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Biomedical subjects

K Barry

Publications and source records attributed to K Barry.

At least 19 recordsLinked to original sources
PubMed2006

Reductions in caloric intake and early postnatal growth prevent glucose intolerance and obesity associated with low birthweight.

AIMS/HYPOTHESIS: Low birthweight (LBW) and rapid postnatal weight gain, or catch-up growth, are independent risk factors for the development of obesity and diabetes during adult life. Individuals who are both small at birth and have postnatal catch-up growth are at the highest risk. We hypothesised that dietary interventions designed to attenuate catch-up growth in LBW subjects may have long-term beneficial consequences. MATERIALS AND METHODS: We used our previously described mouse model of LBW-associated diabetes, created by restricting maternal food intake to 50% during the last week of gestation. Control (C) dams and dams that had been subjected to undernutrition (U) were then provided either chow ad libitum after delivery or 50% food restriction on a per-day basis from delivery until weaning. We designated the resulting four groups control-control (CC), undernutrition-control (UC), control-undernutriton (CU) and undernutrition-undernutrition (UU), indicating the prenatal and postnatal experimental conditions, respectively. Carbohydrate metabolism and adiposity were assessed prospectively in offspring until age 6 months. RESULTS: Males that were small at birth and exhibited early postnatal catch-up growth developed glucose intolerance and obesity by age 6 months. In contrast, LBW mice without catch-up growth (UU) remained smaller than controls (CC), and glucose intolerance and obesity was prevented. Similarly, mice with normal birthweight that had blunted catch-up growth (CU) were leaner and had better tolerance test than CC mice. Catch-up growth during the first week of life correlated better than birthweight with glucose, fat mass and glucose tolerance up to 6 months of age. CONCLUSIONS/INTERPRETATION: Prevention of early catch-up growth reversed the development of glucose intolerance and obesity in our mouse model of LBW-associated diabetes.

Diet, Reducing↗
PubMed2005

A screening study of antidepressant treatment rates and mood symptoms in pregnancy.

STUDY DESIGN: As part of a large screening study of perinatal depression, pregnant women were screened for demographic, depression and treatment variables in obstetrics clinics. Women taking antidepressant medication prior to conception were included in the sample as the study aimed to document rates of antidepressant medication use, and relationship to depressive symptomatology. RESULTS: Among women who reported using antidepressant medications within 2 years prior to screening (n = 390, or 11% of all women), 22% reported current use of these medications. Women who reported using antidepressant medications (52%) and those who discontinued them (49%) evidenced elevated depressive symptoms during pregnancy. CONCLUSIONS: Both women who discontinue and some who continue antidepressants during pregnancy demonstrate depressive symptoms, suggesting sub-optimal management of both groups. Future studies should carefully assess the adequacy of treatments prescribed as well as the monitoring and adherence of recommended treatments. Full symptom remission should be the goal for antenatal and postnatal depression in order to minimize risk to mother and baby.

Adult↗
PubMed2003

An outcomes assessment of intra-articular calcaneal fractures, using patient and physician's assessment profiles.

Thirty-six patients with intra-articular displaced calcaneal fractures were examined to determine both physician- and patient-based outcomes. Three groups were selected. Group A was treated with open reduction and internal fixation, group B was treated with open reduction internal fixation and supplemental bone graft augmentation and the patients in group C were treated with plaster cast immobilisation and no formal operative treatment. All cohorts were well matched for age, sex and severity of injury. Patients were evaluated using both the American Foot and Ankle Society Scoring System (AFASS) and the short form 36 (SF-36). Minimum time to follow up was 4 years. No significant difference was observed between the three groups with regards to pain and functional outcomes using the AFASS score (P>0.05). No difference was observed between the three groups using the SF-36 score (P>0.1). A statistically significant difference was observed, using radiological criteria, between both groups A and B when compared to the non-operative group C. The rate of wound infection in groups A and B was 31.5%. No correlation was found between the SF-36 score and the AFASS score. No correlation was found between the radiological score and either the SF-36 or the AFASS score. This study has found that the conservative treatment of calcaneal fractures can produce satisfactory outcomes with lower morbidity than surgically treated fractures.

