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Biomedical subjects

C McManus

Publications and source records attributed to C McManus.

At least 19 recordsLinked to original sources

Socio-economic deprivation and excess winter mortality and emergency hospital admissions in the South Yorkshire Coalfields Health Action Zone, UK.

The aims of this study were to describe the pattern of excess winter mortality and emergency hospital admissions in the South Yorkshire Coalfields Health Action Zone, and to examine the relationship between excess winter mortality and emergency hospital admissions and socio-economic deprivation at the enumeration district level. We analysed monthly deaths from 1981 to 1999 and monthly emergency hospital admissions from 1990 to 1999 for cardiovascular disease, respiratory disease and all other causes of death for people aged 45 years and above. We used the enumeration district level Townsend socio-economic deprivation score to categorize enumeration districts by quintile. Excess winter mortality ratios (observed/expected) for females and males, respectively, were 1.70 and 1.58 for respiratory disease, 1.25 and 1.20 for cardiovascular disease, and 1.09 and 1.07 for all other causes of death. The excess winter hospital admission ratio for respiratory disease was 1.80 for females and 1.58 for males. No excess was evident for the other two groups of conditions. We found no significant increase in excess winter mortality ratios with increasing socio-economic deprivation. There was also no significant increase in the excess winter respiratory admission ratio with increasing deprivation. With regard to age, we found P<0.0001 and for all other diseases P>0.001 and also in the excess winter hospital admission ratio for respiratory disease P<0.0001 With regard to sex, the excess ratios were lower in men than in women for both respiratory mortality P<0.05 and respiratory hospital admissions P<0.0001 We also observed that excess winter mortality ratios decreased significantly over the 18-year period for cardiovascular disease P<0.05 and for all other diseases P<0.05. Our results suggest that measures to reduce excess winter mortality should be implemented on a population-wide basis and not limited to socio-economically deprived areas. There may also be a case for tailoring interventions to specifically meet the needs of older people.

Aged↗

Transitional choice behavior in concurrent-chain schedules.

The choice responses of four pigeons were examined in 20 periods of transition in a concurrent-chain procedure with variable-interval schedules as initial links and fixed delays to reinforcement as terminal links. In some conditions, the delays to reinforcement were different for the two terminal links, and changes in preference were recorded after the delays for the two response keys were switched. In other conditions, the reinforcer delays were equal for the two keys, but which key delivered 80% of the reinforcers was periodically switched. Choice proportions changed more quickly after a switch in reinforcement percentages than after a switch in the delays, thereby contradicting the hypothesis that faster changes would occur when the switch in conditions was easier to discriminate. Analyses of response sequences showed that the effects of individual reinforcers were larger and lasted longer in conditions with changing reinforcement percentages than in conditions with changing terminal-link delays. Rates of change in choice behavior do not appear to be limited by the unpredictability of variable reinforcement schedules, because the changes in behavior were slow and gradual even when there was a large and sudden change in reinforcer delays.

Journal Article↗

Clinical and microbial evaluation of a histatin-containing mouthrinse in humans with experimental gingivitis.

OBJECTIVE: P-113, a 12 amino acid histatin-based peptide, was evaluated in a mouthrinse formulation for safety, prevention of the development of experimental gingivitis, and for its effects on periodontal flora. METHOD: 159 periodontally healthy subjects abstained from oral hygiene procedures and self-administered either 0.005%, 0.01%, 0.05% P-113 or placebo mouthrinse formulations twice daily over a four week treatment period. During this time, the safety, anti-plaque, and anti-gingivitis effects of P-113 were evaluated. RESULTS: There was a significant reduction in plaque (p=0.046) and a reduction in gingivitis (p=0.086) for subjects using 0.01% P-113 mouthrinse. Significantly more subjects in the 0.01% and 0.05% treatment groups showed a small increase in plaque index of <0.25 as compared to the placebo group (p<0.05). Similar trends were noted for changes in the % of sites with bleeding on probing in the 0.01% P-113 group. There were no treatment-related adverse events, and there were no adverse shifts in supragingival microflora during the study. CONCLUSION: These data suggest that P-113 mouthrinse is safe and reduces plaque, gingivitis and gingival bleeding in the human experimental gingivitis model.

