Biomedical subjects

D Gardner

Publications and source records attributed to D Gardner.

At least 19 recordsLinked to original sources

PubMed2002

An outbreak of viral gastroenteritis following environmental contamination at a concert hall.

In January 1999, an outbreak of viral gastroenteritis affected more than 300 people who attended a metropolitan concert hall over a 5-day period. Norwalk-like virus (NLV) was confirmed in faecal samples by reverse transcription polymerase chain reaction assay. The index case was a concert attendee who vomited in the auditorium and adjacent male toilet. Gastrointestinal illness occurred among members of 8/15 school parties who attended the following day. Children who sat on the same level of the auditorium as the index case were much more likely to be ill than those seated elsewhere (relative risk 7.1, 95% confidence interval 5.4-9.2. P < 0.001). The majority of other reported cases had not been present on the evening of the vomiting incident. Disinfection procedure was poor and the disinfectant used contained no sodium hypochlorite. Transmission most likely occurred through direct contact with contaminated fomites. The outbreak has implications for disinfection procedures following vomiting incidents at public venues.

Adult↗

PubMed2001

Dynamic publication model for neurophysiology databases.

We have implemented a pair of database projects, one serving cortical electrophysiology and the other invertebrate neurones and recordings. The design for each combines aspects of two proven schemes for information interchange. The journal article metaphor determined the type, scope, organization and quantity of data to comprise each submission. Sequence databases encouraged intuitive tools for data viewing, capture, and direct submission by authors. Neurophysiology required transcending these models with new datatypes. Time-series, histogram and bivariate datatypes, including illustration-like wrappers, were selected by their utility to the community of investigators. As interpretation of neurophysiological recordings depends on context supplied by metadata attributes, searches are via visual interfaces to sets of controlled-vocabulary metadata trees. Neurones, for example, can be specified by metadata describing functional and anatomical characteristics. Permanence is advanced by data model and data formats largely independent of contemporary technology or implementation, including Java and the XML standard. All user tools, including dynamic data viewers that serve as a virtual oscilloscope, are Java-based, free, multiplatform, and distributed by our application servers to any contemporary networked computer. Copyright is retained by submitters; viewer displays are dynamic and do not violate copyright of related journal figures. Panels of neurophysiologists view and test schemas and tools, enhancing community support.

Animals↗

PubMed2001

Occupational injuries of physiotherapists in North and Central Queensland.

The National Occupational Health and Safety Commission of Australia has identified musculoskeletal injuries in the health industry as a key area of concern. There is little data available on injuries to physiotherapists. This study aimed to investigate the nature, prevalence, job risk factors and consequences of occupational injuries, with particular focus on musculoskeletal injuries, experienced by physiotherapists in North and Central Queensland. A work-related musculoskeletal injury was defined as pain lasting more than three days that the respondent felt was cause by their work as a physiotherapist. Fifty-five per cent of respondents had experienced a work-related injury and 40% had experienced injury in the previous year. The most injured body areas were the low back, hands and neck. Over half (56%) of the initial episodes of injury occurred within five years of graduation. The job risk factors of most concern to injured respondents were sustained demanding postures, manual therapy techniques, repetition, working while injured and excessive workloads. Injured respondents chose to work while injured and not to take time off on workers' compensation or have surgery. Following injury, 38 of respondents changed work settings. Most injured physiotherapists modified their techniques to continue working. Further research is needed to develop effective preventative strategies.

Adult↗

PubMed2001

Optimal dosing of penicillin G in the third trimester of pregnancy for prophylaxis against group B Streptococcus.

OBJECTIVE: We wanted to determine the optimal dose of intravenous penicillin (PCN) in the third trimester of pregnancy for the prophylaxis of group B Streptococcus. STUDY DESIGN: Healthy women in the third trimester with a singleton pregnancy were recruited. Eligibility included no previous penicillin or cephalosporin allergy and no history of renal disease. We obtained a baseline 24-hour urine collection for total protein concentration and creatinine clearance. Two intravenous catheters were placed, and 1 million units of penicillin G (PCN G) sodium was infused through one catheter. Serial blood samples were obtained through the second catheter at 1, 5, 15, 30, 60, 90, 120, 150, 180, 210, and 240 minutes. Serum was stored at -80 degrees C until assays were performed. Reverse-phase high-performance liquid chromatography was used to determine serum concentrations. RESULTS: Fifteen patients met the requirements for eligibility. The average 24-hour urine sample for total protein concentration was 187 mg/dL (range, 11-252), and creatinine clearance was 191 mL/min (range, 137-245). Average maximum serum concentration (C(max)) was 67 microg/mL (range, 34-132) and was reached within 5 minutes. Average serum PCN concentration was 12 microg/mL (range, 9-25) after 4 hours of urine collection. CONCLUSION: The C(max) was 67 microg/mL (670 x minimum inhibitory concentration). One million units of intravenous PCN G exceeds MIC in the treatment of GBS. The dosing interval should be 4 hours to ensure anti-GBS activity in all patients. More frequent dosing does not increase activity. Current recommendations for GBS prophylaxis which use PCN G should be modified pending future studies of neonatal PCN concentrations.

