Search PubMed⌕ Search

Biomedical subjects

D Campbell

Publications and source records attributed to D Campbell.

At least 217 records · Page 12Linked to original sources
PubMed1991

Social differences in low birthweight and preterm deliveries in twins.

The relationship between low social class and low birthweight or preterm deliveries is well established in singletons but not in twins. We present a study using all twin deliveries registered in Belgium in 1983 and in Aberdeen between 1951 and 1983. No significant relationship was found between social class and low birthweight, very low birthweight or preterm deliveries in the Belgian sample. In Aberdeen, we found significantly higher rates of low birthweight twins in low social classes. This increase of low birthweight twins in low social classes occurred in Aberdeen during the period 1951-1968, but not in the more recent data.

Belgium↗
PubMed1991

Interleukin-2 and granulocyte-macrophage colony-stimulating factor stimulate growth of a virulent strain of Escherichia coli.

The effect of human recombinant interleukin-2 (IL-2) and human recombinant granulocyte-macrophage colony-stimulating factor on the growth of a virulent strain of Escherichia coli in tissue culture medium and in untreated, normal mouse serum was investigated. Both of these cytokines enhanced the growth of the microorganism two- to threefold in tissue culture medium with or without additional fetal calf serum and in untreated mouse serum. IL-4 did not have any effect on the growth of this microbe under the conditions tested. That the enhancement of growth seen with recombinant IL-2 was due to the active cytokine was shown by the following data: (i) addition of an antibody to IL-2 abrogated the growth-promoting effect; (ii) the excipient buffer, which contained everything except the active cytokine, was inactive in modifying bacterial growth; and (iii) heat-inactivated recombinant IL-2 did not promote enhanced microbial growth. The enhancement of growth with IL-2 was significant with concentrations as low as 1 U/ml. Growth of an avirulent strain of E. coli was not stimulated by IL-2. Moreover, addition of IL-2 to growth virulent E. coli in tissue culture medium led to rapid removal of the cytokine from the medium. Collectively, these data suggest that cytokines may act as growth factors for some virulent bacteria.

Escherichia coli↗
PubMed1991

In vitro infection of natural killer cells with different human immunodeficiency virus type 1 isolates.

Natural killer (NK) cells are a discrete subset of leukocytes, distinct from T and B lymphocytes. NK cells mediate spontaneous non-MHC-restricted killing of a wide variety of target cells without prior sensitization and appear to be involved in initial protection against certain viral infections. Depressed NK cell-mediated cytotoxicity, one of the many immunological defects observed in AIDS patients, may contribute to secondary virus infections. Here we report that clonal and purified polyclonal populations of NK cells, which expressed neither surface CD4 nor CD4 mRNA, were susceptible to infection with various isolates of human immunodeficiency virus type 1 (HIV-1). Viral replication was demonstrated by detection of p24 antigen intracellularly and in culture supernatants, by the presence of HIV DNA within infected cells, and by the ability of supernatants derived from HIV-infected NK cells to infect peripheral blood mononuclear cells or CD4+ cell lines. Infection of NK cells was not blocked by anti-CD4 or anti-Fc gamma RIII monoclonal antibodies. NK cells from HIV-infected and uninfected cultures were similar in their ability to lyse three different target cells. Considerable numbers of cells died in HIV-infected NK cell cultures. These results suggest that loss of NK cells in AIDS patients is a direct effect of HIV infection but that reduced NK cell function involves another mechanism. The possibility that NK cells serve as a potential reservoir for HIV-1 must be considered.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Recommendations for standards of sedation and patient monitoring during gastrointestinal endoscopy.

