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Biomedical subjects

B Clarke

Publications and source records attributed to B Clarke.

195 records · Page 11Linked to original sources
PubMedDate not supplied

Fungal pathogens of oat roots and tomato leaves employ closely related enzymes to detoxify different host plant saponins.

Antifungal saponins are produced by many plants and have been implicated as preformed determinants of resistance to fungal attack. The importance of saponin detoxification in fungal pathogenesis has recently been demonstrated for the fungus Gaeumannomyces graminis var. avenae, which produces the enzyme avenacinase. Avenacinase detoxifies the triterpenoid oat root saponin avenacin A-1, and is essential for pathogenicity of G. graminis var.avenae to oats. Here we demonstrate an unexpected relatedness between avenacinase and the tomatinase enzyme produced by Septoria lycopersici (a tomato leaf-infecting fungus), which acts on the steroidal glycoalkaloid alpha-tomatine. The two enzymes share common physicochemical properties and are immunologically cross-reactive; however, there are critical differences in their substrate specificities which reflect the host preferences of the fungi from which the enzymes were purified. The DNA encoding tomatinase was isolated from a S. lycopersici cDNA library using avenacinase DNA as a probe. Comparison of the predicted amino acid sequences of avenacinase and tomatinase revealed that the enzymes are clearly similar.

Amino Acid Sequence↗
PubMedDate not supplied

Continuous subcutaneous insulin infusion in the management of painful diabetic neuropathy.

Nine patients with diabetic neuropathy were treated as outpatients with continuous subcutaneous insulin infusion (CSII). Painful symptoms were scored on a 10-cm horizontal graphic rating scale; motor conduction velocity (MCV) was measured in the median and peroneal nerves; and vibration perception threshold (VPT) was recorded in the great toes. All investigations were repeated after 6 wk and at the completion of 4 mo of CSII. Improved diabetic control was confirmed by significantly lower mean blood glucose levels, M-values, and glycosylated hemoglobin. Symptomatic relief was noted by all patients and was accompanied by a significant improvement in pain scores. There was also significant improvement in VPT and MCV after 6 wk of CSII, which was maintained throughout the 4-mo period. However, sensory studies in the median nerve showed no significant changes during the study. It is concluded that strict glucoregulation is indicated in all cases of symptomatic diabetic neuropathy. It remains to be seen whether strict diabetic control from diagnosis will lead to a reduction in the incidence of this complication.

Adult↗
PubMedDate not supplied

Haemolysis following mitral valve repair.

We report the unusual occurrence of severe intra-vascular haemolysis following mitral valve repair. Mild to moderate mitral regurgitation was detected after repair, but severe haemolysis was the only indication for re-operation. Following prosthetic valve replacement there was an immediate cessation of haemolysis. We postulate that a small regurgitant jet directed against the teflon pledgets used in the repair was the reason for the haemolysis.

Aged↗
PubMedDate not supplied

Prescribing practices in an Irish Long Term Care Setting.

The elderly constitute 11.4% of the Irish Population and are prescribed 47% GMS prescription medications. Polypharmacy is well described in studies as being the norm and not the exception in the elderly. A long term care setting represents a particular group of these patients having medical problems that are both complex in nature and copious in number. Prescribing practices have not been well documented in the Irish Long Term Care setting. We therefore determined a need to describe prescribing patterns in the Irish Long Term Care Setting. Seventy-six patients were identified in two Long Term Care units. Data collected per patient included type of diagnosis, age, and medication prescribed. Paired data was available on 52 patients at baseline and again at six months. The impact of regular consultant review on prescribing was assessed during this period. We found that the average age of the residents was 80.9 years. Female residents accounted for 75% of the patients and males 25%. There was an average of 8.8 diagnoses per patient. At baseline there was an average of 9.2 medications prescribed per patient. The vast majority of prescriptions were for CNS preparations (42%), followed by Cardiovascular (16%) Gastrointestinal (16%) and Respiratory (6%). Medication prescribed changed in nature but numerically was not reduced by regular consultant review. The number of scheduled medications did not change over six months of review, at 5.5 per patient. However there was an increase in the number of PRN prescriptions from 3.7 to 4.25 per patient. We concluded that there is a higher than expected number of medications prescribed to patients in Long Term Care. On the basis of this descriptive study we recommend that standards be set for Prescribing in Long Term Care.

Aged↗
PubMedDate not supplied

A comparative study of the efficacy and toxicity of etodolac and naproxen in the treatment of osteoarthritis.

In a two-period, double-blind, crossover study, patients with osteoarthritis of the knee and/or hip received etodolac 300 mg twice daily for 4 weeks and naproxen 500 mg twice daily for 4 weeks in random order. The assessment of efficacy showed that naproxen and etodolac were equally effective in the management of pain and stiffness in osteoarthritis. However, a significantly higher proportion of patients preferred naproxen to etodolac for the relief of pain intensity. The incidence of adverse events caused by either drug was the same.

Adolescent↗