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Biomedical subjects

L Burns

Publications and source records attributed to L Burns.

At least 19 recordsLinked to original sources
PubMed2000

Predictors of hippocampal, cerebral, and cerebellar volume reduction in childhood epilepsy.

PURPOSE: We examined the factors related to brain volume reduction in a pediatric sample of patients that included those with nonintractable epilepsy. METHODS: Entry criteria were children less than 18 years old with epilepsy referred for MRI, including a whole brain volumetric sequence. The sample size was 231. Risk factors were ascertained from interviews and reviews of medical records. Factors included age of onset, seizure years, family history, status epilepticus, intellectual disability, and febrile convulsions. MRI data were obtained for 44 normal childhood control subjects. RESULTS: Cerebral and cerebellar volumes were significantly associated with age, gender, moderate-to-severe intellectual disability (p < 0.001), seizure years, and status epilepticus (p < 0.03). Compared with controls, the brain volume of all patients was reduced by 10% (p < 0.001). Hippocampal volume was significantly associated with total brain volume, age (p < 0.001), focal cerebral ischemic injury, and complex febrile convulsions (p < 0.05). CONCLUSIONS: Significant brain volume reduction is present in children with epilepsy. A component of this reduction is due to acquired insults. The reduction is seen even in children with infrequent seizures over a brief time, suggesting an innate structural abnormality. When evaluating possible etiologic factors in the development of hippocampal volume reduction, one must control for total brain volume. We have confirmed the association of complex febrile convulsions with unilateral hippocampal volume reduction.

Adolescent↗
PubMed1999

A prospective randomized trial of the anti-emetic efficacy of ondansetron and granisetron during bone marrow transplantation.

To determine the comparative anti-emetic efficacy of ondansetron and granisetron in patients undergoing bone marrow transplantation, we performed a double-blind, randomized trial in pediatric and adult patients receiving transplants at the University of Minnesota. The results in 187 patients stratified by age (<18 years, n = 51; > or =18 years, n = 136) were analyzed. The average number of emetic episodes in the entire group from day -7 to 2 was 0.86/day for patients receiving ondansetron and 0.73/day for those receiving granisetron (p = 0.32). No differences were noted between the two drugs in total days of complete or major control of emesis or in the number of requests for additional drugs to alleviate symptoms of nausea. The use of total-body irradiation-containing conditioning regimens was associated with a decreased number of emetic episodes compared with regimens of chemotherapy alone. Perceived nausea was evaluated using a nausea scoring system, and no differences were apparent between the granisetron and ondansetron groups; however, reported nausea was significantly higher in females (p<0.01) and in the adult population (p = 0.05). We conclude that both ondansetron and granisetron provide good control of nausea and vomiting experienced with conditioning regimens for bone marrow transplantation. The relative cost of the drugs within an institution must be considered in developing standard anti-emetic regimens for bone marrow transplantation.

Adolescent↗
PubMed1999

Plasma vitamin A and E in preterm babies fed on breast milk or formula milk with or without long-chain polyunsaturated fatty acids.

Plasma vitamin A and E, the antioxidant nutrients copper and zinc, and magnesium were investigated in preterm babies. They were fed on their own mother's breast milk, or a formula with, or without, AA and DHA. Vitamin A (2.4 mg/d) and E (15 mg/d) supplements were also given. Vitamin A and E levels of most of the babies were sub-optimal at birth. The mean concentrations of vitamin E increased in all the groups by the expected date of delivery (EDD) (p < 0.001). Those fed on their mother's breast milk had the highest value compared with the other groups (p < 0.001). There was an increase in the mean level of vitamin A (p > 0.05) and copper (p < 0.05) and a decrease in zinc (p < 0.05) between birth and EDD. Concentrations of the two vitamins were not different (p > 0.05) between the babies fed on the formula with, and without, AA and DHA. It is concluded that the amount of AA and DHA incorporated in the formula milk did not adversely influence the plasma vitamin A and E of the babies.

Anthropometry↗
PubMed1997

Alcohol-history taking by nurses and doctors--how accurate are they really?

The aim of this study was to look at how nurses and doctors record alcohol histories on the patients under their care and the frequency and appropriateness of the way they use an alcohol withdrawal scale in the acute hospital setting. To achieve these aims patient records were audited and compared at two points in time, in 1992 and 1994. Results of the study showed that nurses and doctors took alcohol histories from patients on approximately three-quarters of occasions and that this level of recording has not changed over time. The adequacy of alcohol-history taking has, however, increased for both nurses and doctors since 1992. At that time, 71% of the alcohol histories taken by nurses and 74% of alcohol histories taken by doctors were judged to be adequate. By 1994, however, 79% of alcohol histories taken by nurses and 77% of histories by doctors were rated as adequate. The increase in the adequacy of history taking by nurses was significant (chi 2 = 5.05; d.f. = 1; P < 0.05) and the increase by doctors was not significant (chi 2 = 1.03; d.f. = 1; P > 0.05). These results are seen as being positively associated with the major governmental nursing initiative in New South Wales, Australia, the New South Wales Strategic Plan for the Nursing Management of Alcohol and Other Drugs.

