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Biomedical subjects

J Finn

Publications and source records attributed to J Finn.

At least 19 recordsLinked to original sources
PubMed2005

[Technique for percutaneous iliosacral screw insertion with conventional C-arm radiography].

BACKGROUND: During percutaneous iliosacral screw fixation, fluoroscopy with a conventional C-arm X-ray unit is still the standard procedure for intraoperative orientation. Lateral sacral images in combination with the inlet and outlet view are always necessary. Nevertheless, the complex pelvic anatomy makes it difficult to prevent malpositioning of screws. OPERATIVE TECHNIQUE: Defining the correct entry into the bone is the decisive step for ideal screw placement. The better this is defined, the larger safety margins will be concerning cortical perforation by the screws. In the lateral view, an entry ventral to the sacral canal has to be avoided as well as an entry into the cranial half of the first sacral vertebra. To improve the surgeon's three-dimensional orientation with the help of his personal experience and two-dimensional images, it is recommended to place the tip of the screws in the center of the sacrum (in AP view) whenever possible. Routinely performed postoperative CT imaging of 24 screws, consecutively implanted according to the standards described, revealed no case of malpositioning. CONCLUSION: Standard X-ray views in combination with standardized aiming of screw entry position and final screw thread position enable the surgeon to find the "safe zone" for iliosacral screw insertion and to prevent iliosacral screw malpositioning with high accuracy.

Bone Screws↗
PubMed2004

An enhanced autogene-based dual-promoter cytoplasmic expression system yields increased gene expression.

The relatively low levels of transfection that can be achieved by current gene-delivery systems have limited the therapeutic utility of gene transfer. This is especially true for nonviral gene-delivery systems, where the levels of gene expression achieved are usually below the levels achieved by viral gene transfer systems. One strategy for increasing gene expression is to design a cytoplasmic expression system that does not require nuclear delivery for gene expression to occur. This can be achieved through the use of an autocatalytic cytoplasmic expression system using phage RNA polymerases. Here we describe cytoplasmic expression systems that yield increased levels of gene expression following in vitro transfection. We demonstrate direct evidence for an exponential, autocatalytic increase in gene expression using autogenes, as well as levels of reporter gene expression that are 20-fold higher than standard CMV-based nuclear expression systems. The development of a high-efficiency plasmid-based expression system could significantly improve the gene expression properties of nonviral gene-delivery systems, thereby increasing their clinical utility.

Animals↗
PubMed2003

Efficacy of cardiopulmonary resuscitation performed in a dental chair.

BACKGROUND: Within the dental setting, historically there has been some concern as to whether cardiopulmonary resuscitation (CPR) can be performed effectively in the dental chair. This study tested the hypothesis that there is no difference in the efficacy of CPR performed in the dental chair or on the floor. METHODS: Four cycles of two-person CPR were performed by three health professionals on a manikin positioned alternately on the floor and in a dental chair. Ventilation was performed using a Laerdal pocket mask, without oxygen supplementation. Compression and ventilation performance was recorded using a computerized manikin skill meter. RESULTS: Each of the participants was able to achieve a mean cardiac compression depth of between 41 and 50cm, irrespective of the CPR surface. The only statistically significant difference found in expired air resuscitation (EAR) and external cardiac compression performance was that 37 per cent of ventilations performed on the floor were deemed to be too shallow, compared to only 15 per cent in the dental chair (p=0.001). CONCLUSIONS: It is possible for those trained in basic life support to perform CPR effectively in the dental chair. Each of the participants agreed that CPR, in particular EAR, was easier to perform when the manikin was in the dental chair compared with the floor. Dentists are encourage to regularly update their CPR knowledge and skills, including the practice of CPR in the dental chair.

Cardiopulmonary Resuscitation↗
PubMed2001

Dynamic mimicry in an Indo-Malayan octopus.

During research dives in Indonesia (Sulawesi and Bali), we filmed a distinctive long-armed octopus, which is new to science. Diving over 24 h periods revealed that the 'mimic octopus' emerges during daylight hours to forage on sand substrates in full view of pelagic fish predators. We observed nine individuals of this species displaying a repertoire of postures and body patterns, several of which are clearly impersonations of venomous animals co-occurring in this habitat. This 'dynamic mimicry' avoids the genetic constraints that may limit the diversity of genetically polymorphic mimics but has the same effect of decreasing the frequency with which predators encounter particular mimics. Additionally, our observations suggest that the octopus makes decisions about the most appropriate form of mimicry to use, allowing it to enhance further the benefits of mimicking toxic models by employing mimicry according to the nature of perceived threats.

