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Biomedical subjects

P Schofield

Publications and source records attributed to P Schofield.

At least 37 records · Page 2Linked to original sources
PubMed1999

Rate and extent of digestion of the ethanol-soluble and neutral detergent-insoluble fractions of corn grain.

The objectives of this study were to partition corn grain into three digestible fractions and to measure the rate of disappearance of these fractions in vitro. Seventeen corn grain samples with varied fiber concentrations were extracted with either 80% ethanol or neutral detergent to obtain estimates of the pool size and digestion kinetics of the A, B1, B2, and C fractions. The carbohydrate soluble in 80% ethanol averaged only 2.6+/-.3% of the DM, although 80% ethanol extracted 7.1+/-1.2% of DM of corn grain. The ethanol-soluble fraction of corn grain contained protein, ether-extractable compounds, and a small amount of ash in addition to carbohydrate. Because of this chemical heterogeneity and because of the small size of the ethanol-soluble fraction, it was not possible to determine the digestion rate of this fraction by measuring gas production. The NDF content of the corn grain was 10.6+/-.7% of DM and was highly digestible (94.6+/-1.4%). The digestible NDF contributed 9.5% of the total gas production from corn grain. Because the size, digestibility, and digestion rate of the digestible NDF fraction varied little among corn grain samples, it is not necessary to routinely analyze the digestion kinetics of the digestible NDF fraction of dried corn grain. An average gas production curve of this fraction can be used as a base to subtract from the total gas production curve to generate the gas production curve of the neutral detergent-soluble fraction for dried, ground corn grain samples.

Detergents↗
PubMed1998

The novel combination of fat clearance and immunohistochemistry improves prediction of the outcome of patients with colorectal carcinomas: a preliminary study.

To evaluate the significance of micrometastases in relation to survival rate, specimens from 48 colorectal carcinoma patients were analysed after fat clearance. The number and size of the lymph nodes harbouring metastases and the significance of micrometastases for patients' survival were assessed. We found that although the majority of metastatic lymph nodes (71.8%) were 5 mm or less in diameter, their size had no effect on survival. Immunohistochemical staining of lymph nodes revealed that 15 of 25 patients with Dukes' stage B diagnosed by routine staining had micrometastases, 86% of these lymph nodes being less than 5 mm in diameter. The survival rate of this subgroup was found to be considerably poorer than that of Dukes' stage B patients with no micrometastases. None of the three patients with Dukes' stage A carcinoma had micrometastases. Since most of the metastases and micrometastases occur in lymph nodes of 5 mm and less and can be easily missed by routine examination, we suggest that fat clearance and routine immunohistochemical analysis of Dukes' stage B improve the prediction of outcome of colorectal cancer patients.

Aged↗
PubMed1998

Evaluating the use of Snoezelen and chronic pain: the findings of an investigation into its use (Part II).

This is the second of two papers which describes a research project which was designed to evaluate the use of Snoezelen for the management of chronic pain. Part I explored the concepts underpinning both chronic pain and the Snoezelen itself which subsequently resulted in the development of an appropriate study design. The purpose of the study was to compare the use of Snoezelen for the management of chronic pain as a potential relaxation and distraction strategy, compared to the traditional relaxation approach used within the clinic. This paper will present the results that were obtained with the research project and in the light of these findings the author will discuss implications for future investigation and practice.

Adaptation, Psychological↗
PubMed1998

Hereditary juvenile haemochromatosis: a genetically heterogeneous life-threatening iron-storage disease.

