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PubMed1996

Incidence of diabetes mellitus in women following impaired glucose tolerance in pregnancy is lower than following impaired glucose tolerance in the non-pregnant state.

Impaired glucose tolerance (IGT), which is asymptomatic and requires a glucose tolerance test for detection, is a well-known risk factor for diabetes mellitus. Outside the research setting it is rarely identified in people who lack specific risk factors for diabetes except during pregnancy, at which time screening with an oral glucose challenge is a routine procedure. A 75-g oral glucose tolerance test was performed during the latter part of pregnancy or during a routine epidemiology survey in 15-39-year-old Pima Indian women with no history of abnormal glucose tolerance. Those with IGT by World Health Organization criteria were included in this study. Diabetes incidence in women was compared between those whose IGT was first detected during pregnancy and those who were not pregnant when IGT was first recognized. Seventeen of 73 pregnant women and 114 of 244 non-pregnant women developed diabetes within 10 years. When controlled for plasma glucose concentration, age, body mass index, parity and duration of follow-up, those who were not pregnant were at higher risk of developing diabetes than those who were pregnant (hazard rate ratio = 1.71, 95% confidence interval = 1.01-2.91). Previous studies had reported that women with IGT during pregnancy are at higher risk of diabetes than women with normal glucose tolerance. This study suggests that women with IGT during pregnancy are at lower risk than non-pregnant women with a similar plasma glucose concentration who, in the clinical setting, are likely to remain unrecognized.

Adolescent↗

PubMed2001

Comparing the performance of mono- and biplane fluoroscopy systems in diagnostic and interventional neuroangiography using the dose-area product.

Biplane digital imaging systems are favoured in neurointerventional practice since they are believed to contribute to safer, quicker and more efficacious procedures. Our aim was to establish if such equipment exposes patients to the same level of ionising radiation as monoplane systems. We reviewed monoplane and biplane fluoroscopy screening times and dose-area products (DAP) for 267 diagnostic cerebral angiograms and 56 neurointerventional cases. Significantly lower DAP for the latter were recorded on the biplane equipment, demonstrating an important reduction in patient exposure to radiation. There were no significant differences between the two systems for diagnostic cerebral angiography.

Cerebral Angiography↗

PubMed2006

Identification of a bHLH-type G-box binding factor and its regulation activity with G-box and Box I elements of the PsCHS1 promoter.

With the use of in vivo recombination theory, the screening time of yeast one-hybrid system was decreased in the present study. A basic helix-loop-helix (bHLH) protein PsGBF was successfully obtained from a glutathione (GSH)-induced pea cDNA library using the G-box cis-element of the PsCHS1 promoter as a bait. Electrophoretic mobility shift assay (EMSA) and beta-galactosidase assay results suggested that PsGBF possesses both G-box-specific binding and transcription-activating activities. The specific interaction of PsGBF with G-box was further confirmed by in vivo transient expression assays in tobacco. The current study examined the combination effect of G-box with Box I elements in the interaction with PsGBF or OsMYC. The results indicated that PsGBF bound with the G-box, but not the Box I element. Moreover, this combination effect of G-box and Box I only associated with PsGBF but not with other bHLH-type proteins such as OsMYC.

Acyltransferases↗

PubMed2006

Dynamic swallowing study and radiation dose to patients.

