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Biomedical subjects

M Plant

Publications and source records attributed to M Plant.

At least 19 recordsLinked to original sources
PubMed2005

A critical review of foot orthoses in the rheumatoid arthritic foot.

Foot orthoses are commonly prescribed by health professionals as a form of intervention for the symptomatic foot in rheumatoid arthritis. However, there is a limited evidence base to support the use of foot orthoses in this patient group. This article provides a critical review of the use of foot orthoses in the management of rheumatoid arthritic foot pathologies. A search was conducted in the Cochrane Controlled Trials Register (current issue of the Cochrane Library), Physiotherapy evidence database (PEDro), Medline, The Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Allied and Complementary Medicine (AMED) and from reference lists in journal articles. The language was restricted to English. Searching of the databases was undertaken between December 2004 and March 2005. The results indicated there is no consensus of opinion on the choice of foot orthoses used for the management of pathology in the rheumatoid foot, although there is strong evidence that foot orthoses do reduce pain and improve functional ability. The type of foot orthoses used ranged from simple cushioned insoles to custom-made rigid cast devices. Methodological issues raised included small sample size and poor use of valid and reliable outcome measures. There is limited evidence pertaining to cost-effectiveness. The results indicated a need for further investigation into the most clinically and cost-effective foot orthoses to prescribe in the management of the rheumatoid arthritic foot. This review highlights the need to identify the various types of foot orthoses that are most effective in the management of the established rheumatoid arthritic foot.

Arthritis, Rheumatoid↗
PubMed2000

Substance misuse amongst anaesthetists in the United Kingdom and Ireland. The results of a study commissioned by the Association of Anaesthetists of Great Britain and Ireland.

Three hundred and four departments of anaesthesia in UK and Ireland were sent questionnaires about alcohol and drug abuse in anaesthetists over the preceding 10-year period. Information was sought on the nature and extent of substance problems, their presentation and management. The survey achieved a high response rate of 71.7% and a total of 130 cases were reported, of whom 34.6% were consultants and 43.2% were trainees. Over 50% of respondents felt a lack of confidence in dealing with alcohol or drug misuse amongst colleagues. The results of this survey demonstrate that over one anaesthetist per month has presented with significant alcohol or drug misuse in the UK and Ireland over the last 10 years. It is important that those with management responsibilities for departments of anaesthesia are aware that such problems exist and are likely to impact on the professional ability and health of the affected individual. The Working Party on Substance Abuse at the Association of Anaesthetists has recently published guidance in the management of these problems. A case is made for increasing awareness in this sensitive subject to enable early recognition and treatment of an anaesthetist who is misusing alcohol and drugs since intervention can be effective.

Adult↗
PubMed1999

Association of polymorphism in glutathione S-transferase loci with susceptibility and outcome in rheumatoid arthritis: comparison with the shared epitope.

OBJECTIVE: To determine whether glutathione S-transferase GSTM1, GSTM3, GSTT1, and GSTP1 genotypes influence susceptibility or outcome in rheumatoid arthritis (RA). METHODS: 277 RA patients were compared with 577 controls to examine any associations between GST genotypes and susceptibility to RA. The effect of genotypes on outcome (Larsen and functional scores) and time integrated acute phase responses (erythrocyte sedimentation rate and C reactive protein) was assessed in 122 patients with disease duration of 5-10 years. GST and HLA-DRB1 genotypes were determined using polymerase chain reaction based assays. Data were analysed using multiple regression analysis with correction for age, sex, disease duration, and the DRB1 associated shared epitope (SE) and rheumatoid factor (RF) positivity where appropriate. RESULTS: The GSTM1*A/*B genotype was less common in RA cases (3 of 276) than in controls (22 of 591) (exact p = 0.047), though significance was lost when adjustment was made for multiple comparisons. The Larsen score was higher (p = 0.039) in the GSTM1 null patients (89.9) than those with other GSTM1 genotypes (74.7), and this was independent of the SE. Again, correction for multiple testing resulted in loss of significance. The difference in Larsen scores between patients homozygous or negative for the SE (87.9 v 74.3) was similar to that between GSTM1 null and non-null patients. No associations between GSTM3 or GSTT1 genotypes and disease markers were identified although the association between GSTP1*B/*B and Larsen score approached significance (p = 0.096). CONCLUSION: It is proposed that certain GSTs may influence susceptibility and radiological progression in RA and that this is independent of the effect of the HLA-DRB1 associated SE. The mechanism for this effect is presumed to be because of differences in the ability of various GST enzymes to utilise the cytotoxic products of oxidant stress. Although significance was lost after correction for multiple testing, the data indicate that further studies may be of value in RA to determine the influence of the GST and other genes involved in cellular protection against oxidative stress.

