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Biomedical subjects

J D Berg

Publications and source records attributed to J D Berg.

At least 19 recordsLinked to original sources
PubMed2003

Steroid-induced elevation of glucose in Alzheimer's disease: relationship to gender, apolipoprotein E genotype and cognition.

Glucose and insulin may play an important role in the pathophysiology and symptomatology of Alzheimers disease (AD), and prior studies suggest interactions among glucose, insulin, gender and apolipoprotein E genotype. We analyzed the relationship between steroid-induced glucose elevation and gender, presence of the apolipoprotein E epsilon 4 (APOE-4) allele and cognition using data from a multicenter trial of prednisone therapy in AD. The low-dose prednisone regimen (initial dose: 20 mg/day, maintenance dose: 10 mg/day) caused a moderate increase in random blood glucose (mean post-baseline glucose 115 mg/dl). There was a significant interaction between rise in glucose, gender and presence of the APOE-4 allele. There was no important relationship between glucose and cognitive function at baseline or with prednisone treatment. Meta-analysis including data from three other AD trials showed a small influence of random blood glucose on cognitive scores. These results support a relationship between gender, apolipoprotein E genotype and glucose metabolism, but do not indicate that mild changes in glucose have an important impact on cognitive function.

Alleles↗
PubMed2002

Monitoring faecal contamination of the Thames estuary using a semiautomated early warning system.

The Colifast Early Warning System, based on measuring beta-galactosidase activity (2 h method), was evaluated for monitoring the level of faecal contamination in the upper tidal Thames. Two trials were performed, one following heavy rain in November 2000, the next during a dry and sunny period in July 2001. In general the beta-galactosidase activity and the two coliform reference methods (recovery following membrane filtration with membrane lauryl sulphate broth (MLSB) and Colilert Quantitray) were comparable. However, in several samples in July the beta-galactosidase activity seemed to overestimate the number of culturable coliforms, suggesting that the rapid enzymatic method detected beta-galactosidase produced by other bacterial sources, such as Aeromonas spp. or Vibrio spp., or nonculturable coliforms. The later could be attributed to sunlight-induced injury. Nevertheless, the rapid method based on beta-galactosidase activity gave an estimate of the level of culturable coliforms, which did not differ from both coliform reference methods by more than one log. Monitoring of beta-galactosidase activity in river water samples using the Colifast Analyser may therefore be useful as an early warning indicator of faecal contamination.

Automation↗
PubMed2001

Early warning of faecal contamination of water: a dual mode, automated system for high- (< 1 hour) and low-levels (6-11 hours).

There is a recognised need for methods that permit rapid estimation of the sanitary quality of water e.g. during raw water monitoring and emergencies involving water treatment failure or main breaks in a distribution network. In this study, two models for predicting the level of faecal contamination of water were studied. The first format, based on measurement of beta-galactosidase activity by the automated Colifast analyser, detected faecal contamination of high levels, corresponding to > 15 thermotolerant coliforms (FC)/5 mL, in 1-3 h, in a format that allowed for semi-quantification of results. By setting up a cut-off level, the system could be used as an operational tool identifying random increases in faecal contamination during routine raw water monitoring. A second Presence-Absence format was dependent upon the growth of low levels of FC with subsequent detection in the Colifast analyser. 95% of water samples containing 1-15 FC/sample volume showed positive detection after 11 h.

Automation↗
PubMed2000

A randomized controlled trial of prednisone in Alzheimer's disease. Alzheimer's Disease Cooperative Study.

BACKGROUND: Laboratory and epidemiologic studies suggest that anti-inflammatory/immunosuppressive therapy may be useful in the treatment of AD. In preliminary studies, a regimen of low to moderate dose prednisone was found to suppress peripheral inflammatory markers without adverse effects in subjects with AD. METHODS: We conducted a randomized, placebo-controlled multicenter trial to determine whether prednisone treatment slowed the rate of cognitive decline in AD. The active treatment regimen consisted of an initial dose of 20 mg of prednisone daily for 4 weeks tapered to a maintenance dose of 10 mg daily for 1 year, followed by gradual withdrawal during an additional 16 weeks. The primary outcome measure was the 1-year change in the cognitive subscale of the AD Assessment Scale. RESULTS: A total of 138 subjects were randomized to the drug and placebo groups. There was no difference in cognitive decline between the prednisone and placebo treatment groups in the primary intent-to-treat analysis, or in a secondary analysis considering completers only. Subjects treated with prednisone showed behavioral decline compared with those in the placebo group. CONCLUSION: A low-dose regimen of prednisone is not useful in the treatment of AD.

