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Biomedical subjects

P Harris

Publications and source records attributed to P Harris.

At least 19 recordsLinked to original sources
PubMed2006

The behaviour, social status and number of teeth extracted in children under general anaesthesia: a referral centre revisited.

OBJECTIVE: To report on the changing profile of children attending for Dental General Anaesthetic extractions (DGA) at the same centre in 1998 and again in 2004 compared to 1991. DESIGN: Prospective clinical. SETTING: Glasgow Dental Hospital DGA service during August 1999 and August/September 2004. SUBJECTS AND METHOD: Children presenting for DGA extractions. Data recorded: age, gender, number of teeth extracted and level of behaviour using the Frankl scale. RESULTS: In 1999: 190 children (97 boys) mean age five years. In 2004: 106 children (55 boys) mean age five years. There was a significant increase in the mean number of teeth extracted (p < 0.001), 4.2 (1-16) and 7.8 (1-17) in 1999 and 2004 respectively, compared to 3.7 in 1991. Twenty-six per cent of children had between six and 16 teeth extracted in 1999 compared to 74% in 2004. Significantly fewer children demonstrated "definitely positive" behaviour compared to 1991. Children were in the poorest socioeconomic groups, reflecting the geographic area. CONCLUSION: Over half of the children were aged five years and under. Fewer highly co-operative children were treated. More teeth were extracted per child, suggesting that there should be greater opportunities to carry out restorations, not just extractions under general anaesthesia.

Age Factors↗
PubMed2005

Helicobacter pylori vacA s1a and s1b alleles from clinical isolates from different regions of Chile show a distinct geographic distribution.

AIM: To establish the most common vacA alleles in Helicobacter pylori (H pylori) strains isolated from Chilean patients and its relationship with gastritis and gastroduodenal ulcers. METHODS: Two hundred and forty five H pylori clinical isolates were obtained from 79 biopsies from Chilean infected patients suffering from gastrointestinal diseases. An average of 2-3 strains per patient was isolated and the vacA genotype was analyzed by PCR and 3% agarose electrophoresis. Some genotypes were checked by DNA sequencing. RESULTS: The most prevalent vacA genotype in Chilean patients was s1b m1 (76%), followed by s1a m1 (21%). In contrast, the s2 m2 genotype was scarcely represented (3%). The s1b m1 genotype was found most frequently linked to gastropathies (P<0.05) rather than ulcers. Ulcers were found more commonly in male and older patients. Curiously, patients living in cities located North and far South of Santiago, the capital and largest Chilean city, carried almost exclusively strains with the s1b m1 genotype. In contrast, patients from Santiago and cities located South of Santiago carried strains with either one or both s1a m1 and s1b m1 genotypes. Regarding the s2 m2 genotype, comparison with GenBank sequences revealed that Chilean s2 sequence was identical to those of Australian, American, and Colombian strains but quite different from those of Alaska and India. CONCLUSION: Differences in geographic distribution of the s and m vacA alleles in Chile and a relationship of s1b m1 genotype with gastritis were found. Sequence data in part support a hispanic origin for the vacA genotype. Asymmetric distribution of genotypes s1b m1 and s2 m2 recedes H Pylori strain distribution in Spain and Portugal.

Adolescent↗
PubMed2005

Stab wound of the back causing an acute subdural haematoma and a Brown-Sequard neurological syndrome.

OBJECTIVE: To report on an unusual knife stab injury of the thoracic spine, causing an acute subdural haematoma (SDH) and paraparesis. SETTING: Department of Surgical Neurology, Ward 20, The Royal Infirmary of Edinburgh. CASE REPORT: The weapon was a knife, which traversed the mid-thoracic spinal region, causing an incomplete spinal cord lesion, which was demonstrated by myelography to be due to an SDH. The haematoma was removed at operation. There was a full neurological recovery. CONCLUSION: There was no bony injury. The likely cause for the development of the SDH was believed to be due to the sudden impingement on the spine by the weapon, rupturing small subdural veins.

Adolescent↗
PubMed2005

Anterior hypopituitarism following traumatic brain injury.

