Intrathecal methylprednisolone for postherpetic neuralgia.
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Anesthetics, Local↗
Biomedical subjects
G Lewis
Publications and source records attributed to G Lewis.
A massive reservoir of low-excitation molecular gas at high redshift.
Molecular hydrogen (H2) is an important component of galaxies because it fuels star formation and the accretion of gas onto active galactic nuclei (AGN), the two processes that can generate the large infrared luminosities of gas-rich galaxies. Observations of spectral-line emission from the tracer molecule carbon monoxide (CO) are used to probe the properties of this gas. But the lines that have been studied in the local Universe-mostly the lower rotational transitions of J = 1 --> 0 and J = 2 --> 1-have hitherto been unobservable in high-redshift galaxies. Instead, higher transitions have been used, although the densities and temperatures required to excite these higher transitions may not be reached by much of the gas. As a result, past observations may have underestimated the total amount of molecular gas by a substantial amount. Here we report the discovery of large amounts of low-excitation molecular gas around the infrared-luminous quasar APM08279+5255 at redshift z = 3.91, using the two lowest excitation lines of 12 CO (J = 1 --> 0 and J = 2 --> 1). The maps confirm the presence of hot and dense gas near the nucleus, and reveal an extended reservoir of molecular gas with low excitation that is 10 to 100 times more massive than the gas traced by the higher-excitation observations. This raises the possibility that significant amounts of low-excitation molecular gas may exist in the environments of high-redshift (z > 3) galaxies.
Astronomical Phenomena↗
Links between social class and common mental disorders in Northeast Brazil.
BACKGROUND: Social class is an important aspect of all societies. Social class differences in the prevalence of common mental disorder are likely to vary according to time, culture and stage of economic development. The present study aimed to investigate the intermediaries between social class and common mental disorder in a deprived area of Northeast Brazil. The Self Reporting Questionnaire (SRQ) was used to estimate the prevalence of common mental disorder. METHOD: A cross-sectional survey was conducted of 683 adults, aged 15 years and over, living in a random sample of private households in area II of Olinda, Recife Metropolitan Region, Pernambuco, Brazil. RESULTS: Poor education (odds ratio, OR 2.5, 95% CI 1.2-5.2; <5 years vs > or =11 years education) and low income (OR 2.4, 95% CI 1.0-5.6; < or =1/4 minimum wage vs >1 minimum wage) were independently associated with the prevalence of common mental disorder. Univariate associations with occupation, housing conditions and possession of household appliances could be understood in part by their association with poor education. CONCLUSIONS: Brazil has the second most unequal distribution of income in the world. Disparity in educational attainment could be one of the most important factors perpetuating social inequalities in psychiatric disorder in the country.
Adolescent↗
Contamination of potable roof-collected rainwater in Auckland, New Zealand.
One-hundred and twenty-five domestic roof-collected rainwater supplies in four rural Auckland districts were investigated in a cross-sectional survey to determine water quality. Samples of cold faucet water were analysed for physico-chemical and microbiological determinands, including metals (zinc, copper and lead), bacterial indicator organisms--heterotrophic plate count (HPC), total coilforms (TC), faecal coliforms (FC), enterococci (ENT), bacterial pathogens including Salmonella spp., Legionella spp., Campylobacter spp., Aeromonas spp. and the protozoa, Cryptosporidium and Giardia. Twenty-two supplies (17.6%) exceeded one or more of the maximum acceptable values (MAV) or maximum guideline values for chemical determinands of the New Zealand Drinking Water Standards (NZDWS) and 70 (56.0%) supplies exceeded the microbiological criteria of < 1 FC/100 mL. Eighteen supplies (14.4%) exceeded the NZDWS MAV for lead of 0.01 mg/L and three (2.4%) exceeded that for copper, of 2 mg/L. Those supplies with lead or galvanised iron comprising part of the roof or collecting system were more likely to show lead contamination (p = 0.019) as were those supplies with a pH less than 7 (p = 0.013). The presence of the indicator organisms HPC, TC, FC and ENT were all significantly correlated with one another. Aeromonas spp. were identified in 20 (16.0%) supplies. There was a positive association between the presence of Aeromonas and the bacterial indicator organisms. Households reporting at least one member with gastrointestinal symptoms in the month prior to sampling, were more likely to have Aeromonas spp. identified in their water supply than those households without symptoms (odds ratio 3.22, 95% CI 1.15-9.01, p = 0.021). Salmonella typhimurium was detected in one of 115 (0.9%) supplies. Legionella spp. and Campylobacter spp. were not detected. There were 50 supplies sampled for protozoa (sampling criteria: > or = 30 FC or > or = 60 ENT). Cryptosporidium oocysts were detected in 2 (4%) of these. Giardia was not detected. This study demonstrates that roof-collected rainwater systems provide potable supplies of relatively poor physiochemical and microbiological quality in the Auckland area. Further research is required on Aeromonas spp. as potential indicators of both microbiological quality and health risk along with design and maintenance strategies to minimise contamination of potable roof-collected rainwater supplies.