Juvenile haemochromatosis is a rare inborn error of iron metabolism with clinical manifestations before 30 years of age. Unlike adult haemochromatosis which principally affects men, juvenile haemochromatosis affects the sexes equally; it causes early endocrine failure, dilated cardiomyopathy and joint disease. We report four patients (two of each sex) from three pedigrees affected by juvenile haemochromatosis with a mean onset at 22 years (range 14-30). All had endocrine deficiency with postpubertal gonadal failure secondary to pituitary disease; two suffered near-fatal cardiomyopathy with heart failure. Mean time to diagnosis from the first clinical signs of disease was 9.8 years (range 0.5-20) but general health and parameters of iron storage responded favourably to iron-depletion therapy. A 24-year-old man listed for heart transplantation because of cardiomyopathy [left ventricular (LV) ejection fraction 16%] responded to intravenous iron chelation with desferrioxamine combined with phlebotomy (ejection fraction 31%). A 27-year-old woman with subacute biventricular heart failure refractory to medication required orthotopic cardiac transplantation before the diagnosis was established (LV ejection fraction 25%). Genetic studies showed that these two patients with cardiomyopathy from unrelated families were heterozygous for the HFE 845G-->A (C282Y) mutation and wild-type at the H63D locus: complete sequencing of the intron-exon boundaries and entire coding sequence of the HFE gene failed to identify additional lesions. Two siblings in a pedigree without cardiomyopathy were wild-type at the HFE C282Y locus; although the brother harboured a single copy of the 187C-->G (H63D) allele, segregation analysis showed that in neither sibling was the iron-storage disease linked to MHC Class I markers on chromosome 6p. Juvenile haemochromatosis is thus a genetically heterogenous disorder distinct from the common adult variant.

Adolescent↗
PubMed1998

Cognitive function in nondemented older women who took estrogen after menopause.

Investigations of the effects of estrogen replacement on cognitive function in healthy older women have yielded disparate results. We evaluated the relationship between a history of estrogen use and cognitive test performance in 727 women participating in a large community-based study. Participants were followed longitudinally for an average of 2.5 years. Estrogen use history was obtained at baseline. Standardized tests of memory, language, and abstract reasoning were administered at baseline and at follow-up. Results indicate that women who had used estrogen replacement scored significantly higher on cognitive testing at baseline than nonusers, and their performance on verbal memory improved slightly over time. The effect of estrogen on cognition was independent of age, education, ethnicity, and APOE genotype. Results suggest that estrogen replacement therapy may help to maintain cognitive function in nondemented postmenopausal women.

Aged↗
PubMed1998

Ensiling effects of the ethanol fractionation of forages using gas production.

We studied the use of gas curve subtraction to distinguish between two fractions soluble in neutral detergent solution. Samples of unfractionated (whole) forage, residue insoluble in 90% ethanol, and isolated NDF were fermented in vitro, and gas production was monitored. The gas volume associated with the ethanol solubles (A fraction) was determined as the difference between the gas from the whole forage and from the ethanol residue. The gas yield associated with the fraction insoluble in 90% ethanol but soluble in neutral detergent solution (B fraction) was determined by subtracting the isolated NDF gas curve from the corresponding ethanol residue curve. This experiment included three forages (alfalfa, bromegrass, and orchardgrass) harvested at two maturities and preserved by freeze-drying or ensiling to form a 3 x 2 x 2 factorial arrangement. Ensiling reduced the rate of gas formation from the A fraction by approximately 30% (P < .01). Ensiling increased (P < .05) the size of the A fraction (2 to 10% of DM) but did not change the volume of gas produced (P > .05). The gas yield from the B1 fraction was reduced 40% (P < .05) by ensiling with no significant change in rate. Curve subtraction of gas production profiles may be used to obtain rate estimates for multiple neutral detergent soluble pools. The separation of the neutral detergent solubles into two pools clarified the effects caused by ensiling. Changes due to ensiling on the rate of gas produced were associated with the A fraction, and the effects on final gas volume were associated with the B1 fraction.

Animals↗
PubMed1998

Sensory deprivation and chronic pain: a review of the literature.

AIMS AND OBJECTIVES: The aim of this paper is to explore the literature into the use of 'Snoezelen' (Sensory Stimulation) for the management of chronic pain. Within the literature there are a number of research studies which have investigated the concept of sensory deprivation and these are considered. The studies indicate the potential of sensory input as a field of research in particular relation to the care of patients within hospital settings where they are removed from their 'normal' level of sensory input and could subsequently experience sensory deprivation. The relationship between sensory restriction and chronic pain is emphasized. This links with investigations of sensory stimulation (Snoezelen) as a potential strategy for the management of chronic pain. CONCLUSIONS: In conclusion, it is suggested that sensory deprivation cannot exist and the term 'sensory restriction' would be more appropriate. It is proposed that there is a need to develop a tool to assist carers in identifying the existence of sensory restriction in their specific client groups to provide a basis for intervention.