PRIMARY OBJECTIVES: To review evidence that there exists a substantial sub-population of patients with endocrine disorders as a result of traumatic brain injury (TBI) and to underscore the importance of screening patients with TBI considered most at risk for hypopituitarism with the goal of attaining beneficial effects in terms of morbidity and quality of life. DESIGN AND METHODS: Reviewed recent literature regarding the frequency of TBI-induced hypopituitarism. MAIN OUTCOMES AND RESULTS: Studies by Kelly DF, Gaw Gonzalo IT, Cohan P, et al. Hypopituitarism following traumatic brain injury and aneurysmal subarachnoid hemorrhage: A preliminary report. Journal of Neurosurgery 2000;93:743-751, Lieberman SA, Oberoi AL, Gilkison CR, et al. Prevalence of neuroendocrine dysfunction in patients recovering from traumatic brain injury. Journal of Clinical Endocrinology and Metabolism 2001;86:2752-2756 and Aimaretti G, Ambrosio MR, Di Somma C, et al. Traumatic brain injury and subarachnoid haemorrhage are conditions at high risk for hypopituitarism. Screening study at 3 months after the brain injury, In press., found that about one-half to one-third of patients with TBI had anterior pituitary hormone deficiencies, including growth hormone (GH) deficiency in 15-21%, and subtle deficiencies in thyroid, adrenal and gonadal axes. One or more hormonal deficiencies produce diverse physical and psychological symptoms that may mimic symptoms attributed to brain trauma and may impair rehabilitation. A more general concern is the fact that hypopituitarism increases the risk of significant morbidity (e.g. ischaemic heart disease) and mortality (shortened life span). CONCLUSIONS: To attain maximal improvement in mental and physical functioning as well as in quality of life for victims of TBI, it is crucial that anterior pituitary hormonal function be assessed. Appropriate hormone replacement therapy for those patients with both TBI and TBI-induced pituitary function impairment could, for the first time, allow treatment and correction of underlying causes of TBI sequelae rather than merely symptomatic treatment.

Brain Injuries↗
PubMed2004

IPL576,092, a novel anti-inflammatory compound, inhibits leukocyte infiltration and changes in lung function in response to allergen challenge.

IPL576,092, a lead compound from a novel class of polyhydroxylated sterols, was tested in models of allergen-induced bronchoconstriction and airway inflammation. In a rat ovalbumin lung inflammation model, orally administered IPL576,092 significantly inhibited the challenge-mediated increase in total bronchoalveolar lavage leukocyte numbers, and macrophage and lymphocyte infiltration (1-10 mg/kg/day). There was a similar trend towards inhibition of eosinophil and neutrophil accumulation. Sheep were treated with IPL576,092 by inhalation (400 microg/kg/day), and lung resistance and airway hyper-responsiveness (AHR) were determined after Ascaris suum challenge. IPL576,092 significantly reduced the early and late phase bronchoconstrictor responses by 63+/-4.6 and 84+/-4.6%, respectively. IPL576,092 also blocked AHR (2.2+/-5.7% change from pre-challenge PC400), whereas control animals showed a 62.2+/-2.6% decrease in the PC400 (p<0.05). Oral IPL576,092 (5 mg/kg/day) also significantly decreased hyper-reactivity in mice. In a guinea pig model, IPL576,092 (5 mg/kg/day) significantly protected against allergen-induced increases in lung resistance (11.4+/-2.3 control versus 4.8+/-01.5 IPL576,092, area under the curve) and inhibited the increase in lung elastance (280+/-58 control versus 167+/-52 IPL576,092, p<0.05). IPL576,092, unlike dexamethasone, did not significantly decrease rat serum corticosterone levels or thymus and spleen weights, supporting a mechanism of action different from classic glucocorticoids. IPL576,092 significantly attenuates characteristics of an asthmatic response, indicating therapeutic potential for this drug class.

Airway Resistance↗
PubMed2004

Relevance of the pH probe in sleep study analysis in infants.

BACKGROUND: To establish the relationship between sleep apnoea and gastro-oesophageal reflux in infants and describe the clinical, demographic and pHmetric profile and the characteristic of the sleep polysomnography with a pH probe. METHODS: A total of 102 consecutive patients were evaluated. Parents were requested to fill out a questionnaire about symptoms and previous therapy. Gastro-oesophageal reflux was considered abnormal when the percentage of time with pH less than 4 was higher than 4% of total sleep time. RESULTS: A total of 102 infants were enrolled, 53% males. Seventy-four per cent of the infants were full-term babies. At the moment of the polysomnography, the mean age of the sample was 2.6 months. Suspicion of apnoea was the most common clinical diagnosis prior to the study. Only two infants have abnormal electroencephalogram. Mild gastro-oesophageal reflux was seen in 37 (36%) infants, while 22 (21.5%) did not have any reflux episode, and the remaining 43 (42%) infants had reflux index in the pathologic range. Only one patient had an unequivocal temporal relationship between acid oesophageal reflux and respiratory pause with oxygen desaturation. DISCUSSION: Infants with history of apnoea or acute life threatening event frequently had gastro-oesophageal reflux episodes which did not correlated with respiratory events, suggesting that gastro-oesophageal reflux and apnoea often occur in the same infant as two separate events.