Copper↗
In situ analysis of Nitrosomonas spp. in wastewater treatment wetland biofilms.
The presence of the ammonia-oxidising group Nitrosomonas in developing biofilms from a subsurface flow dairy effluent treatment wetland was investigated using in situ hybridisation and a crude semi-quantitative PCR. Fluorescently labelled oligonucleotide probes, specific for the Nitrosomonas europaea and Nitrosomonas eutropha species, showed that nitrifying bacteria were present from the onset of biofilm development but that over a five month period the proportions remained low (averaging less than 1% of the total bacterial population). The greatest presence of these nitrifiers was found in the second trench of the subsurface flow wetland. Nitrosomonas were also found to be susceptible to environmental change; adverse environmental conditions, such as low temperatures, coincided with negligible Nitrosomonas presence throughout the wetland. However, during one period of elevated ammonium concentrations Nitrosomonas presence rapidly increased as high as 7% of the total bacterial population. Investigations of relative occurrence of effluent bacterial population of Nitrosomonas europaea and the biofilm populations showed that Nitrosomonas presence in the effluent coincided with significant presence in adjacent biofilms. This suggests seeding between both sessile and planktonic populations of this species. Nitrosomonas occurred as single cells in biofilms throughout the study and were never observed as dense clusters.
Aerobiosis↗
Properties of crosslinked ultra-high-molecular-weight polyethylene.
Substantially reducing the rate of generation of wear particles at the surfaces of ultra-high-molecular-weight polyethylene (UHMWPE) orthopedic implant bearing components, in vivo, is widely regarded as one of the most formidable challenges in modern arthroplasty. In the light of this, much research attention has been paid to the myriad of endogenous and exogenous factors that have been postulated to affect this wear rate, one such factor being the polymer itself. In recent years, there has been a resurgence of interest in crosslinking the polymer as a way of improving its properties that are considered relevant to its use for fabricating bearing components. Such properties include wear resistance, fatigue life, and fatigue crack propagation rate. Although a large volume of literature exists on the topic on the impact of crosslinking on the properties of UHMWPE, no critical appraisal of this literature has been published. This is one of the goals of the present article, which emphasizes three aspects. The first is the trade-off between improvement in wear resistance and depreciation in other mechanical and physical properties. The second aspect is the presentation of a method of estimating the optimal value of a crosslinking process variable (such as dose in radiation-induced crosslinking) that takes into account this trade-off. The third aspect is the description of a collection of under- and unexplored research areas in the field of crosslinked UHMWPE, such as the role of starting resin on the properties of the crosslinked polymer, and the in vitro evaluation of the wear rate of crosslinked tibial inserts and other bearing components that, in vivo, are subjected to nearly unidirectional motion.
Biocompatible Materials↗
Social roles and the gender difference in rates of the common mental disorders in Britain: a 7-year, population-based cohort study.
