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Biomedical subjects

C Ingram

Publications and source records attributed to C Ingram.

At least 19 recordsLinked to original sources

Effects of a novel formulation of essential oils on glucose-insulin metabolism in diabetic and hypertensive rats: a pilot study.

BACKGROUND: Insulin resistance and its most severe form type 2 diabetes mellitus are rapidly increasing throughout the world. It is generally recognized that natural products with a long history of safety can increase insulin sensitivity. AIMS: The present investigation examined the ability of various combinations of essential oils such as fenugreek, cinnamon, cumin, oregano, etc. to enhance insulin sensitivity. As a first approximation, we examined the effects of these natural products on Zucker fatty rats (ZFRs), a model of obesity and insulin resistance, and spontaneously hypertensive rats (SHRs), a model of genetic hypertension. MATERIAL AND METHODS: Water or essential oils were given orally via droplets, and insulin sensitivity was estimated by systolic blood pressure (SBP) changes and circulating glucose and/or insulin concentrations. RESULTS: We have found that the ability to alter SBP in rat models is the most sensitive early index of insulin sensitivity. The combined essential oils lowered circulating glucose levels and SBP in both ZFRs and SHRs, suggesting that these natural products are enhancing insulin sensitivity. The second series of studies examined two additional combinations of essential oils along with the original formula. The major differences were in the types and proportions of individual oils contributing to a given formula. CONCLUSIONS: Although all the three formulae decreased SBP in ZFRs, one of the formulae was more effective than the others in lowering circulating glucose in the glucose tolerance testing. Accordingly, some essential oils may be added to the long list of natural products that can affect insulin sensitivity.

Administration, Oral↗

Reduced airway distensibility, fixed airflow limitation, and airway wall remodeling in asthma.

The airways of individuals with asthma are less distensible than normal and it has been assumed that this may be due to airway remodeling associated with chronic inflammation, although there are currently no available data directly relating these two aspects of asthma. We have therefore carried out a study of the relationship between airway distensibility (DeltaVD) and subepithelial reticular basement membrane (RBM) thickening as an index of airway remodeling, in a group of patients with relatively mild but symptomatic asthma. Our methods included a cross-sectional study of DeltaVD in patients with mild to moderate atopic asthma, with matched airway biopsy for structural components. We confirmed that DeltaVD was lower in patients with asthma than in normal individuals (19.8 +/- 1.1 versus 24.1 +/- 1.5; p < 0.05) and that RBM thickness was increased in patients with asthma (9.1 +/- 2.2 versus 7.7 +/- 1.2 microm; p < 0.01). There was a negative correlation between DeltaVD and RBM thickness in asthma (r = -0.37, p = 0.03) and positive correlations between percent predicted postbronchodilator large and small airway function (for percent predicted FEV(1 )versus DeltaVD, r = 0.59, p < 0.001). We conclude that, cross-sectionally, DeltaVD was related to airway remodeling (RBM thickening) and airflow limitation (percent predicted large and small airway function). Our findings support the hypothesis that DeltaVD is a physiologic test that is reflective of airway remodeling.

Adult↗

Antifungal activities of origanum oil against Candida albicans.

The antimicrobial properties of volatile aromatic oils from medicinal as well as other edible plants has been recognized since antiquity. Origanum oil, which is used as a food flavoring agent, possesses a broad spectrum of in vitro antimicrobial activities attributed to the high content of phenolic derivatives such as carvacrol and thymol. In the present study, antifungal properties of origanum oil were examined both in vitro and in vivo. Using Candida albicans in broth cultures and a micro dilution method, comparative efficacy of origanum oil, carvacrol, nystatin and amphotericin B were examined in vitro. Origanum oil at 0.25 mg/ml was found to completely inhibit the growth of C. albicans in culture. Growth inhibitions of 75% and >50% were observed at 0.125 mg/ml and 0.0625 mg/ml level, respectively. In addition, both the germination and the mycelial growth of C. albicans were found to be inhibited by origanum oil and carvacrol in a dose-dependent manner. Furthermore, the therapeutic efficacy of origanum oil was examined in an experimental murine systemic candidiasis model. Groups of mice (n = 6) infected with C. albicans (5 x LD50) were fed varying amounts of origanum oil in a final vol. of 0.1 ml of olive oil (vehicle). The daily administration of 8.6 mg of origanum oil in 100 microl of olive oil/kg body weight for 30 days resulted in 80% survivability, with no renal burden of C. albicans as opposed to the group of mice fed olive oil alone, who died within 10 days. Similar results were obtained with carvacrol. However, mice fed origanum oil exhibited cosmetically better clinical appearance compared to those cured with carvacrol. The results from our study encourage examination of the efficacy of origanum oil in other forms of systemic and superficial fungal infections and exploration of its broad spectrum effect against other pathogenic manifestations including malignancy.

