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Biomedical subjects

L Griffiths

Publications and source records attributed to L Griffiths.

At least 19 recordsLinked to original sources
PubMed2002

Somatic and psychological problems in a cohort of sexually abused boys: a six year follow up case-control study.

AIMS: To obtain information about the health and well being of 108 boys six years after their involvement with the same paedophile. METHODS: Case-control study of the health records of 93 male victims of a major episode of school based child sexual abuse and 93 matched controls. Interviews with a sample of their general practitioners. RESULTS: The number and frequency of reported health problems were similar in both cases and controls. However, abused boys were more likely than controls to present with symptoms that persisted for more than a year (31 cases compared with 10 controls). CONCLUSIONS: Boys who have previously suffered sexual abuse at school did not utilise primary health care services more than a group of age matched controls. They did not present with psychological or somatic problems different from those presented by non-abused boys. However, abused boys were more likely to complain of persistent somatic or psychological problems lasting more than a year. This pattern appeared to persist after the abuse had stopped and the perpetrator imprisoned.

Case-Control Studies↗
PubMed2001

Asymptomatic hypoechoic regions on patellar tendon ultrasound: A 4-year clinical and ultrasound followup of 46 tendons.

Patellar tendon ultrasound appearance is commonly used in clinical practice to diagnose patellar tendinopathy and guide management. Using a longitudinal study design we examined whether or not the presence of a hypoechoic ultrasonographic lesion in an asymptomatic patellar tendon conferred a risk for developing jumper's knee compared with a tendon that was ultrasonographically normal. Ultrasonographic, symptomatic and anthropometric assessment was completed at baseline and followup. Magnetic resonance imaging was performed on four tendons that resolved ultrasonographically in the study period. Forty-six patellar tendons were followed over 47+/-11.8 months. Eighteen tendons were hypoechoic at baseline and 28 were ultrasonographically normal. Five tendons resolved ultrasonographically in the study period. Magnetic resonance imaging in four of these tendons was normal. Seven normal patellar tendons at baseline developed a hypoechoic area but only two became symptomatic. Analysis of ultrasonography at baseline and clinical outcome with Fisher's exact test shows there is no association between baseline ultrasound changes and symptoms at followup. In this study there is no statistically significant relationship between ultrasonographic patellar tendon abnormalities and clinical outcome in elite male athletes. Management of jumper's knee should not be solely based on ultrasonographic appearance; clinical assessment remains the cornerstone of appropriate management.

Adult↗
PubMed2001

Direct retroviral delivery of human cytochrome P450 2B6 for gene-directed enzyme prodrug therapy of cancer.

Human cytochrome P450 2B6 (CYP2B6) metabolizes the prodrug cyclophosphamide (CPA) to produce phosphoramide mustard that cross-links DNA leading to cell death. We have constructed a novel retroviral vector encoding CYP2B6 (designated "MetXia-P450") and used it to transduce the human tumor cell lines HT29 and T47D. MetXia-P450 transduction sensitised these cells to the cytotoxic effects of the prodrug CPA. Results from in vitro experiments demonstrated adverse effects on the clonogenic survival of cyclophosphamide-treated cells transduced with MetXia-P450. Cytotoxic activity accompanied by bystander effect was particularly evident in 3-D multicellular spheroid models suggesting that this in vitro system may be a more appropriate model for assessing the efficacy of gene directed-enzyme prodrug therapy (GDEPT). We have applied this approach in a clinically relevant gene therapy protocol on established subcutaneous tumor xenografts. These studies show for the first time the efficacy of a P450-based GDEPT strategy mediated by a direct retroviral gene transfer in vivo.

Animals↗
PubMed2001

Reproducibility and clinical utility of tendon palpation to detect patellar tendinopathy in young basketball players. Victorian Institute of Sport tendon study group.

