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Biomedical subjects

C Sutton

Publications and source records attributed to C Sutton.

At least 19 recordsLinked to original sources
PubMed2003

Health problems following Campylobacter jejuni enteritis in a Lancashire population.

OBJECTIVES: Campylobacter jejuni enteritis can lead to musculoskeletal, neuropathic or other health sequelae. We investigated the coexistence, seasonal occurrence, strain-type associations and impact on work capacity of different health problems following C. jejuni enteritis in a Lancashire population during 1999 and 2001. METHODS: A semistructured questionnaire was used to characterize health problems that occurred in the community after laboratory-confirmed episodes of C. jejuni enteritis. The questionnaire was posted to all adults in the Preston and Chorley area who developed C. jejuni enteritis in 1999 or 2001. All Campylobacter isolates from this population were serotyped. RESULTS: Several types of sequelae occurred consistently in both years, including the coexistence of musculoskeletal and neuropathic problems. There was no evidence of C. jejuni strain-type associations or seasonal preponderance for any type of sequela. The overall health impact of C. jejuni enteritis, as measured by workdays lost, was high in this population. CONCLUSIONS: A variety of health problems occur consistently following C. jejuni enteritis and substantially increase morbidity due to campylobacteriosis in the community.

Acute Disease↗
PubMed2003

Results following conservative lateral sphincteromy for the treatment of chronic anal fissures.

INTRODUCTION: Lateral sphincterotomy is now the standard surgical treatment for fissure-in-ano. Healing is achieved in 90% of cases, however, sphincterotomy also carries a significant risk of incontinence. Traditional sphincterotomy comprises of division of the internal sphincter up to the level of the dentate line, a more conservative division could lead to a lower incontinence rate, with an equivalent healing rate. MATERIALS AND METHODS: A total of 65 patients undergoing conservative lateral sphincterotomy under a single operator between January, 1996 and January, 2002 were reviewed. Specific questions were asked regarding overall success of the operation, leakage of fluid, faeces or flatus and recurrence of fissure symptoms. Supplemental data was obtained from a retrospective analysis of the patients' case notes to ascertain demographics, length of hospital stay and complication rate. RESULTS: Sixty of 65 patients responded to our postal questionnaire. The male to female ratio was 1:1 and the mean age 40.3 years of age. No complications were recorded and 97% of patients had achieved fissure healing by the time of their out-patient follow-up (mean 6.9 weeks). Two patients reported new incontinence following their procedure; one patient experienced incontinence of fluid and flatus (1.7%) and the remaining patient complained of incontinence to flatus only. No patients experienced incontinence of faeces. Eleven patients experienced persistent symptoms of pain and bleeding but only 6 of these patients required treatment from their general practitioner which consisted of stool softeners and topical analgesia. No patients required re-operation. CONCLUSION: A conservative division of the internal anal sphincter results in adequate fissure healing and a much lower incontinence rate than that previously recorded in the literature for more traditional divisions of the internal anal sphincter.

Adult↗
PubMed2002

Fibroid embolization.

The most common surgical treatment for fibroids is hysterectomy and approximately 30,000 are carried out annually in the UK for this condition. The operation, however, carries a significant complication rate. Since the first case was carried out in 1989 there has been increasing interest in the interventional radiological procedure called fibroid embolization where angiographic techniques are used to occlude the vascular supply of fibroids. This article is a review of the world experience of fibroid embolization, its development, techniques, indications, results and complications. So far evidence indicates very promising mid-term results but more long-term comprehensive data is needed from large trials.

Adult↗
PubMed2001

Repeat tuberculin testing in BCG-vaccinated subjects in the United Kingdom. The booster effect varies with the time of reading.