Animals↗

The effect of hyperglycemia on cocaine neurotoxicity and death in mice.

OBJECTIVE: Cocaine toxicity frequently manifests as seizures and status epilepticus. Frequently, dextrose is administered to patients with cocaine-induced seizures. The objective of this study was to examine the effect of pre-existing hyperglycemia on cocaine neurotoxicity and death in mice. METHODS: Swiss albino mice received intraperitoneal dextrose at a dose of 1 g/kg (12.5%) (hyperglycemic group, n = 98). The euglycemic group (n = 98) received an equal volume of 0.9% saline. After 60 minutes, all the animals received intraperitoneal cocaine at a dose of 90 mg/kg. The times to onset of ataxia, seizure, and death were recorded in seconds. Times to events were compared using a Kaplan-Meier method and results were compared using the logrank test. The overall percentage outcomes were compared using chi-square. RESULTS: The ataxia rates (hyperglycemic 97%, euglycemic 97%, chi(2) = 0, p = 1), seizure rates (hyperglycemic 85%, euglycemic 82%, chi(2) = 0.292, p = 0.589), and survival rates (hyperglycemic 62%, euglycemic 51%, chi(2) = 0.2514, p = 0.113) were similar between the groups. The survival following a seizure was significantly higher in the hyperglycemic group (hyperglycemic 57%, euglycemic 41%, chi(2) = 4.439, p = 0.035). The median ataxia time was earlier in the hyperglycemic group (190 sec) than in the euglycemic group (166 sec) (p = 0.031). Seizures occurred no earlier in the hyperglycemic group (331 sec) than in the euglycemic group (342 sec) (p = 0.207). Survival times were not different for the hyperglycemic group (9,133 sec) and the euglycemic group (7,593 sec) (p = 0.394). Survival times following seizures were not different for the hyperglycemic group (8,095 sec) and the euglycemic group (5,816 sec) (p = 0.0752). CONCLUSIONS: In mice with pre-existing hyperglycemia, ataxia occurred earlier and survival following cocaine-induced seizures was longer than for euglycemic mice. No significant difference in the overall percentage of seizures and death was detected. Pre-existing hyperglycemia had minimal effect on worsening cocaine toxicity in mice.

Animals↗

An interdisciplinary approach to a day-long palliative care course for undergraduate students.

Although it is desirable that students in the health sciences be educated together to prepare them for interdisciplinary practice, many educational programs remain discipline specific. An undergraduate course in palliative care, originally designed for medical students at McMaster University, Hamilton, Ont., was expanded in 1993 to include students from various health sciences programs in the region. The course introduces students to the components of palliative care and its interdisciplinary nature in a problem-based way and directs students to additional educational resources. The authors describe the planning, content and evaluation of the course material. The observed decline in attendance by medical students, which coincided with the introduction of the interdisciplinary format, warrants further investigation. Future directions of the course are discussed.

Absenteeism↗

Localisation of phosphatidylethanolamine-binding protein in the brain and other tissues of the rat.