BACKGROUND: Palpation is an important clinical test for jumper's knee. OBJECTIVES: To (a) test the reproducibility of palpation tenderness, (b) evaluate the sensitivity and specificity of palpation in subjects with clinical symptoms of jumper's knee, and (c) determine whether tenderness to palpation may serve as a useful screening test for patellar tendinopathy. The yardstick for diagnosis of patellar tendinopathy was ultrasonographic abnormality. METHODS: In 326 junior symptomatic and asymptomatic athletes' tendons, palpation was performed by a single examiner before ultrasonographic examination by a certified ultrasound radiologist. In 58 tendons, palpation was performed twice to test reliability. Tenderness to palpation was scored on a scale from 0 to 3 where 0 represented no pain, and 1, 2, and 3 represented mild, moderate, and severe tenderness respectively. RESULTS: Patellar tendon palpation was a reliable examination for a single examiner (Pearson r = 0.82). In symptomatic tendons, the positive predictive value of palpation was 68%. As a screening examination in asymptomatic subjects, the positive predictive value of tendon palpation was 36-38%. Moderate and severe palpation tenderness were better predictors of ultrasonographic tendon pathology than absent or mild tenderness (p<0.001). Tender and symptomatic tendons were more likely to have ultrasound abnormality than tenderness alone (p<0.01). CONCLUSIONS: In this age group, palpation is a reliable test but it is not cost effective in detecting patellar tendinopathy in a preparticipation examination. In symptomatic tendons, palpation is a moderately sensitive but not specific test. Mild tenderness in the patellar tendons in asymptomatic jumping athletes should be considered normal.

Adolescent↗
PubMed2000

Survival of bacteria during oxygen limitation.

Regulatory mechanisms that enable bacteria associated with food, drinks and the human body to adapt to changes in the availability of oxygen are reviewed. Excess oxygen induces two adaptive responses to oxidative stress. Five or more control circuits enable enteric bacteria to generate energy and grow well in anaerobic environments. Two sets of enzymes catalyse both nitrate and nitrite reduction, and dual two-component regulatory systems sense and respond to the available nitrate and nitrite in the environment. The periplasmic nitrate reductase enables bacteria to scavenge low concentrations of nitrate: similar systems are found in food-borne and other pathogens.

Anaerobiosis↗
PubMed2000

Talking contracts and taking care: managers and professionals in the British National Health Service internal market.

This paper draws on audio-recordings of a Health Authority's contract monitoring meetings with hospital providers to examine the nature of interactions between managers and clinical professionals in the British National Health Service internal market. It describes how managers and professionals arrive at a working division of labour, which acknowledges their respective spheres of expertise, but also leaves a space where definitions are contested. There is an interplay of competing managerial and professional discourses which construct problems and proposed solutions in fundamentally non-commensurable ways. Yet only rarely do managers or professionals mount challenges in ways that bring them on to the territory of the other group; rather each group seeks to frame problems to mesh with its special domain of competence. Managers seek to push back the boundaries of professional control by constructing a language and set of practices which will govern the contracting process. But they remain reliant on professionals to mediate between the requirements of contracting and the realities of clinical work. Clinical arguments continue to have high perceived legitimacy for managers, and will often be taken up by hospital managers in negotiations with their Health Authority counterparts. It is argued that the dependency of managers on professionals to make the contracting system work, taken together with the continued social and cultural authority of senior medical consultants, limits managers' ability to control professionals.

Contract Services↗
PubMed2000

Patellar tendinopathy in junior basketball players: a controlled clinical and ultrasonographic study of 268 patellar tendons in players aged 14-18 years.

Anterior knee pain is a common presenting complaint amongst adolescent athletes. We hypothesised that patellar tendinopathy may occur at a younger age than is generally recognised. Thus, we studied the patellar tendons in 134 elite 14- to 18-year-old female (n=64) and male (n=70) basketball players and 29 control swimmers (17 female, 12 male) clinically and with ultrasonography. We found that of 268 tendons, 19 (7%) had current patellar tendinopathy on clinical grounds (11% in males, 2% in females). Twenty-six percent of the basketball players' patellar tendons contained an ultrasonographic hypoechoic region. Ultrasonographic abnormality was more prevalent in the oldest tertile of players (17-18 years) than the youngest tertile (14-15.9 years). Of tendons categorised clinically as 'Never patellar tendinopathy', 22% had an ultrasonographic hypoechoic region nevertheless. This study indicates that patellar tendinopathy can occur in 14- to 18-year-old basketball players. Ultrasonographic tendon abnormality is 3 times as common as clinical symptoms.

