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Biomedical subjects

M M Wood

Publications and source records attributed to M M Wood.

At least 19 recordsLinked to original sources

Understanding HIV risks of chronic drug-using men who have sex with men.

Focus groups and individual structured interviews were conducted in six cities with 98 predominantly street-recruited men who had a recent history of smoking crack or injecting drugs and who reported having had sex with other men (MSM) in the past year. Twenty-six focus groups explored the cultural and social context of participant's drug use and sexual activity and addressed outreach and HIV prevention issues pertinent to this population. Narrative summaries developed from verbatim focus group transcripts identified seven themes: (a) sexual orientation and gender identity; (b) interactions within and between MSM networks; (c) drug use, sexual activity and personal relationships; (d) HIV transmission bridges; (e) preferred HIV information sources; (f) HIV knowledge, prevention practices and risk behaviours; and (g) availability of HIV and drug-related services. Of the 98 MSM drug users, 42% identified publicly as gay or homosexual; 35% identified publicly, but only 21% privately, as heterosexual. A total of 51% had one or more female sex partners in the past year. There was a high frequency of unprotected sex in conjunction with drug use and a distinct preference for having sex when high. For most participants, drug use rather than sexual orientation formed the core of personal identity. Participants reported associating primarily with other drug users, usually MSM, and had limited contact with people who did not use drugs and the mainstream gay community. Participants' sexual and drug-injecting activities were judged to be a bridge for transmission of HIV to both people who used drugs and those who did not.

Adolescent↗

Neuropsychological and pharmacokinetic assessment of hospice inpatients receiving morphine.

Eighteen inpatients receiving morphine for cancer pain in a palliative care unit were recruited to a study employing a range of neuropsychological tests to assess cognitive function. The tests employed were National Adult Reading Test, Williams Delayed Recall Test, Immediate Memory for Digits, Trailing Making Test, and the Digit Symbol Substitution Test. These data were correlated with biochemical tests of renal and hepatic function, morphine dose, route of administration, plasma morphine, morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G) concentrations. Despite having no clinical evidence of impairment of cognitive function, the level of current intellectual functioning (Symbol Digit Substitution Test) was on average two standard deviations below normal. Immediate memory appeared to be well preserved, but Delayed Recall and Trailing Making Test scores were significantly above normal. There was no significant correlation between morphine dose, or plasma morphine and M3G and M6G concentrations, and the neuropsychological test results, although a weak correlation was found between plasma morphine concentration and digits forward (r = -0.47, p < 0.05) and Digit Symbol Substitution scores (r = -0.46, p < 0.05). Seven patients had some degree of nausea or vomiting, ascribed as an opioid adverse effect, and had higher serum creatinine concentrations, worse neuropsychological performance, and significantly higher plasma M3G concentrations (p < 0.05). These data provide some evidence to suggest that cognitive functioning in patients with advanced cancer receiving morphine may be significantly impaired despite apparent clinical normality. From these data it is not possible to determine what relative causal contribution the disease and the drug made to these observations, although renal function, plasma morphine, and M3G concentrations may be important. Future research should address a broad range of neuropsychological testing to assist in the modification of practices aimed at enhancement of quality of life, such as opioid substitution or rotation.

Adult↗

Differences in condom behaviors and beliefs among female drug users recruited from two cities.

This paper examines predictors of condom cognitions and condom use for vaginal sex within women's main and paying partnerships. The sample consisted of active injection drug and crack-using women recruited from two cities with disparate HIV rates. A total of 338 drug-using women who reported vaginal sex with a main and/or paying partner in the prior 30 days were recruited for this study. Recruitment site was a significant predictor for several of the variables examined, for both main and paying partners. Ethnicity and prior HIV test result were also significant predictors, but only for main sex partners. Findings support previous research and suggest that the factors which predict condom beliefs, intention, and behaviors are different for main versus paying partners. Interventions designed to increase condom use must recognize that cognitive factors associated with condom use may vary by partner type, ethnicity, and recruitment site, particularly when important contextual variables, such as local seroprevalence, vary.

Adult↗

An increased incidence of total anomalous pulmonary venous drainage among aboriginal Canadians.

