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Biomedical subjects

J Gregory

Publications and source records attributed to J Gregory.

At least 19 recordsLinked to original sources
PubMed2006

A multi-centre prospective case-control study of campylobacter infection in persons aged 5 years and older in Australia.

There are an estimated 277,000 cases of campylobacteriosis in Australia each year, most of which are thought to be sporadically acquired. To explore causes for these infections, we conducted a multi-centre case-control study of patients and community controls across five Australian States during 2001-2002. A total of 881 campylobacter cases and 833 controls aged 5 years were recruited into the study. Crude logistic analyses were conducted within various food and non-food exposure groups. A final most parsimonious multivariable logistic regression model was developed and adjusted odds ratios (aOR), 95% confidence intervals (95% CI) were derived together with adjusted population attributable risks (PAR). Consumption of undercooked chicken (aOR 4.7, 95% CI 2.6-8.4) and offal (aOR 2.0, 95% CI 1.0-4.0), ownership of domestic chickens aged<6 months (aOR 12.4, 95% CI 2.6-59.3) and domestic dogs aged<6 months (aOR 2.1, 95% CI 1.1-4.2) were found to be independent risk factors for illness in the final model. The PAR proportions indicate that eating chicken meat, either cooked or undercooked may account for approximately 30% of campylobacter cases that occur each year in Australia. These results justify the continued need for education of consumers and foodhandlers about the risks associated with the handling of raw chicken and the potential for cross-contamination.

Adolescent↗
PubMed2006

The effect of polymeric flocculants on floc strength and filter performance.

Polymeric flocculants are widely used throughout the water industry as flocculant aids, they are known to increase floc density and aid settlement in the clarification stage of the water treatment process. In this research, polymeric flocculants were used to improve floc strength prior to filtration on a dissolved air flotation (DAF) plant in an attempt to prevent filter breakthrough. A modified jar test procedure using a PDA (photometric dispersion analyser) optical flocculation monitor was developed in order to evaluate the system floc strength. Filtration trials were carried out on a pilot filter rig situated on a surface water treatment works in Yorkshire. The filter feed originated from the main plant filter channel. Filter performance was assessed by continuous online monitoring of effluent particle counts, turbidity and headloss over the period of the filter run. Results indicated that low doses of polymeric flocculants had a beneficial effect on filtered water quality, as measured by particle counts, turbidity, UV254 absorption and dissolved organic carbon (DOC). Polymeric flocculants also had the effect of extending filter run length. The modified jar test results indicated that the flocculants used improved the floc strength and enhanced reflocculation of the micro flocs present after the flotation process.

Filtration↗
PubMed2006

Formation and breakage of flocs using dual polymers.

The effect of shear on the formation and break-up of flocs generated using cationic, anionic and non-ionic polymers, and dual combinations of these, has been investigated using conventional jar test procedure and by continuous optical monitoring. The breakage of flocs was followed at a high stirring speed, corresponding to average shear rate (G) of approximately 520 s(-1). Most of the breakage occurred within a few seconds of increasing the shear rate. After each breakage, the stirring rate was reduced to the original value of 50 rpm (G approximately 23 s(-1)) to allow the flocs to regrow. For cationic-anionic polymers case, the regrowth of flocs was fully reversible and the breakage factors were smallest indicating highest floc strength. In contrast, flocs formed using non-ionic polymer together with anionic or cationic did not produce as strong flocs. It is found that the sequence of polymer addition is not very significant for floc formation and reformation when the cationic-anionic dual system is used.

Acrylic Resins↗
PubMed2005

A review of floc strength and breakage.

The main focus of the paper is to review current understanding of floc structure and strength. This has been done by reviewing current theoretical understanding of floc growth and breakage and an analysis of different techniques used for measuring floc strength. An overview has also been made of the general trends seen in floc strength analysis. The rate of floc formation is a balance between breakage and aggregation with flocs eventually reaching a steady-state size for a given shear rate. The steady-state floc size for a particular shear rate can, therefore, be a good indicator of floc strength. This has resulted in the development of a range of techniques to measure floc size at different applied shear levels using a combination of one or more of the following tools: light scattering and transmission; microscopy; photography; video and image analysis software. Floc strength may be simply quantified using the initial floc size for a given shear rate and the floc strength factor. More complex techniques have used theoretical modelling to determine whether flocs break by large-scale fragmentation or smaller-scale surface erosion effects, although this interpretation is open to debate. Impeller-based mixing, ultrasound and vibrating columns have all been used to provide a uniform, accurate and controllable dissipation of energy onto a floc suspension to determine floc strength. Other more recent techniques have used sensitive micromanipulators to measure the force required to break or compress individual flocs, although these techniques have been limited to the measurement of only a few hundred flocs. General trends emerge showing that smaller flocs tend to have greater strength than larger flocs, whilst the use of polymer seems to give increased strength to only some types of floc. Finally, a comparison of the strength of different types of floc (activated sludge flocs, organic matter flocs, sweep flocs and charge neutralised flocs) has been made highlighting differences in relative floc strength.

