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Biomedical subjects

J C Graham

Publications and source records attributed to J C Graham.

At least 19 recordsLinked to original sources
PubMed2004

Low prevalence of genital candidiasis in children.

In order to determine the prevalence of culture-proven candida infection in children with genital symptoms, a retrospective case-note review was performed to identify all symptomatic children with a culture result positive for Candida spp. during a 15-month period. Between May 2000 and July 2001, a total of 570 specimens were received from 473 children, and 34 positive culture results were recorded for specimens taken from 32 patients. Of these patients, 19 were in the 0-3-year age group, six in the 3-9-year age group and seven in the 9-12-year age group. Underlying risk factors for infection included prematurity, immunosuppression and prior antibiotic therapy. Three children were suspected to have experienced sexual abuse. Candida infection is uncommon in toilet-trained prepubertal girls, and empirical antifungal therapy is not indicated in this age group unless there are well-recognised predisposing factors. If a Candida sp. is isolated from a genital tract specimen taken from a 3-9-year-old girl, then a specific cause needs to be sought.

Age Distribution↗
PubMed2003

Increased rectal mucosal expression of interleukin 1beta in recently acquired post-infectious irritable bowel syndrome.

BACKGROUND AND AIMS: Chronic bowel disturbances resembling irritable bowel syndrome (IBS) develop in approximately 25% of patients after an episode of infectious diarrhoea. Although we have previously shown that psychosocial factors operating at the time of, or prior to, the acute illness appear to predict the development of post-infectious IBS (PI-IBS), our finding of an increased inflammatory cell number in the rectum persisting for at least three months after the acute infection suggested that there is also an organic component involved in the development of PI-IBS. To evaluate this further, we measured expressions of interleukin 1beta (IL-1beta) and its receptor antagonist (IL-1ra) in these patients to provide additional evidence that the pathogenesis of PI-IBS is underpinned by an inflammatory process. METHODS: Sequential rectal biopsy samples were prospectively obtained during and three months after acute gastroenteritis, from eight patients who developed post-infectious IBS (INF-IBS) and seven patients who returned to normal bowel habits after acute gastroenteritis (infection controls, INF-CON). Eighteen healthy volunteers who had not suffered from gastroenteritis in the preceding two years served as normal controls (NOR-CON). IL-1beta and IL-1ra gene expressions were assayed by reverse transcriptase-polymerase chain reaction, and their levels of expression were quantitated by optical densitometry after electrophoresis on agarose gel. RESULTS: INF-IBS patients exhibited significantly greater expression of IL-1beta mRNA in rectal biopsies than INF-CON patients both during and three months after acute gastroenteritis. Moreover, IL-1beta mRNA expression had increased in biopsies taken from INF-IBS patients at three months after the acute infection but no consistent change was observed in INF-CON patients. IL-1beta mRNA expression of INF-IBS patients at three months post gastroenteritis was significantly greater than NOR-CON whereas that of INF-CON patients was not significantly different from NOR-CON. Despite these differential changes in IL-1beta mRNA expression, no significant changes were observed in IL-1ra mRNA expression among the three groups. CONCLUSIONS: These findings indicate that those patients who develop IBS post infection exhibit greater IL-1beta mRNA expression, both during and after the infection, compared with individuals who do not develop PI-IBS. We conclude that such patients may be susceptible to inflammatory stimuli, and that inflammation may play a role in the pathogenesis of PI-IBS.

Acute Disease↗
PubMed2002

Uptake of 40K and 137Cs in native plants of the Marshall Islands.

Uptake of 137Cs and 40K was studied in seven native plant species of the Marshall Islands. Plant and soil samples were obtained across a broad range of soil 137Cs concentrations (0.08-3900 Bq/kg) and a narrower range of 40K soil concentrations (2.3-55 Bq/kg), but with no systematic variation of 40K relative to 137Cs. Potassium-40 concentrations in plants varied little within the range of 40K soil concentrations observed. Unlike the case for 40K, 137Cs concentrations increased in plants with increasing 137Cs soil concentrations though not precisely in a proportionate manner. The best-fit relationship between soil and plant concentrations was P = aSb where a and b are regression coefficients and P and S are plant and soil concentrations, respectively. The exponent b for 40K was zero, implying plant concentrations were a single value, while b for 137Cs varied between 0.51 and 0.82, depending on the species. For both 40K and 137Cs, we observed a decreasing concentration ratio (where concentration ratio=plant concentration/soil concentration) with increasing soil concentrations. For the CR values, the best-fit relationship was of the form CR = aSb/S = aSb(-1). For the 40K CR functions, the exponent b - 1 was close to - 1 for all species. For the 137Cs CR functions, the exponent b - 1 varied from -0.19 to -0.48. The findings presented here, aswell as those by other investigators, collectively argue against the usefulness of simplistic ratio models to accurately predict uptake of either 40K or 137Cs in plants over wide ranges of soil concentration.