PURPOSE: The purpose of this study was to define an optimal radiological procedure to evaluate the results of rehabilitation therapy for swallowing disorders and to calculate both the effective and organ dose to the patient to provide a measure of the radiation risk associated with the procedure. MATERIALS AND METHODS: In order to define the optimal radiological procedure, kerma-area product (KAP) measurements and evaluations of image quality in fluoroscopy and fluorography mode were made using dedicated phantoms. Twenty-two patients were included in the study, and the values of KAP, screening time and average voltage selected were individually recorded. The recorded KAP values were used to estimate radiation risk with the use of dedicated calculation software. RESULTS: Median, first and third quartiles of the KAP distribution were, respectively, 2.1, 1.5 and 2.7 Gy cm2, with a corresponding effective dose of 0.35, 0.26 and 0.46 mSv. A good correlation between KAP and exposure time was also found (R2=0.85). Exposure of the thyroid, which is inside the radiation field, accounts for the greatest share to the effective dose, with a calculated median dose of 6 mGy. CONCLUSIONS: With the defined radiological procedure, the obtained KAP values are lower than recorded doses in interventional radiology, and the corresponding values of entrance skin dose are lower than the threshold dose for deterministic effects. Considering the effective dose at the median KAP value, the probability for stochastic effects is shown to be low, at approximately 1 in 39,000.

Adult↗

PubMed1992

Comparison between single (Inoue) and double balloon mitral valvuloplasty: immediate and short-term results.

This study compared the results in 60 consecutive patients with severe rheumatic mitral stenosis, who underwent percutaneous double-balloon mitral valvuloplasty by means of a combination of 20 mm + 20 mm diameter balloon catheters (group A), with a similar group of 60 consecutive patients who underwent single (Inoue) balloon mitral valvuloplasty (group B). After balloon mitral valvuloplasty the hemodynamic measurements showed significant improvement in both groups: in groups A and B, respectively, mitral valve area calculated with the Gorlin formula increased from 0.9 +/- 0.2 to 2.1 +/- 0.5 cm2 (p less than 0.001) and from 0.8 +/- 0.2 to 1.9 +/- 0.4 cm2 (p less than 0.001). There was a significant improvement in cardiac functional status in both groups. There was no significant difference between the groups with regard to clinical or hemodynamic improvement, technical failure rate, inadequacy of dilatation, or complications. However, the double-balloon technique was more complex and involved a longer screening time--group A, 40 +/- 12 minutes; group B, 21 +/- 10 minutes (p less than 0.001). In our institution the disposable supplies used for the Inoue balloon technique were 40% more expensive than those used for the double-balloon technique.

Adolescent↗

PubMed1994

Comparative results of percutaneous balloon mitral valvuloplasty using the Trefoil/Bifoil and Inoue balloon techniques.

This study compared the results in 150 consecutive patients with rheumatic mitral stenosis who underwent percutaneous balloon mitral valvuloplasty by means of a Trefoil/Bifoil balloon catheter (n = 100, Group 1) or the Inoue balloon catheter (n = 50, Group 2). There was significant improvement in mitral valve area after valvuloplasty in both groups: in Group 1 mitral valve area improved from 0.92 +/- 0.22 to 2.14 +/- 0.64 cm2 (P < 0.001) and in Group 2 from 1.0 +/- 0.26 to 2.06 +/- 0.59 cm2 (P < 0.001). There was no significant difference in the mitral valve area, mean diastolic gradient or mean left atrial pressure between Group 1 and Group 2 patients after valvuloplasty. There was a higher complication rate in Group 1 patients but this was largely related to our early learning experience with the procedure. The Trefoil/Bifoil catheter technique is more complex and involved a longer screening time: Group 1 (39 +/- 15 min) vs. Group 2 (22 +/- 10 min); P < 0.001. The cost of the Inoue balloon technique, however, was almost twice that of the Trefoil/Bifoil technique. This may have important implications for developing countries with limited health care budgets and a high prevalence of rheumatic heart disease.

Adult↗

PubMed1996

ENZEDUC 1.0: a user-friendly software package for computation of hyperbolic enzyme kinetic data in biochemical education.

ENZEDUC 1.0 is a software package developed in Microsoft QuickBASIC v7.1 for computation of hyperbolic enzyme kinetics. The educational focus of the package is laboratory practical teaching. The program can manage a maximum of 18 substrate concentration values and 72 reaction rate values for each substrate concentration (1296 pairs of values). Samples can also be of unequal sizes. More than one reaction rate value for each substrate concentration can be handled. Real-time screen plots are obtained for the Michaelis-Menten function and the most popular linear transformations. Printer outputs are available. Hardware requirements are minimum 640 Kb RAM, EGA graphics card and 80286 processor.

