ultrasound guidance was used initially selectively in 14%, latterly in 100% of procedures and fluoroscopy in all insertions to confirm or adjust catheter position. This service has been well received by patients and oncology services. In addition it provides an interesting area of practice for anaesthetists and an ideal environment for teaching more advanced aspects of central venous access. It may provide a template of service for other centres.

Aged↗
PubMed2004

Medically recorded allergies and the risk of childhood acute lymphoblastic leukaemia.

Data on five allergic conditions were abstracted from the medical records of 180 cases of childhood acute lymphoblastic leukaemia (ALL) and 718 matched controls. Odds Ratios (OR) and 95% Confidence Intervals (CI) were estimated for composite variables and for individual allergies using conditional logistic regression modelling. Allergies were divided into late and early diagnoses (those made within the year before the matched case's ALL diagnosis and those made earlier, respectively). Among the early diagnoses, atopy or hives was significantly associated with ALL (OR=2.20; 95% CI: 1.16-4.16). Significant associations were found for late diagnoses of atopy or hives (OR=3.78; 95% CI: 1.00-14.29) and of asthma (OR=3.10; 95% CI: 1.39-6.95). None of the other allergic conditions were associated with ALL. These results are contrary to those of prior studies of childhood ALL and allergy.

Case-Control Studies↗
PubMed2004

Disruption of Caenorhabditis elegans muscle structure and function caused by mutation of troponin I.

Caenorhabditis elegans strains mutant for the unc-27 gene show abnormal locomotion and muscle structure. Experiments revealed that unc-27 is one of four C. elegans troponin I genes and that three mutant alleles truncate the protein: recessive and presumed null allele e155 terminates after nine codons; semidominant su142sd eliminates the inhibitory and C-terminal regions; and semidominant su195sd abbreviates the extreme C-terminus. Assays of in vivo muscular performance at high and low loads indicated that su142sd is most deleterious, with e155 least and su195sd intermediate. Microscopy revealed in mutant muscle a prevalent disorder of dense body positioning and a less well defined sarcomeric structure, with small islands of thin filaments interspersed within the overlap region of A bands and even within the H zone. The mutants' rigid paralysis and sarcomeric disarray are consistent with unregulated contraction of the sarcomeres, in which small portions of each myofibril shorten irregularly and independently of one another, thereby distorting the disposition of filaments. The exacerbated deficits of su142sd worms are compatible with involvement in vivo of the N-terminal portion of troponin I in enhancing force production, and the severe impairment associated with su195sd highlights importance of the extreme C-terminus in the protein's inhibitory function.

Aging↗