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Biomedical subjects

S Hall

Publications and source records attributed to S Hall.

At least 55 records · Page 3Linked to original sources
PubMed2001

Self-injurious behaviour in young children with Lesch-Nyhan syndrome.

The early development of self-injurious behaviour in three young boys (aged 17, 25, and 30 months at start of study) with Lesch-Nyhan syndrome was examined by means of parental interviews and by direct observations completed at 3 to 4 monthly intervals over an 18-month period. Results suggest that the self-injury began in a different way from that of other young children with autism and/or developmental disabilities in that, from the start, self-injurious responses were sudden and violent, rather than emerging gradually over time. Drastic measures, such as removal of the teeth or provision of tooth guards, were often taken to prevent further tissue damage. Direct observations showed that the boys' self-injury occurred at lower rates, but their carers were highly concerned about the behaviour. Sequential analysis of the observational data indicated that on some occasions the children were more likely to self-injure during periods of low social interaction, suggesting that their self-injury may have been influenced by environmental factors. The theoretical and practical implications of these findings are discussed.

Child, Preschool↗
PubMed2001

A review of gynaecological cancer management: a large West Midlands general hospital experience.

The records of 372 women with gynaecological cancer were reviewed to assess the quality of care which has been given and to compare the standards achieved with those suggested by The West Midlands Gynaecological Oncology Group. The median primary referral interval was 18 days; 54% of patients were seen within 2 weeks of referral. The median interval between first hospital visit and surgery was 32 days and 77.5% of patients had their operation within 8 weeks. The median interval between histology report and starting adjuvant therapy was 19 days and 81% of patients commenced treatment within 6 weeks. The histological diagnosis was available within 2 weeks of surgery in 77% of patients. Less than one-third of patients in our series were referred to the lead consultant of gynaecological oncology, who performed 50% of the operations for gynaecological malignancy. There was no record of the primary referral interval, date of surgery and date of commencement of adjuvant therapy in 35%, 25% and 20% of patients, respectively. More attention must be given to redistribution of caseload with more involvement of the gynaecological cancer team and to improvement in clinical cancer data collection to decrease the extent of missing data. The delays in referral of patients with suspected gynaecological malignancy could be minimised by improving communication between the general practitioners and the hospitals.

Journal Article↗
PubMed2001

Technologic advances for evaluation of cervical cytology: is newer better?

Among those women who have cervical cancer and have been screened, 14% to 33% of the cases represent failure to detect abnormalities that existed at the time of screening. New technologies intended to improve detection of cytologic abnormalities include liquid-based, thin-layer cytology (ThinPrep, AutoCyte), computerized rescreening (PAPNET), and algorithm-based computer rescreening (AutoPap). This report combines evidence reviews conducted for the U.S. Preventive Services Task Force and the Agency for Healthcare Research and Quality, in which we systematically identified articles on cervical neoplasia, cervical dysplasia, and screening published between January 1966 and March 2001. We note the challenges for improving screening methods, providing an overview of methods for collecting and evaluating cytologic samples, and examining the evidence about the diagnostic performance of new technologies for detecting cervical lesions. Using standard criteria for evaluation of the diagnostic tests, we determined that knowledge about the sensitivity, specificity, and predictive values of new technologies is meager. Only one study of liquid-based cytology used a reference standard of colposcopy, with histology as indicated, to assess participants with normal screening results. Lack of an adequate reference standard is the overwhelming reason that test characteristics cannot be properly assessed or compared. Most publications compare results of screening using the new technology with expert panel review of the cytologic specimen. In that case, the tests are not independent measures and do nothing to relate the screening test findings to the true status of the cervix, making determination of false-negatives, and thus sensitivity, specificity, and negative predictive value, impossible. We did not identify any literature about health outcomes or cost effectiveness of using these tools in a system of screening. For the purposes of guiding decision making about choice of screening tools, the current evidence is inadequate to gauge whether new technologies are "better" than conventional cytology..

Colposcopy↗
PubMed2001

Development of the fallopian canal in humans: a morphologic and radiologic study.

