Search PubMed⌕ Search

Biomedical subjects

G J Brown

Publications and source records attributed to G J Brown.

At least 19 recordsLinked to original sources
PubMed2002

The management of porphyria in dental practice.

From time to time a patient may attend your practice with a systemic condition that you may or may not remember from the small print of your undergraduate text books. This paper describes one such systemic condition, porphyria, and its dental management. This paper also describes the use of relative analgesia as an aid to anxiety management in porphyria.

Adult↗
PubMed2001

Cancer risk in young women at risk of hereditary nonpolyposis colorectal cancer: implications for gynecologic surveillance.

OBJECTIVES: The lifetime risk of endometrial and ovarian cancers in hereditary nonpolyposis colorectal cancer (HNPCC) is up to 60 and 12%, respectively, in addition to the high risk of colorectal cancer. International guidelines recommend surveillance of those at risk with colonoscopy every 1--2 years from age 20--25 years and annual gynecologic surveillance from 25--35 years for women. We reviewed our own experience to see whether these recommendations were appropriate. METHODS: Pedigrees of 120 HNPCC families registered with the Familial Bowel Cancer Service at The Royal Melbourne Hospital were reviewed. Ninety families met our criteria for HNPCC and were included in the study. Pedigrees were analyzed to identify early-age onset colorectal and gynecologic cancers and to calculate cumulative incidence of both cancer types for at-risk women (HNPCC-affected and first-degree female relatives of affected family members) for comparison with the general population. RESULTS: Colorectal cancer occurred in 434 individuals, endometrial cancer in 43, and ovarian cancer in 24. Gynecologic and colorectal cancers were diagnosed at similar ages (mean 49.3 versus 51.8 years; P = 0.25), with 5 (7.1%) gynecologic cancers diagnosed by 35 years. Cumulative incidences of gynecologic and colorectal cancers to ages 25, 30, 35, and 40 years were substantially higher among at-risk women than in the general population. CONCLUSIONS: Consideration should be given to offering gynecologic cancer surveillance from the age of 25 years, as for colorectal cancer. However, this approach should be individualized as it has yet to be demonstrated that surveillance reduces the mortality of gynecologic cancer in HNPCC.

Adult↗
PubMed2000

Root extrusion, a practical solution in complicated crown-root incisor fractures.

Implants and fixed and removable prostheses are very successful in replacing missing units but their cost can be inhibitory to a number of patients. In addition fixed and removable prostheses can be destructive to sound abutment teeth and can result in damage to dental and soft tissue. This report describes the restoration of a tooth with a complicated incisor crown-root fracture that extended below both the gingival cuff and the alveolar crest, by using remaining tooth tissue. The restoration was completed after root extrusion with a cast post, diaphragm and core, and porcelain crown.

Adult↗
PubMed2000

Attacking anxiety: a naturalistic study of a multimedia self-help program.

The effects of a commercial multimedia self-help program (Attacking Anxiety) were evaluated by examining the outcome of 176 individuals who participated in the treatment. Results suggested that 62 individuals suffering from anxiety achieved clinically significant improvement. An additional 40 achieved reliable change, despite the fact that these individuals had suffered from anxiety-based problems for years prior to their participation. Only one participant experienced negative change. These results are discussed in relation to the growing literature on self-help interventions and the limitations imposed by the naturalistic nature of the investigation.

Adult↗
PubMed1999

Prevention of the gastrointestinal adverse effects of nonsteroidal anti-inflammatory drugs: the role of proton pump inhibitors.

The associations between nonsteroidal anti-inflammatory drugs (NSAIDs) and the presence and complications of gastroduodenal erosions and ulcers are well established. Evidence that acid aggravates NSAID-induced injury provides a rationale for minimising such damage by acid suppression. Other strategies discussed include avoidance of NSAIDs or minimising their dosage, selecting NSAIDs known to cause less damage, and co-prescription of various agents. Cytoprotection with misoprostol, a prostaglandin analogue, has been shown to be effective in reducing NSAID-related peptic ulcers and their complications. Unfortunately, adverse effects may limit compliance in some patients. Histamine H2 antagonists have only limited efficacy in the prevention of NSAID-induced ulcers in humans, particularly in the stomach, except at higher than standard dosages. This may relate to their relatively modest effect in elevating gastric pH, especially in comparison with proton pump inhibitors. Several studies now confirm the efficacy of proton pump inhibitors in the short and longer term prevention of NSAID-induced upper gastrointestinal injury. Placebo-controlled studies suggest reductions of over 70% in gastric and duodenal ulcer rates over 3 to 6 months. The recent ASTRONAUT (Acid Suppression Trial: Ranitidine versus Omeprazole for NSAID-Associated Ulcer Treatment) study documented the greater prophylactic efficacy of omeprazole over ranitidine at standard dosages for 6 months. The OMNIUM (Omeprazole versus Misoprostol for NSAID-Induced Ulcer Management) study showed omeprazole to be slightly more effective overall than misoprostol in preventing the upper gastrointestinal adverse effects of NSAIDs, with both substantially more effective than placebo, although misoprostol was somewhat less well tolerated. Although substantial reductions in NSAID ulceration are now achievable when co-therapy with a proton pump inhibitor is given, a few patients will still develop ulcers and their complications. Hence the judicious use of NSAIDs in the first instance cannot be overemphasised.

Animals↗
PubMed1996

Transforming growth factor-beta 2 both stimulates and inhibits neurogenesis of rat cerebellar granule cells in culture.

