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Biomedical subjects

K Kendall

Publications and source records attributed to K Kendall.

At least 19 recordsLinked to original sources
PubMed2005

General practice critical incident reviews of patient suicides: benefits, barriers, costs, and family participation.

AIM: To explore the feasibility of holding critical incident reviews (CIRs) after patient suicides in general practice and their ability to change practice. METHODS: Thirteen practices were invited to conduct a facilitated CIR on 18 current patient suicides. Next of kin views were sought. All staff attending a CIR were interviewed after the review. RESULTS: Ten practices reviewed 12 deaths. Twenty six staff attended reviews; all were interviewed. Next of kin contributed to six reviews; only one criticised care. Changes following the reviews included steps to improve internal communication and bereavement support to set up internal CIRs and review prescribing policies. Communications between practices and other agencies were clarified. CONCLUSION: Practices were willing to hold CIRs and appreciated the potential positive value but need reassurance that they will not be blamed for suicides, and that the cost in time and resources will be recognised.

Family↗
PubMed2003

Outcome of women with inadequate cervical smears followed up for five years.

BACKGROUND: The clinical and prognostic significance of "inadequate" cervical smear is unknown, even though women with repeated inadequate smears are referred for colposcopy in the National Health Service (NHS) Cervical Screening Programme. AIM: To follow up a cohort of women with inadequate cervical smears over the following five years to examine outcomes, including detection of high grade cervical intraepithelial neoplasia (CIN). METHODS: The study comprised 1972 women with an inadequate cervical smear reported at Walsall Hospitals NHS Trust between 1 April 1995 and 31 March 1996. Results of cervical smears and biopsies taken over the following five years were reviewed to confirm the outcome. FINDINGS: Within five years, 2.2% of women with an inadequate cervical smear developed histologically confirmed high grade CIN, which was higher than the 1.3% seen among all women with cervical smear tests reported at the same laboratory over the same period, although the difference was not significant at the 95% level of confidence. Where inadequacy resulted from or was contributed to by "polymorphs obscuring", the risk of subsequent development/detection of high grade CIN was 2.6%. CONCLUSIONS: Women with inadequate cervical smears had an increased risk of detection of high grade CIN in the following five years compared with "all women". This increased risk was not significant, although if a larger number of women had been studied significance may have been reached, so that further studies are needed. The increased risk appeared to be at least partially dependent on the reason for inadequacy.

Adult↗
PubMed2001

Phonoscopy--a valuable tool for otolaryngologists and speech-language pathologists in the management of dysphonic patients.

OBJECTIVES: To describe the phonoscopic evaluation, present a rationale for its use, and demonstrate its use in identifying laryngeal and vocal pathology. STUDY DESIGN: Retrospective review. METHODS: One hundred consecutive cases of new patients referred to our voice clinic team were reviewed. Findings on laryngeal examination as reported by the referring otolaryngologist were compared with our findings on "phonoscopic" examination. The phonoscopic examination combines the traditional voice evaluation performed by speech-language pathologists with endoscopy, which is relatively new to the voice clinician, to visualize the larynx during a broad sample of phonatory tasks. Patients with spasmodic dysphonia or tremor were excluded from the study. RESULTS: In 26 cases of the 100 reviewed, our observations were consistent with those of the referring otolaryngologist. In 32 cases, we agreed with the referral diagnosis, but found additional factor(s) related to pathology. In 42 cases, our findings differed from those of the referring physician. CONCLUSIONS: Results support our contention that phonoscopic evaluation can be of value to both the otolaryngologist and speech-language pathologist. It is particularly recommended in those patients whose dysphonia is unexplained following diagnostic laryngeal examination by the otolaryngologist, in cases in which voice use is a suspected factor in the pathology, and when voice therapy is a recommended treatment for a dysphonic patient.

Diagnosis, Differential↗
PubMed2001

Approaching a consensus: psychosocial support services for solid organ transplantation programs.

BACKGROUND: Solid organ transplantation has become an accepted treatment for individuals with end-stage organ dysfunction. Criteria are being developed in the United States to determine medical eligibility for transplant candidates and competencies for transplant centers and physicians. To date, similar criteria for psychosocial services have not been developed. DESIGN AND SETTING: We queried participants in a specialty psychosocial transplant meeting to determine their views of which psychosocial services are essential to the comprehensive care of transplant patients in the United States. RESULTS: There was broad based multidisciplinary support for proactive pretransplant screening to discern individual psychosocial needs; focused pretransplant interventions to improve candidacy and future compliance; and posttransplant programs that address psychosocial, rehabilitation, and financial issues. CONCLUSION: Among psychosocial providers of solid organ transplantation services, there is support for expanding routine screening and support services to individuals who are candidates for and undergo solid organ transplantation.

