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Biomedical subjects

G White

Publications and source records attributed to G White.

At least 19 recordsLinked to original sources
PubMed2006

Health promotion for people with disabilities: development and evaluation of the Living Well with a Disability program.

People with disabilities can benefit from health promotion opportunities to reduce the incidence and severity of secondary conditions that further limit their participation in society. This paper describes participatory action research (PAR) methods we used to develop, implement and evaluate the Living Well with a Disability program. Community-based agencies that provide information and referral services to people with disabilities (independent living centers funded under Title VII, Rehabilitation Act) recruited a convenience sample of 246 people with mobility impairments to participate in a randomly assigned, wait-list control health promotion intervention study. Paper-and-pencil outcome measures included the secondary conditions surveillance instrument, unhealthy days and health care utilization. Logistic regression on outcomes controlling for demographic variables and pre-test measures indicated reductions in all three outcome variables. People with mobility impairments who participated in the Living Well with a Disability program reported less limitation from secondary conditions, fewer unhealthy days and less health care utilization. PAR methods are particularly important to design useful interventions for this population.

Community Health Services↗
PubMed2004

Improving the retention of suturing needles in surgical graspers.

BACKGROUND: Surgical needles are usually held using dedicated grasping instruments. When the tissue to be penetrated is resilient, or the grasping force is low, the needle can swivel, causing it to deviate from the intended path, resulting in suboptimal tissue approximation. Needle swivel is particularly prevalent when needles are not held transversely in the jaws, but it is difficult to maintain a transverse grasp during surgery. An improved swivel-resistant grasper design is proposed. METHODS: Conventional and swivel-resistant graspers were tested to quantify the benefits of the swivel-resistant design. Needles secured in the grasper were repeatedly distracted until swiveling occurred. The torque required to swivel the needles was statistically analyzed. RESULTS: The swivel-resistant grasper offers greatly improved resistance to swivel (p = 0.01) when the needle is not held transversely. CONCLUSIONS: The four-point contact afforded by the modified needle graspers imparts improved needle retention and resistance to swivel.

Equipment Design↗
PubMed2003

Continuous intravenous infusion of a plasma-derived factor IX concentrate (Mononine) in haemophilia B.

This prospective, multicentre, open-label study evaluated the efficacy and safety of a plasma-derived factor IX concentrate [Mononine, Coagulation Factor IX (Human) Monoclonal Antibody Purified] administered by continuous intravenous (CIV) infusion to patients with haemophilia B. Admission criteria included documented diagnosis of haemophilia B (mild, moderate, or severe). Twenty-eight patients (25 surgery, two trauma, one severe spontaneous haemorrhage) were enrolled to receive a therapeutic bolus dose followed by CIV infusion of factor IX (FIX) to maintain FIX:C plasma levels of 0.4-1.0 IU mL(-1) (i.e. 40-100%). A median intravenous bolus dose of 54.2 IU kg(-1) FIX was administered to a subset of 13 non-emergency patients 7-21 days prior to CIV infusion to determine pharmacokinetic parameters in order to guide the dosing for CIV. For treatment, a bolus injection (median FIX dose; 89.6 IU kg(-1)) (range, 12.4-108.3), followed by a median total CIV infusion dose of 396.4 IU kg(-1) (range, 44.9-785.5) was administered at a median rate of 3.84 IU kg(-1) h(-1) (range, 1.74-7.33) for 107.17 h (range, 31.75-144). Twenty-four patients completed 72-120 h of FIX CIV infusion. Overall, 'excellent' (i.e. achievement of normal haemostasis) efficacy was reported in 23 of 24 (96%) evaluable patients, and 'good' (i.e. slight oozing) efficacy was reported in one (4%) patient. Median FIX:C was 72-86% for all patients receiving FIX by CIV on all days. Nine patients reported 13 adverse events that were possibly related to study medication but were not deemed serious by the investigator and were mainly because of local irritation at the infusion site. FIX CIV infusion therapy is safe and effective in the treatment of haemophilia B patients undergoing surgery, exposed to trauma, or experiencing severe spontaneous haemorrhage.

Adolescent↗
PubMed2002

Caprine serum fraction immunomodulator as supplemental treatment of lower respiratory disease in the horse.

