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Biomedical subjects

A White

Publications and source records attributed to A White.

At least 37 records · Page 2Linked to original sources
PubMed2003

Aortic valve calcification on computed tomography predicts the severity of aortic stenosis.

AIM: Incidental aortic valve calcification is often detected during computed tomography. The aim was to compare the severity of valvular stenosis and calcification in patients with aortic stenosis. MATERIALS AND METHODS: One hundred and fifty-seven patients aged 68+/-11 years (range: 34-85) with aortic valve stenosis underwent multislice helical computed tomography and Doppler echocardiography performed by independent, blinded observers. The aortic valve calcium score was determined using automated computer software calibrated with a phantom. RESULTS: Doppler echocardiography demonstrated a post-valve velocity of 3.45+/-0.66 m/s and a peak gradient of 49+/-11 mmHg. Computed tomography showed excellent reproducibility and the median aortic valve calcium score was 5858 AU (interquartile range, 1555-14,596). The computed tomography aortic valve calcium score positively correlated with the Doppler post-valve velocity and peak gradient (r=0.54, p<0.0001 for both) of the aortic valve. All patients with severe aortic stenosis had a calcium score of >3700 AU. CONCLUSION: Calcification of the aortic valve is closely associated with the severity of aortic stenosis, and heavy calcification suggests the presence of severe aortic stenosis that requires urgent cardiological assessment. Patients with lesser degrees of aortic valve calcification should be screened for aortic stenosis and monitored for disease progression.

Adult↗
PubMed2003

Reflexologists' responses to a patient with abdominal pain-a survey on Internet advice.

OBJECTIVE: To generate preliminary data on how individual reflexologists deal with patients seeking medical advice on the Internet. DESIGN: E-mail survey involving reflexologists who were partly blinded for their advice on the Internet. SETTING: Cyberspace. PARTICIPANTS: Two hundred and seventy-seven members of the Association of Reflexologists. Of 842 e-mails sent out we received 323 responses (38% response rate) of which 46 participants later withdrew their responses (14% withdrawal rate). INTERVENTION: Participants were asked to advise a fictitious patient via e-mail who presented various health problems. MAIN OUTCOME MEASURE: Rating of responses according to safety and claims made by reflexologist sample. RESULTS: Eighty-five percent of all respondents advised the fictitious patient to present the health problems to a medical professional. Fifty-eight percent expressed urgency to see a primary care physician or other health care professional and 95% pointed out that a diagnosis cannot and should not be made by a reflexologist. Twenty-nine percent of responders suggested a differential diagnosis or underlying causes for the patient's condition. CONCLUSIONS: In this survey reflexologists from the UK Association of Reflexologists have responded in an encouraging manner to a fictitious patient's request for health advice via electronic mail as only 5% (or possibly 15%) of reflexologists from this survey need to be more cautious about the advice they give their patients. We hope that our study will further encourage therapists to be more cautious giving Internet health advice in the future.

Abdominal Pain↗
PubMed2003

A longitudinal magnetic resonance imaging (MRI) study of differences in abdominal fat distribution between normal mice, and lean overexpressers of mitochondrial uncoupling protein-3 (UCP-3).

AIM: To characterize evolution and distribution of abdominal adipose fat between 6 and 18 weeks of age in an animal model of energy consumption based on mice overexpressing the mitochondrial uncoupler protein 3 (UCP-3). METHODS: T2-weighted multislice MRI was performed six times during the 12 week study; visceral, subcutaneous and intermuscular fat depots were quantified. RESULTS: The overexpressor (UCP-3tg) mice consistently have less subcutaneous, visceral, interskeletal muscle and total fat throughout the experiment. Mean (standard error) volumes (ml) of the three distinct depots change between week 6 and week 18 as follows: wild type: subcutaneous 1.93 (0.28) to 6.18 (0.47), visceral 2.15 (0.34) to 6.37 (0.64), intermuscular 0.23 (0.04) to 0.53 (0.03); UCP-3tg: subcutaneous 1.47 (0.17) to 4.07 (0.57), visceral 1.18 (0.04) to 3.69 (0.59), intermuscular 0.23 (0.01) to 0.32 (0.04). Although they eat more (4.3 g compared with 3.4 g per day) the UCP-3tg's always weigh less than controls. In wild-type control animals, increases of all fat pools between week 6 and week 18 is highly significant, as it is for subcutaneous, visceral and total pools in the UCP-3tg animals. The UCP-3tg mice, however, show no significant absolute or relative increase in intermuscular fat; UCP-3 is predominantly overexpressed in skeletal muscle. CONCLUSION: MRI provides an excellent approach to comparative studies of fat distribution in animal models of energy expenditure such as the UCP-3tg mouse.

