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Biomedical subjects

L Kenny

Publications and source records attributed to L Kenny.

16 recordsLinked to original sources
PubMed2005

Prioritization of radiotherapy in Australia and New Zealand.

The purpose of this study was to document how radiation oncology departments in Australia and New Zealand manage extended waiting lists by prioritizing patients for radiotherapy and how these centres define the "waiting time". A literature search on strategies for management of waiting lists in radiotherapy, both locally and internationally, was performed. A collaborative survey of all the radiotherapy departments in Australia and New Zealand was then undertaken. Of the 32 centres surveyed around Australia and New Zealand, 25 (77%) responded. There was considerable variation in the definitions used for "waiting times". Eleven of the 25 centres had formally documented protocols. New Zealand has a national policy for prioritization of patients for radiotherapy. Six centres had verbal protocols. Four centres had no significant waiting times and did not require a protocol for prioritization. One centre prioritized according to clinician discretion, two centres used a first-come, first-served basis. One centre replied but their protocol was missing. The variation in the definition of waiting time reduces its usefulness as an indirect measure of resources and as a method of comparing centres. There is also wide variation in the management of waiting lists, particularly in the prioritization schedules used by different centres. The major factor contributing to waiting lists at present is a shortage of radiation oncology staff, particularly radiation therapists. The implementation of standardized protocols for prioritizing patients may be useful in helping to manage scarce resources not withstanding the need to increase the resource base. However, the existence of such protocols should not give legitimacy to undue delays in commencing radiation treatment.

Australia↗
PubMed2004

Beliefs and practices of patients with advanced cancer: implications for communication.

The aim of this study was to investigate the beliefs that patients with advanced cancer held about the curability of their cancer, their use of alternatives to conventional medical treatment, and their need to have control over decisions about treatment. Of 149 patients who fulfilled the criteria for participation and completed a self-administered questionnaire, 45 patients (31%) believed their cancer was incurable, 61 (42%) were uncertain and 39 (27%) believed their cancer was curable. The index of need for control over treatment decisions was low in 53 patients (35.6%) and high in only 17 patients (11.4%). Committed users of alternatives to conventional medical treatments were more likely to believe that their cancer was curable (P<0.001) and to have a higher need for control over decisions about treatment (P<0.004). The mean need for control scores were highest in patients who believed that their cancer was curable, or who were uncertain about the curability of their cancer, but who acknowledged that their oncologist had reported that the cancer was incurable. The diverse beliefs, attitudes and actions of these patients were consistent with a range of psychological adaptations to a life-threatening illness, some realistic and others illusory. Illusory responses influence what communication can achieve in daily oncology practice.

Attitude of Health Personnel↗
PubMed2004

Illusions in advanced cancer: the effect of belief systems and attitudes on quality of life.

Patients with advanced cancer frequently express positive attitudes and can be unduly optimistic about the potential benefits of treatment. In order to evaluate an illusory domain in the context of advanced cancer, we developed a scale of will to live and characterized the beliefs that patients held about the curability of their cancer, and how committed they were to using alternative treatments. A measure of quality of life was used as the dependent variable in order to assess the association between these attributes. After a preliminary exploration confirmed the presence of an illusory domain, these concepts were prospectively tested in 149 ambulant patients with advanced cancer who attended for palliative systemic treatment, radiation treatment or supportive care. The scale of global quality of life was reliable (Cronbach's alpha coefficient 0.72). The distribution of the scores of will to live was skewed, with no respondent scoring poorly, and the scale was reliable (Cronbach's alpha coefficient 0.82). The scale of belief in curability showed diverse beliefs. In some cases, there was a discrepancy between respondents' beliefs in curability and what they believed to be the report by their doctors. There was also an association between a committed use of alternative treatments and a belief in the curability of the cancer (p<0.001). In a multiple regression analysis, both will to live and performance status remained associated with better quality of life scores after adjustment for other relevant variables (p<0.05 and <0.001, respectively). These results suggest that positive illusory beliefs can be measured and are an important component of adaption for some patients with advanced cancer. Furthermore, this illusory domain may influence the perception and measurement of quality of life.

Adaptation, Psychological↗
PubMed2001

[Optimization of culture conditions for in vitro rooting of argan (Argania spinosa L.)].

The root system produced of in vitro organ plantlets is of poor quality and not efficient for the transfer to out-door conditions. To overcome such problems, experimentation was undertaken where the effects of growth regulators, nitrogen, sugar, activated charcoal and coconut fiber were tested on root induction and elongation. Modified Murashige and Skoog with half strength salt was used as a basal medium. Root induction (85%) with a mean of 16 roots per explant was obtained when shoots were grown, under dark conditions for 14 days, with a combination of two auxins (IBA and NNA), added at equal concentrations (5 mg.L-1). Secondary roots, 10 cm long, were initiated in 12% of the cultures in presence of 5 g.L-1 activated charcoal. Further improvements in the growth of the primary and secondary roots were obtained when semi-solid medium was substituted with a substrate composed of coconut fibers (80 g) mixed with semi-solid medium (35 mL) and agar (2.5 g.L-1).