Suppurative lower airway disease is a common debilitating disease in performance horses and, while rarely fatal, is often recalcitrant to conventional therapy. A variety of treatments have been used to combat this condition and we conducted two types of studies to determine if caprine serum fraction--immunomodulator (CSFI), a nonspecific immunomodulator, improved recovery from lower respiratory disease. Two dose response studies were performed to ascertain the efficacy of CSFI. Horses were maintained daily on conventional antibiotic therapy. Respiratory tract exudate, nasal discharge, dyspnoea, chest auscultation and cough frequency were monitored weekly. One hundred percent of the horses treated with 2 i.m. injections of either 60 or 120 mg CSFI one week apart showed significant improvement with each weekly evaluation and were fully recovered by week 3. Horses treated with 15 or 30 mg CSFI did not differ significantly from the control group. Only 10% of the control horses responded to conventional antibiotic therapy. An expanded field trial utilising 80 horses diagnosed with lower respiratory disease and housed at 4 equine clinics was conducted. Thirty-five percent of the 40 control horses, treated solely by conventional antibiotic therapies, recovered while 75% of the horses treated with a supplemental administration of 60 mg CSFI as described above recovered. The combined data from these studies showed that CSFI was able to promote an overall recovery from lower respiratory disease of 86%.

Adjuvants, Immunologic↗
PubMed2001

Sodium phenoxyacetate hemihydrate.

The structure of the hemihydrate of sodium phenoxyacetate, Na(+) x C(8)H(7)O(3)(-) x 0.5H(2)O, has been redetermined at low temperature (160 K). The structure consists of ribbons containing octahedral NaO(6) units, and half of the Na(2)O(2) squares within the ribbon are bridged by water molecules which lie across twofold rotation axes in C2/c. The phenyl substituents lie on the outside of the ribbon.

Journal Article↗
PubMed2001

Characterization of germline TP53 splicing mutations and their genetic and functional analysis.

Germline TP53 splicing mutations have been described infrequently (>2%) in the literature, however in a series of 40 patients and families identified by our group in which there are germline TP53 mutations, seven affect splicing (18%). The low figure reported in the literature might reflect the method of mutation detection, which in many studies does not include all splice junctions. These data indicate that a significant proportion of TP53 germline mutations are currently unrecognized. We have carried out detailed studies of the effects of the different mutations on splicing, and see distinct variations in the effects of the same mutation in different patients. Furthermore we have identified the usage of a non-consensus splice donor site in four families with an intron 4 splice donor mutation.

Alternative Splicing↗
PubMed2001

Induction of immunological memory in baboons primed with DNA vaccine as neonates.

DNA immunization is a potential vaccination strategy for neonates and infants. We tested the ability of a prototype DNA vaccine against influenza virus to prime lasting immunity when administered to newborn non-human primates. Neonatal DNA vaccination triggered virus-specific and neutralizing antibodies of titers and persistence depending on the vaccine dose. Subsequent exposure to influenza virus, revealed significantly increased recall responses in the baboons vaccinated with DNA during the neonatal stage. The humoral and cellular responses were enhanced in the baboons primed with DNA vaccine as neonates. Thus, neonatal DNA vaccination of non-human primates triggered immune memory that persisted beyond infancy.

Age Factors↗
PubMed2001

The tissue distribution and functional characterization of human VR1.

The irritant action of capsaicin is mediated by the vanilloid receptor, VR1, which is expressed in sensory neurons termed nociceptors. Capsaicin also desensitizes nociceptors and, thus, is useful clinically as an analgesic. Given the potential importance of VR1 in pain, we have cloned the human capsaicin receptor, hVR1, from a human dorsal root ganglia (DRG) cDNA library. Human VR1 protein is 85% identical to the rat VR1 and many of the amino acid differences are concentrated at the amino and carboxyl termini. VR1 is expressed in DRG as an approximately 4.2 kilobase RNA, and is also expressed in the central nervous system and in the kidney. Capsaicin (EC(50) = 853 nM), low pH (<5.5), and noxious heat (44 degrees C) activate hVR1 expressed in Xenopus oocytes. Subthreshold pH (6.4) sensitizes VR1 to capsaicin (EC(50) = 221 nM). This study demonstrates the similarity of human and rat VR1 in integrating multiple noxious stimuli.

