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Biomedical subjects

J Doyle

Publications and source records attributed to J Doyle.

At least 19 recordsLinked to original sources
PubMed1999

Effect of pulsed dexamethasone therapy on tolerance of intravenously administered lipids in extremely low birth weight infants.

We investigated the effect of dexamethasone on parenteral lipid tolerance in 7-day-old extremely low birth weight infants (n = 28) in a randomized, double-blind trial. Serum triglycerides were measured before and after 3 days of dexamethasone or placebo treatment. Infants treated with dexamethasone responded with higher triglyceride concentrations and greater sensitivity to incremental increases in the intravenous lipid dose.

Dexamethasone↗
PubMed1999

The effect of induced mood states on performance profile areas of perceived need.

The performance profile technique is now widely used by a range of sports scientists, usually as the first step in implementing a training programme. The aim of this study was to examine the effect of altered mood states on areas of perceived need for an individual identified by the performance profile. Sixty-seven university sports science students (30 females, 37 males) participated in the study. They completed their performance profile and a shortened version of the Bi-polar Profile of Mood States before and after four separate mood manipulation treatments (happy, sad, neutral, control). The participants were allocated at random to one of four groups and completed the treatments in a counterbalanced order. Mood manipulation checks identified that both the happy and sad manipulations were successful. Profile areas of perceived need, identified through discrepancies in an individual's perceptions of ideal and current state, were not affected by the sad and neutral manipulations or by the control condition. However, areas of perceived need were significantly lower after the happy mood manipulation than before the treatment. Our results show that asking individuals to complete their profiles when in a happy mood state is likely to affect judgements and result in an underestimation of perceived need for improvement.

Adult↗
PubMed1999

The influence of training on tinnitus perception: an evaluation 12 months after tinnitus management training.

Sixty-five subjects were reviewed 12 months after tinnitus management training, which had been comprised variously of information, relaxation training and a therapeutic noise strategy. Seventy-four per cent of subjects reported increased habituation to tinnitus (n = 48), 65% reported reduced tinnitus annoyance (n = 42), and 52% reported an increased ability to cope with tinnitus (n = 34). Twenty-five per cent of subjects reported deterioration in coping ability (n = 16), 23% reported reduced habituation to tinnitus (n = 15) and 8% reported increased tinnitus-related annoyance (n = 5). None of the management strategies were found to be significantly more effective than others in facilitating improved coping or habituation to tinnitus. Subjects who reported reduced coping and habituation to tinnitus experienced greater levels of general life stress than subjects who reported increased habituation and coping ability. The use of relaxation therapies as applied in this study did not appear to influence the level of tinnitus distress or the level of life stress. Thirty-seven per cent of subjects given long-term low-level white noise (LTWN) stimulation reported benefit. However, LTWN stimulation did not significantly alter tinnitus awareness or the minimum masking level (MML) of tinnitus. Long-term low-level white noise stimulation appeared to influence cognitive reaction to tinnitus rather than its physical perception. Subjects who initially had low ability to cope with tinnitus and preferred a more active coping style reported significantly greater benefit from LTWN stimulation than subjects whose primary approach to coping was to regulate the emotional impact of tinnitus.

Adaptation, Psychological↗
PubMed1998

A high-throughput, microtiter plate assay for paralytic shellfish poisons using the saxitoxin-specific receptor, saxiphilin.

An isoform of the paralytic shellfish poison (PSP)-specific receptor saxiphilin, from the tropical centipede Ethmostigmus rubripes, was used as the basis for a radiometric, high-throughput, microtiter plate assay for this group of toxins. Characterization of the assay revealed that it was able to detect several representatives from the various structural PSP subgroups and yet was insensitive toward tetrodotoxin. To test the utility of the assay as a seafood toxin-monitoring tool, the assay was subjected to a variety of marine organism extracts, some of which were known to contain PSPs, and whole extract toxicity expressed as STX equivalents (STXeq) was measured by two methods: First, by comparison of values from a screening assay with a standard STX inhibition curve and, second, for highly active extracts, by calculation using the IC50 from a full inhibition curve of the extract. For extracts which could be quantified by both methods, there was almost 100% correlation between the derived values. STXeq derived by both methods from the bioassay highly correlated with absolute toxin quantities from HPLC analysis.

Amphibian Proteins↗
PubMed1998

The effect of ongoing litigation on outcome scores following open reduction and internal fixation of the calcaneum.