Community Health Services↗
PubMed1999

Differentiation of spasmodic and psychogenic dysphonias with phonoscopic evaluation.

OBJECTIVES: Identify laryngeal behaviors that differentiate patients with spasmodic dysphonia and patients with psychogenic dysphonia. STUDY DESIGN: Retrospective review of patients evaluated over a 3-year period with a diagnosis of either spasmodic or psychogenic dysphonia. Videotaped phonoscopic (laryngeal imaging) examinations of all noted aberrant behaviors were examined. Tally behaviors according to each subject group. METHODS: Three examiners unfamiliar with patients' previous diagnoses reviewed videotaped studies. Aberrant behaviors were noted and each patient was assigned to spasmodic or psychogenic dysphonia group. Agreement among examiners and agreement with previous diagnoses was established. RESULTS: Six abnormal behaviors were noted, including tremor, hyperadduction, false fold constriction, sphincteric constriction, hyperabduction and paradoxical movements of the true and false folds. Percentage of patients in each group with each behavior was determined. CONCLUSIONS: Individual behaviors did not generally appear to differentiate the two groups; however, patterns of behaviors did, and may be of considerable value in differentiating spasmodic and psychogenic dysphonias.

Adult↗
PubMed1999

Osteochondrodysplasia in Scottish Fold cats.

OBJECTIVE: To better characterise the bone and joint problems which can develop in Scottish Fold cats. DESIGN: Retrospective study of cases seen in five veterinary clinics and radiographic survey of cats in a cattery. RESULTS: Six Scottish Fold cats (four castrated males, two spayed females) aged between 5 months and 6 years were presented for signs of skeletal disease including lameness, reluctance to jump, a stiff stilted gait, short misshapen distal limbs, swelling of plantar tarsometatarsal regions and short thick inflexible tails. A further four cases (one male, three females, 15 months to 11 years) were identified by radiographic screening of a cattery. A diagnosis of osteochondrodysplasia was based on characteristic radiological findings including irregularity in the size and shape of tarsal, carpal, metatarsal and metacarpal bones, phalanges and caudal vertebrae, narrowed joint spaces, and progressive new bone formation around joints of distal limbs with diffuse osteopenia of adjacent bone. A plantar exostosis caudal to the calcaneus was present in advanced cases. In all nine cases where pedigree information was available, affected cats allegedly originated from the mating of a Scottish Fold to a cat with normal ears. The severity and time of onset of physical signs, and rate of progression and extent of radiographic abnormalities, varied from case to case. Limited histological observations suggested the underlying problem may be an osteochondrodysplasia, related to inadequate cartilage maturation. Clinical signs were ameliorated by administration of pentosan subcutaneously in two of three cats in which it was trailed, and one of these also benefited from an oral glycosaminoglycan preparation. CONCLUSIONS: Clinical and radiological findings were ascribed to defective maturation and function of cartilage, particularly in the distal limbs, ears and tail. As all Scottish Fold cats suffered from osteochondrodysplasia of some degree, the best solution would be to avoid using fold-eared cats for breeding and instead use Scottish shorthairs.

Animals↗
PubMed1998

Invasive hyphomycotic rhinitis in a cat due to Metarhizium anisopliae.

Invasive mycotic rhinitis was diagnosed in a cat with a 4-month history of stertor, nasal discharge and subcutaneous swelling of the nasal bridge. Histology demonstrated fungal hyphae in representative biopsies of the nasal cavity and subcutaneous mass. Mycological culture demonstrated a pure growth of Metarhizium anisopliae var. anisopliae. The infection was treated with orally administered itraconazole. This is the first well documented case of infection by M. anisopliae in a mammalian host.

Animals↗
PubMed1997

Prevalences of feline leukaemia virus and feline immunodeficiency virus infections in cats in Sydney.

