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Biomedical subjects

C Cullen

Publications and source records attributed to C Cullen.

At least 19 recordsLinked to original sources
PubMed2006

Re-admission rates within 28 days of total hip replacement.

INTRODUCTION: The aim of the study was to identify the reasons for the higher than expected emergency re-admission to hospital within 28 days of total hip replacement (THR) for Stepping Hill Hospital, Stockport. PATIENTS AND METHODS: Over a 42-month period, 65 (8.5%) of 769 patients were re-admitted within 28 days of discharge following primary THR. Case notes for 61 patients were available for retrospective review to assess premorbidity, initial postoperative complications and reason for re-admission. RESULTS: The main reasons for re-admission were complications related to the procedure. These included thrombo-embolic disease 2.5%, atraumatic dislocation 1.4%, wound complications 1.2% and swollen limb 1.8%. Other causes such as admission to another department for problems not related to THR accounted for 0.8%. CONCLUSIONS: Our findings are comparable with the published literature for early complications following THR. The three main reasons for re-admission were atraumatic dislocation, thrombo-embolic and wound complications such as superficial infection and haematoma are the commonest world-wide. The re-admission rate to hospital within the first 28 days following THR was a clinical indicator suggested by the UK Department of Health. It has subsequently been incorporated in a group of indicators used by the CASPE Healthcare Knowledge Systems (CHKS), a private healthcare consultancy and analysis company, for peer benchmarking. Our re-admission rates are inflated by admissions for non-THR-related reasons. The level of post-THR complications leading to re-admission were acceptable compared with the available published literature regarding 28-day re-admission. We anticipate that this study may act as a benchmark for other trusts.

Adult↗
PubMed2001

Multiple giant synovial chondromatosis of the knee.

This report describes an unusual presentation of monoarticular synovial chondromatosis of the knee. In this case, multiple giant chondroid nodules presented as a painless soft tissue mass. There was no calcification but bony erosion was seen on MR scan. Such lesions may mimic a malignant neoplasm and pose a diagnostic problem.

Adult↗
PubMed2001

Brief report: improvements in the behavior of children with autism following massage therapy.

Twenty children with autism, ages 3 to 6 years, were randomly assigned to massage therapy and reading attention control groups. Parents in the massage therapy group were trained by a massage therapist to massage their children for 15 minutes prior to bedtime every night for 1 month and the parents of the attention control group read Dr. Seuss stories to their children on the same time schedule. Conners Teacher and Parent scales, classroom and playground observations, and sleep diaries were used to assess the effects of therapy on various behaviors, including hyperactivity, stereotypical and off-task behavior, and sleep problems. Results suggested that the children in the massage group exhibited less stereotypic behavior and showed more on-task and social relatedness behavior during play observations at school, and they experienced fewer sleep problems at home.

Analysis of Variance↗
PubMed2000

Auditory integration training for children with autism: no behavioral benefits detected.

Auditory integration training and a control treatment were provided for 16 children with autism in a crossover experimental design. Measures, blind to treatment order, included parent and teacher ratings of behavior, direct observational recordings, IQ, language, and social/adaptive tests. Significant differences tended to show that the control condition was superior on parent-rated measures of hyperactivity and on direct observational measures of ear-occlusion. No differences were detected on teacher-rated measures. Children's IQs and language comprehension did not increase, but adaptive/social behavior scores and expressive language quotients decreased. The majority of parents (56%) were unable to report in retrospect when their child had received auditory integration training. No individual child was identified as benefiting clinically or educationally from the treatment.

Acoustic Stimulation↗
PubMed1999

Outcome after distal vascular reconstruction in women.

Although women are less likely to develop symptomatic atherosclerosis, little data exists on the long-term outcome of women undergoing infrainguinal arterial reconstructions. This study analyzes the operative mortality rate, complications, and the short-term and long-term results after these procedures in both men and women who had symptomatic vascular disease. From 1984 to 1997, 3956 infrainguinal arterial reconstructions were performed at Albany Medical Center. A total of 2474 (62.54%) reconstructions were performed in men and 1482 (37.46%) in women. The mean ages were 67 years for men and 71 years for women. Forty-three percent of the men were smokers compared with 26% of the women. Diabetes was present in 51% of the men and 55% of the women. Claudication was the indication for bypass in 298 (12.05%) men and 110 (7.42%) women. Limb salvage occurred in 2176 (87.95%) men and 1372 (92.58%) women. Perioperative 30-day patency rates were 96.66% in men and 96.50% in women. Primary patency rates at 1, 3, 5, and 10 years were compared; no significant difference existed between men and women. Secondary patency also was similar in both men and women. These results indicate that women requiring arterial reconstruction for infrainguinal occlusive disease had short-term and long-term graft patency results that were comparable with the results of men.

