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Biomedical subjects

D Cummins

Publications and source records attributed to D Cummins.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1996

Myelosuppression associated with azathioprine-allopurinol interaction after heart and lung transplantation.

It is widely recommended that, during concurrent therapy with allopurinol, the azathioprine dosage should be decreased by at least two thirds. We retrospectively studied compliance with this guideline in 24 patients who had commenced allopurinol at a median of 33 months (range, 2-145 months) after heart and/or lung transplantation. The median reduction in azathioprine dose at initiation of allopurinol was 73.3% but ranged from 0% to 90% (>67% in 14 patients). Within 3 months, 11 (46%) of the patients became leukopenic (white blood cell count <4 x 10(9)/L), 7/23 (30%) became moderately anemic (hemoglobin <10 g/dl), and 5/23 (22%) became thrombocytopenic (platelets <150 X 10(9)/L). Decreasing the dose of azathioprine by two thirds or greater reduced but did not abolish the risk of myelotoxicity. These data highlight the need for close hematological monitoring of patients treated with this drug combination. Agents other than allopurinol should be considered for treating hyperuricemia after thoracic organ transplantation.

Adult↗
PubMed1996

A modified chemostat system to study the ecology of oral biofilms.

Previously, we developed a chemostat system to study the behaviour and properties of a community of up to 10 species of oral bacteria. The present study describes modification of this system to incorporate removable and replaceable hydroxyapatite (the major mineral in human dental enamel) disks on which biofilms could develop. Hydroxyapatite disks were immersed in the chemostat for known time periods, and the bacterial content of biofilms determined by viable counting. Initial deposition rates were rapid, with all 10 species detected after 1 h, and the numbers of bacteria in biofilms continued to increase for 21 d. The species composition of biofilms reflected that of the surrounding fluid phase, and showed only limited signs of the type of 'species succession' which is observed in developing dental plaque in vivo, although anaerobic species increased in proportion in older biofilms. Four-day biofilms showed the least variability and were chosen as the 'standard biofilm' for more detailed study. Variability in the bacterial composition of 4-d biofilms was comparable both within a single chemostat run and between independent chemostat runs. Glucose pulsing in the absence of pH control resulted in the selection of cariogenic species; the disruption of the biofilm community was less marked than that of the equivalent planktonic culture. The model system has considerable potential in studying the effects of a variety of factors on biofilm development, as well as in comparing the efficacy of antimicrobial systems against biofilms.

Bacteria↗
PubMed1996

The effect of mouthrinses containing zinc and triclosan on plaque accumulation, development of gingivitis and formation of calculus in a 28-week clinical test.

Experimental mouthrinses containing 0.4% zinc sulphate and 0.15% triclosan, which differed in base formulations were compared to a commercially available non-active control mouthrinse. Following baseline clinical examinations for plaque, gingival bleeding and calculus, the volunteers were provided with a dental prophylaxis and given oral hygiene instruction, stratified into 3 groups and given 1 of 3 mouthrinses. Further clinical assessments were performed after 4, 16 and 28 weeks. Salivary mutans streptococci were also monitored during the study. At 4 weeks, plaque and calculus scores in all groups were low compared to baseline. During the remainder of the study, these improvements were not maintained and both plaque and calculus levels increased in all groups. Plaque was significantly lower (P < 0.05) than in the control at all time points. Calculus was significantly lower (P < 0.05) than in the control at all time points. Calculus was significantly lower at week 28 for experimental mouthrinse group 2. Gingival bleeding also decreased in the initial 4 weeks but increased thereafter in the control group. In contrast, gingival bleeding was significantly (P < 0.05) lower in the two experimental groups than in the control group. No significant changes in mutans streptococci were observed.

Analysis of Variance↗
PubMed1996

Response to periodontal therapy in diabetics and smokers.

Diabetics and smokers are two patient groups at high risk for periodontal disease who also exhibit impaired wound healing and, therefore, constitute two different groups in whom the relationship between host-parasite interaction, outcome of periodontal therapy, and systemic factors is best represented. The results of two independent clinical trials involving treatment of periodontal disease in diabetics and smokers are presented. A new treatment regimen for the management of periodontal disease associated with diabetes mellitus is proposed. This treatment approach incorporates both antimicrobial agents and pharmacological modulation of the host response. Elimination of periodontal infection and reduction of periodontal inflammation in diabetic patients resulted in a significant short-term reduction in the concentration of glycosylated hemoglobin (HbA1c). Control of chronic infections and modulation of the host response offer a new therapeutic approach in the management of patients with both diabetes and periodontal disease. The effect of smoking on periodontal healing is also discussed. The clinical and microbiological response of smokers to non-surgical periodontal therapy is compared to non-smokers. In addition, possible mechanisms whereby diabetes mellitus and cigarette smoking increase the severity of periodontal disease are discussed.

Adjuvants, Immunologic↗
PubMed1995

Red cell alloantibody development associated with heart and lung transplantation.

The development and persistence of clinically significant red cell alloantibodies were studied in 1132 patients who underwent a heart and/or lung transplant at Harefield Hospital. Clinically significant antibodies were detected in 15 patients (1.3%) preoperatively and appeared in a further 15 (2.1%) of 704 patients followed up 1-404 weeks after surgery. Anti-D developed in only 1 of 52 D-negative recipients of a D-positive donor graft and in only 2 of 6 D-negative patients who were transfused with between 6 and 32 units of D-positive red cells. Most antibodies that appeared after transplantation remained detectable for only a few weeks. Antibodies detected preoperatively that reacted only with papain-treated cells became persistently undetectable in 4 patients who were transfused with red cells expressing the corresponding antigen specificity. By contrast, antibodies detected preoperatively by indirect antiglobulin test were still detectable after periods of up to 260 weeks in 4 patients who received only antigen-negative red cells. Immunosuppressive therapy appeared to profoundly affect the natural history of red cell alloantibody production in these patients. The underlying mechanisms warrant further study.

ABO Blood-Group System↗
PubMed1995

Visceral leishmaniasis after cardiac surgery.

An English child developed visceral leishmaniasis (kala-azar) after cardiac surgery. Neither he nor his mother had ever been out of the UK, and his disease was probably transmitted by blood transfusion. Kala-azar should be considered in patients with unexplained fever and hepatosplenomegaly, even if there is no history of foreign travel.

Blood Transfusion↗