Adolescent↗

PubMed2001

Drug use patterns among high school athletes and nonathletes.

This study examined drug use patterns and perceptions of drug intervention programs among adolescent interscholastic athletes and nonathletes. In particular, it explored the issue of whether participation in high school athletics is related to a healthier lifestyle and decreased use of recreational drugs and ergogenic aids. One thousand five hundred fifteen Massachusetts high school students completed a 150-item survey that assessed illicit and nonillicit substance use. Chi-square analyses revealed that athletes were significantly less likely to use cocaine and psychedelics, and were less likely to smoke cigarettes, compared with nonathletes. Conversely, nonathletes were less likely to use creatine than were athletes. There was no difference in the use of anabolic steroids and androstenedione between athletes and nonathletes. Descriptive analyses appear to indicate that drug interventions for athletes are falling short of their objectives. This study suggests that athletes have a healthier lifestyle and that the efficacy of intervention programs must be further examined.

Adolescent↗

PubMed2000

Infection of B cell-deficient mice with CDC 1551, a clinical isolate of Mycobacterium tuberculosis: delay in dissemination and development of lung pathology.

Long-term survival of mice infected with Mycobacterium tuberculosis is dependent upon IFN-gamma and T cells, but events in early phases of the immune response are not well understood. In this study, we describe a role for B cells during early immune responses to infection with a clinical isolate of M. tuberculosis (CDC 1551). Following a low-dose infection with M. tuberculosis CDC 1551, similar numbers of bacteria were detected in the lungs of both B cell knockout (IgH 6-, BKO) and C57BL/6J (wild-type) mice. However, despite comparable bacterial loads in the lungs, less severe pulmonary granuloma formation and delayed dissemination of bacteria from lungs to peripheral organs were observed in BKO mice. BKO mice reconstituted with naive B cells, but not those given M. tuberculosis-specific Abs, before infection developed pulmonary granulomas and dissemination patterns similar to wild-type animals. Further analysis of lung cell populations revealed greater numbers of lymphocytes, especially CD8+ T cells, macrophages, and neutrophils in wild-type and reconstituted mice than in BKO mice. Thus, less severe lesion formation and delayed dissemination of bacteria found in BKO mice were dependent on B cells, not Abs, and were associated with altered cellular infiltrate to the lungs. These observations demonstrate an important, previously unappreciated, role for B cells during early immune responses to M. tuberculosis infections.

Aerosols↗

PubMed2000

Aminoglycoside dosing in diabetes.

Studies have evaluated the comparative efficacy, toxicity and costs associated with extended-interval vs. standard multiple daily dosing of aminoglycosides. In this case, an elderly man with diabetes and good renal function at baseline was switched from standard to extended-interval dosing. During the course of therapy there was evidence of decreased renal function. Pertinent literature was searched for, uncovered and critically evaluated to determine if and what evidence supports using extended dosing of aminoglycosides in this population. No data were found specifically evaluating the different dosing strategies in diabetic patients. However, there were many trials and several meta-analysis located that compared the two dosing strategies, most suggesting at least a cost advantage and possibly less toxicity with extended-interval dosing. Further information is needed to determine whether there is a differential risk for toxicity between these dosing regimens in patient with diabetes.

Aged↗

PubMed2000

Manual handling injuries in health care workers.

Nursing aides are particularly susceptible to manual handling injuries because they have the primary responsibility for heavy lifting. The aim of this study was to determine why a specific group of nursing aides have the highest manual handling injury rate in their hospital. The study investigated the adequacy of the manual handling training program, knowledge of manual handling, mechanical aid availability, and use of mechanical aids. Results indicated that the nursing aides' manual handling knowledge was adequate but that they rarely used mechanical aids. This lack of use of aids was in part due to an over-reliance on their own strength and abilities. This may have been due to a lack of suitable mechanical aids on the wards or a lack of familiarity with the available aids. This study suggests that neither training alone nor the purchase of equipment alone is likely to resolve manual handling problems.

Accidents, Occupational↗

PubMed2000

Deliberate self-harm and antidepressant drugs. Investigation of a possible link.

