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Biomedical subjects

M L Nolan

Publications and source records attributed to M L Nolan.

11 recordsLinked to original sources
PubMed2005

Assessment of CD8 T cell immune activation markers to monitor response to antiretroviral therapy among HIV-1 infected patients in Côte d'Ivoire.

Because of the paucity of plasma HIV RNA viral load (VL) tests in resource-poor settings, the CD4(+) T cell count is often used as the sole laboratory marker to evaluate the effectiveness of antiretroviral therapy (ART) in HIV-infected patients. In untreated patients, the level of activated T cells is positively correlated with VL and represents a prognostic marker of HIV infection. However, little is known about its value to predict early drug failure, taking into account the relatively high non-specific immune activation background observed in many resource-limited tropical countries. We assessed the use of immune activation markers (expression of CD38 and/or human leucocyte antigen-DR on CD8(+) lymphocytes) to predict virological response to ART in a cohort of HIV-1 infected patients in Abidjan, Côte d'Ivoire. Correlations between VL, absolute CD4(+) T cell counts and immune activation levels were examined in 111 HIV patient samples at baseline and after 6 and 12 months of therapy. The percentage of CD38(+) CD8(+) T cells appeared to be the best correlate of VL. In contrast, changes in CD4(+) T cell counts provided a poor correlate of virological response to ART. Unfortunately, CD38(+) CD8(+) percentages lacked specificity for the determination of early virological drug failure and did not appear to be reliable surrogates of RNA viral load. CD38(+) CD8(+) T cell percentages may, rather, provide a sensitive estimate of the overall immune recovery, and be a useful extra laboratory parameter to CD4 counts that would contribute to improve the clinical management of HIV-infected people when VL testing facilities are lacking.

ADP-ribosyl Cyclase↗
PubMed1997

Aims, processes and problems of antenatal education as identified by three groups of childbirth teachers.

OBJECTIVE: To establish whether variations exist in the philosophy and approach of three groups of childbirth teachers working in different organisations in the UK. PARTICIPANTS: Two midwifery Parentcraft Sisters working in the UK maternity services, three National Childbirth Trust Antenatal Teachers and two Active Birth Teachers working in the voluntary sector, and two Midwife Teachers. METHOD: Semi-structured interviews were tape-recorded, transcribed and analysed using a grounded theory approach to identify common categories. FINDINGS: All three groups of teachers identified similar aims for antenatal education, with the need to build clients' confidence in their ability to give birth and care for their babies as the most important. However, the process by which the various teachers attempted to realise their aims appeared to be very different. IMPLICATIONS FOR PRACTICE: In order to ensure the prioritization of antenatal education with purchasers and providers, childbirth teachers need to define more clearly the criteria by which it can be audited.

Attitude of Health Personnel↗
PubMed1997

Antenatal education--where next?

The history of antenatal education throws light on why contemporary class attenders represent only a particular section of the childbearing population. Since Victorian times, the non-availability of the women's network to middle class women has forced them to seek knowledge of their own bodies, confidence in their childbearing capacities and the support of other women through formal educational opportunities. Research suggests that antenatal classes often fail to provide women with a realistic account of birth and parenting to replace the lived experience of earlier decades and may not be facilitated in such a way as to create the support groups which class attenders so critically need. Teaching approaches often promote dependency amongst clients rather than nurturing the decision-making skills required by a consumer-driven maternity service.

England↗
PubMed1997

Hematologic and systemic toxicoses associated with carboplatin administration in cats.