Animals↗
PubMed2001

The influence of age, gender and ethnicity on cadaveric organ recovery rate.

In view of the influence of donor factors such as age on graft outcome and the performance standards that measure OPO productivity by the number of organs recovered and transplanted, it is important to understand the relationship of certain donor factors on organ recovery for transplantation from cadaveric donors. We examined the influence of donor age, gender and ethnicity on the number and type of transplanted organs recovered from 598 consecutive cadaveric donors in our OPO between 1994 and July 1999. The highest number of organs/donor ocurs in the 11-20 donor age range and declines significantly with each age range. The type of organ recovered is also influenced by age, but the least effect is on liver recovery. No difference was seen in the number of organs recovered/donor by race. When the data were re-analyzed with regard to renal and extra-renal organs transplanted/million donor population, 78% of the kidneys (n=781/1006) were from the 11-50 age range and 81% of the extra-renal organs (n=822/1,192) were from that age range. Stepwise regression yielded a model where donor age significantly influenced (P=0.001) the number of organs recovered. Finally, the incidence of recovered and transplanted organs was significantly higher in males compared with females for hearts [51% (187/360) vs. 40% (86/214); P<0.006] and pancreata [18% (66/360) vs. 11% (24/214); P<0.02]. The number of organs recovered and transplanted from cadaveric organ donors is influenced predominantly by the age of the donor, with the exception being liver donors. Increasing organ recovery and transplantation of organs from donors from the two age extremes results in less gain in the number of organs/million population than recovery from the 11-50 age range.

Adolescent↗
PubMed2001

Lack of relationship between functional ability and skin score in patients with systemic sclerosis.

OBJECTIVE: To examine the hypothesis that functional ability is related to skin score in patients with systemic sclerosis (SSc). METHODS: In 140 patients with SSc attending clinics in the northwestern region of England, functional ability (measured using a recently developed 11 item functional questionnaire) was correlated with skin score (measured using a modified Rodnan technique--17 sites, maximum score 3 for each site). RESULTS: The median functional score was 6 (range 0-31) and the median skin score 7 (range 0-37). There was no correlation between functional score and total skin score (rS = 0.11, p = 0.19, Spearman). Because most of the questions of the functional score related to upper limb function, separate analyses were undertaken restricting consideration of skin involvement to (1) upper limbs only and (2) digital skin only, versus the overall functional score. Again, no evidence of an association was observed. CONCLUSION: Functional ability in this broad group of patients with SSc cannot be predicted from the skin score. Although skin score is useful prognostically, it is not a major determinant of a patient's ability to perform activities of everyday living.

Adult↗
PubMed2000

Benefits of lipid lowering on vascular reactivity in patients with coronary artery disease and average cholesterol levels: a mechanism for reducing clinical events?

BACKGROUND: The favorable effects of lowering low-density lipoprotein (LDL)-cholesterol on reducing clinical events in patients with coronary disease have been well established. The mechanisms responsible for this benefit, however, have not been fully understood. This study examined the impact of lipid-lowering therapy on endothelium-dependent vasoreactivity in a subgroup of patients after myocardial infarction with average cholesterol levels who participated in the Cholesterol Recurrent Events (CARE) study to determine whether an effect on endothelial function is a viable mechanism for the observed reduction in clinical events. METHODS AND RESULTS: Participants were recruited from among volunteers in the CARE trial at 2 university-based outpatient cardiology clinics. Patients were randomly assigned to pravastatin or placebo. Plasma lipids were measured at baseline and semiannually thereafter. During the final 6 months of the trial, vasoreactivity was assessed by change in ultrasound-determined brachial artery diameter in response to blood pressure cuff-induced ischemia (endothelium-dependent) and to nitroglycerin, a direct vasodilator. Differences in response were examined between the 2 randomized groups. The relation between change in LDL-cholesterol from baseline to year 5 and the magnitude of endothelium-dependent vasodilation also was examined. There was significantly greater endothelium-dependent vasodilation observed in the pravastatin group compared with the placebo group (13% vs 8%, P =.0002), with no difference between the groups in their response to the endothelium-independent vasodilator nitroglycerin. The magnitude of the endothelium-dependent vasodilation was significantly correlated with the percent change in LDL-cholesterol from baseline to final visit (r = 0.49, P =.015). CONCLUSIONS: These findings indicate that the use of pravastatin in patients after myocardial infarction with average cholesterol levels is associated with greater endothelium-dependent vasodilation compared with those who received placebo. The magnitude of this vasodilatory response is correlated to the reduction in LDL-cholesterol. This improvement in endothelium-dependent vasoreactivity may be a likely mechanism, at least in part, for the reduction in recurrent clinical events observed and reported in the CARE study.

