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Biomedical subjects

M Daniel

Publications and source records attributed to M Daniel.

At least 19 recordsLinked to original sources
PubMed2006

Hydroxyapatite porous coating and the osteointegration of the total hip replacement.

INTRODUCTION: The main purpose of this study is to evaluate the efficacy of the plasma sprayed, combined porous titanium alloy/HA coating in promoting bony ingrowth and mechanical stabilization of total hip implants. The performance of the titanium alloy/HA type coated hip prostheses and the one of the same shape but without any coating, is compared in this paper. MATERIAL AND METHODS: The implants were manufactured from titanium alloy VT-6 (ASTM F-136). The hip stems utilized in the control group were identical to those subsequently coated. The coating consists of a plasma deposited first layer of porous titanium alloy (TiAl(6)V(4)), similar in composition to the forged substrate and a plasma deposited second layer of over-sprayed hydroxyapatite, Ca(10)(PO(4))6(OH)2. Coating is located in the critical area of the hip stems, where high fixation interface strength is desired, i.e. in the proximal area of the stem where the highest stresses occur. The porous titanium alloy/hydroxyapatite (HA) coated femoral stems were implanted in 50 patients. The results were compared with a control group of 50 patients with the same type of endoprosthesis, but without the porous titanium alloy/HA coating. Both groups of patients were operated on and evaluated by the same orthopedic surgeons with a mean follow up of 11.4 years in the HA group and 10.6 years in the control group. RESULTS: HHS in the control group was preoperatively 35.5 points (range 26-49) and 85.1 points (range 54-100) in the time of the last control. HHS in the HA group was preoperatively 34.1 points (range 27-56) and 94.4 points (range 89-100) in the time of the last control. In 28 cases (56%) of the control group a range of translucencies were obvious. These translucent lines, however, did not appear with any of the patients in the coated implant group except one infection stem migration. CONCLUSION: Experience with the HA-type coated hip implants demonstrates substantially higher degree and quality of osteointegration in the porous titanium alloy/HA type implants.

Adult↗
PubMed2006

Is admission for epistaxis more common in Caucasian than in Asian people? A preliminary study.

OBJECTIVES: Epistaxis is a common ENT complaint. Although casual observation suggested that it is more common in Caucasian, compared with Asian people, a literature search failed to find any studies investigating ethnicity and epistaxis. The aim of this study was to identify any differences in emergency admission rates for epistaxis between Asian and Caucasian people. DESIGN: Retrospective observational study using hospital computerised data (HISS). SETTING: Large University Hospital accepting ENT emergencies. PARTICIPANTS: All Asian and Caucasian patients admitted under ENT care as an emergency (1 January 2000 to 30 November 2005), split into two groups: one composed of epistaxis patients, the other of all other ENT emergency admissions. MAIN OUTCOMES MEASURES: The proportions of Asian and Caucasian patients among the two patient groups, either epistaxis admissions or other ENT emergency admissions. RESULTS: The proportions of Asian and Caucasian patients in the group admitted with emergency epistaxis were 7.1% (100/1410) and 92.9% (1310/1410) respectively. However, the proportions of Asian and Caucasian patients in the group composed of any other ENT emergency were 13.2% (729/5515) and 86.8% (4786/5515), respectively (chi-squared P < 0.01). CONCLUSIONS: Caucasian people form an unexpectedly large, and Asians a smaller proportion of emergency epistaxis admissions. The possibility of an ethnic risk factor for epistaxis warrants further investigation.

Asian People↗
PubMed2005

Self-contained Kondo effect in single molecules.

Kondo coupling of and conduction electrons is a common feature of f-electron intermetallics. Similar effects should occur in carbon ring systems (metallocenes). Evidence for Kondo coupling in Ce(C(8)H(8)(2) (cerocene) and the ytterbocene Cp*(2) Yb(bipy) is reported from magnetic susceptibility and L(III)-edge x-ray absorption spectroscopy. These well-defined systems provide a new way to study the Kondo effect on the nanoscale, should generate insight into the Anderson Lattice problem, and indicate the importance of this often-ignored contribution to bonding in organometallics.

Journal Article↗
PubMed2005

Perturbing the superconducting planes in CeCoIn5 by Sn substitution.

In contrast to substitution on the Co or Ce site, Sn substitution has a remarkably strong effect on superconductivity in CeCoIn5-xSnx, with Tc-->0 beyond only 3.6% Sn. Instead of being randomly distributed on in-plane and out-of-plane In sites, extended x-ray absorption fine structure measurements show the Sn atoms preferentially substitute within the Ce-In plane. This result highlights the importance of the In1 site to impurity scattering and clearly demonstrates the two-dimensional nature of superconductivity in CeCoIn5.