AIMS: This study investigated the development of the fallopian canal with particular reference to the mode of ossification and dehiscences, sites of incomplete closure around the facial nerve. BACKGROUND: The precise sequence of events surrounding ossification of the tissues around the facial nerve is uncertain. Incomplete ossification results in dehiscence of the adult structure, which places the nerve at increased risk of damage from disease processes in the middle ear and iatrogenic trauma during otologic surgery. METHODS: Twenty-four temporal bones from 12-to 36-week human fetuses were resected. Eight temporal bones from 22-to 36-week fetuses were microsliced to produce 1.5-mm horizontal sections and radiographed. Sixteen temporal bones from 12-to 35-week fetuses were serially microtomed to produce 7-microm slices, which were stained with hematoxylin and eosin. Quantitative and qualitative analyses of these sections were performed to document patterns of closure of the primitive canal and dehiscence formation. RESULTS: The tympanic part of the primitive fallopian canal, the facial sulcus, developed anteroposteriorly from the geniculate fossa to enclose the facial nerve. The mesenchyme that formed the facial sulcus underwent endochondral ossification, while the bone which capped or closed the sulcus developed in membrane. In the tympanic segment, permanent congenital dehiscences were elliptical and about 1 mm in length. CONCLUSIONS: This study clarifies the mode of development of the fallopian canal, with particular reference to dehiscences, and provides a scientific basis for otologic practice.

Facial Nerve↗
PubMed2001

Early development of self-injurious behavior: an empirical study.

The early development of SIB in young children with developmental disabilities was examined by tracking over an 18-month period 16 school-age children who had recently started to show early SIB. Naturalistic observations were conducted in each child's classroom every 3 months, and the association between early SIB and environmental events was examined. Results showed that for the 4 children whose early SIB had escalated over this period, there was a significant association between early SIB and low levels of social contact across observation points, supporting models of the development of SIB. This association might be considered as a risk marker for the exacerbation of SIB. Implications of this finding for targeting early interventions for SIB are discussed.

Adolescent↗
PubMed2001

Effects of social proximity on multiple aggressive behaviors.

We systematically manipulated social proximity to examine its influence on multiple topographies of aggression. Aggression occurred at high levels during close-proximity sessions and at low levels during distant-proximity sessions even though social contact was presented continuously during both conditions. Topographies of aggression emerged sequentially across the close-proximity sessions, and all topographies were reduced to zero following extended sessions of this condition.

Adolescent↗
PubMed2000

Abundant tax protein expression in CD4+ T cells infected with human T-cell lymphotropic virus type I (HTLV-I) is prevented by cytotoxic T lymphocytes.

The role of the cellular immune response in human T-cell leukemia virus type I (HTLV-I) infection is not fully understood. A persistently activated cytotoxic T lymphocyte (CTL) response to HTLV-I is found in the majority of infected individuals. However, it remains unclear whether this CTL response is protective or causes tissue damage. In addition, several observations paradoxically suggest that HTLV-I is transcriptionally silent in most infected cells and, therefore, not detectable by virus-specific CTLs. With the use of a new flow cytometric procedure, we show here that a high proportion of naturally infected CD4+ peripheral blood mononuclear cells (PBMC) (between 10% and 80%) are capable of expressing Tax, the immunodominant target antigen recognized by virus-specific CTLs. Furthermore, we provide direct evidence that autologous CD8+ T cells rapidly kill CD4+ cells naturally infected with HTLV-I and expressing Tax in vitro by a perforin-dependent mechanism. Consistent with these observations, we observed a significant negative correlation between the frequency of Tax(11-19)-specific CD8+ T cells and the percentage of CD4+ T cells in peripheral blood of patients infected with HTLV-I. Those results are in accordance with the view that virus-specific CTLs participate in a highly efficient immune surveillance mechanism that persistently destroys Tax-expressing HTLV-I-infected CD4+ T cells in vivo. (Blood. 2000;95:1386-1392)

Anti-Bacterial Agents↗
PubMed2000

Psychological consequences for parents of false negative results on prenatal screening for Down's syndrome: retrospective interview study.

