You're not going to give me the umbrella, are you?
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Adult↗
Biomedical subjects
T Martin
Publications and source records attributed to T Martin.
Confusing guidelines.
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Antibiotic Prophylaxis↗
Phonon squeezing in a superconducting molecular transistor.
Josephson transport through a single molecule or carbon nanotube is considered in the presence of a local vibrational mode coupled to the electronic charge. The ground-state solution is obtained exactly in the limit of a large superconducting gap and is extended by variational analysis. The Josephson current induces squeezing of the phonon mode, which is controlled by the superconducting phase difference and by the junction asymmetry. Optical probes of nonclassical phonon states are briefly discussed.
Journal Article↗
Clinical and biochemical outcomes after a randomized trial with a high dose of enteral arginine formula in postsurgical head and neck cancer patients.
OBJECTIVE: Patients with head and neck cancer undergoing surgery have a high incidence of postoperative complications. The aim of our study was to investigate whether postoperative nutrition of head and neck cancer patients, using a higher dose of arginine-enhanced diet (17 g/day) than previous studies, could improve nutritional variables as well as clinical outcomes, when compared with a control enteral diet. DESIGN: Randomized clinical trial. SETTING: Tertiary care. SUBJECTS: A population of 72 patients with oral and laryngeal cancer was enrolled. INTERVENTIONS: At surgery, patients were randomly allocated to two groups: (a) 35 patients receiving an arginine-enhanced formula with arginine (group I) and (b) 37 patients receiving an isocaloric, isonitrogenous enteral formula (group II). RESULTS: No significant intergroup differences in the trend of the three plasma proteins (albumin, transferrin, prealbumin) and lymphocytes were detected. Episodes of diarrhea rate were equal in both groups (22.8% group I and 21.6% group II: NS). The postoperative infections complications were equal in both groups (5.7% group I and 5.4% group II: NS). Fistula (wound complication) was less frequent in enriched nutrition group (2.8% group I and 18.9% group II: P<0.05), whereas wound infection was similar in both groups. The length of postoperative stay was similar in both (27.9+/-21 vs 28.2+/-12 days; NS). CONCLUSIONS: At this dose, arginine-enhanced formula improves fistula rates in postoperative head and neck cancer patients without a high rate of diarrhea.
Arginine↗
Phase II study of unrelated cord blood transplantation for adults with high-risk hematologic malignancies.
Cell dose is a critical determinant of outcomes in unrelated cord blood (CB) transplantation. We investigated a strategy in which CB units should contain at least 2 x 10(7) total nucleated cells/kg of recipient weight, otherwise a second unit had to be added. We report the results of a study that was prematurely closed owing to toxicity. Patients with advanced hematologic malignancies without a human leukocyte antigen-matched sibling or unrelated donor were eligible. Conditioning regimen consisted of fludarabine and 12 Gy of total body irradiation (n=11), or melphalan (n=4), with antithymocyte globulin. Graft-versus-host disease prophylaxis was tacrolimus and methotrexate. Fifteen patients with acute leukemia (n=9), chronic myelogenous leukemia (n=2), multiple myeloma (n=2) and lymphoma (n=2) were treated; 60% had relapsed disease at transplantation. Three patients received double CB transplants. The 100-day and 1-year treatment-related mortality rates were 40 and 53%, respectively. Median time to neutrophil and platelet engraftment was 22 days (n=10) and 37 days (n=10), respectively. One patient had secondary graft failure and five patients failed to engraft. Two patients are alive and disease free; 4-year actuarial survival is 33 versus 0% for patients transplanted in remission versus in relapse. We concluded that disease status was the main determinant of treatment failure in this study.
Adult↗
The mode of action of insecticidal controlled atmospheres.