Journal Article↗
PubMed2005

A double-blinded randomized controlled trial of coblation versus conventional dissection tonsillectomy on post-operative symptoms.

OBJECTIVES: The aim of this study was to compare postoperative symptoms following coblation tonsillectomy with those experienced following a traditional cold dissection. DESIGN: A prospective randomized controlled trial. SETTING: Secondary otorhinolaryngology care. PARTICIPANTS: Ninety-two adult patients with recurrent tonsillitis meriting tonsillectomy were recruited and randomly allocated into either coblation or cold dissection tonsillectomy groups. MAIN OUTCOME MEASURES: Primary outcomes were post-operative pain, otalgia, swallowing and analgesia use at 6-8 hours, 1, 3, 7 and 14 days post-operative. Secondary outcomes were post-operative day returned to eating and returned to normal activities/work. RESULTS: No significant differences between the two groups (P >or= 0.1) were found in any of the above primary outcomes, apart from swallowing at 6-8 hrs post-operatively where the cold dissection group had less pain. This group also returned earlier to normal eating (P = 0.03). The power of the study was sufficient to show a difference in the visual analogue scores of 2 between groups. CONCLUSIONS: The use of coblation to perform tonsillectomy does not confer any symptomatic benefits to the patient over conventional cold dissection tonsillectomy.

Adolescent↗
PubMed2005

Screening for diabetes in Indigenous populations using glycated haemoglobin: sensitivity, specificity, post-test likelihood and risk of disease.

AIMS: Screening for diabetes using glycated haemoglobin (HbA1c) offers potential advantages over fasting glucose or oral glucose tolerance testing. Current recommendations advise against the use of HbA1c for screening but test properties may vary systematically across populations, according to the diabetes prevalence and risk. We aimed to: (i) characterize the properties of test cut-offs of HbA1c for diagnosis of diabetes relative to a diagnosis based on a fasting plasma glucose concentration of 7.0 mmol/l for high-risk Indigenous populations; and (ii) examine test properties across a range of diabetes prevalence from 5 to 30%. METHODS: Data were collected from Aboriginal and Torres Strait Islander communities in Australia and a Canadian First Nations community (diabetes prevalence 12-22%) in the course of diabetes diagnostic and risk factor screening programmes (n = 431). Screening test properties were analyzed for the range of HbA1c observed (3-12.9%). RESULTS: In separate and pooled analyses, a HbA1c cut point of 7.0% proved the optimal limit for classifying diabetes, with summary analysis results of sensitivity = 73 (56-86)%, specificity = 98 (96-99)%, overall agreement (Youden's index) = 0.71, and positive predictive value (for an overall prevalence of 18%) = 88%. For diabetes prevalence from 5 to 30% the post-test likelihood of having diabetes given HbA1c = 7.0% (positive predictive value) ranged from 62.7 to 93.2%; for HbA1c < 7.0%, the post-test likelihood of having diabetes ranged from 4.5 to 27.7%. CONCLUSIONS: The results converge with research on the likelihood of diabetes complications in supporting a HbA1c cut-off of 7.0% in screening for diabetes in epidemiological research. Glycated haemoglobin has potential utility in screening for diabetes in high-risk populations.

Adolescent↗
PubMed2005

Relation between epistaxis, external nasal deformity, and septal deviation following nasal trauma.

OBJECTIVES: To find if the presence of epistaxis after nasal trauma can be used to predict post-traumatic external nasal deformity or a symptomatic deviated nasal septum. METHODS: Retrospective analysis of all patients seen in the fractured nose clinic by the first author between 17 October 2003 and 27 February 2004. Presence of epistaxis, newly developed external nasal deformity, and the presence of a deviated nasal septum with new symptoms of nasal obstruction were noted. RESULTS: A total of 139 patients were included in the study. Epistaxis following injury was noted in 106 (76%). Newly developed external nasal deformity was noted in 71 (51%), and 33 (24%) had a deviated nasal septum with new symptoms of nasal obstruction. Of the 106 patients with post-trauma epistaxis, 50 (67%) had newly developed external nasal deformity and of the 33 patients without post-traumatic epistaxis, 11 (33%) had nasal deformity (p<0.05). Post-trauma epistaxis was not associated with the presence of a newly symptomatic deviated septum (25% in patients with epistaxis after injury versus 18% if there was no epistaxis). CONCLUSIONS: Presence of epistaxis after nasal trauma is associated with a statistically significant increase in external nasal deformity. However, one third of patients without epistaxis following nasal trauma also had external nasal deformity and hence all patients with a swollen nose after injury, irrespective of post-trauma epistaxis, still need to be referred to the fractured nose clinic.