Bioreactors↗
PubMed2005

Sesame seed products contaminated with Salmonella: three outbreaks associated with tahini.

In November 2002, the first of three outbreaks of Salmonella Montevideo infection in Australia and New Zealand was identified in New South Wales, Australia. Affected persons were interviewed, and epidemiologically linked retail outlets inspected. Imported tahini was rapidly identified as the source of infection. The contaminated tahini was recalled and international alerts posted. A second outbreak was identified in Australia in June-July 2003 and another in New Zealand in August 2003. In a total of 68 S. Montevideo infections, 66 cases were contacted. Fifty-four (82%) reported consumption of sesame seed-based foods. Laboratory analyses demonstrated closely related PFGE patterns in the S. Montevideo isolates from human cases and sesame-based foods imported from two countries. On the basis of our investigations sesame-based products were sampled in other jurisdictions and three products in Canada and one in the United Kingdom were positive for Salmonella spp., demonstrating the value of international alerts when food products have a wide distribution and a long shelf life. A review of the controls for Salmonella spp. during the production of sesame-based products is recommended.

Australia↗
PubMed2005

Teduglutide (ALX-0600), a dipeptidyl peptidase IV resistant glucagon-like peptide 2 analogue, improves intestinal function in short bowel syndrome patients.

BACKGROUND AND AIMS: Glucagon-like peptide 2 (GLP-2) may improve intestinal absorption in short bowel syndrome (SBS) patients with an end jejunostomy. Teduglutide (ALX-0600), a dipeptidyl peptidase IV resistant GLP-2 analogue, prolongs the intestinotrophic properties of GLP-2 in animal models. The safety and effect of teduglutide were investigated in SBS patients with and without a colon in continuity. METHODS: Teduglutide was given subcutaneously for 21 days once or twice daily to 16 SBS patients in the per protocol investigational group, 10 with end jejunostomy (doses of 0.03 (n = 2), 0.10 (n = 5), or 0.15 (n = 3) mg/kg/day), one with <50% colon in continuity (dose 0.03 mg/kg/day), and five with > or = 50% colon in continuity (dose 0.10 mg/kg/day). Nutrient balance studies, D-xylose tests, and intestinal mucosa biopsies were performed at baseline, on the last three days of treatment, and after three weeks of follow up. Pre-study fasting native GLP-2 levels were determined for the five patients with > or = 50% colon in continuity. RESULTS: Pooled across groups and compared with baseline, teduglutide increased absolute (+743 (477) g/day; p<0.001) and relative (+22 (16)%; p<0.001) wet weight absorption, urine weight (+555 (485) g/day; p<0.001), and urine sodium excretion (+53 (40) mmol/day; p<0.001). Teduglutide decreased faecal wet weight (-711 (734) g/day; p = 0.001) and faecal energy excretion (-808 (1453) kJ/day (-193 (347) kcal/day); p = 0.040). In SBS patients with end jejunostomy, teduglutide significantly increased villus height (+38 (45)%; p = 0.030), crypt depth (+22 (18)%; p = 0.010), and mitotic index (+115 (108)%; p = 0.010). Crypt depth and mitotic index did not change in colonic biopsies from SBS patients with colon in continuity. The most common side effects were enlargement of the stoma nipple and mild lower leg oedema. The improvements in intestinal absorption and decreases in faecal excretion noted after treatment had reversed after the drug free follow up period. A controlled study with a more robust design is ongoing in order to determine the optimal dosage of teduglutide for SBS patients to achieve the maximal effect and utility of this drug in clinical practice. CONCLUSION: Teduglutide, at three dose levels for 21 days, was safe and well tolerated, intestinotrophic, and significantly increased intestinal wet weight absorption in SBS patients with an end jejunostomy or a colon in continuity.

Adult↗
PubMed2004

The metabolic marker tumour pyruvate kinase type M2 (tumour M2-PK) shows increased expression along the metaplasia-dysplasia-adenocarcinoma sequence in Barrett's oesophagus.