OBJECTIVE: To determine whether Aboriginal Canadians from Manitoba and Ontario have an increased incidence of isolated total anomalous pulmonary venous drainage (TAPVD) and to compare results obtained from two different data sources and time periods. DESIGN: A nonconcurrent cohort study was undertaken. Incidence rates and relative risk from 'traditional' data sources (cases from medical records data; births from Census, Vital Statistics and Native Registry data for Manitoba and Ontario) from 1972-84 were derived and compared with those from computerized hospital abstract data from Manitoba for 1987-91. RESULTS: Using traditional data sources an incidence of 0.282/1000 live births was noted in Aboriginals versus 0.062 in non-Aboriginals for a relative risk of 4.6 (95% CI = 2.7-7.7). For Manitoba only the relative risk was 5.8 (95% CI = 2.6-12.8). Using computerized administrative data from Manitoba the relative risk was 5.8 (95% CI = 1.3-25.8). CONCLUSION: There is an increased incidence of isolated TAPVD in Aboriginal peoples from Manitoba and Ontario. Further epidemiological investigation is necessary to determine the nature of this association.

Cohort Studies↗

Initial experiences with clozapine at Kenmore Psychiatric Hospital.

OBJECTIVE: To replicate overseas experience with clozapine, a new antipsychotic drug reputed to be effective in producing major improvement in a high proportion of patients with treatment-resistant schizophrenia. DESIGN AND SETTING: A prospective clinical trial at Kenmore Psychiatric Hospital, Goulburn, NSW. This paper is a preliminary communication covering 14 to 18 weeks after commencement of clozapine. PATIENTS: Twelve patients with treatment-refractory chronic schizophrenia, chosen on the basis of the severity of their disability. INTERVENTION: After existing medication was changed to be compatible with clozapine, it was reduced to the minimum level acceptable for staff and patient safety. Clozapine was then introduced gradually while other medication was withdrawn. OUTCOME MEASURES: Progress was monitored in terms of clinical presentation, side effects, use of supplementary medication and assessments by means of three standardised scaling systems. RESULTS: None of the patients deteriorated. Of six patients aged 35 years or less, three showed dramatic improvement and three showed clinically significant improvement. None of the six older patients showed major improvement, except that extrapyramidal symptoms were reduced in all cases. Drowsiness and hypersalivation were the only common side effects. CONCLUSIONS: These preliminary findings are consistent with results reported overseas.

Adult↗

Comparison of nine antigen detection kits for diagnosis of urogenital infections due to Chlamydia psittaci in koalas.

Chlamydia psittaci is the major cause of infectious disease in the koala (Phascolarctos cinereus). It causes four disease syndromes in the koala, namely, conjunctivitis, rhinitis, cystitis, and infertility (females only). Diagnosis of chlamydial infections in koalas relies primarily on isolation of the organism in cell culture. Serology has generally not been useful, and little use has previously been made of the commercially available antigen detection kits. We examined the sensitivity, specificity, and usefulness of three direct fluorescent-antibody kits (Vet-IF [Cell Labs], IMAGEN [Celltech], Chlamydia-Direct IF [Bio Merieux]) and six antigen detection enzyme-linked immunosorbent assay (ELISA) kits (Clearview [Unipath], Surecell [Kodak], Pathfinder [Kallestad], Chlamydia-EIA [Pharmacia], Chlamydiazyme [Abbott], IDEIA [Celltech]) for the detection of urogenital infections in koalas. Laboratory studies showed that the direct fluorescent-antibody kits were the least sensitive in this case and did not detect fewer than 10(4) elementary bodies per ml, while most ELISA kits detected between 130 and 600 elementary bodies per ml. Field study results showed that the Clearview kit was the most sensitive (91%) compared with the IDEIA (88%) and the Surecell (73%) kits. All three kits were more sensitive than cell culture (36%), highlighting viability loss problems that occur during transport. This study showed that the Clearview kit is sensitive, specific, and easy to use for the detection of type II (urogenital) C. psittaci from koalas in the field and warrants further evaluation.

Animals↗

Neuropsychologic outcome after craniofacial fracture.

