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Biomedical subjects

A Scott

Publications and source records attributed to A Scott.

At least 37 records · Page 2Linked to original sources

Longitudinal study of Campylobacter jejuni bacteriophages and their hosts from broiler chickens.

A longitudinal study of bacteriophages and their hosts was carried out at a broiler house that had been identified as having a population of Campylobacter-specific bacteriophages. Cloacal and excreta samples were collected from three successive broiler flocks reared in the same barn. Campylobacter jejuni was isolated from each flock, whereas bacteriophages could be isolated from flocks 1 and 2 but were not isolated from flock 3. The bacteriophages isolated from flocks 1 and 2 were closely related to each other in terms of host range, morphology, genome size, and genetic content. All Campylobacter isolates from flock 1 were genotypically indistinguishable by pulsed-field gel electrophoresis (PFGE). PFGE and multilocus sequence typing indicated that this C. jejuni type was maintained from flock 1 to flock 2 but was largely superseded by three genetically distinct C. jejuni types insensitive to the resident bacteriophages. All isolates from the third batch of birds were insensitive to bacteriophages and genotypically distinct. These results are significant because this is the first study of an environmental population of C. jejuni bacteriophages and their influence on the Campylobacter populations of broiler house chickens. The role of developing bacteriophage resistance was investigated as this is a possible obstacle to the use of bacteriophage therapy to reduce the numbers of campylobacters in chickens. In this broiler house succession was largely due to incursion of new genotypes rather than to de novo development of resistance.

Animals↗

What do we mean by the term "inflammation"? A contemporary basic science update for sports medicine.

Most practicing sports medicine clinicians refer to the concept of "inflammation" many times a day when diagnosing and treating acute and overuse injuries. What is meant by this term? Is it a "good" or a "bad" process? The major advances in the understanding of inflammation in recent years are summarised, and some clinical implications of the contemporary model of inflammation are highlighted.

Anti-Inflammatory Agents↗

Consultants in nhs scotland: a survey of work commitments, remuneration, job satisfaction and retirement plans.

BACKGROUND AND AIMS: UK consultants have reported working long hours, increased stress and reduced morale. This study set out to elicit consultants' views on flexible working and to gather data on consultants' workloads, remuneration, job satisfaction and retirement plans. As such it is the first comprehensive study of consultants in NHS Scotland. METHODS: The Information and Statistics Division of the Scottish Executive Health Dept provided a list of consultants working in NHS Scotland Focus groups and interviews informed the design of a postal self-completion, questionnaire. RESULTS: The response ratewas 61%. Almost two-thirds (65%) of respondents felt their workloads were unreasonable and unsustainable and 67% were unable to provide their desired standards of patient care. Two-thirds (67%) did not normally take meal breaks, 63% had insufficient time for outside interests, whilst 44% felt their health was being adversely affected Many (84%) believed that some of their work could be delegated to someone less qualified but 79% agreed that there were insufficient staff to make this possible. The average planned retirement age was 60 years, with 23% describing their plans as definite and 70% as quite or very likely. When asked what might induce them to postpone retirement, 50% cited reduced workload/work intensity. CONCLUSIONS: In 2003, a majority of consultants in the UK voted in favour of the new consultant contract. This will improve consultant pay and introduce a standard 40-hour working week, including worked on-call. This should address tow of the main areas of consultant dissatisfaction in NHS Scotland. However, staff shortages will require to be addressed if the contract is to be successfully implemented.

Adult↗

What does GP out of hours care cost? An analysis of different models of out of hours care in Scotland.

BACKGROUND: The changes to out of hours care provided by General Practitioners have led to wide variation in the types and costs of out of hours care across the country. AIM: To examine the costs of different models of service delivery for GP out of hours organisations. METHODS: This was a prospective cross-sectional survey of eight GP out of hours organisations and samples of their patients. A deputising service, rotas, and various types of GP co-operative across Scotland were surveyed. Information on the quantities of resources used by each organisation was combined with unit costs. Costs incurred by patients and other NHS costs subsequent to the out of hours contact were also calculated. RESULTS: Annual costs incurred by the GP out of hours organisation per 1,000 population ranged from pounds sterling 2,916 to pounds sterling 12,120. There was no relationship between costs and type and size of organisation. There was a three-fold variation in total costs per out of hours contact (pounds sterling 15 to pounds sterling 51). Costs per phone contact were lowest (pounds sterling 6 to pounds sterling 11), followed by cost per centre contact (pounds sterling 10 to pounds sterling 16) and cost per home contact (pounds sterling 21 to pounds sterling 60). Total costs per episode ranged from pounds sterling 78 to pounds sterling 136 for centre contacts, from pounds sterling 130 to pounds sterling 303 for home contacts, and from pounds sterling 70 to pounds sterling 553 for telephone contacts. Home contacts had the highest average cost per episode (pounds sterling 212), followed by telephone contacts (pounds sterling 117) and centre contacts (pounds sterling 85). CONCLUSIONS: There are wide variations in the costs of operating GP out of hours services, It is likely that the context in which organisations were set up and local geography infuence variations in costs, as well as the level of GP cover.