The booster effect varies between populations, but has not been studied in the UK. The aim of this study was to investigate the effect of repeat tuberculin tests at 1 wk in BCG-vaccinated healthy subjects (all hospital employees) in the UK; we have assessed whether a booster effect is present 48 and 72 h after injection. Twenty-six subjects received two tuberculin tests (both 10 units) administered by the Mantoux technique-Tests 1 and 2. At Test 2 there was a significant increase in induration at 48 h (mean, 7.8 mm; p < 0.001), no difference at 72 h (mean, 0.2 mm; p = 0.93), and a reduction at 96 h (mean, -4.2 mm; p = 0.02). There were more positive results (> 15 mm induration) at Test 2 compared with Test 1 at 48 h (19 vs. 9, respectively; p = 0.002), but similar numbers at 72 h (11 vs. 10, respectively). These results show that repeat tuberculin testing in this BCG-vaccinated population caused a booster effect that varied with the time of measurement and was maximal at 48 h.

Adolescent↗
PubMed2001

Endometrial laser intrauterine thermotherapy for the treatment of dysfunctional uterine bleeding: the first British experience.

Forty patients due to undergo endometrial ablation as a treatment for dysfunctional uterine bleeding were recruited to assess the efficacy and safety of endometrial laser intrauterine thermo-therapy using the gynelase. At 12 months the average menstrual score reduction was 88%, the amenorrhoea rate was 70%, and the hypomenorrhoea rate 16%. Four women (10%) have had a hysterectomy for persistent menorrhagia, and one (3%) for pelvic pain. One patient (3%) has had a further endometrial laser ablation. There were no major complications. and 34 patients (85%) were most satisfied with the treatment. The system is easy to use and has a short learning curve.

Adult↗
PubMed2001

Long term outcome following laparoscopic supracervical hysterectomy.

OBJECTIVES: To assess the long term outcome of laparoscopic supracervical hysterectomy. DESIGN: Retrospective study. SETTING: Minimal Access Surgical Unit, Department of Gynaecology, Royal Surrey County Hospital, Surrey. METHODS: Analysis of patient case records. POPULATION: Seventy consecutive women who had a laparoscopic supracervical hysterectomy. OUTCOME MEASURES Symptoms related to the cervical stump and the need for further surgery. RESULTS: The mean time of patient follow up was 66 months (range 52-84). The mean time from initial procedure to second treatment was 14 months (range 3-53). Seventeen women (24.3%) reported symptoms related to the cervical stump, and all required further surgery. The cervical stump was removed in 16 (22.8%). One patient had laparoscopic adhesiolysis only and two had a laparotomy and trachelectomy because the bowel was adherent to the cervical stump. Nine had a laparoscopically assisted cervical trachelectomy as the sole procedure. Five had laser treatment to endometriotic deposits, and laparoscopically assisted cervical trachelectomy. Histological analysis showed normal cervical tissue in six (35.3%). Endometriosis was detected in four cervical stumps (23.5 %), residual endometrium in another four (23.5 %) cases, and chronic cervicitis, mild CIN and a mucocoele in a further three patients. Of the 17 women who reported cervical stump symptoms, 14 (82.3%) had been treated for endometriosis in the past, compared with 17/53 (32%) who did not have symptoms (P < 0.0002, chi2 test). CONCLUSIONS: Symptoms related to the cervical stump requiring further surgery frequently occur following a laparoscopic supracervical hysterectomy.

Adult↗
PubMed1999

Efforts to incorporate social justice perspectives into a family training program.

This paper describes the efforts of the faculty of the Family Institute of New Jersey in recent years to develop a collaborative family training program that takes into account issues of gender, race, culture, class, and sexual orientation. We have come to realize how strongly traditional approaches have been skewed in the direction of the dominant culture--white, male, heterosexist, and prioritizing the needs and experience of the middle and upper classes. We have attempted to modify our teaching, supervision, reading lists, and overall training approach to challenge trainees and ourselves to move toward broader, strength-based, and equity-based multicultural perspectives in our training. We describe our vision, how we incorporate it into our program structure, and a few of our training initiatives.