Abdomen↗
PubMed2003

The influence of dietary intake on the insulin-like growth factor (IGF) system across three ethnic groups: a population-based study.

OBJECTIVE: The insulin-like growth factor (IGF) system has been implicated in the aetiopathogenesis of cancer, cardiovascular disease and diabetes. Since dietary factors and ethnicity are considered contributory to the development of these diseases, we examined the IGF system in relation to nutritional intake by ethnic group. DESIGN, SUBJECTS AND SETTING: Dietary intake in 257 subjects of White European, African-Caribbean and Pakistani ethnic origin living in Manchester, UK was assessed using ethnic-group-specific food-frequency questionnaires to assess habitual nutrient intake over the previous 12 months. Fasting IGF-I, IGF-II and IGF-binding protein-1 (IGFBP-1) concentrations were determined and their relationship to specific dietary constituents was analysed. RESULTS: Analysis by quintiles of nutrient intake showed a significant increase in circulating IGF-I concentration with increasing dietary fat intake (F for trend=3.9, ), saturated fat intake and for protein intake There was also a significant increase in IGF-II by quintiles of dietary protein intake There was a trend for increasing IGF-I with increasing energy intake. The relationships between circulating concentration of IGFBP-1, an acute regulator of IGF action, and fat/protein intake were opposite to those for IGF-I and IGF-II. Multiple linear regression modelling showed that people of Pakistani origin and older subjects had lower levels of IGF-I (Pakistani origin vs. others, ) (age, for both). There was an independent inverse relationship between IGF-I and dietary carbohydrate intake CONCLUSIONS: This study provides evidence for a dietary contribution to regulation of the IGF system, although the effects of ethnicity on circulating IGF levels remain dominant. We propose that the IGF system's influences on cancer risk in specific ethnic groups are potentially modifiable by dietary intervention.

Adult↗
PubMed2003

Assessing stages of change for fruit and vegetable intake in young adults: a combination of traditional staging algorithms and food-frequency questionnaires.

Adequate fruit and vegetable intake is strongly associated with a reduced risk for various chronic diseases. US national surveys show that 18- to-24-year-olds are not consuming enough of these foods. Theory-based nutrition interventions, e.g. stage-tailored education programs, are needed for promoting fruit and vegetable consumption in this age group. Accurate stage assignment is the basis for developing effective stage-tailored interventions. In the current study, three different methods were compared for assigning stages of change in fruit and vegetable intakes by young adults. Significant differences in food intake, decisional balance and self-efficacy were found between respondents with concordant responses to the traditional stage algorithm and the food-frequency questionnaire (FFQ) and those with discordant responses. The stage assignment method that combined the staging algorithm and FFQ identified a distinct stage, labeled 'non-reflective action', in addition to the traditional five stages of change. This stage lay between the preparation and action stages with regard to food intake and psychosocial variables. Implications of the findings were discussed for future intervention programs that attempt to promote fruit and vegetable intake.

Adult↗
PubMed2003

Individualised homeopathy as an adjunct in the treatment of childhood asthma: a randomised placebo controlled trial.

BACKGROUND: Homeopathy is frequently used to treat asthma in children. In the common classical form of homeopathy, prescriptions are individualised for each patient. There has been no rigorous investigation into this form of treatment for asthma. METHODS: In a randomised, double blind, placebo controlled trial the effects of individualised homeopathic remedies were compared with placebo medication in 96 children with mild to moderate asthma as an adjunct to conventional treatment. The main outcome measure was the active quality of living subscale of the Childhood Asthma Questionnaire administered at baseline and follow up at 12 months. Other outcome measures included other subscales of the same questionnaire, peak flow rates, use of medication, symptom scores, days off school, asthma events, global assessment of change, and adverse reactions. RESULTS: There were no clinically relevant or statistically significant changes in the active quality of life score. Other subscales, notably those measuring severity, indicated relative improvements but the sizes of the effects were small. There were no differences between the groups for other measures. CONCLUSIONS: This study provides no evidence that adjunctive homeopathic remedies, as prescribed by experienced homeopathic practitioners, are superior to placebo in improving the quality of life of children with mild to moderate asthma in addition to conventional treatment in primary care.

