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Biomedical subjects

D Cummins

Publications and source records attributed to D Cummins.

At least 19 recordsLinked to original sources
PubMed2001

Chronic disseminated intravascular coagulation after surgery for abdominal aortic aneurysm: clinical and haemostatic response to dalteparin.

A 77-year-old man developed chronic disseminated intravascular coagulation (DIC) after surgical repair of a large infrarenal aortic aneurysm. Self-administered subcutaneous dalteparin therapy (5000 units o.d.) led to rapid relief of symptoms and sustained improvements in his platelet count and fibrinogen level; activation of coagulation and fibrinolysis appeared to be relatively unaffected. Long-term treatment with low-molecular-weight heparin can provide good symptomatic control of chronic DIC associated with abdominal aortic aneurysm.

Aged↗
PubMed2001

A fully automated microscope bacterial enumeration system for studies of oral microbial ecology.

A fast and fully automated image analysis technique for the enumeration of fluorescence-labeled bacteria in oral sampleswas developed. This paper describes the system configuration, application strategy, automated operation, and initial validation experiments using fluorescent microspheres, bacterial cultures, in vitro grown biofilms and human dental plaque. Following a series of brief operator-controlled calibration steps, the technique automatically performs all necessary microscope operations (stage translation, focus, sampling and analysis) on slides with up to 48 wells for as many different samples. It quantifies bacteria from differential interference contrast images, images showing cells that had been labeled by immunofluorescence with monoclonal antibodies, or images with cells labeled by a fluorescent DNA stain. With all evaluated samples, close agreement between the automated system and the assessor's visual counts was observed. This novel automated image grabbing and analysis procedure is applicable to the enumeration of specific taxa in clinical samples by both immunofluorescence and fluorescent in situ hybridization.

Automation↗
PubMed2000

Neutrophil dysplasia caused by mycophenolate mofetil.

Two transplant recipients developed striking morphological abnormalities in their circulating neutrophils while receiving mycophenolate. The changes included nuclear hypolobulation and abnormal clumping of nuclear chromatin and were presumably related to inhibition of guanosine nucleoside synthesis. In both cases the neutrophil abnormalities preceded the development of neutropenia and were thus a sign of impending hematological toxicity. The hematological changes resolved after the drug was discontinued.

Adult↗
PubMed2000

Fascinating rhythm

Explore the source record for details and available documents.

Journal Article↗
PubMed2000

The BCSH guideline on addressograph labels: experience at a cardiothoracic unit and findings of a telephone survey.

In 1998 we implemented a BCSH recommendation that addressograph labels should not be used on blood transfusion specimen tubes. Over a 12-month period before the ban was introduced our laboratory received 5964 red cell transfusion requests, 182 (3.1%) of which contained an error in the identification details (ID) supplied on the request form and/or specimen. Three of these errors were of the 'wrong patient' type, i.e. the sample belonged to a different patient from the one whose ID appeared on the specimen tube and request form. Over the 12 months after the ban was introduced 511 (8. 1%) of 6326 requests contained a labelling error, an increase in error rate of 165%; no wrong-patient errors were identified, however. In a survey, seven (29.2%) of 24 transfusion laboratories in the UK accepted specimens labelled with addressograph stickers; in four of these cases a local blood transfusion committee had agreed that the BCSH guideline should not be followed. We believe the BCSH guideline is valid; its implementation, however, has major financial and workload implications, which probably explains why many hospitals apparently do not comply with it.

Blood Banks↗
PubMed2000

Some distinctive features of the impact of managed care on psychiatry.