Adult↗
PubMed1999

Identification of a novel mycobacterial histone H1 homologue (HupB) as an antigenic target of pANCA monoclonal antibody and serum immunoglobulin A from patients with Crohn's disease.

pANCA is a marker antibody associated with inflammatory bowel disease (IBD), including most patients with ulcerative colitis and a subset with Crohn's disease. This study addressed the hypothesis that pANCA reacts with an antigen(s) of microbial agents potentially relevant to IBD pathogenesis. Using a pANCA monoclonal antibody, we have previously identified the C-terminal basic random-coil domain of histone H1 as a pANCA autoantigen. BLAST analysis of the peptide databases revealed H1 epitope homologues in open reading frames of the Mycobacterium tuberculosis genome. Western analysis of extracts from six mycobacterial species directly demonstrated reactivity to a single, conserved approximately 32-kDa protein. Direct protein sequencing, followed by gene cloning, revealed a novel 214-amino-acid protein, an iron-regulated protein recently termed HupB. Sequence analysis demonstrated its homology with the mammalian histone H1 gene family, and recombinant protein expression confirmed its reactivity with the 5-3 pANCA monoclonal antibody. Binding activity of patient serum immunoglobulin G (IgG) to HupB did not correlate with reactivity to histone H1 or pANCA, indicating the complex character of the pANCA antigen. However, anti-HupB IgA was strongly associated with Crohn's disease (P < 0.001). These findings indicate that the 5-3 pANCA monoclonal antibody detects a structural domain recurrent among mycobacteria and cross-reactive with a DNA-binding domain of histone H1. The association of HupB-binding serum IgA with IBD provides new evidence for the association of a mycobacterial species with Crohn's disease.

Amino Acid Sequence↗
PubMed1999

Laboratory evaluation of crude oil biodegradation with commercial or natural microbial inocula.

Experiments have been performed to screen eight microbial commercial products that, according to the manufacturers, are able to degrade crude oil. This study compared the crude oil biodegradation activity of commercial inocula with that of natural inocula (activated sludge and tropical aquarium water). Some of the latter were previously adapted to the crude oil as the only carbon source. Nutrients and sorbents in the commercial formulations were eliminated, and each inoculum was precultured on marine yeast extract medium. Crude oil biodegradability tests were conducted with close initial substrate concentration to initial bacterial concentration ratios (S0/X0) of 0.94 g of crude oil/10(9) CFU, which allowed a comparison of biodegradation activity. The inocula oxidized the crude oil after a short lag time of less than 3-18 days. After that time, the rate of oxidation varied between 45 and 244 mg O2/(L.day). Crude oil biodegradation after a 28-day test was effective only for 10 out of 12 inocula (from 0.1 to 25% in weight). Biodegradation mainly corresponded to the saturated fraction of the crude oil; the asphaltene fraction was never significantly biodegraded. Our results led to the conclusion that natural inocula, either adapted or not adapted to crude oil, were the most active (from 16 to 25% of loss in crude oil weight) and only one commercial inoculum was able to degrade 18% of the crude oil. Other inocula had a biodegradation activity ranging from 0.1 to 14%.

Bacteria↗
PubMed1999

Learning rate for laparoscopic surgical skills on MIST VR, a virtual reality simulator: quality of human-computer interface.

Acquiring laparoscopic surgical skills involves initial learning of cognitive and motor skills followed by refinement of those skills. The successful use of a virtual reality simulator depends on the quality of the interface for the human-computer interaction and this can be determined by the initial learning rate. MIST VR, a part-task virtual reality laparoscopic simulator, provides objective assessment of psychomotor skills and can generate an overall score for performance, based upon errors made and time taken for six different tasks. This study analysed the rate of early task/instrument/computer familiarization on consecutive scores achieved by surgically experienced and naive individuals. Eleven surgeons, 18 medical students and seven non-medical personnel were tested on the simulator up to ten consecutive times, within a 2-week period. Performance data from every task and repetition were analysed to obtain individual scores of task performance. The calculation of overall score penalized errors far more heavily than total time taken, with high scores indicating poor performance. The surgeon-computer interface generated a rapid and significant early familiarization curve up to the third session on the simulator, with significant reductions in both time taken and total contact errors made. These results suggest that MIST VR represents a high quality interface. Surgeons scored consistently and significantly better than other subjects on all tasks. For surgically naive individuals, it was possible to predict the level of laparoscopic skills performance that would be attained after overcoming initial simulator learning curve, by studying their initial score. Overall scores reflected surgical experience and suggest that the simulator is measuring surgically relevant parameters. MIST VR provides a validated and much needed method for objective assessment of laparoscopic skills, for a variety of surgical disciplines.