Adolescent↗
PubMed2005

Altitudinal distribution limit of the tick Ixodes ricinus shifted considerably towards higher altitudes in central Europe: results of three years monitoring in the Krkonose Mts. (Czech Republic).

The aim of the study was to monitor present status of the Ixodes ricinus tick vertical distribution in the Krkonose Mts. (Czech Republic) and evaluate its potential changes. Two methods were used: monitoring of tick presence on dogs in 2001-2002 and direct monitoring of host-seeking ticks by flagging on two vertical transects reaching from 620 to 1270 m above sea level (a. s. l.) and from 600 to 1020 m in 2002-2003. Moreover ticks were monitored by flagging at another 13 localities situated in 800-1299 m a. s. l. in 2003. Both monitoring methods revealed an obvious shift in altitudinal distribution limit of the tick I. ricinus in the Krkonose Mts. They both showed that ticks recently penetrate even up to a timberline (approximately 1250 m a. s. l.). The number of recorded host-seeking ticks rapidly decreased with increasing altitude. Whereas the average number of recorded nymphs converted per 60 minutes of flagging reached 15.2-25.7 nymphs in 700-799 m a. s. l. and 3.3-23.3 in 800-899 m, it was 4-9.6 nymphs in 900-999 m, 1.5-1.7 nymphs in 1000-1099 m and only 0.2 nymph in 1100-1299 m a. s. l. The observed shift of the tick altitudinal distribution limit at the same time results in extension of areas with potential risk of tick-borne diseases.

Altitude↗
PubMed2004

Results of a technology demonstration project to compare rapid aquatic toxicity screening tests in the analysis of industrial effluents.

The results of a 'BioWise' demonstration project to assess the comparative sensitivity and practicality of seven new assays for the direct assessment of ecotoxicity in industrial effluents are presented. In addition the aim of the project was to validate the results of the new assays against benchmark data generated from non-proprietary, rapid, microplate screening assays using the regulatory species; freshwater crustacean Daphnia magna and green algae Selenastrum capricornutum, chosen in view of their environmental relevance. The new commercial test assays were: Daphnia magna, Selenastrum capricornutum and Thamnocephalus platyurus Toxkits supplied by Vickers Laboratories Ltd, containing dormant, immobilised life stages of the test species; GreenScreen EM, a yeast based assay for genotoxicity and general acute toxicity supplied by Gentronix Ltd; and CellSense a mediated, amperometric whole cell biosensor based on immobilised activated sludge and E. coli. 38 effluent samples supplied by members of SOCSA (Specialised Organic Chemicals Sector Association) were examined over a period of 13 months, in the project co-ordinated by the AstraZeneca Brixham Environmental Laboratory, and part funded by BioWise via the UK Government Department of Trade and Industry.

Animals↗
PubMed2004

The Randomized Nitric Oxide Tocolysis Trial (RNOTT) for the treatment of preterm labor.

OBJECTIVE: This study was undertaken to assess the effectiveness of glyceryl trinitrate (GTN) patches in comparison with beta2 sympathomimetics (beta2) for the treatment of preterm labor. STUDY DESIGN: A multicenter, multinational, randomized controlled trial was conducted in tertiary referral teaching hospitals. Women in threatened preterm labor with positive fetal fibronectin or ruptured membranes between 24 and 35 weeks' gestation were recruited and randomly assigned to either beta2 or GTN with rescue beta2 tocolysis if moderate-to-strong contractions persisted at 2 hours. Obstetric and neonatal outcomes were assessed. RESULTS: Two hundred thirty-eight women were recruited and randomly assigned, 117 to beta2 and 121 to GTN. On a strict intention-to-treat basis, there was no significant difference in the time to delivery using Kaplan-Meier curves (P = .451). At 2 hours, 27% of women receiving beta2 had moderate or stronger contractions compared with 53% in the GTN group (P < .001). This led to 35% of women in the GTN group receiving rescue treatment. If delivery or requirement for beta2 rescue are regarded as treatment failure, then a significant difference was observed between the 2 arms (P = .0032). There were no significant differences in neonatal outcomes. CONCLUSION: GTN is a less efficacious tocolytic compared with ss2 sympathomimetics.

Adrenergic beta-2 Receptor Agonists↗
PubMed2004

Socio-economic conditions and other anthropogenic factors influencing tick-borne encephalitis incidence in the Czech Republic.