Arthropods cope with reduced oxygen and elevated carbon dioxide atmospheres with a reduction in metabolic rate, also called metabolic arrest. The reduction in metabolism lessens the pressure on the organism to initiate anaerobic metabolism, but also leads to a reduction in ATP production. The natural permeability of cellular membranes appears to be important for the survival of the arthropod under low oxygen or high carbon dioxide atmospheres. Despite the similarities in response, arthropod mortality is generally greater in response to high carbon dioxide as apposed to low oxygen atmospheres. There appears to be a greater decrease in ATP and energy charge in arthropods exposed to high carbon dioxide as compared with low oxygen atmospheres, and this may be due to greater membrane permeability under carbon dioxide leading to an inefficient production of ATP. Reduced oxygen and elevated carbon dioxide atmospheres can have an additive effect in some cases, depending on the concentrations used. The effect of these atmospheres on arthropods depends also on temperature, species and life stage. Additional work is needed to fully understand the mode of action of controlled atmospheres on arthropod pests.
Adaptation, Biological↗
Clinician perceptions of personal safety and confidence to manage inpatient aggression in a forensic psychiatric setting.
Inpatient mental health clinicians need to feel safe in the workplace. They also require confidence in their ability to work with aggressive patients, allowing the provision of therapeutic care while protecting themselves and other patients from psychological and physical harm. The authors initiated this study with the predetermined belief that a comprehensive and integrated organizational approach to inpatient aggression was required to support clinicians and that this approach increased confidence and staff perceptions of personal safety. To assess perceptions of personal safety and confidence, clinicians in a forensic psychiatric hospital were surveyed using an adapted version of the Confidence in Coping With Patient Aggression Instrument. In this study clinicians reported the hospital as safe. They reported confidence in their work with aggressive patients. The factors that most impacted on clinicians' confidence to manage aggression were colleagues' knowledge, experience and skill, management of aggression training, use of prevention and intervention strategies, teamwork and the staff profile. These results are considered with reference to an expanding literature on inpatient aggression. It is concluded that organizational resources, policies and frameworks support clinician perceptions of safety and confidence to manage inpatient aggression. However, how these are valued by clinicians and translated into practice at unit level needs ongoing attention.
Adaptation, Psychological↗
Efficacy of mosquito netting for sustainable small holders' cabbage production in Africa.
The efficacy of a mosquito netting to protect cabbages, Brassica oleracea L., against pests was investigated in field trials in Benin, West Africa. A polyester net covered the plants at night by using a wood armature. The net was removed during the day to prevent overheating and excessive shade, both problems of insect-proof screens used under tropical conditions. The number of all lepidopteran larvae with netting protection and foliar insecticide sprays was significantly lower than the unprotected control. The number of diamondback moth, Plutella xylostella (L.), was significantly lower with netting protection compared with foliar insecticide sprays and control. Netting treated with deltamethrin gave total protection of young plants against the aphid Lipaphis erysimi (Kaltenbach). At harvest, the number of marketable cabbages protected with untreated netting was significantly higher compared with the production with foliar insecticide sprays. The protection of cabbages with netting can be an economically viable method. Considering the price of cabbages on local markets (US dollars 1/unit), the net returns per 100 m2 were US dollars 247 by using netting, US dollars 149 by using insecticides, and US dollars 117 for controls. The net returns for using netting are based on replacing the netting each crop cycle. But netting can be reused several times, depending upon conditions, increasing the profit margin. The netting protection may be an alternative to the growing unsustainable practices of vegetable cropping in peri-urban areas of tropical countries.
Animals↗
[A rare diagnosis: a case report of an isolated pulmonary valve endocarditis].
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Adult↗
Current and noise in a model of an alternating current scanning tunneling microscope molecule-metal junction.
The transport properties of a simple model for a finite level structure (a molecule or a dot) connected to metal electrodes in an alternating current scanning tunneling microscope (ac-STM) configuration is studied. The finite level structure is assumed to have strong binding properties with the metallic substrate, and the bias between the STM tip and the hybrid metal-molecule interface has both an ac and a dc component. The finite frequency current response and the zero-frequency photoassisted shot noise are computed using the Keldysh technique, and examples for a single-site molecule (a quantum dot) and for a two-site molecule are examined. The model may be useful for the interpretation of recent experiments using an ac-STM for the study of both conducting and insulating surfaces, where the third harmonic component of the current is measured. The zero-frequency photoassisted shot noise serves as a useful diagnosis for analyzing the energy level structure of the molecule. The present work motivates the need for further analysis of current fluctuations in electronic molecular transport.
Journal Article↗
Increased oxygen administration during awake carotid surgery can reverse neurological deficit following carotid cross-clamping.
