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Biomedical subjects

D Gray

Publications and source records attributed to D Gray.

At least 55 records · Page 3Linked to original sources
PubMed2001

Evaluating pressure-reducing foam mattresses and electric bed frames.

It could be argued that pressure ulcer prevention is simply a matter of matching those patients at risk of developing tissue damage with suitable pressure-reducing equipment. However, as many authors have identified, this can be complicated because of the lack of reliable evidence to support many products. This article seeks to evaluate the combination of a pressure-reducing mattress with an electric profiling bed frame. The study was conducted in a high-dependency cardiac surgery unit. Forty-four subjects were recruited during a 6-month period and their progress observed. Two outcome measures were used: pressure ulcer incidence and perceptions of comfort. No pressure ulcers developed during the trial and the perceptions of comfort were generally positive. The small sample size restricts the conclusions that can be drawn from the study, but when taken in conjunction with other small studies in this area there appear to be benefits from using such a combination of equipment.

Beds↗
PubMed2001

Nutrition and wound healing: what is the link?

Given the important role played by nutrients in wound healing, all patients with wounds should receive a nutritional assessment. Action must then be taken to address any deficiency.

Anthropometry↗
PubMed2001

Identification of an interactive effect of beta3- and alpha2b-adrenoceptor gene polymorphisms on fat mass in Caucasian women.

Several adrenoceptor subtypes are expressed in adipocytes, which together exert their influence on adipocyte metabolism. Therefore, we specifically examined the interactive effect of Trp64Arg (beta3) and Glu12/Glu9 (alpha2b) adrenoceptor (AR) polymorphisms on energy metabolism and body composition in healthy women with a wide range of body habitus. We genotyped 909 unrelated women (age 55 +/- 12 [mean +/- SD] years, range 19-87; body weight 88 +/- 22 kg, range 40-167; and BMI 33 +/- 8 kg/m2, range 16-64) for Trp64Arg beta3AR and Glu12/Glu9 alpha2bAR variants. We examined the independent effect of the Glu12/Glu9 alpha2bAR variant on body composition and energy balance, in a large cohort of Caucasian women (n = 909). A second goal was to examine the interaction effect of Glu12/Glu9 alpha2bAR and Trp64Arg beta3AR on the same phenotypes. The obesity-related phenotypes studied were as follows: body weight, BMI, fat mass, visceral fat, fat-free mass, resting metabolic rate (RMR), VO2max, leisure time physical activity, and daily energy intake. Body composition and body fat distribution were measured by dual-energy X-ray absorptiometry and radiographic imagery, VO2max by a treadmill test to exhaustion, and RMR by indirect calorimetry. An analysis of covariance indicated that in the entire cohort, there was no significant difference between Glu12/Glu9 alpha2bAR carriers and control subjects for any of the obesity-related phenotypes that were examined. However, we observed a significant interaction effect of the Trp64Arg and Glu12/Glu9 variants on fat mass (P = 0.009) and percent fat (P = 0.016). Age, height, body weight, BMI, fat-free mass, visceral fat, energy expenditure, respiratory quotient, physical fitness, and energy intake were not different among groups. Collectively, these findings support an interaction effect of the two adrenoceptor variants on body fatness in Caucasian women, although the physiological mechanism by which they exert this effect remains to be determined.

Adipose Tissue↗
PubMed2001

Epstein-Barr Virus and HLA-DPB1-*0301 in young adult Hodgkin's disease: evidence for inherited susceptibility to Epstein-Barr Virus in cases that are EBV(+ve).

Cases of Hodgkin's disease (HD) may be distinguished by whether they do [EBV-positive ((+ve)) cases] or do not [EBV-negative ((-ve)) cases] have evidence of EBV DNA in the Reed-Sternberg cells. Only one study has attempted to distinguish epidemiological risk factors for EBV(+ve) and EBV(-ve) HD, and none have compared inherited susceptibility. The present study involves a population-based case series of HD, diagnosed in patients between 16-24 years of age in the United Kingdom (n = 118), of whom 87% were classified by EBV status (EBV(+ve), 19, EBV(-ve), 84). History of infectious illness, EBV antibody titers, and HLA-DPB1 type have been compared in EBV(+ve) and EBV(-ve) cases. Reported infectious mononucleosis was more frequent in EBV(+ve) cases (odds ratio (OR), 5.10; 95% confidence interval (CI), 1.12-24.4). EBV antibody titers to viral capsid antigen were significantly higher in EBV(+ve) cases (P for trend = 0.02). Higher proportions of EBV(+ve) (43%) than EBV(-ve) (31%) cases typed positive for HLA-DPB1*0301, but this was not statistically significant; the association of infectious mononucleosis with EBV(+ve) cases was stronger in this HLA subgroup (OR, 17.1; 95%CI, 1.06-1177) than in other cases (OR, 1.24; 95% CI, 0.02-15.4). Although these results are based on small numbers of HD cases, they provide suggestive evidence that the etiology of EBV(+ve) HD may involve inherited susceptibility to EBV.