OBJECTIVE: To determine the psychological consequences for parents of children with Down's syndrome of having received a false negative result on prenatal screening. DESIGN: Comparison of adjustment of parents who received a false negative result with that of parents not offered a test and those who declined a test. SETTING: Parents were interviewed in their own homes. PARTICIPANTS: Parents of 179 children with Down's syndrome (mean age 4 (range 2-6) years). MAIN OUTCOME MEASURES: Anxiety, depression, parenting stress, attitudes towards the child, and attributions of blame for the birth of the affected child. RESULTS: Overall, regardless of screening history, parents adjusted well to having a child with Down's syndrome. Compared with mothers who declined a test, mothers in the false negative group had higher parenting stress (mean score 81.2 v 71.8, P=0.016, 95% confidence interval for the difference 1.8 to 17.0) and more negative attitudes towards their children (124.9 v 134.2, P=0. 009, -16.2 to -2.4). Fathers in the false negative group had higher parenting stress test scores (77.8 v 70.0, P=0.046, 1.5 to 14.2) than fathers not offered a test. Mothers in the false negative group were more likely to blame others for the outcome than mothers who had not been offered the test (28% v 13%, P=0.032, 3% to 27%). Mothers and fathers in the false negative group were more likely to blame others for this outcome than parents who had declined a test (mothers 28% v 0%, P=0.001, 19% to 37%; fathers 27% v 0%, P=0.004, 17% to 38%). Blaming others was associated with poorer adjustment for mothers and fathers. CONCLUSIONS: A false negative result on prenatal screening seems to have a small adverse effect on parental adjustment evident two to six years after the birth of an affected child.

Adult↗
PubMed2000

Frequency and allelic association of common variants in the lipoprotein lipase gene in different ethnic groups: the Wandsworth Heart and Stroke Study.

The lower serum triglyceride (Tg), higher high density cholesterol (HDL-C) levels and low coronary heart disease (CHD) mortality in black populations, contrast with that in whites. By comparison, South Asian populations display a higher mortality from CHD associated with increased Tg and low HDL-C levels. Lipoprotein lipase (LPL) plays a major role in Tg metabolism. To determine if variation in the LPL gene contributes to the differences in lipid levels, we studied the frequencies and allelic associations of five common variants in the lipoprotein lipase (LPL) gene (-93T/G, D9N, N291S, S447X, and the HinddIII RFLP in intron 8) with serum Tg and HDL-cholesterol concentrations in population samples of middle-aged men and women of whites, South Asians, and blacks of African origin co-resident in South London. Significantly higher frequencies of the H(-) (P < 0.00001), N9 (P < 0.001), and -93G (P < 10(-10)) alleles were seen in blacks compared to the other two groups. Allelic association between -93G and N9, and H(+) and X447 was strong in all three groups. However, no association was observed between serum Tg and HDL-cholesterol concentrations and these variants in the three ethnic groups. A single common polymorphism in the LPL gene is unlikely to account for the differences in fasting serum Tg in populations of different ethnic background. The importance of the differences in frequencies and the mechanism(s) whereby these may contribute towards a beneficial LPL genotype in black populations remain to be determined.

Adult↗
PubMed2000

Influence of laminin-2 on Schwann cell-axon interactions.

The dy/dy mouse suffers from a form of muscular dystrophy caused by a substantial reduction in laminin alpha2-chain protein, a major component of both muscle and Schwann cell basal laminae. This article examines the effect of laminin alpha2 deficiency on Schwann cell-axon interactions both in vivo at varying intervals after nerve crush, and in vitro, in cocultures of neurons and Schwann cells. The morphological spectrum of aberrant Schwann cell-axon associations seen in uncrushed dy/dy sciatic nerves was recapitulated during regeneration: myelination of regenerating axons was delayed compared with the process in unaffected mice and the relatively few myelin sheaths which were formed in dy/dy distal nerve stumps were often uncompacted. In vitro, Schwann cells dissociated from adult dy/dy sciatic nerves predictably failed to express detectable laminin alpha2-chain and displayed an unusual multipolar morphology. Branching of neurites, in terms both of numbers of terminal branches and of complexity of branching, from dorsal root ganglia neurons grown on dy/dy Schwann cells, was significantly less extensive than that seen when neurons were cocultured with Schwann cells from unaffected littermates, but this effect was reversed by exogenous laminin-2. Our results lend strong support to the view that laminin-2 is essential for establishing and/or maintaining Schwann cell-axon interactions, in normal and in regenerating nerves.

