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Biomedical subjects

D Reeves

Publications and source records attributed to D Reeves.

At least 19 recordsLinked to original sources
PubMed1995

The use of anti-psychotic drugs with adults with learning disabilities and challenging behaviour.

The use of anti-psychotic medication with an adult population of people with learning disabilities and challenging behaviours was investigated as part of an epidemiological study covering seven district health authorities and corresponding local authorities in North West England. The study found a high rate of prescription of anti-psychotic drugs (48.1%). Chlorpromazine was the most frequently prescribed drug, followed by Thioridazine and Haloperidol. Three variables, psychiatric diagnosis, where the person was resident (hospital disturbed ward, hospital non-disturbed ward, hostel or family home) and district of origin were found to be significant determinants of prescriptions when all other variables were controlled. Of the variables reflecting individual characteristics those significantly related to prescription suggested that the socially disruptive effects of challenging behaviour were determining prescription. The results are discussed in the context of differing prescription practices across residence and district in the context of the management of socially disruptive behaviour.

Activities of Daily Living↗
PubMed1995

Epididymitis in older boys: dysfunctional voiding as an etiology.

Although male infants and young boys with epididymitis have a high incidence of anatomical pathology, dysfunctional voiding is not a well established cause of epididymitis. In our series 36 boys with epididymitis underwent noninvasive urodynamic studies to determine whether a physiological defect could be assigned as an etiology. The 2 mechanisms proposed are similar to that in children with vesicoureteral reflux associated with dyssynergia or bladder instability and to a cause of recurrent urinary tract infection in children (the infrequent voider syndrome). Urinalysis and urine culture are recommended in all children with epididymitis and urethral swabs are obtained from those who are sexually active. We recommend renal/bladder ultrasound and voiding cystourethrography in all infants and young children with epididymitis. In the older child we advocate detailed questioning regarding voiding symptoms and the performance of noninvasive urodynamic studies.

Adolescent↗
PubMed1994

Preliminary study using species-specific oligonucleotide probe for rRNA of Bilophila wadsworthia.

Portions of the 16S RNA from a urease-positive Bilophila wadsworthia strain were sequenced, and a probe was constructed. The probe was end labeled with [32P]ATP and polynucleotide kinase and hybridized on a nylon filter (by dot blot hybridization) to the immobilized rRNA of 12 B. wadsworthia strains and eight other anaerobic isolates. The probe efficiently hybridized only to the Bilophila strains. Cross-reactivity at high RNA levels (2,000 ng) was observed with one strain of Bacteroides thetaiotamicron and one strain of Bacteroides fragilis (with 10x SET buffer [20x SET buffer is 0.5 M NaCl, 0.03 M Tris, and 2 mM EDTA]) but was not seen at lower RNA levels or with 5x SET buffer. When tested against mixed cultures of aerobic and anaerobic isolates representative of appendiceal abscess flora, the probe did not react with mixed cultures containing no Bilophila cells and could detect > or = 10(5) Bilophila CFU/ml when the mixture was seeded with Bilophila cells. This probe is of potential use in the rapid identification of pure isolates and in the direct identification of B. wadsworthia in clinical specimens.

Base Sequence↗
PubMed1992

Expression of human alpha 1 antitrypsin in transgenic sheep.

We have recently described the production of large amounts (< or = 65 grams per litre) of enzymatically active human alpha 1 antitrypsin in the milk of transgenic sheep (Wright et al., 1991). Here, we describe in more detail the expression of the human protein in the milk of these animals throughout the lactation period. Human alpha 1 antitrypsin is also found at much lower levels in the plasma of transgenic ewes before, during and after lactation. It is also detected in male plasma at very low levels. We have previously shown human alpha 1 antitrypsin purified from transgenic sheep milk to be indistinguishable from commercially available human plasma derived alpha 1 antitrypsin in terms of gross sugar content and in vitro activity. Here we extend this comparison to more detailed analyses of glycosylation state, amino-terminal sequence, pI value, and molecular weight determination by mass spectrometry.

Amino Acid Sequence↗
PubMed1991

High level expression of active human alpha-1-antitrypsin in the milk of transgenic sheep.

We describe the generation of five sheep transgenic for a fusion of the ovine beta-lactoglobulin gene promotor to the human alpha 1-antitrypsin (h alpha 1AT) genomic sequences. Four of these animals are female and one male. Analysis of the expression of h alpha 1AT in the milk of three of these females shows that all express the human protein at levels greater than 1 gram per liter. In one case initial levels exceeded 60 grams per liter and stabilized at approximately 35 grams per liter as lactation progressed. Human alpha 1AT purified from the milk of these animals appears to be fully N-glycosylated and has a biological activity indistinguishable from human plasma-derived material.