Adult↗
PubMed2000

Cardiac troponin I in pre-eclampsia and gestational hypertension.

OBJECTIVE: To investigate serum cardiac troponin I, a sensitive marker of cardiac myocyte damage, in normal pregnancy and pregnancies complicated by hypertension with and without significant proteinuria. DESIGN: Prospective cross sectional study. SETTING: University hospital delivery suite. SAMPLE: Serum samples obtained from women in normal pregnancy and in pregnancies complicated by hypertension with and without significant proteinuria. METHOD: Women with hypertension in pregnancy (at least two readings of systolic blood pressure > 140 mmHg and diastolic blood pressure > 90 mmHg) (n = 26) and normotensive women (n = 43) were included in the study. Serum cardiac troponin I was measured using Beckman Access immunoassay. MAIN OUTCOME MEASURE: Serum cardiac troponin I level in the pregnancies complicated by hypertension (with and without significant proteinuria) compared with the levels measured in normotensive women. RESULTS: The median serum cardiac troponin I level in pregnancies complicated by hypertension was 0.118 ng/mL (n = 26) which was significantly greater than that measured in samples obtained from normotensive women in pregnancy (0.03 ng/mL; n = 43) (P < 0.0001). There were higher median serum cardiac troponin I levels in hypertensive women with significant proteinuria (0.155 ng/mL; n = 6), compared with those without proteinuria (0.089 ng/mL; n = 20; P = 0.03). CONCLUSION: Serum cardiac troponin I is elevated in women with hypertensive disorders of pregnancy indicating some degree of cardiac myofibrillary damage in these disorders.

Adult↗
PubMed1999

Rational herbicide design by inhibition of tryptophan biosynthesis.

Compounds designed to mimic the tryptophan synthase alpha subunit reactive intermediate were found to be potent inhibitors of the enzyme. These compounds are herbicidal and the herbicidal mode of action was demonstrated to be due to disruption of tryptophan biosynthesis.

Enzyme Inhibitors↗
PubMed1999

An exploration of helping processes in an online self-help group focusing on issues of disability.

This article reviews the growing use of online self-help and mutual aid groups and explores the helping mechanisms and content of an online self-help group for issues related to disability. Messages were downloaded from the group and coded by raters into helping categories to examine the extent to which therapeutic processes were found. The categories included both task and socioemotional-related functions. The study found that the group provided many of the processes used in face-to-face self-help and mutual aid groups, with an emphasis on mutual problem solving, information sharing, expression of feelings, catharsis, and mutual support and empathy. Implications for social work and health care providers and the need for further research are discussed.

Persons with Disabilities↗
PubMed1999

Communication of social support in computer-mediated groups for people with disabilities.

This study documented the types and extent of social support messages exchanged by persons with disabilities who participated in a computer-based support group. A modified version of Cutrona & Suhr's (1992) social support category system was used to code 1,472 support messages. The largest percentage of these messages offered emotional and informational support, whereas network support and tangible assistance were least frequently offered. It appeared that many of the support messages directly redressed limitations and challenges associated with disability-related mobility, socialization, and self-care. Results are discussed in terms of the generalizability of existing category systems for coding support to this mediated context, the relative importance of different types of support in the communication of support group members, and the unique features of social support in mediated environments. The implications of this study for social support researchers, persons with disabilities, and human services professionals are also discussed.

Journal Article↗
PubMed1997

Clinical value of CYFRA 21.1, carcinoembryonic antigen, neurone-specific enolase, tissue polypeptide specific antigen and tissue polypeptide antigen in the diagnosis of lung cancer.