All sixteen patients who had undergone open reduction and internal fixation (ORIF) of the calcaneum by the senior author between April 1993 and August 1996 were included in the study. Two had died from unrelated illnesses and one had failed to attend any follow-up following discharge. The remaining 13 were reviewed by the main author. As part of a complete clinical, radiological and functional assessment, Buckley and Meek (B&M) and Kerr and Atkins (K&A) outcome scores were calculated as well as a satisfaction score obtained by a visual analogue scale (VAS). Statistical analysis of the results using Wilcoxen's paired and unpaired ranking scores showed that the initial grade of the fracture, degree of operative reduction, correction of width of the heel and post-operative ranges of motion had no significant correlation to either B&M or K&A outcome scores or to the VAS score. However, the presence of ongoing litigation was significantly correlated to the scores (VAS < 0.01, B&M < 0.05, K&A < 0.05). These findings cast doubt on the validity of post operative scoring for fracture of the calcaneum in the presence of ongoing litigation.

Calcaneus↗
PubMed1998

New indications for radical prostatectomy.

PURPOSE: Radical prostatectomy is considered the gold standard for treatment of localized prostate cancer, either as primary or salvage therapy. Recently with the advent of increased organ transplantation, use of prostatic specific antigen for cancer detection and cryoablation as an alternative treatment, more men with prostate cancer can be considered for radical surgery. We review these new indications. MATERIALS AND METHODS: Clinically localized untreated prostate cancers were identified in 3 men being considered for cardiac or lung transplantation (group 1), and 4 men originally treated with transperineal cryoablation had local relapse (group 2). All 7 men underwent radical prostatectomy. RESULTS: Organ confined cancer (pT2C) was found in all 3 patients in group 1. All 3 men underwent successful cardiac or lung transplantation 1 to 12 months after radical prostatectomy, and they are disease-free at short-term followup. Of the group 2 patients 2 had organ confined disease (pT2b and c) and 2 had extensive extraprostatic disease (pT3cN1 and pT3cN0). Only 2 patients remain disease-free and do not require adjuvant endocrine therapy. Major perioperative complications of rectotomy and total incontinence occurred only in group 2 patients. CONCLUSIONS: Patients being considered for heart and lung transplantation need to be free of concurrent malignancy because of immunosuppressive therapy. Radical prostatectomy can achieve this goal in select patients. Cases of failed cryoablation can be salvaged with radical prostatectomy but with less chance of success and with greater risk of complications.

Aged↗
PubMed1998

Psychobiology and the athlete with anterior cruciate ligament (ACL) injury.

Over the past decade, research has increasingly highlighted the need for psychological aspects associated with sporting injury to be considered in treatment programmes. However, contemporary practice continues to focus on the treatment of the physical injury. The purpose of this article is to summarise research and contemporary thoughts on the psychological aspects associated with sporting injury. The potential for incorporating both physical and psychological aspects into the treatment of injury is discussed with special reference to the anterior cruciate ligament (ACL) injury. Specifically, the potential importance of athlete involvement throughout the treatment programme is discussed. Additionally, the physical and psychological measures that are available to the sports medicine team to measure rehabilitation outcome are critically evaluated. The limitations of psychological measures of the athlete's perception of outcome are outlined. Evidence for the utility of the performance profile technique is critically evaluated. The technique provides valid and reliable measures of the idiosyncratic responses of athletes to injury to provide a framework for effective treatment for optimised outcome.

Anterior Cruciate Ligament Injuries↗
PubMed1998

Prisoners as patients. The experience of delivering mental health nursing care in an Australian prison.

Correctional or prison mental health nursing is a highly specialized area of practice that has undergone substantive role development in recent years. However, little research has explored aspects of prison-based nursing practice or practice arrangements. The experience of delivering mental health nursing care in prison can be disempowering, resulting in feelings of frustration, isolation, and stigma. In developed nations, prison mental health nurses face the rewarding challenge of gaining greater recognition for the specialized nature of their practice and their key role in the correctional and criminal justice continuum.

Female↗
PubMed1997

Mutations in the Cacnl1a4 calcium channel gene are associated with seizures, cerebellar degeneration, and ataxia in tottering and leaner mutant mice.

Tottering and leaner, two mutations of the mouse tottering locus, have been studied extensively as models for human epilepsy. Here we describe the isolation, mapping, and expression analysis of Cacnl1a4, a gene encoding the alpha subunit of a proposed P-type calcium channel, and also report the physical mapping and expression patterns of the orthologous human gene. DNA sequencing and gene expression data demonstrate that Cacnl1a4 mutations are the primary cause of seizures and ataxia in tottering and leaner mutant mice, and suggest that tottering locus mutations and human diseases, episodic ataxia 2 and familial hemiplegic migraine, represent mutations in mouse and human versions of the same channel-encoding gene.