Animals↗
PubMed1991

In-vitro activity of temafloxacin against anaerobic bacteria: a comparative study.

The antimicrobial activity of temafloxacin for 328 anaerobic bacteria was determined and compared to that of cefotetan, cefoxitin, ciprofloxacin and metronidazole. The Wadsworth agar dilution technique using Brucella-lysed sheep blood agar was used throughout. At the recommended breakpoint concentration 4 mg/L, temafloxacin inhibited 60/62 (97%) of the isolates of Bacteroides fragilis and 82/87 (94%) of the isolates of other species of the B. fragilis group. Ninety-six percent of the 24 isolates of Peptostreptococcus, 97% of the 31 isolates of other Bacteroides species and 88% of 66 isolates of Fusobacterium species were also inhibited by 4 mg/L temafloxacin. Metronidazole (breakpoint 16 mg/L) had a broader spectrum of activity than temafloxacin (judged by the percentage of strains tested susceptible at the breakpoints employed) with the exception of non-sporing Gram-positive bacilli. The cephalosporins tested (breakpoint 32 mg/L) had a narrower spectrum of activity. Ciprofloxacin (breakpoint 2 mg/L) was the least effective agent against the majority of the anaerobes tested.

Anti-Infective Agents↗
PubMed1991

Application of phase-induced lateralization to the Stenger test.

The Stenger test was employed to estimate the genuine hearing thresholds in normally hearing volunteer subjects simulating a total unilateral loss. The test was carried out in its standard form and in a modified form in which a phase shift was introduced between the signal delivered to the two ears, set to produce phase-induced lateralization towards the 'poor' ear. The standard test estimated the thresholds at a mean of 13.5 dB above the true thresholds at five frequencies from 250 Hz to 4 kHz. Thresholds at the different frequencies were compared, and although thresholds were lower for the higher frequencies, the apparent effect of frequency was not statistically significant. The modified test, using a 90 degrees phase shift, was found to enhance the test at 250 and 500 Hz (thresholds estimated at about 7 dB above true values), but not significantly at 1 kHz.

Adult↗
PubMed1990

Response of oral leukoplakia to beta-carotene.

Leukoplakia is associated with increased risk of oral cancer and is considered a premalignant lesion. Retinoids, particularly 13-cis retinoic acid, can frequently reverse leukoplakia. However, these drugs have considerable toxicity and are not suitable for large-scale use in the prevention of oral cancer. Beta-carotene is a naturally occurring, nontoxic carotenoid with biologic properties that suggest that it might be efficacious against oral leukoplakia. In 1986, we began a randomized study of 13-cis retinoic acid (1 mg/kg/d) versus beta-carotene (30 mg/d) in leukoplakia. However, owing to the marked differences in toxicity between the two compounds outlined in the consent form, 11 of the initial 16 eligible patients refused to participate unless they were "guaranteed" beta-carotene. Therefore, the study design was changed to a phase II trial of beta-carotene in which the compound was given daily for 3 months. Responding patients were continued for another 3 months of treatment. All lesions were examined histologically at entry. Responses were monitored by bidimensional measurements and photography done at entry, then monthly while on treatment and at study completion. Twenty-four evaluable patients were treated, and 17 had major responses (two complete, 15 partial), a response rate of 71% (95% confidence limits, 53% to 89%). There was no significant toxicity requiring drug discontinuation or dose reduction. These results indicate that beta-carotene has substantial activity in oral premalignancy. Because of its lack of toxicity, it is an excellent candidate for a preventive agent for oral cancer.

Aged↗
PubMed1988

Antibiotic susceptibility testing of anaerobic organisms using the agar dilution method: comparison of three techniques.

Three currently used anaerobic susceptibility testing methods were compared: (1) the technique used at the Wadsworth Microbial Diseases Research Laboratory, (2) the technique listed as the reference standard by the National Committee on Clinical Laboratory Standards, and (3) the technique used at the Tufts New England Medical Center. Four-hundred-seventy anaerobic microorganisms, isolated from clinical specimens, were tested against cefoxitin, cefotetan, ceftizoxime, cefotaxime, ceftazidime, imipenem, and clindamycin. Significant differences were noted in mean inhibitory concentrations and percent susceptible at breakpoint among the three techniques used and varied with the antimicrobial agent and species tested.