OBJECTIVE: To determine prevalences of feline leukaemia virus (FeLV) and feline immunodeficiency virus (FIV) infections in 'healthy' cats that, through acute misadventure or other circumstance, were presented to veterinary practitioners. Prevalences of FeLV and FIV in this population were compared to those in a population of predominantly sick cats. DESIGN AND PROCEDURES: Serum specimens were obtained over a 2-year period from 200 cats older than 1 year of age presented to veterinary clinics for routine procedures, including cat fight injuries or abscesses, vehicular trauma, neutering, dental scaling, vaccination, grooming or boarding. An additional 894 sera were obtained over approximately the same period from specimens submitted by veterinarians to a private clinical pathology laboratory, mainly from sick cars suspected of having immune dysfunction, but including some sera from healthy cats being screened prior to FeLV vaccination. FIV antibody and FeLV antigen were detected in samples using commercial enzyme immunoassays. RESULTS: Amongst 200 'healthy' cats, the prevalence of FeLV infection was 0 to 2%, and the prevalence of FIV was 6.5 to 7.5%, depending on the stringency of the criteria used to define positivity. FIV infection was significantly more prevalent in cats which resided in an inner city environment (P = 0.013). Of the 894 serum specimens submitted to the laboratory by practitioners, 11/761 (1.4%) were FeLV positive, while 148/711 (20.8%) were FIV positive. The prevalence of FIV was significantly higher in these predominantly 'sick' cats than in cats seen for routine veterinary procedures (P < 0.00001), while there was no difference in the prevalence of FeLV (P = 0.75) CONCLUSIONS: The prevalence of FeLV and FIV in healthy cats may have been substantially overestimated in some previous Australian surveys. FeLV infection would appear to be a rare cause of disease in Australian cats. The higher prevalence of FIV positivity in sick as opposed to healthy cats infers that FIV infection contributes to the development of disease.

Animals↗
PubMed1995

A Long-Chain Secondary Alcohol Dehydrogenase from Rhodococcus erythropolis ATCC 4277.

A NAD-dependent secondary alcohol dehydrogenase has been purified from the alkane-degrading bacterium, Rhodococcus erythropolis ATCC 4277. The enzyme was found to be active against a broad range of substrates, particularly long-chain secondary aliphatic alcohols. Although optimal activity was observed with linear 2-alcohols containing between 6 and 11 carbon atoms, secondary alcohols as long as 2-tetradecanol were oxidized at 25% of the rate seen with mid-range alcohols. The purified enzyme was specific for the S-(+) stereoisomer of 2-octanol and had a specific activity for 2-octanol of over 200 (mu)mol/min/mg of protein at pH 9 and 37(deg)C, 25-fold higher than that of any previously reported S-(+) secondary alcohol dehydrogenase. Linear primary alcohols containing between 3 and 13 carbon atoms were utilized 20- to 40-fold less efficiently than the corresponding secondary alcohols. The apparent K(infm) value for NAD(sup+) with 2-octanol as the substrate was 260 (mu)M, whereas the apparent K(infm) values for the 2-alcohols ranged from over 5 mM for 2-pentanol to less than 2 (mu)M for 2-tetradecanol. The enzyme showed moderate thermostability (half-life of 4 h at 60(deg)C) and could potentially be useful for the synthesis of optically pure stereoisomers of secondary alcohols.

Journal Article↗
PubMed1994

Cloning and analysis of a gene cluster from Streptomyces coelicolor that causes accelerated aerial mycelium formation in Streptomyces lividans.

We describe the cloning and analysis of two overlapping DNA fragments from Streptomyces coelicolor that cause aerial mycelium to appear more rapidly than usual when introduced into Streptomyces lividans on a low-copy-number plasmid vector. Colonies of S. lividans TK64 harboring either clone produce visible aerial mycelia after only 48 h of growth, rather than the usual 72 to 96 h. From deletion and sequence analysis, this rapid aerial mycelium (Ram) phenotype appears to be due to a cluster of three genes that we have designated ramA, ramB, and ramR. Both ramA and ramB potentially encode 65-kDa proteins with homology to ATP-dependent membrane-translocating proteins. A chromosomal ramB disruption mutant of S. lividans was found to be severely defective in aerial mycelium formation. ramR could encode a 21-kDa protein with significant homology to the UhpA subset of bacterial two-component response regulator proteins. The overall organization and potential proteins encoded by the cloned DNA suggest that this is the S. coelicolor homolog of the amf gene cluster that has been shown to be important for aerial mycelium formation in Streptomyces griseus. However, despite the fact that the two regions probably have identical functions, there is relatively poor homology between the two gene clusters at the DNA sequence level.

ATP-Binding Cassette Transporters↗
PubMed1994

Implantable left ventricular assist device. Approaching an alternative for end-stage heart failure. Implantable LVAD Study Group.

