PubMed Health⌕ Search

Biomedical subjects

S Bloomfield

Publications and source records attributed to S Bloomfield.

At least 19 recordsLinked to original sources
PubMed2005

Surgical treatments for ingrowing toenails.

BACKGROUND: Ingrowing toenails are a common condition which, when recurrent and painful, are often treated surgically. OBJECTIVES: To evaluate the effectiveness of methods of the surgical treatment of ingrowing toenails. SEARCH STRATEGY: Electronic database searching (CENTRAL, MEDLINE, EMBASE, CINAHL) followed by investigation of reference lists of the papers identified from the initial search. SELECTION CRITERIA: Any randomised (or quasi-randomised) controlled trial which compares one form of surgical removal of all or part of a toenail due to its impact on the soft tissues to another or others. Studies must have a minimum follow period of six months and aim to permanently remove the troublesome portion of the nail. DATA COLLECTION AND ANALYSIS: Data extraction was carried out independently by the two reviewers using a pre-derived data extraction form and entered into RevMan. Categorical outcomes were analysed as odds ratios with 95% confidence intervals. MAIN RESULTS: Avulsion with phenol versus surgical excision: Phenolisation combined with simple avulsion of a nail is more effective than the use of more invasive excisional surgical procedures to prevent symptomatic recurrence at six months or more (OR 0.44 CI 95% 0.24 - 0.80). Avulsion with phenol versus avulsion without phenol: The addition of phenol, when performing a total or partial nail avulsion dramatically reduces the rate of symptomatic recurrence, (OR 0.07 95% CI 0.04 - 0.12). This is offset by a significant increase in the rate of post-operative infection when phenol is used (OR 5.69 95% CI 1.93 - 16.77). AUTHORS' CONCLUSIONS: The evidence suggests that simple nail avulsion combined with the use of phenol, compared to surgical excisional techniques without the use of phenol, is more effective at preventing symptomatic recurrence of ingrowing toenails. The addition of phenol when simple nail avulsion is performed dramatically decreases symptomatic recurrence, but at the cost of increased post-operative infection.

Combined Modality Therapy↗
PubMed2003

Biglycan-deficient mice have delayed osteogenesis after marrow ablation.

Biglycan (bgn) is a small proteoglycan in skeletal tissue that binds and regulates collagen and TGF-beta activities. Mice deficient in bgn (bgn-KO) develop age-dependent osteopenia and have multiple metabolic defects in their bone marrow stromal cells including increased apoptosis, reduced numbers of colony-forming units-fibroblastic (CFU-F) and decreased collagen production. In the present study we tested the hypothesis that bone formation capability in response to a physiological stress is compromised in bgn deficiency. We tested this theory using an in vivo bone marrow ablation assay. Ablation was performed on 6-week-old wild type (wt) and bgn-KO mice and bones were analyzed at days 7, 10, and 17 postsurgery. X-ray analysis showed that bone marrow ablation in femora induced vigorous new bone formation within 10 days in both genotypes but appeared greater in the wt compared to the bgn-KO. In order to quantitate the changes in bone formation in the ablated animals, bone densities of the proximal, midshaft, and distal femora were assessed using peripheral quantitative computed tomography (pQCT). The ratio of cancellous bone density at the midshaft (ablated limb/control limb) was significantly higher in wt compared to bgn-KO at day 10 postsurgery. Wt and bgn-KO femora had similar total and cancellous bone densities at days 7 and 17 postsurgery at all three locations indicating that the ablation effects were temporal and limited to the cancellous bone of the mid-shaft region. These data indicate that the absence of bgn directly impeded bone formation. Our results support the concept that bgn is important in controlling osteogenesis following marrow ablation.

Animals↗
PubMed2003

Changes in vasoactive factors associated with altered vessel morphology in the tibial metaphysis during ovariectomy-induced bone loss in rats.