BACKGROUND: It is not known why the most common mental disorders (CMD), anxiety and depression, are more prevalent among women. This gradient has not been explained by differences in the number or type of social roles occupied by men and women. Given the dearth of longitudinal studies, these negative findings could reflect reverse causality, if men with CMD relinquish social roles more readily than women. METHODS: Cohort study using data from the first seven (annual) waves of the British Household Panel Survey. The prevalence of CMD was assessed using the General Health Questionnaire (GHQ), 12 months after ascertaining occupancy of five social roles. Of 12379 participants aged 16-70, 9947 completed the GHQ on at least two consecutive occasions, resulting in 44139 paired observations. Random effects models adjusted for the correlation of repeated measures and for baseline GHQ score. RESULTS: The odds ratio for the gender difference in the future prevalence of CMD (adjusted for baseline GHQ score) was 192 (95% CI 1.75-2.10). Neither the number or type of social roles occupied, nor socio-economic status explained the gender difference in these conditions (adjusted OR 182, 95% CI 1.66-1.99). While CMD at baseline was associated with a subsequent reduction in social role occupancy, this did not vary between men and women. CONCLUSIONS: Gender differences in CMD were not explained by differences in the number or type of social roles occupied by men and women, or by reverse causality. Future studies should consider characteristics of social roles, such as demand, control and reward.
Cohort Studies↗
Once-daily treatment of patients with hypertension: a placebo-controlled study of amlodipine and benazepril vs amlodipine or benazepril alone.
OBJECTIVE: To compare the efficacy, tolerability, and safety of once-daily therapy with amlodipine 5 mg/benazepril 10 mg vs amlodipine 5 mg, benazepril 10 mg, and placebo. DESIGN: Randomised, double-blind, placebo-controlled, parallel-group, multicentre trial. SETTING: Twenty-two clinical centres, including private practice groups and academic research clinics. PATIENTS: A total of 530 patients between 21 and 80 years of age with essential hypertension were screened for the study, and 454 were randomised to treatment with amlodipine 5 mg/benazepril 10 mg, amlodipine 5 mg, benazepril 10 mg, or placebo for 8 weeks. RESULTS: Amlodipine 5 mg/benazepril 10 mg produced greater reductions from baseline in sitting diastolic blood pressure than amlodipine 5 mg (P < 0.03), benazepril 10 mg (P < 0.001), and placebo (P < 0.001). The response rate in the amlodipine 5-mg/benazepril 10-mg treatment group (66.4%) was better than that observed in the amlodipine 5-mg (50.0% P < 0.02), benazepril 10-mg (38.3% P < 0.001), and placebo (24.4% P < 0.001) groups. There was no significant difference in heart rate among the four groups. The incidence of oedema in the amlodipine 5-mg/benazepril 10-mg (1.7%) group was somewhat less than that in the amlodipine 5-mg (4.5%) group. CONCLUSIONS: Therapy with amlodipine 5 mg/benazepril 10 mg was well tolerated and was superior to amlodipine 5 mg, benazepril 10 mg, and placebo in reducing sitting diastolic blood pressure in patients with essential hypertension.
Adult↗
Classification, disability and the public health agenda.
Depression is a common and disabling illness. For some time the disability has been relatively neglected by those interested in public health. Public health priorities have largely been determined by statistics on mortality. The World Health Organization has argued for some time that public health should be concerned with 'adding life to years' as well as 'adding years to life'. This article will argue that depression should be a key priority for public health research.
Anxiety↗
Phenotypic resistance of Staphylococcus aureus, selected Enterobacteriaceae, and Pseudomonas aeruginosa after single and multiple in vitro exposures to ciprofloxacin, levofloxacin, and trovafloxacin.
The phenotypic resistance of selected organisms to ciprofloxacin, levofloxacin, and trovafloxacin was defined as a MIC of > or =4 microg/ml. The dynamics of resistance were studied after single and sequential drug exposures: clinical isolates of methicillin-susceptible and methicillin-resistant Staphylococcus aureus (MSSA and MRSA), Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens, and Pseudomonas aeruginosa were utilized. After a single 48-h exposure of a large inoculum to four times the initial MIC for the organism, the frequency of selection of resistant mutants of MSSA was greater for trovafloxacin than levofloxacin (P = 0.008); for E. cloacae, the frequency was highest for ciprofloxacin and lowest for levofloxacin and trovafloxacin; for S. marcescens, the frequency was highest for trovafloxacin and lowest for ciprofloxacin (P = 0.003). The results of serial passage experiments were analyzed both by the Kaplan-Meier product-limited method as well as by analysis of variance of mean inhibitory values. By both methods, MSSA and MRSA expressed mutants resistant to ciprofloxacin after fewer passages than were required for either levofloxacin or trovafloxacin. For the aerobic gram-negative bacilli, two general patterns emerged. Mutants resistant to trovafloxacin appeared sooner and reached higher mean MICs than did mutants resistant to levofloxacin or ciprofloxacin. Mutants resistant to ciprofloxacin appeared later and reached mean MICs lower than the MICs of the other two drugs studied. Even though individual strain variation occurred, the mean MICs were reproduced when the serial passage experiment was repeated using an identical panel of E. coli isolates. In summary, the dynamic selection of fluoroquinolone-resistant bacteria can be demonstrated in experiments that employ serial passage of bacteria in vitro.