Forty eight patients with facial fractures resulting from trauma were admitted to a Plastic Surgical Unit. The fractures were treated on standard lines and ten of the patients required craniotomy for CSF rhinorrhea or repair of depressed frontal fractures. Neuropsychologic assessment was carried out on all patients approximately 17 months after the initial injury. An assessment of the extent to which the trauma had affected the personality and social adjustment of each individual was also carried out at that time. In four patients there was no evidence of any neuropsychologic impairment on any of the tests administered. The neuropsychologic deficits were most noticeable in those who had suffered a cranial fracture. In patients with facial fractures but no evidence of cranial fractures, there was no association between neuropsychologic impairment and site of injury. Loss of consciousness was associated with poor social adjustment and a marked change in personality. The best predictor of subsequent neuropsychologic deficits and social maladjustment was found to be the Glasgow Coma Score at the point of admission to the hospital after injury. It is concluded that with this type of injury careful neuropsychologic assessment is important in identifying the subtle deficits that might otherwise remain undetected.

Adolescent↗

Dendritic development in human occipital cortical neurons.

Using quantitative techniques on rapid Golgi impregnations, the dendrites from neurons of visual cortex from 14 infants ranging in age from 20 weeks gestation to 7 years were assessed. Neurons in layers 3 and 5 were separately evaluated. The total dendritic length for all dendritic branches reached a maximum of 2800 microns for layer 3 neurons and 3400 microns for layer 5 neurons. At or before 40 weeks gestation, the dendritic tree of layer 3 neurons had reached 35% of the maximum compared with 55% of the maximum for layer 5 neurons. Dendritic branching occurred earlier in layer 5 and growth continued to be more advanced than in layer 3. After 40 weeks gestation in these layers no new branch orders were added to basal dendrites but 3 branch orders were added to apical dendrites. The determination of normal values for dendritic length, number of orders, and number of branches during early development provides a foundation for comparison of dendritic maturation in children with a variety of neurologic disorders.

Child↗

Use of an ammonia electrode to study bacterial deamination of amino acids with special reference to D-asparagine breakdown by campylobacters.

A method using an ammonia electrode is being developed for investigating the deamination of amino acids and amides by bacteria. Application of this method to Campylobacter jejuni and C. coli has led to the demonstration of D-asparaginase activity in some strains. This has allowed the subdivision of both species into D-asparaginase-positive and -negative biotypes. Even though the method is in the developmental stage, it was found to be generally reproducible and easy to perform. Areas for further improving the procedure have been identified. The ammonia electrode offers the theoretical possibility of investigating the breakdown of any amino acid by bacteria. It thus opens up a new and practical approach for separating species and strains, particularly in those bacterial groups that are difficult to subdivide by conventional means.

Amino Acids↗

Right ventricular size and ventricular septal motion after repair of atrial septal defect in children.

An enlarged right ventricle and abnormal ventricular septal motion are characteristic echocardiographic features of atrial septal defect and often persist after the defect has been completely closed, even when the operation clinically is judged to be successful. These features were examined retrospectively 15 to 21 months after operation in a group of children whose atrial septal defect had been closed between January 1976 and July 1979. Despite satisfactory postoperative results in all, about two thirds had an enlarged right ventricular dimension and about the same number had abnormal septal motion when examined echocardiographically an average of 18 months after operation. The best operative strategy seems to be to operate while the right ventricular end-diastolic dimension is still relatively small in echocardiographic terms.

Adolescent↗

EMG levels in the occipitofrontalis muscles under an experimental stress condition.

In view of the importance attached to the frontalis muscles by researchers into the etiology of head pain and its treatment by biofeedback techniques, it is surprising that no data have yet been reported on the functioning of the occipitalis muscles, which have a close physiological relationship to the frontales. This study explores the response of the frontalis and occipitalis muscles under a condition of experimental stress. Migraine and tension-headache sufferers were separately compared with a headache-free control group under four conditions: baseline, while listening to instructions, while carrying out an auditory vigilance task, and for a further resting period equivalent to baseline. Results showed that tension levels in the frontalis muscles were not elevated at rest in any of the experimental groups, nor were they significantly responsive to the experimental task. The occipitales however proved to have significantly higher levels in both the tension-headache and migraine groups during the task and recovery periods. The results for the tension group reached significance because of a drop in control group values. These results may have significance in determining the best site for electrode placement in biofeedback.