Acute-Phase Reaction↗
PubMed1998

Characterization of CHO-K1 cells stably expressing PDE-IV enzymes. Whole-cell cAMP determinations vs broken-cell enzymatic assays.

A CHO-K1 cell line stably expressing a recombinant full-length human PDE-IVa (HSPDE4A4B) enzyme was established under hygromycin B selection. Full-length expression of the protein was determined by Western blot analysis, which revealed the presence of a 125-kDa immunoreactive band using rabbit anti-PDE-IVa antibodies. The potency of inhibitor compounds was examined by their ability to increase cAMP in the whole-cell, and by their ability to inhibit cAMP hydrolysis in a 100,000 g supernatant (soluble enzyme preparation) obtained from the same cell line. Inhibition of the expressed PDE-IVa activity by selective PDE-IV inhibitors--(R) and (S)-rolipram, RS 14203, and CDP 840--at 100 nM substrate demonstrated that RS 14203 and CDP 840 were the most potent with IC50 = 9 nM, followed by (R)-rolipram (IC50 = 110 nM) and (S)-rolipram (IC50 = 420 nM). The rank order of potencies of the inhibitors in elevating cAMP in the whole-cell assay was quite different from that on the soluble enzyme. RS 14203 was still the most potent compound in elevating cAMP. Moreover, the relative rank order of potencies between CDP 840 and (R)-rolipram changed dramatically, such that (R)-rolipram was more potent than CDP 840 = (S)-rolipram. An apparent 30-fold stereoselectivity between (R)- and (S)-rolipram was also noted. The whole-cell rank order of potencies was also maintained when PKA activity ratios were measured in place of cAMP levels. The ability of the compounds to elevate cAMP in the stable CHO-K1 cells appeared to track better with the potency of the compounds against the high-affinity (Sr) conformer of the enzyme rather than the low-affinity catalytic state.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed1996

Drinking, smoking, and illicit drug use among 15 and 16 year olds in the United Kingdom.

OBJECTIVE: To examine patterns of self reported drinking, smoking, and illicit drug use among a representative United Kingdom sample of people born in 1979. DESIGN: Cross sectional, single phase survey based on a stratified cluster sample of 70 United Kingdom secondary schools during March and April 1995. Pupils completed a 406 item standardised questionnaire under examination conditions. SETTING: United Kingdom state and private secondary schools. SUBJECTS: 7722 pupils aged 15 and 16. MAIN OUTCOME MEASURES: Reported use of alcohol, tobacco, and illicit drugs. RESULTS: Almost all the pupils had drunk alcohol, 36% (2772/7689) had smoked cigarettes in the past 30 days, and 42.3% (3264/7722) had at some time used illicit drugs, mainly cannabis. 43% (1546/3546) of boys and 38% (1529/4009) of girls had tried cannabis. Higher levels of smoking were associated with poorer school performance (20.4% (783/3840) with average performance v 44.1% (214/486) with below average performance, F = 79.06, P < 0.01). Levels of drug use in 15 and 16 year olds in 1995 were higher in Scotland than in England, Wales, or Northern Ireland. CONCLUSIONS: Drug experimentation was high among 15 and 16 year olds, and use of cannabis was particularly high among smokers. Cigarette smoking was more common among girls than boys.

Adolescent↗
PubMed1996

Abstaining and carousing: substance use among adolescents in the Western Isles of Scotland.

An account is presented of a survey of self-reported substance use among 839 adolescents in the Western Isles (Outer Hebrides) of Scotland. The study group was aged 13-16. The drinking habits of those surveyed were extremely polarised. Results showed that while only 81.2% had ever used alcohol, nearly 40% of males and a third of females reported having consumed at least 11 units of alcohol on their last drinking occasion. Levels of tobacco and illicit drug use were less striking: 21.4% considered themselves current smokers, while fewer than one-quarter had ever used illicit drugs or solvents. Results are related to recent UK surveys of adolescents and to the distinctive culture of the study area. It is concluded that the polarisation of youthful drinking in the Western Isles poses special problems in relation to the provision of alcohol education.

Adolescent↗
PubMed1996

Ethics, funding and alcohol research.

The field of alcohol research is a multidisciplinary area of inquiry. Moreover the debate about alcohol issues is highly politicized, involving not only researchers but also 'advocates' and those with strong ideological orientations or who represent powerful vested interests. Researchers may easily be caught in the crossfire in polemics involving such people. From time to time ethical malpractice is evident, yet there are often neither clear guidelines to delineate which behaviours are unacceptable nor how ethical violations are to be handled. This paper considers a number of key issues currently topical in the field. These are specifically concerned with the relationships between funders or sponsors and policy makers and researchers. Such issues include the ownership of data, sponsor control and the divergent cultures and outlooks of researchers and sponsors/funders. It is concluded that the field of alcohol research requires a code of ethics to regulate the relationship between researchers and funders. This should provide protection for subjects, patients, clients, researchers and those who pay for research. Some tentative suggestions are put forward for discussion.