Aged↗
PubMed2000

Field evaluation of a semiautomated method for rapid and simple analysis of recreational water microbiological quality.

An early warning system using a rapid enzymatic semiautomated method suitable for fecal coliform detection in recreational waters within 8 h was developed further and evaluated in this study. This rapid method was compared to the standard method followed in the United Kingdom. We used 1,011 samples originating from 206 different locations in Wales. When we assessed the presence or absence of fecal coliforms, targeting very low levels of contamination, we obtained 83.9% agreement between the rapid method and the lauryl sulfate broth-membrane filtration technique, whereas direct confirmation of the samples processed by the rapid method showed 89. 3% agreement. Environmental enzymatic background activity was found to be the main limiting factor for this method. Owing to a specific and integrated handling of the results by the software of the instrument, the percentage of false-positive results (a consequence of enzymatic background) was successfully limited to 2.9% by the direct confirmation evaluation. However, 7.8% false-negative results due to "late-growers" had to be accepted in order to produce results within a working day. At present, the method can be used in a more conservative way to assess the environmental threshold of 100 CFU of fecal coliforms per 100 ml in recreational waters. The implications of our findings with regard to the applicability of rapid enzymatic methods are discussed.

Acinetobacter↗
PubMed1999

Nursing home placement is related to dementia progression: experience from a clinical trial. Alzheimer's Disease Cooperative Study.

OBJECTIVES: To examine the relationship between nursing home placement (NHP) and measures of change in other well-established clinical disease assessments in a longitudinal study of patients with probable AD. BACKGROUND: NHP is a common, major milestone in the natural history of AD. NHP is a readily identified event that can be accurately dated. NHP can be used in survival analyses, which are an efficient means of determining efficacy in clinical trials. NHP usually occurs in the setting of severe AD, but in cross-sectional studies, the strength of the association with disease severity has been controversial. DESIGN/METHODS: We used data from 341 AD patients who were enrolled in a recently published clinical trial of selegiline and tocopherol. At entry, all were rated as Clinical Dementia Rating (CDR) stage 2, were community-dwelling, and had an identified caregiver. Patients were followed at 3-month intervals for 2 years. We examined the relationship between four measures of dementia severity and a measure of behavioral dysfunction and NHP. The measures included changes in CDR status, changes in activities of daily living performance, changes from baseline to last measurement in dependence level, changes from baseline to last measurement on the Blessed Dementia Rating Scale (BDRS) score, and changes from baseline to last measurement on the total score and subscales of the Behavior Rating Scale for Dementia (BRSD). Statistical models were used to assess the strength of the associations. RESULTS: At the end of the 2-year period, 33% of patients had been institutionalized. The NHP patients did not differ at baseline from the not-NHP patients in gender, age, caregiver status, duration of illness, CDR sum of boxes, BDRS, or dependence level. The NHP patients had a lower baseline Mini-Mental State Examination score and a slightly worse BRSD total score. Patients reaching CDR3 were eight times more likely to be institutionalized than those who remained at CDR2. The change scores on all four dementia severity measures were strongly associated with NHP; the change score on the BRSD and its subscales were not. On the other hand, adverse events that included a behavioral disturbance, especially agitation, were associated with NHP. CONCLUSION: These data show that NHP closely reflects dementia progression in the context of a clinical trial. Coupled with the high face validity of NHP as a milestone of severe dementia, NHP is a valid primary outcome measure for AD clinical trials.

Aged↗
PubMed1993

A novel reconstructive technique for pylorus-preserving pancreaticoduodenectomy: avoidance of early postoperative gastric stasis.

