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Biomedical subjects

G Gray

Publications and source records attributed to G Gray.

At least 37 records · Page 2Linked to original sources
PubMed2000

Cystourethroscopic findings before and after prostate brachytherapy.

PURPOSE: To assess the role of cystourethroscopy in predicting the risk of postimplant urinary retention. MATERIALS AND METHODS: Fifteen unselected prostate brachytherapy patients implanted with 125I or 103Pd under spinal or general anesthesia were studied. Following induction of anesthesia, the patient was placed in the lithotomy position and cystourethroscopy performed using a 17 sheath and a 30 degrees lens. Irrigation pressure was 100-cm water. A photograph was taken from the level of the verumontanum. At completion of the implant procedure, a second cystourethroscopy was performed and another photograph taken. The degree of obstruction was rated using a 3-point scale. Each patient was contacted at the time of this report to update postimplant morbidity information with follow-up from 1 to 10 months. RESULTS: The patients' preimplant cystourethroscopic findings ranged from minimal to complete occlusion. There was no clear relationship between the American Urologic Association (AUA) score or preimplant prostate volume and the degree of obstruction. Nearly all patients had some increased physical obstruction following completion of the procedure, but only 8 of 14 patients had an increase in obstruction grade. Six patients were completely obstructed at the completion of the implant procedure, only one of whom developed urinary retention. CONCLUSIONS: Marked variability in cystourethroscopy findings do not appear to have a strong influence on the likelihood of postimplant urinary retention and are not a reliable predictor of retention.

Brachytherapy↗
PubMed2000

The Naval Health Research Center Respiratory Disease Laboratory.

Concern about emerging and reemerging respiratory pathogens prompted the development of a respiratory disease reference laboratory at the Naval Health Research Center. Professionals working in this laboratory have instituted population-based surveillance for pathogens that affect military trainees and responded to threats of increased respiratory disease among high-risk military groups. Capabilities of this laboratory that are unique within the Department of Defense include adenovirus testing by viral shell culture and microneutralization serotyping, influenza culture and hemagglutination inhibition serotyping, and other special testing for Streptococcus pneumoniae, Streptococcus pyogenes, Mycoplasma pneumonia, and Chlamydia pneumoniae. Projected capabilities of this laboratory include more advanced testing for these pathogens and testing for other emerging pathogens, including Bordetella pertussis, Legionella pneumoniae, and Haemophilus influenzae type B. Such capabilities make the laboratory a valuable resource for military public health.

Clinical Laboratory Techniques↗
PubMed2000

Long-term results of telescopic crown retained dentures--a retrospective study.

The clinical data for 250 telescopic crown retained dentures involving 617 abutment teeth preparations were collected and analysed in a retrospective study to ascertain the survival rate of the dentures and their abutment teeth. During the study period 10.6% of the abutment teeth had to be extracted. An increased number of telescopic crowns significantly improved the longevity of the prostheses and their associated abutment teeth in most denture designs, but this was not found to be the case with bilateral free-end saddle designs without an anterior bounded saddle. The use of more than four abutment teeth did not result in a higher survival rate.

Crowns↗
PubMed1999

Prevention of vertical transmission of HIV: analysis of cost effectiveness of options available in South Africa.

OBJECTIVE: To assess the cost effectiveness of vertical transmission prevention strategies by using a mathematical simulation model. DESIGN: A Markov chain model was used to simulate the cost effectiveness of four formula feeding strategies, three antiretroviral interventions, and combined formula feeding and antiretroviral interventions on a cohort of 20 000 pregnancies. All children born to HIV positive mothers were followed up until age of likely death given current life expectancy and a cost per life year gained calculated for each strategy. SETTING: Model of working class, urban South African population. RESULTS: Low cost antiretroviral regimens were almost as effective as high cost ones and more cost effective when formula feeding interventions were added. With or without formula feeding, low cost antiretroviral interventions were likely to save lives and money. Interventions that allowed breast feeding early on, to be replaced by formula feeding at 4 or 7 months, seemed likely to save fewer lives and offered poorer value for money. CONCLUSIONS: Antiretroviral interventions are probably cost effective across a wide range of settings, with or without formula feeding interventions. The appropriateness of formula feeding was highly cost effective only in settings with high seroprevalence and reasonable levels of child survival and dangerous where infant mortality was high or the protective effect of breast feeding substantial. Pilot projects are now needed to ensure the feasibility of implementation.

Acquired Immunodeficiency Syndrome↗
PubMed1999

'No gaps' health insurance: a gain for consumers or a windfall for specialists?

Attempts to introduce contracts between the purchasers and providers of Australian health services in the 1990s in order to reduce the gaps, or 'copayments', that patients pay have met with limited success. However, the Harradine requirement that health funds introduce 'no gap' or 'known gap' policies by the middle of the year 2000 has raised a political storm within the AMA and set the funds and doctors in an adversarial position. This paper traces the history of 'gaps' and gap insurance, provides an interpretation of the present situation and speculates about likely outcomes.

Australia↗
PubMed1999

Personality and the subjective assessment of hearing aids.