Adolescent↗

Diurnal variation in urine [15N]urea content, estimates of whole body protein turnover, and isotope recycling in healthy meal-fed children with cystic fibrosis.

The pattern of urinary urea excretion and labelling with 15N was examined in eight meal-fed 6 to 9 year old children, over a 3-day period using a simulated constant infusion of the label. The children had cystic fibrosis but were healthy and in a good nutritional status at the time of the study. Reciprocal diurnal patterns of urea excretion and [15N]urea enrichment were noted and found to be suitable for mathematical description. Urea excretion was maximal in the evening at approximately 2000 and minimal at 0800, whereas the [15N]urea enrichment was maximal at about 0800 and minimal at 2000. In addition to the diurnal variation the [15N]urea enrichment increased exponentially to a plateau or isotopic steady state. The diurnal variation in [15N]urea enrichment resulted in large diurnal changes in the calculated rates of whole body amino nitrogen flux, synthesis, and breakdown. Flux rates were approximately 44% higher in the evening than in the morning. Synthesis rates were 19% higher in the evening, whereas breakdown rates were 27% greater in the morning. Mean amino nitrogen flux rates were 1.28 (SD 0.13) . g N . kg-1 . day-1. Isotope recycling was estimated from the slope of the [15N]urea enrichment curve between 30 and 54 h from the start of the study. There was a wide range in recycling, 2.9 - 19.4% (mean 11.4, SD 5.4). Some of the biological and pharmacological importance of the diurnal variation in the protein metabolism is discussed.

Amino Acids↗

The ECG in aortic stenosis. Value of TAVF and QV6.

Fifty patients with a mean age of 9.2 years (range, 1.2 to 17.5 years) had cardiac catheterization performed under standardized conditions plus a scalar ECG the previous day. Twenty different direct measurements and 25 derived measurements from the ECG were correlated with the resting peak systolic gradient across the aortic valve. Some of the best correlations were with the measured TAVF, TV6, QV6, and the sum of SV1 + RV6 with r values between .33 and .59. Another group of different patients with isolated aortic stenosis were studied with measurements of the important ECG segments. The r value of this "test" series was similar to that of the original group, so the groups were pooled. The best three-term regression equation involved TAVF, QV6, and the sum (SV1 + RV6), with r = .636. A scoring system was also devised to predict severity. If the TAVF is 0.1 mV or less or the TV6 is 0.3 mV or less or if there is no Q in V6, the gradient may be high. In our series, the ECG estimation of resting peak systolic gradient across the aortic valve in aortic stenosis was enhanced by the inclusion of TAVF and QV6 in the regression equation, as well as SV1 + RV6.

Adolescent↗

Problems in screening for congenital hypothyroidism using thyroxine assays from small dried blood discs.

The feasibility of screening for neonatal hypothyroidism by initial thyroxine (T4) measurements from small (3.2 mm diam.) discs of dried heel or cord blood was assessed using double-antibody radioimmunoassay and solid-phase radioassay kits. Adult heparinized venous blood or finger-prick capillary blood served as references. Reproducibility of results was satisfactory in adult but not infant samples, probably because of problems in collecting and handling the latter. In comparative studies, most of the 16 infants with congenital primary hypothyroidism had within-run T4 values above the 2.5 percentile; some were as high as the 7th and the 5th percentile for heel and cord blood, respectively. Simultaneously determined heel and cord dried-blood thyrotropin (TSH) values were clearly increased to greater than 40 microU/ml in 15 of these infants. Thus, when small discs are used for initial blood T4 screening to detect primary hypothyroidism, a higher cut-off points is recommended to safeguard against the observed technical problems.

Blood Specimen Collection↗

Results of a double-blind controlled study on the use of betamethasone in the prevention of respiratory distress syndrome.

A double-blind controlled study on the prenatal use of betamethasone in the prevention of respiratory distress syndrome (RDS) was carried out on 137 patients from 24 to 34 weeks' gestation. The incidence of RDS was less in the treated group (5%) than in control group (17%). The neonatal mortality rate was lower in the treated group (5%) than in the control group (18%) due to an excess of neonatal deaths in the placebo group.

Betamethasone↗