Administration, Inhalation↗
PubMed2003

Analytical and clinical aspects of adrenocorticotrophin determination.

Adrenocorticotrophin (ACTH) is formed from the cleavage of pro-opiomelanocortin. Measurement of plasma ACTH is a key step in the differential diagnosis of hypothalamic-pituitary-adrenal disorders. Prior to the development of radioimmunoassay, the bioassays employed for the determination of ACTH were highly complex, time-consuming and costly in terms of number of animals used. Their sensitivity was such that the normal early morning peak of ACTH could not be determined. The introduction of immunoassay methodology enabled the measurement of low normal ACTH concentrations. Immunological recognition of ACTH by the antibodies employed offered improvements with regard to specificity. The development of two-site immunometric assays further improved specificity and the ability to measure low normal ACTH concentrations without the need to extract large volumes of plasma. The quantification of ACTH is now routinely performed in clinical laboratories, with non-radioisotopic methods becoming increasingly popular. ACTH measurement is of limited value in distinguishing between the causes of Cushing's syndrome, as there is considerable overlap in circulating ACTH concentrations in subjects with either a pituitary or an ectopic tumour. The role of ACTH precursor and related peptides in normal and pathological states and the clinical utility of their measurement remain to be fully elucidated. However, there is evidence that measurement of ACTH precursors can be a useful diagnostic tool in identifying the aetiology of Cushing's syndrome. This review will primarily address methodological aspects of ACTH measurement in the diagnosis of clinical conditions.

Adrenocorticotropic Hormone↗
PubMed2003

Peritoneal involvement in stage II colon cancer.

A pathologist (K.S.) reviewed histologic slides for peritoneal involvement by tumor cells for 118 patients with stage II colon cancer. Patients were followed up for a median of 6 years. Tumor cells were found free in the peritoneal space in 16 cases (13.6%). The presence of cancer cells free in the peritoneal space was associated with lymphovascular invasion (P = .001) and neural invasion (P < .001). The overall 5-year survival was 80% in the patient population, but was 39% and 86% for those with and without tumor cells free in the peritoneal space, respectively (P < .0001). Multivariate analysis confirmed that free tumor cells within the peritoneal space (P < .0001) and lymphovascular invasion (P = .007) were related independently to outcome. Peritoneal involvement with tumor cells free in the peritoneal space in stage II colon cancer is a powerful indicator of outcome; patients have a survival similar to that for patients with stage III disease.

Adult↗
PubMed2002

Faecal progesterone metabolites and behavioural observations for the non-invasive assessment of oestrous cycles in the common wombat (Vombatus ursinus) and the southern hairy-nosed wombat (Lasiorhinus latifrons).

Wombats belong to Australia's unique marsupial species. Two of the three remaining species, the common wombat (Vombatus ursinus) and the southern hairy-nosed wombat (Lasiorhinus latifrons) are abundant. The third species, the northern hairy-nosed wombat (Lasiorhinus krefftii) has only about 115 individuals left in the wild. This study aimed to gain further insight into the basic reproductive biology of wombat species and evaluate the value of faecal progesterone metabolites and behavioural patterns as a means for non-invasive monitoring of the oestrous cycle in common and the southern hairy-nosed wombats. In an initial study, three different faecal steroid assays showed that 20alpha-OH-pregnanes were the main progesterone metabolites. These metabolites were examined in captive female common wombats (n = 5) and southern hairy-nosed wombats (n = 2). In one female common wombat 11.7 days with a follicular phase of 25.6 +/- 6.3 days and a luteal phase of 28.2 +/- 12.7 days. The data for faecal pregnanes obtained in the southern and in one male common wombat oestrous related behavioural data were obtained. Individual cycling females exhibited a significant relationship between plasma progesterone and faecal pregnanes. In the common wombat, the values for faecal pregnanes showed an oestrous cycle length of 55.1 +/- hairy-nosed wombat during the breeding season gave an oestrous cycle length of 41.1 +/- 12.8 days with a follicular phase of 27.9 +/- 12.3 days and a short luteal phase of 13.3 +/- 1.1 days. The behavioural data show that the faecal sniffing behaviour of the male, tended to increase around the time that oestrous was found. In conclusion, monitoring of 20alpha-OH-pregnanes in wombat faeces could be a useful methodology to monitor reproductive cycles in the wombat, and can possibly be applied to monitor the endangered northern hairy-nosed wombat.

