Risk factors for anaesthetic-related death in referred dogs.
Explore the source record for details and available documents.
Acepromazine↗
Biomedical subjects
R Hammond
Publications and source records attributed to R Hammond.
Spontaneous chronic spinal subdural hematoma associated with spinal arachnoiditis and syringomyelia.
Spontaneous chronic spinal subdural hematoma is rare. We describe a case of spontaneous chronic spinal subdural hematoma associated with arachnoiditis and syringomyelia in a 76-year old woman who presented with a 14-year history of progressive myelopathy. MRI scan revealed a thoraco-lumbar subdural cystic lesion and a thoracic syrinx. The patient underwent thoracic laminectomy and decompression of the lesion, which was a subdural hematoma. A myelotomy was performed to drain the syrinx. Pathological examination revealed features consistent with chronic subdural membrane. This report attempts to elucidate the pathogenesis of chronic spinal subdural hematoma. We discuss possible etiological factors in light of the current literature and pathogenesis of both spinal subdural hematoma and syrinx formation.
Aged↗
Changing occupational therapy and physiotherapy practice through guidelines and audit in the United Kingdom.
BACKGROUND: The National Clinical Guidelines for Stroke (NCGS) were produced and three rounds of the National Sentinel Audit of Stroke conducted to improve the quality of stroke care in the UK. OBJECTIVE: To compare the results of the occupational therapy and physiotherapy elements of the most recent national sentinel audit with the occupational therapy- and physiotherapy-specific recommendations of the NCGS. METHODS: Retrospective case-note audit. RESULTS: Over 95% of hospitals/sites who manage stroke in England, Wales and Northern Ireland took part in the most recent round of the sentinel audit. The clinical audit took place from 1 April to 30 June 2001 and incorporated 235 hospitals/sites. The organizational audit took place in January 2002 and incorporated 240 hospitals/sites. Data are presented from the 235 with both clinical and organizational data, under the headings of: approaches to rehabilitation; carers/families; rehabilitation interventions; and transfer to the community. Low rates of compliance with national standards were observed for all domains. CONCLUSION: Our findings suggest that occupational therapists and physiotherapists are not fully complying with the national standards for stroke care.
England↗
Psychiatric inpatient care for adults with intellectual disabilities: generic or specialist units?
BACKGROUND: When adults with intellectual disabilities (ID) require a psychiatric admission, general adult mental health units are often used. Specialist units have emerged recently as a care option but there is only limited evidence of their effectiveness. Thus this study aims to describe and evaluate the effectiveness of a specialist inpatient unit and report on the utilization of generic and specialist inpatient services. METHOD: All patients admitted to a specialist ID psychiatric unit were evaluated on admission and immediately after discharge on a number of outcome measures. In addition, they were compared with those admitted to general adult mental health units covering the same catchment area. RESULTS: Significant improvements were demonstrated within the specialist unit cohort on measures including psychopathology, global level of functioning, behavioural impairment and severity of mental illness. The specialist unit patients had a longer length of inpatient stay but were less likely to be discharged to out-of-area residential placement. CONCLUSIONS: Specialist units are an effective care option for this group of people.
Adult↗
The Framework Convention on Tobacco Control: promising start, uncertain future.
Explore the source record for details and available documents.
Global Health↗
Postanaesthetic cerebral necrosis in five horses.
Explore the source record for details and available documents.
Anesthesia, General↗
School-associated violent deaths in the United States, 1994-1999.
CONTEXT: Despite the public alarm following a series of high-profile school shootings that occurred in the United States during the late 1990s, little is known about the actual incidence and characteristics of school-associated violent deaths. OBJECTIVE: To describe recent trends and features of school-associated violent deaths in the United States. DESIGN, SETTING, AND SUBJECTS: Population-based surveillance study of data collected from media databases, state and local agencies, and police and school officials for July 1, 1994, through June 30, 1999. A case was defined as a homicide, suicide, legal intervention, or unintentional firearm-related death of a student or nonstudent in which the fatal injury occurred (1) on the campus of a public or private elementary or secondary school, (2) while the victim was on the way to or from such a school, or (3) while the victim was attending or traveling to or from an official school-sponsored event. MAIN OUTCOME MEASURES: National estimates of risk of school-associated violent death; national trends in school-associated violent deaths; common features of these events; and potential risk factors for perpetration and victimization. RESULTS: Between 1994 and 1999, 220 events resulting in 253 deaths were identified; 202 events involved 1 death and 18 involved multiple deaths (median, 2 deaths per multiple-victim event). Of the 220 events, 172 were homicides, 30 were suicides, 11 were homicide-suicides, 5 were legal intervention deaths, and 2 were unintentional firearm-related deaths. Students accounted for 172 (68.0%) of these deaths, resulting in an estimated average annual incidence of 0.068 per 100 000 students. Between 1992 and 1999, the rate of single-victim student homicides decreased significantly (P =.03); however, homicide rates for students killed in multiple-victim events increased (P =.047). Most events occurred around the start of the school day, the lunch period, or the end of the school day. For 120 (54.5%) of the incidents, respondents reported that a note, threat, or other action potentially indicating risk for violence occurred prior to the event. Homicide offenders were more likely than homicide victims to have expressed some form of suicidal behavior prior to the event (odds ratio [OR], 6.96; 95% confidence interval [CI], 1.96-24.65) and been bullied by their peers (OR, 2.57; 95% CI, 1.12-5.92). CONCLUSIONS: Although school-associated violent deaths remain rare events, they have occurred often enough to allow for the detection of patterns and the identification of potential risk factors. This information may help schools respond to this problem.
