Acute exacerbations in idiopathic pulmonary fibrosis.
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Humans↗
Biomedical subjects
Peter Kelly
Publications and source records attributed to Peter Kelly.
Successful treatment of massive pulmonary embolism with prolonged catheter-directed thrombolysis.
This is a case report of a young woman who presented with an extensive pulmonary embolism and echocardiographic evidence of right ventricular dysfunction. Although hemodynamically stable, the patient's clinical condition failed to improve with standard heparin anticoagulation. Successful local catheter-directed thrombolysis was performed over an extended period of 48 h with regular monitoring of response to therapy by computed tomography-pulmonary angiography and echocardiography. To our knowledge, treatment of a pulmonary embolism by catheter-directed thrombolytic infusion over an extended period of 48 h has not previously been described.
Catheterization↗
Competing discourses of workplace health.
This article presents an analysis of workplace health programme discourses within an international information technology company. Discourse refers to a system of statements that share a common force and coherence and which are socially constitutive. The representation of entities such as workplace health can be subject to competition between discourses. A critical discourse analysis was undertaken on semi-structured interviews, participant observation and workplace health programme documents. Two competing discourses were identified: health as safety and health as lifestyle. Each discourse is described and shown to both implicitly and explicitly define health within this particular workplace. Lifestyle discourse encouraged moves towards linking of the employees' working and private lives while safety discourse defined health in the relationship between workers and their physical environment. Competition between discourses both constricts and opens spaces for alternative understandings of health in the workplace. The implications of this competition for workplace health policy and practice are discussed.
Attitude of Health Personnel↗
Correlation of probiotic Lactobacillus salivarius growth phase with its cell wall-associated proteome.
Lactobacillus salivarius subsp. salivarius UCC118 is a probiotic bacterium that was originally isolated from human intestinal tissues and was subsequently shown in a pilot study to alleviate symptoms associated with mild-moderate Crohn's disease. Strain UCC118 can adhere to animal and human intestinal tissue, and to both healthy and inflamed ulcerative colitis mucosa, irrespective of location in the gut. In this study, an enzymatic technique has been combined with proteomic analysis to correlate bacterial growth phase with the presence of factors present in the cell wall of the bacterium. Using PAGE electrophoresis, it was determined that progression from lag to log to stationary growth phases in vitro correlated with increasing prominence of an 84kD protein associated with in vitro adherence ability. Isolated proteins from the 84kD band region were further separated by two-dimensional electrophoresis, resolving this band into 20 individual protein spots at differing isoelectric points. The protein moieties were excised, trypsin digested and subjected to tandem mass spectrometry. The observed proteins are analogous to those reported to be associated with the Listeria monocytogenes cell-wall proteome, and include DnaK, Ef-Ts and pyruvate kinase. These data suggest that at least some of the beneficial attributes of probiotic lactobacilli, and in particular this strain, may be due to nonpathogenic mimicry of pathogens and potentially be mediated through a form of attenuated virulence.
Amino Acid Sequence↗
Transplantation for myocarditis: a controversy revisited.
Myocarditis is a major cause of end-stage heart failure and is responsible for up to 10% of cases of idiopathic dilated cardiomyopathy (IDC). Worldwide, approximately 45% of all heart transplants are performed for IDC and up to 8% for myocarditis. Early reports suggested that survival after transplantation for myocarditis was poor and patients had an increased risk of rejection. More recently, larger case series suggest that overall survival after transplantation for myocarditis is similar to survival after transplantation for other causes. However, certain disorders, including cardiac sarcoidosis and giant cell myocarditis (GCM), require heightened surveillance for post-transplantation disease recurrence. We present the case of a 42-year-old man with recurrence of GCM 8 years after transplantation and review the literature on the role of cardiac transplantation for patients with myocarditis.
Adult↗
Lactobacillus and bifidobacterium in irritable bowel syndrome: symptom responses and relationship to cytokine profiles.
