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Biomedical subjects

G Scott

Publications and source records attributed to G Scott.

At least 19 recordsLinked to original sources
PubMed2007

Influence of 4- and 6-color flow cytometers and acquisition/analysis softwares on the determination of lymphocyte subsets in HIV infection.

BACKGROUND AND OBJECTIVES: Lymphocyte immunophenotyping provides valuable information for the diagnosis and monitoring of patients with cellular immunodeficiencies, such as HIV/AIDS. In this study, we have assessed the influence of 4-color and 6-color flow cytometers, and respective analytical softwares on the enumeration of lymphocytes in HIV infected individuals. METHODS: The expression of various cell surface markers on lymphocytes was measured from the EDTA blood of 66 HIV infected patients on the FACSCalibur (4-color) and FACSCanto (6-color) flow cytometers. Percentage of lymphocytes expressing a particular cell surface marker was analyzed on FACSCalibur using the Cell Quest Pro software (v 5.2), while the analysis on FACSCanto was done using FACSCanto (v 1.0.3) and FACSDiva (v 4.1) softwares respectively. RESULTS: The data shows significantly higher mean CD3 T-cell counts on FACSCalibur, Cell Quest Pro (1,864 +/- 1,044 cells/microl) as compared to FACSCanto (1,840 +/- 1,040 cells/microl) (P < 0.05). The CD4 T-cell counts were also higher on FACSCalibur, Cell Quest Pro (885 +/- 770 cells/microl), and FACSDiva (892 +/- 773 cells/microl) versus FACSCanto (867 +/- 767 cells/microl) (P < 0.05). FACSCalibur, Cell Quest Pro, and FACSDiva showed similar values except for CD8 T-lymphocytes where FACSDiva had significantly lower values (P < 0.05). The B-cell counts were unaffected when either of the instruments or softwares were used, while the natural killer (NK) cells (CD16 + 56 positive cells) showed similar trend like CD3 and CD4 counts with significant differences in the mean cell counts between FACSCalibur, Cell Quest Pro (240 +/- 165 cells/microl), and FACSDiva (238 +/- 163 cells/microl) versus FACSCanto with higher NK cell counts (260 +/- 176 cells/microl). CONCLUSIONS: The enumeration of lymphocyte subsets was comparable between FACSCalibur, Cell Quest Pro, and FACSDiva, based analysis and it was significantly different than FACSCanto software based analysis. Our observations suggest that FACSDiva software should be preferred over the FACSCanto software for immunophenotyping on FACSCanto flow cytometer and the laboratories should report the instrument and software used for the specimen analysis while reporting immunophenotyping results.

Antigens, Surface↗
PubMed2006

An evaluation of contaminated estuarine sites using sediment quality guidelines and ecological assessment methodologies.

Toxic contaminants may enter estuarine ecosystems through a variety of pathways. When sediment contaminant levels become sufficiently high, they may impact resident biota. One approach to predict sediment-associated toxicity in estuarine ecosystems involves the use of sediment quality guidelines (ERMs, ERLs) and site-specific contaminant chemistry while a second approach utilizes site-specific ecological sampling to assess impacts at the population or community level. The goal of this study was to utilize an integrated approach including chemical contaminant analysis, sediment quality guidelines and grass shrimp population monitoring to evaluate the impact of contaminants from industrial sources. Three impacted sites and one reference site were selected for study. Grass shrimp populations were sampled using a push-netting approach. Sediment samples were collected at each site and analyzed for metals, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs) and pesticides. Contaminant levels were then compared to sediment quality guidelines. In general, grass shrimp population densities at the sites decreased as the ERM quotients increased. Grass shrimp densities were significantly reduced at the impacted site that had an ERM exceedance for chromium and the highest Mean ERM quotient. Regression analysis indicated that sediment chromium concentrations were negatively correlated with grass shrimp density. Grass shrimp size was reduced at two sites with intermediate levels of contamination. These findings support the use of both sediment quality guidelines and site-specific population monitoring to evaluate the impacts of sediment-associated contaminants in estuarine systems.