Bacteria, Anaerobic↗
PubMed1987

The application of temperament questionnaires to a British sample: issues of reliability and validity.

One hundred and five mothers of British children aged 1-5 years completed the EASI-1 Temperament Survey and the age appropriate version of the Carey questionnaire (Toddler Temperament Scale or Behavioural Style Questionnaire). Detailed statistical analyses revealed psychometric weakness in all three instruments, most notably in the Carey questionnaires. Neither factor analysis nor item-to-scale correlations provided clear support for the nine NYLS dimensions incorporated within the TTS and BSQ. Mothers' opinions of their child's temperament constellation differed considerably from those resulting from the questionnaire analysis for the STWU and Difficult constellations. Issues of reliability and validity are discussed.

Child, Preschool↗
PubMed1985

Latamoxef: single agent prophylaxis in colorectal surgery.

To assess the suitability of latamoxef (moxalactam) as single agent chemoprophylaxis in elective colorectal surgery, 120 consecutive patients were randomized to receive latamoxef (L) 1 g or cephazolin 1 g and metronidazole 500 mg (CM) administered intravenously at induction of anaesthesia and 6 and 12 h postoperatively. The groups were well matched for age, sex, pathology and procedures. Serum and tissue levels of latamoxef were well above the MIC90 for most bowel organisms. Inpatient stay was similar for both groups. Pyrexia was seen in 44 patients (11 L, 23 CM) and eight developed a wound infection (3 L, 5 CM). Major intra-abdominal sepsis occurred in seven patients (2 L, 5 CM), secondary to anastomotic leakage in four (1 L, 3 CM). Twenty patients developed a chest infection (5 L, 15 CM) and eight urinary sepsis (2 L, 6 CM). No bleeding complication occurred, and there was no difference in clotting function between the two groups. Six patients died prior to follow-up at six weeks (1 L, 5 CM), two from anastomotic dehiscence. All but three wounds had healed (1 L, 2 CM) and one further patient had an incisional hernia (CM). These results suggest that latamoxef is an efficient chemoprophylactic agent in elective colorectal surgery, and is marginally better than cephazolin plus metronidazole.

Adult↗
PubMed1985

Ototoxicity of intraventricularly administered gentamicin in adult rabbits.

To determine whether daily intraventricular injection of gentamicin sulfate is ototoxic, adult male rabbits were given 0.2 ml of saline (group 1; n = 8) or 0.25 mg/kg of gentamicin sulfate in 0.2 ml of saline (group 2; n = 7) by intraventricular infusion once a day for 21 d. All rabbits were also given intramuscular gentamicin sulfate, 2 mg/kg, twice daily. Before and after antibiotic treatment, brainstem auditory evoked responses (BAERs) were recorded. During the experimental period, neurologic examinations were performed on all rabbits. After treatment, the animals were euthanized; brain tissue and cochleas were then removed for histopathologic examination. The ratios of neurologic abnormalities observed in group 1 and 2 animals, respectively, were 0/8 and 5/7; of abnormal BAERs, 0/8 and 5/7; of abnormal brain morphology, 2/5 and 6/6; and of abnormal cochlear morphology, 0/6 and 7/7. The electrophysiologic evidence of auditory deficit and the structural evidence of ototoxic insult are significantly associated (p less than or equal to 0.006) with intraventricularly administered gentamicin sulfate. These data suggest that intraventricular gentamicin should be used with caution.

Animals↗
PubMed1982

Characteristics of peripheral blood monocytes in hereditary xerocytosis and spherocytosis.

Peripheral blood monocytes isolated from patients with congenital hemolytic anemia, hereditary xerocytosis and spherocytosis, demonstrated in vivo engulfment of red cell and platelet fragments. In addition, morphometric studies performed on these monocytes showed an increase in cytoplasmic/nuclear ratio as well as lysosome and phagosome volumes. The production of carbon dioxide from glucose-1-14C in abnormal monocytes was increased (15-80%) but the intracellular values of beta-glucuronidase and esterase activity were similar to control monocytes. Monocyte locomotion assessed in the presence of chemotactic stimuli was found significantly increased (73 +/- 12 monocytes/oil immersion fields vs. 46 +/- 5 for control monocytes). We concluded that the monocytes in hemolytic anemias associated with increased in vitro red cell fragmentation have some features resembling the 'stimulated' monocytes and that this alteration may be due to red blood cell fragment ingestion.

Anemia, Hemolytic, Congenital↗