Adolescent↗
PubMed2000

The macrophage - a novel system to deliver gene therapy to pathological hypoxia.

The use of activated macrophages in the treatment of cancer has been largely ineffectual. By 'arming' these cells with the ability to express a therapeutic gene we demonstrate significant advances in the efficacy of this approach. We have used a hypoxia-regulated adenoviral vector to transduce human macrophages with either a reporter or a therapeutic gene encoding human cytochrome P4502B6 (CYP2B6). Infiltration of transduced macrophages into a tumour spheroid results in induction of gene expression. We demonstrate significant tumour cell killing only in the presence of cyclophosphamide via activation by P4502B6 and show that this can be further targeted to tumours through hypoxia regulated gene expression. Gene Therapy (2000) 7, 255-262.

Adenoviridae↗
PubMed2000

Electroconvulsive therapy: a review of the literature.

Electroconvulsive therapy (ECT) is a procedure that has been used in the treatment of mental illness for over 60 years. Despite its continued use it remains a controversial treatment, with questions concerning its efficacy being raised not only by mental health professionals, but also service users themselves. The following article reviews the current literature on the administration and effectiveness of ECT, highlighting some of the main points of contention in the debate over its use. In providing a balanced review of the literature, this article aims to serve as an information source for nurses and other mental health professionals who may be involved in the administration of ECT and care of the patients receiving treatment.

Depressive Disorder↗
PubMed2000

Astroblastoma: report of a case with microsatellite analysis.

A 5-year-old girl who developed progressive headache, vomiting, and left hemiparesis was found to have a cystic tumor with an enhanced mural nodule in the right frontoparietal region on a computed tomography examination. The lesion was histologically and ultrastructurally verified as an astroblastoma, an uncommon neuroepithelial tumor of uncertain origin. Molecular analysis using 17 microsatellite markers on chromosomes 9, 10, 11, 17, 19, and 22 showed loss of heterozygosity at the D19S412 locus on the long arm of chromsome 19. This observation suggests that there is a tumor suppressor gene in this chromosomal region, which plays a role in the pathogenesis of astroblastoma.

Brain Neoplasms↗
PubMed2000

Opening Pandora's box? Freedom of information and health services research.

The introduction, or extension, of freedom of information legislation in Britain and other Western countries seems certain to influence the climate for health services research. However, researchers should be clear that, although such legislation may improve access to certain types of data, it will also create new problems and dilemmas. Statutory freedom of information regimes are likely to raise difficult issues of adaptation and compliance for health service bodies. Researchers may find that this translates into reluctance to agree access and accentuates difficulties in managing field relationships. They may, inter alia, face difficult dilemmas in deciding whether, or how, to report non-compliance, judging whether to extend research into areas where consent has not been obtained and weighing the benefits of using the official rules to insist on disclosure against the dis-benefits of jeopardising relationships. Health services researchers should regard freedom of information legislation, not simply as a resource, but a topic deserving study in its own right.

Confidentiality↗
PubMed2000

Prospective imaging study of asymptomatic patellar tendinopathy in elite junior basketball players.

To evaluate the ability of ultrasonography to predict eventual symptoms in an at-risk population, 52 elite junior basketball players' patellar tendons were studied at baseline and again 16 months later. The group consisted of 10 study tendons (ultrasonographically hypoechoic at baseline) and 42 control tendons (ultrasonographically normal at baseline). By design, all tendons were asymptomatic at baseline. No differences were noted between subjects and controls at baseline for age, height, weight, training hours, and vertical jump. Functional (P < 0.01) and symptomatic outcome (P < 0.05) were poorer for subjects' tendons than for controls. Relative risk for developing symptoms of jumper's knee was 4.2 times greater in case tendons than in control tendons. Men were more likely to develop ultrasonographic changes than women (P < 0.025), and they also had significantly increased training hours per week (P < 0.01) in the study period. Half (50%) of abnormal tendons in women became ultrasonographically normal in the study period. Our data suggest that presence of an ultrasonographic hypoechoic area is associated with a greater risk of developing jumper's knee symptoms. Ultrasonographic patellar tendon changes may resolve, but this is not necessary for an athlete to become asymptomatic. Qualitative or quantitative analysis of baseline ultrasonographic images revealed it was not possible to predict which tendons would develop symptoms or resolve ultrasonographically.

