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Biomedical subjects

N Campbell

Publications and source records attributed to N Campbell.

At least 19 recordsLinked to original sources
PubMed1998

Fluctuations in blood lipid levels during furosemide therapy: a randomized, double-blind, placebo-controlled crossover study.

BACKGROUND: Acute decreases in intravascular volume are associated with increases in lipid levels. Furosemide causes acute changes in intravascular volume during prolonged therapy but is thought to have little effect on lipid levels. METHODS: To determine if there are daily acute rises in lipid and lipoprotein levels associated with changes in intravascular volume during long-term furosemide ingestion therapy, we performed a randomized, double-blind, placebo-controlled crossover study in 10 patients. RESULTS: In the 8 hours after furosemide ingestion there were increases in levels of plasma cholesterol (10.1%; P = .001), high-density lipoprotein cholesterol (9.0%; P = .006), and apolipoprotein B (9.8%; P = .003). The increases in levels of triglycerides (11.5%; P = .17) and apolipoprotein A-1 (13.3%; P = .051) were of similar magnitude but more variable and did not achieve statistical significance. There was no substantial change in the total cholesterol-high-density lipoprotein cholesterol ratio (0.6%; 95% CI,-0.74% to 8.6%; P =.88). CONCLUSION: This study indicates that there are acute increases in lipid levels after furosemide ingestion during prolonged therapy, which could affect the interpretation of lipid levels and cardiovascular risk in patients.

Aged↗
PubMed1998

Gradient, high-resolution, magic angle spinning 1H nuclear magnetic resonance spectroscopy of intact cells.

The application of new gradient, high-resolution, magic angle spinning (MAS) 1H nuclear magnetic resonance (NMR) spectroscopy to the study of intact undifferentiated and differentiated NIH 3T3 F442A cells demonstrated improved spectral resolution and sensitivity compared with static studies. MAS of cells permits the detection and quantitation of many cellular metabolites that are not clearly resolved in nonspinning measurements and provides an improved visibility of phospholipids. Gradient, MAS enables the use of diffusion weighting for compartment assignment and the determination of mobility for many metabolites which are incompletely resolved using static techniques. The smaller, undifferentiated preadipocytes show no microscopic evidence of cell lysis after 2 h of MAS at 3.5 kHz and 82% of these cells remain viable by trypan blue exclusion. In contrast, 15-19% of the larger, lipid-laden differentiated adipocytes were found to suffer some degree of cell lysis with MAS. This new method is an attractive alternative to either nonspinning perfusion or extraction techniques for NMR studies of cells.

3T3 Cells↗
PubMed1997

Factors influencing blood loss in transurethral resection of the prostate (TURP): auditing TURP.

OBJECTIVES: To assess the blood loss accompanying TURP and investigate its association with the resected weight of prostatic tissue, type of anaesthesia, type of presentation, histology, different surgeons and their differing techniques, and thus to reduce the morbidity associated with blood loss and transfusion. PATIENTS AND METHODS: All prostatectomies carried out in a district general hospital were audited prospectively, recording the pre- and post-operative haemoglobin concentration (Hb), blood transfusions and the variables listed above. The audit was repeated a year later. RESULTS: The peri-operative blood loss, as assessed by various indicators, was equivalent to a decrease in Hb of 10-15 g/L (8-11%). The weight of the resected prostatic tissue was the most important measurable factor in determining blood loss. Regional anaesthesia was associated with less blood loss than general anaesthesia. The added use of a suprapubic catheter for irrigation appeared to have a marginal advantage in large resections. The type of presentation, elective or otherwise, and the histological nature of the prostate did not influence blood loss. Smaller transfusions were probably avoidable in patients having smaller resections and a normal pre-operative Hb. On re-auditing, the overall transfusion rate was reduced from 10.8% to 8.2% and from 4.4% to 1% in patients having resections of < 30 g. CONCLUSION: Blood transfusion can be reduced and rationalized. Patients with a normal pre-operative Hb and undergoing resections of < 30 g do not usually require transfusion. Regional anaesthesia is associated with less blood loss but its advantage is overshadowed in practice by the weight of the resected tissue. An audit of this type is repeatable and is useful in raising awareness, objectively assessing differences and advocating and assessing any changes made.

