PubMed Health⌕ Search

Biomedical subjects

K D Allen

Publications and source records attributed to K D Allen.

At least 19 recordsLinked to original sources
PubMed2006

Relationship of global assessment of change to AUSCAN and pinch and grip strength among individuals with hand osteoarthritis.

OBJECTIVE: This study assessed the utility and construct validity of a new patient global assessment of symptom change for hand osteoarthritis (OA) by examining its associations with change over time in grip strength, pinch strength, and AUStralian CANadian Osteoarthritis Hand Index (AUSCAN). METHODS: Participants (N=531, 80% female, mean age=68) were part of a study on the Genetics of Generalized Osteoarthritis (GOGO) and completed two assessments (average 4 years apart). At the second assessment, participants described change in their right and left hand pain, aching, and stiffness on a 15-point scale with descriptors ranging from "Great deal worse" to "Great deal better". Linear regression models examined associations of global change scores with changes in hand strength and AUSCAN, controlling for age, gender, number of hand joints with OA, and time between assessments. RESULTS: Both right and left hand global assessment of change scores were significantly associated with change in AUSCAN, grip strength, and right hand pinch strength (P<0.05), and approached significance for left hand pinch strength (P=0.06). The strongest associations were between global change scores and AUSCAN change (right hand: beta=0.29, P<0.001; left hand: beta=0.27, P<0.001). Associations of change scores with grip and pinch strength were stronger among participants with greater radiographic OA severity at baseline. CONCLUSION: Results support the validity of this new global assessment of symptom change. This measure is particularly useful for assessing change over time when no baseline data are available. Additional research should examine this measure's responsiveness in the context of clinical trials.

Aged↗
PubMed2006

Growth factor effects on passaged TMJ disk cells in monolayer and pellet cultures.

OBJECTIVES: Previously, we demonstrated rapid changes in temporomandibular joint (TMJ) disk gene expression during monolayer expansion. This study's objective was to investigate the ability of pellet culture and growth factors to rescue TMJ disk gene expression changes. DESIGN: Temporomandibular joint disk cells were isolated from mature porcine tissue and passaged up to five times. At each passage, 300 000 cells were placed in a monolayer or pellet culture environment before being exposed to transforming growth factor-beta 3 (TGF-beta3) (5 ng/ml), TGF-beta1 (5 ng/ml), and insulin-like growth factor I (IGF-I) (10 ng/ml). OUTCOME MEASURE: After 24 h, gene expression was analyzed via reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: Pelleting was detrimental to TMJ disk gene expression, marked by gene expression decreases in collagen type I (5.5-fold), aggrecan (1.4-fold), decorin (0.73-fold), and biglycan (0.73-fold) relative to monolayer cultures. IGF-I, TGF-beta1, and TGF-beta3 demonstrated limited ability to rescue TMJ disk gene expression in the pellet culture. In monolayer, TGF-beta3 and TGF-beta1 increased decorin and biglycan gene expression relative to passaged controls. Collagen type I expression, the TMJ disk's primary matrix constituent, was highest in TGF-beta3 cultures; however, differences were not statistically significant. CONCLUSION: These results indicate that pellet cultures are a poor choice for TMJ disk tissue engineering, and the effects of TGF-beta1, TGF-beta3, and IGF-I on TMJ disk gene expression are minimal relative to passaging and pelleting effects.

Aggrecans↗
PubMed2003

Mycobacterium malmoense septic arthritis.

We report a case of septic arthritis of an interphalangeal joint and osteomyelitis of the phalanx due toMycobacterium malmoense in a 61-year-old man with a 20 year history of rheumatoid arthritis treated with steroids and azathioprine. This was successfully treated with ethambutol, rifampicin and clarithromycin. To our knowledge this is the only reported case of septic arthritis due to this pathogen which is usually associated with respiratory disease or cervical lymphadenitis.

Antitubercular Agents↗
PubMed2003

Epidemiology of penicillin-resistant pneumococci in a Merseyside Health District over a 14-year period.

OBJECTIVES: To determine the prevalence and epidemiology of penicillin-resistantStreptococcus pneumoniae isolates in the St Helens and Knowsley Health District of Merseyside. METHODS: Penicillin-resistant pneumococci were isolated from clinical samples taken from 549 patients between January 1987 and December 2000. Patient profile, bacterial serotype and resistance patterns were analysed. RESULTS: Between January 1987 and December 2000, the prevalence of penicillin-resistant pneumococci increased from 1.4% to a peak of 12.9% in 1997, subsequently falling to 8.9%. High-level penicillin resistance was found in 243 (44.3%) of the isolates. Two hundred and eighty isolates were from children (mean age 2.2 years), of whom only 25% were clinically infected. Two hundred and sixty nine isolates were from adults (average age 68.4 years) of whom 88% were infected. Over 65% of isolates were community acquired with 53% of patients having received antibiotics in the 3 months prior to their first isolate. Twenty six per cent of patients had underlying disease of the respiratory tract. The changing evolution of serotypes over the 14 years of the study was associated with changes in sensitivity patterns. Serotype 9 was the most common serotype (36%). CONCLUSIONS: The study demonstrates the evolution of penicillin resistance in the patient population of this District over the past 14 years.