Animals↗
PubMed2000

Intercessory prayer for the alleviation of ill health.

BACKGROUND: Prayer is an ancient and widely used intervention for alleviating illness and promoting good health. This review focuses specifically on intercessory prayer, which is organised, regular and committed, and those who practise it will almost inevitably hold some committed belief that they are praying to God. Whilst the outcomes of trials of prayer cannot be interpreted as 'proof/disproof' of God's response to those praying, there may be an effect of prayer not dependent on divine intervention. This may be quantifiable, making this investigation of a most widely used health care intervention both possible and important. OBJECTIVES: To review the effectiveness of prayer as an additional intervention for those with health problems already receiving standard medical care. SEARCH STRATEGY: ATLA (1949-1997), Biological Abstracts (1985-1999), CINAHL (1982-1999), The Cochrane Schizophrenia Group's Register (December 1999), CCTR of the Cochrane Library (Issue 4, 1999), EMBASE (1980-1999), MEDLINE (1966-1999) and PsycLIT (1887-1999), Sociofile (1974-1996) and Sociological Abstracts (1963-1999) were methodically searched. All references of articles selected were searched for further relevant trials. SELECTION CRITERIA: Randomised trials of personal, focused, committed and organised intercessory prayer on behalf of anyone with a health problem were considered. Outcomes such as achievement of desired goals, death, illness, quality of life and well-being for the recipients of prayer, those praying and the care-givers were sought. DATA COLLECTION AND ANALYSIS: Studies were reliably selected and assessed for methodological quality. Data were extracted by two reviewers working independently. Dichotomous data were analysed on an intention-to-treat basis. MAIN RESULTS: There was no evidence that prayer affected the numbers of people dying from leukaemia or heart disease (OR 1.11, CI 0.79-1.56, n=1424). Intercessory prayer did not clearly decrease the odds of people with heart problems experiencing a bad or intermediate outcome (OR 0.8, CI 0.64-1.00, n=1444) but this finding was moved towards the null by inclusion of a negative assumption for those who were dropped from the analysis in one study. Prayer increased the odds of readmission to the Coronary Care Unit (OR 1.54 CI 1.02-2.33, n=1406) but these results are made significantly negative by the inclusion of an assumption of poor outcome for those not accounted for in the final analyses. REVIEWER'S CONCLUSIONS: Data in this review are too inconclusive to guide those wishing to uphold or refute the effect of intercessory prayer on health care outcomes. In the light of the best available data, there are no grounds to change current practices. There are few completed trials of the value of intercessory prayer, and the evidence presented so far is interesting enough to justify further study. If prayer is seen as a human endeavour it may or may not be beneficial, and further trials could uncover this. It could be the case that any effects are due to elements beyond present scientific understanding that will, in time, be understood. If any benefit derives from God's response to prayer it may be beyond any such trials to prove or disprove.

Humans↗
PubMed2000

Substitution of asparagine for aspartic acid at residue 9 (D9N) of lipoprotein lipase markedly augments risk of ischaemic heart disease in male smokers.