We hypothesized that estrogen deficiency induces changes in bone vascularization which might be involved in bone loss mechanisms. First, we studied gene expression of angiogenic (vascular endothelial growth factor (VEGF), fibroblast growth factor-2 (FGF-2)) and vasodilator (endothelial nitric oxide synthase (ecNOS), neuronal NOS (nNOS), inducible NOS (iNOS), PTH-related protein (PTHrP), and its receptor PTH/PTHrP) factors in proximal tibial metaphysis of ovariectomized (OVX) rats and OVX 17beta-estradiol-treated rats at 3, 7, and 14 days. We then evaluated bone and vessel histomorphometry in secondary spongiosae by infusing vessels with a mixture of India ink/barium sulfate after 7 and 14 days of OVX. After 7 days expression of angiogenic and vasodilator factors decreased, concomitant with a decrease in the bone vessel number and possibly area. After 14 days all factors except FGF-2 exhibited either increased or normalized expression, which was associated with the stimulation of both bone formation and resorption. 17beta-Estradiol administration for 7 or 14 days prevented not only the OVX-induced changes in bone remodeling but also the morphological alterations observed in bone vessels. It also prevented the alterations in the expression of genes modified by OVX, except for that of FGF-2 whose transcription was similarly down-regulated in OVX rats with or without estrogen treatment.

Animals↗
PubMed2000

Known and novel terpenes from Buddleja globosa displaying selective antifungal activity against dermatophytes.

Lipophilic extracts of the stembark of Buddleja globosa were found to have antifungal activity at 125 microg/mL against three dermatophytic fungal species but had no activity at 1000 microg/mL against four other fungal species or two yeast species. Bioassay-guided fractionation of Si gel column eluates using the sensitive fungal species resulted in active fractions from which were isolated five compounds that were characterized by spectroscopic methods as one novel and four known compounds. The known compounds were the diterpene buddlejone (1), the bisditerpene maytenone, and the two sesquiterpenes buddledin A and buddledin B, while the novel compound was characterized as the diterpene deoxybuddlejone (2). The minimum inhibitory concentration of all the compounds was determined against all the microorganisms under test, and buddledins A and B were shown to exhibit the greatest antifungal activity, with values of 43 microM and 51 microM, respectively, against the sensitive fungi Trichophyton rubrum, Tricophyton interdigitale, and Epidermophyton floccosum.

Antifungal Agents↗
PubMed2000

Disuse bone loss in hindquarter suspended rats: partial weightbearing, exercise and ibandronate treatment as countermeasures.

The purpose of this study was to evaluate potential countermeasures for bone loss during long-term space missions in the hindquarter suspended rat, including partial weight bearing (surrogate for artificial gravity) episodic full weight bearing (2 hour/day full weight bearing) and treatment with the third generation bisphosphonate ibandronate (Roche). Graded mechanical loading was studied by housing the animals on a novel servo controlled force plate system which permitted the titration of mechanical force at varying frequency and amplitude and different levels of weight bearing. The force plate, which forms the cage floor, is a glass platform supported by an 18" diameter speaker cone filled with expanding polyurethane foam. An infrared optical sensor attached to the speaker cone yields a voltage linearly related to vertical displacement of the glass platform. The dynamic force on the paw was computed as a product of the apparent mass of the animal on the platform at rest and the acceleration of the platform determined from the second derivative of the optical sensor output. The mass of the animal on the platform was varied by adjusting tension on the tether suspending the animal. Mechanical impact loading was titrated with the force plate resonating at different frequencies, including 3 Hz and 16 Hz.

Animals↗
PubMed1997

Routine skin cleansing with povidone-iodine is not a common cause of transient neonatal hypothyroidism in North America: a prospective controlled study.