Adult↗
PubMed1998

Prospective comparative study of the evolution of probable Alzheimer's disease and Parkinson's disease dementia.

No previous comparison of test performance in probable Alzheimer's disease (pAD) and Parkinson's disease (PD) dementia has provided information about potential differences in the dementing process. This study compared the evolution of cognitive changes associated with these dementias. Generalized estimating equations (GEE) applied to regression analyses with repeated measures were used to evaluate cognitive changes over 1 to 3 years prior to the point when dementia was diagnosed in 40 matched pairs of patients with incident pAD and PD dementia. Both groups' performance declined on the Short Blessed, Selective Reminding Test (SRT; total recall, long-term retrieval, and delayed recall), Boston Naming Test, Category Fluency, and Similarities. The decline on naming and SRT delayed recall was more rapid in the PD dementia group, suggesting that these performance deficits emerge earlier in the development of pAD. The PD dementia group performed worse on Category Fluency throughout the follow-up period, suggesting either that dementia is overlaid on this preexisting performance deficit or that this type of executive deficit is an early manifestation of dementia in PD. The pAD group performed more poorly throughout the follow-up period on SRT delayed recognition, consistent with a pAD-specific encoding deficit. We conclude that while pAD and PD dementia are similar in many respects, differences in their evolution support previous observation of unique features in the 2 dementias and suggest different underlying pathologies.

Aged↗
PubMed1997

Localization of frontotemporal dementia with parkinsonism in an Australian kindred to chromosome 17q21-22.

An Australian family with autosomal dominant presenile nonspecific dementia was recently described. The disease results in behavioral changes, usually disinhibition, followed by the onset of dementia accompanied occasionally by parkinsonism. Twenty-eight affected individuals were identified with an age of onset of 39 to 66 years (mean, 53 +/- 8.9 years). We mapped the disease locus to an approximately 26-cM region of chromosome 17q21-22 with a maximum two-point LOD score of 2.87. Affected individuals share a common haplotype between markers D17S783 and D17S808. This region of chromosome 17 contains the loci for several neurodegenerative diseases that lack distinctive pathological features, suggesting that these dementias, collectively referred to as frontotemporal dementia with parkinsonism linked to chromosome 17 (FTDP-17), are caused by mutations in the same gene. The entire coding region of five genes, mapped to the FTDP-17 candidate region, were also sequenced. This analysis included the microtubule-associated protein tau that is the major component of the paired helical filaments observed in Alzheimer's disease. No pathogenic mutations were identified in either the tau gene or in any of the other genes analyzed.

Adult↗
PubMed1997

Cross-cultural neuropsychological assessment: a comparison of randomly selected, demographically matched cohorts of English- and Spanish-speaking older adults.

As the US population of elderly Hispanics continues to grow, there is an increasingly greater need for neuropsychological measures that are appropriate for assessing Spanish-speaking elders. The current study compared the performance of randomly selected, community-based samples of English- and Spanish-speaking elders on a brief neuropsychological test battery. Subject groups were matched for age and education. Multivariate analysis indicated significant group differences on the test battery. English and Spanish speakers scored comparably on many language-based tasks, but Spanish speakers scored significantly lower on almost all of the nonverbal measures. Significant group differences were observed on multiple-choice matching and recognition memory for stimuli from the Benton Visual Retention Test, as well as on Identities and Oddities from the Mattis Dementia Rating Scale, category fluency, and Complex Ideational Material from the Boston Diagnostic Aphasia Examination (BDAE). Results suggest that caution is warranted when using nonverbal as well as verbal measures to assess non-English-speaking individuals.

