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Biomedical subjects

R Gillespie

Publications and source records attributed to R Gillespie.

At least 19 recordsLinked to original sources
PubMed2000

Human immunodeficiency virus-related primary cutaneous aspergillosis.

A 31-year-old Caucasian man with AIDS developed a crusted violaceous plaque under adhesive tape near a central venous catheter insertion site. Histological examination demonstrated a ruptured hair follicle containing collections of fungal hyphae typical of Aspergillus spp. A culture of the biopsy material grew Aspergillus fumigatus. The patient responded to removal of the catheter and the occlusive dressing, in addition to itraconazole therapy. Aspergillosis must be considered in the differential diagnosis of cutaneous lesions in human immunodeficiency virus-infected patients, in particular when the lesion occurs under adhesive tape or an occlusive dressing.

AIDS-Related Opportunistic Infections↗
PubMed2000

Voiding cystourethrograms and urinary tract infections: how long to wait?

OBJECTIVES: Many authorities recommend an interval of at least 3 to 6 weeks after a urinary tract infection (UTI) before performing a voiding cystourethrogram (VCUG). However, such an interval may reduce the likelihood of completing the procedure. This study was performed to investigate whether the length of the interval between a UTI and the performance of the VCUG influences the presence or severity of reflux, and whether it influences the likelihood of actually having the study performed. DESIGN: We reviewed 352 admissions of children under 10 years old whose discharge diagnoses indicated UTIs. These admissions occurred over a 27-month period between October 1994 and December 1996 at the Children's Hospital of Austin, Texas. We identified 213 patients with confirmed UTIs and no other previously defined urinary tract pathology. These patients were divided into 2 groups according to whether they had a VCUG scheduled to be performed either within 1 week after the diagnosis of a UTI (the early group), or later than 1 week after the diagnosis (the late group). We compared the presence and severity of reflux in the 2 groups as well as the proportion of scheduled VCUGs that were actually performed. RESULTS: Reflux was present in 19% of the patients studied within 1 week after UTI (95% confidence interval [CI]: 12.9-26.4) and in 18% of those studied after 1 week (95% CI: 6. 7-34.5). This difference was not statistically significant (chi(2) =. 034; DF = 1). However there was a substantial difference between the 2 groups with regard to the number of scheduled VCUGs actually performed. Whereas 100% of the scheduled VCUGs in the early group were performed, only 48% (95% CI: 35.9-60.1) of those scheduled in the late group were performed. This difference is statistically significant (chi(2) = 89.6; DF = 1). CONCLUSIONS: In the hospitalized children who underwent VCUGs within a week after diagnosis of UTI, the presence of reflux is not significantly different from those studied later. Furthermore, late scheduling of VCUGs resulted in failure to perform the procedure in more than half of the patients. Some of the patients who were not evaluated would be expected to have vesicoureteral reflux and thus be at risk for chronic renal disease. Therefore, the traditional recommendation to perform the VCUG at 3 to 6 weeks after the diagnosis of UTI should be reconsidered, especially for hospitalized children.

Child↗
PubMed1999

Comparison of clinical and genetic variables of cardiac events associated with loud noise versus swimming among subjects with the long QT syndrome.

Acute auditory stimuli and swimming activities are frequently associated with syncope, aborted cardiac arrest, and death in the long QT syndrome (LQTS). We investigated the clinical and genetic findings associated with cardiac events precipitated by these arousal factors. The study population involved 195 patients with an index cardiac event associated with a loud noise (n = 77) or swimming activity (n = 118). Patients with events associated with loud auditory stimuli were older at their index event and were more likely to be women than patients who experienced events during swimming-related activities. Patients with an index event associated with loud noise were likely to have subsequent events related to auditory stimuli; patients with an index event associated with swimming were likely to have recurrent events related to swimming or physical activities. Family patterning of auditory and swimming and/or physical activity-related events was evident. Genotype analyses in 25 patients revealed a significant difference in the distribution of index cardiac events by genotype (p <0.001), with all 19 patients with swimming-related episodes associated with LQT1 genotype and 5 of 6 patients with auditory-related events associated with LQT2 genotype. The clinical profile and genotype findings of patients with LQTS who experience cardiac events related to acute auditory stimuli are quite different from those who experience events accompanying swimming activities.

Acoustic Stimulation↗
PubMed1999

The lateral hypothalamic syndrome in the weanling rat: bone geometry and biomechanics.

