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Biomedical subjects

D Wright

Publications and source records attributed to D Wright.

At least 19 recordsLinked to original sources
PubMed2007

Social disability in different mental disorders.

OBJECTIVE: To assess the social disability of people with different psychiatric disorders. METHODS: Cross-site survey in five psychiatric hospitals (Dresden, Wrocław, London, Michalovce and Prague). Working-aged patients diagnosed (ICD-10) with schizophrenia and related disorders (F2), affective disorders (F3), anxiety disorders (F4), eating disorders (F5) and personality disorders (F6), were assessed at admission (n=969) and 3 months after discharge (n=753) using the Brief Psychiatric Rating Scale and the Groningen Social Disability Schedule. The main outcome measure was Interviewer-rated social disability. RESULTS: During acute episodes patients with personality, eating and schizophrenic disorders functioned less effectively than those with affective or anxiety disorders. After controlling for age and severity of psychopathology, there was no significant effect of the diagnosis (during remission), sex, education and history of disorder on disability. Site, employment and partnership were significant factors for the level of social disability in both measure points. CONCLUSION: Severity of psychopathological symptoms, not the diagnosis of a mental disorder, was the most significant factor in determining the level of social functioning, particularly during the remission period. Site, employment and partnership appeared as significant factors influencing the level of social disability.

Adult↗
PubMed2006

Role of fine-needle aspiration cytology and core biopsy in the preoperative diagnosis of screen-detected breast carcinoma.

Core biopsy (CB) has now largely replaced fine-needle aspiration cytology (FNAC) in the preoperative assessment of breast cancer in the UK. We studied the contribution of FNAC and CB in the preoperative diagnosis of screen-detected breast carcinoma. Data were prospectively collected on 150 840 women who underwent breast screening over a 4-year period from 1999 to 2003. Data on women who had both FNAC and CB taken from the same lesion preoperatively and in whom surgical excision of the lesion subsequently confirmed malignancy was analysed. In 763 cancers, FNAC was inadequate (C1) in 8% and benign (C2) in 10%. Most of these cases presented with microcalcification (25% were C1 or C2). Core biopsy was not representative (B1) or benign (B2) in 7%. The absolute and complete sensitivities were 65 and 82% for FNAC and 80 and 93% for CB in the diagnosis of cancer. Core biopsy was abnormal (B3 or above) in 86% of the cancers missed by FNAC and FNAC was abnormal (C3 or above) in 65% of those missed by CB. Core biopsy is better than FNAC at preoperative diagnosis of screen-detected breast cancer as it missed fewer cancers. However, combining FNAC resulted in a better preoperative diagnosis rate.

Biopsy↗
PubMed2006

The effect of cannabis on urge incontinence in patients with multiple sclerosis: a multicentre, randomised placebo-controlled trial (CAMS-LUTS).

OBJECTIVE: To test whether cannabinoids reduce urge incontinence episodes without affecting voiding in patients with multiple sclerosis. This was part of the multicentre trial of the Cannabinoids in Multiple Sclerosis (CAMS) study. SUBJECTS AND METHODS: The CAMS study randomised 630 patients to receive oral administration of cannabis extract, Delta(9)-tetrahydrocannabinol (THC) or matched placebo. For this substudy subjects completed incontinence diaries. RESULTS: All three groups showed a significant reduction, p<0.01, in adjusted episode rate (i.e. correcting for baseline imbalance) from baseline to the end of treatment: cannabis extract, 38%; THC, 33%; and placebo, 18%. Both active treatments showed significant effects over placebo (cannabis extract, p=0.005; THC, p=0.039). CONCLUSION: The findings are suggestive of a clinical effect of cannabis on incontinence episodes in patients with MS. This is in contrast to the negative finding of the CAMS study, where no difference was seen in the primary outcome of spasticity.

Analgesics, Non-Narcotic↗
PubMed2006

16-detector row computed tomographic coronary angiography in patients undergoing evaluation for aortic valve replacement: comparison with catheter angiography.

