PubMed Health⌕ Search

Biomedical subjects

R Walker

Publications and source records attributed to R Walker.

At least 73 records · Page 4Linked to original sources
PubMed2001

Dissemination of heart health promotion: lessons from the Canadian Heart Health Initiative Ontario Project.

Situated in central-eastern Canada, Ontario is the largest province with a population of 11 million. Ontario is considered a fairly rich province at the centre of Canada's manufacturing and financial sectors. Public health services in Ontario are primarily delivered through public health departments, each administered by a local board of health and regulated by provincial legislation and program guidelines. The Canadian Heart Health Initiative Ontario Project (CHHIOP) was a four year project (1994 to 1998) undertaken as part of the dissemination phase of the Canadian Heart Health Initiative (CHHI) (see O'Loughlin et al., p.4). CHHIOP is one component of a long-term process to develop and implement effective heart health programs in Ontario.

Canada↗
PubMed2000

Phase I trial of 6-hour infusion of glufosfamide, a new alkylating agent with potentially enhanced selectivity for tumors that overexpress transmembrane glucose transporters: a study of the European Organization for Research and Treatment of Cancer Early Clinical Studies Group.

PURPOSE: To determine the maximum-tolerated dose (MTD), the principal toxicities, and the pharmacokinetics of 6-hour infusion of glufosfamide (beta-D-glucosylisophosphoramide mustard; D-19575), a novel alkylating agent with the potential to target the glucose transporter system. PATIENTS AND METHODS: Twenty-one patients (10 women and 11 men; median age, 56 years) with refractory solid tumors were treated with doses ranging from 800 to 6,000 mg/m(2). Glufosfamide was administered every 3 weeks as a two-step (fast/slow) intravenous infusion over a 6-hour period. All patients underwent pharmacokinetic sampling at the first course. RESULTS: The MTD was 6,000 mg/m(2). At this dose, two of six patients developed a reversible, dose-limiting renal tubular acidosis and a slight increase in serum creatinine the week after the second and third courses of treatment, respectively, whereas three of six patients experienced short-lived grade 4 neutropenia/leukopenia. Other side effects were generally mild. Pharmacokinetics indicated linearity of area under the time-versus-concentration curve against dose over the dose range studied and a short elimination half-life. There was clear evidence of antitumor activity, with a long-lasting complete response of an advanced pancreatic adenocarcinoma and minor tumor shrinkage of two refractory colon carcinomas and one heavily pretreated breast cancer. CONCLUSION: The principal toxicity of 6-hour infusion of glufosfamide is reversible renal tubular acidosis, the MTD is 6,000 mg/m(2), and the recommended phase II dose is 4, 500 mg/m(2). Close monitoring of serum potassium and creatinine levels is suggested for patients receiving glufosfamide for early detection of possible renal toxicity. Evidence of antitumor activity in resistant carcinomas warrants further clinical exploration of glufosfamide in phase II studies.

Adult↗
PubMed2000

The oculomotor distractor effect in normal and hemianopic vision.

The present study investigated the inhibitory effect of visual distractors on the latency of saccades made by hemianopic and normal human subjects. The latency of saccades made by hemianopic subjects to stimuli in their intact visual field was not affected by visual distractors presented within their hemianopic field. In contrast, the latency of saccades made by normal subjects was increased significantly under distractor conditions. The latency increase was larger for temporal than nasal distractors. The results are inconsistent with previous proposals that the crossed retinotectal pathway from the nasal hemiretina to the superior colliculus may mediate a blindsight inhibitory effect when distractors appear within a hemianopic temporal visual field. Instead, the distractor effect appears to reflect the normal processes involved in saccade target selection which may be mediated by a circuit involving both cortical and subcortical structures.