Chile↗
PubMed2003

Error reduction: academic detailing as a method to reduce incorrect prescriptions.

OBJECTIVES: Clinical decision making can be influenced by academic detailing, and it was hypothesised that this technique may be used to reduce simple errors when prescribing drugs of addiction. These prescriptions require specific details to be included, otherwise the prescription has to be returned to the prescriber and re-written, wasting the time of the dispenser and prescriber alike. METHODS: The legal requirements for the prescription of addictive drugs were used to define prescription errors. Prescription error rates at six hospitals were assessed, including a control and an intervention hospital where academic detailing was carried out. Prescription error rates were documented before and after an academic detailing visit to junior doctors, including the provision of a bookmark containing the requirements for these drugs. These errors were expressed as a percentage of the total written for a 4-week period. RESULTS: At the intervention hospital, there was a significant decrease in error rate (from 41% to 24%, P<0.0001) with an improvement in all the requirements stated on the bookmark. At this hospital, the confidence of the junior doctors on a self-rating 5-point scale in writing prescriptions for these drugs increased from a mean of 3.25 (95% CI 2.92-3.58) to 4.14 (95%CI 3.90-4.38) after the intervention (P=0.03). The baseline error rates at the other hospitals ranged from 25% to 46%, but the control hospital did not show a significant change in error rate over the same study period ( P=0.66). A post-hoc review suggested that liquid preparations were more difficult to prescribe correctly, which in part accounted for the differences in error rate between hospitals. CONCLUSIONS: Academic detailing appears to be a useful method of reducing erroneous hospital prescriptions; and, to our knowledge, this is a novel finding.

Analgesics, Opioid↗
PubMed2003

Phobic anxiety in 11 nations. Part I: Dimensional constancy of the five-factor model.

The Fear Survey Schedule-III (FSS-III) was administered to a total of 5491 students in Australia, East Germany, Great Britain, Greece, Guatemala, Hungary, Italy, Japan, Spain, Sweden, and Venezuela, and submitted to the multiple group method of confirmatory analysis (MGM) in order to determine the cross-national dimensional constancy of the five-factor model of self-assessed fears originally established in Dutch, British, and Canadian samples. The model comprises fears of bodily injury-illness-death, agoraphobic fears, social fears, fears of sexual and aggressive scenes, and harmless animals fears. Close correspondence between the factors was demonstrated across national samples. In each country, the corresponding scales were internally consistent, were intercorrelated at magnitudes comparable to those yielded in the original samples, and yielded (in 93% of the total number of 55 comparisons) sex differences in line with the usual finding (higher scores for females). In each country, the relatively largest sex differences were obtained on harmless animals fears. The organization of self-assessed fears is sufficiently similar across nations to warrant the use of the same weight matrix (scoring key) for the FSS-III in the different countries and to make cross-national comparisons feasible. This opens the way to further studies that attempt to predict (on an a priori basis) cross-national variations in fear levels with dimensions of national cultures.

Adolescent↗
PubMed2003

A Bayesian neural network approach for modelling censored data with an application to prognosis after surgery for breast cancer.

A Bayesian framework is introduced to carry out Automatic Relevance Determination (ARD) in feedforward neural networks to model censored data. A procedure to identify and interpret the prognostic group allocation is also described. These methodologies are applied to 1616 records routinely collected at Christie Hospital, in a monthly cohort study with 5-year follow-up. Two cohort studies are presented, for low- and high-risk patients allocated by standard clinical staging. The results of contrasting the Partial Logistic Artificial Neural Network (PLANN)-ARD model with the proportional hazards model are that the two are consistent, but the neural network may be more specific in the allocation of patients into prognostic groups. With automatic model selection, the regularised neural network is more conservative than the default stepwise forward selection procedure implemented by SPSS with the Akaike Information Criterion.