Adolescent↗
Comparison of spectroscopic techniques for the determination of Kjeldahl and ammoniacal nitrogen content of farmyard manure.
The feasibility of determining the nitrogen content of farmyard manure using infrared spectroscopy was investigated. Fifteen samples each of cattle, pig, and turkey manure were analyzed by three infrared techniques: Fourier transform mid-infrared (MIR), using attenuated total reflection (ATR); near-infrared reflectance (NIR-R); and near-infrared optothermal photoacoustic (NIR-OT). The near-infrared measurements were made at wavelengths determined respectively by four (NIR-OT) and five (NIR-R) band-pass filters. The total nitrogen (using the Kjeldahl method) and volatile (ammoniacal) nitrogen contents of all samples were measured by wet chemistry. Internally cross-validated (ICV) partial least-squares (PLS) regression was then used to obtain calibrations for the nitrogen content. The data sets obtained by each technique were treated separately. Within these sets, data from each manure type were treated both separately and combined: the best predictive ability was obtained by combining data from all three manure types. From the combined data set, the residual standard deviations and correlation coefficients for the ICV-predicted versus actual Kjeldahl nitrogen content were, respectively, 6772 mg/kg dry wt, 0.862 (MIR); 9434 mg/kg dry wt, 0.771 (NIR-OT); and 8943 mg/kg dry wt, 0.865 (NIR-R). For the ammoniacal nitrogen content, the residual standard deviations and correlation coefficients were 3869 mg/kg dry wt, 0.899 (MIR); 6079 mg/kg dry wt, 0.820 (NIR-OT); and 3498 mg/kg dry wt, 0.961 (NIR-R).
Animals↗
Mug shot exposure prior to lineup identification: interference, transference, and commitment effects.
The effects of viewing mug shots on subsequent identification performance are as yet unclear. Two experiments used a live staged-crime paradigm to determine if interpolated eyewitness exposure to mug shots caused interference, unconscious transference, or commitment effects influencing subsequent lineup accuracy. Experiment 1 (N = 104) tested interference effects. Similar correct decision rates were obtained for the mug shot and no mug shot groups from both perpetrator-present and absent lineups. Experiment 2 (N = 132) tested for commitment and transference effects. Results showed that the commitment group made significantly more incorrect identifications than either the control or the transference group, which had similar false-identification rates. Commitment effects present a serious threat to identification accuracy from lineups following mug shot searches.
Adult↗
Seizures in infants and young children: an exploratory study of family experiences and needs for information and support.
An exploratory study of the experiences of parents caring for young children with seizure disorders and their perceived needs for information and support was conducted. A questionnaire and interview protocol was designed to elicit information about the child's seizure history, child and parent health history, medical and support services, child and family demographic information, parent experiences in caring for a young child with seizures, and perceptions about needs for information and support. Interviews were conducted with 31 parents who were recruited from a pediatric neurology clinic at a university hospital. Interviews were audiotaped, transcribed, and analyzed for major themes. The study revealed a broad range of experiences in caring for young children with seizures, and the early onset and severity of seizures often influenced these experiences. Obtaining information that was easily accessible and helped them to better understand their child's diagnosis and treatment was a challenge reported by many parents. In addition, interviews revealed that parents felt a need for support and information from individuals who were knowledgeable about the medical, developmental, emotional, and family issues related to coping with seizures in infants and young children. Recommendations for a comprehensive approach to the management of seizures for infants and young children are proposed, with particular focus on the role of nurses and early intervention professionals in providing information and support to families.
Activities of Daily Living↗
Seroprevalence of varicella zoster virus, parvovirus B19 and Toxoplasma gondii in a Melbourne obstetric population: implications for management.