Adolescent↗
PubMed2000

Sustained kilowatt lasing in a free-electron laser with same-cell energy recovery

Jefferson Laboratory's kW-level infrared free-electron laser utilizes a superconducting accelerator that recovers about 75% of the electron-beam power. In achieving first lasing, the accelerator operated "straight ahead" to deliver 38-MeV, 1.1-mA cw current for lasing near 5 &mgr;m. The waste beam was sent directly to a dump while producing stable operation at up to 311 W. Utilizing the recirculation loop to send the electron beam back to the linac for energy recovery, the machine has now recovered cw average currents up to 5 mA, and has lased cw with up to 1720 W output at 3.1 &mgr;m.

Journal Article↗
PubMed2000

Turbo STIR magnetic resonance imaging as a whole-body screening tool for metastases in patients with breast carcinoma: preliminary clinical experience.

This study was undertaken to assess the utility of whole-body turbo short tau inversion recovery (STIR) magnetic resonance imaging (MRI) to detect metastases to liver, brain, and bone as a single examination in women with breast cancer. Seventeen patients with biopsy-proven breast cancer and suspected metastatic disease attending over a 12-month period referred for both conventional imaging and whole-body MRI were included in the study. Three patients were found to be free of metastases at both conventional and MR imaging. Appendicular or axial skeletal metastases were identified in 11 of 17 patients, with correlation between findings at whole-body MRI and scintigraphy in 15 of the 17 patients. Five patients had evidence of hepatic metastases on whole-body MRI, of which metastases were identified in only three patients at CT despite contrast enhancement. Four patients had brain abnormalities (metastases in three patients, meningioma in one patient) detected on both whole-body and dedicated brain MRI. Preliminary clinical experience suggests that turbo STIR whole-body MRI may represent a convenient and cost-effective method of total body screening for metastases in patients with breast carcinoma.

Adult↗
PubMed2000

An analysis of the possibility for health implications of joint actions and interactions between food additives.

The possibility that structurally unrelated food additives could show either joint actions or interactions has been assessed based on their potential to share common sites and mechanisms of action or common pathways of elimination. All food additives approved in the European Union and allocated numerical acceptable daily intake values were studied, initially based on the reports by the FAO-WHO Joint Expert Committee for Food Additives. Target organs were identified based on the effects reported at doses above the no-observed-adverse-effect level (NOAEL) in animal and human studies. The descriptions of the pathological and other changes reported were used to assess whether different additives, sharing the same target organ, would produce a common toxic effect. In all but a very few cases, the possibility of joint actions or interactions could be excluded on scientific grounds. The exceptions were on the liver (curcumin, thiabendazole, propyl gallate, and BHT), the kidney (diphenyl, o-phenylphenol, and ferrocyanide salts), the blood (azorubine and propyl gallate), and the thyroid (erythosine, thiabendazole, and nitrate). Toxicokinetic interactions were considered unlikely because of the low dosages involved, the diverse nature of the routes of metabolism and elimination, and the fact that enzyme induction or inhibition would have influenced selection of the NOAEL. Many of those additives which could not be excluded from showing joint actions or interactions would have low intakes; in some cases they were alternatives for the same application, thereby further lowering the combined intake. In consequence, joint actions or interactions between additives do not represent a significant health concern.

Drug Interactions↗
PubMed2000

Collaborative study for the quality control of trace element determinations in paint coatings. Part 2. Certification of alkyd resin paint reference materials for the migratable contents of trace elements (CRMs 620 and 623).

This paper describes the preparation, homogeneity studies and certification of a series of two paint reference materials (mild steel coated with alkyd resin paint, CRM620, and comminuted paint from alkyd resin paint, CRM623) which have been produced in support of the EU Toy Safety Directive (88/378/EEC). The reference materials have been certified for levels of toxic element migration using the method specified in European Standard EN71-3:1994 published by the European Committee for Standardization. As such, the certified values, indicative values and range data quoted for the reference materials in this paper are method specific and relate only to European Standard EN71-3:1994. The paper summarizes the analytical work carried out and gives a description of the analytical methods used to measure As, Ba, Cd, Cr, Hg, Pb, Sb and Se, the 8 toxic elements specified in European Standard EN71-3:1994, in the sample extracts. Descriptions of the reference materials, certified values, indicative values together with their associated uncertainties or range of laboratory means as appropriate are given. The preparation of a (not certified) reference material (beechwood coated with nitrocellulose paint, RM621) is also described and assigned values for As, Ba, Cd and Se are given. The Hg content could not be certified in any of the reference materials, owing to a high dispersion of results.