Cesium Radioisotopes↗
PubMed2002

Hospital-acquired listeriosis.

We report four cases of listeriosis that occurred over a two-month period in north east England. Due to the apparent nosocomial acquisition of infection and the clustering of cases in time and place, extended epidemiological investigation was performed and the outbreak was traced to a caterer who was providing sandwiches for hospital shops. We discuss the difficulties in preventing food-borne listeriosis in the hospital setting.

Aged↗
PubMed2002

A mass in the liver.

We report a case of alveolar echinococcosis. To our knowledge this is the first report of human alveolar echinococcosis to be confirmed in the UK and if contracted in Afghanistan the first report for that country.

Afghanistan↗
PubMed2002

Role of aminoglycosides in the treatment of bacterial endocarditis.

Aminoglycosides are often used in combination with glycopeptides and beta-lactams for the treatment of bacterial endocarditis caused by alpha-haemolytic streptococci, staphylococci and enterococci. Recommendations on dosing and duration of aminoglycoside therapy vary; we detail the laboratory and clinical evidence base for the treatment regimens advised. A number of deficiencies in the published guidelines are highlighted, as is the limited evidence base upon which many of the regimens are recommended. With the increasing use of outpatient treatment of severe infections and once daily administration of aminoglycosides the opportunity should be taken for larger, multicentre clinical trials to evaluate formally both old and new regimens.

Aminoglycosides↗
PubMed2001

Tuberculosis transmitted through transplantation.

Tuberculosis in solid organ transplant recipients is associated with relatively high morbidity and mortality and is often extra-pulmonary. Reactivation of dormant infection is the usual mode of acquisition with donor and nosocomial transmission occurring infrequently. We report two cases of probable donor transmitted extra-pulmonary infection where both isolates of Mycobacterium tuberculosis proved to be indistinguishable using hemi-nested inverse PCR of the IS 6110 region.

Adult↗
PubMed2001

Resistance training in patients with peripheral arterial disease: effects on myosin isoforms, fiber type distribution, and capillary supply to skeletal muscle.

The purpose of this study was to investigate the effects of a progressive resistance training program on myosin heavy chain isoform expression, fiber type, and capillarization in patients with symptomatic peripheral arterial disease. Patients were randomized to either a training group (n = 11, mean +/- SD, 70 +/- 6 years, 4 men, 7 women) or a control group (n = 9, 66 +/- 6 years, 5 men, 4 women). The training sessions were completed 3 times/week, using 2 sets of various exercises, each performed for 8-15 repetitions. Muscle biopsies were obtained before and after 24 weeks from the medial gastrocnemius. Following the 24-week training program, the training group had significantly decreased the percentage of myosin heavy chain type IIB. The proportion of type IIB/AB fibers as measured by using myosin adenosine triphosphatase histochemistry decreased significantly in the training group. There were significant increases in type I and type II fiber areas, and capillary density also increased significantly in the training group. There were significant increases in 10 repetition maximum leg press and calf press strengths in the trained subjects. There were no significant changes in any of the measurements in the control group. It is concluded that progressive resistance training results in significant increases in muscle strength and alters skeletal muscle composition of subjects with peripheral arterial disease.

Aged↗
PubMed2001

Muscle fiber characteristics in patients with peripheral arterial disease.