A high incidence of transient neonatal hypothyroidism has been observed in premature infants after routine skin cleansing with iodine. Because these reports have been predominantly from Europe, a borderline, iodine-deficient area, we wished to determine whether this was also true in North America, an iodine-sufficient area. A prospective, controlled study was performed in premature babies < or = 36 weeks gestation admitted to a neonatal intensive care nursery. Thyroxine (T4) and thyrotropin (TSH) were measured at day 1, days 4 to 6, and 10 to 12 after skin preparation with iodine or with a noniodine-containing antiseptic solution (chlorhexidine) that served as control. If repeat cleansing was required, this sequence was repeated. Urinary iodine was quantitated on days 1 to 3 to estimate iodine exposure. There was no difference in the mean T4 concentration at any of the time points evaluated nor in the incidence of transient hypothyroidism between the iodine-exposed (2/17) and control babies (0/14) despite urinary iodine excretion up to 88 times the control value. Unexpectedly 5 iodine-exposed but 0 control babies developed severe hypothyroxinemia (T4 < 40 nmol/L), compatible with the sick euthyroid syndrome; one of them died. We conclude that, unlike in Europe, transient hypothyroidism is not a common sequela of routine skin cleansing with iodine in premature newborn infants in North America. This difference in incidence may be due to prior iodine status. Whether excessive iodine absorption in premature infants is associated with thyroid-independent toxic effects remains to be clarified.

Anti-Infective Agents, Local↗
PubMed1997

Ropivacaine 0.75% for extradural anaesthesia in elective caesarean section: an open clinical and pharmacokinetic study in mother and neonate.

In an open study we have investigated the efficacy of 20 ml of 0.75% ropivacaine (7.5 mg ml-1) to provide extradural anaesthesia for elective Caesarean section. Plasma concentrations (total and free) were estimated in the mother and neonate. Anaesthesia was effective and safe. Plasma concentrations of ropivacaine in the mother and neonate were within safe limits and consistent with previous studies. Two mothers received accidental i.v. injections of ropivacaine 75 mg and 150 mg, respectively, without serious adverse effects.

Adult↗
PubMed1995

Analysis of breakthrough pain in 50 patients treated with intrathecal morphine infusion therapy. Development of tolerance or infusion system malfunction.

Fifty patients with intractable benign pain were treated with intrathecal morphine (IT-MS) infusion therapy. Median follow-up was 39 months (range 5-70). Breakthrough pain was reported in 45 (90%) patients in 75 outpatient clinic events. A diagnostic algorithm was developed to evaluate and efficiently treat these patients. A programmed bolus (50% of daily dose) identified that 50 (67%) breakthrough events where due to partial tolerance to the IT-MS. Radiographic survey of the catheters identified malfunctions in 11 patients. Attempts to withdraw CSF from the side-port demonstrated obstruction in 7 due to kinking not seen on X-rays. Side-port myelography demonstrated scarring that obstructed the flow of morphine to the spinal cord in 2 patients. Benefits were regained after all surgical catheter corrections. In total, partial tolerance was seen in 23 patients (46%) during 50 (67%) breakthrough events, 15 patients (30%) required 22 catheter revisions during 27% of breakthrough events and 2 patients had progressive disease. True tolerance was encountered in only 5 patients (10%) during 5 (7%) breakthrough pain events.

Adult↗
PubMed1994

Diabetes: its differential impact on child and family.

We argue that there are two groups of diabetic children who cope differently with the treatment regimen, (a) those who maximize their metabolic control and whose difficulties are associated with better control, and (b) those who maintain control less tightly and whose difficulties are associated with poorer control. This hypothesis was investigated with a sample of 47 diabetic children and their mothers. Analyses confirmed the hypothesis, indicating two distinct groups based on the type of symptom (emotional versus conduct) the child exhibited. Symptom type was associated with mother's knowledge of diabetes, diabetic control, scores received on a standardized measure of psychological disturbance and diabetes-specific concerns. The comparison of these two diabetic groups proved more sensitive to differences in diabetic adjustment than did comparisons made on the basis of psychiatric disturbance.

Adaptation, Psychological↗
PubMed1994

The treatment of intracranial lesions with stereotactic radiosurgery.

Stereotactic radiosurgery is a new method of delivering a high dose of megavoltage, ionizing radiation therapy to a localized area in the brain in a single session. A substantial variety of intracranial lesions can be treated with the use of a stereotactic head frame and set up of tertiary collimators on an existing linear accelerator. This state-of-the-art technique has been used since June 1992 at the Robert C. Byrd Health Sciences Center of West Virginia University in Morgantown. Radiosurgery treatment has been well tolerated by all 24 patients treated thus far.

Brain Neoplasms↗
PubMed1993

Childhood meningioma associated with meningio-angiomatosis. Case report.