Adult↗
PubMed2003

Antibiotic prescribing and penicillin-resistant pneumococci in a Merseyside Health District.

OBJECTIVES: To measure the effects of antibiotic prescribing changes in the community on the prevalence of penicillin-resistant pneumococci. METHODS: Penicillin-resistant pneumococci were isolated from clinical samples taken from 549 patients between January 1987 and December 2000. Changes in the percentage of penicillin-resistant pneumococci isolated over the 14-year period and changes in prescribing practices were determined. RESULTS: Between January 1987 and December 2000, the prevalence of penicillin resistant pneumococci increased from 1.4% to a peak of 12.9% in 1997, subsequently falling to 8.9% after changes in antibiotic prescribing practices in the community. Over 65% of isolates were community acquired with 53% of patients having received antibiotics in the 3 months prior to their first isolate. Thirteen patients had a history of recent travel abroad. CONCLUSION: Reduction in antibiotic prescribing in general practice was followed by a reduction in the prevalence of penicillin-resistant pneumococci.

Anti-Bacterial Agents↗
PubMed2001

Extending the efficacy of a thermal biofeedback treatment package to the management of tension-type headaches in children.

This study explored the efficacy of a thermal biofeedback treatment package as an intervention with children with tension-type headaches. In a within-subject, time-lagged, multiple baseline design, five children, aged 8 to 14 years, were assigned to baselines of varying lengths prior to receiving treatment. Treatment was introduced sequentially across subjects and involved six thermal biofeedback treatment visits. Parents were also given guidelines for how best to encourage children to independently use the biofeedback skills. Data confirm that the participants learned the handwarming skill, practiced the skill on a regular basis during treatment, and independently used the skills to manage their pain. All participants demonstrated clinically significant reductions in one or more headache parameters (frequency, duration, intensity) following treatment. At 6-month follow-up, four of the five participants were headache-free. Although the thermal biofeedback treatment package was generally effective for these children with tension-type headaches, the specific type of headache experienced by each child appeared to influence the specific response to treatment. In addition, no single measure of headache activity was the best indicator of response to treatment. The efficacy of the thermal biofeedback treatment package is supported as an alternative treatment for children suffering from tension-type headaches.

Adolescent↗
PubMed2001

Critical care unit outbreak of Serratia liquefaciens from contaminated pressure monitoring equipment.

Between October and December 1999, Serratia liquefaciens was isolated from 11 patients in an adult critical care unit. One patient was infected on two separate occasions. In total, there were 10 positive blood cultures and five positive intravascular catheter tips. Eight cases were clinically infected, three were possibly infected and one was not. All patients with clinical isolates received appropriate empirical antibiotic treatment and responded well. Environmental investigation revealed S. liquefaciens in syringes and connector tubing used to calibrate the intravascular line pressure monitoring equipment of eight patients. Three of these patients also had clinical isolates of S. liquefaciens. Analysis by pulsed-field gel electrophoresis found clinical and environmental isolates to be of the same strain. The most likely mode of transmission was a non-sterile sphygmomanometer tip used daily for calibration. Inadequate microbiological sampling methods may have limited detection of S. liquefaciens. Several other examples of poor infection control techniques were identified during the outbreak, notably lapses in hand hygiene during intravascular pressure monitoring. It was also observed that unlabelled multidose heparin and insulin vials were shared between patients and personal hand creams were used by staff. However, these were not directly implicated in the outbreak. The outbreak ended when poor infection control practices were corrected. Calibration syringes and connector tubing were discarded after a single use. The sphygmomanometer was replaced by a pneumatic pressure transducer tester with connector tube and the frequency of calibration reduced to a single test following line insertion only. The non-disposable tube was disinfected with alcohol wipes between patients.

Adult↗
PubMed2001

Exposure-based treatment to control excessive blood glucose monitoring.

We investigated an exposure-based procedure for reducing excessive checking of blood glucose by a child with diabetes. In a changing criterion design, an exposure-based procedure was implemented by systematically exposing the child to decreasing amounts of information about blood sugar levels (checking) and thereby increasing exposure to potential hypoglycemia. Access to information was reduced in graduated increments, with the parents setting criteria to levels at which they were willing to adhere. Results demonstrated that the procedure was effective in reducing excessive blood glucose checking and in improving metabolic control.

