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Biomedical subjects

N Raymond

Publications and source records attributed to N Raymond.

16 recordsLinked to original sources
PubMed2006

Peritoneal dialysis: a clinical update congestive heart failure and PD.

BACKGROUND: There is a belief that peritoneal dialysis may be an important treatment modality for refractory heart failure, allowing at least an improvement in quality if not quantity of life during the last stage of this debilitating chronic disease. This paper examines the rationale behind this modality, critically appraises the available literature, calls for more research in the area and puts forward a framework for considering peritoneal dialysis in refractory heart failure. CONCLUSION: When faced with a patient with refractory heart failure admitted to hospital on multiple occasions because of complications of volume overload, the following approach to initiating peritoneal dialysis should be considered: subjects for dialysis must have a minimal blood pressure, and those whose hemodynamic status improves with diuresis, even though they develop a pre-renal picture, may be the best candidates.

Diuretics↗
PubMed2005

Overweight and obesity in Irish primary schools: retrospective cohort study.

BACKGROUND: This retrospective cohort study investigates the feasibility of using established methods and routinely generated data from the statutory primary school health-screening programme to estimate prevalence rates for childhood overweight and obesity in children from a rural area in the Republic of Ireland (ROI). METHOD: Paper-based records in the primary school health service for County Leitrim and parts of County Cavan in north-west of ROI were hand searched to identify children attending senior infant classes during academic year 2001/2002. Electronic calculation of body mass index (BMI) and age at examination was carried out. Application of age- and sex-specific cut-off points from International Obesity Task Force (IOTF) and United Kingdom (UK) standard definitions for childhood overweight and obesity was used to determine age- and sex-specific prevalence rates for childhood overweight and obesity. RESULTS: The eligible cohort was almost completely identified and consisted of 361 children. Weight and height measurements were available on 328 (91%) children aged between 4.22 and 7.92 years. IOTF standard application gave prevalence rates of 25% for obesity and overweight in boys and 26% in girls. With the UK growth standard, this increased to 34% in boys and reduced to 23% in girls. CONCLUSION: It is feasible to generate prevalence rates for childhood overweight and obesity from data routinely obtained through the statutory school health-screening programme in ROI. This study suggests levels of childhood overweight and obesity comparable to other Western societies. Further research on developing a universally accepted standard definition of childhood overweight and obesity is required.

Body Height↗
PubMed2003

eThrombosis: the 21st century variant of venous thromboembolism associated with immobility.

The association between immobility with prolonged sitting and venous thromboembolism has been recognised for > 60 yrs, most recently with long distance air travel. The case of a 32-yr-old male, in whom immobility associated with sitting for long periods at a computer represented the major provoking risk factor for his life-threatening venous thromboembolism, is presented. The authors propose the term "eThrombosis" to describe this 21st Century variant of venous thromboembolism associated with immobility from prolonged sitting. In view of the widespread use of computers in relation to work, recreation and personal communication, the potential burden of eThrombosis may be considerable.

Adult↗
PubMed2002

Degradation of phenanthrene, methylphenanthrenes and dibenzothiophene by a Sphingomonas strain 2mpII.

Strain Sphingomonassp. (2MPII), isolated from marine sediment, was able to utilize phenanthrene (P) or 2-methylphenanthrene (2MP) as the sole carbon source. However, 9-methylphenanthrene (9MP) and dibenzothiophene (DBT) were weakly degraded. The degradation rates of 9MP and DBT increased in the presence of 2MP, whilst the degradation rate of 2MP increased in the presence of 9MP. However, the presence of DBT inhibited the degradation of 2MP. DBT sulfone, a DBT metabolite, was not assimilated by the bacteria and its presence also decreased the degradation rate of 2MP.

Biodegradation, Environmental↗
PubMed2000

Impact of an urban effluent on antibiotic resistance of riverine Enterobacteriaceae and Aeromonas spp.

In order to evaluate the impact of an urban effluent on antibiotic resistance of freshwater bacterial populations, water samples were collected from the Arga river (Spain), upstream and downstream from the wastewater discharge of the city of Pamplona. Strains of Enterobacteriaceae (representative of the human and animal commensal flora) (110 isolates) and Aeromonas (typically waterborne bacteria) (118 isolates) were selected for antibiotic susceptibility testing. Most of the Aeromonas strains (72%) and many of the Enterobacteriaceae (20%) were resistant to nalidixic acid. Singly nalidixic acid-resistant strains were frequent regardless of the sampling site for Aeromonas, whereas they were more common upstream from the discharge for enterobacteria. The most common resistances to antibiotics other than quinolones were to tetracycline (24.3%) and beta-lactams (20.5%) for Enterobacteriaceae and to tetracycline (27.5%) and co-trimoxazole (26.6%) for Aeromonas. The rates of these antibiotic resistances increased downstream from the discharge at similar degrees for the two bacterial groups; it remained at high levels for enterobacteria but decreased along the 30-km study zone for Aeromonas. Genetic analysis of representative strains demonstrated that these resistances were mostly (enterobacteria) or exclusively (Aeromonas) chromosomally mediated. Moreover, a reference strain of Aeromonas caviae (CIP 7616) could not be transformed with conjugative R plasmids of enterobacteria. Thus, the urban effluent resulted in an increase of the rates of resistance to antibiotics other than quinolones in the riverine bacterial populations, despite limited genetic exchanges between enterobacteria and Aeromonas. Quinolone resistance probably was selected by heavy antibiotic discharges of unknown origin upstream from the urban effluent.