Male weanling Sprague-Dawley rats received bilateral electrolytic lesions in the lateral hypothalamic area (LHAL). One group of sham-operated controls was fed ad lib (CON-ADLIB), another was pair fed to the LHAL group (CON-PF). The experiment was terminated 1 month after surgery. At that time, LHAL rats were 49% and CON-PF rats were 41% lighter than CON-ADLIB. Carcass protein in LHAL rats was significantly reduced in LHAL: versus CON-ADLIB. Linear growth was significantly reduced by 18% in LHAL versus CON-ADLIB, as well as LHAL: versus CON-PF by 6%. Mean caloric intake was significantly reduced by 48% in LHAL versus CON-ADLIB, as was caloric efficiency (body weight gained per calories eaten) by 36%, as well as, in CON-PF versus CON-ADLIB by 20%. LHAL rats showed a significantly shorter (10%), narrower (15%) and thinner (25 %) cortex at midshaft of the femur. Resistance to torsional loads was reduced by 25% in both LHAL and CON-PF, but this did not reach statistical significance, in comparison to CON-ADLIB. There was no statistical significance among the groups in stiffness and maximal angular displacement. We conclude that the reduced bone geometrical and biomechanical properties in both LHAL rats and CON-PF versus CON-ADLIB are similar because both former groups of rats were greatly subcaloric. Thus, the changes here observed are not due to a specific neuroendocrine/autonomic lesion effect but may be attributable to the reduced food intake, i.e., nutritional factors.

Animals↗
PubMed1998

Comparison of exercise electron beam computed tomography and sestamibi in the evaluation of coronary artery disease.

This blinded, single center study prospectively compares exercise electron beam computed tomography (EBCT) with stress technetium-99m (Tc-99m) sestamibi single-photon emission computed tomography (SPECT) in 33 patients undergoing coronary angiography for evaluation of chest pain. Patients undergoing routine cardiac catheterization for the diagnosis of chest pain were imaged at rest using EBCT. Patients exercised on a semi-supine ergometer, and exercise EBCT was immediately followed by injection of Tc-99m sestamibi for assessment of myocardial ischemia. At peak exercise, Tc-99m SPECT, followed immediately by nonionic contrast material, was injected intravenously to directly compare these 2 imaging techniques. Patients were reimaged with Tc-99m SPECT at rest 24 to 48 hours after stress. Exercise EBCT, which was analyzed using a global ejection fraction measure, had a sensitivity of 81% and a specificity of 76%, compared with angiography. Using the development of a new regional wall motion abnormality as evidence of obstructive coronary artery disease (CAD), EBCT yielded a specificity of 100% and a sensitivity of 88%. Reversible perfusion defects identified by SPECT, as evidence of obstructive CAD, revealed a sensitivity of 75% and a specificity of 71%. The specificity of regional wall motion analysis by EBCT was significantly better than SPECT (p <0.01) in this population. This study demonstrates regional wall motion assessed by EBCT to be as sensitive and more specific than SPECT myocardial perfusion imaging in identifying obstructive CAD as defined by angiography.

Aged↗
PubMed1998

The effects of dietary-induced obesity on the biomechanical properties of femora in male rats.

OBJECTIVE: To assess the effects of diet-induced obesity (DIO), on the biomechanical and biochemical properties of the femur in mature male rats. DESIGN AND SUBJECTS: Two groups of male rats were studied. The DIO experimental group was fed a high caloric diet and a 31% sucrose solution as drinking fluid for a month, whereas the control group was fed lab chow and tap water. MEASUREMENT: Body weight; body water; lean body mass; femoral length; average cortical thickness; outer anteroposterior diameter; outer mediolateral diameter; cortex area; moment of inertia; cortical and cancellous bone hydration; tendon and muscle hydration; ash content of cortical and cancellous bone; ultimate load; deflection at ultimate load; ultimate strength; stiffness; elastic modulus and energy absorption capacity. RESULTS: 'Gainers' (final body weight in excess of three standard error of mean of the controls) were 19.1% heavier, with higher body fat, whereas body water, lean body mass, hydration of cancellous bone and ash content of cortical bone were lower, when compared to controls. Rats that failed to gain weight, despite the high caloric diet, were termed 'resisters' (weight gain less than three standard error of mean of the controls). Ultimate load, deflection at ultimate load and femoral energy absorption capacity were significantly higher in the experimental group when compared to the controls. However, no differences were found among the groups with respect to ultimate stress and stiffness. CONCLUSION: The weight gain produced by DIO may lead to bone adaptation and improved biomechanics.

Analysis of Variance↗
PubMed1997

Septic Arthritis of the Hip in Children.

Recent advances in the management of septic arthritis of the hip in children include a better understanding of the effects of infection on articular cartilage; improvements in diagnostic tests, including erythrocyte sedimentation rate, C-reactive protein analysis, and ultrasonography; and more efficacious home intravenous and oral antibiotic therapy. Early diagnosis is essential to successful treatment. Needle aspiration is the most specific diagnostic test; however, false-negative results are possible. Prompt surgical drainage and postoperative antibiotic therapy until signs of infection resolve are necessary to prevent late sequelae. Surgical treatment of limb-length inequality is more useful than attempts to salvage the destroyed or incongruent joint.

Journal Article↗
PubMed1996

Women, the body and brand extension in medicine: cosmetic surgery and the paradox of choice.

This paper explores the relationship between Western medicine, female body image and gender inequalities. It evaluates the extent to which the medicalisation of appearance through cosmetic surgery may serve to reinforce limited and restrictive models of femininity. Collusion with these processes, it is suggested, may be rational for some women at the individual level as they seek to increase their social power in a society where women are judged by their appearance more than men. At the social level, however, such action can be seen to go against women's collective interests and perpetuate wider social inequalities.