After-Hours Care↗

Adverse reactions to protective gloves used in the dental profession: experience of the UK Adverse Reaction Reporting Project.

The Adverse Reaction Reporting Project (ARRP) was set up to measure the extent and severity of adverse reactions to dental materials in the UK. Further analysis into the use of protective gloves has been carried out to establish the degree to which gloves are having a deleterious effect on the dental profession. In addition the survey aimed to establish the techniques used to manage adverse reactions and their effectiveness. In a 23-month period, 369 reports were received concerning adverse reactions to protective gloves used in dental practices. Reporters were contacted for further information, and a 92% response rate was achieved. The 330 reports analysed showed dentists to be the largest group to report adverse reactions, whilst dental technicians reported the fewest. The referral rate for staff and patients was similar with a third of adverse reactions being referred (n=110) to a specialist for diagnosis. A confirmed diagnosis was received in 65% of referred cases (n=72), but the symptoms reported suggested a larger degree of Type I reactions occurring than diagnosed. The use of non-powdered gloves appeared to be favoured over powdered gloves in 42% of glove changes, and nitrile gloves were used as an alternative to latex in 39% of changes. In conclusion, the results from this survey showed that wearing gloves in dental practices in the UK caused a range of adverse reactions. In 79% (n=330) of cases reported and analysed, these reactions were readily resolved or improved by self-medication, prescribed medication and/or changing to a different type of protective glove.

Dental Staff↗

Overexpression of Skp2 in carcinoma of the cervix does not correlate inversely with p27 expression.

S-phase kinase associated protein 2 (Skp2) is a member of the F-box family of substrate recognition subunits of SCF-ubiquitin ligase complexes and controls progression from G(1)-S-phase by targeting cell cycle regulators such as p21 and p27. Its locus is at 5p13, a region of frequent amplification in several cancers including carcinoma of the cervix (CaCx). Overexpression of Skp2 has been observed in many cancers of an advanced stage. We examine the expression of Skp2 in 42 invasive CaCx and its correlation with tumour differentiation state and p27 expression. Using immunohistochemistry we found increased nuclear expression of Skp2 in 55% of invasive CaCx cases analysed. It is significant that poorly differentiated tumours invariably exhibit high Skp2 expression (>40% positive nuclei), whereas well-differentiated tumours express Skp2 at a lower level (<20% positive nuclei). Skp2 expression in normal cervical epithelia is <10% (positive nuclei). Increased Skp2 protein levels did not correlate inversely with p27 expression. Our data suggest that Skp2 may contribute to the progression of CaCx, however, unlike non-human papillomavirus (HPV) containing tumours, p27 is unlikely to be the major target protein contributing to malignant progression. The high prevalence of HPV types in CaCx may circumvent the need for Skp2 to eliminate p27.

Cell Cycle↗

Management of benign rectal strictures: a review of present therapeutic procedures.

PURPOSE: A significant benign stricture of the rectum is uncommon but can be a recalcitrant condition to treat. Case reports detailing a particular treatment option abound in the surgical literature. An overall précis of the different techniques available is presented, with a comparison of their relative strengths and weaknesses. METHODS: A literature search was undertaken from 1963 to the present day, using MEDLINE. Keywords were benign, strictures, and rectum. RESULTS: Balloon dilation is the most frequent intervention described in the literature. Repeated dilation with time often is required to achieve normal bowel function. Electrocautery resection or incision combined with dilation increases the success rate without increasing the complication rate. Transanal strictureplasty with mechanical staplers is reported as achieving the best success with the smallest complication rate; however, only a minority of strictures are suitable to be managed in this way, and therefore, the numbers treated are small. CONCLUSIONS: All of the techniques reviewed compared favorably with formal stricture resection in terms of success rate and complications.

Anastomosis, Surgical↗

An investigation of the toxicity of gadolinium based MRI contrast agents using neutron activation analysis.

