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Biomedical subjects

P Hannah

Publications and source records attributed to P Hannah.

17 recordsLinked to original sources
PubMed2005

Effects of a height and weight adjusted dose of local anaesthetic for spinal anaesthesia for elective Caesarean section.

In this prospective, randomised, double-blind study, we compared the effects of two dosage regimens. Pregnant patients at term were randomly assigned to two groups to be given diamorphine 0.4 mg in hyperbaric bupivacaine 0.5% 2.4 ml or diamorphine 0.4 mg in a volume of hyperbaric bupivacaine 0.5% adjusted according to the patient's height and weight. Adequate anaesthesia was provided in all patients in both groups. The onset of the sensory block for cold and pinprick was faster with the fixed dose regimen (p = 0.01). There were more spinal blocks to above the first thoracic dermatome in the fixed dose group (17.1% vs. 2.2%, p = 0.022). Hypotension occurred in 71.7% vs. 50.0% of patients in the fixed dose and adjusted dose groups respectively (p = 0.035). In the fixed dose group, more patients required ephedrine to treat hypotension (79.5% vs. 56.8%, p = 0.022) and a larger median dose was administered (9 mg vs. 6 mg, p = 0.042). The decrease in mean (SD) arterial pressure was less in the adjusted group (35.0 (16.4) mmHg vs. 28.0 (13.5) mmHg, p = 0.036).

Adult↗
PubMed2005

Evaluation of antibiotic resistance analysis and ribotyping for identification of faecal pollution sources in an urban watershed.

AIMS: The accuracy of ribotyping and antibiotic resistance analysis (ARA) for prediction of sources of faecal bacterial pollution in an urban southern California watershed was determined using blinded proficiency samples. METHODS AND RESULTS: Antibiotic resistance patterns and HindIII ribotypes of Escherichia coli (n = 997), and antibiotic resistance patterns of Enterococcus spp. (n = 3657) were used to construct libraries from sewage samples and from faeces of seagulls, dogs, cats, horses and humans within the watershed. The three libraries were analysed to determine the accuracy of host source prediction. The internal accuracy of the libraries (average rate of correct classification, ARCC) with six source categories was 44% for E. coli ARA, 69% for E. coli ribotyping and 48% for Enterococcus ARA. Each library's predictive ability towards isolates that were not part of the library was determined using a blinded proficiency panel of 97 E. coli and 99 Enterococcus isolates. Twenty-eight per cent (by ARA) and 27% (by ribotyping) of the E. coli proficiency isolates were assigned to the correct source category. Sixteen per cent were assigned to the same source category by both methods, and 6% were assigned to the correct category. Addition of 2480 E. coli isolates to the ARA library did not improve the ARCC or proficiency accuracy. In contrast, 45% of Enterococcus proficiency isolates were correctly identified by ARA. CONCLUSIONS: None of the methods performed well enough on the proficiency panel to be judged ready for application to environmental samples. SIGNIFICANCE AND IMPACT OF THE STUDY: Most microbial source tracking (MST) studies published have demonstrated library accuracy solely by the internal ARCC measurement. Low rates of correct classification for E. coli proficiency isolates compared with the ARCCs of the libraries indicate that testing of bacteria from samples that are not represented in the library, such as blinded proficiency samples, is necessary to accurately measure predictive ability. The library-based MST methods used in this study may not be suited for determination of the source(s) of faecal pollution in large, urban watersheds.

Animals↗
PubMed1996

Paracetamol (acetominophen) sulphoconjugation in man: no correlation with tyramine sulphoconjugation.

There is considerable evidence that subjects vulnerable to endogenous depression excrete less tyramine sulphate after an oral dose of free tyramine than controls (the tyramine test). In this study, 26 psychiatric inpatients, exhibiting a wide range of responses to the test, and 10 normal controls were challenged with oral doses of paracetamol and tyramine on two separate occasions. Urinary output of paracetamol sulphate and paracetamol glucuronide in all subjects was monitored but there were no significant correlations with tyramine sulphate output. Thus, the output of these metabolites appears to be under complex control, and paracetamol cannot be substituted for tyramine in the "tyramine test". The basic deficit responsible for low values in the tyramine test is unlikely to stem from sulphate depletion or a generalised disturbance of the sulphation system, and remains obscure.