Bayes Theorem↗
PubMed2002

Measuring staff support in services for people with intellectual disability: the Staff Support and Satisfaction Questionnaire, Version 2.

Social support is an important determinant of well-being, including the stress experienced within the work setting. The present paper reports on the development of the Staff Support and Satisfaction Questionnaire (3SQ), from a previously published measure: the Staff Support Questionnaire. The 3SQ was piloted with 21 health professionals and examined for evidence of test-retest reliability with 24 staff. Data on internal reliability were collected on three occasions from a total sample of 177 staff. The validity of the 3SQ was examined in four studies with a total of 238 staff by testing it against validated measures of psychological well-being. The data showed that the total scale had a high level of test--retest reliability (rs=0.82, P < 0.001) and consistently high internal reliability. Three out of the four validity studies showed statistically significant inverse relationships between the total scale and measures of psychological well-being. The weakest link was the 'Supportive People' subscale. The reliability and validity studies suggest that the psychometric properties of the 3SQ are generally robust, except for the 'Supportive People' subscale, which should be interpreted with caution.

Adult↗
PubMed2002

The 6p deletion syndrome: a new orofacial clefting syndrome and its implications for antenatal screening.

Foetal genetic screening has become the centre of the ethical debate surrounding the screening of foetuses for chromosomal defects to help create 'eugenic' children with either perceived advantageous characteristics or traits that could be used to medically aid unhealthy siblings. This report highlights the problems facing the medical establishment by citing, by way of example, a case of a genetic abnormality producing a clefting syndrome. The 6p deletion syndrome was first described almost 20 years ago, and the evidence is mounting for its inclusion as an orofacial clefting syndrome. This case report includes a description of the syndrome, the method used for detecting chromosomal aberrations and a comparison with other reports of the syndrome published to date. However, by pursuing a genetic-testing policy at our unit to detect new abnormalities or to help substantiate previously reported abnormalities, the way could be left open for its subsequent abuse by parents and corporations alike, so having implications not only for the individual but also for the unit performing the test. A brief synopsis is therefore also provided regarding the current circumstances of foetal screening in the UK.

Chromosome Deletion↗
PubMed2002

Nature and extent of gastric lesions in symptomatic Chilean children with Helicobacter pylori-associated gastritis.

UNLABELLED: Chile has one of the highest rates of gastric cancer in the world and most children and adolescents in the country are colonized by Helicobacter pylori. This study assessed the nature and extent of the gastric lesions in 73 consecutive patients aged 5-17 y, referred for upper gastrointestinal endoscopy. Their H. pylori-associated gastric pathology was characterized and these data were compared with their sociodemographic status. Endoscopic assessment was normal in 43 patients while in 30 there was a variety of mucosal lesions. Sixty patients (83%) had histological chronic gastritis of the antrum and in 45 (63%) the lesions also involved the gastric corpus; 90% of patients with chronic gastritis were colonized by H. pylori. Although most of these patients had epithelial erosions and dedifferentiation of the pit epithelium, atrophy and metaplasia were not found. Patients' socioeconomic status was inversely correlated with their rate of colonization by H. pylori (p < 0.005), the frequency of gastric lesions on endoscopy (p < 0.01) and the frequency of involvement of antral and corpus mucosa by chronic gastritis (p < 0.002). This latter feature was positively correlated with age (p < 0.001). CONCLUSION: This study shows a high frequency of extensive lesions of H. pylori-associated chronic gastritis in young Chilean patients. This histological picture is consistent with the hypothesis of a H. pylori-associated progressive gastric pathology which may represent a major factor in the high local rate of gastric cancer.

Adolescent↗
PubMed2002

Comparison of the metabolic responses of trained Arabians and Thoroughbreds during high- and low-intensity exercise.