PURPOSE: There have been conflicting reports of muscle fiber type changes in patients with peripheral arterial disease (PAD). The purpose of this study was to examine the myosin heavy chain (MHC) expression as well as histochemical changes in the gastrocnemius muscle in patients with symptomatic PAD. METHODS: Needle biopsy specimens were obtained from the medial gastrocnemius of 14 subjects with PAD (mean age (+/- SD), 69.7 +/- 4.8 yr) and eight activity-matched control subjects (mean age, 65.1 +/- 6.6 yr). Ankle-brachial index was assessed using Doppler ultrasound to determine the hemodynamic status of the patients, and maximal walking performance was determined during a graded treadmill test. Expression of MHC isoforms was determined by SDS-PAGE. RESULTS: The proportion of MHC I was significantly smaller in PAD than in the controls (45.6 +/- 9.1% vs 58.8 +/- 15.0%). The proportion of MHC IIx was also larger in the subjects with PAD compared with the controls (22.9 +/- 9.1% vs 16.0 +/- 11.3%). In addition, there was a significant decrease in the cross-sectional area of the type I and type IIA fibers in the subjects with PAD as well as enhanced capillary density. CONCLUSIONS: This study showed a significant modification in the expression of MHC isoforms and muscle fiber type in the gastrocnemius in patients with symptomatic PAD. These results suggest that muscle ischemia resulting from PAD is an important factor in causing the adaptations in the contractile apparatus of the muscle.

Adenosine Triphosphatases↗
PubMed2001

Analysis of Escherichia coli strains causing bacteriuria during pregnancy: selection for strains that do not express type 1 fimbriae.

Escherichia coli isolates from patients with bacteriuria of pregnancy were compared by PCR with isolates from patients with community-acquired cystitis for the presence of established virulence determinants. The strains from patients with bacteriuria of pregnancy were less likely to carry genes for P-family, S-family, and F1C adhesins, cytotoxic necrotizing factor 1, and aerobactin, but virtually all of the strains carried the genes for type 1 fimbriae. Standard mannose-sensitive agglutination of yeast cells showed that only 15 of 42 bacteriuria strains (36%) expressed type 1 fimbriae compared with 32 of 42 strains from community-acquired symptomatic infections (76%) (P < 0.01). This difference was confirmed by analysis of all isolates for an allele of the type 1 fimbrial regulatory region (fim switch), which negates type 1 fimbrial expression by preventing the fim switch from being inverted to the on phase. This allele, fimS49, was found in 8 of 47 bacteriuria strains from pregnant women (17.0%) compared with 2 of 60 strains isolated from patients with cystitis (3.3%) (P < 0.05). Determination of the phase switch orientation in vivo by analysis of freshly collected infected urine from patients with bacteriuria showed that the fim switch was detectable in the off orientation in 17 of 23 urine samples analyzed (74%). These data indicate that type 1 fimbriae are not necessary to maintain the majority of E. coli bacteriurias in pregnant women since there appears to be selection against their expression in this particular group. This is in contrast to the considered role of this adhesin in community-acquired symptomatic infections. The lack of type 1 fimbria expression is likely to contribute to the asymptomatic nature of bacteriuria in pregnant women, although approximately one-third of the bacteriuria isolates do possess key virulence determinants. If left untreated, this subset of isolates pose the greatest threat to the health of the mother and unborn child.

Alleles↗
PubMed2001

ACP Best Practice No 167: the laboratory diagnosis of urinary tract infection.

Urinary tract infection is common, and it is not surprising that urine specimens make up a large proportion of those samples submitted to the routine diagnostic laboratory. Many of these specimens will show no evidence of infection and several methods can be used to screen out negative samples. Those that grow bacteria need to be carefully assessed to quantify the degree of bacteriuria and hence clinical relevance. To influence treatment, a final report should be produced within 24 hours of specimen receipt, with turnaround times continuously monitored. Much work needs to be done to determine the cost effectiveness involved in processing urine specimens and the evidence base for the final report provided.

Adult↗
PubMed2000

Feline non-ocular melanoma: a retrospective study of 23 cases (1991-1999).

Non-ocular melanoma is considered to be a rare neoplasm in cats; however, more than 150 cases have been reported in the literature since 1961. The objective of this study was to characterise this tumour better by evaluating case outcome and survival data for cats with melanoma and to compare clinical and histopathological findings with those of previous reports. Twenty-three feline non-ocular melanomas were identified, the most common locations being the nose, digit and pinna. Cats with digital melanomas had survival rates similar to their canine counterparts. Histological assignation of benignity, malignancy or junctional activity was not found to be an accurate predictor of clinical behaviour. Melanoma should be considered as a differential diagnosis for cats presenting with pigmented or non-pigmented masses and histopathology is essential for definitive diagnosis, as other tumours may clinically appear quite similar. Regular follow-up examinations are recommended indefinitely for benign or malignant feline melanomas.