Anti-Infective Agents↗
Mental health after head injury.
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Brain Concussion↗
Income inequality and the prevalence of common mental disorders in Britain.
BACKGROUND: It has been hypothesised that the association between greater income inequality and increased mortality is mediated by poor psychosocial health. AIMS: To test the hypothesis that individuals in regions of Britain with the highest income inequality have a higher prevalence of the common mental disorders, after adjusting for individual income. METHOD: Cross-sectional survey of 8191 adults aged 16-75 in private households in England, Wales and Scotland. The prevalence of common mental disorders was assessed using the General Health Questionnaire. RESULTS: The association between income inequality and prevalence of the common mental disorders varied with individual income level. Among persons with the highest incomes, common mental disorders were more frequent in regions with greater income inequality (as indicated by high Gini coefficient) (adjusted OR 1.31,95% C1 1.05-1.65; P: = 0.02). The opposite was true for those with the lowest incomes. CONCLUSIONS: Income inequality was associated with worse mental health among the most affluent individuals.
Adolescent↗
Common mental disorders in Santiago, Chile: prevalence and socio-demographic correlates.
BACKGROUND: There have been relatively few surveys in Latin America that have attempted to estimate the prevalence of psychiatric morbidity in private households. AIMS: To determine the prevalence of common mental disorders and socio-demographic correlates among adults from Santiago, Chile. METHOD: Cross-sectional survey of private households with a probabilistic sampling design was used. Common mental disorders were measured using the Clinical Interview Schedule-Revised (CIS-R). RESULTS: Three thousand eight hundred and seventy adults were interviewed. Twenty-five per cent were CIS-R cases and 13% met criteria for an ICD-10 diagnosis. Low education, female gender, unemployment, separation, low social status and lone parenthood were associated with a higher prevalence. CONCLUSIONS: Prevalence rates were higher than those found in urban areas of Great Britain, both for ICD-10 diagnoses and 'non-specific neurotic disorders'. Similar socio-demographic factors were associated with an increased prevalence of common mental disorders in Chile as in the UK. There is a need to unify methodologies to be able to compare results internationally.
Adolescent↗
Signs of asphyxia at birth and risk of schizophrenia. Population-based case-control study.
BACKGROUND: Previous research has found an association between obstetric complications and schizophrenia, but in many studies the sample size was limited, and no assessment of specific exposures was possible. AIMS: To assess the role of different complications, and in particular to distinguish between disordered foetal development and hypoxia at birth. METHOD: From the Stockholm County In-Patient Register and community registers, we identified 524 cases of schizophrenia and 1043 controls, matched for age, gender, hospital and parish of birth. Data on obstetric complications were obtained from birth records. RESULTS: There was a strong association between signs of asphyxia at birth and schizophrenia (OR 4.4; 95% C11.9-10.3) after adjustment for other obstetric complications, maternal history of psychotic illness and social class. CONCLUSIONS: Signs of asphyxia at birth are associated with an increased risk of schizophrenia in adults.
Adolescent↗
Obstetric complications and risk of schizophrenia. Effect of gender, age at diagnosis and maternal history of psychosis.