Past research suggests that the spread of managed care is affecting the treatment of mental and physical illnesses differently. This article develops six hypotheses that could explain the differential effects of managed behavioral health care, based on characteristics of mental disorders, professional norms of treatment, and the broader societal consequences of untreated mental illness. Using data from the 1998 Socioeconomic Monitoring System fielded by the American Medical Association, we tested these hypotheses by comparing the experiences of psychiatrists under managed care with those of primary care providers and medical specialists. We found the following: (1) psychiatrists face substantially more aggressive external review than do primary care providers and are less successful in overturning denials; (2) psychiatrists feel significantly more at risk for disaffiliation from health plans; (3) psychiatrists report facing review protocols that are more confusing than those for primary care physicians, but psychiatrists' staff spend less time on external review; (4) psychiatrists are more likely than other physicians to report that their patients have difficulty making informed choices about managed care; and (5) psychiatrists evidence greater time commitment to advocacy on behalf of their patients with respect to managed care.

Cost Allocation↗
PubMed1999

Is a man's facial appearance predictive of how he will die?

The ability of a range of health professionals including an oncologist, a haematologist, a cardiologist, a general practitioner and a counsellor to predict the cause of death from facial appearance has been evaluated. Each participant was asked to predict the cause of death from facial photographs of 200 caucasian male doctors whose cause of death was known to be due to either arterial disease or neoplasia. Statistically significant concordance was found between the oncologist and both the GP and the counsellor in their predictions of cause of death, although the individual accuracy was no greater than would be expected by chance. This suggests that common judgments based on facial appearances may be shared among certain health professionals.

Adult↗
PubMed1998

Haematological changes associated with influenza vaccination in people aged over 65: case report and prospective study.

Blood count abnormalities are a recognized feature of many viral infections and immunizations but little is known about the haematological effects of influenza vaccination. We report a 67-year-old patient who developed thrombocytopenia and severe neutropenia 3 weeks after she was vaccinated against influenza. The case led us to study prospectively the blood counts of 70 people aged over 65 before and after they received influenza vaccine. There were no significant changes in the levels of haemoglobin, neutrophils, monocytes, eosinophils or platelets after vaccination, but the total WBC counts (mean +/- SD, 6.86 +/- 1.52) and lymphocyte counts (1.69 +/- 0.61) were significantly lower at 4 weeks than at baseline (7.22 +/- 1.60 [P = 0.02] and 1.86 +/- 0.62 [P = 0.001] respectively) and in four subjects the lymphocyte count fell to below 0.7 x 10(9)/l. Since influenza vaccine does not contain live virus, its haematological effects presumably relate to the host immune response rather than to viral replication.

Aged↗
PubMed1997

Identification of a zinc-binding cystic fibrosis antigen in human saliva by 65Zn probing and N-terminal sequencing.

Human whole saliva was collected at 4 degrees C into a protein inhibitor cocktail to prevent proteolytic degradation. Saliva was clarified by centrifugation and fractionated by immobilized metal affinity chromatography (IMAC) after charging the column with zinc ions. Proteins with an affinity for zinc were eluted from the IMAC column, characterized by sodium dodecylsulphate-polyacrylamide gel electrophoresis, and probed with 65ZnCl2 after electrotransfer on to polyvinylidenefluoride membranes. A zinc-binding protein of approx. 11 kDa was characterized by N-terminal sequencing followed by a FASTA search of Genbank. The first 40 residues were sequenced, of which the first 34 residues were used to conduct a FASTA search and yielded and homology > 97% coding for sequences of mRNA of two proteins, a cystic fibrosis antigen with an M(r) of 10,938 and a calcium-binding inflammatory protein MRP8 with an M(r) of 10,835 expressed in chronic inflammation. The identity of the last 15 residues of the sequence and the likelihood that the protein is secreted via saliva indicates that the 11-kDa protein is the cystic fibrosis antigen, a protein not previously reported in saliva.

Amino Acid Sequence↗
PubMed1997

Longitudinal study of prognostic factors in established periodontitis patients.