At an antenatal clinic at a Melbourne obstetric hospital, 308 women were questioned about a known past history of infection with varicella zoster virus (VZV), human parvovirus B19 and Toxoplasma gondii. Immunoglobulin G (IgG) concentrations were determined for the 3 infectious agents and a recalled history of infection was compared with the presence of specific antibody. Exactly 66% of women recalled being infected with chickenpox (VZV) and 94% showed serological evidence of past exposure. Although 64% of women had parvovirus specific IgG, only one gave a definite history of past parvovirus infection. None of the 23% of women with evidence of previous exposure to Toxoplasma gondii recalled a past infection. The proportion of antenatal women at risk in this study was used to estimate the potential burden of disease from congenital infections in Australia and to examine implications for management of pregnancies complicated by these 3 infections.
Adolescent↗
Multiparametric MRI tissue characterization in clinical stroke with correlation to clinical outcome: part 2.
BACKGROUND AND PURPOSE: Multiparametric MRI generates different zones within the lesion that may reflect heterogeneity of tissue damage in cerebral ischemia. This study presents the application of a novel model of tissue characterization based on an angular separation between tissues obtained with the use of an objective (unsupervised) computer segmentation algorithm implementing a modified version of the Iterative Self-Organizing Data Analysis Technique (ISODATA). We test the utility of this model to identify ischemic tissue in clinical stroke. METHODS: MR parameters diffusion-, T2-, and T1-weighted imaging (DWI, T2WI, and T1WI, respectively) were obtained from 10 patients at 3 time points (30 studies) after stroke: acute (</=12 hours), subacute (3 to 5 days), and chronic (3 months). The National Institutes of Health Stroke Scale (NIHSS) was measured, and volumes were obtained from the ISODATA, DWI, and T2WI maps on patients at each time point. RESULTS: The acute (</=12 hours) multiparametric ISODATA volume was significantly correlated with the acute (</=12 hours) DWI (r=0.96, P<0.05; n=10) and chronic (3 months) T2WI volume (r=0.69, P<0.05; n=10). The ISODATA-defined tissue regions exhibited MR indices consistent with ischemic and/or infarcted tissue at each time point. The acute (</=12 hours) multiparametric ISODATA volumes were significantly correlated (r=0.82, P<0.009; n=10) with the final NIHSS score. In comparison, the acute (</=12 hours) DWI volumes were less correlated (r=0.77, P<0.05; n=10) and T2WI volume (</=12h) exhibited a marginal correlation (r=0.66, P<0.05; n=10) with the final NIHSS score. CONCLUSIONS: The integrated ISODATA approach to tissue segmentation and classification discriminated abnormal from normal tissue at each time point. The ISODATA volume was significantly correlated with the current MR standards used in the clinical setting and the 3-month clinical status of the patient.
Adult↗
Outbreak of Salmonella serotype Anatum infection associated with unpasteurized orange juice.
In March 1999, a patient was infected with Salmonella serotype Anatum after having consumed unpasteurized orange juice from a manufacturer in Florida. We conducted a cohort study among customers of the manufacturer, performed pulsed-field gel electrophoresis (PFGE) on isolates, and inspected the manufacturing plant. Surveillance data identified three additional patients infected with Salmonella Anatum showing indistinguishable or closely related PFGE patterns. Three of the four patients had consumed orange juice from the same manufacturer. In the cohort study, 6 of 68 persons (9%) who consumed orange juice and/or orange ice cream from the manufacturer were ill, compared with 1 of 47 (2%) who did not. A positive antigen test for Salmonella species and coliform growth in juice samples taken from the production line suggested contamination during the manufacturing process. Commercially produced orange juice should be pasteurized or otherwise processed to achieve equivalent reduction of pathogens.
Child, Preschool↗
The age-specific prevalence of human parvovirus immunity in Victoria, Australia compared with other parts of the world.
The age-specific immunity to human parvovirus infection was estimated in Victoria, Australia using prospectively collected samples from the Royal Children's Hospital, the Royal Women's Hospital and the Australian Red Cross Blood Service and from sera stored at the Victorian Infectious Diseases Reference Laboratory (VIDRL). All testing was performed at VIDRL using a commercial enzyme-linked immunosorbent assay (Biotrin). Of the 824 sera tested, 28% of those drawn from people aged 0-9 years contained protective antibodies to human parvovirus. This rose to 51% in the next decade of life. There was then a slow rise to about 78% immunity over 50 years of age. An analysis of all requests for parvovirus serology at VIDRL from 1992 to 1998 suggested that parvovirus tended to occur in 4-year cycles, with 2 epidemic years followed by 2 endemic years. A review of published reports of parvovirus immunity suggested that parvovirus infection may be more common, with a correspondingly higher proportion of the community immune, in temperate as opposed to tropical countries.
Adolescent↗
Damage and repair of DNA in HIV encephalitis.