BACKGROUND: Obstetric complications have been studied frequently as possible risk factors for schizophrenia. AIMS: To test the hypotheses that individual obstetric complications are most strongly associated with an increased risk of schizophrenia in males, in patients with an early age at first diagnosis and in subjects with a maternal history of psychosis. METHOD: Cases of schizophrenia diagnosed between January 1971 and June 1994 were identified in the Stockholm County In-Patient Register. Controls were matched on age, gender, hospital of birth and parish of birth. Obstetric data were recorded blind to case-control status for 524 cases and 1043 controls. RESULTS: This study did not find any large or consistent effect of gender, age at diagnosis or maternal history of psychosis on the risk of schizophrenia associated with individual complications. CONCLUSIONS: Future studies should examine these effects using a much larger sample that includes patients with schizophrenia and control subjects whose genetic risk of schizophrenia has been assessed accurately.
Adolescent↗
Nicotine, alcohol and drug dependence and psychiatric comorbidity. Results of a national household survey.
BACKGROUND: There is a well-recognised relationship between substance use disorders and other psychiatric disorders. This relationship has been well documented in a range of population-based studies. AIMS: This study aims to report on consumption patterns of and dependence on nicotine, alcohol and non-prescribed drugs and to report on the levels of psychiatric morbidity in these groups. METHOD: A national household study of psychiatric morbidity was conducted in England and Wales. Psychiatric assessment was based on the Clinical Interview Schedule-Revised (CIS-R). Measures of nicotine, alcohol and drug use and dependence were obtained. This paper compares the levels of psychiatric morbidity in the non-dependent and the nicotine-, alcohol- and drug-dependent cases. RESULTS: Twelve per cent of the non-dependent population were assessed as having any psychiatric disorder compared with 22% of the nicotine-dependent, 30% of the alcohol-dependent and 45% of the drug-dependent population. CONCLUSIONS: There is a clear relationship between dependence on nicotine, alcohol and drugs and other psychiatric morbidity.
Adolescent↗
Survival of poliovirus in New Zealand green-lipped mussels, Perna canaliculus, on refrigerated and frozen storage.
Poliovirus survival in live and frozen mussels during storage was assessed by both viral culture and molecular methods. Live New Zealand green-lipped mussels were incubated overnight at 20 degrees C in an aerated tank of filtered seawater seeded with the poliovirus 2 (PV2) vaccine strain. An extraction and concentration method that preserved viral infectivity was used to recover PV2 taken up by the mussels at day 0, at day 2 after storage at 4 degrees C, and at days 7, 14, and 28 after storage at -20 degrees C. This method allowed both culture and molecular analysis to be carried out. Presence of intact PV2 in each batch of mussels was determined by a pan-enterovirus specific reverse transcription-polymerase chain reaction (RT-PCR) and confirmed by dot-blot hybridization. Survival of infectious PV2 was determined by the monolayer plaque assay. After 48 h at 4 degrees C, infectious PV2 levels were 81% of the original level detected in the mussels. Infective virus levels then declined to 66, 53, and 44% after storage at -20 degrees C for 7, 14, and 28 days, respectively. Generic RT-PCR methods were 10 times more sensitive than cell culture techniques for virus detection but did not give information on virus infectivity. The survival of infectious pathogenic viruses in fresh and frozen mussels on storage constitutes a potential health risk and so is a major concern for public health authorities.
Animals↗
Effect of crosslinking UHMWPE on its tensile and compressive creep performance.
The in vitro quasi-static tensile and compressive creep properties of three sets of GUR 1050 ultra-high-molecular-weight polyethylene (UHMWPE) specimens were obtained. These sets were: control (as-received stock); "low-gamma" (specimens were crosslinked using gamma radiation, with a minimum dose of 5 Mrad); and "high-gamma" (specimens were crosslinked using gamma radiation, with a minimum dose of 15 Mrad). The % crystallinity (%C) and crosslink density (rho(x)) of the specimens in the three sets were also obtained. It was found that, in both tension and compression, crosslinking resulted in a significant depreciation in the creep properties, relative to control. The trend in the creep results is explained in terms of the impact of crosslinking on the polymer's %C and rho(x). The present results are in contrast to literature reports that show that crosslinking enhances the wear resistance of the polymer. The implications of the present results, taken together with the aforementioned literature results, are fully discussed vis-a-vis the use of crosslinked UHMWPE for fabricating articular components for arthroplasties.
Biocompatible Materials↗