Adolescent↗
PubMed2000

Cellular interactions involved in Th cell memory.

The cellular interactions involved in maintaining CD4+ T cell memory have hitherto not been identified. In this report, we have investigated the roles played by B cells and dendritic cells (DCs) in this process. We show that long-lasting Th cell memory depends on the presence of B cells, but that direct Ag presentation by B cells is not required. Instead, Ag presentation by DCs is critical for the survival of memory Th cells. DCs presenting specific Ag can be detected in animals long after immunization. These findings support a model in which B cells provide an environment in which Ags may be trapped and retained. This Ag is periodically presented to memory CD4+ T cells by DCs, providing an essential survival signal.

Animals↗
PubMed2000

Development of a high-performance liquid chromatographic-mass spectrometric assay for the specific and sensitive quantification of Ro 64-0802, an anti-influenza drug, and its pro-drug, oseltamivir, in human and animal plasma and urine.

Oseltamivir phosphate (Ro 64-0796/002) is a pro-drug of the anti-influenza neuraminidase inhibitor, Ro 64-0802, and as Tamiflu, has been developed for the treatment of both A and B strains of the disease. This paper describes an HPLC-MS-MS assay for both compounds in plasma and urine which fulfils all of the criteria for a good analytical method. It is sensitive with limits of quantification of 1 and 10 ng/ml for the pro-drug and active neuraminidase inhibitor, respectively. It is both accurate and precise with typical coefficients of variation from some 5,000 quality control samples of approximately +/-3 and +/-6%, respectively. Extensive stability studies have demonstrated the absence of significant problems associated with the decomposition of either compound, although ex vivo hydrolysis of Ro 64-0796 to Ro 64-0802 in rodent plasma has to be prevented by the use of the esterase inhibitor, dichlorvos.

Acetamides↗
PubMed2000

Analysis of immunoglobulin (Ig) isotype diversity and IgM/D memory in the response to phenyl-oxazolone.

The distribution of immunoglobulin (Ig) isotypes within specific B cell clones in vivo after immunization is not well defined. Using an IgV(H)/CDR3- and isotype-specific reverse transcription polymerase chain reaction method, we have carried out a survey of the diversification of the isotype in a splenic response to phenyl-oxazolone (phOx) on a chicken serum albumin carrier. The phOx-specific V(H) (V(H)Ox-1 with specific CDR3 motif) is associated with all of the heavy chains (mu, delta, alpha, gamma, and epsilon) after simple immunization with antigen in alum. The kinetics of expression of each isotype are distinct and reproducible. Focusing mainly on the expression of secretory Ig transcripts, IgM, IgG1, and IgE are found after priming, whereas IgD and IgA appear after boosting. Secretory IgD transcripts are found reproducibly at moderate levels and may, therefore, contribute significantly to the secreted Ig response in mice. Most crucially, we find enhanced levels of secretory IgM/V(H)Ox-1 transcripts (with 'phOx-specific' CDR3) after boosting, strongly indicating the existence of IgM memory cells that give rise to an enhanced specific IgM secretion in the secondary response.

Animals↗
PubMed2000

Role of B cells in maintaining helper T-cell memory.

The cellular interactions involved in maintaining CD4+ T-cell memory have hitherto not been identified. In this report, we have investigated the role played by B cells in this process. We show that that long-lasting helper T-cell memory depends on the presence of B cells, but that direct antigen presentation by B cells is not required. These findings provide new insights into the mechanisms which underlie helper T-cell memory. They also suggest that the efficacy of future vaccines will depend critically on the inclusion of B- as well as T-cell epitopes.

Animals↗
PubMed2000

Suppression of temperature fluctuations and energy barrier generation by velocity shear

First measurements of temperature fluctuations in a region of high velocity shear show that absolute and normalized fluctuation levels are reduced across the shear layer, a result that is consistent with weak parallel electron thermal conduction in the electron temperature dynamics. The concomitant reduction of temperature, density, and electric field fluctuations reduces the anomalous conducted and convected heat fluxes.

Journal Article↗
PubMed2000

Oscillations of voltage and resistance in Malpighian tubules of Aedes aegypti.

The transepithelial voltage (V(t)) of isolated Malpighian tubules of the yellow fever mosquito Aedes aegypti spontaneously oscillates in more than half the tubules. Typically, V(t) decreases and then rises at a frequency of 2 oscillations/min with a duration of 16 s. In 6 isolated perfused tubules studied in detail, V(t) oscillates between 50.5 mV and 15.7 mV in parallel with (1) oscillations of the transepithelial resistance (R(t)) between 7.61 kOmegacm and 3.63 kOmegacm, (2) oscillations of the basolateral membrane voltage of principal cells between -56.7 mV and -72.2 mV, and (3) oscillations of the apical membrane voltage between 107.2 mV and 87.8 mV. The oscillations are dependent on the Cl concentration in the extracellular solutions. As R(t) decreases during the oscillations V(t) goes to the transepithelial equilibrium potential of Cl (E(cl)) indicating transient changes in transepithelial Cl conductance as the mechanism of voltage and resistance oscillations. Since the largest voltage oscillations take place across the whole epithelium and not across cell membranes, oscillating Cl conductances are localized to a single transepithelial Cl diffusion barrier such as the paracellular pathway. This conclusion is supported by the analysis of electrically equivalent circuits that identify the shunt pathway as the site of oscillating Cl conductances.