Adult↗
PubMed1998

Lipocortin 1 co-associates with cytokeratins 8 and 18 in A549 cells via the N-terminal domain.

An affinity chromatography strategy was used to search for proteins in A549 cells which interact with the N-terminus of lipocortin 1 (annexin 1). Using the biologically active fragment Lc13-25 as the affinity ligand, two proteins of molecular weight (m.w.) 52 and 48kDa were extracted. Affinity blots of these proteins bound iodinated Lc13-25. Partial tryptic digests of these proteins were analysed by matrix assisted laser desorption mass spectrometry and found to display fragmentation patterns with a strong similarity to those of cytokeratin 8 and 18 respectively. Subsequent blotting with a panel of specific cytokeratin antibodies strongly supported the idea that the two proteins were cytokeratin 8 and cytokeratin 18. Cytokeratin 8 was isolated from A549 cells in intermediate filament (IF) preparations which were also found to contain lipocortin 1 as a potential intermediate filament associated protein (IFAP). This association persisted throughout cycles of IF assembly and disassembly. Dual-labelling immuno-histochemistry in A549 cells showed strong co-localization of lipocortin 1 and cytokeratin 8. The implications of this finding are discussed in the light of the biological activity and possible function of lipocortin 1.

Annexin A1↗
PubMed1998

The role of screening blood tests in patients with arterial disease attending vascular outpatients.

OBJECTIVE: To evaluate the benefits of a policy of performing screening blood tests in new patients with arterial disease referred to the vascular outpatients department. METHODS: Clinical audit over a 12-month period of all new referrals with arterial disease to the vascular outpatients department at the Leicester General Hospital. RESULTS: Two hundred and seventy-two patients had at least one blood test performed at their outpatient visit. All of these patients had a full blood count performed, of which 21 results (21%) were abnormal. Further investigation of patients with abnormal results revealed one case of bladder cancer, one case of leukaemia and one patient with polycythaemia. Urea and electrolytes were measured in 269 patients (99%). Of these, 26 (10%) were expectedly abnormal in patients with known renal impairment. A further 27 patients (10%) were identified to have some degree of unrecognised renal impairment. Serum non-fasting glucose was measured in 252 patients (93%). There were 11 unexpectedly raised results, but further investigation of these patients only diagnosed one of these patients as diabetic. Serum cholesterol was measured in 201 patients (74%). One hundred and thirty-two patients (66%) had an abnormally raised serum cholesterol level. Of these, only 12 patients (6%) were known to have hyperlipidaemia. CONCLUSIONS: Screening new patients with arterial disease in vascular outpatients does identify significant abnormalities, in particular renal impairment and hyperlipidaemia. Correction of these abnormalities may reduce the morbidity associated with contrast induced nephrotoxic acute renal failure, and also contribute to secondary prevention of vascular events associated with raised lipids.

Adult↗
PubMed1998

The evidence for the management of endometriosis.

This review article has focussed on identifying the evidence from randomized controlled trials for the medical and surgical management of endometriosis. A critical summary of the medical management has shown that there is little difference in effectiveness of various medical treatments, but there are differences in the side-effect profiles. Few randomized controlled trials have been undertaken in surgery, but these have shown that surgical management is effective in the management of both painful symptoms and subfertility.

Endometriosis↗