Adolescent↗
PubMed2000

Quantification of facial contamination with blood during orthopaedic procedures.

Operative surgery exposes the surgeon to possible blood-borne infections. Risks include pen-etrating injuries and conjunctival contact with infected blood. Visor masks worn during orthopaedic trauma procedures were assessed for blood contamination using computer analysis. This was found to be present on 86% of masks, of which only 15% was recognized by the surgeon intraoperatively. Of the blood splashes 80% were less than 0.6mm in diameter. We conclude that power instrumentation produces a blood particulate mist causing considerable microscopic, facial contamination which is a significant risk to the surgeon.

Blood-Borne Pathogens↗
PubMed1997

Social behavior and aggressive problems of cats.

Cats form social groups in which individuals recognize each other, and the cohesiveness of the group is maintained by a variety of amicable behaviors. Agonistic behavior may occur between group members and between group members and nongroup members. Within the domestic environment, agonistic behavior may become a problem when it is directed at housemates or humans. Differential diagnosis and treatment of various problems of aggressive behavior are discussed.

Aggression↗
PubMed1996

Fiber architecture of the extensors of the hindlimb in semiterrestrial and arboreal guenons.

Fiber architecture of the extensor musculature of the knee and ankle is examined in two African gueon species--the semiterrestrial Cercopithecus aethiops, and the arboreal C. ascanius. Using histologic and microscopic techniques to measure lengths of sarcomeres, the original lengths of muscle fasciculi and angles of pinnation in quadriceps femoris and triceps surae are reconstructed from direct measurements on cadavers. Calculations of reduced physiological cross-sectional area, mass/predicted effective tetanic tension, maximum excursion, and tendon length/fasciculus+tendon lengths are correlated to preferred locomotor modalities in the wild. For both species, greater morphological differences occur among the bellies of quadriceps femoris--rectus femoris, vastus intermedius, v. lateralis, and v. medialis--than among the bellies of triceps surae--gastrocnemius lateralis, g. medialis, plantaris, and soleus. With regard to quadriceps femoris, few differences occur between species. Interspecific differences in the triceps surae indicate (1) redirection of muscle force to accommodate arboreality in which the substrate is less than body width; (2) muscles more suited for velocity in the semiterrestrial vervets; and (3) muscles used more isotonically in vervets and more isometrically in red-tailed monkeys. The inherent flexibility of muscles may be preadaptive to a primary species shift in locomotor modality until the bony morphology is able to adapt through natural selection.

Animals↗
PubMed1996

Pre-operative health screening for total knee replacement.

One hundred patients on the waiting list for total knee replacement at the Wirral Hospitals underwent a domiciliary pre-operative assessment with the rheumatology clinical nurse specialist. As a result of this assessment the operations of 31 of the 100 patients were postponed and seven were cancelled because of a variety of medical and surgical problems. All patients, when eventually admitted, underwent their surgery on the appointed date with no further postponements.

Aged↗
PubMed1995

Cardiorespiratory effects of laparoscopy with and without gas insufflation.

BACKGROUND: Patients who are undergoing laparoscopic procedures can present with a number of ventilatory and circulatory problems. The use of a gasless technique for performing a laparoscopy by using a mechanical lifting device may potentially avoid such problems. OBJECTIVE: To compare the cardiorespiratory effects of laparoscopy with and without gas insufflation. METHODS: Twelve adult pigs were randomized to undergo a laparoscopy by using either carbon dioxide insufflation or mechanical elevation. Full invasive monitoring was performed preoperatively and at 10-minute intervals throughout the operative period. Parameters that were measured included blood gas determinations, mean arterial pressure, pulmonary arterial pressure, pulmonary capillary wedge pressure, central venous pressure, cardiac output, stroke volume, and total peripheral resistance. RESULTS: Carbon dioxide insufflation unlike mechanical elevation led to a fall in PO2 and absorption of a significant quantity of CO2, resulting in hypercapnia, acidosis, and a consequent hyperdynamic circulation. CONCLUSION: These findings have significant implications for the use of CO2 insufflation for laparoscopy in patients with a compromised respiratory or cardiac status.