BACKGROUND: The implantable left ventricular assist device (LVAD) was designed to provide circulatory support as an alternative to heart transplantation or to continued medical therapy of end-stage heart failure. Initial experience with the implantable LVAD used as a bridge to heart transplantation provides a clinical opportunity to study the function of the device and adaptation by the patient. METHODS AND RESULTS: Nineteen heart transplant candidates (mean age, 50 years; 17 males) underwent insertion of the HeartMate LVAD as a bridge to heart transplantation from December 1991 to November 1993. All patients were in cardiogenic shock on inotropes, and 16 (84%) were on an intra-aortic balloon pump. Three patients died because of multiple organ failure; all had right ventricular (RV) dysfunction (2 required RV assist devices). Sixteen patients (84%) improved markedly and were rehabilitated to New York Heart Association functional class I-II. Three patients are still on support. Significant improvements in hemodynamic function (based on analysis of the percent change from pre-LVAD condition to pretransplantation) were observed: cardiac index rose from 1.6 +/- 0.2 to 3.2 +/- 0.9 L/min per m2 (P = .0002), left atrial pressure fell from 22.9 +/- 9.5 to 8.0 +/- 5.5 mm Hg (P = .003), RV ejection fraction increased from 19.8 +/- 11.3% to 40.8 +/- 8.9% (P = .0004), pulmonary vascular resistance decreased from 5.2 +/- 2.6 to 2.0 +/- 0.8 Wood units (P = .004). Thirteen patients had successful transplants after a mean duration of 66 days on the LVAD (range, 22 to 101 days). There were no thromboembolic events while the patients were on the LVAD. Only aspirin with dipyridamole was given for anticoagulation during a total of > 1100 patient days of support. CONCLUSIONS: Bridge to transplant implantable LVAD experience indicates that hemodynamic improvement should be significant after insertion of the devices and that the risk of thromboembolic events with the HeartMate LVAD should be extremely low. Rehabilitation and quality of life should be markedly improved. Limitations of extrapolating this clinical experience to the permanent implantable LVAD include that these patients were hospitalized (permanent implants will be outpatients); the "vented-electric" HeartMate LVAD was not tested (it is a portable, battery-powered device), and true "chronic" LVAD support (> 1 year) was not tested, so questions regarding long-term device reliability and the chronic risk of infection are unknown.

Equipment Design↗
PubMed1993

A study of 133 suicides among Canadian federal prisoners.

This paper reviews the literature on prison suicide. The characteristics of suicide within the Canadian Federal Penitentiary Service are compared with previous data. In the population examined, prison suicide was found to be a predominantly male phenomenon, not associated with age, offence type, previous convictions or length of sentence. It was most commonly committed by hanging, frequently occurring in the period shortly after sentencing. Suicide was associated with single marital status, earlier suicide attempts, a history of drug or alcohol abuse, and a previous history of psychiatric illness.

Canada↗
PubMed1992

Innovative materials processing strategies: a biomimetic approach.

Many organisms construct structural ceramic (biomineral) composites from seemingly mundane materials; cell-mediated processes control both the nucleation and growth of mineral and the development of composite microarchitecture. Living systems fabricate biocomposites by: (i) confining biomineralization within specific subunit compartments; (ii) producing a specific mineral with defined crystal size and orientation; and (iii) packaging many incremental units together in a moving front process to form fully densified, macroscopic structures. By adapting biological principles, materials scientists are attempting to produce novel materials. To date, neither the elegance of the biomineral assembly mechanisms nor the intricate composite microarchitectures have been duplicated by nonbiological processing. However, substantial progress has been made in the understanding of how biomineralization occurs, and the first steps are now being taken to exploit the basic principles involved.

Animals↗
PubMed1992

Laboratory evaluation of a filter for the control of cross-infection during pulmonary function testing.

Nosocomial transmission of respiratory pathogens is a possible complication of lung function testing. The use of a filter, placed between the patient and the spirometer equipment may be one way of preventing such nosocomial spread. This paper reports the laboratory evaluation of the efficiency of such a filter at removing bacteria from exhaled breath. Volunteers exhaled 100 normal breaths or four forced exhalations through a filter on to a blood agar plate. Bacterial counts on the agar plate were compared with recoverable bacterial counts from the filter. Total challenge from the forced exhalations ranged from 161-84,200 colony forming units. The calculated efficiency of 10 volunteers was 99.9%. For the normal breaths the challenge ranged from 0-262,000 colony forming units. There was no growth on any of the blood-agar plates. These filters appear to be highly efficient at removing exhaled bacteria.

Bacteria↗
PubMed1991

Dirofilaria immitis in cats from inner Sydney.

Two hundred feral cats from the inner suburbs of Sydney were examined post mortem for adult Dirofilaria immitis and circulating microfilariae, and 101 of these cats were tested for heartworm antigens by an ELISA. Only 2 cats (1%) had adult heartworms, the blood sample from another cat contained a single microfilaria. The blood of a further three cats contained small amounts of D immitis antigen. Although D immitis occurs in cats in Sydney, the prevalence is not high enough to warrant prophylactic treatment.

Animals↗