Neuronal damage and dementia are common sequelae of HIV encephalitis. The mechanism by which HIV infection of CNS macrophages results in neuronal damage is not known. We examined the brains from 15 AIDS autopsies (8 with HIV encephalitis and 7 without) and 4 non-infected control autopsies for the presence of DNA strand breaks, for associated changes in the expression of the DNA repair enzymes KU80 and Poly (ADP-ribose) polymerase (PARP), and for accumulation of amyloid precursor protein (APP). Abundant DNA damage was observed with terminal transferase-mediated dUTP nick end-labeling (TUNEL), however, there was no morphologic evidence of significant neuroglial apoptosis. The DNA repair enzyme KU80 was immunocytochemically detectable in neuronal and glial cells in autopsy brains from patients with and without HIV encephalitis; however, in cases with HIV encephalitis the staining was more prominent than in the infected or non-infected controls without encephalitis. There was no difference in KU80 immunostaining in oligodendroglia from autopsies with and without encephalitis. Immunostaining for PARP was more intense in gray and white matter of cases with HIV encephalitis. No clear spatial relationship existed between expression of DNA repair enzymes and the spatial proximity of microglial nodules or HIV-infected macrophages. The cytoplasm of cortical and subcortical neurons immunostained for APP Stronger cortical neuronal APP staining was observed in cases without HIV encephalitis. Staining of deep gray matter neurons was similar, irrespective of the presence or absence of encephalitis. While foci of intense APP staining were noted in white matter not related to HIV infection, they were associated with foci of opportunistic infections (e.g. due to CMV or PML). We conclude that damaged DNA and altered patterns of expression of DNA repair proteins and APP are common findings in the brains of AIDS patients at autopsy, but do not have a spatial relationship to HIV-infected macrophages.
AIDS Dementia Complex↗
Knowledge and attitudes of pediatric office nursing staff about breastfeeding.
This descriptive study documents nurses' breastfeeding knowledge and attitudes. The nursing staffs of 27 private pediatric practices in North Carolina were surveyed. The 42-item questionnaire included questions about who was responsible for breastfeeding support, what staff nurses knew and believed about breastfeeding, and where their breastfeeding education was obtained. The response rate was 59% (134 out of 227). Only 5% responded that a breastfeeding patient experiencing problems would be referred to a physician, whereas 81% selected a lactation consultant, and 38% selected a member of the nursing staff. Knowledge scores ranged from 19 to 33 (out of 33). Attitude scores ranged from 10 to 30 (out of 30). Only 46% of respondents reported having received breastfeeding education in their training programs; 85% had received on-the-job training. The nurses surveyed were involved in breastfeeding support, yet many had incorrect information and negative attitudes toward breastfeeding.
Adult↗
Novel inhibitors of Erm methyltransferases from NMR and parallel synthesis.
The Erm family of methyltransferases confers resistance to the macrolide-lincosamide-streptogramin type B (MLS) antibiotics through the methylation of 23S ribosomal RNA. Upon the methylation of RNA, the MLS antibiotics lose their ability to bind to the ribosome and exhibit their antibiotic activity. Using an NMR-based screen, we identified a series of triazine-containing compounds that bind weakly to ErmAM. These initial lead compounds were optimized by the parallel synthesis of a large number of analogues, resulting in compounds which inhibit the Erm-mediated methylation of rRNA in the low micromolar range. NMR and X-ray structures of enzyme/inhibitor complexes reveal that the inhibitors bind to the S-adenosylmethionine binding site on the Erm protein. These compounds represent novel methyltransferase inhibitors that serve as new leads for the reversal of Erm-mediated MLS antibiotic resistance.
Binding Sites↗
Induction of ribosome methylation in MLS-resistant Streptococcus pneumoniae by macrolides and ketolides.
One major mechanism for resistance to macrolide antibiotics in Streptococcus pneumoniae is MLS (macrolide, lincosamide, and streptogramin B) resistance, manifested when the 23S rRNA is methylated by the product of an erm gene. This modification results in the decreased binding of all known macrolide, lincosamide, and streptogramin B antibiotics to the ribosome. More than 30 ermAM-containing clinical isolates of S. pneumoniae were examined in our lab and showed high-level resistance (MIC > or =128 microg/ml) to erythromycin, azithromycin, tylosin, clindamycin, and ketolide (macrolides that lack the cladinose sugar) TE-802. We found that the new generation of ketolides A965 and A088 displayed variable activity against the same group of resistant S. pneumoniae strains. To understand the basis of variability of the minimal inhibitory concentration (MIC) values of A965 and A088, we examined the effects of a series of macrolides and ketolides on the level of 23S rRNA methylation in five ermAM-containing resistant S. pneumoniae isolates. We show here that the basal levels of ribosomal methylation vary from strain to strain. The level of rRNA methylation can be strongly induced by erythromycin, azithromycin, and TE-802, resulting in high-level of resistance to these compounds. Ketolide A965 and A088, however, are weak inducers at sub-MIC drug concentrations, therefore showing variable activities in strains with differential methylation levels.
Anti-Bacterial Agents↗