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Biomedical subjects

J Collins

Publications and source records attributed to J Collins.

At least 19 recordsLinked to original sources
PubMed1992

Antenatal care of low risk obstetric patients by midwives. A randomised controlled trial.

OBJECTIVES: To assess the practicality, acceptability to patients and salary costs of the antenatal care of low risk obstetric patients by midwives. DESIGN: A randomised controlled trial. SETTING: The antenatal clinic at Westmead Hospital, a teaching hospital of the University of Sydney in western Sydney. PATIENTS: From January 1989 until November 1990, 89 women booking for full antenatal care at Westmead Hospital and classified as low risk were randomly allocated to one of two groups. Group 1 (43 patients) had their antenatal care provided by registered midwives. Group 2 (46 patients) had their antenatal care provided by an obstetrician (either Visiting Medical Officer or Staff Specialist) in a routine hospital antenatal clinic. INTERVENTIONS: Patients in the midwives' clinic were seen by an obstetrician at their first visit to the antenatal clinic and again at 30 weeks and at 40 weeks. MAIN OUTCOME MEASURES: These were the salary costs of each clinic and the patients' levels of satisfaction. Maternal and neonatal indicators, delivery details and analgesic requirements were also considered. These indicators were planned before data collection commenced. RESULTS: The major differences found were a 28% to 68% salary cost saving and that patients cared for by midwives showed appreciation of the continuity of care and information given at the midwives' clinic. CONCLUSIONS: The care of low risk obstetric patients by midwives in a midwives' clinic showed salary cost savings and high patient acceptance.

Continuity of Patient Care↗
PubMed1992

Three-dimensional structure of a recombinant variant of human pancreatic secretory trypsin inhibitor (Kazal type).

A modified version of the human pancreatic trypsin inhibitor (PSTI), generated in a protein-design project, has been crystallized in spacegroup P4(3) with lattice constants a = 40.15 A, c = 33.91 A. The structure has been solved by molecular replacement. Refinement of the structure by simulated annealing and conventional restrained least-squares yielded for 8.0 to 2.3 A data a final R-value of 19.1%. Differences to the known structures of porcine PSTI complexed with trypsinogen and modified human PSTI complexed with chymotrypsinogen occur at the flexible N-terminal part of the molecule. These differences are influenced by crystal packing, as are low temperature factors for the binding loop. The geometry of the binding loop is similar to the complexed structures.

Amino Acid Sequence↗
PubMed1992

A rapid heat-resistant technique for presumptive identification of Salmonella on desoxycholate-citrate agar.

A caprylate esterase chromogenic test, which was considered to indicate positivity in 5 minutes if a bright colour appeared on the filter paper inoculum site to which one colony had been applied, was used to test 534 Salmonella, 535 other bacteria capable of growth on desoxycholate-citrate agar (DCA), and 517 non-lactose fermenting colonies from stool cultures on DCA. It was found to be 100% sensitive for Salmonella, 99% specific, and more accurate than either direct antiserum agglutination or a urease test in these respects. The test kit could be stored at room temperature.

Agar↗
PubMed1992

The development and application of automated gridding for efficient screening of yeast and bacterial ordered libraries.

An automated gridding procedure for the inoculation of yeast and bacterial clones in high-density arrays has been developed. A 96-pin inoculating tool compatible with the standard microtiter plate format and an eight-position tablet have been designed to fit the Biomek 1000 programmable robotic workstation (Beckman Instruments). The system is used to inoculate six copies of 80 x 120-mm filters representing a total of approximately 20,000 individual clones in approximately 3 h. High-density arrays of yeast artificial chromosome (YAC) and cosmid clones have been used for rapid large-scale hybridization screens of ordered libraries. In addition, an improved PCR library screening strategy has been developed using strips cut from the high-density arrays to prepare row and column DNA pools for PCR analysis. This strategy eliminates the final hybridization step and allows identification of a single clone by PCR in 2 days. The development of automated gridding technology will have a significant impact on the establishment of fully versatile screening of ordered library resources for genomic studies.

Animals↗
PubMed1992

Patient classification systems: a new approach to computing reliability.

Patient classification systems are an integral part of managing nursing care that requires accuracy and consistency. Assessing interrater reliability is essential in monitoring and evaluating patient classification systems. Unfortunately, little attention has been paid to statistically assessing reliability. The most commonly used method, percentage of agreement, is limited and tends to be inflated due to chance variation. The ANOVA method, although more complex computationally, offers more accuracy and flexibility.