Adult↗
PubMed1997

Molecular beacons: trial of a fluorescence-based solution hybridization technique for ecological studies with ruminal bacteria.

Molecular beacons are fluorescent probes developed for solution rather than membrane hybridization. We have investigated the utility of these probes to study rumen microbial ecology. Two cellulolytic species, Ruminococcus albus and Fibrobacter succinogenes, were tested. Membrane and solution hybridizations gave similar results in competition experiments with cocultures of R. albus 8 and F. succinogenes S85.

Animals↗
PubMed1997

Predictors of returning for second round screening at a population based mammographic screening programme in Melbourne, Australia.

OBJECTIVE: To examine factors associated with returning for second round mammography screening. SETTING: This was a population based mammographic screening programme in Melbourne, Australia. DESIGN: A cohort design was used whereby 668 women were interviewed before the screening programme began and attendance for both first and second round screening was ascertained from programme records. The cohort sample was drawn from two regions of a defined area (close to and distant from the screening centre). MAIN RESULTS: Of the 315 women who attended for first round screening, 75% from the proximal sample and 70% from the distal sample returned for second round screening. Attendance at the second round was predicted by the following: the method of recruitment for first round screening, with women who required a letter of invitation and a reminder being less likely to reattend than those who initially attended in response to a community campaign (OR = 0.34; CI 0.19, 0.61); mammographic history before the initial screen, with women who reported previous diagnostic mammography being more likely to reattend than those who did not (OR = 2.97; CI 1.01, 8.9); stated intention of attending for the initial screen, with those with weakest intention of attending for their first round being less likely to attend for second round (OR = 0.44; CI 0.23, 0.85); and increasing scores on a scale that measured preventive orientation to health (OR = 1.24; CI 1.02, 1.50). CONCLUSION: Our findings corroborate other findings of reduced long term attendance for screening from people who are "reluctant participants" initially.

Aged↗
PubMed1997

Behavioural dynamics of a clinical trial of sunscreens for reducing solar keratoses in Victoria, Australia.

OBJECTIVE: To determine whether the behaviour of participants based on perception of treatment group in a randomised trial contributed to clinical outcome. DESIGN: A double blind randomised controlled trial of the effect of daily application of SPF 17 broad spectrum sunscreen cream (or placebo) on solar keratoses. SETTING: A rural city in Victoria, Australia. Residents aged 40 years or over were invited by letter to attend for a skin cancer screening check. Of these, 588 people with between one and 30 solar keratoses enrolled in the trial and 431 completed the trial, which extended over a six month period that included summer. Participants' perceptions of their treatment allocation, adherence with the treatment regimen, adoption of other sun protection behaviours, side effects, and perceptions of change in condition were measured at two monthly intervals. RESULTS: There were no significant differences between those who completed the study and those that did not for sex, age, treatment group, skin type, number of solar keratoses or correct perception of treatment group. Thirty per cent of those completing the study correctly guessed their treatment allocation, and people were just as likely to be right as to be wrong when they stated their opinion about their treatment allocation (z = 1.04; p = 0.15). Study group, skin type, amount of time spent outdoors, presence of side effects, perceptions of change in skin condition did not significantly predict correct perception of treatment allocation. Multivariate analysis of variance indicated that adoption of other sun protection and adherence with cream use were not significantly affected by actual treatment allocation, correct perception of treatment allocation nor by their interaction. Poisson regression analysis showed a significantly lower difference ratio of solar keratoses in the sunscreen group compared with the placebo base cream group (OR 0.55; CI = 0.46, 0.64), and for women compared with men (OR = 0.76; CI = 0.63, 0.93) but no independent effect of any of the indices of other sun protection or adherence. CONCLUSIONS: A sufficient level of commitment to study procedures was achieved, so that trial participants did not adopt other behaviours that affected treatment outcomes. It is recommended that the potential threat to validity posed by the behaviour of participants be recognised at an early stage in planning of clinical trials, so that strategies to deal with this can be integrated into study protocols.