AIM: To evaluate the diagnostic accuracy of 16-detector row computed tomography (CT) in assessing haemodynamically significant coronary artery stenoses in patients under evaluation for aortic stenosis pre-aortic valve replacement. SUBJECTS AND METHODS: Forty consecutive patients under evaluation for severe aortic stenosis and listed for cardiac catheterization before potential aortic valve replacement underwent coronary artery calcium (CAC) scoring and retrospective electrocardiogram (ECG)-gated multi-detector row computed tomographic coronary angiography (MDCTA) using a GE Lightspeed 16-detector row CT within 1 month of invasive coronary angiography (ICA) for comparative purposes. All 13 major coronary artery segments of the American Heart Association model were evaluated for the presence of > or =50% stenosis and compared to the reference standard. Data were analysed on a segment-by-segment basis and also in "whole patient" terms. RESULTS: A total of 412/450 segments from 35 patients were suitable for analysis. The overall accuracy of MDCTA for detection of segments with > or =50% stenosis was high, with a sensitivity of 81.3%, specificity 95.0%, positive predictive value (PPV) 57.8%, and negative predictive value (NPV) 98.4%. On a "whole-patient" basis, 100% (19/19) of patients with significant coronary disease were correctly identified and there were no false-negatives. Excluding patients with CAC >1000 from the analysis improved the accuracy of MDCTA to: sensitivity 90%, specificity 98.1%, PPV 60%, NPV 99.7%. CONCLUSION: Non-invasive 16-detector row MDCTA accurately excludes significant coronary disease in patients with severe aortic stenosis undergoing evaluation before aortic valve replacement and in whom ICA can therefore be avoided. Its segment-by-segment accuracy is improved further if CAC>1000 is used as a gatekeeper to MDCTA.

Adult↗
PubMed2006

Effect of varying metabolizable energy and crude protein concentrations in diets of Pearl Gray guinea fowl pullets 1. Growth performance.

This study was undertaken to assess dietary ME and CP concentrations for optimum growth performance of Pearl Gray guinea fowl pullets. In a 3 x 3 factorial arrangement, 540 one-day-old Pearl Gray guinea keets were randomly assigned to experimental diets with 2,900, 3,000, and 3,100 kcal of ME/kg of diet, each containing 20, 22, and 24% CP, respectively, from 0 to 8 wk of age (WOA). From 9 to 16 WOA, these diets were adjusted to contain 3,000, 3,100, and 3,200 kcal of ME/ kg, and each had 17, 19, and 21% CP, respectively. Each dietary treatment was replicated 4 times, and feed and water were provided ad libitum. Body weight and feed consumption were measured weekly. Mortality was recorded as it occurred. Overall, feed consumption was higher in birds on 2,900 and 3,000 kcal of ME/kg of feed and the 24 and 21% CP diets than other dietary treatments at 0 to 8 and 9 to 16 WOA, respectively. When compared with other dietary treatments, cumulative BW gains were higher (P < 0.05) in birds fed 3,000, 3,000 and 3,100, and 3,100 and 3,200 kcal of ME/kg of diet at 2 to 5, 6 to 8, and 9 to 16 WOA, respectively. Pullets receiving 24 and 21% CP diets also exhibited higher BW gains than other dietary treatments at 0 to 8 and 9 to 16 WOA, respectively. Feed conversion ratios were lower (P < 0.05) in birds fed 3,000, 3,100, and both 3,100 and 3,200 kcal of ME/kg of diet at 1 to 5, 6 to 8, and 9 to 16 WOA, respectively, than other dietary treatments. Pullets fed 24% CP diets and either 17 or 19% CP diets exhibited lower (P < 0.05) feed conversion ratios than other dietary treatments at 1 to 8 and 9 to 16 WOA, respectively. Thus, diets comprising 3,000 and 3,100 kcal of ME/kg were utilized more efficiently by the Pearl Gray guinea fowl pullets at 0 to 5 and 5 to 16 WOA, respectively. Also, these birds more efficiently utilized diets containing 24 and 17% CP at 0 to 8 and 9 to 16 WOA, respectively.

Aging↗
PubMed2006

Growth characteristics of pearl gray guinea fowl as predicted by the Richards, Gompertz, and logistic models.