Algorithms↗

PubMed2005

The impact of secondary tasks on multi-tasking in a virtual environment.

One experiment is described that examined the possible involvement of working memory in the Virtual Errands Test (McGeorge et al. (2001). Using virtual environments in the assessment of executive dysfunction. Presence, 10, 375-383), which requires participants to complete errands within a virtual environment, presented on a computer screen. Time was limited, therefore participants had to swap between tasks (multi-task) efficiently to complete the errands. Forty-two undergraduates participated, all attempting the test twice. On one of these occasions they were asked to perform a concurrent task throughout (order of single and dual-task conditions was counterbalanced). The type of secondary task was manipulated between groups. Twenty-one participants were asked to randomly generate months of the year aloud in the dual-task condition, while another 21 were asked to suppress articulation by repeating the word "December". An overall dual-task effect on the Virtual Errands Test was observed, although this was qualified by an interaction with the order of single and dual-task conditions. Analysis of the secondary task data showed a drop in performance (relative to baseline) under dual-task conditions, and that drop was greater for the random generation group than the articulatory suppression group. These data are interpreted as suggesting that the central executive and phonological loop components of working memory are implicated in this test of multi-tasking.

Adolescent↗

PubMed2006

Supersize teens: the metabolic syndrome.

With obesity and type 2 diabetes on the rise in children and adolescents, there has been recent interest in the study of the metabolic (insulin resistance) syndrome in this population. Characteristics of the syndrome include impaired glucose tolerance, hypertension, dyslipidemia, and abdominal obesity. These features are known to cluster and convey increased cardiovascular risk over time. Screening of children and adolescents is important to the goal of prevention, and therapeutic lifestyle modification is the primary treatment modality. When this fails, pharmacotherapy aimed at the individual risk factors may be indicated.

Adolescent↗

PubMed2006

Treatment of PCOS in adolescence.

Polycystic ovary syndrome (PCOS) is increasingly being recognized in adolescent girls seeking treatment for signs and symptoms of hyperandrogenism. It is difficult to diagnose PCOS in adolescents, therefore a high index of suspicion is necessary. Timely screening and treatment are crucial because another important component of the syndrome is insulin resistance/hyperinsulinemia increasing the risk for type 2 diabetes, dyslipidemia, and cardiovascular sequelae. Diagnosis of PCOS in adolescents should include a thorough family history, exclusion of other causes of hyperandrogenism, and appropriate laboratory evaluation. The scarcity of controlled clinical trials makes treatment controversial. Therapeutic options include lifestyle intervention, oral contraceptive pills, and insulin sensitizers. Long-term follow-up is needed to determine the effectiveness of these approaches in changing the natural history of the reproductive and metabolic outcomes without causing undue harm.

Adolescent↗

PubMed2003

Hypertensive crisis inducing rhabdomyolysis during laparoscopic resection of a large pheochromocytoma: a case report.

Intense vasospasm during hypertensive crisis as a cause for rhabdomyolysis has been described in ambulatory patients with pheochromocytoma. We report this phenomenon as an intraoperative complication in a patient during laparoscopic pheochromocytoma resection and discuss patient and procedure related risk factors. Unexplained intraoperative hyperkalemia following a severe hypertensive episode during surgery may be a first sign of rhabdomyolysis. Anesthesiologists should be aware of such a possibility. Intra- and postoperative serial electrolyte determinations and if suspected, timely screening for myoglobiuria, may aid in early detection and treatment of intraoperative rhabdomyolysis during pheochromocytoma resections.

Adrenal Gland Neoplasms↗

PubMed2006

Validation of a 24-h physical activity recall in indigenous and non-indigenous Australian adolescents.