Animals↗
PubMed1994

Anorectal functional deficit in the Brown Bowel syndrome.

The Brown Bowel Syndrome is characterised by degeneration and pigmentation of large bowel mucosa. We present a report of this unusual syndrome in which, for the first time, a functional deficit, reflected in a reduced internal and sphincter tone, is documented. This abnormality was reversed following sub-total colectomy and vitamin E therapy.

Anal Canal↗
PubMed1994

Medical education about substance abuse: changes in curriculum and faculty between 1976 and 1992.

PURPOSE: To examine changes in substance abuse education in U.S. medical schools between 1976 and 1992. METHODS: In 1991-92 the authors conducted a 16-year follow-up survey of six clinical departments in each of the 126 U.S. medical schools. Two previous surveys by scholars and surveys conducted by the Liaison Committee on Medical Education, Association of American Medical Colleges, and the National Center for Medical Fellowships in the Addictions provided baseline data for comparison. The statistical methods used in the comparisons were paired t-tests, one-way analyses of variance, and tests of differences between proportions. RESULTS: Significant increases were found in the numbers of required and elective curriculum units for medical students between 1986-87 and 1991-92. The number of medical schools requiring courses in substance abuse treatment increased from five to eight between 1986-87 and 1991-92. For residents, there were significant increases in the numbers of curriculum units for residents in family medicine and pediatrics. The average number of faculty in the 116 medical schools that reported units on substance abuse was 4.1. There were 45 fellowships in addiction medicine identified in 1991-92, with a total of 61 fellows in training. CONCLUSION: While the findings confirm positive changes, the amount of curricula time and the number of faculty having expertise in substance abuse education do not compare well with the amounts of time and numbers of faculty involved in clinical problems of similar prevalence, such as cancer and heart disease.

Curriculum↗
PubMed1994

The collateral ligament flexion-extension test (CLEFT) in total knee replacement.

We present a simple preoperative clinical test, the collateral ligament extension-flexion test (CLEFT). In patients undergoing total knee arthroplasty, with a preoperative valgus or varus deformity, this test establishes which knees have balanced collateral ligaments. It predicts which knees will not require soft tissue adjustment during the course of their surgery despite, in some cases, large deformities. The mechanism of the test is based on the observation that, in certain patients, a deformity present in extension is seen to correct in flexion. The sensitivity of this observation was checked in 44 consecutive patients undergoing total knee arthroplasty, and who had either a valgus or varus deformity in extension greater than 10 degrees. In 34 patients the test was positive, and none of these required ipsilateral collateral ligament release. All of the 10 patients with a negative test required soft tissue adjustment. In patients undergoing unconstrained total knee arthroplasty this test is reliably predictive of those knees with preoperative deformity which can be corrected simply by correctly aligned bone cuts. It supports the principle of bony resection prior to soft tissue adjustment in this form of surgery.

Biomechanical Phenomena↗
PubMed1994

Na+/H+ exchange mediates meal-stimulated ileal absorption.