Laboratory confirmed cases of tick-borne encephalitis (TBE) have been reported in the Czech Republic since 1971. Peaks of incidence occurred at 2 to 5-year intervals. The incidence in the eighties was generally lower than in seventies. In the nineties there was a sharp increase in incidence that peaked in 1995 (7.2/100,000). TBE cases occur from April to November with maximum incidence in July. During the last decade the second peak of incidence occurred in most years in September and/or October. In the last decade, an extension of the TBE season towards the spring and autumn periods has been observed. In addition to a general increase in TBE incidence in the last decade, some other changes in the epidemiology of TBE were observed in the Czech Republic. During the whole period sex-specific incidence was higher in men than in women (men to women ratio 1.5:1). Age-specific incidence over recent years increased steadily in children and adolescent age groups. In the ten-year age groups from 25 to 65, it remains practically at the same level (6-8/100,000). In older persons it fell to 2-3/100,000. Tick bites infect patients mainly during their recreational activities. A very small proportion (less than 1%) acquires the infection through the alimentary route. We have tested the hypothesis whether the increase in TBE incidence in the nineties was due to economical or social changes after the velvet revolution of 1989. Between 1991 and 1995 unemployment largely remained on the same level (between 2-3%). Over the next years the percentage of unemployed persons increased rapidly to 9.3% in 1999 (7.8% in 2001). This trend differs significantly from the trend of TBE incidence that peaked in 1995. No correlation between the district incidence of TBE and the district percentage of unemployment in the years 1997-2001 was found (r=-0.20). The percentage of unemployed persons among the TBE cases was 1-3% in contrast to the Czech Republic figures which were 5-9% for the same period. The gross domestic product in USD per capita increased from dollars 2,600 in 1991 to dollars 5,000 in 1995. Since then it has varied between dollars 4,800 and dollars 5,600. This trend, therefore, differs from the trend of TBE incidence as well. Among the TBE cases the percentage of foresters and other persons working in the forests in the years 1997-2001 was 0.5-1%. The behavioral and socio-economic aspects of TBE cases remained stable despite the political changes which have take place in the Czech Republic since the beginning of the nineties. They are not, therefore, responsible for the increased TBE incidence. In the industrial areas most polluted by SO2 in the past in northern Bohemia the sharp increase in TBE incidence seems to be connected with measures aiming to eliminate SO2 emissions from brown coal power stations.

Adolescent↗
PubMed2004

GIS tools for tick and tick-borne disease occurrence.

Geographic information systems (GIS), their fundamental components and technologies are described. GIS is a computer-based system enabling the storage, integration, query, display and analysis of data using information on data location. Further, remote sensing (RS) methods and their application in landscape characterization are described. Landscape pattern analysis, combined with statistical analysis, allows the determination of landscape predictors of disease risk. This makes RS/GIS a powerful set of tools for disease surveillance, enabling the prediction of potential disease outbreaks and targeting intervention programs. The 'pre-GIS era' is briefly described including the early mapping of tick distribution, analyses and the display of biogeographical and medical data. The theory of natural focality of diseases (NFD) is explained and its significance in tick-borne diseases (TBD) research is discussed. Many problems of tick ecology and TBD epidemiology and epizootology have been addressed by means of GIS and examples of these studies are presented and discussed.

Animals↗
PubMed2004

Association between smoking, insulin resistance and beta-cell function in a North-western First Nation.

AIMS: Aboriginal peoples have a high prevalence of smoking and are at major risk for diabetes. The role of insulin resistance vs. compromised beta-cell function in the link between smoking and glycaemic disease is not clear. This study tested whether relations between insulin resistance and beta-cell function differ between current smokers, former smokers and non-smokers, and if having diabetes modifies smoking-related effects. METHODS: A community-based diabetes screening initiative was mounted for a North-western First Nation (Interior Salishan) in rural British Columbia, Canada. Respondents were on-reserve Aboriginal people (n=156), all adults 18+ years. Glycaemic status was determined by oral glucose tolerance test. Fasting values for glucose and insulin were used to estimate beta-cell function and insulin resistance by homeostasis model assessment (HOMA). Analyses adjusted for age, sex, alcohol intake, education, body mass index and physical activity. RESULTS: For normoglycaemic persons (n=119) current smokers relative to non-smokers had high beta-cell values [difference (95% confidence interval) 19.5 (17.1, 21.9)], while former smokers had low beta-cell values [difference -22.8 (-20.3, -25.3)] (P<0.0001). For diabetic persons (n=37) differences were of equivalent direction but greater magnitude (P<0.0001). Insulin resistance was for normoglycaemic persons highest for current smokers, and for diabetic persons lowest for current smokers (P=0.021). CONCLUSIONS: Former smoking is associated with low beta-cell function, and current smoking with high beta-cell function, independent of diabetes in the North-western First Nation surveyed. Associations between smoking and insulin resistance vary according to glycaemic status. Smoking may have diametric acute and post-cessation effects on beta-cell function and insulin resistance.

