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Biomedical subjects

D Moriarty

Publications and source records attributed to D Moriarty.

16 recordsLinked to original sources

Tissue cytokine and chemokine expression in inflammatory bowel disease.

OBJECTIVE AND DESIGN: This study aimed to determine if mucosal expression of the chemokines IL-8, RANTES and MCP-1 and the pro-inflammatory cytokines TNFalpha and IL-6 are elevated in patients with inflammatory bowel disease. MATERIALS AND SUBJECTS: Intestinal mucosa samples were obtained at the time of surgical resection, n = 16 from each of the following groups: normal/control, CD and UC. METHODS: An homogenate was prepared of each tissue sample and cytokines measured by ELISA. RESULTS: IL-8 was significantly increased in both disease groups compared to controls Similarly, RANTES levels were also significantly increased. MCP-1 levels were increased in both disease groups, this increase was statistically significant in the UC group only. TNFalpha and IL-6 were significantly increased in the CD group only. CONCLUSIONS: Chemokines, together with key cytokines that promote their release are elevated in mucosal tissues from patients with IBD. It is likely that these chemokines play an important role in the perpetuation of tissue destructive inflammatory processes.

Chemokine CCL2↗

Human colonic anti-secretory activity of the potent NK(1) antagonist, SR140333: assessment of potential anti-diarrhoeal activity in food allergy and inflammatory bowel disease.

1. This in vitro study was designed to determine the potential use of the NK(1) antagonist, SR140333 as an anti-diarrhoeal treatment for food allergy or inflammatory bowel disease. The effect of various immune and neuronal stimuli on human colonic substance P (SP) release and the effect of SR140333 on subsequently stimulated mucosal ion transport was investigated. 2. Submucosal and sensory nerve fibre stimulation using electrical field stimulation (1 ms/7 Hz/7 V) and capsaicin (50 microM) respectively, mast cell activation by anti-IgE (1/250 dilution) and granulocyte stimulation using fMLP (50 microM) each released SP and evoked a secretory response. 3. SP and the NK(1) selective agonist, Sar-SP (0.1 - 1000 nM) stimulated an increase in colonic secretion which was antagonized by SR140333 (pD'(2)=6.7 and 7.25 versus SP and Sar-SP respectively). 4. SR140333, at a concentration that blocked NK(1)-mediated secretion (500 nM), also reduced the secretory response to both alphaIgE and capsaicin. This suggests a pathophysiologic role for NK(1) receptors. 5. Capsaicin evoked SP release was increased in tissue taken from Crohn's disease but not ulcerative colitis patients. The response to SP was however reduced by 70 and 89% respectively. 6. Mast cells and sensory afferents contribute to allergic diarrhoea. Since SR140333 reduced the secretory response to mast cell and afferent stimulation this compound may be particularly useful in reducing the symptoms of food allergy.

Animals↗

Potent NK1 antagonism by SR-140333 reduces rat colonic secretory response to immunocyte activation.

The potent neurokinin receptor 1 (NK1) antagonist SR-140333 has previously been shown to reduce castor oil-induced secretion in animal models. The importance of tachykinins in neuroimmune control of secretion and the effect of SR-140333 on key points in this pathway were elucidated in the present study to determine the type of intestinal dysfunction best targeted by this antagonist. Rat colonic secretion and substance P (SP) release were determined in vitro with the use of Ussing chamber and enzyme immunoassay techniques. NK1 receptors played a secretory role as receptor agonists stimulated secretion and SR-140333 antagonized the response to SP response (pK(b) = 9.2). Sensory fiber stimulation released SP and evoked a large secretion that was reduced by 69% in the presence of SR-140333 (10 nM). Likewise, mastocytes also released SP. The subsequent secretory response was reduced by 43% in the presence of SR-140333 (50 nM). SP was also released from granulocytes; however, this did not cause secretion. Functional NK3 receptors were present in the colon as senktide stimulated secretion, an effect that was increased during stress. We conclude that NK3 receptors may play a role in stress-related disorders, whereas NK1 receptors are more important in mast cell/afferent-mediated secretion.

Animals↗

Hypodermoclysis for rehydration in the community.

During 1999 and 2000 the practice development unit of Greater Glasgow Primary Care Trust received an increasing number of requests from community staff for guidance in caring for patients receiving subcutaneous fluids for rehydration. This article describes the process of developing guidelines in order to address the issue. Hypodermoclysis is a relatively safe, simple and cost-effective technique, suitable for use in the community with a range of client groups, e.g. older people or those recovering from recent cardiovascular accidents. Its use in palliative care, however, raises problems in terms of clinical evidence and ethical issues which need to be addressed. Various factors, i.e. products not being licensed for this specific use, staff requests for clinical guidance and the anticipated increasing use of hypodermoclysis for rehydration, all indicated the need for a collaborative approach, address the complexity of issues in the decision-making process and provide clinical guidance with the aim of improving nursing practice and patient outcomes.

Aged↗

Evolutionary change in the use of skills within the district nursing team: a study in two Health Board areas in Scotland.