Adult↗
PubMed1997

Neutral detergent fiber disappearance and gas and volatile fatty acid production during the in vitro fermentation of six forages.

Samples of unfractionated forage and isolated NDF from six forages were fermented in vitro, and NDF disappearance and gas and VFA production were measured over time. Rates based on each of these data sets were calculated using a one-pool logistic model. The rates of NDF disappearance and gas and VFA production did not differ within each forage. Gas and VFA production were linearly related to NDF digestion. Gas yield was .35 mL/mg (r2 = .92) of NDF digested for the isolated NDF. The amount of total VFA produced per milligram of NDF digested was more variable than gas (r2 = .72), with a slope of .01 mmol VFA/mg of NDF digested. The relationship between gas and VFA production was linear (mean slope of 1.43 mmol gas/mmol VFA, r2 = .69). The ratios of end products (gas and VFA) to NDF digestion and the ratio of acetate:propionate were variable during the first 8 h of fermentation but changed little after this time. Changes in the acetate: propionate ratio explained 23% of the variation in gas produced per millimole of total VFA detected.

Acetates↗
PubMed1997

The effect of preservation method on the neutral detergent soluble fraction of forages.

Fermentation of neutral detergent solubles (NDS) was assessed using a 3 x 3 x 3 factorial arrangement. Three forage species (alfalfa, bromegrass, and orchardgrass) were collected at three maturities and preserved either by freeze drying, oven drying at 50 degrees C, or by ensiling. Each feed sample and its isolated NDF were fermented in vitro and gas production was monitored. Gas yield from NDS was determined as the difference between gas from the unfractionated forage and from its respective NDF. The forages ranged from 23 (immature alfalfa) to 68% NDF (mature orchardgrass). The silages were well fermented with a final pH of < or = 4.5. Increasing maturity decreased the final gas volume but did not change the rate of gas production from the NDS fraction. There was little difference in gas production between freeze-dried and oven-dried forage samples. Ensiling decreased gas yield from the unfractionated forage. The rate of gas production from the NDS fraction of the ensiled forages decreased an average of .05 h-1 compared with the freeze-dried sample. Gas yield from the NDS fraction decreased (from the freeze-dried sample) between 7 and 36% upon ensiling. The curve substraction approach can be used to evaluate the effects of ensiling on the neutral detergent-soluble fraction of forages.

Animals↗
PubMed1996

Effect of age, ethnicity, and head injury on the association between APOE genotypes and Alzheimer's disease.

The association between apolipoprotein E (APOE)-epsilon 4 and Alzheimer's disease has been confirmed worldwide. We and others have observed a diminished association in the very old and among African-Americans compared to Caucasians and Hispanics in New York. In this review we describe a new method we developed to compare relative risks by APOE genotypes in an expanded cohort of cases and controls from three ethnic groups in a New York City community and discuss the association as between APOE epsilon 4 and Alzheimer's disease as modified by head injury. Compared to persons with APOE epsilon 3/epsilon 3 genotypes, relative risk (RR) for Alzheimer's disease associated with APOE epsilon 4 homozygosity was similar across ethnic groups (African-American RR = 3.3; 95% c.i. 1.6-6.8; Caucasian RR = 5.3; 1.6-16.0; Hispanic RR = 2.5; 1.1-5.8). The risk was also increased for APOE epsilon 4 heterozygous Caucasians (RR = 3.2; 1.8-5.8) and Hispanics (RR 1.5; 1.0-2.2) but not African-Americans (RR = 0.6; 0.4-0.9). Risk of AD was not significantly diminished for individuals in any group with APOE epsilon 2/epsilon 2 or -epsilon 2/epsilon 3 genotypes. A 10-fold increase in the risk of Alzheimer's disease was associated with both APOE epsilon 4 and a history of traumatic head injury, compared to a twofold increase in risk with APOE epsilon 4 alone. Head injury in the absence of an APOE epsilon 4 allele did not increase risk. These results imply that in Alzheimer's disease genotypic risk associated with APOE may be influenced by age, ethnicity, and certain environmental factors.

Black or African American↗