The purpose of this study was to evaluate the concurrent validity of a modified version of the widely used previous day physical activity recall (PDPAR-24) self-report instrument in a diverse sample of Australian adolescents comprising Aboriginal and Torres Strait Islanders (A&TSI) and non-indigenous high school students. A sample of 63 A&TSI and 59 non-indigenous high school students (N=122) from five public secondary schools participated in the study. Participants completed the PDPAR-24 after wearing a sealed electronic pedometer on the previous day. Significant positive correlations were observed between the self-reported physical activity variables (mean MET level, blocks of vigorous activity, and blocks of moderate-to-vigorous physical activity) and 24-h step counts. Validity coefficients (rho) ranged from 0.29 to 0.34 (p<0.05). A significant inverse correlation was observed for self-reported screen time and 24-h step count (rho=-0.19, p<0.05). Correlations for A&TSI students were equal to or greater than those observed for non-indigenous students. The PDPAR-24 instrument is a quick, unobtrusive, and cost-effective assessment tool that would be useful for evaluating physical activity and sedentary behaviour in population-based studies.

Adolescent↗

PubMed1995

A barium enema training programme for radiographers: a pilot study.

We describe a training programme designed to instruct radiographers how to perform the double contrast barium enema (DCBE). The programme was assessed by comparing the first 50 unsupervised examinations with studies performed by senior registrars in radiology. Comparison was made by marking each study blind in terms of barium coating, colonic distension and visualisation of the colon in double contrast. A note was also made of the number of exposures, screening time, examination time and complications. No difference was found in any of these parameters when comparing the two groups. A further 50 patients were assessed at one year and this showed that standards had been maintained in terms of the above criteria. Follow-up at 3 years in the initial group has shown no missed pathology. We believe that delegation of the performance of the DCBE to radiographers is both acceptable to the patient and safe.

Barium Sulfate↗

PubMed2002

Intramedullary hip screw versus sliding hip screw for unstable intertrochanteric femoral fractures in the elderly.

We report a randomised, prospective study comparing a standard sliding hip screw and the intramedullary hip screw for the treatment of unstable intertrochanteric fractures in the elderly. One hundred and two patients were randomised on admission to two treatment groups. Fifty-two patients were treated with a compression hip screw (CHS), and fifty had intramedullary fixation with an intramedullary hip screw (IMHS). Patients were followed for 1 year and had a clinical and radiological review at 3, 6 and 12 months. The mean duration of operation and fluoroscopy screening time was significantly greater for insertion of the intramedullary hip screw. There was no difference between the groups with regard to transfusion requirements or time to mobilise after surgery. There were two technical complications in the CHS group and three in the IMHS group. There was no significant difference between the two groups in radiological or functional outcome at 12 months. It remains to be shown whether the theoretical advantages of intramedullary fixation of extracapsular hip fractures bring a significant improvement in eventual outcome.

Aged↗

PubMed2003

Rapid site-directed mutagenesis of chemokines and their purification from a bacterial expression system.

Chemokines are a family of small chemoattractant cytokines implicated in the recruitment and migration of leukocytes from the blood into tissues during disease and routine immune homeostasis. Although there are many similarities in the structure and function of certain chemokines, the importance of many residues in the function of these proteins is yet to be determined, and studies from related chemokines have shown that similar sequences may play different roles in each protein. The migration-inducing capacity of many chemokines is thought to involve the cell surface glycosaminoglycan (GAG), heparan sulphate (HS), which may assist in the formation of an immobilised chemokine gradient within inflamed tissues. To examine the heparan sulphate binding ability of the CC chemokine monocyte chemoattractant protein (MCP)-3 and its importance in chemotactic migration, we have identified and mutated conserved basic residues within the mature MCP-3 protein to the neutral amino acid alanine using a novel inverse polymerase chain reaction (I-PCR) method that rapidly generates essentially 100% mutational efficiency due to decreased requirements for template DNA and an alkaline denaturation step; this increased mutational efficiency reduces both screening time and sequencing costs. We also describe an optimised method for the expression of soluble, correctly folded MCP-3 in a bacterial system using nickel affinity columns and reverse-phase fast protein liquid chromatography (RP-FPLC), and achieve purified yields of up to 0.4 mg/l of initial culture medium after 5 h of induction. These optimised methods could work equally well for any small circular plasmid (< or =4.5 kb) incorporating a polyhistidine tag.