Adult↗

The factor structure of the BDI in facial pain and other chronic pain patients: a comparison of two models using confirmatory factor analysis.

OBJECTIVES: 1) To compare two measurement models of the BDI in chronic pain sufferers to see which provides the better fit; 2) to assess whether model fit differs for a facial pain sample compared to a sample of pain sufferers attending a multidisciplinary pain clinic; and 3) to establish which affective and somatic sub-scales of the BDI could be used in chronic pain research. DESIGN: Two groups of chronic pain sufferers, a facial pain group, and a group attending a multidisciplinary pain clinic completed self-report questionnaires on pain (Multidimensional Pain Inventory), depression (BDI), and measures of anxiety and depression-related pain cognitions (the Spielberger State-Trait Anxiety Inventory and the Pain Cognitions Questionnaire). The measurement models of the BDI were tested using LISREL structural equation modelling and their construct validity examined using partial correlation analysis. METHOD: A total of 173 people attending a multidisciplinary pain clinic and 157 patients attending a facial pain clinic completed self-report measures of pain and mood prior to their respective clinical consultations. RESULTS: The model offered by Novy et al. (containing one affective factor 'Negative-attitude suicide' and two somatic factors 'Performance difficulty' and 'Physiological manifestations') fitted both pain groups better than the model offered by Williams and Richardson (containing one affective factor 'Self-reproach', one somatic factor 'Somatic disturbance' and one factor with a mixture of both affective and somatic items 'Sadness about health'). However, when the factors were allowed to correlate in the latter model, both models were broadly equivalent. CONCLUSIONS: The two measurement models adequately fitted data in both pain samples when the factors were allowed to intercorrelate in the Williams and Richardson model. Both the affective scales offered by both models could be used in future research, although the somatic factor offered by the Williams and Richardson model offered much higher levels of internal reliability than either of those offered in the Novy et al. model. The findings are discussed in relation to the issue of depression in chronic pain.

Journal Article↗

HIV-1 gp120 and chemokines activate ion channels in primary macrophages through CCR5 and CXCR4 stimulation.

HIV type 1 (HIV-1) uses the chemokine receptors CCR5 and CXCR4 as coreceptors for entry into target cells. Here we show that the HIV-1 envelope gp120 (Env) activates multiple ionic signaling responses in primary human macrophages, which are important targets for HIV-1 in vivo. Env from both CCR5-dependent JRFL (R5) and CXCR4-dependent IIIB (X4) HIV-1 opened calcium-activated potassium (K(Ca)), chloride, and calcium-permeant nonselective cation channels in macrophages. These signals were mediated by CCR5 and CXCR4 because macrophages lacking CCR5 failed to respond to JRFL and an inhibitor of CXCR4 blocked ion current activation by IIIB. MIP-1beta and SDF-1alpha, chemokine ligands for CCR5 and CXCR4, respectively, also activated K(Ca) and Cl(-) currents in macrophages, but nonselective cation channel activation was unique to gp120. Intracellular Ca(2+) levels were also elevated by gp120. The patterns of activation mediated by CCR5 and CXCR4 were qualitatively similar but quantitatively distinct, as R5 Env activated the K(Ca) current more frequently, elicited Cl(-) currents that were approximately 2-fold greater in amplitude, and elevated intracellular Ca(+2) to higher peak and steady-state levels. Env from R5 and X4 primary isolates evoked similar current responses as the corresponding prototype strains. Thus, the interaction of HIV-1 gp120 with CCR5 or CXCR4 evokes complex and distinct signaling responses in primary macrophages, and gp120-evoked signals differ from those activated by the coreceptors' chemokine ligands. Intracellular signaling responses of macrophages to HIV-1 may modulate postentry steps of infection and cell functions apart from infection.

Calcium↗

Stereotastic radiosurgery for glomus jugulare tumors.