Aged↗
PubMed1996

A phase II study of single agent paclitaxel in patients at first relapse following initial chemotherapy for breast cancer.

This study was initiated to evaluate the safety and efficacy of 3-weekly paclitaxel given at 225 mg/m2 over 3 hours without colony stimulating factor support in patients at their first relapse following adjuvant therapy for breast cancer. Thirty patients were entered into the study; all were assessable for response and toxicity. All patients had received adjuvant/neo-adjuvant chemotherapy; 22 patients had had prior hormonal therapy and 26 previous adjuvant radiotherapy. The group was characterized by a short time to first relapse (median 7.5 months (range 2-43)) and widespread disease, with 22 patients having multiple disease sites including: nodes (43%), skin and soft tissue (43%), liver (40%), lung (37%) and bone (50%). A total of 219 cycles of paclitaxel were given, with a median of eight per patient. The major non-haematological toxicities were: grade 3 alopecia (82% cycles), grade 2/3 arthralgia/myalgia (26%), grade 2/3 fatigue (16%) and grade 2/3 peripheral nervous system toxicity (12%). Haematological toxicity was mainly neutropenia of short duration, with grade 4 counts documented in 16% of cycles. Thrombocytopenia was minimal and there were no significant hypersensitivity reactions. The objective response rate was 60% (95% CI 42.5-77.5) with one complete response and 17 partial responses. The median duration of overall response was 30 weeks (range 15-75+ (95% CI 25-33)) with a median survival time for all patients of 42 weeks (range 1-124+). This study demonstrates that paclitaxel 225 mg/m2 is well tolerated as a 3-hour infusion and can be given safely in an outpatient setting without routine use of granulocyte colony stimulating factor. The response rate is encouraging and shows that this regimen is effective in this poor prognosis patient population.

Adult↗
PubMed1996

Closed kinetic chain tarsal mechanics of subtalar joint arthroereisis.

The weightbearing biomechanics of the tarsus with and without subtalar joint arthroereisis was investigated in 11 fresh frozen cadaver specimens using a three-dimensional (3-D) radiowave tracking system. Specimens, consisting of the distal half of the tibia and fibula and the intact ankle and foot, were mounted on a nonmetallic loading frame test system that allowed positioning of the foot to simulate midstance position of gait. The tibia was axially loaded to 756 N (one bodyweight) with 15% of the total load diverted through the fibula. Receiving transducers were attached to the talus, navicular, calcaneus, and cuboid bones. Tarsal movements were monitored as the specimen was loaded with and without subtalar joint arthroereisis. Three-dimensional data sets of osseous positions and orientations were collected and analyzed. Significant rotational differences were detected with and without subtalar joint arthroereisis for all four tarsal bones (p < or = 0.05). Tarsal translational position changes were small and not statistically significant.

Arthrodesis↗
PubMed1995

A comparison of two transcutaneous monitors for the measurement of arterial PO2 and PCO2 in neonates.

We examined the ability of two transcutaneous devices (Fastrac, Sensormedics Corporation, Yorba Linda, California, U.S.A. and Hewlett Packard M1018A, Hewlett Packard Component Monitoring System, Hewlett Packard, North Hollywood, U.S.A.) to measure arterial PCO2 and PO2 in neonates. Thirty-seven neonates had transcutaneous oxygen measured with the Hewlett Packard (HPO2 group), 38 neonates had transcutaneous carbon dioxide measured with the Hewlett Packard (HPCO2 group) and the Fastrac was used on 27 neonates (FTCO2 group). Both devices were operated with electrode temperatures of 43.5 degrees C although an additional ten subjects were studied using the Fastrac with an electrode temperature of 43.0 degrees C. The mean differences (transcutaneous--arterial) and upper and lower limits of agreement were calculated for each group. For the HPO2 group they were 3.78 mmHg (-12.23 to 19.80 mmHg), for the HPCO2 group they were 0.40 mmHg (-4.50 to 5.30 mmHg) and for the FTCO2 they were -0.96 mmHg (-7.85 to 5.92 mmHg). For the Fastrac group at an electrode temperature of 43.0 degrees C the mean difference and limits of agreement were -1.00 mmHg and -4.58 mmHg to 2.58 mmHg. The average sensitivity and specificity for both machines for the detection of hypocarbia were 82% and 92% respectively while for hypercarbia they were 90% and 94% respectively. For hypoxaemia, the sensitivity and specificity were 40% and 94% while for hyperoxaemia the sensitivity and specificity were 83% and 97%. We conclude that both machines provide a useful supplement to arterial PCO2 measurements and the Fastrac performs better at 43.0 degrees C. The measurement of PO2 is less accurate but is still of clinical use.