Animals↗
PubMed2002

Effect of cyclodextrins on the solubility and antimycotic activity of sertaconazole: experimental and computational studies.

This study investigated the effects of the complexation of sertaconazole nitrate with different cyclodextrin (CD) derivatives (alpha-CD, beta-CD, gamma-CD, hydroxypropyl-beta-CD, and hydroxypropyl-gamma-CD) on the aqueous solubility and antimycotic activity of the drug. Phase solubility studies indicated that the solubility of sertaconazole in enzyme-free simulated gastric- and enzyme-free simulated enteric fluids was significantly increased in the presence of cyclodextrins. The observed order of solubility increasing effect was: gamma-CD > HPgamma-CD > HPbeta-CD > beta-CD > alpha-CD. Solid-state sertaconazole-cyclodextrin complexes were prepared by freeze drying, and characterized by X-ray powder difractometry, differential scanning calorimetry (DSC), and infrared spectroscopy (FTIR). Freeze-dried complexes showed markedly higher solubility than both physical mixtures and sertaconazole alone. The antimycotic activities of sertaconazole-cyclodextrin complexes in solution were evaluated by inhibition zone assays with Candida albicans. The activity ranking agrees with the solubility ranking observed for these complexes, with the gamma-CD-sertaconazole complex showing the strongest antimycotic activity. Finally, molecular modeling studies were carried out using the MM2 force field method, for complexes in vacuum and in water. This enable indentification of the preferred orientation of sertaconazole in the gamma-CD cavity and of the main structural features responsible for the enhancement of its solubility and antimycotic activity.

Antifungal Agents↗
PubMed2002

Starting point or solution? Community-based marine protected areas in the Philippines.

In 1985, in response to declining coral reef conditions, local residents and officials established small, no-take marine sanctuaries on Balicasag and Pamilacan Islands through a community-based process. The implementation of marine protected areas (MPAs) on Balicasag and Pamilacan Islands has been a partial success. As a direct result of protection, living hard coral cover has increased by 119% in Balicasag's sanctuary and by 67% in the non-sanctuary during the period 1984 to 1999, but Balicasag's reef is increasingly affected by breakage from anchors from dive boats and Crown-of-thorns starfish infestations. During the same period, living hard coral cover decreased by 20% in Pamilacan's sanctuary and by 45% in the non-sanctuary from 1984 to 1999. The decrease in living hard coral cover in Pamilacan's sanctuary is most likely a result of the 1998 bleaching event, Crown-of-thorn starfish and possible storm damage. Although there was an initial increase in the economically important target fish abundance in the Balicasag sanctuary and non-sanctuary and in the Pamilacan sanctuary during the first two years of implementation in the mid-1980s, there has since been a significant decline. Mean target fish abundance for the Balicasag non-sanctuary at 230 (+/- 65) individuals per 500 m2 is not significantly different from control sites without MPAs on nearby Panglao and Cabilao Islands at 164 (+/- 67) individuals per 500 m2. In general, fish abundance and diversity inside and outside the sanctuaries peaked in 1986, a year after the establishment of the sanctuaries when enforcement was strictest. Therefore, despite considerable success in enforcing regulations associated with these small MPAs at Balicasag and Pamilacan Islands, a trend of declining fish abundance and species richness among economically valuable species immediately outside the no-take areas highlights the limitations of small and isolated MPAs. This study contributes to the growing sentiment that it is not realistic for scattered, small no-take areas to maintain fish abundance and diversity on surrounding reefs when intensive fishing effort immediately adjacent to no-take areas removes most fish that exit these areas. This finding emphasizes the importance of nesting individual MPAs within broader management regimes that lead to overall fishing effort reduction and networking of MPAs. Among other recommendations, the authors advocate for continued support for community-based MPAs, a network of MPAs, reduced fishing effort in areas surrounding the MPAs and other management measures to improve the quality of the coral reef habitats.

Animals↗
PubMed2002

Investigations into the regulation of lipid biosynthesis in Brassica napus using antisense down-regulation.