This study was undertaken to describe the growth pattern of the pearl gray Guinea fowl. Using BW data from hatch to 22 wk, 3 nonlinear mathematical functions (Richards, Gompertz, and logistic) were used to estimate growth patterns of the pearl gray guinea fowl. The logistic and Gompertz models are a special case of the Richards model, which has a variable point of inflection defined by the shape or growth trajectory parameter, m. The shape parameter m was 1.08 and 0.98 in males and females, respectively, suggesting that the growth pattern of the pearl gray female guinea fowl is Gompertz. The pearl gray guinea fowl exhibited sexual dimorphism for their growth characteristics. From the Gompertz model, the asymptotic BW, growth rate, and age at maximum growth were 1.62 kg, 0.22 kg/wk, and 6.65 wk in males, respectively, and 1.70 kg, 0.19 kg/wk, and 6.70 wk in females, respectively. The ages at maximum growth were 6.65, 6.47, and 8.12 wk for the Richards, Gompertz, and logistic models, respectively. The pearl gray guinea fowl females have a higher asymptotic BW compared with the males. The average asymptotic BW of about 1.57 kg for both sexes predicted by the logistic model was below the average predicted BW from the Richards (1.66 kg) and Gompertz (1.67 kg) models, respectively, at 22 wk of age. The inverse relationship between the asymptotic weight and both relative growth and age at maximum growth of the pearl gray guinea fowl is similar to that of chickens, quail, and ducks. Success in studying the growth characteristics of guinea fowl will contribute to the efforts of genetically improving this least-studied avian species.

Aging↗
PubMed2006

Laying performance of pearl gray guinea fowl hens as affected by caging density.

The caging density required for optimal egg production by various avian species and varieties is highly variable. Even so, little is known of the required cage density for optimum performance of the laying guinea fowl (Numida meleagris). The objective of this study was to assess the effect of varying cage densities on production performance of pearl gray guinea fowl laying hens. In 3 replicates, 270 pearl gray guinea hens [28 wk of age (WOA)] were weighed individually and randomly assigned to laying cages at densities of 1, 2, and 3 birds/cage, equivalent to 1394, 697, and 465 cm2/bird, respectively. During the experiment, all birds received a 16-h lighting regimen and were fed the same diet, comprising 2800 kcal of ME/kg of diet and 16% CP (28 to 59 WOA) and 2800 kcal of ME/kg of diet and 14% CP (60 to 76 WOA). Feed and water were provided for ad libitum consumption. Experimental birds were observed for feed consumption (FC), hen-day egg production (HDEP), egg weight, egg mass (EM), feed conversion ratio, internal egg quality, and shell thickness at the end of each 28-d lay period for 11 consecutive periods. Mean FC and HDEP decreased significantly with increases in cage density, such that 1394 > 697 > 465 cm2/bird. Mean EM was also higher (P < 0.05) for birds reared in cages at 1394 cm2/bird than those reared in cages at 697 and 465 cm2/bird (24.8, 17.4, and 14 g/hen per d, respectively). Feed conversion, HDEP, and EM were negatively correlated with cage density (P < 0.05). Mean feed conversion ratio and percentage of mortality were also lower in birds reared in cages at 1394 cm2/bird than in other treatment groups. Therefore, laying guinea fowl hens exhibited superior performance when raised at a density of 1 bird/cage (1394 cm2/bird) than those reared at densities of 2 and 3 birds/cage (697 and 465 cm2/bird, respectively).

Aging↗
PubMed2006

Quantitative trait loci analysis of egg and meat production traits in a red junglefowlxWhite Leghorn cross.

Egg and production traits are of considerable economic importance in chickens. Using a White Leghorn x red junglefowl F(2) intercross, standard production measures of liver weight and colour, egg size, eggshell thickness, egg taste and meat quality were taken. A total of 160 markers covering 29 autosomes and the Z chromosome were genotyped on 175-243 individuals, depending on the trait under consideration. A total of nine significant quantitative trait loci (QTL) and three suggestive QTL were found on chicken chromosomes 1, 2, 4, 5, 7, 8, 10, 12, E47W24 and E22C19W28.

Animals↗
PubMed2005

Chemistry of styrene (water)n clusters, n = 1-5: spectroscopy and structure of the neutral clusters, deprotonation of styrene dimer cation, and implication to the inhibition of cationic polymerization.