Blood Gas Monitoring, Transcutaneous↗
PubMed1995

Mobilizing churches for health promotion in Latino communities: Compañeros en la Salud.

Compañeros en la Salud (Partners in Health) is a 3-year project funded by the National Cancer Institute to conduct a church-based health promotion program whose aim is to reduce the risk of breast, cervical, and diet-related cancers in Latino/Hispanic women by increasing their knowledge of preventive behaviors, motivating healthy behavior change, and increasing their access to and utilization of preventive health services. From a systems perspective, churches serve as miniature, dynamic communities that present an opportunity for developing and implementing a program of health promotion. An analysis of church, Promotora (peer health worker), and participant characteristics from the preintervention base-line data revealed a naturally occurring segmentation of churches by congregation size and denomination. The Catholic churches almost exclusively were larger, whereas the Protestant churches almost exclusively were smaller. An analysis of the psychosocial characteristics of the various Latino women, when stratified by church congregation size, revealed that the women from the smaller, Protestant churches were poorer, had a lower level of acculturation, and had lower lifetime rates of clinical breast examinations. These results suggested greater resource deficits and a relatively higher need for Promotora outreach services for women from the smaller, Protestant churches. Implications are presented for differential approaches to effective health promotion among various types of churches.

Adolescent↗
PubMed1995

Early recurrent otitis media, language and central auditory processing in children.

The study examines the relationships that exist between early recurrent otitis media, language and central auditory processing in children. A retrospective case-control experimental design was employed and ten subjects were allocated to each of the two research groups, namely children with a history of early recurrent otitis media (research group 1) and children without a history of early recurrent otitis media (research group 2). The children in both research groups were in grade one and turning 7 years old. The language and central auditory processing of the subjects were assessed using the Clinical Evaluation of Language Function (Wiig & Semel, 1980) and the Willeford Battery of Central Auditory Function (Willeford, 1974). The results showed that the language and central auditory processing of the children with a history of early recurrent otitis media were significantly poorer than that of their disease-free peers. The results stress the importance of vigorous identification and management programmes for children with a history of early recurrent otitis media.

Audiometry↗
PubMed1994

Vaccination of sheep with purified cysteine proteinases of Fasciola hepatica decreases worm fecundity.

There has been some evidence from several parasite systems that proteinases might have potential as protective antigens against parasitic infection. A cysteine proteinase complex identified in the regurgitant of adult F. hepatica was examined in this context. The thiol-cathepsin-related proteinases of M(r) 28,000 were purified and tested in vaccine trials of sheep infected with liver fluke. Ten animals were immunised with the purified proteinases and developed antibodies to the cysteine proteinases prior to challenge with F. hepatica metacercariae. Infection appeared to cause a boost in antibody response by Week 4 into infection, and antibody levels were generally sustained throughout infection. The cysteine proteinases are not novel antigens, since low-level antibody titres were also detected in nonimmunised controls by late infection. On completion of the trial, there was no difference in worm burden between the two groups. However, faecal egg counts and therefore worm fecundity were significantly decreased.

Animals↗
PubMed1994

Breast self-examination: knowledge and practices of Hispanic women in two southwestern metropolitan areas.

The breast self-examination (BSE) practices of 1,453 Hispanic women in Phoenix, Arizona and San Diego, California were the focus of this study. Variables proposed as factors that influence the frequency and proficiency of BSE were demographic variables, particularly language and level of acculturation, having been taught BSE by a health professional, and experience with the disease. Results indicate that even though the majority of the women at both the Phoenix (78.1%) and San Diego (83.7%) sites had been taught BSE by a professional and most women in Phoenix (62.5%) and San Diego (63.4%) reported performing BSE within the past month, only 0.7% of the women at both sites were found to be proficient in the technique of BSE. Further, results indicate that language and acculturation were correlated with whether or not a woman performed BSE. These findings suggest that BSE education classes must provide information and techniques that promote proficiency in BSE, and must be designed to meet the unique needs of Hispanic women, particularly those of low acculturation levels.