Numerous indicators for disease progression have been described in the last decade. The purpose of this study was to examine, longitudinally, a large battery of clinical, microbiological, and immunological indicators, to try to determine whether the presence of one or a combination of these parameters at baseline, would correlate positively with increased attachment and or bone loss (true prognostic factors). Following initial screening, 79 patients with established periodontitis were monitored longitudinally for one year. Whole mouth clinical measurements, plaque gingival and calculus indices, together with pocket depth and attachment level measurements, were repeated every three months. Full mouth radiographic survey, performed at baseline and 12 months, served to determine changes in crestal bone height using an image enhancement technique. Subgingival plaque samples were taken at baseline and every 3 months. Immunofluorescence assays were performed for the a battery of target microorganisms. Serum and GCF samples for IgG subclasses analysis were obtained at each visit and assayed using ELISA techniques. Likewise blood, samples were also drawn at each visit for a quantitative analysis of serum cotinine level. The overall mean attachment loss (AL) and bone loss (BL) were almost identical (0.159 mm and 0.164 mm, respectively). Individual patients variation was large (-0.733 to +1.004 mm). An overall 6.89% of sites were active; individual patients' means ranged from 0-28.9%. Mean pocket depth (PD) showed minimal change over the study period (-0.033 mm) thus suggesting that most if not all the AL was accompained by concomitant gingival recession. Smokers exhibited greater AL and radiographic BL compared to non-smokers. Likewise, patients' cotinine level showed direct correlation with outcomes of progressive periodontal breakdown. Past severity of periodontal involvement, as reflected in the patients baseline PD, AL and crestal bone height, showed good correlation with longitudinal changes in the periodontium. This correlation was higher for crestal BL as the outcome variable, while somewhat smaller for change in AL as the outcome variable. Bacteroides forsythus (Bf.), Prevotella intermedia (Pi.) and Porphyromonas gingivalis (Pg.) were frequently found in these patients. The presence of these microorganisms at baseline was associated with further disease progression. Subjects with mean baseline pocket depth equal or greater than 3.2 mm were at greater risk for future bone loss 1 year later (O.R. 2.97; C.I. 1.02-8.70). Smokers were at significantly greater risk for further attachment loss when compared to non-smokers (O.R. 5.41; C.I. 1.50-19.5). Subjects that harbored B. forsythus at baseline, were at seven times greater risk for increased pocket depth (O.R. 7.84; C.I.1.74-35.3). In conclusion, past periodontal destruction, smoking habits, Bf., Pg., & Pi. are prognostic factors for further periodontal breakdown. When designing clinical trials, or when evaluating epidemiological data, it is most important to balance for these factors. Also, treatment strategies should attempt to eliminate or modify these factors.

Adult↗
PubMed1997

Interaction of zinc with a synthetic calcium phosphate mineral.

As zinc has been included in several oral health products as an anticalculus and antiplaque agent, the interaction of zinc with a synthetic phosphate was investigated. The synthetic calcium phosphate used in this study was beta-tricalcium phosphate, or whitlockite, which is a major constituent of mature calculus. The aim of this work was to study the mechanism of uptake of zinc to this mineral. Zinc was readily taken up by the calcium phosphate to a maximum level of 13.9 mumol/m2. The interaction was reversible and followed a Langmuir adsorption isotherm. There was no concomitant release of calcium with zinc uptake. Inclusion of calcium in the exposure solution did however marginally depress the acquisition of zinc (12% max), but fluoride had no significant effect on uptake.

Adsorption↗
PubMed1997

Effects of smoking and smoking cessation on healing after mechanical periodontal therapy.

This study investigated the effect of cigarette smoking on 143 patients' clinical and microbiological responses to mechanical therapy. Treatment included four to six sessions of subgingival scaling and root planing and instruction in oral hygiene. Results indicate that current smokers have less healing and reduction in subgingival Bacteroides forsythus and Porphyromonas gingivalis after treatment compared to former and nonsmokers, suggesting that smoking impairs periodontal healing. As the healing and microbial response of former smokers is comparable to that of nonsmokers, smoking cessation may restore the normal periodontal healing response.

Adult↗