Body Image↗
PubMed1994

Maternal ethanol consumption: effects on G proteins and second messengers in brain regions of offspring.

Previous work in this and other laboratories has demonstrated that in utero ethanol exposure adversely affects the development of the serotonergic, dopaminergic, cholinergic, and other neurotransmitter systems. In several of these systems, receptor number is significantly altered. To determine whether the altered number of two G protein-linked receptors is reflected in changes in cell function, we examined dopamine-stimulated adenylate cyclase in the striatum and cortex and carbachol-stimulated phosphoinositide (PI) hydrolysis in the cortex. Serotonin-stimulated cortical PI hydrolysis was assessed for comparison. We also studied G proteins that link adenylate cyclase and other second messenger systems to their receptors. The G proteins that were analyzed include the alpha-subunits for Gs, G0, Gi1, Gi2, and Gi3. G proteins were analyzed in the cortex and cortical regions, as well as in the brain stem. The results of these experiments demonstrated that dopamine-stimulated adenylate cyclase activity was comparable in the striatum of 5- and 19-day offspring of control and ethanol-fed rats and in the motor cortex of 19-day offspring. We also found that carbachol- and serotonin-stimulated hydrolysis of cortical phosphoinositides was unchanged in ethanol-exposed offspring on gestational day 19, and on postnatal days 5 and 19. G protein content was examined by Western blot analysis, using antibodies directed against the alpha-subunits of Gs, G0, and the Gi1/Gi2 and Gi3/G0 combinations. These investigations indicated that, with two minor exceptions (approximately 10% change in the proteins detected by antibodies against the alpha-subunits of the Gi1/Gi2 and Gi3/G0 combinations), there were no significant differences in the content of any of the G proteins analyzed.

Acetylcholine↗
PubMed1994

Importance of severity of coronary artery disease for the tolerance to normovolemic hemodilution. Comparison of single-vessel versus multivessel stenoses in a canine model.

The response of global cardiovascular and regional myocardial function (as seen with sonomicrometry) to continuous, progressive hemodilution (Dextran 70) was compared in dogs with proximal circumflex coronary artery stenosis and dogs with proximal circumflex coronary artery and proximal left anterior descending artery stenoses. Hemodilution-induced failure, defined as greater than 50% loss in function or death of the animal, was determined for systolic shortening in the circumflex coronary artery and left anterior descending artery territories, mean arterial pressure, and maximum left ventricular rate of pressure rise. Time to failure was compared between groups by log-rank tests. Systolic shortening of the circumflex coronary artery failed at a similar median time point in both groups (30 minutes in the group with single-vessel stenosis and hemodilution versus 40 minutes in the group with multivessel stenosis and hemodilution). Systolic shortening of the left anterior descending artery (80 versus 50 minutes), mean arterial pressure (70 versus 50 minutes), and maximum left ventricular rate of pressure rise (70 versus 40 minutes), however, failed significantly later (p < 0.01) in animals with single circumflex coronary artery stenosis. A marked increase (+50%) in systolic shortening of the left anterior descending artery was observed during hemodilution only in the circumflex coronary artery stenosis group. The better hemodilution tolerance in the circumflex coronary artery stenosis group may be explained by the compensatory increase in myocardial contractile function in non-coronary flow-compromised myocardium, which seems to be crucial for global cardiovascular stability during hemodilution in the presence of coronary stenoses.

Animals↗
PubMed1993

Multi-cultural health provision.

It has almost become a cliché now that the changes the NHS is currently undergoing are the most far reaching since its inception in 1948. Some say that the NHS and Community Care Act represents the greatest opportunity for improvement: Rosemary Gillespie looks at the means to better the NHS's poor record on provision for ethnic minorities.

Cultural Characteristics↗
PubMed1991

The classification and treatment of proximal femoral deficiencies.

After a review of previous classifications the authors suggest that cases of congenital longitudinal deficiency of the femur fall into one of two groups, each with specific features. The treatment alternatives and their indications are discussed in detail and a treatment plan suggested.

Congenital Abnormalities↗
PubMed1990

Hazards of internal fixation in the treatment of slipped capital femoral epiphysis.

We reviewed the records of 202 patients (308 hips) in whom a slipped capital femoral epiphysis had been fixed with pins or screws. A serious complication that was directly related to the use of internal fixation developed in eighty hips (26 per cent). The rate of complications in the 202 patients was 40 per cent. In thirty-six (18 per cent) of the 202 patients, an additional procedure was done to correct a pin-related complication. Forty-one hip joints had been penetrated by a pin. Other complications included avascular necrosis (fourteen hips), chondrolysis (nine), fracture (one), infection (one), further slippage (one), sciatic-nerve injury (one), and breakage of a screw (eight). Ways of decreasing the incidence of complications of fixation were explored.

Bone Nails↗