Animals↗
PubMed2006

Nephrogenic systemic fibrosis among liver transplant recipients: a single institution experience and topic update.

Nephrogenic systemic fibrosis (NSF) is a recently characterized systemic fibrosing disorder developing in the setting of renal insufficiency. NSF's rapidly progressive nature resulting in disability within weeks of onset makes early diagnosis important. Two reports of NSF after liver transplantation are known of. We present three cases of NSF developing within a few months after liver transplantation and review the current literature. Loss of regulatory control of the circulating fibrocyte, its aberrant recruitment, in a milieu of renal failure and a recent vascular procedure appear important in its development. Known current therapies lack consistent efficacy. Only an improvement in renal function has the greatest likelihood of NSF's resolution. Delayed recognition may pose a significant barrier to functional recovery in the ubiquitously deconditioned liver transplant patient. Early recognition and implementation of aggressive physical therapy appear to have the greatest impact on halting its progression.

Aged↗
PubMed2006

Failure of a "screw-in" acetabular component: ten-year results, survivorship analysis, and the prediction of failure.

The Rotalok screw-in threaded acetabular component was prospectively reviewed with 10-year clinical and radiological follow-up for 60 patients. Nine patients died and 5 were lost to follow-up. Clinically, 28 patients were pain-free, 13 had mild pain, and 3 had moderate pain. Thirteen patients underwent revision for loosening and 3 required revision but were unfit. Superior migration, angular migration, and zone lucency were measured radiologically. Cumulative survival was 70.75% with revision surgery as the end point and 60% with combined clinical failure and revision as the end point. Angular migration of 3 degrees or more was a significant predictor of clinical failure and revision (P < .0001), with 5 degrees being very highly predictive with a sensitivity of 0.72 and a specificity of 1.00. Revision was associated with younger patients (P = .03) and autograft use without screw stabilization (P = .024). The high failure rate of the Rotalok necessitates careful clinical and radiological follow-up, with asymptomatic radiological angular migration often the first predictor of failure.

Acetabulum↗
PubMed2006

A rapid method for identifying high-risk patients consenting for HIV testing: introducing The Edinburgh Risk Assessment Table for HIV testing.

Lack of time for conducting standard HIV pre-test counselling has been reported as a barrier to HIV testing. Use of a risk assessment table will identify high-risk patients to whom pre-test counselling may be limited. The aim of this study is to investigate the performance of a Risk Assessment Table for HIV testing designed in the Department of Genitourinary (GU) Medicine, Edinburgh. A prospective study was carried out on patients attending the Department of GU Medicine, Edinburgh between June 30th 2002 and July 1st 2003, who consented to HIV testing. Patients with any risk factor had standard pre-and post-test counselling. Those without any risk factor were tested and provided with leaflets on HIV testing.A total of 3337 patients were tested in the study period and 727 (22%) had risk factor for HIV infection. Twenty-nine patients (0.9%) were HIV-infected. The Risk Assessment Table failed to identify two infected patients. Routine use of the Risk Assessment Table saves time of the medical staff by only providing pre-test counselling to high-risk patients.

Adult↗
PubMed2006

Comparison of time to undetectable HIV viral load in the first 16 weeks after the start of three and four antiretroviral regimens.

The aim of this paper is to compare the time to a viral load <50 copies/mL of three or four antiretroviral therapy (ART) regimens among ART naïve patients within the first 16 weeks after the start of treatment. A retrospective study was carried out on ART naïve patients who started HAART between 1 January 1999 and 1 January 2004. ART naïve patients with a viral load >5.3 log10 copies/mL at the time of treatment were routinely started on four ART regimens in one of the HIV centres in Edinburgh. These patients were compared with ART naïve patients with viral load >5.3 log10 copies/mL at the time of start of three ART regimens in the other centre within the study period. During the study period, of 93 ART naïve patients with a viral load >5.3 log10 copies/mL, 56 and 37 commenced four drug and three drug regimens, respectively. Patients in each group were matched for their age, prevalence of HCV, median age, and median viral load at the start of therapy; however, patients on three drug regimens had significantly lower CD4 counts (P<0.01). The median time to undetectable viral load was 13.5 weeks for three and four drug regimens (P>0.05). By the time of undetectable viral load, there was no difference in the CD4 count of patients on three or four drug regimens. Similar proportions of immunosuppressed patients on three and four ART regimens had undetectable viral load within the first 16 weeks of therapy.