Aged↗
PubMed1997

A transcript map for the 2.8-Mb region containing the multiple endocrine neoplasia type 1 locus.

Multiple endocrine neoplasia type 1 (MEN 1) is an inherited cancer syndrome in which affected individuals develop multiple parathyroid, enteropancreatic, and pituitary tumors. The locus for MEN1 is tightly linked to the marker PYGM on chromosome 11q13, and linkage analysis places the MEN1 gene within a 2-Mb interval flanked by the markers D11S1883 and D11S449. Loss of heterozygosity studies in MEN 1 and sporadic tumors suggest that the MEN1 gene encodes a tumor suppressor and have helped to narrow the location of the gene to a 600-kb interval between PYGM and D11S449. Focusing on this smaller MEN1 interval, we have identified and mapped 12 transcripts to this 600-kb region. A precise ordered map of 33 transcripts, including 12 genes known to map to this region, was generated for the 2.8-Mb D11S480-D11S913 interval. Fifteen candidate genes (of which 10 were examined exhaustively) were evaluated by Southern blot and/or dideoxy fingerprinting analysis to identify the gene harboring disease-causing mutations.

Chromosome Mapping↗
PubMed1997

Cytokine-primed bone marrow stem cells vs. peripheral blood stem cells for autologous transplantation: a randomized comparison of GM-CSF vs. G-CSF.

Autologous transplantation for non-Hodgkins lymphoma and Hodgkin's disease is widely used as standard therapy for those with high-risk or relapsed tumor. Peripheral blood stem cell (PBSC) collections have nearly completely replaced bone marrow stem cell (BMSC) harvests because of the perceived advantages of more rapid engraftment, less tumor contamination in the inoculum, and better survival after therapy. The advantage of PBSC, however, may derive from the hematopoietic stimulating cytokines used for PBSC mobilization. Therefore, we tested a randomized comparison of GM-CSF vs. G-CSF used to prime either BMSC or PBSC before collection for use in autologous transplantation. Sixty-two patients receiving transplants (31 PBSC; 31 BMSC) for non-Hodgkin's lymphoma (n = 51) or Hodgkin's disease (n = 11) were treated. All patients received 6 days of randomly assigned cytokine. Those with cellular marrow in morphologic remission underwent BMSC harvest, while those with hypocellular marrow or microscopic marrow tumor involvement had PBSC collected. Neutrophil recovery was similarly rapid in all groups (median 14 days; range 10-23 days), though two patients had delayed neutrophil recovery using GM-CSF primed PBSC (p = 0.01). Red cell and platelet recovery were significantly quicker after BMSC mobilized with GM-CSF or PBSC mobilized with G-CSF. This speedier hematologic recovery resulted in earlier hospital discharge as well. However, in multivariate analysis, neither the stem cell source nor randomly assigned G-CSF vs. GM-CSF was independently associated with earlier multilineage hematologic recovery or shorter hospital stay. Relapse-free survival was not independently affected by either the assigned stem cell source or the randomly assigned priming cytokine, though malignant relapse was more frequent in those assigned to PBSC (RR of relapse 3.15, p = 0.03). These data document that BMSC, when collected following cytokine priming, can yield a similarly rapid hematologic recovery and short hospital stay compared with cytokine-primed PBSC. Using primed BMSC, no difference in malignant relapse or relapse-free survival was observed. These findings suggest that despite widespread use of PBSC for transplantation, BMSC, when collected following hematopoietically stimulating cytokines, may remain a satisfactory source of stem cells for autologous transplantation. G-CSF and GM-CSF are both effective in priming autologous PBSC or BMSC for collection.

Adult↗
PubMed1996

The use of dilemma situations to analyse industrial action by nurses.

Traditionally, the history of nursing has emphasised sacrifice and the obligation to care, placing limits on the way that nurses could argue for improved conditions and status. However, over the past decade nursing has changed significantly both in terms of its educational system and in respect of the context in which nurses now work. In an increasingly technological environment, nurses now seem more ready to consider the industrial actions that other professions take. The present study measures the particular orientation to care (personal or technical) that nurses currently hold and then looks at whether this orientation has an effect on nurses' industrial activism, and the degree of difficulty felt by nurses when faced with choosing between industrial options. Orientation to care was measured through the choice of actions in a series of behaviours which were pre-rated as to whether they primarily involved technical or personal care. Industrial activism was measured through a series of vignette situations, with behavioural options ranging from low to high activism. Results of the study demonstrated that a particular orientation to care does in fact impact on industrial activism and difficulty scores. Overall, the results of this study demonstrated, firstly, that nurses who preferred to express their care in a personal rather than a technical manner were more ready to take industrial action. Secondly, those nurses who held a strong duty of care towards their patients were less ready to take industrial action than those who considered workers' rights as the more important issue. However, at the same time, nurses who held a strong duty of care had more difficulty in choosing between options.

Adult↗
PubMed1996

General practice receptionists' attitudes and beliefs towards preventive medicine before and after training and support interventions.