The styrene-water binary clusters SW(n), with n = 1-5 have been studied by the (one-color) resonant two-photon ionization technique using the resonance of styrene. The structures and energetics of the neutral clusters are investigated using a search technique that employs Monte Carlo procedure. The strong tendency for water molecules to form cyclic hydrogen-bonded structures is clearly observed in the SW(n) structures starting from n =3. The results indicate that the spectral shifts correlate with the interaction energies between styrene and the water subcluster (W(n)) within the SW(n) clusters. Evidence is presented that points to (1) the formation of a covalent bonded styrene radical cation dimer following the 193 nm MPI of styrene neutral clusters, (2) proton transfer from the styrene dimer cation to the water or methanol subcluster, resulting in the formation of protonated water or methanol clusters and a styrene dimer radical, and (3) extensive solvation of the styrene dimer radical within the protonated solvent molecules. The proton-transfer reactions may explain the strong inhibition effects exerted by small concentrations of water or methanol on the cationic polymerization of styrene. These results provide a molecular level view of the inhibition mechanism exerted by protic solvents on the cationic polymerization of styrene.

Journal Article↗
PubMed2005

Evaluation of ER, PgR, HER-2 and Ki-67 as predictors of response to neoadjuvant anthracycline chemotherapy for operable breast cancer.

Primary systemic therapy (PST) for operable breast cancer enables the identification of in vivo biological markers that predict response to treatment. A total of 118 patients with T2-4 N0-1 M0 primary breast cancer received six cycles of anthracycline-based PST. Clinical and radiological response was assessed before and after treatment using UICC criteria. A grading system to score pathological response was devised. Diagnostic biopsies and postchemotherapy surgical specimens were stained for oestrogen (ER) and progesterone (PgR) receptor, HER-2 and cell proliferation (Ki-67). Clinical, radiological and pathological response rates were 78, 72 and 38%, respectively. There was a strong correlation between ER and PgR staining (P < 0.0001). Higher Ki-67 proliferation indices were associated with PgR- tumours (median 28.3%, PgR+ 22.9%; P = 0.042). There was no relationship between HER-2 and other biological markers. No single pretreatment or postchemotherapy biological parameter predicted response by any modality of assessment. In all, 10 tumours changed hormone receptor classification after chemotherapy (three ER, seven PgR); HER-2 staining changed in nine cases. Median Ki-67 index was 24.9% before and 18.1% after treatment (P = 0.02); the median reduction in Ki-67 index after treatment was 21.2%. Tumours displaying >75% reduction in Ki-67 after chemotherapy were more likely to achieve a pathological response (77.8 vs 26.7%, P = 0.004).

Adult↗
PubMed2005

Is primary care access to CT brain examinations effective?

AIM: Primary care access to CT head examinations could enable common neurological conditions to be managed within primary care. Outcome data from the first 8 years of a local service were used to identify effective referral criteria. METHODS: Primary care head CT results from 1 March 1995 to 31 October 2003 were categorized as normal, incidental or significant findings. Normal reports were cross-referenced for referral to secondary care. Case notes with incidental or significant CT findings were reviewed for secondary care attendance and outcome. RESULTS: Records of 1403/1645 CT head examinations (85%) were available for review. Of these 1403, 951 (67.8%) returned normal findings, 317 (22.6%) incidental findings and 135 (9.6%) significant findings. The commonest indication for referral was investigation of headaches (46.6%). Of the total 533 patients under 50 years of age, 13 (2.4%) yielded significant findings and all 13 showed other features in addition to headache. Of 314 cases presenting with focal neurology, 83 (26.4%) showed significant findings. 314 patients were referred from primary to secondary care. 189 had normal scans and 74 had findings described as incidental. 60% of secondary care referrals were for normal CT scans. In patients with focal neurology, 90 of 314 were referred, allowing 71% to be managed in primary care. Yield was also 0% for headaches, dizziness, visual disturbance or nausea and vomiting. CONCLUSION: Primary care access to CT brain examinations is effective for patients with focal neurology, neurological symptoms or a known malignancy, but not for patients aged less than 50 years, or with uncomplicated headaches, dizziness or diplopia.

Aged↗
PubMed2005

Effects of dietary metabolizable energy and crude protein concentrations on growth performance and carcass characteristics of French guinea broilers.