(1) Safety and monitoring should be part of a quality assurance programme for endoscopy units. (2) Resuscitation equipment and drugs must be available in the endoscopy and recovery areas. (3) Staff of all grades and disciplines should be familiar with resuscitation methods and undergo periodic retraining. (4) Equipment and drugs necessary for the maintenance of airway, breathing, and circulation should be present in the endoscopy unit and recovery area (if outside the unit) and checked regularly. (5) A qualified nurse, trained in endoscopic techniques and adequately trained in resuscitation techniques, should monitor the patient's condition during procedures. (6) Before endoscopy, adverse risk factors should be identified. This may be aided by the use of a check list. (7) The dosage of all drugs should be kept to the minimum necessary. There is evidence that benzodiazepine/opioid mixtures are hazardous. (8) Specific antagonists for benzodiazepines and opioids exist and should be available in the event of emergency. (9) A cannula should be placed in a vein during endoscopy on 'at risk' patients. (10) Oxygen enriched air should be given to 'at risk' patients undergoing endoscopic procedures. (11) The endoscopist should ensure the well being and clinical observation of the patient undergoing endoscopy in conjunction with another individual. This individual should be a qualified nurse trained in endoscopic techniques or another medically qualified practitioner. (12) Monitoring techniques such as pulse oximetry are recommended. (13) Clinical monitoring of the patient must be continued into the recovery area. (14) Records of management and outcome should be collected and will provide data for appropriate audit.

Anesthesia Recovery Period↗
PubMed1991

Learning disabilities and school problems in a regional cohort of extremely low birth weight (less than 1000 G) children: a comparison with term controls.

We compared the prevalence of learning disabilities at age 8 years in a subgroup of 68 of 129 (53%) regional cohort of extremely low birth weight (ELBW) children who were considered "normal" neurologically and intellectually (IQ greater than or equal to 85) with that of 114 term group matched controls (C). Both groups were tested with a battery of psychoeducational measures, and parents and teachers completed questionnaires on the school performance of the children. ELBW children were comparable with C on measures of intelligence (ELBW 101 +/- 8, C 104 +/- 11), language, and academic achievement but fared significantly less well in motor performance (p less than .0001). The prevalence of learning disabilities (by predefined criteria) in ELBW children (26%) was not increased compared with C (19%). However, teachers rated significantly more ELBW children as performing below grade level than were C (31% vs 16%, p less than .05), and by parent report, a higher proportion of ELBW children had received special assistance in school compared with C (37% vs 16%, p less than .001). We conclude that although the prevalence of learning disabilities in normal ELBW children was not different from that in controls, ELBW children did less well and utilized more special resources.

Achievement↗
PubMed1990

Effect of dietary fiber on symptoms and rectosigmoid motility in patients with irritable bowel syndrome. A controlled, crossover study.

The aims of this study were to determine (a) whether dietary fiber supplements modify symptoms in patients with irritable bowel syndrome, (b) the effect of fiber on rectosigmoid pressures, and (c) the relationship, if any, between rectosigmoid pressure and symptoms. Fourteen patients entered and 9 completed a double-blind, controlled, cross-over study of 7 mo duration. The mean age was 26 yr (range, 18-37). Patients received 4 cookies daily containing 20 mg corn fiber or placebo. Symptoms and compliance were evaluated monthly. Rectosigmoid pressures and dietary intake were evaluated at the outset and completion of each study arm. Symptoms improved during both fiber and placebo treatments. Those symptoms demonstrating significant improvement with time were pain severity, stool frequency, stool consistency (p = 0.001), number of additional gastrointestinal symptoms present (p = 0.02), and total symptom score (p less than 0.001). Rectosigmoid pressures were not significantly altered by fiber or placebo. Fasting pressures at the distal recording site tended to correlate with pain severity (r = 0.6; p = 0.06). It was concluded that (a) corn fiber and placebo were both effective in alleviating symptoms, (b) there was a correlation between symptom severity and fasting rectosigmoid pressure, and (c) there was a trend toward reduction in fasting and postprandial rectosigmoid pressures after fiber therapy.

Adult↗
PubMed1990

Intellectual and functional status at school entry of children who weighed 1000 grams or less at birth: a regional perspective of births in the 1980s.