OBJECTIVES/HYPOTHESIS: Surgery is considered to be the mainstay of treatment for glomus jugulare tumors. A subset of patients are poor surgical candidates based on age, medical problems, tumor size, or prior treatment failure. The purpose of this study was to review our results with stereotactic radiosurgery (gamma knife treatment) in this group of patients, with particular attention to adverse reactions and symptom relief. STUDY DESIGN: Retrospective review and phone survey. METHODS: Charts were reviewed for size and location of tumor, history of previous treatment, symptoms before and after treatment, amount of radiation received, acute and late complications, and functional level before and after treatment. Pre-treatment and posttreatment magnetic resonance imaging scans were also reviewed. Identified patients were then contacted for a phone interview. RESULTS: Eight patients were identified. Phone interviews were conducted with four patients. Four patients had failed previous treatment. Follow-up ranged from 7 to 104 months. One patient experienced an acute complication: intractable vertigo requiring hospitalization. No patient experienced delayed cranial neuropathies. No patient reported worsening of any of the following symptoms: pulsatile tinnitus, hearing loss, facial weakness, hoarseness, or difficulty swallowing. Three patients reported improvement in their pulsatile tinnitus. Two patients reported improvement in hearing loss, and one patient each reported improvement in vertigo and difficulty swallowing. CONCLUSIONS: Preliminary results suggest that stereotactic radiosurgery is useful to control symptoms and may be delivered safely in patients with primary or recurrent glomus jugulare tumors who are poor surgical candidates.

Aged↗

MCP-1, MCP-2 and MCP-3 expression in multiple sclerosis lesions: an immunohistochemical and in situ hybridization study.

Chemokines are low molecular weight chemotactic cytokines that have been shown to play a central role in the perivascular transmigration and accumulation of specific subsets of leukocytes at sites of tissue damage. Two major families have been defined depending on the positioning of four conserved cysteines. The CXC chemokines predominantly attract neutrophils, whereas the CC chemokines predominantly attract monocytes and other leukocyte cell types. Members of the monocyte chemotactic protein (MCP)-1 family form a major component of the CC family of chemokines and are considered the principal chemokines involved in the recruitment of monocytes/macrophages and activated lymphocytes. In this study we addressed the expression and distribution of MCP-1, -2 and -3 in multiple sclerosis (MS) lesions of differing ages and levels of inflammatory activity using immunohistochemistry and in situ hybridization. In acute and chronic-active MS lesions immunoreactivity for MCP-1, -2 and -3 was prominent throughout the lesion center with reactivity diminishing abruptly at the lesion edge. Hypertrophic astrocytes were strongly reactive and inflammatory cells showed variable reactivity. Outside of the lesion only hypertrophic astrocytes were reactive. The results obtained by in situ hybridization for MCP-1 were in agreement with those obtained by immunostaining. In more chronic lesions immunoreactivity for MCP-1, -2 and -3 was considerably diminished, and in chronic-silent lesions immunoreactivity was restricted to a few scattered reactive astrocytes. Normal control brains showed no immunoreactivity for MCP-1, -2 and -3. Although the cellular distribution of all three members of this family was similar, antibodies to MCP-3 gave prominent staining of the extracellular matrix that was not noted for MCP-1 and -2. These results support the conclusion that members of the MCP family of chemokines are involved in the development of MS lesions in the central nervous system.

Adult↗

Physician-poets.

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History, 20th Century↗

Psychological adjustment and family functioning in a group of British children with sickle cell disease: preliminary empirical findings and a meta-analysis.

Sickle cell disease (SCD) is a family of inherited blood disorders of variable severity which have in common haemolytic anaemia, recurrent painful crises, end-organ failure and the risk of reduced life expectancy. In Britain, the condition predominantly occurs among families of African or Afro-Caribbean origin. This study examines the effects of the condition on the psychological adjustment and family functioning of 39 children with SCD and 24 control children. Participants were assessed on measures of behaviour, depression, self-esteem, IQ and reading skills, family relationships and maternal mental health. Assessment on the Family Environment Scale showed that SCD children came from families who reported more cohesion and less conflict than did the families of controls. Maternal mental health showed no significant differences between the SCD group and controls. Children with SCD showed an IQ deficit of five points, a difference that was not statistically significant. However, a meta-analysis of six studies in the literature, including this one, did show a highly significantly decreased intellectual ability. SCD children did not show significant differences from controls on measures of depression and self-esteem. However, differences in behavioural problems were found between the three groups, with the SC group showing more behavioural problems. Results of regression analyses suggest that maternal mental health is associated with children's behavioural problems.

Adaptation, Psychological↗

Pruritus.

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Pruritus↗