This study was undertaken to assess dietary CP and ME concentrations for optimum growth performance and carcass characteristics of French guinea broilers. In a 3 x 3 factorial arrangement, 396 1-d-old French guinea keets were randomly assigned to experimental diets with 3,050, 3,100, and 3,150 kcal of ME/kg of diet; each contained 21, 23, and 25% CP, respectively, from 0 to 4 wk of age (WOA). From 5 to 8 WOA, experimental diets had 3,100, 3,150, and 3,200 kcal of ME/kg of diet, and each contained 19, 21, and 23% CP, respectively. Each dietary treatment was replicated 3 times, and feed and water were provided ad libitum. Body weight and feed consumption were measured weekly, whereas carcass characteristics were evaluated at 8 WOA. For the most part, birds on 3,100 and 3,150 kcal of ME/kg of diet at 0 to 4 WOA exhibited greater (P < 0.05) BW gain, greater carcass and breast weights (P < 0.05), and lower (P < 0.05) feed consumption and feed conversion ratios (FCR) than those on a diet with 3,050 kcal of ME/kg. Mean feed consumption of birds fed 25% CP diets was higher (P < 0.05) than those on other dietary CP concentrations. Mean BW gain, FCR, and carcass and breast weights of birds fed 25 and 23% CP diets from 0 to 4 WOA were not different (P > 0.05), but they were better (P < 0.05) than those of birds on 21% CP diets. Positive correlations (P < 0.01) were noted between live weight and weight of carcass, breast, thigh, drumstick, and wing of guinea broilers. Thus, diets with 3,100 kcal of ME/kg and 23% CP or with 3,150 kcal of ME/kg and 21% CP at 0 to 4 WOA and 5 to 8 WOA, respectively, were used more efficiently by French guinea broilers.

Animal Feed↗
PubMed2005

Performance of ORTHO HCV core antigen and trak-C assays for detection of viraemia in pre-seroconversion plasma and whole blood donors.

OBJECTIVE: Logistics and cost of nucleic acid amplification testing (NAT) screening preclude its current use in many developing countries. Development of hepatitis C virus (HCV) core antigen assays offer an alternative to NAT. We evaluated two specimen populations to assess the sensitivity, relative to NAT, of the HCV core antigen (HCVcAg) ELISA (enzyme-linked immunosorbent assay) test system and the trak-C assay: (1) plasma donor HCV NAT-conversion panels and (2) cross-sectional whole blood donor NAT yield specimens. METHODS: Differential sensitivities among NAT (NGI; Chiron/Gen-Probe) and both HCVcAg assays (Ortho-Clinical Diagnostics, Rochester, NY) were evaluated using: (1) 102 serial ramp-up phase specimens from 37 plasma donor NAT-conversion panels (Alpha Therapeutic/BioClinical Partners); and (2) 42 cross-sectional whole blood donor NAT yield specimens (confirmed RNA positive, antibody negative) plus 54 NAT false-positive specimens (American Red Cross). RESULTS: Viral load among the plasma donor NAT-conversion panels at the cutoffs for HCVcAg and trak-C assays were 32 000 copies/ml (95% confidence interval [CI] 8000-120 000) and 8000 copies/ml (95% CI: 2200-28 000), respectively. The mean (95% CI) difference in window period reduction compared to routine mini-pool NAT screening (estimated sensitivity 100 copies/ml) was delayed 5.2 days (2.2-7.6 days) for HCVcAg assay and 3.8 days (2.1-5.5 days) for the trak-C assay. Among the 42 NAT yield specimens, the HCVcAg assay detected 31 (74%) as core antigen-positive while the trak-C assay detected 37 (88%) as core antigen-positive. Viral loads for the five specimens not detected by the trak-C HCVcAg assay ranged from 100 to 7770 copies/ml. All 54 NAT false-positive specimens were non-reactive on both HCV core antigen assays. CONCLUSION: These data indicate that the trak-C assay has sensitivity approaching routine mini-pool NAT screening for the detection of seronegative HCV infection. In the absence of routine NAT screening for early HCV infection, the use of an HCV core antigen assay should be considered.

Blood Donors↗
PubMed2005

Economic modelling of antenatal screening and ultrasound scanning programmes for identification of fetal abnormalities.