Anti-Retroviral Agents↗
PubMed2006

The effect of a neck-retaining femoral implant on leg-length inequality following total hip arthroplasty: a radiological study.

The aim of this study was to assess whether a femoral component which retained the neck reduced the incidence of leg-length inequality following total hip arthroplasty. A retrospective review was undertaken of 130 consecutive primary total hip arthroplasties performed between April 1996 and April 2004 using such an implant. There were 102 suitable patients for the study. Standardised pre- and post-operative pelvic radiographs were measured by an independent investigator to the nearest millimetre. The leg-length inequality was reduced from a mean pre-operative value of -0.71 cm to a mean of 0.11 cm post-operatively. Of the 102 patients 24 (23.5%) had an equal leg-length post-operatively, and 95 (93.1%) had a leg-length inequality between -1 cm and 1 cm.

Arthroplasty, Replacement, Hip↗
PubMed2005

Quality assessment of South African herbal medicines by means of HPLC fingerprinting.

An estimated 70% of South Africans regularly use traditional plant medicines. Incorporation of these medicines within the formal health care system, which is the stated intention of the Health Ministry, requires the establishment of standards for quality control. Except in the case of a handful of South African plant species, such standards are lacking. Of central importance with respect to quality control is correct identification of the species concerned, whether in the fresh, dried or powdered state. In cases where botanical identification is impossible, high performance liquid chromatography (HPLC) with diode array detection (DAD), offers an alternative qualitative profile and is being increasingly used for the authentication of crude drugs or their extracts. As a contribution to establishing quality standards for South African plant species used as traditional medicines, HPLC-DAD "fingerprints" of 60 commonly-used species have been generated in our laboratory. One of these species is presented here, together with UV spectra of individual components represented by major peaks in the HPLC profiles.

Chromatography, High Pressure Liquid↗
PubMed2005

The significance of surface changes on retrieved femoral components after total knee replacement.

We investigated the changes in surface roughness of retrieved femoral components in 18 men and four women at revision knee surgery. The mean age at revision was 68.4 years and the mean period of implantation was for 55.6 months. Eighteen implants were retrieved for aseptic loosening and four for infection. The surface changes in the articulating areas were inspected visually and the roughness (Ra) analysed with a profilometer. Parallel scratching and burnishing were the two main forms of damage. The mean Ra measurements in the articulating areas showed no statistically significant difference when compared with those in a control area on either side of the patellar groove at the apex of the femoral flange. This suggests that it is not essential to revise a well-fixed and correctly aligned femoral component where the polished surface has become burnished or bears fine parallel scratches, if the revision is conducted solely for failure of the tibial component.

Aged↗
PubMed2005

The use of tranexamic acid to reduce blood loss during total hip arthroplasty: an observational study.

INTRODUCTION: To test the hypothesis that the fall in haemoglobin following total hip arthroplasty is reduced by tranexamic acid administration. PATIENTS AND METHODS: A cohort of 64 patients were studied, 32 received tranexamic acid 20 mg/kg on induction. Surgery was performed by the senior author in a standardised fashion. Haemoglobin levels were measured 2 weeks pre- and 3 days postoperatively. Any complications were noted. The study group was matched using the bone and joint research database for age, sex, procedure, disease and pre-operative haemoglobin level. RESULTS: In the group receiving no tranexamic acid, the mean fall in haemoglobin was 3.8 g/dl (CI of mean 3.4-4.3) and in the group treated with tranexamic acid 2.8 g/dl (CI of mean 2.5-3.2) P < 0.05. Complications included one non-fatal pulmonary embolus in the tranexamic acid group. CONCLUSIONS: The administration of 20 mg/kg of tranexamic acid on induction of surgery is an effective method of reducing the haemoglobin fall following hip arthroplasty.