We describe the management of two patients undergoing awake carotid surgery who developed signs of cerebral ischaemia following cross-clamping of the internal carotid artery. Administration of oxygen 100% with a close-fitting anaesthetic facemask reversed the neurological deficit, avoiding the need for insertion of an internal carotid artery shunt. Thus, the incidence of shunt insertion, which is reduced by the use of regional rather than general anaesthesia, could be reduced further by supplementary oxygenation. The possible mechanism and implications are discussed.
Aged↗
Rituximab inefficiency during type I cryoglobulinaemia.
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Adult↗
Trematode infection correlates with shell shape and defence morphology in a freshwater snail.
Parasitism often influences the phenotype of individuals. Many of the resulting changes are due to changes in resource allocation that come with infection. Here we examine the effect of a trematode parasite on the shape and defence morphology of a New Zealand freshwater snail, Potamopyrgus antipodarum. The trematode Microphallus sp. asexually produces hundreds of metacercarial cysts in the snail. The length, width and 2-dimensional area of each snail were measured. Snails were also assessed for their degree of spininess. Snails were dissected to determine gender, brooding condition and parasitism. Snails infected with Microphallus sp. were found to be significantly less spiny than uninfected snails. Microphallus-infected snails were also found to have a significantly greater width to length ratio at larger sizes than their uninfected counterparts. These trends could be explained in at least 3 ways. (1) Infection causes the snails to not produce spines and to become wider. (2) Spiny and narrower snails are more likely to die when they become infected. (3) Spiny and narrower snails are more resistant to infection. The changes in phenotype observed are unlikely to be adaptive for either the host or parasite and probably represent physiological by-products of the host-parasite relationship.
Animals↗
[The thoracoscopic thymectomy for myasthenia gravis].
UNLABELLED: Myasthenia gravis (MG) is a chronic autoimmune disease that usually responds positively to treatment with thymectomy. Standard surgical procedures have been shown to result in a favorite outcome. The optimal surgical access, however, is under discussion. PATIENTS AND METHOD: In a prospective study conducted between 8/97 and 4/05, 173 patients with MG underwent thoracoscopic thymectomy, for which a left-sided approach was generally applied. An analysis of the intraoperative and postoperative course was performed in 137 patients (8/97 and 12/03), as well as of the impact of the surgical procedure on further development of the disease. The results obtained were compared with those published in the literature, with particular reference to results obtained with open surgery. In 8 patients, the procedure was converted to an anterolateral thoracotomy or sternotomy, so we examined 129 patients, which were operated thoracoscopically. RESULTS: The patients in this study were 93 females and 36 males, with a mean age of 35.8 (range: 9-83) years. The mean preoperative duration of the disease was 22.9 (range: 1-140) months. The duration of operation was 50 to 85 minutes, the blood loss was lower than 100 ml. The mean follow up was 24.7 (range: 1-57) months. Complete remission was noted in 30 patients (23.3 %), and improvements reflected either in a reduction of the required medication, or a decrease in symptom severity, were seen in a total of 86 patients (66.6 %). CONCLUSION: Complete thoracoscopic thymectomy is a technically feasible operation, and as effective as conventional open surgery. Remissions or symptomatic improvements were observed in more than 89 % of the patients. The low morbidity rate, in combination with excellent cosmetic results, has led to increasing acceptance of the operation both by patients and neurologists. Therefore, thoracoscopic thymectomy represents a new, alternative method for treatment of patients with MG.
Adolescent↗
Lack of association of matrix metalloproteinase 3 (MMP3) genotypes with ankylosing spondylitis susceptibility and severity.
