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Biomedical subjects

A Macdonald

Publications and source records attributed to A Macdonald.

At least 37 records · Page 2Linked to original sources

Creon 10,000 Minimicrospheres vs. Creon 8,000 microspheres--an open randomised crossover preference study.

Creon 10,000 Minimicrospherestrade mark (Creon) 10,000 MMS) is a pancreatic enzyme formulation that contains smaller spheres of pancreatin in a 50% smaller capsule than conventional microspheres (Creon) 8,000). This three-centre study investigated the preference of cystic fibrosis (CF) patients for these products. In one centre, 72 h stool fat excretion and coefficient of fat absorption (CFA) were also compared. Fifty-nine patients with a mean age 10 years (range 3-17) took Creon 8,000 ms for 14 days and were then randomised to 28 days of Creon 8,000 ms followed by 28 days of Creon 10,000 MMS, or vice versa. Dosing was lipase for lipase according to the labelled declaration. At the end of the second treatment period, 51 of 54 patients who completed the study expressed a preference, with a statistically significant preference in favour of Creon 10,000 MMS (47/51; 87%) vs. Creon 8,000 ms (4/51; 7.4%; P<0.0001). Stool fat (g/day) and CFA (%) were measured in 24 patients at the end of each treatment period: the products were therapeutically equivalent (Creon 10,000: 8.4 g/day, 91.3% CFA; Creon 8,000: 6.7 g/day, 93.5% CFA). Both products were well tolerated. In conclusion, in CF children we found a clear preference for Creon 10,000 MMS compared with Creon 8,000 ms with no difference in fat absorption between the two products. Creon 10,000s smaller capsules are easier to take and should aid patient compliance.

Administration, Oral↗

No unique role for nausea attributed to eating a food in the recalled acquisition of sensory aversion for that food.

Currently in the U.K., as in the U.S.A. 20 years ago, when students were asked to name a food that they did not like, more dislike for the food was attributed to nausea or vomiting after eating than to other gastrointestinal symptoms or to illness in other parts of the body. However, when members of the public first identified adverse symptoms and then attributed them to foods, and dislike for the food was first enquired about on a later occasion, there was no evidence for a unique role for a causal association with nausea in the human acquisition of food aversions. Furthermore, fear of the symptom was more prevalent than acquired sensory aversion when there was more precise recall of memories of the food being followed by nausea or vomiting and greater likelihood of there having been causal contingency rather than mere coincidence. Therefore, the more frequent invocation of nausea than of some other symptoms as the cause of a sensory aversion to a food may result from personal theory of the body, rather than from a veridically recalled occasion when nausea was contingent on eating the food---an event that must occur for aversion to arise from associative conditioning.

Adolescent↗

Community study of people who live in squalor.

BACKGROUND: The reasons why people live in squalor have been the subject of much debate but little systematic research other than reports of case series from secondary health-care services. We did a study in the community using standardised instruments to investigate the relation between squalor and mental and physical disorders. METHODS: We did a cross-sectional study of the clients of a local-authority special cleaning service. Levels of domestic squalor and self neglect were measured with the living conditions rating scale, and diagnoses of mental disorder were made by use of WHO's schedules for clinical assessment in neuropsychiatry (SCAN). FINDINGS: 91 individuals were eligible for inclusion; 81 from 76 households consented and were interviewed (a response rate of 89%). 41 (51%) were younger than 65 years of age. 57 individuals (70%) were diagnosed as having a mental disorder at interview, as defined by the SCAN, and 21 participants (26%) had a physical health problem which contributed significantly to the unclean state of their living environment. Those with a contributory physical disorder had a lower severity of domestic squalor. People older than 65 years were less likely to have a mental disorder than those younger than 65 years, but a contributory physical disorder was not associated with the presence of active mental disorder. Only 30 (53%) of the 57 individuals with active mental disorder had had any contact with mental-health services in the previous year. INTERPRETATION: People who live in squalor and who receive special cleaning services have high rates of mental disorder, and squalor affects younger as well as older people. Living in squalid conditions in the group was generally associated with a mental or physical disorder, and there were possible deficits in the health care received. The extent to which these disorders might respond to more assertive treatment from health services requires further study, but questions are raised about the adequacy of their current health care.

Adult↗

Supervision of site radiography contractors.

Gamma radiography is used extensively under conditions of site radiography for non destructive testing of components where it is not reasonably practicable to check these components in a shielded enclosure. This is one of the few occasions when a high activity radioactive source is used outside a shielded enclosure and administrative controls are the principal means of restricting exposure. A company where site radiography is required should carry out certain checks themselves to ensure that other personnel not involved in the radiography are not exposed to ionizing radiation. Prior discussion with the radiography company on their safety systems and equipment and checks by the client before and during radiography will reduce the likelihood of unintentional exposures and ensure that no radioactive materials are left on the site.

Gamma Rays↗

An unusual cause of haematuria.

A case of gross haematuria is described in a young woman. This was initially attributed to the use of analgesics. Subsequent history and investigation confirmed that the cause for the haematuria was sickle cell trait occurring in an individual in whom it was not initially suspected.

Adult↗

Level of termination of the spinal cord and the dural sac: a magnetic resonance study.

Previous studies concerning the level of termination of the human spinal cord have been carried out in unselected cadavers. We have used magnetic resonance imaging to determine this level of termination, and that of the dural sac, in normal living subjects. We found a wider range of the level of termination of both the spinal cord and dural sac and a higher median level of termination of each than is commonly described. These anatomical findings are of clinical relevance to clinicians practicing regional anesthesia.

Adult↗

A simple, sensitive and reproducible assay for pyridoxal 5'-phosphate and 4-pyridoxic acid in human plasma.

We describe a procedure for the measurement of pyridoxal 5'-phosphate and of 4-pyridoxic acid in human plasma samples. It is based on the conversion of pyridoxal 5'-phosphate to 4-pyridoxic acid 5'-phosphate by cyanide in alkaline medium, followed by a high pressure liquid chromatographic separation, with fluorescence detection at acid pH. The assay is robust, sensitive, linear over a wide range, reproducible, and simple to perform. Samples stored at -80 degrees C are stable. Satisfactory agreement was obtained with results from the tyrosine decarboxylase-based assay for pyridoxal 5'-phosphate, in two other laboratories. Plasma samples from a National Survey of older British people were analyzed, and reference intervals for plasma pyridoxal 5'-phosphate intervals were derived. From the lower 2.5 percentile of the reference group, taken as the lower cut-off of the normal range, ca. 20% of elderly men and 11% of elderly women in the UK showed evidence of biochemical deficiency.

Aged↗

Neurotoxicity associated with acyclovir in end stage renal failure.

AIMS: To alert practitioners to the danger of acyclovir neurotoxicity occurring in the presence of renal failure. METHODS: Two case reports of acyclovir neurotoxicity in the patients on continuous ambulatory peritoneal dialysis. RESULTS: In one case neurotoxicity resulted from the use of a dosage regimen that would be appropriate in patients with normal renal function. In the other case, neurotoxicity occurred even though a reduced dose of acyclovir was given. Supportive management resulted in a complete recovery. CONCLUSIONS: In patients with end stage renal failure with varicella zoster infections, when acyclovir is prescribed the loading dose should be 400 mg and the maintenance dose should be 200 mg twice daily.

Acyclovir↗