Grade mix within the district nursing team in the United Kingdom has changed markedly over the last 10 years but the relationship between grade mix and skill mix has received only intermittent research attention. This study adopted an ethnographic approach and aimed to explore the way in which grade and skill are taken into account in the delegation of nursing care. After gaining ethical approval, a total of 76 members of 21 district nursing teams in two areas were observed and interviewed. Delegation practices were found to vary both within and between areas and considerable differences were uncovered in the responsibilities allocated to more junior and unqualified team members. The developing role of nursing auxiliaries is discussed in relation to the role of the G grade sister, resource constraints and the standards of patient care. The paper concludes by arguing that the supervision and leadership role provided by the G grade sister should be fully recognized and safeguarded.

Attitude of Health Personnel↗

Improved quality of re-sliced MR images using re-normalized sinc interpolation.

This article shows that re-normalizing the interpolation kernel for a constant integral can make a significant improvement in performance of sinc interpolation methods. A comparison was performed between standard and re-normalized sinc kernels of various sizes using data from four commonly used magnetic resonance (MR) imaging sequences. Standard rotations were performed and compared with a "gold standard" data set generated by use of a large (13 x 13 x 13) sinc kernel. Measurements of systematic pixel intensity offset error and variance of generated residuals were used to estimate resultant interpolation error. Theoretical estimates of the consequent savings in computation time were compared with the measured time required for each algorithm and with the automated image registration (AIR) program. The use of a small (5 x 5 x 5) re-normalized kernel produced relative errors comparable to those in the gold standard data set, allowing saving in computation time of up to 30 times in comparison with standard sinc interpolation. This approach brings the implementation of MR volume re-slicing much closer to the demands of a clinical environment. J. Magn. Reson. Imaging 1999;10:582-588.

Brain↗

Optic neuritis: MR imaging with combined fat- and water-suppression techniques.

PURPOSE: To examine the benefits of combined fat- and water-suppressed T2-weighted magnetic resonance (MR) images in the diagnosis of optic neuritis. MATERIALS AND METHODS: MR imaging was performed with a 1.5-T unit in five healthy volunteers and 18 patients (21 nerves). All patients had abnormalities of visual evoked potentials and fulfilled the clinical criteria for the diagnosis of optic neuritis. Imaging was performed within 4 weeks of diagnosis (n = 12) or between 3 and 6 months after diagnosis (n = 6). Coronal images were obtained throughout the course of the optic nerve with use of three sequences: (a) short inversion time inversion recovery with fast spin-echo (SE) acquisition, (b) selective partial inversion-recovery (SPIR) prepared T2-weighted fast SE acquisition, and (c) SPIR-fluid-attenuated inversion recovery (FLAIR) with fast SE acquisition. RESULTS: Neuritic segments were demonstrated in all 21 symptomatic nerves. The extent of neuritic involvement (number of images showing abnormality) was significantly greater with the SPIR-FLAIR sequence (P < .01). The contrast ratio between neuritic optic nerve and orbital fat, normal nerve, and cerebral spinal fluid was significantly greater with SPIR-FLAIR than with the other sequences (P < .001). SPIR-FLAIR images also improved demonstration of optic nerve atrophy in chronic neuritis when compared with the other sequences. CONCLUSION: The SPIR-FLAIR sequence offers important advantages over current methods in the demonstration of optic neuritis.

Adult↗

Haemodynamic changes with the laryngeal mask airway--off the cuff.

The cross-sectional area of the common carotid artery bulb was measured using a 5 MHz pulse wave Doppler probe in a patient undergoing general anaesthesia using a laryngeal mask airway (LMA). A simultaneous measurement of blood velocity was performed to allow determination of the blood flow. Following inflation of the cuff on the LMA, the cross-sectional area of the right carotid artery bulb decreased from 1.09 to 0.89 cm2, flow velocity increased 120 to 176 cm s-1 and the blood flow increased from 130.8 to 156.6 cm3 s-1. On the left the cross-sectional area decreased from 1.16 to 1.13 cm2, the velocity increased 136 to 151 cm s-1 and the blood flow increased from 157.8 to 170.6 cm3 s-1. While a reduction in cross-sectional area was observed in the carotid bulb in this patient, this was accompanied by an increase in the velocity and a consequent increase in blood flow. In patients with atheromatous disease involving the carotid arteries this decrease in cross-sectional area may prove clinically significant. The use of the LMA may not be suitable for this population.

Aged↗

Physical illness stigma and social rejection.

We use the stigma of illness as a model for uncovering which dimensions of stigmas are critical for causing social rejection. Subjects responded to 'medical case histories' representing 66 illnesses, rating the illness on a variety of dimensions (e.g. contagious/not contagious, common/rare), and a measure of social rejection. Regression analysis revealed that two dimensions predicted rejection: the severity of the illness, and whether the illness was behaviourally caused (multiple R = .68). In a second experiment, subjects responded to a case history of a fictitious disease that was either mild or severe, and was either behaviourally caused or not. Behavioural causality and severity emerged as reliable, independent sources of rejection. Diseases perceived to be severe or under personal control are most likely to lead to social rejection.

Adult↗