Animals↗
PubMed2000

Comparison of PCR detection of mecA with methicillin and oxacillin disc susceptibility testing in coagulase-negative staphylococci.

The provisional BSAC method for the detection of methicillin sensitivity in coagulase-negative staphylococci (CNS) requires incubation of isolates for 48 h and raises the problem of timely reporting of susceptibility data. The forthcoming withdrawal of methicillin raises another difficulty. We evaluated 42 clinically significant CNS blood culture isolates by PCR, methicillin and oxacillin disc testing and by using methicillin Etests. Our results suggest that, although oxacillin disc susceptibility testing is a reasonable first line step, optimal and timely detection of resistance or susceptibility may require a combination of phenotypic and genotypic methods.

Coagulase↗
PubMed2000

Effects of treatment with growth hormone and somatostatin on efficacy of diammine [1,1-cyclobutane dicarboxylato (2-)-0,0']-(SP-4-2) in athymic rats with osteosarcoma.

OBJECTIVE: To determine the effect of exogenous growth hormone or somatostatin on chemotherapeutic efficacy in athymic (nude) rats with osteosarcoma. ANIMALS: 66 female athymic rats. PROCEDURE: Osteosarcoma was induced at an intratibial site. Rats were randomly allotted to 6 treatment groups. Rats were treated with saline (0.9% NaCl) solution alone, platinum, diammine [1,1-cyclobutane dicaboxylato (2-)-0,0']-(SP-4-2) (CBDCA; ie, carboplatin) plus saline solution, somatostatin alone, somatostatin plus CBDCA, growth hormone alone, or growth hormone plus CBDCA. Variables measured included estimated WBC count and percentage of neutrophils, plasma concentration of insulin-like growth factor I (IGF-I), body weight, tumor volume, weight of primary tumor, survival time, and distant metastasis at time of death. RESULTS: Tumors formed at the injection sites in all rats. Treatment with growth hormone increased, and treatment with somatostatin decreased, plasma IGF-I concentration. Treatment with growth hormone or somatostatin altered CBDCA efficacy, as determined by evaluation of mean and median survival times. Metastatic pulmonary disease developed in 63 of 64 rats. CONCLUSIONS AND CLINICAL RELEVANCE: The technique used here reliably induced local osteosarcomas and metastatic pulmonary disease. Treatment with growth hormone and CBDCA or somatostatin may improve chemotherapeutic efficacy without increasing toxic effects. IMPLICATIONS FOR HUMAN MEDICINE: Results reported here may be useful in the study of osteosarcoma in humans.

Animals↗
PubMed1999

Primary renal tumours in cats: 19 cases (1992-1998).

A search from databases of four veterinary colleges and one private referral practice between January 1992 and April 1998 provided 20 cases diagnosed with primary renal neoplasia. Review of these cases revealed 19 primary renal tumours, excluding lymphoma. Of the 20 histologically reviewed cases, the diagnosis was amended in eight. There were 13 renal carcinomas (11 tubular and two tubulopapillary), three transitional cell carcinomas, one malignant nephroblastoma, one haemangiosarcoma and one adenoma. The haemangiosarcoma is, to our knowledge, the first reported case of this tumour type as a primary renal tumour in the cat. Most cats were presented for non-specific clinical signs such as anorexia and weight loss. One cat presented with tumour-associated polycythaemia which has not, to our knowledge, been reported previously. The metastatic rate for cats with complete staging was 64%, and 100% for transitional cell carcinomas.

Adenoma↗
PubMed1999

EMST in Papua New Guinea: more than just a course. Early Management of Severe Trauma.

BACKGROUND: Trauma in Papua New Guinea (PNG) is a major reason for acute hospital admission. The Early Management of Severe Trauma Course (EMST) of the Royal Australasian College of Surgeons was introduced to PNG in 1993 to help in trauma education. METHODS: Four EMST courses have been held in Port Moresby since 1993 with the support of the Department of Surgery of the University of PNG. RESULTS: Sixty-two doctors have attended a course and three PNG doctors have been trained as course instructors. Trauma workshops were held in other provincial hospitals extending the course principles to nurses and health professionals in these areas. CONCLUSION: The introduction of EMST to PNG has proven to be a worthwhile endeavour and the program is now firmly established in PNG.

Education, Medical, Continuing↗