Biomedical subjects

Roger Hall

Publications and source records attributed to Roger Hall.

5 recordsLinked to original sources

PubMed2006

Vaccination of calves with an attenuated cell line of Theileria annulata and the sporozoite antigen SPAG-1 produces a synergistic effect.

The sporozoite surface antigen, SPAG-1 and the attenuated schizont infected Tunisian line CL1 of Theileria annulata have been shown, in previous studies, to induce variable levels of protection against homologous and heterologous sporozoite challenge, respectively. We report here the result of a vaccination trial comparing the protection level induced by the SPAG-1 antigen (as a recombinant full length His tagged protein) and the attenuated cell line, used singly or in combination. The results, after challenge of immunised calves with a lethal dose of sporozoites, show that SPAG-1 provides limited protection (one out of seven calves surviving), while the attenuated cell line provides moderate protection (three out of seven calves recovered). The combination of SPAG-1 and the attenuated cell line induced the best protection as indicated by the survival of all the vaccinated calves. These results, together with a range of parasitological and clinical parameters, demonstrate the enhanced protection provided by combining sporozoite and schizont antigens in vaccination against tropical theileriosis.

Animals↗

PubMed2006

Enhanced external counterpulsation for treatment of refractory angina pectoris.

OBJECTIVE: Enhanced external counterpulsation (EECP) is a noninvasive, well-tolerated treatment, effective for managing patients with refractory angina pectoris. The aim of this study was to evaluate the efficacy of EECP to relieve symptoms, to decrease myocardial ischaemia and to improve cardiac performance in patients with intractable angina, refractory to surgical and medical treatment. METHODS: Twenty-five patients (24 men and one woman, mean age 65 years) with persistent ischaemia notwithstanding optimal medical therapy or after interventional or surgical procedure, received EECP sessions for 35 h. Each patient underwent dobutamine stress echocardiography before and after treatment. We evaluated modifications in either cardiac systolic or diastolic function, and in wall motion score index. RESULTS: Eighty-four percent of patients showed an increase in at least one functional angina class. We did not observe any significant changes in fractional shortening and diastolic function. Thirty-six percent of patients had a reduction in the area of inducible ischaemia at dobutamine stress echocardiography after treatment. Unfortunately, because of the small sample size, we did not find any statistically significant difference. There was a trend showing that patients who benefited the most were those with the worst systolic function and with severely compromised segmental kinesis (P = NS). CONCLUSIONS: EECP is effective in relieving symptoms in patients with refractory angina and may reduce inducible ischaemia at dobutamine stress echocardiography, especially in patients with reduced systolic function and compromised segmental kinesis.

Aged↗

PubMed2004

Learning on the Web. Case 6: aortic valve replacement in the elderly.

A 90 year old man was found at home by his daughter, slumped at the bottom of his stairs. He recalled quite severe tight central chest pain associated with breathlessness and sweating while going up stairs which was not relieved by taking a spray of sublingual glyceryl trinitrate (GTN). He sensed that he was "about to die" before collapsing with loss of consciousness. He was sent to the accident and emergency department (emergency room) of his local hospital by ambulance. The patient had a five year history of angina pectoris that limited him to one flight of stairs within the house and light housework only. Over the two weeks preceding his admission to hospital he had experienced increasing frequency of these symptoms and used his GTN spray more often than usual. He had not smoked for over 50 years and there were no other risk factors for cardiovascular disease. There was no other notable past medical history and he was otherwise fit, living completely independently. The significance of these signs and symptoms, the diagnosis, and the short and long term treatment of these problems are discussed in an interactive case presentation.

Aged, 80 and over↗

PubMed2004

Learning on the Web. Case 5: infective endocarditis.

A 70 year old man presented with microscopic haematuria and proteinuria and a fever five months after having a transurethral resection of the prostate (TURP). Initially urological review was arranged as the family doctor thought that a urinary infection was the most likely diagnosis. The patient was concerned that he was not getting better and he self-referred to a physician. He had continuing fever, weight loss, and malaise. The physician detected a mitral pan-systolic murmur that had not been heard before. On the basis of this finding infective endocarditis was suspected and investigations begun. His subsequent course and its management are discussed in an interactive case presentation.

Aged↗

PubMed2003

Learning on the Web. Case 1: syncope and palpitation in a patient following aortic valve replacement.

A usually very fit man aged 90 presented with syncope and angina of effort. He was found to have severe calcific aortic stenosis and associated coronary disease restricted to the left anterior descending (LAD) coronary artery. He underwent an aortic valve replacement with tissue prosthesis and a single coronary graft to the LAD. He came off bypass without difficulty but on the third postoperative period, when he had left the intensive care unit and was making excellent progress mobilising, he had further episodes of syncope and also developed palpitations. The significance of these symptoms and the diagnosis and treatment of these postoperative problems is discussed in an interactive case presentation.

Aged, 80 and over↗