Relatively little is known about the influence of patients' personality features on the responses they make to self-assessment items used to measure the outcome of a hearing aid fitting. If the personality of the hearing aid wearer has a significant influence on self-report outcome data, it would be important to explore the relevant personality variables and to be cognizant of their effects when using subjective outcome data to justify decisions about clinical services or other matters. This investigation explored the relationship between several personality attributes and responses to the Abbreviated Profile of Hearing Aid Benefit (APHAB). It found that more extroverted patients tend to report more hearing aid benefit in all speech communication situations. In addition, patients with a more external locus of control tend to have more negative reactions to loud environmental sounds, both with and without amplification. Anxiety also played a small additional role in determining APHAB responses. Although personality variables were found to explain a relatively small amount of the variance in APHAB responses (usually around 10%), these outcomes should alert practitioners and researchers to the potential effects of personality variables in all self-report data.

Aged↗
PubMed1998

The Notch ligand, Jagged-1, influences the development of primitive hematopoietic precursor cells.

We examined the expression of two members of the Notch family, Notch-1 and Notch-2, and one Notch ligand, Jagged-1, in hematopoietic cells. Both Notch-1 and Notch-2 were detected in murine marrow precursors (Lin-Sca-1+c-kit+). The Notch ligand, Jagged-1, was not detected in whole marrow or in precursors. However, Jagged-1 was seen in cultured primary murine fetal liver stroma, cultured primary murine bone marrow stroma, and in stromal cell lines. These results indicate a potential role for Notch-Notch ligand interactions in hematopoiesis. To further test this possibility, the effect of Jagged-1 on murine marrow precursor cells was assessed by coculturing sorted precursor cells (Lin-Sca-1+c-kit+) with a 3T3 cell layer that expressed human Jagged-1 or by incubating sorted precursors with beads coated with the purified extracellular domain of human Jagged-1 (Jagged-1(ext)). We found that Jagged-1, presented both on the cell surface and on beads, promoted a twofold to threefold increase in the formation of primitive precursor cell populations. These results suggest a potential use for Notch ligands in expanding precursor cell populations in vitro.

3T3 Cells↗
PubMed1998

Developing a nursing research culture in the university and health sectors in Western Sydney, Australia.

The context for the development of a research culture in both the health and education sectors in Australia is similar to that in other developed countries. Contextual factors, especially those resulting from increasing fiscal constraint, militate against improved research productivity for nurses in both university and health sectors. Despite this, however, an impressive range of initiatives have been designed and introduced, both unisectorally and intersectorally, in the last 14 months to expedite the development of a nursing research culture in Western Sydney. The former include, in the University of Western Sydney (UWS), reward systems for research productivity and development, the funding of Designated Research Groups and Faculty Research Support Units. In the health service they include the funding of a Clinical Development Unit (Nursing)--CDU(N)--leadership program and the provision in 1997-98 of seed funds for research projects to be undertaken in the CDU(N)s. Intersectoral initiatives include the joint funding of four 'clinical' nursing Chairs, other sub-professorial positions and a 'flagship' series of nursing research seminars. All these initiatives will be described, together with an assessment of their impact to date, in terms of (1) research productivity, (2) improved intersectoral relationships and (3) heightened visibility and appreciation of nursing and nursing research.

Academic Medical Centers↗
PubMed1998

Ultrasonographic measurement of crown-rump length in high-order multifetal pregnancies.

The objective of the study was to evaluate the crown-rump length (CRL) in high-order multifetal pregnancies (three or more fetuses). The records of patients who underwent multifetal pregnancy reduction were reviewed. The following parameters were defined: the mean CRL (CRLMEAN) and the difference between the largest and smallest CRL (CRLRANGE) for each pregnancy. CRLMEAN was plotted versus gestational age (GA) and the line of best fit was derived. The residual for each CRL (CRLRES) was calculated by subtracting the value predicted by the regression line from the individual CRL (CRLIND). Regression lines for single-tons with confirmed GA from four previously reported studies were used for comparison. A total of 82 patients were included (29 triplets, 38 quadruplets and 15 quintuplets; mean GA 10.7 +/- 0.78 weeks). CRLMEAN correlated with GA (CRLMEAN = 38.88 - 8.78(GA) + 0.82(GA)2; R = 0.83; R2 = 0.70). This second-degree polynomial remained within the range for singletons. No significant differences in maternal age, GA and CRLMEAN were noted between the patients with different numbers of fetuses. The median CRLRANGE was largest in quintuplets, followed by quadruplets and triplets. The CRLRANGE correlated poorly with GA. The mean CRL in multifetal pregnancies increases with GA similarly to that in singletons. The variability of individual measurements increases with the number of fetuses and CRLs are lower in quintuplets.

Adult↗
PubMed1998

Contact toxicity of permethrin-impregnated fabric to Hyalomma anatolicum excavatum (Acari: Ixodidae): effects of laundering and exposure and recovery times.