Phosphatidylethanolamine-binding protein (PEBP) is a highly-conserved 21- to 23-kDa basic protein that shows preferential affinity in vitro for phosphatidylethanolamine. Previous studies have focussed on PEBP in the brain and male reproductive tract where it has been proposed to play a role in membrane biogenesis. In the present more comprehensive study, rat PEBP transcripts and protein have been found to be expressed in all tissues examined, although the levels vary considerably between tissues. However, at the cellular level, PEBP expression is enigmatic, being restricted to a diverse range of highly specialised neuronal and non-neuronal cell types. The nature of this diversity, ranging from oligodendrocytes to plasma cells, whilst not precluding a role for PEBP in membrane biogenesis in some cell types, would imply that this is not the major function in others.

Adrenal Glands↗

Perivalvular abscess complicating infective endocarditis: complementary role of echocardiography and indium-111-labeled leukocytes.

A 49-year-old black man with hypertension-induced chronic renal failure requiring hemodialysis and a history of arteriovenous access graft infection was admitted with Staphylococcus aureus sepsis, dyspnea, and peri-incisional erythema over his arteriovenous graft fistula. Results of a transthoracic echo demonstrated aortic sclerosis and concentric left ventricular hypertrophy. Results of a whole-body In-111 white cell (WBC) scan were negative over the arteriovenous graft site; however, an intense abnormal focus of labeled WBCs was evident to the left of the sternum. A subsequent transesophageal echocardiogram showed a mixed cystic-solid calcified mass adjacent the left aortic cusp. Surgery confirmed a perivalvular abscess. As a whole-body imaging modality, the In-111 WBC scintigram indicated the true location of the infectious process responsible for the patient's sepsis. The combination of echocardiography and radiolabeled WBC imaging increases sensitivity for detection of endocarditis/perivalvular abscess. Radiolabeled WBC imaging is more efficacious for monitoring therapy because the echocardiogram often does not change with treatment of endocarditis/perivalvular abscess.

Abscess↗

Evaluation of an educational game for health sciences students.

An educational game was developed to promote student problem solving in the context of small group, problem-based learning (PBL). This study evaluated the game's effects on hypothesis and issue generation in PBL. Students in the Year III PBL course of a BScN program (N = 131) were stratified by program status and then randomly assigned to groups of 9 to 11 people per group. Half of the groups were randomly assigned to use the game (G); the remaining groups used the conventional method (CM) of generating issues and hypotheses. The G and CM groups crossed over for Term II. A Term I posttest demonstrated G groups had a higher proportion of accurate responses (85%) than CM groups (74%). A Term II posttest demonstrated no important differences between G and CM groups, suggesting the educational impact of the game persisted after students stopped using it. Strengths and limitations of the game as a learning aid also are addressed.

Adult↗

The effects on asthmatics of exposure to a conventional water-based and a volatile organic compound-free paint.

The water-based paints now frequently used for house painting still contain small amounts of volatile organic compounds (VOCs), with the potential to exacerbate symptoms of asthma. Because of these potential problems and environmental concerns, some manufacturers have produced paints with no VOC content. We wished to compare the effects on asthmatics of conventional water-based paint and the new VOC-free paint. Seventeen asthmatics were recruited on the basis of having previously reported exacerbation of symptoms by paint or other odours. Each undertook a standard painting task with identically coloured conventional acrylic and VOC-free paints in a double-blind, crossover study. Respiratory symptoms, lung function, and airway responsiveness were measured at each visit. A significant increase in reported "wheeze" was detected during use of conventional paint (p<0.01), but not with the new paint. There was also a significantly greater increase in reported "breathlessness" whilst using conventional paint than with the new paint (p<0.05). In contrast, lung function measurements showed a small but significant increase during the use of both paints (p<0.05). There was no significant change in airway responsiveness after use of either paint. The new paint appears to be less likely to cause a worsening of respiratory symptoms than conventional acrylic paint, although this difference is not reflected in measurements of lung function or airway responsiveness. Although the benefit conferred in the majority of asthmatics is probably modest, there may be some patients with an increased sensitivity to paint odour, who would derive a useful symptomatic benefit from using the VOC-free paint.

Adult↗

Geometric, shape and area measurement considerations for diabetic neuropathic plantar ulcers.