Aeromonas↗
PubMed1999

Impact of an urban effluent on the bacterial community structure in the Arga River (Spain), with special reference to culturable gram-negative rods.

The Arga River is an interesting system in which to study the impact of urban effluent pollution because it receives a single effluent in the form of wastewater discharge from the city of Pamplona. To analyze the extent of this discharge, total bacteria, culturable heterotrophic bacteria, and Gram-negative heterotrophic bacteria were enumerated and 409 isolates of the latter were identified. One sampling station was located upstream from the inflow, while five were located up to 30 km downstream. Bacterial counts increased drastically downstream from the wastewater inflow. Total bacterial numbers decreased along the 30 km downstream, the last station attaining similar values to those recorded upstream from the discharge. However, culturable heterotrophic and Gram-negative heterotrophic bacteria levels generally remained significantly higher within the 30 km zone investigated. Among the 409 isolates identified, Aeromonas spp. were the most frequent both upstream and downstream from the discharge. In contrast, although strains belonging to different genera of Enterobacteriaceae were found in all stations, their occurrence was significantly higher just downstream from the polluted discharge. Acinetobacter spp., which were never found upstream, were detected in all stations below the discharge. Our results clearly show that the bacterial community structure changes definitively downstream from the discharge and that Aeromonas were common throughout the sampling zone. Thus they cannot be considered good indicators of pollution in this setting compared to some genera of Enterobacteriaceae or some species of Acinetobacter, the distribution of which correlated better with the distance from the wastewater discharge.

Acinetobacter↗
PubMed1998

Rate of decline in renal function in Indo-Asians and Whites with diabetic nephropathy.

The incidence of end-stage renal failure (ESRF) is higher in the Indo-Asian ethnic group as compared to the White. To investigate whether this might be associated with faster rates of progression to ESRF in Indo-Asian diabetic patients, we studied a total of 39 Type 2 diabetic patients, using the Department of Nephrology database showing serial serum creatinine measurements from the time of first referral to the clinic until they reached a level of >500 micromol l(-1) or ESRF requiring renal replacement therapy (RRT), either dialysis or renal transplantation. They were grouped into Indo-Asian (n = 24) and White (n = 15). The rate of progression of those who developed ESRF, calculated as the slope of log serum creatinine against time, was not significantly different between the Indo-Asian and White patients, p = 0.73. We conclude that the higher incidence of ESRF in the Indo-Asian Type 2 diabetic patient with nephropathy is therefore not due to a faster rate of deterioration in renal function.

Adult↗
PubMed1998

Leptin in anorexia nervosa.

Serum leptin levels are low in untreated anorexia nervosa, but studies of the exact relationship between leptin and body weight and the impact of refeeding in anorectics are limited. Therefore, we studied serum leptin, insulin-like growth factor I, and other endocrine parameters in female anorectics before and after gaining weight and in female normal body weight controls. Leptin levels in untreated anorectics were significantly lower than those in normal body weight controls (3.6 +/- 1.6 vs. 12.0 +/- 6.9 ng/mL; P < 0.001), and they uncoupled from body weight in a nonlinear relationship, suggesting a threshold effect at lowest body weights. Leptin increased significantly with refeeding (5.6 +/- 3.8 ng/mL; P < 0.01). The significant linear correlations of leptin with body mass index in the anorectics after weight gain and in normal body weight controls (r = 0.69; P < 0.001 and r = 0.76; P < 0.001, respectively) are consistent with a normal physiological increase in leptin with weight gain. Leptin and insulin-like growth factor I were highly correlated, even after controlling for body weight (r = 0.63; P = 0.001) during starvation, but were no longer significantly correlated after body weight gain in the anorectics or the normal body weight controls. Further studies are necessary to elucidate the relationship of leptin to neuroendrocrine abnormalities seen in starvation and to determine a possible contribution of leptin to difficulties with weight restoration in anorexia nervosa.

Adolescent↗
PubMed1997

Effect of body weight and caloric restriction on serum complement proteins, including Factor D/adipsin: studies in anorexia nervosa and obesity.