Antifibrinolytic Agents↗
PubMed2004

Trachipleistophora hominis infection in the myocardium and skeletal muscle of a patient with AIDS.

OBJECTIVES: To review the literature relevant to microsporidial infection of muscle and to describe a case of human microsporidial infection involving both skeletal and cardiac muscle. METHODS: Samples from an AIDS patient with myositis have been examined by light and electron microscopy. RESULTS: We describe the findings at autopsy of a 47 year old Australian male with late stage AIDS, who had skeletal and cardiac muscle involvement with the microsporidian Trachipleistophora hominis. This is the third definitively identified case of human T. hominis infection and the first to describe infection of the myocardium. CONCLUSIONS: Microsporidial infection of muscle is rare in humans, but more work is needed to elucidate both the organisms and routes of transmission of this group of parasitic protozoa.

AIDS-Related Opportunistic Infections↗
PubMed2004

Hot dentures.

Explore the source record for details and available documents.

Burns↗
PubMed2004

Cryptococcal meningitis in two apparently immunocompetent Maltese patients.

Two cases of cryptococcal meningitis occurring in immunocompetent men are described. The first case involves a farmer in whom cryptococcal meningitis was rapidly diagnosed using direct microscopy, latex antigen tests and culture of cerebrospinal fluid (CSF). In the second case, initial mycological tests on CSF (direct microscopy and culture) were repetitively negative and latex antigen tests gave unconvincing results. The patient was started on triple antituberculosis therapy, on which he improved immediately; therapy was continued for 1 year with the patient remaining well. However, within 1 week of stopping therapy, he had to be readmitted with neurological signs and symptoms. Culture of CSF this time yielded Cryptococcus neoformans and the antigen test was consistently positive. These are the first reported cases of cryptococcal meningitis in immunocompetent patients in Malta.

Cerebrospinal Fluid↗
PubMed2004

A survey of the perspectives of specialist palliative care providers in the UK of inpatient respite.

One of the major reasons for admission of patients to hospital in late stage disease is the inability of carers to continue to provide care at home. Specialist palliative care services have typically admitted patients for acute symptom control, terminal care and respite care to benefit them and their carers. This paper reports the results of a cross-sectional survey of inpatient respite care provision provided by specialist palliative care services and hospices in the UK. A structured questionnaire was mailed to 242 clinical services managers listed in the Hospice Information Directory in 2003. A 69% response rate was achieved. The questionnaire explored the nature of respite services, their purpose, organization, delivery and examined definitions used. The analysis indicated that 80% of the sample provided inpatient respite care. Most inpatient respite admissions were planned, of fixed duration (7-14 days) and were intended to benefit patients and carers. There was some evidence that respite provision was regarded as a lower priority than admissions for symptom control and terminal care, and that patients' needs were prioritized over those of carers. Only 10% of services conducted regular, routine audit, with very few seeking the views of service users. Findings suggest that carers' needs and wishes are not prioritized by specialist palliative care services offering inpatient respite, which may mean that they find it difficult to maintain their caregiving roles over longer disease trajectories or in the face of overwhelming demands.

Caregivers↗
PubMed2004

Heterosexual men and women with HIV test positive at a later stage of infection than homo- or bisexual men.