The toxicity of gadolinium (Gd) based MRI contrast agents, is based upon the amount of Gd that dissociates from its chelate and deposits in tissues. In this study, the toxicities of two contrast agents were tested using different injection strategies in two animal models. Following a bolus injection of 0.2 mmol/kg of Gd-DTPA in a pilot study with a single canine, Gd levels were as high as 2.05 +/- 0.17 ppm and 0.47 +/- 0.11 ppm 2 weeks post injection in the kidney and liver tissues, respectively. To evaluate the role that the injection strategy plays in toxicity, 0.8 mmol/kg of Gd-(HP-DO3A) was injected into rats, in a second study, via bolus and constant infusion techniques. Gd was only detected in the kidney in the bolus injected rats but in the lung as well in the constant infusion injected rats. Concentrations detected in the kidney for both strategies, were comparable within error: 1.37 +/- 0.46 ppm for the bolus and 1.24 +/- 0.39 ppm for the bolus/constant infusion strategy and 0.16 +/- 0.14 ppm in the lung for the constant infusion technique. The contrast infusion technique does not appear to present an increased risk of toxicity over the bolus technique except perhaps to a small degree in the lung.

Animals↗

Preventable in-hospital medical injury under the "no fault" system in New Zealand.

OBJECTIVES: To describe the pattern of preventable in-hospital medical injury under the "no fault" system and to assess the level of serious preventable patient harm. DESIGN: Cross sectional survey using a two stage retrospective assessment of medical records conducted by structured implicit review. SETTING: General hospitals with over 100 beds providing acute care in New Zealand. PARTICIPANTS: A sample of 6579 patients admitted in 1998 to 13 hospitals selected by stratified systematic list sample. MAIN OUTCOME MEASURES: Occurrence, preventability, and impact of adverse events. RESULTS: Over 5% of admissions were associated with a preventable in-hospital event, of which nearly half had an element of systems failure. The elderly, ethnic minority groups, and particular clinical areas were at higher risk. The chances of a patient experiencing a serious preventable adverse event subsequent to hospital admission were just under 1%, a figure close to published results from comparable studies under tort. On average, these events required an additional 4 weeks in hospital. System related issues of protocol use and development, communication, and organisation, as well as requirements for consultation and education, were pre-eminent. CONCLUSIONS: The risk of serious preventable in-hospital medical injury for patients in New Zealand, a well established "no fault" jurisdiction, is within the range reported in comparable investigations under tort.

Adolescent↗

Chromosomal assignment of 20 candidate genes for canine congenital sensorineural deafness by FISH and RH mapping.

The analysis of inherited diseases in the domestic dog (Canis familiaris) provides a resource for the continued use of this species as a model system for human diseases. Many different dog breeds are affected by congenital sensorineural deafness. Since mutations in various genes have already been found causative for sensorineural hearing impairment in humans or mice, 20 of these genes were considered as candidates for deafness in dogs. For each of the candidate genes a canine BAC clone was isolated by screening with heterologous human or murine cDNA probes. The gene-containing BAC clones were physically assigned to the canine genome by FISH and the BAC-derived STS-markers were positioned with the RHDF5000 panel on the canine RH map. The mapping data, which confirm the established conservation of synteny between canine and human chromosomes, provide a resource for further association studies in segregating canine populations and the basis for new insights into this common canine and human disease.

Animals↗

The effect of soft tissue deloading tape on thoracic spine pressure pain thresholds in asymptomatic subjects.

The application of tape to deload soft tissue is used in the management of thoracic spine pain. A reported clinical feature of this treatment is reduced tenderness of the spine during postero-anterior mobilizations. A randomized, single blind, placebo controlled, repeated measures design study was employed to investigate the effects of deloading tape on pressure pain threshold measurements at the level of the T7 spinous process in an asymptomatic group of 24 subjects. Pressure pain thresholds were assessed prior to and following the application of deloading tape, placebo sham tape and no-tape control conditions. All subjects received all three conditions in a randomized order on three separate days. Differences between the pre- and post-measurements were used as indicators of change in a subject's pressure pain threshold. No significant change in pressure pain threshold measurements was found between conditions. In summary, this study demonstrated that deloading tape applied to the level of the T7 spinous process did not significantly change pressure pain threshold measurements in asymptomatic subjects, raising the possibility that any pain relieving effect may well be conditional upon pain being present.

Adult↗

The experience of caring for older people with dementia in a rural area: using services.

This paper reports findings from the carer component of the Gwynedd Dementia Study. It is based on carer interviews, using quantitative and qualitative data. It confirms earlier findings that carers for people with dementia are typically female and older than other carers, although it notes that caring husbands are amongst the oldest carers. The problems that are most common are those that cause psychological stress to carers. Carers were found to receive both help and appreciation from their families and to perceive neighbours to be helpful if needed. In Gwynedd, as elsewhere, levels of formal service inputs are low, but most of the carers appeared to receive the services they needed. Problems are primarily associated with crisis support and long-term care is accepted reluctantly. It is suggested that community care dementia specialists could play a supporting role for carers.

Aged↗