Amino Acid Sequence↗
PubMed2001

Characterization of the mouse phenylalanine hydroxylase mutation Pah(enu3).

Phenylketonuria (PKU) is an inborn error of metabolism that is inherited in an autosomal recessive manner. It arises from a deficiency of phenylalanine hydroxylase, which is responsible for converting phenylalanine to tyrosine and thereby hastening its catabolism. To produce mouse models for the study of PKU, male mice were mutagenized with ethylnitrosourea and their progeny were screened for the elevated phenylalanine levels characteristic of phenylalanine hydroxylase deficiency. Of three mutant alleles recovered, two (Pah(enu1) and Pah(enu2)) were characterized previously and shown to be missense mutations. Sequencing of phenylalanine hydroxylase cDNA from the third mutant allele, Pah(enu3), revealed that two differently sized transcripts were being produced. These transcripts contained either a 5-nucleotide insertion or a 5-nucleotide deletion and both of these modifications occurred at the same location, the exon 11-exon 12 junction. Sequencing of the exon 11-intron 11 boundary revealed a T --> G transversion in the invariant GT dinucleotide of the wild-type 5' splice donor site. The analogous human Pah mutation would be called c.1199 + 2T > G. Sequence analysis also revealed two cryptic splice donor sites, upstream and downstream of the wild-type splice site, that appear to be used when the wild type is ablated and to thereby yield the observed differently sized transcripts. The 5-nucleotide insertion and the 5-nucleotide deletion are both predicted to cause frame shifting in exon 12 and exon 13, leading to premature termination.

Alleles↗
PubMed2001

Isolation and characterization of an endogenous cytomegalovirus (BaCMV) from baboons.

This report describes the isolation of CMV-like viruses from olive, yellow and chacma sub-species of baboons. The viruses were identified as CMVs by their characteristic growth properties in cell culture, virion morphology under the TEM, and antigenic cross-reactivity with other primate CMVs. The glycoprotein B gene homologue from an olive baboon CMV isolate (BaCMV OCOM4-37) was identified, cloned and sequenced. We present the sequence of this gene and by phylogenetic analysis demonstrate that BaCMV is in fact a cytomegalovirus, and is more closely related to rhesus CMV than to human CMV. An ELISA was developed to measure anti-BaCMV antibodies in baboon sera. Serological testing of colony-bred and wild-born baboons indicated that BaCMV is ubiquitous in all baboon populations, with >95% of adult baboons of all sub-species being infected.

Animals↗
PubMed2001

The feasibility of a nurse practitioner-led primary health care clinic in a school setting: a community needs analysis.

AIM: The aim of this New Zealand study was to determine the feasibility of establishing a nurse practitioner-led, family focused, primary health care clinic within a primary school environment as a means of addressing the health needs of children and families. A secondary aim was to ascertain whether public health nurses (PHNs) were the most appropriate nurses to lead such a clinic. METHOD: Utilizing a community needs analysis method, data were collected from three sources --known demographic data, 17 key informant interviews and two focus group interviews. Questions were asked regarding the health needs of the community, the perceptions of participants regarding the role of the PHN, and the practicalities of establishing a clinic including the services participants would expect a clinic to provide. Analysis was exploratory and descriptive. RESULTS: Findings included the identification of a wide range of health issues. These included asthma management and control issues, the need to address poor parenting, and specific problems of the refugee and migrant population. Findings also demonstrated that participant understanding of the role of the PHN was less than anticipated and that community expectations were such that for a PHN to lead a primary health care clinic it would be likely that further skills would be required. Outcomes from investigating the practicalities of establishing a nurse practitioner-led clinic resulted in the preparation of a community-developed plan that would serve to address the health needs of children and families in the area the study was undertaken. Services that participants identified as being appropriate included health information, health education, health assessment and referral. CONCLUSION: Overall findings indicated that the establishment of a nurse practitioner-led, family focused, primary health care clinic in a primary school environment was feasible. While a PHN may fulfil the role of the nurse practitioner, it was established that preparation to an advanced level of practice would be required.

Adolescent↗
PubMed2001

Sodium hydrogen bis(phenoxyacetate).