Though neuropathic plantar ulcers are known to be "round-like," systematic quantitative data on their shape and geometric features are not readily available. A sample of 305 ulcers were retrospectively assessed to provide distribution data on quantitative geometric and shape parameters. After tracing the ulcer during the patient's initial visit, the following parameters were determined: surface area (A), maximum length (L), maximum perpendicular width (W), perimeter (p), shape factor (SF), and an ulcer regularity index (URI). SF assesses ulcer "circularity" and URI measures ulcer perimeter "smoothness" in comparison to a fictitious circle with the same contained area. SF and URI values of 1.0 correspond to 100 percent circularity and regularity. These data and the associated distributions, which are derived from a reasonably large random sample, provide a useful quantitative description of plantar ulcer geometry and shape.

Anthropometry↗

Management of acute myocardial infarction in Auckland.

AIM: To analyse the utilisation of therapies in coronary care units for patients with acute myocardial infarction. METHODS: An evaluation form was completed prospectively by a designated nurse in each coronary care unit of the four Auckland hospitals in 1993. RESULTS: One thousand and eighty one patients who were admitted with definite or probable acute myocardial infarction had a coronary care unit stay of 63.4 (SD 49.3) hours, and hospital stay of 7.3 (5.1) days. The mortality for definite myocardial infarction was 13.7% (< 70 years 7.1%). Coronary angiography was performed on 10% of patients during their hospital admission, and 4.9% underwent revascularisation. Thrombolytic therapy was administered to 52% (495/948) of patients with definite infarction and 4% had contraindications. Patients aged > or = 70 years (47% vs 55% p = 0.02) or diabetics (46% vs 56%, p = 0.04) were less likely to receive thrombolysis. The utilisation of aspirin and oral beta-blockers was 86% and 40%, respectively, in patients with definite infarction and both were used less frequently in patients > or = 70 years. Intravenous beta-blockers were administered to < 1% of patients. Angiotensin converting enzyme (ACE) inhibitors were prescribed in 21%, intravenous or long acting nitrates in 41% and calcium antagonists in 14%; the latter two therapies were used more frequently in patients > or = 70 years. There was no evidence of gender or ethnic bias for either investigation or treatment. CONCLUSION: On the basis of results of recent clinical trials, there may be under utilisation of some treatments for acute myocardial infarction including aspirin, thrombolytic therapy, beta-blockers and ACE inhibitors, while calcium antagonists may be over used.

Adrenergic beta-Antagonists↗

Prospective evaluation of eligibility for thrombolytic therapy in acute myocardial infarction.

OBJECTIVES: To determine the proportion of patients presenting with acute myocardial infarction who are eligible for thrombolytic therapy. DESIGN: Cohort follow up study. SETTING: The four coronary care units in Auckland, New Zealand. SUBJECTS: All 3014 patients presenting to the units with suspected myocardial infarction in 1993. MAIN OUTCOME MEASURES: Eligibility for reperfusion with thrombolytic therapy (presentation within 12 hours of the onset of ischaemic chest pain with ST elevation > or = 2 mm in leads V1-V3, ST elevation > or = 1 mm in any other two contiguous leads, or new left bundle branch block); proportions of (a) patients eligible for reperfusion and (b) patients with contraindications to thrombolysis; death (including causes); definite myocardial infarction. RESULTS: 948 patients had definite myocardial infarction, 124 probable myocardial infarction, and nine ST elevation but no infarction; 1274 patients had unstable angina and 659 chest pain of other causes. Of patients with definite or probable myocardial infarction, 576 (53.3%) were eligible for reperfusion, 39 had definite contraindications to thrombolysis (risk of bleeding). Hence 49.7% of patients (537/1081) were eligible for thrombolysis and 43.5% (470) received this treatment. Hospital mortality among patients eligible for reperfusion was 11.7% (55/470 cases) among those who received thrombolysis and 17.0% (18/106) among those who did not. CONCLUSIONS: On current criteria about half of patients admitted to coronary care units with definite or probable myocardial infarction are eligible for thrombolytic therapy. Few eligible patients have definite contraindications to thrombolytic therapy. Mortality for all community admissions for myocardial infarction remains high.

Age Factors↗