Genetic variants of lipoprotein lipase (LPL), a key enzyme in the hydrolysis of triglyceride (TG)-rich particles, may contribute to ischaemic heart disease (IHD) risk. We have examined the risk of IHD in carriers of two common LPL variants, asparagine substitution for aspartic acid at residue 9 (D9N) and serine for asparagine at residue 291 (N291S) in 2708 middle-aged healthy European men, followed for over 6 years. The carrier frequencies were 2.6% for N9, and 3.9% for S291. Both variants were associated with higher plasma TG at baseline of 9% and 14%, respectively. At baseline, 28% of men were current smokers and smoking was unrelated to genotype. Associations between LPL variants and disease outcome, according to smoking status, were assessed by Cox's proportional hazards analysis. S291 carriers showed no increased risk of IHD compared to non-carriers, while there was strong evidence of interaction between D9N genotype and smoking status (P = 0.0003) in determining the risk of IHD. In 2248 non-carriers of N9, smoking increased the risk of an IHD event by 1.6 (95% CI: 1.1-2.4%) times. Among 58 N9 carriers, no IHD events occurred in 42 who were non-smokers, whereas five events were reported in 16 who smoked. The combined effect of smoking and N9 allele was to increase the risk of an IHD event by 10.4 (95% CI: 4.7-22.8%) times compared with D9 non-smokers. These findings could not be explained by confounding effects of baseline TG. Carriers of N9 appear to be especially vulnerable to the adverse effects of cigarette smoking on IHD risk, but this susceptibility is unrelated to the influence of this variant on plasma TG levels.

Asparagine↗
PubMed2000

Neurotoxic shellfish poisoning and brevetoxin metabolites: a case study from Florida.

In June of 1996, three family members were diagnosed as suffering from neurotoxic shellfish poisoning (NSP) as a result of eating shellfish harvested from Sarasota Bay, Florida. Urine from two of these patients and extracts of shellfish collected from the same location were analyzed by radioimmunoassay (RIA) and by receptor binding assay. Activity consistent with brevetoxins was present in both urine and shellfish extracts. High performance liquid chromatographic (HPLC) analysis of shellfish extracts demonstrated multiple fractions recognized by specific anti-brevetoxin antibodies, suggesting metabolic conversion of parent brevetoxins. Affinity-purification of these extracts yielded four major peaks of activity. One peak was identified by HPLC-mass spectroscopy (HPLC-MS) to be PbTx-3, which was likely produced metabolically from the dominant parent toxin PbTx-2. No PbTx-2, however, was detected. Other peaks of activity were determined to consist of compounds of apparent masses of [M + H]+ of 1018, 1034, and 1005. These higher masses are suggestive of conjugated metabolites, but their structures have yet to be determined. The material associated with these latter three peaks were recognized by both RIA and receptor binding assay, but they quantitated differently. This finding suggests that these metabolites react differently in the two assays, and this result may have important implications for seafood safety and regulation. We suggest these metabolites to be the true cause of NSP, and they should be taken into account during regulatory testing.

Animals↗
PubMed2000

Receiving shadows: governance and liminality in the night-time economy.

This paper focuses upon the emergence of the night-time economy both materially and culturally as a powerful manifestation of post-industrial society. This emergence features two key processes: firstly a shift in economic development from the industrial to the post-industrial; secondly a significant orientation of urban governance involving a move away from the traditional managerial functions of local service provision, towards an entrepreneurial stance primarily focused on the facilitation of economic growth. Central to this new economic era is the identification and promotion of liminality. The State's apparent inability to control these new leisure zones constitutes the creation of an urban frontier that is governed by commercial imperatives.

Commerce↗
PubMed2000

Survival of Escherichia coli in foods.

Studies describing the survival of Escherichia coli in foods, more often than not use the O157:H7 serovar as the target organism. Whilst E. coli O157:H7 is undoubtedly the predominant agent of concern for foodborne disease caused by enterohaemorrhagic E. coli (EHEC), a consequence of this concern is the commonly held view that this one serovar is 'atypical' in its response to stress conditions and therefore better able to survive adverse environments. Many of the studies published do not make comparisons with other E. coli (either commensal organisms or other pathogenic types) or other members of the Enterobacteriaceae, that would justify this view. Nevertheless, there has been a great deal of valuable data and information generated describing the fate of E. coli O157:H7 in a range of foods stored under various conditions. In many respects, the results of these studies are not surprising considering the survivability of other closely related pathogens, such as Shigella spp. This ability to survive in foods for long periods of time confirms the need for reliable control measures where contamination is possible or likely, e.g. proper handling and thorough cooking of beefburgers. The factors that may influence survival in different foods are described, with the intention of providing an insight in this area of food safety. Key considerations for carrying out survival studies are identified, with particular reference to methodologies used.

Animals↗