BACKGROUND: The ingestion of a meal increases water and electrolyte absorption from the jejunoileum. Recent observations have implicated Na(+)-glucose cotransport as a primary mediator of meal-stimulated jejunal absorption. The current experiments tested the hypothesis that Na+/H+ exchange is a major mediator of basal and meal-stimulated ileal absorption. METHODS: Absorption studies (n = 36) were performed on dogs with 25 cm ileal Thiry-Vella fistulas. Six groups were studied for 4 hours. Luminal perfusion with 14C-polyethylene glycol was used to calculate absorption of water, sodium, chloride, and glucose. A 480 kcal canine meal was ingested in groups 2, 3, 5, and 6. Luminal amiloride (1 mmol/L) was used to inhibit Na+/H+ exchange in groups 1, 3, 4, and 6. To assess Na(+)-glucose cotransport the luminal perfusate contained either 10 mmol/L glucose (groups 1 through 3) or 10 mmol/L mannitol, a nontransported hexose (groups 4 through 6). RESULTS: Ileal absorption increased significantly in response to a meal in the presence of both glucose (group 2) and mannitol (group 5). Amiloride caused a significant reduction in basal and postmeal water and electrolyte absorption, largely independent of the glucose-mannitol content of the luminal perfusate. Mannitol significantly reduced basal absorption of water and electrolytes. CONCLUSIONS: These data indicate that both Na+/H+ exchange and Na(+)-glucose cotransport contribute to basal ileal water and electrolyte absorption, whereas Na+/H+ exchange appears to be the primary mediator of meal-stimulated ileal absorption. Na+/H+ exchange appears to play a major role in the physiologic regulation of postprandial ileal absorption.

Amiloride↗
PubMed1993

Factors affecting the range of movement of total knee arthroplasty.

We have investigated those factors which influence the range of movement after total knee arthroplasty, including sex, age, preoperative diagnosis and preoperative flexion deformity and flexion range. We also compared cemented and cementless tibial fixation, the influence of collateral ligament and lateral parapatellar releases and of replacement of the patella, and of the period of postoperative immobilisation. We reviewed 516 Johnson-Elloy (Accord) knee arthroplasties performed between 1982 and 1989, with a minimum follow-up of 12 months. The most important factors in the range of flexion achieved after arthroplasty are the diagnosis and the preoperative range of flexion. In patients with osteoarthritis there was a mean loss of flexion; in rheumatoid arthritis there was a mean gain. In both groups, the stiffer knees gained motion and the more mobile knees lost it. Post-operative range of motion was not influenced significantly by cement fixation, collateral ligament or patellar retinacular releases, prolonged immobilisation or patellar replacement.

Age Factors↗
PubMed1993

Surgery for Crohn's disease.

In the last 12 years, 72 operations have been performed on 41 patients for Crohn's disease in this hospital. The patients were predominantly young (mean age 32 yrs) and there were more females than males. 28 had ileocolic disease, three small intestinal, two pan-enteric and eight colonic. Pain (in 76%), diarrhoea (56%) and weight loss (66%) were the main presenting symptoms. Diarrhoea occurred in all those with colonic disease, but in only 43% of those with ileocolic disease. A right hemicolectomy (28 patients), colonic resection (12) and small intestinal resection (9) were the commonest operations. There were no deaths. 22 patients had a total of 26 complications after surgery, eight necessitating further surgery. The mean post-operative stay was 15 days, being lowest in those with ileocolic disease. 19 patients have required only one operation, with a mean follow-up of 5.3 years. These patients also had significantly less complications (p < 0.05). Half of the patients requiring surgery for Crohn's disease have done very well. The other half require many operations and have a substantial morbidity.

Adolescent↗
PubMed1992

Gonococcal porin vaccine evaluation: comparison of Por proteosomes, liposomes, and blebs isolated from rmp deletion mutants.

The gonococcal major outer membrane protein, Por (protein I), is a potential vaccine candidate. A large-scale animal trial compared the immunogenicity of Por inserted in liposomes (mimicking its in vivo structure) with previously used vaccines containing Por. Por was purified from Rmp (protein III)-negative gonococcal mutants and made into five different formulations: proteosomes, proteosomes absorbed to alum, liposomes, gonococcal membrane blebs, and gonococcal membrane blebs absorbed to alum. Por liposomes induced the greatest amount of Por antibodies; proteosomes and both preparations of blebs induced minimal amounts of Por antibodies. Proteosomes absorbed to alum induced slightly lower amounts of Por antibodies than did liposomes, especially when protein IA was used. Whole-organism absorption studies revealed that a significantly greater percentage of liposome-induced Por antibodies recognized exposed portions of the protein than did proteosome- or proteosome/alum-induced antibodies.

Adjuvants, Immunologic↗