Analysis of Variance↗
PubMed1992

Pterin metabolism in depression: an extension of the amine hypothesis and possible marker of response to ECT.

Urinary excretion of neopterins and biopterins was measured in 23 patients with severe depression before and after receiving electroconvulsive therapy (ECT) and 26 healthy control subjects. Patients with psychotic depression and those responding to ECT had neopterin:biopterin (N:B) ratio significantly higher than controls before commencing ECT and positive therapeutic response was associated with reduction of N:B ratio towards control values. As a raised N:B ratio implies failure to convert neopterin to biopterin it is possible that reduced availability of tetrahydrobiopterin, the essential cofactor for the formation of noradrenaline, serotonin and dopamine, may exert rate limiting control over the synthesis of monoamines implicated in the pathogenesis of depressive disorders. The N:B ratio may be a marker for certain depressive subtypes and response to ECT.

Adult↗
PubMed1992

Antibody production in silkworm cells and silkworm larvae infected with a dual recombinant Bombyx mori nuclear polyhedrosis virus.

We have examined the efficiency of coexpression of two heterologous genes from a recombinant Bombyx mori nuclear polyhedrosis virus for the production of antibodies in silkworm larvae. The cDNAs encoding the light and the heavy chains of a murine immunoglobulin, directed against lipoprotein I of Pseudomonas aeruginosa, were brought under the control of two separate copies of the viral polyhedrin promotor. Infection of silkworm cells with the recombinant baculovirus yielded a maximum of 6.4 micrograms/ml IgG2A in the culture supernatant 72 hours post infection, while 800 micrograms/ml IgG2A was found in the hemolymph of infected fifth instar silkworm larvae seven days after infection with the same construct. The recombinant antibody exhibited a similar antigen specificity and avidity to that of the monoclonal antibody derived from ascites fluid.

Animals↗
PubMed1992

Sequential estrogen receptor determinations from primary breast cancer and at relapse: prognostic and therapeutic relevance. The International Breast Cancer Study Group (formerly Ludwig Group).

We retrospectively evaluated 401 selected patients who had estrogen receptor (ER) assays both at primary surgery and at relapse in an accessible site to determine the clinical relevance of the subsequent ER determination. The median time between ER assessments was 27 months (range: 2-122 months). The median follow-up time from diagnosis was 6 years (range: 2-12 years). For patients with ER+ tumors at primary diagnosis, 29% (76/261) had ER- tumors at relapse, while for ER- primaries, the conversion rate was 33% (46/140). Conversions from ER+ to ER- occurred more often when the time interval between assays was less than one year (p = 0.004), while conversions from ER- to ER+ tended to occur late (beyond three years; p = 0.0003). Treatments received between assays (usually adjuvant therapy) had only a slight influence on ER status conversion. Post-relapse survival was poor for patients who had the biopsy accessible recurrence within one year; an expression of the aggressive nature of the disease. Among patients whose accessible relapse was beyond one year, those with ER- primaries who converted to ER+ had a longer survival than those whose recurrence was classified again as ER- (p = 0.006). This group of patients with ER- primaries who recurred beyond one year with an ER+ tumor in an accessible site represented 29% (40/140) of all patients with ER- primaries and had an estimated overall survival rate of more than 60% at 6 years from the accessible relapse. ER determination upon relapse within one year has very little clinical relevance.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Combined antitumor therapy with the chemotherapeutic drug doxorubicin and an anti-transferrin receptor immunotoxin: in vitro and in vivo studies.

We have determined the in vitro and in vivo efficacy of the combination of doxorubicin and an anti-transferrin receptor-monoclonal antibody (MAb)-ricin A chain immunotoxin. These agents both possess antineoplastic activity and their differing mechanisms of action and toxicities suggest that they may work well in combination. In vitro cytotoxicity was assayed by the inhibition of both 3H-leucine and 3H-thymidine incorporation into H-MESO-1 human malignant mesothelioma cells. In vivo, tumoricidal activity was determined by the effect of treatment on the survival of nude mice bearing H-MESO-1 as an intraperitoneal xenograft. The effect of doxorubicin on the antitumor activity of immunotoxin was directly compared to that of monensin, a well-described immunotoxin potentiator. The coincubation of doxorubicin (1 microM) with immunotoxin in vitro produced no increase in cytotoxicity or rate of cell kill when compared to immunotoxin alone. The addition of monensin to immunotoxin produced a significant increase in both cytotoxicity and the rate of cell kill. In animal trials, all treated groups demonstrated a significant increase in median survival when compared to controls. Treatment with doxorubicin or immunotoxin produced a mean survival time (MST) of 22 and 23 days, respectively, vs. control MST of 10 days. The combination of immunotoxin and doxorubicin increased the MST to 31 days (p = 0.004 vs immunotoxin or doxorubicin alone). Immunotoxin combined with monensin emulsion produced an increase in survival equivalent to doxorubicin/immunotoxin. The use of all three agents produced an additional improvement in survival. Combinations of standard chemotherapeutic drugs and ricin A chain immunotoxins may have additive antitumor effects in the therapy of solid tumors.