In order to compare the metabolic responses to exercise in 2 similarly managed breeds of horses, 5 Arabian (AR) and 5 Thoroughbred (TB) horses, fed an identical diet with a similar diet and exercise training programme for the 2 preceding months, undertook 3 treadmill (3 degree incline) trials with a minimum of 7 days between tests: 1) an incremental test (MAX) for determination of aerobic capacity, V(LA4) and lactate threshold (LT; the percentage of VO2max when plasma lactate = 4 mmol/l); 2) a single high-speed exercise test (SPR) at 115% VO2max for estimation of maximal accumulated oxygen deficit (MAOD) and 3) a 90 min test at 35% VO2max (LO). VO2max (P<0.001) and running speed (P<0.05) at VO2max were higher in TB (mean +/- s.e. 154 +/- 3 ml/kg/min at 12.9 +/- 0.5 m/s) than in AR (129 +/- 2.5 ml/kg/min at 11.8 +/- 0.2 m/s). Total run time during MAX was greater (P<0.05) in TB (10.5 +/- 0.5 min) than in AR (93 +/- 0.3 min). However, V(LA4) and LT were not different between groups. Run time during SPR (TB 149 +/- 16; AR 109 +/- 11 s) and MAOD (TB 88 +/- 4; AR 70 +/- 6 ml O2/kg) were higher (P<0.05) in the TB group. During LO, FFA were higher (P<0.05) and the respiratory exchange ratio (RER) lower (P<0.05) in AR than in TB between 60 and 90 min, of exercise, indicating a greater use of fat for energy. These metabolic differences may reflect breed variation in muscle fibre types. However, further studies are needed to determine the mechanisms underlying the apparent breed differences in energy metabolism during exercise.

Animals↗
PubMed2002

Effect of nutritional antioxidant supplementation on systemic and pulmonary antioxidant status, airway inflammation and lung function in heaves-affected horses.

An oxidant/antioxidant imbalance in favour of oxidants has been identified as playing a decisive role in the pathogenesis of chronic inflammatory airway diseases. Nutritional antioxidant supplementation might reduce oxidative damage by enhancement of the antioxidant defence, thereby modulating inflammatory processes. In a placebo-controlled, blind study, it was tested whether a dietary antioxidant supplement administered for 4 weeks would improve lung function and reduce airway inflammation in heaves-affected horses. Eight horses in clinical remission of heaves were investigated at rest and after a standardised exercise test before and after treatment with an antioxidant supplement (consisting of a mixture of natural antioxidants including vitamins E and C and selenium from a variety of sources) or placebo (oatfeed pellets without additive). Pulmonary function and exercise tolerance were monitored; systemic and pulmonary lining fluid uric acid, glutathione and 8-epi-PGF(2alpha) were analysed, and bronchoalveolar lavage (BAL) cytology and inflammatory scoring of the airways were performed. The antioxidant treatment significantly improved exercise tolerance and significantly reduced endoscopic inflammatory score. Plasma uric acid concentrations were significantly reduced, suggesting downregulation of the xanthine-dehydrogenase and xanthine-oxydase pathway. Haemolysate glutathione showed a nonsignificant trend to increase, while plasma 8-epi-PGF(2alpha) remained unchanged. Pulmonary markers and BAL cytology were not significantly affected by antioxidant supplementation. The present study suggests that the antioxidant supplement tested modulated oxidant/antioxidant balance and airway inflammation of heaves-affected horses.

Animals↗
PubMed2002

Foraging enrichment for stabled horses: effects on behaviour and selection.

The restricted access to pasture experienced by many competition horses has been linked to the exhibition of stereotypic and redirected behaviour patterns. It has been suggested that racehorses provided with more than one source of forage are less likely to perform these patterns; however, the reasons for this are currently unclear. To investigate this in 4 replicated trials, up to 12 horses were introduced into each of 2 identical stables containing a single forage, or 6 forages for 5 min. To detect novelty effects, in the first and third trials the single forage was hay. In the second and fourth, it was the preferred forage from the preceding trial. Trials were videotaped and 12 mutually exclusive behaviour patterns compared. When hay was presented as the single forage (Trials 1 and 3), all recorded behaviour patterns were significantly different between stables; e.g. during Trial 3 in the 'Single' stable, horses looked over the stable door more frequently (P<0.001), moved for longer (P<0.001), foraged on straw bedding longer (P<0.001), and exhibited behaviour indicative of motivation to search for alternative resources (P<0.001) more frequently. When a previously preferred forage was presented as the single forage (Trials 2 and 4) behaviour was also significantly different between stables, e.g in Trial 4 horses looked out over the stable door more frequently (P<0.005) and foraged for longer in their straw bedding (P<0.005). Further study is required to determine whether these effects persist over longer periods. However, these trials indicate that enrichment of the stable environment through provision of multiple forages may have welfare benefits for horses, in reducing straw consumption and facilitating the expression of highly motivated foraging behaviour.

Animal Feed↗