Conservation of Natural Resources↗
PubMed2001

Breast radiotherapy: an Australasian survey of current treatment techniques.

Prior to the dissemination of evidence-based quality assurance guidelines, the Australian National Breast Cancer Centre Radiation Oncology Group conducted a process survey of breast radiotherapy treatment delivery throughout Australia. A process survey was conducted in August/September 1998. This survey comprised questions enquiring about treatment positioning, immobilization devices used, planning strategies, simulation and dose computation methods, treatment prescribing and quality assurance. The survey was sent to 123 Australian fellows of the Royal Australian and New Zealand College of Radiologists (RANZCR) and to the six directors of New Zealand radiation oncology departments. Fifty-eight questionnaires were returned of which 38 were received from individuals and 20 represented a reply from a department with a routine breast radiotherapy protocol (representing an average of 4.5 radiation oncologists per reply). The study identified great consistency between departments with respect to dose and fractionation for breast tangents. The study also identified some areas of treatment planning and delivery that varied between individuals or departments. These mainly reflected a lack of evidence in some areas of radiotherapy treatment delivery. The circulation of quality assurance guidelines will perhaps improve consistency of radiotherapy techniques in which studies have identified that technique changes improve outcome. This study identified that these areas include the taking of simulation and port films and the use of off-axis dosimetry. Further studies are required for areas of radiotherapy treatment delivery that have little evidence for or against their implementation.

Australia↗
PubMed2001

Applications of low-cost, dual-fraction dust samplers.

Porous polyurethane foams provide a low-cost method for separating dust into health-related fractions in accordance with recognized sampling conventions. A number of dust sampling instruments that make use of foam selectors have been described in recent literature, but practical experiences of using these instruments in real workplaces have not been widely reported. An IOM inhalable dust sampler incorporating a respirable-fraction selector foam was evaluated in a range of industries, for general occupational dust monitoring. The key issues addressed were those that determine the practicability of the instrument, such as limitations on particulate loading, losses or movements of particles during transportation of samples, and equivalence with conventional respirable dust sampling methods. The new sampler was found to be satisfactory in all these respects. The minor problems experienced have been addressed during the design of the production version of the foam cassette, which is available as an accessory for the existing IOM inhalable dust sampler. The key advantage of the new dust sampler is that it measures both inhalable and respirable dust concentrations in a single sample (hence the name: dual-fraction dust sampler). Therefore, it saves both time and money in industries where both inhalable and respirable dust are routinely monitored.

Air Pollutants, Occupational↗
PubMed1999

Maternal pathophysiology in pre-eclampsia.

Pre-eclampsia is a common condition, unique to pregnancy, and almost unique among medical conditions in that we have, at best, only a patchy knowledge of the underlying aetiology and pathophysiology. In this chapter, established and new hypotheses will be discussed and the recent supporting evidence for each will be reviewed. The principal systems affected by pre-eclampsia, namely the cardiovascular, coagulation, liver and renal systems, together with cerebral manifestations of this disease will be discussed in turn.

Blood Coagulation↗
PubMed1994

Genetic analysis of liver tumorigenesis in SV40 T antigen transgenic mice implies a role for imprinted genes.

Liver tumors from interspecific hybrid, transgenic mice containing the SV40 early region linked to a mouse major urinary protein enhancer/promoter were analyzed for loss of heterozygosity to identify chromosomal regions which potentially contain genetic loci involved in multistep tumorigenesis. A broad pattern of complete and partial loss of heterozygosity or allelic imbalance was observed with frequent loss of heterozygosity/partial loss of heterozygosity of loci on chromosomes 1, 5, 7, 8, and 12. In tumors from Mus domesticus x Mus spretus F1 mice a strong preference for loss of the domesticus allele of H19 on chromosome 7 was observed, whereas loss of heterozygosity/partial loss of heterozygosity on chromosome 8 involved preferential loss of spretus alleles. In tumors from reciprocal crosses with Mus castaneus, the maternal chromosome 7 H19 allele was preferentially lost irrespective of whether it was domesticus or castaneus, strongly suggesting the involvement of an imprinted gene(s) in tumor progression.

Alleles↗
PubMed1990

Isolation and characterization of renin-expressing cell lines from transgenic mice containing a renin-promoter viral oncogene fusion construct.