The intellectual and functional status of a regional cohort of children who weighed 501 to 1000 gm when born between 1980 and 1982 was evaluated at a mean age of 5 1/2 years by standard psychometric tests. Of 90 long-term survivors (survival rate 49%), 78 children (87%) had the full test battery, 5 children (6%) had other tests (4 were blind), and one child was untestable. Most of the mean scores were within 1 SD of the test norms; the lowest scores were in the McCarthy Motor scale and in the Beery Test of Visual-Motor Integration. Children without neurologic impairments and those with an IQ greater than or equal to 68 (n = 60) had higher overall scores but still performed poorly on the Motor subscale and the Beery test. Children who weighed less than 800 gm at birth (n = 28) were similar to those who weighed greater than 800 gm (n = 50), except in the Memory and Motor subscales, in which they performed significantly less well. At a functional level, determined by the Vineland Adaptive Behaviour Scales, two thirds of the children were performing in the adequate range and the remainder in the moderately low to low range. Of the 43 children with no neurosensory impairments and an IQ greater than or equal to 84, 49% were identified (by the Florida Kindergarten Screening Battery) to be at mild to high risk for future learning disabilities. The data from this unselected population provide an unbiased estimate of the prevalence of intellectual and functional problems in children who weighed less than or equal to 1000 gm at birth.

Anthropometry↗
PubMed1990

Methylsulphasalazine in rheumatoid arthritis.

Methylsulphasalazine, which differs from sulphasalazine by the addition of one methyl group, may provide the benefits of the parent drug with fewer side-effects in rheumatoid arthritis (RA). We describe the outcome of its use in RA. Of 21 patients entered into the study, 10 successfully completed 6 months of therapy; five developed adverse effects, four withdrew for reasons unrelated to drug treatment and two stopped because of inefficacy. No serious adverse effects were reported. A statistically significant improvement in most clinical assessments was observed from weeks 8-12 onwards. Significant improvement in plasma viscosity was observed and there was a trend towards improvement in serum CRP, histidine and IgM concentrations. There was a good correlation between mean serial changes in clinical and biochemical assessments indicating that the drug may exhibit the properties of a second-line agent. Median steady-state serum concentrations of methylsulphasalazine and methylsulphapyridine were 26.6 micrograms/ml and 2.85 micrograms/ml respectively.

Adult↗
PubMed1990

Changes in alveolar macrophage, monocyte, and neutrophil cell profiles after smoke inhalation injury.

Thirty two fire victims with smoke inhalation, with or without burns, and 26 control subjects had bronchoalveolar lavage performed. Cell yields and differential cell counts were assessed. All patients and controls were cigarette smokers. Patients with smoke inhalation (SI) injury generally showed higher total bronchoalveolar lavage (BAL) cell yields, and this was significant on repeat lavage from 12 patients. The increase was almost entirely due to an increase in the proportion of neutrophils in patients with smoke inhalation alone (S) and those with cutaneous burns as well as smoke inhalation (S + B). On sequential lavage of 12 patients with smoke inhalation (SI) the proportion of neutrophils had increased; this was significantly higher than on initial lavage. Using various macrophage markers, the proportions of macrophage subgroups were determined. There was an increase in UCHM1 and RFD9 positive cells in each subgroup: the increase in UCHM1 positive cells was significant in patients with burns as well as smoke inhalation, and the increase in RFD9 positive cells was significant in patients with smoke inhalation alone. Assessment of the role of such cells in the development of acute lung injury (such as adult respiratory distress syndrome) may be important in our understanding of the mechanisms entailed.

Bronchoalveolar Lavage Fluid↗
PubMed1990

Meningiomas presenting with paranasal sinus involvement.

Extracranial paranasal spread of meningiomas is uncommon. We describe the management of four cases, all of which first presented to an oto-rhino-laryngologist for an opinion. We suggest that greater use of modern imaging techniques could lead to earlier diagnosis. The natural history of extracranial spread is relatively benign but the management of regrowth of residual disease is difficult. We therefore suggest radical surgery in the first instance provided that the patients general health and configuration of the tumour allow.

Adult↗
PubMed1990

Psychiatric disorders at five years among children with birthweights less than 1000g: a regional perspective.

The relationship between extremely low birthweight (ELBW) and psychiatric disorder was investigated in a cohort of children of 500 to 1000g birthweight, born between 1980 and 1982. At five years of age data were collected for 82 of 90 survivors on psychiatric symptoms, parent-reported developmental delay and various aspects of psychosocial disadvantage. Compared with controls, ELBW children did not come from more disadvantaged environments, but were much more likely to experience developmental delay and problems with motor co-ordination. 16 per cent had an attention deficit disorder with hyperactivity (ADDH), compared with 6.9 per cent of controls. Rates of conduct disorder and emotional disorder were not raised, indicating that ELBW is a specific risk factor for ADDH. Controlling for the effect of neurodevelopmental problems rendered the association between ELBW and ADDH non-significant.