Adolescent↗
PubMed2000

Long-term MRSA carriage in hospital patients.

A retrospective study was performed to determine the frequency of and risk factors for long-term carriage of methicillin-resistant Staphylococcus aureus amongst 79 patients who initially acquired MRSA during hospital admission and were re-admitted at least once during the study period (28 months in total). Of the 52 patients who were re-screened during their re-admissions, 33 (63%) had positive MRSA screens on at least one re-screening and 19 (37%) had all negative screens. Patients whose case notes had been tagged were more likely to have screens performed. Of the potential risk factors assessed, only the presence of skin lesions significantly increased the risk of prolonged MRSA carriage (P = 0.032). Evaluation of the effect of anti-MRSA eradication treatment showed that patients who were subsequently MRSA negative on all re-admissions were more likely to have received some form of anti-MRSA treatment than those who remained positive on at least one re-admission (P = 0.048). The results show that the strain of MRSA at our hospitals (predominantly EMRSA 15) is associated with prolonged carriage in certain patients and that attempts at eradication often do not affect the duration of carriage. This has infection control implications for the management of known MRSA positive patients re-admitted to hospital.

Adult↗
PubMed2000

The problem of parental nonadherence in clinical behavior analysis: effective treatment is not enough.

Applied behavior analysts have developed many effective interventions for common childhood problems and have repeatedly demonstrated that childhood behavior responds to properly managed contingencies. The success of these interventions is dependent upon their basic effectiveness, as demonstrated in the literature, their precise delivery by the clinician to the parent, and adherence to or consistent implementation of the intervention. Unfortunately, arranging the consistent implementation of effective parenting strategies is a significant challenge for behavior analysts who work in homes, schools, and outpatient or primary care clinics. Much has been done to address issues of adherence or implementation in the clinic, but relatively little has been done to increase our understanding of the contingencies that affect parental adherence beyond the supervised clinic environment. An analysis of the contingencies that strengthen or weaken adherence might suggest strategies to improve implementation outside the clinic setting. What follows is an analysis of the variables associated with adherence by parents to recommendations designed to solve common childhood problems.

Adult↗
PubMed1999

Cloning and characterization of an esophageal-gland-specific chorismate mutase from the phytoparasitic nematode Meloidogyne javanica.

Root-knot nematodes are obligate plant parasites that alter plant cell growth and development by inducing the formation of giant feeder cells. It is thought that nematodes inject secretions from their esophageal glands into plant cells while feeding, and that these secretions cause giant cell formation. To elucidate the mechanisms underlying the formation of giant cells, a strategy was developed to clone esophageal gland genes from the root-knot nematode Meloidogyne javanica. One clone, shown to be expressed in the nematode's esophageal gland, codes for a potentially secreted chorismate mutase (CM). CM is a key branch-point regulatory enzyme in the shikimate pathway and converts chorismate to prephenate, a precursor of phenylalanine and tyrosine. The shikimate pathway is not found in animals, but in plants, where it produces aromatic amino acids and derivative compounds that play critical roles in growth and defense. Therefore, we hypothesize that this CM is involved in allowing nematodes to parasitize plants.

Amino Acid Sequence↗
PubMed1998

Muscle satellite cells from dystrophic (mdx) mice have elevated levels of heparan sulphate proteoglycan receptors for fibroblast growth factor.

Skeletal muscle has the remarkable capacity to regenerate new muscle fibres in the event of injury or disease. This capacity lies in the satellite cells, which are myogenic stem cells residing in adult muscle. While the signals that activate satellite cells to divide in vivo are not fully understood, satellite cells grown in culture respond to the mitogenic action of fibroblast growth factor (FGF). Satellite cells from the dystrophic mdx mouse are more sensitive to FGF in culture than satellite cells from normal mice. In this study we investigated the basis for this heightened sensitivity of mdx satellite cells to FGF by measuring the number and affinity of protein and heparan sulphate proteoglycan (HSPG) receptors for FGF. We found that HSPG receptors were elevated over four-fold in the mdx cells compared with cells from normal animals. We supported this observation by measuring the synthesis of heparan sulphate (HS) and chondroitin sulphate (CS) by satellite cells in culture. Mdx satellite cells synthesized approximately ten times more of these sulphated glycosaminoglycans (GAGs) than did normal cells. For muscle fibroblasts, however, we found no significant difference in the number or affinity of protein or HSPG receptors, or in the amount of sulphated GAGs synthesized, between normal and mdx cells. We propose that the increase in FGF HSPG receptors is the basis for the heightened response of mdx satellite cells to FGF in culture and may reflect exposure of the cells to growth factors in the degenerating mdx muscle.

Animals↗