BACKGROUND: It is not clear if the frequency of deliberate self-harm (DSH) is the same in patients taking different pharmacological classes of antidepressant drugs. AIMS: To compare the frequency of DSH in patients who had been prescribed a tricyclic antidepressant (TCA) or a selective serotonin reuptake inhibitor (SSRI) prior to the DSH event. METHOD: This was a prospective study in 2776 consecutive DSH cases attending an accident and emergency department. The incidence of DSH in TCA-treated cases and SSRI-treated cases is expressed as number of DSH events per 10 000 prescriptions of each antidepressant. RESULTS: Significantly more DSH events occurred following the prescription of an SSRI than that of a TCA (P<0.001). The occurrence of DSH was highest with fluoxetine and lowest with amitriptyline. CONCLUSIONS: Merely prescribing safer-in-overdose antidepressants is unlikely to reduce the overall morbidity from DSH.

Adolescent↗

PubMed2000

General practitioner training in palliative care: an experiential approach.

With the rising incidence of cancer and with more terminally ill patients wishing to be cared for at home, it is clear that there is a growing need for general practitioners (GPs) who are skilled in providing palliative care. In an attempt to improve the palliative care knowledge and skills of GPs in Western Australia and the quality of care they provide, a 14-week training program was developed by the Silver Chain Nursing Association and the Perth South Eastern Division of General Practice. The program used experiential learning techniques, such as a clinical attachment and mentoring. Research has shown that performance-based rather than cognitive education methods have a greater impact on practice outcomes. The program was evaluated by an external body and found to have achieved its objectives. The results of the evaluation are discussed, together with their implications for postgraduate education.

Education, Medical, Continuing↗

PubMed1999

Combinatorial Methods for the Synthesis of Aluminophosphate Molecular Sieves.

Automatic dispensing of reagents into autoclave blocks followed by synthesis, isolation, and automated structure analysis with X-ray diffractometry represents an efficient methodology for the combinatorial synthesis of microporous materials. The figure shows a typical diffractogram of as-synthesized AFI-type molecular sieves taken with a CCD camera.

Journal Article↗

PubMed1999

An outbreak of Salmonella typhimurium DT170 associated with kebab meat and yogurt relish.

During July 1995, an outbreak of Salmonella typhimurium definitive type (DT) 170, an unusual strain, occurred in South Wales. A case-control study found that illness was associated with eating kebabs (odds ratio undefined, P = 0.002), doner kebabs (odds ratio 7.9, 95 % confidence interval 1.5-20.5, P = 0.02) and kebabs with yoghurt based relish (odds ratio undefined, P = 0.009) but not with eating kebabs with mayonnaise-based relish (odds ratio 2.4, 95 % confidence interval 0.4-13.9, P = 0.53). Environmental investigations discovered a complex web of producers and wholesale suppliers. Kebab meat and yoghurt had been supplied to the two main implicated outlets by a single wholesaler. Samples of raw minced lamb and several environmental swabs taken at the wholesaler were positive for S. typhimurium DT170. Blood-stained, unsealed yoghurt pots were observed to be stored under a rack of raw lamb. Investigators of food poisoning outbreaks linked to takeaway food should consider cross-contaminated relishes and dressings as well as undercooked meat as potential vehicles of infection.

Adolescent↗

PubMed1999

Mechanical equipment injuries in small manufacturing businesses. Knowledge, behavioural, and management issues.

This paper presents findings from an extensive study into factors that impact upon the high rate of injuries due to mechanical equipment, especially in small manufacturing firms. Issues relating to knowledge of health and safety issues and to management practices have been shown to be extremely important with regards to safety in small businesses. Knowledge and awareness of hazards were found to be relatively low and few respondents, especially managers, had received adequate safety training. Managers did not regard the identification and control of risks as a priority. Workplaces generally lacked effective safety management procedures such as safety rules and regulations, procedures for recording and learning from accidents, and clearly defined responsibilities for safety. Some issues requiring further investigation, and some recommendations for improving safety in small businesses, are presented.

Accidents, Occupational↗

PubMed1999

The fetal cleft palate: I. Characterization of a congenital model.

Any animal model of a human congenital anomaly established by iatrogenic methods involving intrauterine fetal manipulation has limited clinical applicability. A congenital model that more closely simulates the etiopathogenesis of a human anomaly may provide data that can more readily be extrapolated to that anomaly and, therefore, be used in diagnostic and management strategies. The present work provides a description and characterization of a congenital model of cleft palate in the goat. Palatal shelf closure normally occurs at approximately day 38 of gestation in the caprine species. Sixteen pregnant goats were gavaged twice daily during gestational days 32 through 41 [term, 145 days] with a plant slurry of Nicotiana glauca containing the piperidine alkaloid teratogen anabasine. Gross analysis and measurement of fetal clefts were performed at 60, 70, and 85 days gestation (four fetuses were studied at each time point). Seventeen clefted kids were sacrificed at specific intervals after birth (2 weeks, and 1, 3, and 6 months); after skull debridement and preparation, they were compared with 12 unclefted control kids. Complete clefting of the secondary palate occurred in 97 percent of the fetuses. In all cases, the cleft extended from the posterior aspect of the alveolar ridge to the uvula; the majority of these clefts were bilateral, with complete detachment of the vomer. Morphologically, these clefts were similar to human clefts. Eighteen percent of clefted newborn kids demonstrated gross maxillary hypoplasia and midfacial retrusion at birth with a relative Class III malocclusion. Direct measurement of the congenital caprine skulls confirmed these findings. The incidence of midfacial growth abnormalities in these clefted animals raises questions regarding the etiopathogenesis of facial dysmorphology that is unrelated to scarring of the maxilla. This congenital cleft palate model is currently being used to explore these questions and others related to craniofacial growth and palatal function after in utero repair.