Attention Deficit Disorder with Hyperactivity↗
PubMed1990

Wagner resurfacing hip arthroplasty. The results of one hundred consecutive arthroplasties after eight to ten years.

In a prospective study of 100 consecutive Wagner resurfacing hip arthroplasties in ninety-three patients, the outcomes for all hips were determined for an eight to ten-year follow-up period. By survivorship analysis, the rate of survival of the arthroplasty was calculated to be 70 per cent at five years, but only 40 per cent at eight years. The major cause of failure was aseptic loosening of the acetabular or femoral component, or both. Fracture of the neck of the femur occurred in three hips. Although the medium-term results (at fifty-six to eighty-three months) were better than those in most comparable studies of resurfacing arthroplasty, the poor long-term results (at ninety-one to 118 months) show that meaningful studies of new prosthetic designs must continue for at least eight years, and, if at all possible, must include 100 per cent follow-up. The survival curve for the resurfacing arthroplasties in this study can serve as the basis for comparison of the early, medium, and long-term results of future designs of resurfacing hip prostheses.

Adult↗
PubMed1989

Metastatic potential of human colorectal carcinomas implanted into nude mice: prediction of clinical outcome in patients operated upon for cure.

To determine whether the production of experimental hepatic metastases in athymic nude mice by human colorectal carcinomas (HCC) correlated with the clinical outcome in patients, we harvested colorectal carcinomas from 82 patients, dissociated the tumors with collagenase and DNase, and injected them into groups of nude mice, either in the flank to assess experimental tumorigenicity or into the spleen to produce experimental metastasis in the liver. Growth in mice was then associated with clinicopathological factors and clinical outcome. Growth of HCC in either the flanks or the livers of nude mice was associated with the time to recurrence in a Wilcoxon analysis. Analysis of the outcome data in a Cox proportional hazards model suggested that there was an interaction between tumorigenicity and metastatic potential of HCC in nude mice and serum CEA concentration in the patient and stage of disease. A univariate analysis indicated that both tumorigenicity and metastatic potential of HCC in nude mice were significantly associated with the serum CEA concentration of the patient but not with the other variables of stage of disease, mucin production, local tissue invasion, state of differentiation, or sex. A subset of 57 patients was operated upon for cure and followed prospectively for up to 61 months. Tumorigenicity and, to a lesser extent, experimental metastatic potential were associated with disease recurrence in 23 of these patients. Seventy-eight % of the subset of patients who were operated upon for cure developed liver metastasis as one site of their progressive disease. Thus, the ability of HCC cells isolated from surgical specimens to grow in athymic nude mice correlates with the development of advanced disease in patients.

Adult↗
PubMed1989

Predictive value of quantitative dipyridamole-thallium scintigraphy in assessing cardiovascular risk after vascular surgery in diabetes mellitus.

Cardiac complications represent a major risk to patients undergoing vascular surgery. Diabetic patients may be particularly prone to such complications due to the high incidence of concomitant coronary artery disease, the severity of which may be clinically unrecognized. Attempts to stratify groups by clinical criteria have been useful but lack the predictive value of currently used noninvasive techniques such as dipyridamole-thallium scintigraphy. One hundred one diabetic patients were evaluated with dipyridamole-thallium scintigraphy before undergoing vascular surgery. The incidence of thallium abnormalities was high (80%) and did not correlate with clinical markers of coronary disease. Even in a subgroup of patients with no overt clinical evidence of underlying heart disease, thallium abnormalities were present in 59%. Cardiovascular complications, however, occurred in only 11% of all patients. Statistically significant prediction of risk was not achieved with simple assessment of thallium results as normal or abnormal. Quantification of total number of reversible defects, as well as assessment of ischemia in the distribution of the left anterior descending coronary artery was required for optimum predictive accuracy. The prevalence of dipyridamole-thallium abnormalities in a diabetic population is much higher than that reported in nondiabetic patients and cannot be predicted by usual clinical indicators of heart disease. In addition, cardiovascular risk of vascular surgery can be optimally assessed by quantitative analysis of dipyridamole-thallium scintigraphy and identification of high- and low-risk subgroups.

Angina Pectoris↗