OBJECTIVE: Within the framework of a health technology assessment and using an economic model, to determine the most clinically and cost effective policy of scanning and screening for fetal abnormalities in early pregnancy. DESIGN: A discrete event simulation model of 50,000 singleton pregnancies. SETTING: Maternity services in Scotland. POPULATION: Women during the first 24 weeks of their pregnancy. METHODS: The mathematical model was populated with data on uptake of screening, prevalence, detection and false positive rates for eight fetal abnormalities and with costs for ultrasound scanning and serum screening. Inclusion of abnormalities was based on the relative prevalence and clinical importance of conditions and the availability of data. Six strategies for the identification of abnormalities prenatally including combinations of first and second trimester ultrasound scanning and first and second trimester screening for chromosomal abnormalities were compared. MAIN OUTCOME MEASURES: The number of abnormalities detected and missed, the number of iatrogenic losses resulting from invasive tests, the total cost of strategies and the cost per abnormality detected were compared between strategies. RESULTS: First trimester screening for chromosomal abnormalities costs more than second trimester screening but results in fewer iatrogenic losses. Strategies which include a second trimester ultrasound scan result in more abnormalities being detected and have lower costs per anomaly detected. CONCLUSIONS: The preferred strategy includes both first and second trimester ultrasound scans and a first trimester screening test for chromosomal abnormalities. It has been recommended that this policy is offered to all women in Scotland.

Chromosome Aberrations↗
PubMed2004

Cannabis for dyskinesia in Parkinson disease: a randomized double-blind crossover study.

BACKGROUND: The long-term treatment of Parkinson disease (PD) may be complicated by the development of levodopa-induced dyskinesia. Clinical and animal model data support the view that modulation of cannabinoid function may exert an antidyskinetic effect. The authors conducted a randomized, double-blind, placebo-controlled crossover trial to examine the hypothesis that cannabis may have a beneficial effect on dyskinesia in PD. METHODS: A 4-week dose escalation study was performed to assess the safety and tolerability of cannabis in six PD patients with levodopa-induced dyskinesia. Then a randomized placebo-controlled crossover study (RCT) was performed, in which 19 PD patients were randomized to receive oral cannabis extract followed by placebo or vice versa. Each treatment phase lasted for 4 weeks with an intervening 2-week washout phase. The primary outcome measure was a change in Unified Parkinson's Disease Rating Scale (UPDRS) (items 32 to 34) dyskinesia score. Secondary outcome measures included the Rush scale, Bain scale, tablet arm drawing task, and total UPDRS score following a levodopa challenge, as well as patient-completed measures of a dyskinesia activities of daily living (ADL) scale, the PDQ-39, on-off diaries, and a range of category rating scales. RESULTS: Seventeen patients completed the RCT. Cannabis was well tolerated, and had no pro- or antiparkinsonian action. There was no evidence for a treatment effect on levodopa-induced dyskinesia as assessed by the UPDRS, or any of the secondary outcome measures. CONCLUSIONS: Orally administered cannabis extract resulted in no objective or subjective improvement in dyskinesias or parkinsonism.

Aged↗
PubMed2004

Spectral encoding of the polarization state of light in multiplexed polarization-sensitive lasing structures.

We report the experimental demonstration of spectral encoding of the polarization state of light by use of multiplexed distributed-feedback lasers in a dye-doped organic thin film by exploiting the pump polarization selectivity of the superimposed resonators. Measurement of the Stokes parameters of the pump light without a priori knowledge of the lasing properties of the structure is discussed.

Journal Article↗
PubMed2004

Chemical, biological, radiological and nuclear terrorism: an introduction for occupational physicians.

BACKGROUND: Chemical, biological, radiological and nuclear terrorism poses considerable threat throughout the world. AIM: To provide occupational physicians with an understanding of this threat and its main forms and what action can be taken to counter this threat. METHODS: Presenters at a conference on chemical, biological, radiological and nuclear terrorism were asked to contribute their evidence-based opinions in order to produce a review article. RESULTS: This paper presents a summary of the different forms of chemical, biological, radiological and nuclear terrorism and the effective counter-measures and also provides a review of current scientific literature. CONCLUSION: The threat of chemical, biological, radiological and nuclear terrorism is present throughout the world and is one that occupational physicians should be aware of, as well as the action that can be taken to counter it.

Anthrax↗