BACKGROUND & AIMS: The aim of this study was to compare the response of symptoms and cytokine ratios in irritable bowel syndrome (IBS) with ingestion of probiotic preparations containing a lactobacillus or bifidobacterium strain. METHODS: Seventy-seven subjects with IBS were randomized to receive either Lactobacillus salivarius UCC4331 or Bifidobacterium infantis 35624, each in a dose of 1 x 10 10 live bacterial cells in a malted milk drink, or the malted milk drink alone as placebo for 8 weeks. The cardinal symptoms of IBS were recorded on a daily basis and assessed each week. Quality of life assessment, stool microbiologic studies, and blood sampling for estimation of peripheral blood mononuclear cell release of the cytokines interleukin (IL)-10 and IL-12 were performed at the beginning and at the end of the treatment phase. RESULTS: For all symptoms, with the exception of bowel movement frequency and consistency, those randomized to B infantis 35624 experienced a greater reduction in symptom scores; composite and individual scores for abdominal pain/discomfort, bloating/distention, and bowel movement difficulty were significantly lower than for placebo for those randomized to B infantis 35624 for most weeks of the treatment phase. At baseline, patients with IBS demonstrated an abnormal IL-10/IL-12 ratio, indicative of a proinflammatory, Th-1 state. This ratio was normalized by B infantis 35624 feeding alone. CONCLUSIONS: B infantis 35624 alleviates symptoms in IBS; this symptomatic response was associated with normalization of the ratio of an anti-inflammatory to a proinflammatory cytokine, suggesting an immune-modulating role for this organism, in this disorder.
Adult↗
Effect of Söderberg smelting technology, anode paste composition, and work shift on the relationship between benzo[a]pyrene and individual polycyclic aromatic hydrocarbons.
This follow-up study of Farant and Gariepy study investigates the relationship between benzo[a]pyrene (B[a]P) and other polycyclic aromatic hydrocarbons (PAHs) found in coal tar pitch volatiles in two types of Soderberg aluminum smelters-horizontal and vertical stud. The study confirms the strong relationships between B[a]P and total PAHs, and that B[a]P was a good indicator for other PAHs in this industry. The PAH profiles were consistent within each smelter, but the smelter technology used and the changes in the raw material formulation resulted in significantly different profiles. B[a]P toxic equivalency factors for emitted PAH mixtures were greater in the horizontal stud smelter than in the vertical stud smelter. Overall, this study illustrates the potential usefulness of B[a]P relative abundance ratios to simplify exposure assessment in the workplace and reduce associated costs.
Aluminum↗
Patient satisfaction following restoration of shortened mandibular dental arches in a randomized controlled trial.
PURPOSE: Removable partial dentures (RPD) used to restore the severely shortened mandible may adversely affect the remaining natural teeth and are associated with a low prevalence of use. This pilot study investigated patient satisfaction following restoration of mandibular shortened dental arches. MATERIALS AND METHODS: Sixty subjects with mandibular shortened dental arches entered a randomized controlled trial comparing two types of mandibular prostheses: bilateral free-end saddle RPDs and distal cantilever resin-bonded fixed partial dentures (FPD). Patient satisfaction was assessed using self-administered questionnaires before (baseline), 3 months after, and 1 year after provision of new prostheses. RESULTS: Improvements in levels of general satisfaction with teeth, appearance of teeth, and perceived masticatory ability were significant for the FPD group. Significant improvements in perceived masticatory ability were noted for both groups. There were also significant improvements in perceived levels of comfort of mandibular prostheses in both groups. Changes in summary satisfaction scores indicated improved satisfaction for both treatment groups but suggested a larger clinical effect for the FPD group. Significant differences between treatment groups were not established. CONCLUSION: Patient-based outcomes reported suggested that resin-bonded cantilever FPDs are an effective means of restoring the shortened mandibular dental arch in terms of patient comfort and acceptance.
Adult↗