Complement plays important roles in host immune defences, and recent studies suggest that adipose tissue is an important site of production for some complement proteins. Starvation has been associated with low complement levels, but studied populations have usually had concomitant opportunistic infections or other conditions which might affect complement levels. To determine the impact of body weight and changes in body weight on serum complement, we investigated levels of complement proteins in otherwise healthy patients with a wide range of body weights, including patients with anorexia nervosa before and after treatment, obese dieters before and after weight loss, and normal weight controls. We found that complement proteins of the alternative pathway (C3, B, and D), alternative pathway haemolytic activity (AP50) and the inhibitors H and I were low in starving anorectics and normalized with weight gain. C3a levels were comparable in anorectics at low weight and after weight gain, indicating that low serum complement levels were attributable to hypoproduction and not complement cascade activation with consumption. Further, levels of C3, B, AP50, H and I, but not D, were higher than controls in obese patients and decreased toward normal after weight loss. Overall, percentage of ideal body weight, changes in body weight, and serum transferrin were each highly correlated with serum levels of complement proteins. We conclude that levels of alternative pathway complement components are determined in part by factors that influence body weight and by weight changes, possibly due to changes in production in adipose tissue or at other sites.

Adult↗
PubMed1993

Survival analysis of response to group psychotherapy in bulimia nervosa.

A reanalysis of treatment response and relapse was performed using survival analysis in a 12-week clinical trial of cognitive behavioral group psychotherapy for the treatment of bulimia nervosa. One hundred forty-three (143) bulimic women with high incidence of binge eating, self-induced vomiting, and/or laxative abuse were randomly assigned to one of four possible treatment conditions that consisted of a combination of two factors: (1) emphasis on abstinence (high and low), and (2) treatment intensity (high and low). "Initial" and "maintained" response to treatment based on "total" and "near" abstinence criteria were determined using self-reported binge eating, vomiting, and laxative use data. Results suggest that an emphasis on abstinence appears important in achieving initial abstinence, whereas intensity of treatment may be important in maintaining abstinence.

Adolescent↗
PubMed1993

A review of the controlled trials of pharmacotherapy and psychotherapy in the treatment of bulimia nervosa.

The treatment literature on bulimia nervosa includes several double-blind placebo controlled studies, the majority of which examine the use of antidepressants in bulimia nervosa. The psychotherapy literature has focused heavily on the use of cognitive behavioral therapy (CBT) in the treatment of this eating disorder. Some studies have compared CBT to other types of therapy or waiting list controls. The following review will examine the methodology and outcome of the pharmacotherapy and psychotherapy treatment studies of bulimia nervosa. The authors conclude that while the studies indicate treatment is somewhat effective, there remains uncertainty regarding the long-term effectiveness of most of the reported treatments.

Antidepressive Agents↗
PubMedDate not supplied

Psychopathology in subgroups of obese women with and without binge eating disorder.

The examination of psychopathology in subgroups of obese patients is a new area of research in psychiatry. This project studied rates and types of psychopathology among obese subjects meeting the proposed DSM-IV criteria of binge eating disorder (BED) and obese subjects without BED. One hundred obese women with a mean age of 39.2 years and a mean body mass index (BMI) of 35.9 kg/m2 were evaluated using the Structured Clinical Interview for DSM-III-R (SCID-Modified Version) and a self-rating personality inventory, Personality Diagnostic Questionnaire-Revised (PDQ-R), before entering a treatment study for weight reduction. Those subjects meeting proposed DSM-IV criteria for BED had significantly higher lifetime rates for an axis I diagnosis compared with those that did not meet criteria for BED. Subjects with BED showed higher rates of lifetime affective disorder and bulimia nervosa, but did not differ on any other axis I diagnoses. Axis II cluster B and cluster C diagnoses were found more frequently among BED subjects. The specific diagnoses of histrionic, borderline, and avoidant personality disorders were found significantly more often among BED subjects. The results support the idea that binge eating may identify a distinct subgroup among the obese population who have significantly higher rates of certain forms of psychopathology on both Axis I and Axis II. The findings of increased rates of depression are consistent with other studies and suggest that our treatment modalities need to address this problem.

Adult↗
PubMedDate not supplied

Compulsive sexual behavior inventory: a preliminary study of reliability and validity.

This preliminary study was designed to develop empirically a scale of compulsive sexual behavior (CSB) and to test its reliability and validity in a sample of individuals with nonparaphilic CSB (N = 15), in a sample of pedophiles (N = 35) in treatment for sexual offending, and in a sample of normal controls (N = 42). Following a factor analysis and a varimax rotation, those items with factor loadings on the rotated factors of greater than .60 were retained. Three factors were identified, which appeared to measure control, abuse, and violence. Cronbach's alphas indicated that the subscales have good reliability. The 28-item scale was then tested for validity by a linear discriminant function analysis. The scale successfully discriminated the nonparaphilic CSB sample and the pedophiles from controls. Further analysis indicated that this scale is a valid measure of CSB in that there were significant differences between the three groups on the control subscale. Pedophiles scored significantly lower than the other two groups on the abuse subscale, with the other two groups not scoring significantly differently from one another. This indicated that pedophiles were more abusive than the nonparaphilic CSB individuals or the controls. Pedophiles scored significantly lower than controls on the violence subscale. Nonparaphilic individuals with compulsive sexual behavior scored slightly lower on the violence subscale, although not significantly different. As a preliminary study, there are several limitations to this study, which should be addressed, in further studies with larger sample sizes.

Adult↗