A previous study that documented enhanced host attachment by the camel ticks Hyalomma dromedarii Koch after permethrin exposure prompted a similar investigation of permethrin effects in H. anatolicum excavatum Koch, an Old World hardbacked tick suspected of vectoring human pathogens. Contact toxicity tests were conducted with laboratory-colonized male and female H. a. excavatum of the same age exposed for periods of 5, 10, 30, and 60 min to each of 5 fabric treatments: unwashed/untreated; unwashed and treated; and treated fabric given 1, 2, or 3 laundry cycles of warm-water detergent machine washing, followed by hot-air drying. Fabric was tropical weight 100% cotton military uniform. Treated fabric was impregnated with permethrin at 0.125 mg (AI)/cm2. Contact toxicity was measured immediately after and 24 h after fabric contact as proportion of ticks that attached mouthparts to the skin of a host (rabbit) within a 60-min quest period and time lapse (minutes) between contact with the host and attachment. Attachment response immediately after permethrin contact was exposure time- and wash-dependent in both sexes. Proportion of attaching ticks and times to attachment were comparable in controls and in groups exposed to all permethrin-treated fabrics for 5 or 10 min. Contact periods of 30 and 60 min with 0-wash/treated or 1-wash and treated fabric significantly reduced the frequency of attachment and significantly prolonged mean times to attachment. Compared with low levels of attachment response observed immediately after fabric contact, recovery of attachment response was observed 24 h after exposure in these wash/treatment groups, but inhibition was still evident. Permethrin-induced intoxication was more pronounced in males than females. Mortality 24 h after exposure was only significant among females exposed to 0-wash/treated fabric for 60 min. There was no evidence of permethrin-mediated stimulation of the attachment response in H. a. excavatum.

Animals↗
PubMed1998

Treatment of survivors of political torture: administrative and clinical issues.

Treatment of survivors of political torture is a new field, the symptoms of survivors are many and difficult, clinicians in general are not experienced in treatment, and there is little money available. Both administrative and clinical decisions often must take into account political realities not found in other treatment environments. To overcome these obstacles has required building an agency with a small economy, a sense of community among its workers, flexibility about the presence and pervasiveness of politics, the ability to address countertransference, and goals that allow workers to cope with the difficulty and size of the problem of torture.

Caregivers↗
PubMed1998

Access to medical care under strain: new pressures in Canada and Australia.

Health policy changes intended to achieve cost control in OECD countries run the risk of reintroducing financial barriers to health care. However, although the problems faced are similar, different countries are dealing with the situation in different ways. For example, Canada and Australia, which share many similarities, have taken quite different policy paths in the last decade: Canada has preserved universal access, whereas Australian policy is promoting a two-tier system through the provision of public subsidies for private insurance. The evidence is that country-specific factors such as institutional arrangements, attitudes, and values intersect with economic and financial factors to shape policy outcomes. Moreover, the Canadian and Australian experiences suggest that in relation to access issues, attitudes and values are the key policy determinants.

Australia↗
PubMed1998

How Australia came to have a National Women's Health Policy.

A National Women's Health Policy was launched in Australia in 1989, and Australia became the only country to have a comprehensive policy on women's health. The policy is intended to provide a framework for decision-making in both mainstream and separate women's health services. The author examines the forces and factors that led to the formulation and adoption of the policy, then addresses the question of why Australia is alone in choosing a national policy as a focus for women's health action. A number of key influences, either absent or weaker in comparable countries, worked together to facilitate policy development. The activities of women working in a number of arenas coincided with the election of relatively supportive governments, creation of women's policy machinery in bureaucracies, employment of feminists in key positions, and opportunities for policy expansion afforded by federalism. These influences, within the Australian ideological context of strong support for social liberalism, account for the country's distinctive policy position.

Australia↗
PubMed1997

The molecular basis of medium-chain acyl-CoA dehydrogenase (MCAD) deficiency in compound heterozygous patients: is there correlation between genotype and phenotype?

Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency is the most commonly recognized defect of mitochondrial beta-oxidation. It is potentially fatal, but shows a wide clinical spectrum. The aim of the present study was to investigate whether any correlation exists between MCAD genotype and disease phenotype. We determined the prevalence of the 14 known and seven previously unknown non-G985 mutations in 52 families with MCAD deficiency not caused by homozygosity for the prevalent G985 mutation. This showed that none of the non-G985 mutations are prevalent, and led to the identification of both disease-causing mutations in 14 families in whom both mutations had not previously been reported. We then evaluated the severity of the mutations identified in these 14 families. Using expression of mutant MCAD in Escherichia coli with or without co-overexpression of the molecular chaperonins GroESL we showed that five of the missense mutations affect the folding and/or stability of the protein, and that the residual enzyme activity of some of them could be modulated to a different extent depending on the amounts of available chaperonins. Thus, some of the missense mutations may result in relatively high levels of residual enzyme activity, whereas the mutations leading to premature stop codons will result in no residual enzyme activity. By correlating the observed types of mutations identified to the clinical/biochemical data in the 14 patients in whom we identified both disease-causing mutations, we show that a genotype/phenotype correlation in MCAD deficiency is not straightforward. Different mutations may contribute with different susceptibilities for disease precipitation, when the patient is subjected to metabolic stress, but other genetic and environmental factors may play an equally important role.

Acyl-CoA Dehydrogenase↗