The current strategy of offering HIV testing to individuals with known risk has had no impact on the reduction in the number of patients diagnosed with immune suppression of infection. A prospective observational study to compare the baseline CD4+ T-cell counts in HIV-infected homosexual/bisexual men, intravenous drug users, heterosexual men and women diagnosed in GUM/RIDU and that of patients diagnosed during routine maternal screening for HIV between December 1999 and January 2003 was carried out at the Departments of Genitourinary Medicine (GUM), Regional Infectious Disease Unit (RIDU) and Obstetrics in Edinburgh. Late presentation was defined as positive HIV test with baseline CD4+ T-cell count of less than 200 cells/mL. During the study period, 189 patients tested in GUM/RIDU setting and 13 screened women were diagnosed with HIV infection. Thirty-four percent of the former and 38% of the latter group had CD4+ T-cell count of less than 200 cells/mL by the time of diagnosis. Heterosexual individuals contributed to 78% of HIV tests in the GUM/RIDU setting. Amongst the 78 HIV-infected heterosexual individuals diagnosed in GUM/RIDU 45% were late presenters. Significantly fewer homosexual men were late presenters. There was no difference between the proportion of late presenters amongst women screened at the antenatal (5/13) compared to heterosexual patients diagnosed in GUM/RIDU (35/78). A significant number of HIV infected heterosexual patients are late presenters in the HIV testing at GUM/RIDU. HIV screening programmes for heterosexual individuals in any medical encounter may reduce the number of late presenters.

AIDS Serodiagnosis↗
PubMed2003

Gastroduodenal tolerability of lumiracoxib vs placebo and naproxen: a pilot endoscopic study in healthy male subjects.

BACKGROUND: Lumiracoxib (Prexige) is a cyclooxygenase-2 (COX-2) selective inhibitor. AIM: To compare the gastroduodenal tolerability of lumiracoxib with placebo and naproxen in a randomized, parallel-group, double-blind study. METHODS: : Sixty-five healthy male subjects were randomized to receive 8 days' dosing with lumiracoxib 200 mg twice daily (b.d.) (n = 21), placebo (n = 22) or naproxen 500 mg b.d. (n = 22). Endoscopic evaluations of gastric and duodenal mucosae were conducted at baseline and after 8 days' dosing. Serum was assayed for ex-vivo concentrations of thromboxane B2 (TxB2) to determine cyclooxygenase-1 (COX-1) inhibitory activity. RESULTS: Sixty subjects (20 per group) completed the study. No gastroduodenal erosions were observed in subjects receiving lumiracoxib. Thirteen subjects receiving naproxen developed duodenal erosions. At the gastric site, one subject in each of the naproxen and placebo groups had erosions; one subject receiving naproxen also developed a small asymptomatic gastric ulcer. Gastrointestinal adverse events accounted for 42.3% of all adverse events, occurring in 3/21, 4/22 and 6/22 of the lumiracoxib, placebo and naproxen groups, respectively. TxB2 levels were similar for patients receiving placebo or lumiracoxib, but were reduced by > 95% in patients receiving naproxen, compared with placebo. CONCLUSIONS: Multiple doses of lumiracoxib resulted in gastroduodenal tolerability similar to placebo and superior to naproxen.

Adolescent↗
PubMed2003

Hydroxyapatite-coated femoral components in total knee arthroplasty: medium term results.

Thirty-six consecutive total knee arthroplasties with hydroxyapatite (HA)-coated femoral components were prospectively followed up according to a standardised protocol for a mean period of 10 years (range, 7-11 years). Clinical and radiologic examination was performed at each follow-up evaluation. One patient (1 knee) was lost to follow up at 7 years, and 4 other patients (6 knees) died. Radiographs were studied for signs of loosening and presence of lucencies. Survival analysis was performed using a life table with revision as the criterion for failure. Two knees (1 patient) were revised because of aseptic loosening. The tibial component of one other knee was revised because of osteolysis in the medial tibial condyle. In the remaining knees, no radiologic evidence of loosening was seen. The survival of the femoral component at a mean follow-up time of 7 years, when 31.5 knees were at risk, was 94% with revision for femoral aseptic loosening as the end point. At 10 years, when 24 knees were at risk, the survival remained 94%.

Activities of Daily Living↗