In this study we looked at what useful information cytokeratin fragment detected by antibodies BM 19-21 and KS 19-1 (CYFRA 21.1), carcinoembryonic antigen (CEA), neurone-specific enolase (NSE), tissue polypeptide specific antigen (TPS), and tissue polypeptide antigen (TPA) gave when measured prospectively. All patients who were suspected of having lung cancer and who underwent diagnostic bronchoscopy in this hospital between July 1994 and May 1995 were included in the study. Of 184 patients, 87 were subsequently found to have intrathoracic malignancy, 93 were found to have benign lung disease and four were lost to follow-up. CYFRA 21.1 was the most efficient marker in differentiating benign from malignant disease, with a sensitivity of 54% and a positive predictive value of 96%. Thirty seven patients who had a negative bronchoscopy subsequently turned out to have malignant disease. Either CYFRA 21.1 or CEA was elevated in 26 (70%) of such patients. Multivariate analysis showed that only CYFRA 21.1 and CEA contributed significantly to the discriminatory power of the data. We conclude that measurement of cytokeratin fragment detected by antibodies BM 19-21 and KS 19-1 and carcinoembryonic antigen at the time of bronchoscopy significantly increased the diagnostic yield in this population and was especially useful in those patients in whom tumour biopsy was not possible at bronchoscopy.

Antigens, Neoplasm↗
PubMed1996

The role of nurses in cardiopulmonary resuscitation and defibrillation.

Cardiac [corrected] arrest outcome studies have identified early defibrillation (among other variables) as a strong predictor of survival--with the emphasis placed on minimal delay between arrest and 'shock'. Nurses play a key role in the management of in-hospital cardiac arrest. Often they are first on the scene of an arrest--initiating cardiopulmonary resuscitation (CPR) as well as summoning assistance from the 'advanced life support'/'arrest' team. Thus it is argued that nurses should be willing (and able) to perform defibrillation when required. Notwithstanding this, the community has an expectation (rightly or wrongly) that all nurses are able to appropriately manage a collapse situation. However, research clearly demonstrates that not all nurses are competent in CPR. There is obviously a mismatch between community expectations and reality, which nursing needs to address. Nurses can contribute to the prevention of cardiac arrest in the community by promoting the importance of seeking medical care in the event of chest pain. Furthermore, skilled clinical assessment and recognition of the prodromes of cardiorespiratory collapse may reduce the incidence of in-hospital cardiac arrests.

Cardiopulmonary Resuscitation↗
PubMed1996

Does exposure to immunosuppressive therapy increase the 10 year malignancy and mortality risks in rheumatoid arthritis? A matched cohort study.

Rheumatoid arthritis (RA) is associated with increased mortality and an increased risk of neoplasms of the immune system (NIM). To establish whether immunosuppressive therapy alters these risks, a matched cohort study was conducted. The exposed cohort were 259 RA patients, resident in the UK, who first received immunosuppressive drugs (mainly azathioprine, cyclophosphamide and chlorambucil) between 1979 and 1982. The unexposed cohort were 259 patients matched for age, sex and disease, resident in the USA, who had never received immunosuppressives. Both cohorts had no prior reported malignancies and were followed for 10 yr. There was a small increase in mortality in the exposed compared to the unexposed cohort. Most of the excess deaths were due to malignancy. The relative risk (RR) of developing malignancy [1.5 (95% CI 0.9-2.3)] was lower than the RR of dying from malignancy [4.2 (95% CI 1.7-10.0)]. The RR of developing a NIM in the immunosuppressive-exposed group was 7.0 (95% CI 0.9-56.5). These results may be explained in part by differences in cancer registration and death rates between the UK and the USA. Nevertheless, the results suggest that exposure to immunosuppressive therapy increases the 10 yr malignancy risk in RA, but not mortality from other causes.

Adult↗
PubMed1996

Personal decisionmaking styles and long-term care choices.

To learn more about how older people make decisions about long-term care (LTC), in-depth interviews were conducted with 63 elderly individuals and 56 of their relatives to obtain information on the decisionmaking process. This qualitative research showed that LTC decisionmaking does not always follow typical consumer decisionmaking models, in which a consumer seeks a product or service, selects among the alternatives, and assesses the choice. Further, the interviews yielded four long-term care decisionmaking styles among older adults related to their degree of planning or not planning. This study underscores the need to develop tailored communications for older people and their families aimed at encouraging appropriate and cost-effective use of LTC services.

Activities of Daily Living↗