We constructed transgenic mice containing a renin-promoter SV40 T antigen fusion transgene with the intention of inducing neoplasia in renin-expressing cells and isolating renin-expressing cell lines in vitro. We examined six kidney tumors from mice representing three different transgenic lines and found they expressed their endogenous renin gene. Initially, five nonclonal kidney tumor-derived cell lines were established which expressed their endogenous renin gene in addition to the transgene. They retained active renin intracellularly and constitutively secreted an inactive form of renin (prorenin). One of these cell lines was cloned to homogeneity. This line maintained high level expression of renin mRNA throughout 3 months of continuous culture. Although the cells contained an equal proportion of active and inactive renin, the species constitutively secreted into the media was predominantly (95%) prorenin. However, active renin secretion was stimulated 2.3- and 4.6-fold by treatment with 8-bromo-cAMP after 4 and 15 h, respectively. In addition, the presence of multiple secretory granules was confirmed by ultrastructural analysis. These cells, which express renin mRNA and can regulate secretion of active renin, should provide an excellent tool for studying renin gene regulation and secretion. Furthermore, these mice should provide a useful source for the establishment of renin-expressing cell lines from a variety of renin-expressing tissues.

Animals↗
PubMedDate not supplied

Analysis of chromatin proteins from human placenta.

Low-salt extracts of chromatin from human term placenta have been examined for the presence of the high mobility group (HMG) proteins. Based upon salt-dissociation characteristics, solubilities in trichloroacetic acid and electrophoretic behaviour on sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and non-equilibrium pH gradient gel electrophoresis (NEPHGE), each of the HMG proteins is present, including HMG-1, -2, -E, -14, and -17. A remarkably large amount of HMG-E is present in term human placenta. Additionally, a protein not previously recognized, which we designate HMG-PL, is present in term placenta. Electrophoretic comparison of the HMG proteins from placentae of varying gestational age, using NEPHGE, demonstrates that all of the placental HMG proteins exhibit multiplicity, reminiscent of chicken erythrocyte HMG proteins. Specifically, we found HMG-E to be unaltered in amounts relative to HMG-1 and -2 in placentae varying from 20 to 40 weeks of gestation. HMG-PL, however, is differentially expressed, increasing in amounts as gestation proceeds past 34 weeks. HMG-PL was purified and subjected to amino acid analysis. Its composition supports the notion that HMG-PL is a member of the HMG-1 family.

Amino Acids↗
PubMedDate not supplied

Preeclampsia: the endothelium, circulating factor(s) and vascular endothelial growth factor.

It has been proposed that endothelial cell activation is the primary event in the multisystem disorder of preeclampsia. Evidence for endothelial involvement in this condition abounds. The best-characterized morphologic abnormality of this syndrome, glomerular endotheliosis, involves endothelial cells. Also associated with preeclampsia is a loss of endothelial cell integrity, with the consequent increase in vascular permeability, and an increase in the circulating levels of the endothelial cell markers, fibronectin, von Willebrand factor, tissue plasminogen activator, and plasminogen activator inhibitor-1. It is now well documented that endothelial activation contributes to the coagulation abnormalities observed in this disease. There is much evidence that the endothelial alterations in preeclampsia result from one or more circulating factors. The incubation of cultured endothelial cells with serum or plasma samples, taken from normal pregnant women and women with preeclampsia, results in marked alterations in cell behavior and metabolic processes. More recently, experiments employing myographic techniques have demonstrated convincingly the effects of a circulating factor(s) on the function of endothelial cells of resistance arteries. Vascular endothelial growth factor (VEGF) possesses many of the characteristics required of a candidate circulating factor. It contains a hydrophobic secretory signal sequence, exerts in vitro effects specific to vascular endothelial cell, and promotes endothelial expression of procoagulant activity. Circulating VEGF concentrations are elevated in women with preeclampsia, and VEGF increases microvascular endothelial cell prostacyclin production in a dose-dependent manner, analogous to the acute effects of plasma from patients with preeclampsia. Similarly, in myographic studies, when myometrial resistance arteries are incubated with VEGF, there are dose-dependent alterations in endothelium-dependent behavior, mirroring those found after incubation with plasma from patients with preeclampsia.

Endothelial Growth Factors↗
PubMedDate not supplied

Tuberculosis in the workplace: a labor perspective.

It was not until several health care unions petitioned OSHA for a bloodborne pathogen standard in 1986 that OSHA began to play a major role in regulating the health care industry. The authors examine the Service Employees International Union's current effort to urge OSHA to develop a standard to protect workers from occupational exposure to TB. They also cover ramifications of the CDC's revised guidelines for preventing the transmission of TB in health care settings.

Guidelines as Topic↗