Animals↗

PubMed1998

Best-link matching of Scottish health data sets.

Methods are described used to link the Community Health Index and the National Health Service Central Register (NHSCR) in Scotland to provide a basis for a national patient index. The linkage used a combination of deterministic and probability matching techniques. A best-link principle was used by which each Community Health Index record was allowed to link only to the NHSCR record with which it achieved the highest match weight. This strategy, applied in the context of two files which each covered virtually the entire population of Scotland, increased the accuracy of linkage approximately a thousand-fold compared with the likely results of a less structured probability matching approach. By this means, 98.8% of linkable records were linked automatically with a sufficient degree of confidence for administrative purposes.

Community Health Planning↗

PubMed1998

A case of risperidone overdose in early schizophrenia: a review of potential complications.

Deliberate drug overdose is a frequent occurrence in patients with schizophrenia. Typical antipsychotic medications can be lethal at doses 5 times the recommended therapeutic range. Clozapine, an atypical antipsychotic, can be toxic at doses 4 times a moderate dose. Little is known about the lethal effects of the novel antipsychotic risperidone, despite the fact that it is now one of the most widely prescribed antipsychotics in North America. To date, only 1 death attributable to risperidone overdose has been reported. The case presented here documents adverse cardiac effects in a 28-year-old man who intentionally ingested 24 mg of risperidone--4 times the recommended dose. A potential drug interaction with fluvoxamine and the role of active metabolites are discussed.

Adult↗

PubMed1997

A high-resolution genetic map of the familial Mediterranean fever candidate region allows identification of haplotype-sharing among ethnic groups.

Familial Mediterranean fever (FMF) is a recessive disorder of inflammation caused by mutations in a gene (designated MEFV) on chromosome 16p13.3. We have recently constructed a 1-Mb cosmid contig that includes the FMF critical region. Here we show genotype data for 12 markers from our physical map, including 5 newly identified microsatellites, in FMF families. Intrafamilial recombinations placed MEFV in the approximately 285 kb between D16S468/D16S3070 and D16S3376. We observed significant linkage disequilibrium in the North African Jewish population, and historical recombinants in the founder haplotype placed MEFV between D16S3082 and D16S3373 (approximately 200 kb). In smaller panels of Iraqi Jewish, Arab, and Armenian families, there were significant allelic associations only for D16S3370 and D16S2617 among the Armenians. A sizable minority of Iraqi Jewish and Armenian carrier chromosomes appeared to be derived from the North African Jewish ancestral haplotype. We observed a unique FMF haplotype common to Iraqi Jews, Arabs, and Armenians and two other haplotypes restricted to either the Iraqi Jewish or the Armenian population. These data support the view that a few major mutations account for a large percentage of the cases of FMF and suggest that some of these mutations arose before the affected Middle Eastern populations diverged from one another.

Alleles↗

PubMed1997

Construction of a 1-Mb restriction-mapped cosmid contig containing the candidate region for the familial Mediterranean fever locus (MEFV) on chromosome 16p 13.3.

In this paper we describe the assembly and restriction map of a 1.05-Mb cosmid contig spanning the candidate region for familial Mediterranean fever (FMF), a recessively inherited disorder of inflammation localized to 16p13.3. Using a combination of cosmid walking and screening for P1, PAC, BAC, and YAC clones, we have generated a contig of genomic clones spanning approximately 1050 kb that contains the FMF critical region. The map consists of 179 cosmid, 15 P1, 10 PAC, 3 BAC, and 17 YAC clones, anchored by 27 STS markers. Eight additional STSs have been developed from the approximately 700 kb immediately centromeric to this genomic region. Five of the 35 STSs are microsatellites that have not been previously reported. NotI and EcoRI mapping of the overlapping cosmids, hybridization of restriction fragments from cosmids to one another, and STS analyses have been used to validate the assembly of the contig. Our contig totally subsumes the 250-kb interval recently reported, by founder haplotype analysis, to contain the FMF gene. Thus, our high-resolution clone map provides an ideal resource for transcriptional mapping toward the eventual identification of this disease gene.

Base Sequence↗