Certification↗
PubMed2000

Control of voluntary and reflexive saccades.

The latency of 'reflexive' saccades (made in response to peripheral visual stimuli) was compared to that of 'voluntary' saccades performed in anti-saccade and symbolically cued paradigms. Manipulation of visual events at fixation was carefully controlled across all conditions. Reflexive saccade latency was significantly faster than the latency of all forms of voluntary saccades. Importantly, the latency of saccades made after presentation of a symbolic cue at central fixation (voluntary arrow-cue condition) was greater than that made in the anti-saccade paradigm that requires suppression of a reflexive response. It is suggested that the increase in latency of saccades made in the voluntary arrow-cue condition may reflect differences in programming a 'When' trigger signal for saccades made in the absence of a peripheral stimulus.

Adult↗
PubMed2000

The range and biological activity of FMRFamide-related peptides and classical neurotransmitters in nematodes.

Nematodes include both major parasites of humans, livestock and plants in addition to free-living species such as Caenorhabditis elegans. The nematode nervous system (especially in C. elegans) is exceptionally well defined in terms of the number, location and projections of the small number of neurons in the nervous system and their integration into circuits involved in regulatory behaviours vital to their survival. This review will summarize what is known about the biological activity of neurotransmitters in nematodes: the biosynthetic pathways and genes involved, their receptors, inactivation mechanisms and secondary messenger signalling systems. It will cover the 'classical' transmitters, such as acetylcholine (ACh), GABA, glutamate, serotonin, dopamine, octopamine, noradrenaline and nitric oxide. The localization of peptides throughout the nematode nervous system is summarized, in addition to the isolation of nematode neuropeptides by both traditional biochemical techniques and more modern genetic means. The major contribution of the completion of the C. elegans genome-sequencing program is highlighted throughout. Efforts to unravel neurotransmitter action in various physiological actions such as locomotion, feeding and reproduction are detailed as well as the various inactivation mechanisms for the current complement of nematode transmitters.

Animals↗
PubMed2000

Assessment of HER2 status in breast cancer: why, when and how?

Human epidermal growth factor receptor 2 (HER2) is overexpressed, usually as a result of HER2 proto-oncogene amplification, in 20-30% of breast cancers. A HER2-positive status is generally associated with more aggressive disease and a worse prognosis. Furthermore, a positive HER2 status may predict the likelihood of resistance to some conventional therapies, as well as probably being predictive of sensitivity to anthracycline dose intensification. In addition to this prognostic/predictive value, HER2 is a target for specific therapy, with anti-HER2 monoclonal antibody therapy available in the USA. This article reviews the different assays used to determine HER2 status, discussing their relative advantages/disadvantages and the need for their standardisation before integration alongside other pathological indices into the clinical management of breast cancer.

Biomarkers, Tumor↗
PubMed2000

Clinical decision-support systems for intensive care units using case-based reasoning.

The artificial intelligence approach used in this work focusses on case-based reasoning techniques for the estimation of medical outcomes and resource utilization. The systems were designed with a view to help medical and nursing personnel to assess patient status, assist in making a diagnosis, and facilitate the selection of a course of therapy. The initial prototype provided information on the closest-matching patient cases to the newest patient admission in an adult intensive care unit (ICU). The system was subsequently re-designed for use in a neonatal ICU. The results of a short clinical pilot evaluation performed in both adult and neonatal units are reported and have led to substantial improvement of the prototype. Future work will include longer-term clinical trials for both adult and neonatal ICUs, once all the software changes have been made to both prototypes in response to the comments of the users made during the preliminary evaluations. To date, the results are very encouraging and physician interest in the potential clinical usefulness of these two systems remains high, and particularly so in the new testing environment in Ottawa.

Adult↗