Base Sequence↗

PubMed2003

Improved PCR-based method for the direct screening of Streptomyces transformants.

Streptomycetes are attractive microorganisms because of their high secretion capacity and for the production of secondary metabolites. We report the improvement of a PCR-based method for screening of solid media-grown Streptomyces transformants. By resuspending mycelium into 2.5-10% dimethyl sulfoxide (DMSO), extensive manipulation prior to PCR could be avoided, thus significantly reducing screening time. Results proved to be both reliable and specific.

Dimethyl Sulfoxide↗

PubMed1998

Is micronuclei yield variability a problem for overexposure dose assessment to ionizing radiation?

Scoring of micronuclei (Mni) in cytokinesis-blocked human blood peripheral lymphocytes after an accidental radiation overexposure appears an easier and faster alternative for biological dosimetry than dicentrics analysis. However, an increase of Mni rate could be difficult to interpret particularly at low doses, because of the known variability of individual dose response and the unknown background frequency. Moreover, in case of nuclear emergency, there are the added problems of large samples numbers for processing and so screening time. In this paper, we wish to propose some solutions using both methodological and statistical approaches. Firstly, we have tried to check the micronuclei assay in order to obtain a sufficient number of micronuclei in binucleated cells in the shortest time possible, even at higher exposition dose. Two techniques were compared using frequencies of binucleated cells and micronuclei in normal lymphocytes and after exposure to gamma-irradiation (60 Co) for doses up to 6 Gy. Secondly, we have supposed that, if the individual radiosensitivity was a critical problem for dose estimation, conversely, it would be not possible to build a reference curve combining many individuals. Thus, we have assessed the Mni response from 47 carefully selected healthy male blood donors for gamma-irradiation between 0 and 4 Gy. We show in this study that a realistic dose-effect relationship could be always fitted. In addition, the related coefficients could be compared with other published dose-effect relationships for gamma rays. However, the background incidence calculated from these 47 healthy individuals were found to be larger as expected so that this approach increases the detection limit for which an overexposure suspicion could be significantly detected to 0.32 Gy.

Dose-Response Relationship, Radiation↗

PubMed2026

Causal relationships between somatic movement, brain structures, and mental well-being: A multi-stage Mendelian randomization study.

BACKGROUND: While the relationships between somatic movement, mental well-being, and brain health have been well established, the causal nature and underlying mechanisms of such associations remain incompletely understood. METHODS: By applying multi-stage Mendelian randomization to multi-source summary data derived from genome-wide association studies, we examined the causal effects of 4 somatic movement measures on 2 mental well-being indices and 13 types of brain structures, followed by testing the mediating roles of brain structures in accounting for the causal associations between somatic movement and mental well-being. RESULTS: Two-sample Mendelian randomization revealed that more physical activity was causally associated with greater mental well-being (life satisfaction and positive affect), while more sedentary behavior (longer leisure screen time and more sedentary behavior at work) with lower mental well-being. With respect to brain structures, sedentary behavior was causally linked to decreased volume, surface area, and local gyrification index in distributed cortical regions. Remarkably, decreased surface area of the piriform cortex was found to mediate the causal associations between sedentary behavior and lower mental well-being. CONCLUSIONS: Our findings not only complement and extend earlier reports on the associations of somatic movement with mental well-being and brain health by further resolving the causality but also help elucidate the neural mechanisms by which sedentary behavior adversely affects mental well-being.

Humans↗