Aged↗
PubMed1999

Double fluorescent-amplification refractory mutation detection (dF-ARMS) of the factor V Leiden and prothrombin mutations.

Simultaneous fluorescent [F] detection of the factor V Leiden (G1691A) and the prothrombin 3'-untranslated region (G20210A) mutations were performed in a single tube polymerase chain reaction (PCR). Amplification refractory mutation detection system (ARMS) formed the basis of this assay design. Fluorescent-labelled primers incorporated into amplicons during the reaction facilitated detection directly by GeneScan analysis without further manipulation. To test the efficacy of this double [F]-ARMS (dF-ARMS) method, 48 patients with unexplained thrombotic tendencies were investigated for their factor V Leiden and prothrombin genotypes. These results corresponded exactly with data achieved using the more conventional methods of restriction fragment length polymorphism (RFLP)-PCR and direct DNA sequencing. Three out of the 48 patients in this group were found to be compound heterozygotes.

Alleles↗
PubMed1998

The safety and efficacy of electroconvulsive therapy in patients over age 75.

OBJECTIVES: To examine the safety and efficacy of electroconvulsive therapy (ECT) in patients over the age of 75 years. METHOD: Retrospective study of all patients over 75 years treated with ECT in three hospitals between 1995 and 1997. RESULTS: Ninety-three ECT courses were administered during the study period. Ten patients (10.8%) suffered complications following ECT. The most common adverse events were prolonged confusion and hypomania, all of which resolved within 2 weeks of the cessation of treatment. Eighty-five per cent of patients made a marked or moderate response to treatment. CONCLUSIONS: ECT is a relatively safe and effective procedure in patients over age 75.

Aged↗
PubMed1998

An examination of the effects of gentle teaching on people with complex learning disabilities and challenging behaviour.

OBJECTIVES: This study was conducted to investigate the efficacy of gentle teaching when compared with individual educational programming (IEP) for a group of people with complex learning disabilities and challenging behaviour. DESIGN: An A-B design was used, in which gentle teaching was introduced as an addition to the IEP procedures already in place. Other designs, such as reversal, multiple baseline or group comparisons would have been impractical in this clinical setting. METHODS: Thirteen students and seven staff were observed, using a hand-held computer for direct observations, and video-recordings for measures of interaction. Staff attitudes to gentle teaching and to the IEP system were also assessed. The intervention was systematic workshop-based training in gentle teaching for all staff. Measures were taken pre-intervention for 13 weeks and post-intervention for 23 weeks. Approximately 45 hours of direct observational data and over 50 hours of video-recording were analysed. RESULTS: We found very few effects of gentle teaching. Wherever there were differences between gentle teaching and IEP these were in favour of gentle teaching, although they were generally relatively minor in terms of clinical (rather than statistical) significance. Inter-rater reliabilities were generally poor, although the figures for those categories where there was a difference between gentle teaching and IEP were amongst the most respectable. CONCLUSIONS: Gentle teaching did not have a major impact on staff behaviour, and no discernible effect on student behaviour, but it did not lead to poorer interactions and may be a useful adjunct to more structured approaches such as individual educational programming.

Attitude of Health Personnel↗
PubMed1997

HLA class I DNA typing of 215 "HLA-A, -B, -DR zero mismatched" kidney transplants.

DNA typing for HLA class II improves the typing quality and this was shown previously to be relevant for kidney graft survival. In this project we addressed the question whether molecular typing for HLA class I also increases the efficacy of HLA matching in kidney transplantation. 215 HLA-A,-B,-DR zero-mismatched donor/recipient pairs as defined by serological typing were selected. Retrospective HLA-A and HLA-B typing was performed both by the PCR-SSP and the PCR-SSOP method. DNA typing for HLA-A revealed discrepant results to serology in 5.7% of the donors and 2.8% of the recipients. HLA-B typing discrepancies were found in 6.6% of the donors and 5.6% of the recipients. 10.4% of the donors and 6.5% of the recipients showed either an HLA-A or an HLA-B discrepancy Nearly one-third of the HLA-A discrepancies affected A19 splits. The most common reason for HLA-A discrepancies was the erroneous assignment of serological blanks, whereas HLA-B errors were caused mainly by the assignment of incorrect specificities. DNA typing allowed the definition of HLA-A and -B split specificities in all 118 "splitable" cases for which only broad specificities were reported based on serological typing. A total of 183 DNA class I compatible transplants had a 15% higher one-year graft survival rate than 32 transplants for which DNA typing revealed a class I incompatibility

DNA Probes, HLA↗
PubMed1996

Inhibition of nitric oxide generation: normalization of in vitro insulin secretion in mice with multiple low-dose streptozotocin and in mice injected with mononuclear splenocytes from diabetic syngeneic donors.