Amino Acid Sequence↗
PubMed1997

Platelet and immune responses to oral cyclic dexamethasone therapy in childhood chronic immune thrombocytopenic purpura.

OBJECTIVE: To examine the effectiveness of cyclic oral high-dose (HD) dexamethasone therapy in pediatric patients with chronic immune thrombocytopenic purpura (ITP), which has been reported to cause complete remission in adults with chronic ITP. STUDY DESIGN: Eleven children with primary chronic ITP, with a median disease duration of 28 months (range, 6 to 120 months), were treated with cycles of HD dexamethasone therapy. RESULTS: Excellent short-term responses (initial platelet counts < or = 50 x 10(9)/L, increasing to > 100 x 10(9)/L within 72 hours of completion of an HD dexamethasone cycle) were observed in 78% of 41 cycles. Long-term effects include one complete response (platelet count > or = 150 x 10(9)/L) and three partial responses (platelet count > or = 50 and < 150 x 10(9)/L) in 11 children followed for 6 or more months after completing cyclic HD dexamethasone therapy. Because side effects were substantial, three children did not complete their sixth treatment cycle. At day 6 of treatment, B lymphocytes were significantly increased (p = 0.005). CONCLUSIONS: Dexamethasone, given orally in high doses, is an effective drug in achieving short-term platelet responses, but it induced long-term remissions in fewer than half of the children with well-established chronic ITP. Its effect on B lymphocytes requires further elucidation. A prospective, controlled study will be needed to establish whether cyclic HD dexamethasone therapy can alter the natural history of children with early chronic ITP and thus avoid splenectomy.

Administration, Oral↗
PubMed1997

Does vitamin C cause hemolysis in premature newborn infants? Results of a multicenter double-blind, randomized, controlled trial.

OBJECTIVE: We tested the hypothesis that vitamin C supplementation of premature neonates is associated with hemolysis. STUDY DESIGN: A double-blind, randomized, controlled trial of vitamin C supplementation (50 mg/day) was undertaken in premature neonates (birth weight, 1000 to 1500 gm). Infants were randomly assigned to receive vitamin C (Ce-Vi-Sol) (n = 32) or placebo (n = 24) for 14 days. Twenty-three subjects per group were required to detect a difference of 1 SD in corrected carboxyhemoglobin values (alpha = 0.05, beta = 0.10). RESULTS: Day 14 vitamin C levels were lower in control subjects than in supplemented neonates (62 +/- 24 vs 125 +/- 62 micromol/L, p = 0.005). There was no difference in corrected blood carboxyhemoglogin concentrations (0.72 +/- 0.44 vs 0.72 +/- 0.23%; p = 0.95), other parameters of hemolysis, weight gain, blood sampled, presumed septic episodes, necrotizing enterocolitis, feeding intolerance, or transfusion. On day 14, bilirubin values were higher in control subjects than in the supplemented group (77 +/- 37 vs 55 +/- 33 micromol/L; p = 0.04). When a distant outlier in the nonsupplemented group was excluded (163 micromol/L), statistical significance was lost (73 +/- 32 vs 55 +/- 33 micromol/L; p = 0.09). CONCLUSION: Oral supplementation of premature infants with vitamin C is not associated with evidence of increased erythrocyte destruction, hyperbilirubinemia, or other morbidity.

Anemia, Hemolytic↗
PubMed1997

Leukemia and/or myeloproliferative syndrome in neonates with Down syndrome.

Approximately 10% of newborn infants with Down Syndrome develop a form of megakaryoblastic leukemia which usually disappears spontaneously during the first months of life. The evidence that this "Transient Leukemia" is truly leukemia includes the following: it is clonal proliferation, it can be fatal and tissue infiltration of leukemic cells occurs. Also in approximately 25% of cases that recover, Acute Megakaryoblastic Leukemia will develop in the first four years of life, which, if not treated, is fatal. Evidence regarding the megakaryoblastic nature of the leukemic cells is presented as well as a description of the lethal forms of the disease. The study of Transient Leukemia is of considerable importance because it can provide insight into both the nature of leukemia and its relation to trisomy 21.

Biopsy↗
PubMed1997

An improved limited sampling method for individualised busulphan dosing in bone marrow transplantation in children.