Animals↗
PubMed1992

Polymerase chain reaction in detection of CMV DNA in renal allograft recipients.

This study investigates the use of polymerase chain reaction (PCR) in comparison with viral culture and serology for monitoring of cytomegalovirus (CMV) infection in 21 consecutive renal allograft recipients treated with a quadruple immunosuppression protocol. In addition, an attempt is made to explore the significance of quantitation of CMV signals obtained from peripheral blood leucocytes. CMV infection developed in 16 patients with seven of these patients having organ involvement. All of these 16 patients had a fourfold rise in antibody titres as well as positive identification of CMV DNA in peripheral blood leucocytes by PCR. Blood viral cultures were negative in two of these patients. All five patients who remained PCR negative also remained culture negative with no antibody change. PCR detected CMV infection on average 15 days and 20 days earlier than viral culture and serology respectively. All except one of the patients with CMV organ involvement had an initial peak of CMV DNA followed by prolonged carriage of detectable CMV. The majority of patients with fever only or asymptomatic CMV infection had a transient peak of CMV DNA. A high incidence of CMV disease with organ involvement occurred in seronegative recipients of kidneys from seropositive donors (3/5) and in seropositive recipients of kidneys from seronegative donors (3/7). OKT3 was associated with a higher incidence of CMV organ involvement compared to Antilymphocytic globulin (3/5 v 4/16) but there was a higher incidence of CMV mismatched patients in the OKT3 treated group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Changing perceived control in patients with physical disabilities: an intervention study with patients receiving rehabilitation.

Physiotherapy patients' perceptions of personal control over recovery (during rehabilitation) have been shown to be predictive of their progress. An experimental letter, consisting of the routine appointment letter plus some paragraphs designed to increase perceived control, was sent to 39 randomly selected patients prior to their first appointment. The remaining 32 control patients received the routine letter only. Approximately one week after each patient's first appointment, all patients were interviewed. The group to whom the experimental letter had been sent were found, on average, to have significantly higher levels of perceived control and tended to be more satisfied with information than the control group. There were no significant differences between groups on accuracy of expectations of physiotherapy. It is suggested that this type of communication given prior to treatment might lead to patients making better and faster progress with recovery. However, this possibility needs to be investigated by further study.

Persons with Disabilities↗
PubMed1992

Mycobacteria in Crohn's disease: DNA probes identify the wood pigeon strain of Mycobacterium avium and Mycobacterium paratuberculosis from human tissue.

Mycobacterium paratuberculosis is known to cause Johne's disease, a granulomatous ileitis in ruminants, and may be involved in some cases of Crohn's disease. Like M. paratuberculosis, the wood pigeon strain of Mycobacterium avium may also show mycobactin dependence on primary isolation that is attenuated on further subculturing. A wood pigeon strain, M. avium restriction fragment length polymorphism (RFLP) type A/I, is also capable of causing granulomatous ileitis in experimental animal models but is not known to cause disease in humans. M. avium RFLP type A is associated with disease in immunocompromised hosts. Three DNA probes, pMB22 and the two subclones pMB22/S4 and pMB/S12, were found to be capable of distinguishing among M. paratuberculosis, M. avium type A, and M. avium type A/I (wood pigeon strain) on the basis of RFLPs. These DNA probes were used to identify two mycobacterial isolates (M. paratuberculosis and M. avium type A/I, wood pigeon strain) derived from the intestinal tissues of two patients with Crohn's disease. In addition, the wood pigeon strain of M. avium was identified from a patient with ulcerative colitis, and M. avium RFLP type A was identified from a patient with colonic carcinoma. This is the first time that M. avium A/I (wood pigeon strain) is known to have been isolated from human tissue. There are too few isolates to speculate about the etiological significance of mycobacteria and inflammatory bowel disease, but it is reasonable to conjecture that M. paratuberculosis may be responsible for some cases of Crohn's disease and that the wood pigeon strain of M. avium may also be an inflammatory bowel disease pathogen in humans.

Crohn Disease↗