Acculturation↗
PubMed1994

The prevalence of suicidal behavior among preadolescent children who are psychiatric inpatients.

The prevalence of suicidal behavior displayed by preadolescent children hospitalized on inpatient psychiatric units is estimated to range between 18% and 80% of the population. The current study provides an independent estimate of the prevalence of this problem. A semistructured interview was used to assess suicidal behavior displayed by 61 admissions to a child psychiatric inpatient unit between April 1988 and September 1989. According to the Pfeffer Spectrum of Suicidal Behavior Scale, 63% of the sample engaged in some form of suicidal behavior. Preadolescents and their parents reported similar rates of suicidal thoughts, threats and attempts. The dangerousness of recent suicidal behavior was not found to differ by age, sex, legal custody status or socioeconomic status.

Child↗
PubMed1994

Oral treatment with low molecular weight heparin normalizes blood pressure in hypertensive rats.

Increased calcium uptake in vascular tissue, leading to elevated cytosolic free calcium has been implicated in the pathophysiology of hypertension. This study examined the effect of oral low molecular weight heparin (Logiparin) on systolic blood pressure, platelet cytosolic free calcium and aortic calcium uptake in spontaneously hypertensive rats. Starting at age 12 weeks, spontaneously hypertensive rats were divided into three groups of six animals each. The drinking water of groups 1, 2 and 3 was replaced by 100% H2O, 0.5 mg (low dose) or 1 mg (high dose) low molecular weight heparin/ml H2O, respectively, for next 11 weeks. Six normotensive Wistar-Kyoto rats (age 12 weeks) on H2O and six on low dose heparin in H2O were used as controls. At age 23 weeks, increase in systolic blood pressure, platelet cytosolic free calcium and aortic calcium uptake in spontaneously hypertensive rats was significantly lowered by low dose LMW heparin as compared to spontaneously hypertensive rats on H2O, but was significantly higher than Wistar-Kyoto rats on H2O and LMW heparin. This dose of heparin did not have any effect on these parameters in normotensive Wistar-Kyoto rats. High dose LMW heparin normalized the elevated platelet cytosolic free calcium, aortic calcium uptake and systolic blood pressure in spontaneously hypertensive rats, but it had a limited effect on adverse renal vascular changes. Oral low molecular weight heparin did not cause any abnormal hematological, biochemical or pathological changes in rats.

Administration, Oral↗
PubMed1993

Rumination: the eating disorder of infancy.

Rumination is a relatively rare, potentially fatal syndrome in infants. This article reviews the historical and current treatment of rumination. Two cases are presented: a six-month-old who narrowly escaped surgery when the disorder was not recognized, and a complicated case from the neonatology intensive care unit. Environmental changes and enhanced mothering are described as being critical to correction of rumination and appropriate weight gain.

Developmental Disabilities↗
PubMed1993

Plasma intestinal alkaline phosphatase isoenzymes in neonates with bowel necrosis.

AIM: To determine if the intestinal isoenzymes of alkaline phosphatase (ALP) are biochemical markers of bowel necrosis in neonates. METHODS: Plasma ALP isoenzymes were measured in 22 babies with bowel necrosis, histologically confirmed, and in 22 matched controls. The isoenzymes were also measured in 16 infants with signs of necrotising enterocolitis, who recovered without histological confirmation of bowel necrosis. The isoenzymes were separated by polyacrylamide gel electrophoresis. Auxiliary tests for identification included neuraminidase digestion and treatment with monoclonal and polyclonal antiplacental antibodies. RESULTS: Intestinal ALP was detected in 16 infants with bowel necrosis--13 had fetal intestinal ALP (FI-ALP) and three had adult intestinal ALP (AI-ALP). FI-ALP was detected in nine of the controls. In the babies with bowel necrosis intestinal ALP was found over all gestations, but in the controls only in those less than 34 weeks. The percentages of total ALP activity due to intestinal ALP were significantly higher in those with bowel necrosis compared with matched controls (p = 0.028). In babies of all gestations diagnostic sensitivity for the presence of intestinal ALP as a marker of bowel necrosis was 73% and diagnostic specificity 59%. In babies greater than 34 weeks' gestation, diagnostic sensitivity fell to 60% but the test became completely specific. In two babies FI-ALP increased from zero/trace to high activity coincident with the episode of bowel necrosis. In 16 babies with signs of necrotising enterocolitis but unconfirmed bowel necrosis FI-ALP was detected in four. CONCLUSION: Intestinal ALP seems to be released into the circulation in some babies with bowel necrosis, but its detection does not have the diagnostic sensitivity and specificity to be a reliable biochemical marker of the condition.