Journal Article↗
PubMed2000

What works? A review of evaluated alcohol misuse interventions among aboriginal Australians.

AIMS: To identify which intervention strategies have been effective in reducing excessive consumption of alcohol, and related harm, among some segments of Australia's Aboriginal population. DESIGN: Items dealing with 'alcohol' and 'evaluation' (27) were identified from the comprehensive electronic data base on Aboriginal alcohol and other drug issues, maintained by Australia's National Centre for Research into the Prevention of Drug Abuse. From these were selected all reports (14) dealing specifically with evaluation of particular intervention projects. These were grouped and systematically reviewed under the broad categories of treatment, health promotion education, acute interventions and supply reduction. FINDINGS: A broad range of intervention strategies has been employed. However, few systematic evaluations have been undertaken and the methodologies employed have been generally insufficient to allow robust generalization. The impact of most interventions appears limited but, in part, this may be a function of inadequate resourcing and programme support. CONCLUSIONS: Despite the limitations of the evaluation reports, several conclusions can be tentatively drawn. It appears there is a need to employ a broader range of treatment models and complementary intervention strategies. Interventions are generally inadequately resourced. There is a suggestion that supply reduction interventions may be effective. Most importantly, there is a pressing need for more rigorous evaluation studies in cooperation with Aboriginal community organizations.

Alcohol-Related Disorders↗
PubMed2000

Mortality of patients admitted with a suspected acute myocardial infarction in whom the diagnosis is not confirmed.

AIMS: To examine the survival of patients admitted with a suspected acute myocardial infarction in whom the diagnosis was not confirmed ('possible myocardial infarction'). METHODS AND RESULTS: A cohort study based on the Nottingham Heart Attack Register of 1716 sequential patients discharged alive from two acute teaching hospitals following admission in 1992. The main outcome was mortality following hospital discharge after 5 years of follow-up. Survival of the cohort of patients in whom myocardial infarction was suspected but not confirmed was 58% (95% C.I. 56 to 60%) after 5 years of follow-up, compared with an expected survival of 76% in an age/sex matched general population. Patients with ECG abnormalities that were not diagnostic of myocardial infarction had a 5-year survival of 56%, compared with 77% in those without such changes (P<0.00001). In the 703 patients who died in the first 5 years of follow-up, the cause of death was cardiovascular in at least 53% of cases. Survival following hospital discharge was worse than that in patients discharged alive in the same year following a confirmed myocardial infarction (63% vs 69% after 4 years of follow-up P=0.0016). CONCLUSION: Patients in this study had a substantially increased risk of death in the 5 years after discharge from hospital, compared with an age- and sex-matched population, and worse than patients discharged following a confirmed myocardial infarction. Almost half of those with ECG changes at the time of their admission died over the next 5 years. As over half of all deaths in this cohort were due to cardiovascular causes, further work is needed to identify patients at high and low risk of subsequent mortality who may warrant investigation and treatment following hospital discharge.

Aged↗
PubMed2000

Identifying the risk of death following hospital discharge in patients admitted with a suspected acute myocardial infarction in whom the diagnosis is not confirmed.

AIMS: To describe clinical factors, available at the time of discharge, that predicted survival of patients admitted with a suspected acute myocardial infarction in whom the diagnosis was not confirmed. METHODS AND RESULTS: A cohort study based on the Nottingham Heart Attack Register of 1716 sequential patients discharged alive from two acute teaching hospitals following admission in 1992. The main outcome was identification of high and low mortality risk groups over 5 years of follow-up. Overall 5-year survival was 58% (95% CI 56 to 60%). Having abnormal cardiac enzyme changes or an abnormal ECG that was insufficient to meet established diagnostic criteria of myocardial infarction, or both, identified three groups with a 5 year survival of 77%, 60% or 51%. Multivariate methods were used to develop a risk score from seven variables available at the time of discharge (age, sex, past history of myocardial infarction, ECG abnormalities, cardiac enzyme abnormalities, Killip score of 2 or 3 on admission and being discharged on a diuretic). Quartiles of this risk score then identified four groups with 5 year survival ranging from 89% to 25%. CONCLUSION: Among the study cohort, it was possible to identify subgroups with a markedly different risk of subsequent mortality from clinical indicators that were readily available at the time of hospital discharge. Risk stratification has the potential to improve targeting of subsequent secondary preventive efforts, but further work is required to ascertain whether cardiovascular risk can be modified through a more intensive approach to management.

Aged↗