Adolescent↗
PubMed1999

Competition between Escherichia coli strains expressing either a periplasmic or a membrane-bound nitrate reductase: does Nap confer a selective advantage during nitrate-limited growth?

The physiological role of the periplasmic nitrate reductase, Nap, one of the three nitrate reductases synthesized by Escherichia coli K-12, has been investigated. A series of double mutants that express only one nitrate reductase were grown anaerobically in batch cultures with glycerol as the non-fermentable carbon source and nitrate as the terminal electron acceptor. Only the strain expressing nitrate reductase A grew rapidly under these conditions. Introduction of a narL mutation severely decreased the growth rate of the nitrate reductase A strain, but enhanced the growth of the Nap(+) strain. The ability to use nitrate as a terminal electron acceptor for anaerobic growth is therefore regulated primarily by the NarL protein at the level of transcription. Furthermore, the strain expressing nitrate reductase A had a substantial selective advantage in competition with the strain expressing only Nap during nitrate-sufficient continuous culture. However, the strain expressing Nap was preferentially selected during nitrate-limited continuous growth. The saturation constants for nitrate for the two strains (which numerically are equal to the nitrate concentrations at half of the maximum specific growth rate and therefore reflect the relative affinities for nitrate) were estimated using the integrated Monod equation to be 15 and 50 microM for Nap and nitrate reductase A respectively. This difference is sufficient to explain the selective advantage of the Nap(+) strain during nitrate-limited growth. It is concluded that one physiological role of the periplasmic nitrate reductase of enteric bacteria is to enable bacteria to scavenge nitrate in nitrate-limited environments.

Anaerobiosis↗
PubMed1999

Detecting child sexual abuse in general practice: a retrospective case-control study from Wales.

OBJECTIVE: To investigate if routine medical contacts provide indicators that would assist general practitioners in detecting male child abuse. DESIGN: A case-control study of the general practice records of male victims of a major episode of school-based child abuse and matched controls. SETTING: General practices serving cases and controls from two South Wales schools. SUBJECTS: 107 abused boys and 107 aged-matched controls. RESULTS: No boys had disclosed sexual abuse to general practitioners. Somatic and behavioural symptoms were reported by small numbers in both groups (18 cases/25 controls). Odds ratios showed no significant positive association between abuse and numbers of boys presenting with symptoms (odds ratio 0.66; 95% confidence interval 0.32-1.37), and no difference could be found in the nature of the symptoms complained of by boys from the two groups. However, abused boys were more likely than controls to present with symptoms that persisted for more than a year (eight cases compared with one control). The two-tailed p-value calculated using the Fisher exact test was 0.035, suggesting a statistically significant association between abuse and persistent symptoms. CONCLUSIONS: Sexually-abused boys are unlikely to visit general practitioners with open requests for help, and do not appear to present with behavioural or somatic symptoms different from those presented by non-abused boys. However, where boys complain of persistent, inexplicable, somatic or behaviour problems over a period of time, the possibility of abuse should be considered.

Case-Control Studies↗
PubMed1999

Antipronation taping and temporary orthoses. Effects on tibial rotation position after exercise.

Abnormal lower-limb biomechanics--in particular, abnormal pronation of the subtalar joint with concomitant increased internal rotation of the tibia--is one of the major causes of overuse injuries of the lower limb. A randomized, controlled, within-subjects research design (N = 14) was used to investigate the effect of a temporary felt orthosis and an antipronation taping technique to control the transverse tibial rotation position immediately after application and after each of two 10-minute periods of exercise. The results showed that the taping technique was superior to both the orthosis and no intervention in controlling tibial rotation position immediately after application and after 10 minutes of exercise. After 20 minutes of exercise, neither the tape nor the orthosis was significantly superior to the control; however, the trends suggested that some residual control was maintained. Future studies are needed to determine the amount of foot pronation control required to relieve symptoms in a symptomatic population in order to determine the clinical effectiveness of these treatment methods.

Adolescent↗