In the title compound, Na(+) x H(+) x [2C(8)H(7)O(3)](-), the anion contains a short Speakman-type hydrogen bond [O...O = 2.413 (2) A]. The anions and the Na atoms lie across twofold axes.

Journal Article↗
PubMed2001

Spontaneous Waterhouse-Friderichsen syndrome in a gang-housed baboon.

Waterhouse-Friderichsen syndrome can cause acute death in the baboon without specific signs. Furthermore, this syndrome could result from stress-related intestinal permeability changes that allow macromolecules and/or microbiological entities to enter the systemic circulation. The resulting sepsis could cause adrenocortical insufficiency, hypotension and shock leading to death.

Adrenal Cortex Diseases↗
PubMed2001

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Adult↗
PubMed2001

Enteral tube feeding training for nurses and care assistants.

Increasing numbers of patients are enteral tube-fed in the community, often requiring community nursing support. Appropriate training facilitates effective patient care in this rapidly changing area of practice. The project described involved the development, piloting and evaluation of a validated home enteral tube-feeding training programme for community staff. Following wide consultation, four pilot days were provided (two for registered nurses and two for care assistants) which were positively evaluated. Post-training evaluation suggested the training led to beneficial changes in practice. Additional funding obtained has enabled the basic training to continue on a monthly basis for 2 years with biannual updates. Significant risks are attached to home enteral tube feeding; opportunities to integrate theory and practice in a safe environment should enhance patient care and decrease clinical risk.

Education, Nursing↗
PubMed2001

Critical analysis and diagnostic usefulness of limited immunophenotyping of B-cell non-Hodgkin lymphomas by flow cytometry.

We report the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of various immunophenotypes characteristic of each class of B-cell non-Hodgkin lymphoma (NHL) based on analysis of 352 morphologically well-characterized B-cell NHLs and 175 benign lymph nodes (LNs) using 2-color flow cytometry. All B-cell NHLs that exhibited a characteristic immunophenotype (except diffuse large B-cell lymphoma) had a high NPV. The immunophenotypes of small lymphocytic lymphoma and mantle cell lymphoma showed high specificity, but only small lymphocytic lymphoma also showed a high PPV. One third of follicular lymphomas coexpressed CD23 and CD10. Diffuse large B-cell NHL showed no consistent immunophenotype. About 90% of all benign LNs expressed no substantial amounts of CD5, CD10, or CD23. Most benign LNs also failed to express substantial amounts of immunoglobulin heavy chains. In contrast, about 90% of NHLs showed expression of 1 or 2 heavy chains. The expression pattern of immunoglobulin light chains was not found helpful in favoring one lymphoma type over another. The usefulness of each immunophenotype for each lymphoma group is of particular diagnostic importance in limited specimens, such as fine-needle aspiration biopsies, small core biopsies, body effusions, extranodal sites, and nodal tissues with various artifacts.

CD5 Antigens↗
PubMed2001

Diagnostic criteria for minimally differentiated acute myeloid leukemia (AML-M0). Evaluation and a proposal.

We studied immunophenotypic features of 30 cases of minimally differentiated acute myeloid leukemia (AML-M0) using multiparameter flow cytometry and immunohistochemistry and evaluated the immunophenotypic features of previously reported cases to facilitate correct identification of myeloid lineage. All but 1 of our 30 cases expressed CD13 and/or CD33; 2 expressed CD19; 1 expressed CD10; none expressed both CD10 and CD19. Eleven of 30 cases expressed T-cell-associated antigens. All but 2 cases expressed CD34 and/or HLA-DR. Twelve of 27 cases expressed terminal deoxynucleotidyl transferase. Myeloperoxidase (MPO) expression was seen in 22 of 22 cases by immunohistochemistry and 1 of 4 by flow cytometry. None of 27 cases expressed cyCD3 and cyCD79a. We propose following modified criteria for AML-M0: (1) standard criteria for acute leukemia; (2) undetectable or less than 3% MPO or Sudan black B staining in blasts; (3) lack of expression of lymphoid-specific antigens, cyCD3 for T lineage and cyCD79 and cyCD22 for B lineage; and (4) positivity for any of the myelomonocytic lineage antigens known not to be expressed on normal T or B lymphocytes or positivity for MPO as detected by ultrastructural cytochemistry, immunohistochemistry, or flow cytometry.

Adolescent↗