Acetaminophen↗
PubMed1993

The tyramine test is not a marker for postnatal depression: early postpartum euphoria may be.

Abnormally low tyramine test values are known to be markers for vulnerability to unipolar, but not bipolar, endogenous depression. In the present study, 37 women with recent postnatal depression (25 major, 12 minor) and 22 puerperal controls with no depressive disorder, all assessed by Schedule for Affective Disorder and Schizophrenia (SADS-L) interview, together with 17 other controls, underwent the test. No significant differences in tyramine sulfate output were demonstrated between the different groups. Those subjects with endogenous features according to Newcastle score (n = 7) or Research Diagnostic Criteria (RDC) (n = 6) also had normal output. Thus, the tyramine test does not appear to be a useful marker for vulnerability to postnatal depression. Over half the subjects recalled that their postnatal depression had started in the first 2 weeks postpartum. Of the total of 62 postpartum subjects interviewed with the SADS-L, ten recalled a period of euphoria in the first postpartum week, which met RDC for hypomania and eight of them went on to become depressed postnatally. An additional patient from the total group was hospitalized with mania.

Adult↗
PubMed1993

Natural adrenocorticosteroids do not restore resistance to endotoxin in the adrenalectomized mouse.

Chronic loss of adrenocorticosteroid activity by adrenalectomy (10 days) or acute inhibition of glucocorticoid receptor function by injection of an anti-progestin (RU-38486) increased sensitivity to lipopolysaccharide about 200-fold, compared to that of control animals. Daily subcutaneous injection of a mixture of the natural glucocorticoid corticosterone and the mineralocorticoid deoxycorticosterone did not restore resistance to the endotoxin. The largest dose of steroid, 400 micrograms corticosterone + 200 micrograms deoxycorticosterone, provided only partial protection against 20 micrograms LPS, which was 10% of the LD50 for animals with adrenals. The mechanisms involved in lack of effectiveness of natural corticosteroids will require further experimentation.

Adrenal Cortex Hormones↗
PubMed1992

Abnormal platelet 5-hydroxytryptamine uptake and imipramine binding in postnatal dysphoria.

Platelet 14C-5-hydroxytryptamine (14C-5-HT) uptake, 3H-imipramine binding and monoamine oxidase (MAO) activity were measured in women 5 days postpartum and compared with depression scores (Edinburgh Postnatal Depression Scale) at that time and 6 weeks later. Mean Km of 14C-5-HT uptake was significantly reduced in the group showing dysphoria at 5 days (p less than 0.01). Mean Kd of 3H-imipramine binding was significantly increased in the group who later went on to become depressed at 6 weeks postpartum (p less than 0.03). Vmax for 14C-5-HT uptake, Bmax for 3H-imipramine binding and MAO activity did not differ between depressed and non-depressed patients on either occasion. Although the observed changes manifested in a system known to be disturbed in other forms of depression, they were in affinity rather than Bmax or Vmax. Even though probably not of direct physiological significance, such results, if confirmed, together with other pointers in the literature, suggest biochemical abnormalities specific to the puerperal period.

Adult↗
PubMed1992

Is the tyramine test for depressive illness useful in elderly patients?

There were no significant differences in tyramine sulphate excretion following tyramine ingestion between elderly depressed, demented or control patient groups, in contrast with younger subjects where this test is a trait marker for unipolar endogenous depression. There are inherent problems in urine collection studies in the elderly and the results may have been influenced by the medication that elderly patients have to take for other disorders. This study suggests that the tyramine test is unlikely to be of clinical usefulness in the over 65 age group.

Aged↗
PubMed1992

Links between early post-partum mood and post-natal depression.

The Edinburgh Postnatal Depression Scale (EPDS) was used to rate 217 patients at five days and six weeks post-partum. There was a highly significant positive correlation between the two scores, together with similar symptom profiles. Of the 25 women who suffered post-natal depression (6-week EPDS score greater than or equal to 13), 17 had similar symptoms in the first week post-partum (5-day EPDS score greater than or equal to 10). Low birth weight of the baby, delivery by Caesarean section, a delivery much more difficult than expected, and bottle feeding were all significantly associated with a high EPDS score in the first week post-partum. Bottle feeding and delivery by Caesarean section were the only factors associated with depression at the sixth week. A recollection of low mood after a previous birth was also associated with post-natal depression after the current birth. This, together with an EPDS score of 13 or more at five days post-partum, increased the risk of post-natal depression at six weeks 85-fold.