OBJECTIVE: To determine prevalence and severity of carboplatin-induced dose-limiting toxicoses in the cat. ANIMALS: 9 healthy, 6- to 7-month-old cats weighing 4.7 (range, 3.0 to 6.5) kg. PROCEDURE: Cats were given a single i.v. bolus of carboplatin at a dosage of 150 (n = 3), 200 (n = 3), or 250 (n = 3) mg/m2 of body surface area. RESULTS: Dose-limiting neutropenia and thrombocytopenia were significant in all cats given carboplatin at 200 or 250 mg/m2. Weight loss, changes in appetite, and evidence of respiratory difficulty, as well as vomiting, diarrhea, or lethargy were not observed at any time during the 28-day period. At a highest dosage (250 mg/m2), the neutrophil nadir (560 +/- 303 neutrophils/microliters) was observed on day 17 and the platelet count nadir (96,500 +/- 11,815 platelets/microliters) was observed on day 14 after carboplatin administration. CONCLUSIONS: Carboplatin appears to be safe and clinically well-tolerated when given i.v. as a single bolus at a dosage of 200 mg/m2 to clinically normal cats. The dose-limiting toxicity of a single i.v. administered bolus is neutropenia. The nadir of a 200 mg/m2 i.v. administered dose occurs on day 17 (1,110 +/- 165 neutrophils/microliters) and neutropenia (< 2,000 neutrophils/microliters) lasts from day 14 through day 25 after carboplatin administration. CLINICAL RELEVANCE: The fatal dose-related pulmonary toxicosis observed in cisplatin-treated cats was inapparent in carboplatin-treated cats. To adequately determine the therapeutic role of carboplatin in tumor-bearing cats, a moderately tolerated dose of carboplatin of 200 mg/m2 given i.v. once every 4 weeks should be considered.

Animals↗
PubMed1995

A comparison of attenders at antenatal classes in the voluntary and statutory sectors: education and organisational implications.

OBJECTIVE: this study sought to identify whether differences existed in the demographic details of clients attending each of three types of antenatal classes: those provided at a large inner city hospital, and those provided in the voluntary sector by National Childbirth Trust (NCT) and Active Birth teachers. The aim was to establish whether there is an overlap in provision of antenatal education which might warrant a rationalisation of services. DESIGN: a survey was conducted using questionnaires which asked for basic demographic details. SETTING: the questionnaires were distributed at antenatal classes held in the hospital and in the venues used by the lay teachers (generally their homes). PARTICIPANTS: these included 78 primiparae attending 'couples' classes at the hospital, 36 primiparae attending NCT classes and 25 primiparae attending Active Birth classes. FINDINGS: the women in the three groups were largely similar in terms of being older than the national average for childbearing women, middle-class and affluent as measured by car-ownership. Women from social classes 4 and 5 and very young women were almost entirely unrepresented. Twenty-three per cent of hospital class attenders, 61% of NCT attenders and 48% of Active Birth attenders were also going to a second set of antenatal classes, suggesting a considerable duplication of effort on behalf of childbirth educators. KEY CONCLUSIONS: liaison between the voluntary and statutory sectors could lead to a more rational deployment of childbirth educators for the group of women currently attending antenatal classes, thus freeing midwives for one-to-one information giving or alternative educational provision for women who do not now attend formal classes and who may be considered at risk.

Adult↗
PubMedDate not supplied

Dose response and time course of carboplatin-induced micronucleated polychromatic erythrocytes in the cat: implications for combination carboplatin chemotherapy.

The dose response and time course of micronucleated polychromatic erythrocytes (mPCE) in cat peripheral blood induced by various doses (150-250 mg/m2) of carboplatin in vivo was determined. The data indicate that carboplatin produced a significant (p < 0.05) dose-dependent increase in the number of mPCE over baseline values; however, the times following carboplatin administration when mPCE were first observed differed significantly (p < 0.05) between the three carboplatin dose groups. mPCE were present in significantly greater numbers (p < 0.05) on smears at an earlier time interval following a single carboplatin dose of 150 mg/m2 than for a dose of either 200 or 250 mg/m2. The peak number of mPCE occurred on days 7, 14 and 17.5 following administration of a carboplatin dose of 150, 200 and 250 mg/m2, respectively. The pattern of time course delay following carboplatin administration suggests that the block of erythropoietic stem cells in G2 is dose dependent. Indeed, the administration of carboplatin arrested the cell cycle in the G2 phase and, at higher doses, diminished the number of cycling erythroid precursor cells. mPCE were apparent in blood smears only after recovery from this arrest and resumption of replication. This observation has implications for the scheduling of carboplatin administration when used in combination with other anticancer drugs.

Animals↗
PubMedDate not supplied

Metastatic pheochromocytoma in a parakeet.

Pheochromocytoma, a tumor of the adrenal medulla, was diagnosed in a budgerigar based on gross, histopathologic, and electron microscopic findings.

Adrenal Gland Neoplasms↗