We have generated antisense plants of Brassica napus, targeting either the cytoplasmic Type I acetyl-CoA carboxylase or the beta-ketoacyl-acyl carrier protein reductase of the Type II dissociable fatty acid synthase, in order to investigate the importance of these components in regulating lipid metabolism in plants. Using a range of down-regulated plants, it has become clear that down-regulation of these genes also causes down-regulation of other components of lipid metabolism, at the activity, translational and transcriptional levels. These plants exhibit effects, not immediately predicted, on oil yield and carbon resource allocation in seeds.

Brassica napus↗
PubMed2002

National audit of the management of peritonsillar abscess.

An anonymous postal survey of 200 consultants was used to audit the current prevalent practices in the management of quinsy in the UK; 101 responded. The findings reveal that on average an otolaryngology department treats 29 cases per year, the vast majority (94%) on an inpatient basis. The main initial treatment was needle aspiration combined with intravenous antibiotics. Interestingly, those departments treating more than 20 cases a year are more likely to use needle aspiration, while departments in England and Wales use significantly more incision and drainage than those in Scotland. Incision and drainage (52%) was the most common form of treatment of non-resolving patients. The median hospital stay was two days.

Anti-Bacterial Agents↗
PubMed2002

Failure of steroid regulation of the MMTV promoter in a small cell lung cancer cell line is caused by a DNA sequence flanking the glucocorticoid response element.

We have previously described a panel of human small cell lung carcinoma (SCLC) cell lines that have profound glucocorticoid resistance, resulting from various molecular defects in glucocorticoid signalling. However, in one SCLC cell line, CORL103, the cause of the resistance is unknown. These cells are refractory to dexamethasone stimulation of MMTV even when exogenous wild-type glucocorticoid receptor (GR) is co-transfected. This is in contrast to cell lines DMS79 and CORL24 where resistance is overcome by transfection of the wild-type receptor. Sequencing of the GR from CORL103 cells revealed two point mutations, but neither of these induced dominant negative activity. Steroid hormone resistance extended to mineralocorticoid and progesterone receptor (MR, PR) activation of MMTV-luc, whereas oestrogen and thyroid hormone receptor transactivation were normal. A simpler reporter, TAT3-luc, containing three copies of the tyrosine aminotransferase glucocorticoid response element (GRE), was responsive when transfected into CORL103 cells with GR, MR and PR expression vectors and activated with their respective ligands. Similarly, pHH-luc and pAH-luc (truncated MMTV variants containing the GRE region, both derived from a different strain of MMTV), were effectively transactivated with dexamethasone. This suggests that the minor changes in the flanking sequence of the MMTV promoter are critically important in determining steroid responsiveness in CORL103 cells. We propose that minor differences in MMTV may determine recruitment of co-factors, which destabilise GR binding to the MMTV GREs. These findings represent a new, selective, model of glucocorticoid resistance that may explain specific cell and target gene differences in glucocorticoid sensitivity.

3' Flanking Region↗
PubMed2002

Pro-opiomelanocortin processing in the hypothalamus: impact on melanocortin signalling and obesity.

Bioactive peptides derived from the prohormone, pro-opiomelanocortin (POMC), are generated in neurons of the hypothalamus and act as endogenous ligands for the melanocortin-4 receptor (MC4R), a key molecule underlying appetite control and energy homeostasis. It is therefore important to understand many aspects of POMC gene regulation in the brain, as pharmacological manipulation of POMC expression/processing could be a potential strategy to combat obesity. Most studies that have analysed POMC gene expression in the hypothalamus have focused on gene transcription experiments. Ultimately, however, factors that regulate post-translational processing and secretion of peptides will have most bearing on melanocortin signalling. This article focuses on (a) current evidence that POMC is involved in obesity, (b) how POMC transcription is regulated in the hypothalamus, (c) the mechanism by which proteolytic processing of POMC is controlled in the hypothalamus and what peptides are produced and (d) which POMC-derived peptides are the most potent ligands at the melanocortin receptor in vitro and in vivo. It seems that post-translational cleavage of POMC in the hypothalamus may be regulated with respect to energy requirement. We predict that further research into hypothalamic POMC processing, and the proteolytic enzymes involved, may yield important new clues on how flux through the MC4R pathway is regulated.

Animals↗