Transforming growth factor-beta 2 (TGF beta 2) is expressed in the developing cerebellar cortex during the period of granule cell proliferation and maturation. However, the role of TGF beta 2 in granule cell development is confused by conflicting observations regarding TGF beta 2 control of neurogenesis. To resolve these conflicts and determine the effect of TGF beta 2 on neurogenesis, rat cerebellar granule cell cultures were treated with TGF beta 2 (0.1-100 ng/ml, 24 h) in the presence or absence of exogenous serum. Neuroblast proliferation was quantified by bromodeoxyuridine and [3H]thymidine incorporation. TGF beta 2 stimulated proliferation to 220% of controls in the presence of serum (ED50 = 0.4 ng/ml) based on bromodeoxyuridine labeled granule cell counts. In contrast, in serum free medium, TGF beta 2 inhibited proliferation 75% (ED50 = 0.7 ng/ml). DNA synthesis measured by [3H]thymidine incorporation was increased to 122% in the presence of serum factors, but inhibited 70% in serum free medium, as a result of TGF beta 2 activity. Thus, TGF beta 2 differentially regulates neurogenesis of cerebellar granule cells depending on the presence of exogenous, undefined regulatory factors derived from serum. This suggests that TGF beta 2 activity in cerebellar neurogenesis is complex as it may be modulated by the repertoire of other endogenous regulatory factors in the developing cerebellar cortex.

Animals↗
PubMed1996

Transforming growth factor-beta2 increases NMDA receptor-mediated excitotoxicity in rat cerebral cortical neurons independently of glia.

The ability of transforming growth factor-beta2 (TGFbeta2) to directly regulate neuronal sensitivity to glutamate and N-methyl-D-aspartate (NMDA) excitotoxicity in rat cerebral cortical neurons was investigated. Mixed neuronal-glial cultures treated with TGFbeta2 (1-10 ng/ml) exhibited a significant 25-50% increase in neuronal death compared to control cultures. TGFbeta2 potentiation of this endogenous glutamate excitotoxicity was blocked by the selective NMDA receptor antagonist, 2-amino-5-phosphonovalerate. In addition, neuronal death induced by brief NMDA exposure in both mixed neuronal-glial and pure neuronal cultures was increased by TGFbeta2 (1-30 ng/ml) with a similar dose-response curve. These findings indicate that TGFbeta2, at physiologically relevant concentrations, potentiates NMDA receptor-mediated excitotoxicity and that this occurs independently of TGFbeta2 effects on glia.

2-Amino-5-phosphonovalerate↗
PubMed1993

Comparison of terbinafine and clotrimazole in treating tinea pedis.

OBJECTIVE: To compare the efficacy and safety of terbinafine 1% cream and clotrimazole 1% cream in the treatment of tinea pedis. DESIGN: Multicentre, double blind parallel group study. SETTING: 32 general practices and one hospital. PATIENTS: 256 patients with mycologically confirmed tinea pedis. Of the 211 patients evaluable, 107 were randomised to terbinafine (75 male, 32 female; mean (range) age 40 (12-81) years) and 104 to clotrimazole (79 male, 25 female; mean (range) age 36 (12-71) years). INTERVENTIONS: Terbinafine 1% cream applied twice daily for one week and inert cream applied twice daily for the next three weeks. Clotrimazole 1% cream applied twice daily for four weeks. MAIN OUTCOME MEASURES: Mycological cure (negative results on microscopy and culture) and effective treatment (mycological cure plus no or minimal signs and symptoms) measured at weeks 1, 2, 3, 4, and 6. RESULTS: At week four rates of mycological cure were 93.5% for terbinafine and 73.1% for clotrimazole (p = 0.0001); and at week six 97.2% for terbinafine and 83.7% for clotrimazole (p = 0.001). Rates of effective treatment at week 4 were 89.7% for terbinafine and 58.7% for clotrimazole (p = 0.0001); and 89.7% for terbinafine and 73.1% for clotrimazole (p = 0.002) at week 6. CONCLUSION: These results indicate that a one week course of terbinafine 1% cream is more effective in the treatment of tinea pedis than a four week course of clotrimazole 1% cream, both in terms of mycological cure and effective treatment.

Adolescent↗
PubMed1993

Computational auditory scene analysis: listening to several things at once.

The problem of distinguishing particular sounds, such as conversation, against a background of irrelevant noise is a matter of common experience. Psychologists have studied it for some 40 years, but it is only comparatively recently that computer modelling of the phenomenon has been attempted. This article reviews progress made, possible practical applications, and prospects for the future.

Attention↗
PubMed1991

A community-based study into the possible reasons for the high incidence of cardiovascular disease in the west Highland District of Lochaber.

Cardiovascular screening of 726 males in a Fort William group practice was undertaken in an effort to determine possible causes for the high incidence of cardiovascular disease in the area. Sixty-four per cent of those sampled were born outside the area. The mean fasting plasma cholesterol level was surprisingly low at 5.4 mmol/l. Forty-three per cent of the sample were smokers and 22% had diastolic blood pressures above 90 mm Hg, 24% were clinically obese and 29% had a history of ischaemic heart disease amongst first degree relatives. Public awareness of cardiovascular risk factors was found to be low. A local health education programme could prove to be of great benefit.

Adult↗
PubMed1989

Mesenteric panniculitis.

We have reviewed the case of a young man with an omental mass diagnosed as mesenteric panniculitis. The clinical history, physical findings, and laboratory and radiologic studies were typical of this disorder. The diagnosis was suggested by CT scan, and confirmed on surgical biopsy. Our patient has had the typically benign course seen with mesenteric panniculitis.

Adult↗