In 30 patients a reconstructive technique was used after pylorus-preserving pancreaticoduodenectomy in which the anastomoses were constructed in the sequence: duodenojejunal, hepaticojejunal (8-10 cm distal) and finally duct-to-mucosa pancreaticojejunal to a separate Roux loop. Indications for surgery included periampullary tumours, (n = 13), carcinoma of the head of the pancreas (n = 10) and chronic pancreatitis (n = 4). No patient required prolonged (> 7 days) nasogastric intubation for primary gastroparesis in the early postoperative period. Postoperative morbidity (17% overall) delayed recovery and return of gastrointestinal function in one patient with a minor biliary leak (closed with 5 days' somatostatin treatment). Other morbidity included gastrointestinal haemorrhage (n = 1), wound infection (n = 2) and respiratory infection (n = 2). There were no pancreatic leaks. One patient died from a subhepatic abscess (mortality 3%). Retrospective investigations, at 3-18 months postoperatively, included endoscopy (normal in 20 patients, none taking anti-ulcer therapy), gastric emptying studies in the first 10 patients (no delay) and bentiromide test in 12 patients considered to have normal pancreatic remnants (all patients > 24% PABA excretion index). All patients who underwent resection for tumour returned to their preoperative weight.

Adult↗
PubMed1991

Theophylline analysis at the chest clinic--comparison of a portable versus conventional system.

The running cost and clinical application of a new, portable, direct-injection, high-performance, liquid chromatograph for the measurement of theophylline was compared with conventional laboratory-based analysis by studying the two methods in two parallel chest clinics. Thirty-six patients were managed with the portable method and 33 by the conventional system. They were already receiving theophylline preparations for treatment of their asthma or chronic airflow limitation. Over the 12-week period of study, the percentage of patients with levels in the therapeutic range rose from 33% to approximately 87% in both clinics, but this change was achieved in only 6 weeks using the portable system. Patients whose theophylline levels were increased into the therapeutic range had improved symptom scores as measured by visual analogue scales but we were unable to demonstrate any significant change in spirometry. The cost of the portable system compared favourably with laboratory analysis, and had the additional benefit of quicker detection of non-compliance and facility for discussion with the patients at the time of consultation.

Adult↗
PubMed1988

Rapid detection of total and fecal coliforms in water by enzymatic hydrolysis of 4-methylumbelliferone-beta-D-galactoside.

Three fluorogenic methylumbelliferone (MU) substrates were evaluated for rapid detection of total and fecal coliform bacteria (TC and FC) in drinking water. 4-MU-beta-D-galactoside, MU-heptanoate, and MU-glucuronide were used to determine enzyme activity as a surrogate measure of coliform concentration. Coliforms occurring in river water and in potable water artificially contaminated with raw sewage were tested. The initial rate of hydrolysis (delta F) of MU-beta-D-galactoside showed promise as an indicator of TC and FC within 15 min. delta F of MU-glucuronide was insufficient in the 15-min assay, and combinations of the MU substrates did not enhance delta F. A direct membrane filter method incorporating MU-beta-D-galactoside into an agar medium allowed the detection of as few as 1 FC per 100 ml within 6 h.

Colony Count, Microbial↗
PubMed1988

Simplified oral pancreatic function test.

The standard Bentiromide test and a new modified test using p-aminosalicylic acid (PAS) as a pharmacokinetic marker for p-aminobenzoic acid (PABA) have been evaluated in the detection of pancreatic exocrine insufficiency in children. The conventional two day test using a colorimetric assay for urinary PABA discriminated poorly between five children with pancreatic insufficiency and 13 others with normal pancreatic function. Two further groups of patients, comprising 28 with pancreatic exocrine insufficiency and 20 with normal pancreatic function underwent the modified test, and urine samples were analysed by high performance liquid chromatography. The results showed a complete separation between groups. The use of PAS eliminates a number of sources of error inherent in a two day Bentiromide test and provides a simplified and accurate diagnostic test for pancreatic insufficiency. The PABA-PAS modified test enables collection of the urine to be done during a single six hour period.

4-Aminobenzoic Acid↗
PubMed1987

Antimicrobial activity of electrolyzed saline solutions.

Electrolysis of solutions containing certain electrolytes, through the use of novel electrodes, produces significant levels of ozone, oxygen, and chlorine at the anode. The process works at ordinary temperatures, and with dilute solutions. These solutions, after electrolysis, can be much more effective, by a factor of several hundred, against microorganisms than solutions containing comparable hypochlorite solutions.