Alcoholism↗
PubMed1995

Effect of dexamethasone on antigen-induced high molecular weight glycoconjugate secretion in allergic guinea pigs.

The ovalbumin-sensitized guinea pig is commonly used as a small animal model of allergic asthma. This animal model exhibits many of the hallmark characteristics observed in patients afflicted with asthma including nonspecific airway hyperreactivity, airway eosinophilia, early and late phase bronchoconstriction, and plasma extravasation into the airways. In addition, mucous hypersecretion in the airways of asthmatic patients is thought to be responsible for the plugging of distal airways and to contribute to the morbidity and mortality associated with the disease process. In this study we examined whether the allergic guinea pig model exhibits an increase in airway high molecular weight glycoconjugate (HMWG) secretion in response to an antigen challenge and whether dexamethasone exerts any modulatory effects upon the response. Ovalbumin (OVA) -sensitized guinea pigs were challenged with OVA 2 wk following the initial exposure. Trachobronchoalveolar lavages (TBAL) were performed, and the samples were assayed for total eosinophil cell number, eosinophil peroxidase activity (EPO), and both acidic and neutral HMWG content. Morphometric analysis of mucous-containing cells was also performed on tissue sections prepared from the trachea, mainstem bronchus, and three lobes of the left lung. Within 24 h of an antigen challenge, TBAL samples obtained from the allergic guinea pigs exhibited increases in eosinophil cell number, measured EPO enzyme activity, and acidic HMWG content compared to TBAL samples prepared from vehicle-exposed animals. These antigen-induced changes were dependent on the concentration of aerosolized OVA administered. Exposing the animals to 0.3% OVA provoked a 6.23-fold increase in airway eosinophils, 15-fold elevation in TBAL EPO enzyme activity, and 175% increase in TBAL acidic HMWG. No significant changes in TBAL neutral HMWG were measured. The changes in measured EPO activity correlated with the levels of acidic HMWG found in the TBAL samples (r = 0.73, P < or = 0.001). The measured increase in TBAL acidic HMWG was time dependent and was found to be maximal at 2 h post-antigen challenge. Morphometric analysis of Alcian blue (pH 2.5) -stained airway sections showed a decline in stored mucosubstances following the antigen exposure, supporting the notion that the allergic guinea pig model exhibits a mucosecretory component. Pretreating the animals with dexamethasone attenuated the antigen-induced release of HMWG and changes in measured EPO activity. In conclusion, these data indicate that the allergic guinea pig may be a useful model for examining the neural and cellular mechanisms underlying mucus hypersecretion in individuals afflicted with bronchial asthma.

Animals↗
PubMed1995

Alcohol, tobacco, illicit drugs, and sex: an analysis of risky behaviors among young adults.

This paper reexamines data from two previous surveys. It looks at self-reported alcohol, tobacco, and illicit drug use and sexual risk-taking among three subgroups of young adults. All subjects (N = 1,387) were aged 20-30. The samples consisted of nurses in the Lothian Region, and residents in Muirhouse (Edinburgh) and Easterhouse (Glasgow). Factor analysis revealed that risk-taking behavior was neither entirely general nor entirely specific. Although there was some tendency for a risk-taker in one area to be a risk-taker in others, five fairly distinct types of risk-taking could be distinguished. These included sexual risk-taking, illicit use of drugs, and excessive alcohol consumption. The samples differed in the extent to which they indulged in the different types of risk-taking, and various other predictors of these behaviors were found. Different patterns of association emerged in relation to specific subgroups of respondents.

Adolescent↗
PubMed1992

Lipid and lipoprotein (a) concentrations in renal transplant patients.

Lipid and lipoprotein concentrations, including lipoprotein (a), were measured in 67 clinically stable renal allograft recipients and compared with age- and sex-matched controls. Median lipoprotein (a) concentrations were significantly elevated in the transplant group (P = 0.048), with the distribution of apoprotein (a) isoforms being similar between the two groups. The transplant group also demonstrated significant elevations in cholesterol (P less than 0.0001), triglycerides (P = 0.0007) and low-density lipoprotein cholesterol (P less than 0.0001). There was no significant difference in high-density lipoprotein cholesterol concentrations between the groups although there was the expected tendency for higher values in females. Lipoprotein abnormalities are common following renal transplantation and these patients also demonstrate elevated lipoprotein (a) values. This unique lipoprotein is known to be atherogenic and may contribute to the development of vascular disease, which is a common mode of death in these patients.

Adolescent↗