OBJECTIVES: Receptionists are an integral part of the primary care service. We aimed to discover their views on preventive medicine issues. METHOD: One hundred and fifty receptionists from general practices in Sydney, Australia, completed a questionnaire on their attitudes and beliefs towards preventive medicine and brief intervention for alcohol. They were matched according to practice variables into a control, no, minimal, or maximal training and support condition. In all conditions except the control condition, receptionists received 5 minutes of initial training in implementing a brief intervention programme; the amount of ongoing support varied across conditions. Attitudes and beliefs were re-assessed 3 months later. RESULTS AND CONCLUSIONS: The results indicated that when no training and support were given, receptionists developed negative views towards being involved in preventive medicine activities. When training and support were provided, these negative effects were abolished.

Adolescent↗
PubMed1996

The BRMD thyroid-neck phantom: design and construction.

The Human Monitoring Laboratory, which acts as the Canadian National Calibration Reference Center for In Vivo monitoring, has constructed a robust neck-thyroid phantom for use in the Canadian Thyroid Intercomparison Program. The phantom is rugged and capable of being distributed through the mail with no expectation of a leak of radioactive materials; it is anthropomorphic; the thyroid inserts simulate 125I and 131I; the phantom can be used to mimic different layers of adipose tissue over the thyroid insert; and it is cost effective. This paper describes the design criteria and the manufacturing process; the performance characteristics have been described in an earlier publication.

Canada↗
PubMed1995

Policing pubs: what happens to crime?

The aim of this study was to test the effect of heightened police enforcement of the NSW Liquor and Registered Clubs Acts on overall criminal offences and, specifically, the number of assaults. Ten police patrols were included in the study. Five of these patrols were allocated to the experimental condition and five were allocated to the control condition. Beat police in the experimental controls conducted frequent but random visits to predesignated licensed premises over a 2-month period. Police in the control patrols maintained their normal duties. Numbers of offences in the experimental and control patrols were then compared for 2 months before the intervention, for the 2-month intervention phase and for 2 months post-intervention. Results of the study indicated a significant increase in the number of offences in the experimental patrols during the intervention phase. Reasons for this increase are discussed.

Journal Article↗
PubMed1994

Vitamin A and related essential nutrients in cord blood: relationships with anthropometric measurements at birth.

Following the advice given by the Department of Health to women who are, or may become pregnant, not to eat liver and liver products because of the risk of vitamin A toxicity, the concentrations of vitamins A and E, and copper, magnesium and zinc in cord blood were investigated. The study was conducted in Hackney, an inner city area of London. Esters of vitamin A were not detected in any of the samples, indicating that there was no biochemical evidence of a risk of toxicity. Indeed, vitamin A correlated significantly with birthweight, head circumference, length, and gestation period. There was also a significant positive relationship between zinc and birthweight. In contrast, copper showed a negative correlation with birthweight and head circumference. Vitamin E and magnesium were not associated with any of the anthropometric measurements, although magnesium showed an increasing trend with birthweight. The data suggest that most of the mothers of the subjects studied may have been marginal with respect to vitamins A and E and zinc. In those with low birthweight babies. a higher intake would have improved their nutritional status and possibly the outcome of their pregnancy. For these low-income mothers, liver and liver products are the cheapest and the best source of vitamins A and E, haem iron, B vitamins and several other essential nutrients; hence the advice of the Department of Health may have been misplaced.

Adult↗
PubMed1994

Molecular cloning of the canine angiotensin II receptor. An AT1-like receptor with reduced affinity for DuP753.

Canine aortic strip studies revealed insensitivity of angiotensin II (AII)-induced aortic contraction to inhibition by the non-peptide antagonist DuP753 (pKB = 6.7 +/- 0.1). In order to determine the origin of this phenomenon we cloned the canine homologue of the AT1 AII receptor. Expression of this cDNA in COS-7 cells indicated a low affinity of DuP753 for the cloned receptor (KD = 92 nM). The predicted amino acid sequence is highly homologous to other mammalian AT1 receptors; sequence comparisons suggest the pharmacological difference may be the result of a threonine residue in position 163 in the IVth transmembrane domain.

Amino Acid Sequence↗
PubMed1994

Dopamine terminal loss and onset of motor symptoms in MPTP-treated monkeys: a positron emission tomography study with 11C-CFT.

We studied the time course of dopamine (DA) terminal loss in three macaca fascicularis injected with MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) intravenously every 10-14 days for up to 389 days. Striatal DA terminal loss was monitored in vivo by positron emission tomography using 11C-CFT (WIN 35,428), a cocaine derivative that labels the DA transporter. The 11C-CFT uptake rate constant in the striatum of MPTP-treated monkeys decreased exponentially over time, with the putamen significantly more affected than the caudate. Spontaneous locomotor activity decreased in parallel with the decline of the 11C-CFT uptake rate; however, overt parkinsonian signs appeared only after the 11C-CFT uptake rate had declined to about 30% of the pretreatment values. We conclude that a long-term intermittent mode of administration of MPTP can lead to a pattern of terminal loss that closely resembles idiopathic Parkinson disease.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