Adult↗
PubMed2004

Is a doctor needed in the adult ENT pre-admission clinic?

OBJECTIVES: Pre-admission clinics are traditionally run jointly by nurses and doctors. Within an adult ENT pre-admission clinic, we wished to assess what doctors added to nurses' pre-clerking, to determine whether doctors were actually needed in the clinic. METHODS: Prospective study, looking at how often doctors, seeing patients after ward-based nurses, changed or added to clerking or tests as organized by nurses. RESULTS: Out of 184 patients, doctors changed or added to nurses' clerking or planned investigations in 47 patients (26 per cent), making 64 different changes. The commonest reasons for changes were ordering blood tests (22 changes), chest X-rays (eight), cancelling due to hypertension (seven), altering drug history (five) and requesting electrocardiograms (five changes). CONCLUSION: Most changes made by doctors could be eliminated by designing a pre-admission clinic protocol that could easily be used by nurses. We recommend that all ENT departments consider implementing nurse-led pre-admission clinics.

Adult↗
PubMed2004

Prevalence of Borrelia burgdorferi sensu lato genospecies in host-seeking Ixodes ricinus ticks in selected South Bohemian locations (Czech Republic).

In selected localities of Ceské Budĕjovice and Ceský, Krumlov districts, well known by stable high incidence of tick-borne encephalitis (TBE) human cases but with low incidence of Lyme borreliosis, monitoring of Borrelia burgdorferi sensu lato (s.l.) in Ixodes ricinus ticks was performed. Research was also aimed at the spread of I. ricinus to mountain areas of this region (National Park Sumava), as well as at investigating this tick for B. burgdorferi s.l. genospecies and TBE virus infection. Altogether 498 nymphs, 88 females and 11 males of I. ricinus from lower locations and 58 nymphs from mountain locations (760-1080 m above sea level) were tested by polymerase chain reaction. In lower locations total prevalence of Borrelia burgdorferi s.l. in Ixodes ricinus ticks was 35%. Single infection of Borrelia afzelii, B. garinii and B. burgdorferi sensu stricto (s.s.) was found in 59, 50 and 63 ticks, respectively (i.e. in 12.8, 11.2 and 14.1%). Double infection was found in 42 ticks (6.0%) and triple infection in three ticks (0.4%). The high frequency of B. burgdorferi s.s. exceeds the as yet reported occurrence in Central Europe. These circumstances are discussed. In mountain locations B. afzelii was found in five ticks, that including two co-infection with B. garinii, in elevations of 762 m and 1024 m above sea level, respectively. This fact signals a real danger of human infections in a region that was previously deemed to be without risk. Moreover, this region is more and more the target destination of tourist activities. The results also suggest that the penetration of infection can be rapid and formation and establishment of natural focus of Lyme borreliosis might be rather quick.

Animals↗
PubMed2004

[Effects of climate change on the incidence of tick-borne encephalitis in the Czech Republic in the past two decades].

The study objective was an attempt to explain uneven distribution of the incidence of tick-borne encephalitis (TBE) throughout the past two decades. A sharp rise was recorded in the last decade: while 2596 TBE cases were reported in the decade 1983-1992, as many as 5892 TBE cases were reported in the decade 1993-2002, with high rates persisting also in the following years (606 TBE cases reported in 2003). Data from the database TBE EPIDAT of the National Institute of Public Health, Prague, and that of the Communicable Diseases Information System, Ostrava, were used for analysis. Meteorological data were taken from the database of the Czech Institute of Hydrometeorology, Prague. In 1971 to 2003, 13 231 laboratory confirmed TBE cases were reported in the Czech Republic. Uneven distribution of these TBE cases in time is consistent with the observations of climate variation made between 1931 and 2000. The increase in the TBE incidence in the Czech Republic in the last decade was characterized by the following features: 1) higher rates of TBE cases manifested in regular TBE natural focuses, 2) reemergence of TBE in the same localities after 20 and more year intervals and 3) emergence of TBE in localities where it was not reported before. At the same time shifts in TBE seasonal trends (i.e. to March and October-November) were observed, associated with a TBE incidence peak in autumn. Field research revealed that the major factor are the climate-related changes in ecology of the TBE vector Ixodes ricinus and resulting variation in its population density. TBE emergence in new areas is linked to the occurrence of ticks Ixodes ricinus at higher altitudes (previously found at 700 m and currently spreading to 1200 m) as well as to a coming warm climate era.

Czech Republic↗