We studied the effect on in vitro glucose-induced insulin secretion of in vivo administration of L-Ng-monomethyl-arginine (L-NMMA), a competitive inhibitor of nitric oxide (NO) synthase, to mice injected with multiple low-dose streptozotocin (mld-SZ). In addition, the effect of L-NMMA treatment on the capacity of mononuclear spleen cells (MS) from mld-SZ mice to transfer alterations in insulin secretion from normal syngeneic receptors was also investigated. We also studied the effect of in vivo treatment with L-NMMA on anti-beta-cell cellular immune aggression (CIA) by coculturing MS from mld-SZ mice with rat dispersed islet cells. Our results show that mld-SZ mice treated with 0.25 mg L-NMMA/g body weight had normoglycemia, first and second-phase glucose-stimulated insulin secretion similar to those obtained in nondiabetic mice-effects not observed with a lower dose of L-NMMA (0.17 mg/g body weight)-and a diminished anti-beta-cell CIA. We also demonstrate that mice injected with MS from syngeneic donors treated with mld-SZ plus 0.25 mg L-NMMA/g had normal levels for first-phase glucose-stimulated insulin secretion and an absence of CIA. Taken together, these findings seem to indicate that prevention of in vivo NO production may block the onset of diabetes in mld-SZ mice, and that L-NMMA administration to diabetic donor mice prevents inhibition of first-phase insulin secretion and CIA in the transferred recipient mice. Although a nonimmunological mechanism or mechanisms of diabetes prevention by L-NMMA cannot be excluded, these results suggest that L-NMMA treatment could also be acting on T-cell-dependent immune reactions.

Animals↗
PubMed1996

Ultrastructure of liver from piglets fed Tower rapeseed oil.

Effect of Tower rapeseed oil (RO) containing lower (0.4%) erucic acid on the piglet liver was studied by electron microscopy. The animals were placed in two groups of four and were fed the diets for eight weeks. Animals in the treated group were given a basal diet comprising corn-soybean plus Tower RO at a 10% concentration; animals that were given the basal diet with no added oil served as the controls. Architecture of the liver from animals of the control group appeared normal. Ultrastructural changes in the liver of RO-fed animals included dilation of lumens and loss of microvilli in bile canaliculi. In addition, closely aligned mitochondrial cristae, elevated number of peroxisomes, and an unusual increase in the size and number of membrane bound spaces in zone 3 of liver acini were noticed. These alterations may reflect a disturbance in piglet liver functions following Tower RO feeding.

Animals↗
PubMed1995

Genomic fingerprinting Acinetobacter baumannii: amplification of multiple inter-repetitive extragenic palindromic sequences.

Acinetobacter species are important nosocomial pathogens. A rapid and sensitive identification system, capable of providing strain identity at the genetic level, is required to identify outbreak strains and facilitate the early implementation of infection control procedures. Repetitive extragenic palindromic (REP) elements, have been identified in numerous bacteria and these genomic sequences provide useful targets for DNA amplification. A method for amplifying inter-REP DNA sequences, REP-multiple arbitrary amplicon profiling (REP-MAAP), is described and applied to 29 Acinetobacter baumannii from clinical samples. Amplified polymorphic DNA patterns were demonstrated for all isolates and those displaying identical REP-MAAP patterns were considered identical at the genetic level. In the spring of 1993, 10 intensive care unit patients had endotracheal colonization with A. baumannii (five with REP-MAAP I and five with REP-MAAP II patterns). These findings suggested nosocomial transmission of organisms which was terminated by standard infection control measures. No further A. baumannii were detected until the winter of 1993 when isolates of different REP-MAAP groups emerged, suggesting that factors other than nosocomial transmission were implicated.

Acinetobacter↗
PubMed1995

The effects of deinstitutionalization on adults with learning disabilities.

We compared a group of people with learning disabilities who have been deinstitutionalized with a control group remaining in an institution on measures of adaptive and maladaptive behaviour, community living skills, social skills, and quality of life. In general, there was no change over 30 months for the control group. Changes for the experimental group were either not seen or were generally modest in scale, and tended to occur within 6 months of moving, the measures staying relatively stable thereafter. Implications for detailed examination of the effects of deinstitutionalization were discussed.

Activities of Daily Living↗
PubMed1995

Modification of an HLA-B PCR-SSOP typing system leading to improved allele determination.

Modifications have been introduced to a previously reported HLA-B PCR-SSOP typing system. This has enabled further definition of alleles, determination of the probe pattern of some alleles not previously examined and identification of patterns of possible new alleles. However there are still some alleles that cannot be differentiated and there are several alleles which when present as a homozygote have the same pattern as in combination with another allele. When the method was applied to the typing of 66 consecutive cadaveric donors there were three donors whose type differed from the serological type.

Alleles↗