Adult↗
PubMed1991

Tyramine conjugation test distinguishes unipolar from bipolar depressed patients and controls.

Tyramine sulphate conjugation following oral tyramine administration (the tyramine test) has previously been found to distinguish endogenous unipolar from neurotic depression and appears to be a trait marker. In this study, the test was used in 24 unipolar depressed patients compared with similar sized matched groups of bipolar depressed patients and normal controls. Most of the depressed patients in each group showed endogenous features. The study found that whereas tyramine sulphate conjugation was significantly impaired in unipolar patients, values in the bipolars were similar to those of controls. These results provide further evidence for the biological difference between unipolar and bipolar depression.

Administration, Oral↗
PubMed1991

Kinetics of platelet 5-hydroxytryptamine uptake in headache patients.

Platelet 5-hydroxytryptamine (5-HT) uptake was measured in asymptomatic headache patients attending a specialist migraine clinic, and in hospital staff who did not suffer from regular or severe headache. Current levels of anxiety and depression were assessed in all subjects using the Hospital Anxiety and Depression (HAD) scale and their possible influence on the uptake kinetics taken into account during the analysis of results. The Michaelis-Menten constant (Km) was significantly raised in common migraine and tension headache compared with controls (p less than 0.001 and p less than 0.01, respectively), but not in classical migraine or cluster headache. The increase remained significant after adjusting for differences in age, sex, presence of anxiety or depression (HAD sub-scale score greater than or equal to 8), drug intake during the week before testing, time elapsed since last attack and time of assay (am or pm). No differences were observed between patients and controls in the maximal rate of uptake (Vmax) or platelet count, and previous reports of a reduction in Vmax in patients experiencing attack within 5 days prior to testing could not be confirmed. The cause and significance of an increased Km are not clear, but plasma factors acting as competitive inhibitors for the uptake site or an alteration in the configuration of the uptake site are possible explanations. If confirmed, the shared biochemical abnormality may suggest that common migraine and tension headache have a common pathogenesis.

Analysis of Variance↗
PubMed1990

Survival in acute leukemia in elderly patients. No improvement in the 1980s.

Acute leukemia is more common in older people than in the young or middle-aged. However, the possibilities of achieving remission or prolonging survival are both inversely correlated with increasing age. We studied survival in 118 acute leukemia patients over the age of 64 seen at a university hospital from 1970 to 1987. Seventy percent had myeloid morphology. Median survival times were 106 days in those diagnosed in the 1970s and 71 days for those diagnosed in the 1980s. This was little changed from an earlier series from the same hospital extending back to the 1940s in which median survival was 69 days. Considering the two decades separately, age at diagnosis, sex, race, type of leukemia, and whether or not disease-specific treatment was applied had no significant effect on survival duration. Acute leukemia in the older patient demands difficult medical and ethical choices. Supportive therapy provides immediate comfort and relatively limited morbidity with certainty of death within a few months. Disease-specific therapy causes immediate morbidity for all, shortened life for the majority, and extended life for the minority.

Acute Disease↗
PubMed1987

Rhinosporidiosis of vagina: a case report.

This is a case report of a 60 year old woman with Rhinosporidiosis of vagina. The female genital tract is an extremely rare site for Rhinosporidiosis. The exact mode of transmission is not known.

Female↗
PubMed1982

Isolation and rapid identification of Haemophilus ducreyi.

During a 2-month period, 62 strains of Haemophilus ducreyi were isolated from 168 genital lesions and 2 lymph node aspirates. Of these strains, 22 were found on both chocolate agar and fetal bovine serum agar supplemented with vancomycin, 29 were found only on chocolate agar, and 9 were found only on fetal bovine serum agar. Two additional strains were isolated on sheep blood agar. All of these isolates were correctly identified with the RapID NH system (Innovative Diagnostic Systems, Inc., Decatur, Ga.) a new identification kit that has a database for Haemophilus, Neisseria, and other genera that include fastidious gram-negative bacilli.

Culture Media↗