OBJECTIVE: To study the linkage and association of ankylosing spondylitis (AS) with genotypes for matrix metalloproteinase 3 (MMP3), a gene located at chromosome 11q22.3 and lying within the 101-124 cM region observed in a recent genome-wide scan as a region associated with AS susceptibility. METHODS: MMP3 genotypes were examined in 229 pedigrees with AS, 131 sporadic AS cases and 87 Caucasian controls. Eight single-nucleotide polymorphisms (SNPs) were selected and genotyped using Taqman. Non-parametric linkage (NPL) analysis was conducted between the eight MMP3 SNPs and AS using the NPL-all statistic and two-point parametric linkage analysis using GeneHunter Plus. Unrelated AS cases and controls were compared using chi2 statistics, and family-based controls using the transmission disequilibrium test and pedigree disequilibrium test. RESULTS: None of the eight MMP3 SNPs were significantly associated with AS, either using the 131 sporadic cases alone or in analyses which combined these cases with the 226 unrelated affected AS patients derived from the pedigrees. Analysis of linkage disequilibrium (LD) demonstrated that seven of the eight SNPs studied were in strong LD except for rs626750, which is about 6 kb upstream of the 5' end of the gene. No significant linkage was observed using NPL and LODs in the families. No association was seen of any of the MMP3 SNPs with disease severity (defined by patient functioning), as measured either by the Bath Ankylosing Spondylitis Functional Index or the modified Health Assessment Questionnaire. CONCLUSION: These data suggest that MMP3 genotypes are not involved in AS susceptibility or severity.
Adult↗
Prolonged survival of an HIV-infected patient with multidrug-resistant Mycobacterium bovis infection treated with surgical resection.
We describe a case of multidrug-resistant tuberculosis due to Mycobacterium bovis in a human immunodeficiency virus-infected woman with good immunologic status. The patient presented with a hard mass measuring 10 cm in diameter on the lower left ribs and a lung nodule measuring 3 cm in diameter in the left superior lobe. No adequate pharmacological treatment was available. Both lesions were surgically resected. The patient has remained asymptomatic (without fever, cough, lymphadenopathy, or cutaneous masses) for 20 months, after discharge from the hospital.
Adult↗
In vivo thermoluminescence dosimetry dose verification of transperineal 192Ir high-dose-rate brachytherapy using CT-based planning for the treatment of prostate cancer.
PURPOSE: To evaluate the potential of in vivo thermoluminescence dosimetry to estimate the accuracy of dose delivery in conformal high-dose-rate brachytherapy of prostate cancer. METHODS AND MATERIALS: A total of 50 LiF, TLD-100 cylindrical rods were calibrated in the dose range of interest and used as a batch for all fractions. Fourteen dosimeters for every treatment fraction were loaded in a plastic 4F catheter that was fixed in either one of the 6F needles implanted for treatment purposes or in an extra needle implanted after consulting with the patient. The 6F needles were placed either close to the urethra or in the vicinity of the median posterior wall of the prostate. Initial results are presented for 18 treatment fractions in 5 patients and compared to corresponding data calculated using the commercial treatment planning system used for the planning of the treatments based on CT images acquired postimplantation. RESULTS: The maximum observed mean difference between planned and delivered dose within a single treatment fraction was 8.57% +/- 2.61% (root mean square [RMS] errors from 4.03% to 9.73%). Corresponding values obtained after averaging results over all fractions of a patient were 6.88% +/- 4.93% (RMS errors from 4.82% to 7.32%). Experimental results of each fraction corresponding to the same patient point were found to agree within experimental uncertainties. CONCLUSIONS: Experimental results indicate that the proposed method is feasible for dose verification purposes and suggest that dose delivery in transperineal high-dose-rate brachytherapy after CT-based planning can be of acceptable accuracy.
Brachytherapy↗
Atomic force microscopy and scanning near-field optical microscopy studies on the characterization of human metaphase chromosomes.
A better knowledge of biochemical and structural properties of human chromosomes is important for cytogenetic investigations and diagnostics. Fluorescence in situ hybridization (FISH) is a commonly used technique for the visualization of chromosomal details. Localizing specific gene probes by FISH combined with conventional fluorescence microscopy has reached its limit. Also, microdissecting DNA from G-banded human metaphase chromosomes by either a glass tip or by laser capture needs further improvement. By both atomic force microscopy (AFM) and scanning near-field optical microscopy (SNOM), local information from G-bands and chromosomal probes can be obtained. The final resolution allows a more precise localization compared to standard techniques, and the extraction of very small amounts of chromosomal DNA by the scanning probe is possible. Besides new strategies towards a better G-band and fluorescent probe detection, this study is focused on the combination of biochemical and nanomanipulation techniques which enable both nanodissection and nanoextraction of chromosomal DNA.
Cell Separation↗