Anti-Bacterial Agents↗
PubMed1987

Evaluation of a fluorescent antibody technique for the rapid enumeration of Bacteroides fragilis group of organisms in water.

The Bacteroides fragilis group has been evaluated as a prospective rapid indicator of faecal contamination of water. Fluorescent antibody (FA) stained B. fragilis group bacteria were enumerated microscopically and compared with faecal coliform or Escherichia coli counts as indicators of faecal contamination. Environmental samples included surface waters (raw drinking water and known contaminated water). Laboratory disinfection experiments with ozone, chlorine and u.v. radiation were also performed. Bacteroides FA counts specifically detected recent human faecal contamination in field samples in 2-3 h. Samples with a high content of particulates or debris limited the sensitivity to about 10 FA counts/ml. Viable counts showed that the sensitivity to all three disinfection agents was essentially the same for Bacteroides and E. coli. Fluorescent antibody counts of Bacteroides, conversely, were not altered by any of the agents. Therefore, the Bacteroides FA method is not recommended for routine monitoring but may be useful for cases where extensive human faecal contamination is suspected (e.g. pipeline rupture or pollution of recreational water) and where rapid remedial action must be taken to protect the public health.

Bacteroides↗
PubMed1987

Drugs as probes of organ function: evaluation of the hepatobiliary axis using oral rifampicin and novel high performance liquid chromatography.

Investigation of the uptake and metabolism of drugs by organs such as the liver may allow assessment of specific aspects of organ function. Rifampicin, when orally administered, is transported into the hepatocyte from portal blood and thence passes, with its deacetylated metabolite, into the systemic circulation and into bile. This paper reports an investigation of the pharmacokinetics of a sub-therapeutic oral dose of rifampicin in healthy subjects, in patients with cirrhosis and in subjects with Gilbert's syndrome. The areas under the plasma concentration curves (AUC) in patients with cirrhosis were significantly greater than in healthy subjects. Subjects with Gilbert's syndrome had decreased AUCs compared with healthy subjects and were clearly distinguished from patients with cirrhosis. Rifampicin concentration in serum was measured by HPLC using a novel direct injection technique.

Acetylation↗
PubMed1987

Rapid measurement of anticonvulsant drug concentrations in the out-patient clinic, using HPLC with direct injection of plasma.

A manual column-switching technique is described for the measurement of phenytoin, phenobarbitone, carbamazepine, and carbamazepine 10,11-epoxide. The analytical system is designed to be portable for use at the out-patient clinic and comprises an isocratic pump, UV detector and injection valve, together with a preparation column. Diluted plasma or serum is injected, without pre-extraction, onto a preparation column which replaces the sample loop on the injection valve. After washing unwanted material to waste, the preparation column is switched in-line with the analytical column, where separation of analytes occurs. The precision, accuracy and carryover of this extra-laboratory system are comparable with those obtained with laboratory-based immunoassay systems. Operation of the system allows the reporting of results within 5 min of sample injection and requires no specialist skills. The technique should be of particular interest to district general hospital laboratories where workload does not justify the cost of an automated HPLC system as the total capital cost is comparable to that of a portable glucose analyser. In contrast to immunoassay systems consumable costs are minimal. The equipment is easy to transport and may be used in the out-patient department to provide an analytical service similar to that provided for the determination of prothrombin time at the anticoagulant clinic.

Carbamazepine↗
PubMed1986

Effect of chlorine dioxide on selected membrane functions of Escherichia coli.

The mode of action of chlorine dioxide on Escherichia coli was assessed by studying outer membrane permeability to macromolecules and potassium, and observing effects on respiration. The results indicate that gross cellular damage involving significant leakage of intracellular macromolecules does not occur. There was a substantial efflux of potassium, however, and respiration was inhibited even at sublethal doses. It was concluded that the inhibition of respiration, which could be due to the damage to the cell envelope, was not the primary lethal event. Observations of the efflux of K+ strongly implicate the loss of permeability control as the primary lethal event at the physiological level, with nonspecific oxidative damage to the outer membrane leading to the destruction of the trans-membrane ionic gradient.

Cell Membrane↗