This paper reports childhood meningioma in association with meningioangiomatosis. The patient was an 11-month-old baby boy who presented with a left focal seizure. He had no stigmata of neurofibromatosis. Computerized tomography and magnetic resonance imaging revealed an extra-axial, contrast-enhancing mass in the interhemispheric fissure which indented the right frontal lobe. The tumor was totally removed. Microscopically, the lesion was a fibrous and transitional meningioma with foci of necrosis and scattered mitotic figures. The adherent neural parenchyma showed the histological features of meningioangiomatosis. It is concluded that meningioangiomatosis may accompany childhood meningiomas more often than is generally appreciated.

Angiomatosis↗
PubMed1990

A project in diabetes education for children.

Forty-eight families with children less than 13 years old attending a paediatric diabetic clinic volunteered for a 2-year randomized crossover trial to determine whether an informal education programme (diabetic club) could improve diabetic control. Group A attended the diabetic club for 10 afternoons of informal education in the first year, while Group B continued at the routine clinic (5 visits per year). For the second year Group A returned to the clinic, Group B attended the club. Glycosylated haemoglobin (HbA1) remained stable while attending the club but rose significantly (p less than 0.01) while attending the clinic in both groups (HbA1 at baseline, 1 year, and 2 years: Group A, 9.6 (SD 1.2), 9.6(1.4), 10.7(2.1)%; Group B 8.9(1.3), 10.4(1.4), 10.5(1.4)% (normal reference range 4.7-7.9%)). Other indices of control were unchanged. Diabetic problem-solving scores of parents improved (p less than 0.01) but their knowledge of diabetes did not correlate with their child's HbA1. Dietary intake showed a reduction in percentage of energy taken as fat (40% vs 37.7%, p less than 0.05) during club attendance. The percentage of parents reporting helpful social contact between families increased during their club year (Group A 50 to 78%, Group B 32 to 57%, p less than 0.001). Psychological measurements remained unchanged. An education programme for diabetic children may stabilize diabetic control in the short term but this effect is not sustained. The main benefit was the support provided by increased social contact with families of other diabetic children within the informal framework of the diabetic club.

Child↗
PubMed1990

Is a specialist paediatric diabetic clinic better?

Diabetic control in 88 children attending three general paediatric clinics was compared prospectively over one year with that of 89 children attending a specialist paediatric diabetic clinic. Glycated haemoglobin (HbA1) concentration and days admitted were significantly lower in the group attending the specialist clinic. This has implications for the organisation of paediatric diabetic services.

Child↗
PubMed1985

Extracellular K+ activity changes related to electroretinogram components. II. Rabbit (E-type) retinas.

Electroretinogram (ERG) and extracellular potassium activity (K+o) measurements were carried out in isolated superfused rabbit eyecup preparations under control conditions and during the application of pharmacological agents that selectively modify the light-responsive retinal network. Light-evoked K+o changes in the rabbit (E-type) retina resemble those previously described in amphibian (I-type) retinas. Different components of the light-evoked K+o changes can be distinguished on the bases of retinal depth, V vs. log I properties, and their responses to pharmacological agents. We find two separable sources of light-evoked increases in extracellular K+: a proximal source and a distal source. The properties of the distal light-evoked K+o increase are consistent with the hypothesis that it initiates a K+-mediated current through Müller cells that is detected as the primary voltage of the electroretinographic b-wave. These experiments also support previous studies indicating that both the corneal-positive component of c-wave and the corneal-negative slow PIII potential result from K+-mediated influences on, respectively, the retinal pigment epithelium and Müller cells.

Acetylcholine↗
PubMed1982

Thymic hypoplasia, auto-immune haemolytic anaemia and juvenile pemphigoid in an infant.

A female infant developed auto-immune haemolytic anaemia and juvenile pemphigoid, and died at the age of 10 months. Autopsy showed evidence of thymic hypoplasia and T lymphocyte deficiency. It was concluded that the two rare auto-immune diseases occurring in this child probably resulted from a lack of T cell regulation of antibody-producing B lymphocytes.

Anemia, Hemolytic, Autoimmune↗