Alkaline Phosphatase↗
PubMed1992

Antenatal detection of renal abnormalities.

The aim of this retrospective study is to assess the value of routine ultrasonography in the detection of renal abnormalities. Twenty-nine pregnancies (one set of twins) with suspected renal abnormalities (i.e. renal cystic spaces, oligohydramnios or hyperechoic kidneys) were delivered over a two year period (1.8.1987-31-7-1989) in a unit where 90% of pregnancies (6,562) were scanned routinely at 18-20 weeks gestation or later, if booking for confinement was delayed. In pregnancies with suspected anomalies prenatal ultrasound was performed monthly until 28 weeks and fortnightly until delivery. Non survivors [5] had histological or postmortem examination. Liveborn infants [25] had renal ultrasonography in the neonatal period and paediatric follow-up if abnormal. Sixteen (53%) of the 30 cases (one set of twins) suspected of renal abnormalities by routine prenatal ultrasonography had renal anomalies confirmed postnatally. Five women were non survivors, all of which had associated anomalies. In the eleven survivors the diagnoses were pelvi-ureteric junction obstruction [6], renal dysplasia [2], vesicoureteric reflux [2] and suspected ureterocele [1]. Fourteen infants with pelvicalyceal dilatation had normal postnatal renal ultrasound. Although abnormal prenatal renal ultrasound is a useful indicator of postnatal disease and aids decisions on the management of pregnancy, further large collaborative studies with extended paediatric follow-up are required to assess the significance of pelvicalyceal dilatation.

Female↗
PubMed1991

Increased calcium uptake in vascular tissue by plasma of patients with essential hypertension.

Plasma factors have been implicated in causing increased calcium uptake and cytosolic (Ca++) in vascular tissue leading to hypertension. We compared the effect of plasma from hypertensive and normotensive subjects on rat aortic calcium uptake. Plasma from hypertensive subjects was fractionated and the fractions assessed for their activity on aortic calcium uptake. Aortic calcium uptake was significantly higher in plasma from hypertensives as compared to normotensives (p less than 0.05). There was a significant positive correlation between diastolic blood pressure and aortic calcium uptake (r = 0.645; p = 0.002). There was a significant positive correlation between percentage ideal body weight and aortic calcium uptake in normotensives and hypertensives (r = 0.522; p less than 0.05). The calcium uptake stimulatory activity in plasma of hypertensives was found in nonesterified fatty acid and cholesterol ester fractions.

Adult↗
PubMed1991

Differences in cancer-risk-related behaviors in Latino and Anglo adults.

METHODS. Latino (n = 358) and Anglo (n = 113) adults living in the San Diego area were surveyed on nutrition, smoking, and cancer screening behaviors. The Latino respondents were dichotomized into a low (L-Latino) or high (H-Latino) acculturation group according to a median split of an acculturation index. RESULTS. After controlling for age, years of education, gender, marital status, and income, significant cross-cultural differences were found in saturated fat/cholesterol avoidance, and fiber and high calorie food consumption. L-Latino respondents had the lowest degree of saturated fat/cholesterol avoidance, followed by H-Latinos and Anglos. A pattern of decreasing consumption with increasing acculturation was observed for fiber and high calorie foods. Significant differences were found among women in the prevalence of Pap smear exams, with L-Latinas having the lowest prevalence of ever and in the past year having had a Pap smear, followed by H-Latinas and Anglos. A similar significant pattern was observed among women 50 years of age or older with respect to the prevalence of ever having had a mammogram.

Adult↗