Busulphan (BU) pharmacokinetic (PK) studies in children undergoing bone marrow transplantation suggest that individual BU dosing may be necessary to optimise BU systemic exposure. Optimising BU systemic exposure may improve outcome and decrease toxicity in BMT. Because of practical limitations in obtaining blood from children and for financial reasons, a limited sampling method (LSM) is needed. However, such methods for BU have not been validated in children. In the present study, we individualized oral BU dosing in 10 children to target an area under the curve of BU (BU AUC) of 900-1400 microM/min based on BU AUC(0-infinity) calculated from nine serum BU concentrations performed after a BU test dose of 40 mg/m2. We validated a LSM using 3 BU concentrations to determine AUC. Six of nine patients studied (one patient non-evaluable), required their doses modified (3, lower; 3, higher). The mean percent dose change was 26.2% (range -33.3% to +45.3%). Our three sample LSM BU AUC(0-infinity) (1098 +/- 344, mean +/- 1 s.d.) correlated highly with our nine sample BU AUC(0-infinity) (1132 +/- 389, Pearson r = 0.98, P = 0.0001) and was not significantly different by t-test (P = 0.3). The mean percentage difference between the three sample LSM AUCs and the nine sample AUCs in each of our patients was 7.5%, (range -10.99% to +9.4%). Trough levels correlated extremely well with AUC (r = 0.95, P = 0.0001). Individual BU dosing, based on AUC, is necessary in most children to achieve targeted levels of BU therapy. An LSM of three BU concentrations performed at 0.5 h, 1 h and 6 h post-BU test dose closely predicts the AUC calculated from nine sampling points.

Alkylating Agents↗
PubMed1997

Controlled pilot study of rapid amphotericin B infusions.

This pilot study compared the toxicity of a one hour with a four hour amphotericin B infusion in children. There were more severe chills in the former group on the first day of infusion, and more hypotension in the latter group over the study duration.

Adolescent↗
PubMed1997

Analysis of the cost-effectiveness of paclitaxel as alternative combination therapy for advanced ovarian cancer.

PURPOSE: A phase III trial by the Gynecologic Oncology Group (GOG) provides strong evidence that a new alternative therapy--paclitaxel (Taxol; Bristol-Myers Squibb Co, Princeton, NJ) in combination with cisplatin (Platinol; Bristol-Myers Squibb Co)--is clinically more effective than the standard therapy using cyclophosphamide (Cytoxan; Bristol-Myers Squibb Co) in combination with cisplatin in the treatment of advanced ovarian cancer. We conducted a pharmacoeconomic analysis to determine whether the alternative paclitaxel-cisplatin (TP) therapy is cost-effective (CE) in comparison to standard cyclophosphamide-cisplatin (CP) therapy. METHODS: Using an economic model, we applied cost data figures to resource utilization data derived from the two arms of the GOG trial. We examined paclitaxel benefits in terms of increased mean survival time, as well as median survival time. Estimates of the cumulative proportion surviving in the trial were based on Kaplan-Meier procedures. RESULTS: Per year of life gained (YLG), TP therapy costs more ($19,820 more for inpatient treatment; $21,222 outpatient) than CP treatment. CONCLUSION: The TP regimen's increased mean survival cost per YLG (inpatient and outpatient settings) adds a substantial benefit at an acceptable cost compared with CP therapy.

Antineoplastic Agents↗
PubMed1997

Audiological and psychological characteristics of a group of tinnitus sufferers, prior to tinnitus management training.

A profile of audiological and psychological characteristics, obtained before starting tinnitus management training, is presented for 96 subjects with tinnitus. Variability was marked in all measures. A history of headaches, neck or back pain, or balance problems was not related to the ability to cope with tinnitus. The coping strategies used to manage tinnitus were influenced by the beliefs held about tinnitus, but the coping strategies chosen were not necessarily effective. No gender differences were found in coping ability or overall stress levels, although there were gender differences on some psychological measures and stress influences. Subjects who had previously sought assistance differed from those who had not in the complexity of the tinnitus sounds, the level of emotional reaction and the use of coping behaviours.

Adaptation, Psychological↗
PubMed1997

Managing tinnitus: a comparison of different approaches to tinnitus management training.

A series of studies examining the interaction between the characteristics of individual tinnitus sufferers and the effectiveness of the methods used to assist them has been conducted. The first of these studies provided a baseline description of 96 people with tinnitus, according to a range of audiological and psychological variables. In the present paper four differing tinnitus management programmes are described and the related changes in tinnitus perception reported three months after tinnitus management training. For the majority of subjects, the tinnitus was less annoying and less distressing three months after attending tinnitus management training. However, the majority of subjects reported no change in tinnitus loudness, or tinnitus awareness and no change in their tinnitus coping ability. Subjects receiving low level white noise stimulation reported greater improvement in tinnitus coping ability than subjects who received information and relaxation training, although there was no associated improvement in tinnitus awareness. Subjects' beliefs about tinnitus and preferred coping style may have influenced the reported benefit or otherwise of the differing tinnitus management techniques.

Acoustic Stimulation↗