BACKGROUND: Proliferating and tumour cells express the glycolytic isoenzyme, pyruvate kinase type M2 (M2-PK). In tumours cells, M2-PK usually exists in dimeric form (tumour M2-PK), causing the accumulation of glycolytic phosphometabolites, which allows cells to invade areas with low oxygen and glucose concentrations. AIMS: To investigate the expression of tumour M2-PK during the metaplasia-dysplasia-adenocarcinoma sequence of Barrett's oesophagus, and to assess the prognostic usefulness of tumour M2-PK in oesophageal cancer. MATERIALS/METHODS: One hundred and ninety cases selected from the histopathology archives as follows: 17 reflux oesophagitis, 37 Barrett's oesophagus, 21 high grade dysplasia, 112 adenocarcinomas, and three control tumours. Sections were stained immunohistochemically with antibody to tumour M2-PK. RESULTS: Tumour M2-PK was expressed in all cases, and increased cytoplasmic expression was seen with progression along the metaplasia-dysplasia-adenocarcinoma sequence. All cases of adenocarcinoma showed 100% staining so that tumour M2-PK was not a useful prognostic marker. CONCLUSIONS: Tumour M2-PK is not a specific marker of Barrett's adenocarcinoma, but may be important as a marker of transformed and highly proliferating clones during progression along the metaplasia-dysplasia-adenocarcinoma sequence.

Adenocarcinoma↗
PubMed2004

A review of 187 gunshot wound admissions to a teaching hospital over a 54-month period: training and service implications.

BACKGROUND: Violence involving the use of firearms has increased in the UK over the past decade. This study assesses the implications of such injuries for service provision and training by reviewing the experience at one hospital. METHODS: Accident and emergency triage data were searched for patients presenting with gunshot wounds over a 54-month period. Case notes were reviewed and patterns of care established. The resources required for clinical management were ascertained, and the financial consequences determined at contemporary full cost. RESULTS: There were 187 attendances with 247 wounds. Mean age was 21 years (range, 8-63 years). Of the attendances, 69% were out of normal working hours. Of the 187 cases, 97 patients were admitted to one hospital (83 of whom required surgery) and 10 patients were transferred to other hospitals (6 for plastic surgery not available at the Manchester Royal Infirmary and 4 due to lack of beds). Of the 80 patients who were not admitted, 4 died in accident and emergency, the rest were either air gun wounds or relatively simple higher calibre injuries. A wide range of surgical specialties was involved (limb injury, 53; thoraco-abdominal and vascular, 28; head and neck, 5; and orbit, 2), and combinations of injuries transgressed specialty and sub-specialty boundaries. The total cost of patient care was pound 267,000. CONCLUSIONS: Gunshot wounds present a heavy demand on the clinical and financial resources of the receiving hospital, and surgeons responsible for unselected acute admissions in "general surgery" should be capable of dealing with these indiscriminate injuries. Current training and service trends towards increasing sub-specialisation may mitigate against them achieving or retaining this capability.

Adolescent↗
PubMed2004

Monitoring floc formation and breakage.

Monitoring of flocculation processes is of great practical importance and can give very useful information on the action of different coagulants under various conditions. It is shown that a continuous optical monitoring technique provides a convenient means of following the formation, break-up and regrowth of flocs under standard mixing and stirring conditions. Examples of results using this approach are given, with alum and PACl coagulants as well as a cationic polyelectrolyte. PACl products give larger flocs than with alum, but they show about the same relative degree of breakage when the shear rate is increased. With all of these coagulants, floc breakage is not fully reversible; i.e. flocs only re-grow to a limited extent when the shear rate is reduced. This is in marked contrast to the action of a cationic polyelectrolyte, where floc breakage is almost completely reversible. Some possible reasons for these observations are discussed, but, so far, there is no adequate model available.

Alum Compounds↗
PubMed2004

Temperature effects on flocculation, using different coagulants.

Temperature is known to affect flocculation and filter performance. Jar tests have been conducted in the laboratory, using a photometric dispersion analyser (PDA) to assess the effects of temperature on floc formation, breakage and reformation. Alum, ferric sulphate and three polyaluminium chloride (PACI) coagulants have been investigated for temperatures ranging between 6 and 29 degrees C for a suspension of kaolin clay in London tap water. Results confirm that floc formation is slower at lower temperatures for all coagulants. A commercial PACl product, PAX XL 19, produces the largest flocs for all temperatures; and alum the smallest. Increasing the shear rate results in floc breakage in all cases and the flocs never reform to their original size. This effect is most notable for temperatures around 15 degrees C. Breakage, in terms of floc size reduction, is greater for higher temperatures, suggesting a weaker floc. Recovery after increased shear is greater at lower temperatures implying that floc break-up is more reversible for lower temperatures.

Alum Compounds↗
PubMed2002

The use of sequential studies in a salmonellosis outbreak linked to continental custard cakes.

We investigated an outbreak of 54 cases of Salmonella Typhimurium phage type 9 (STM9) with a specific antibiotic resistance pattern. We used sequential analytic studies: two retrospective cohort studies, a case-control study, and a modified case-control study. An outbreak of salmonellosis due to Salmonella Typhimurium PT9 SSu (resistant to streptomycin and sulphafurazole) was identified. Fifty-four cases had illness onset from November 1998 to March 1999. Notifications commenced following a restaurant birthday party in December 1998. An initial cohort and case control study found no association with consumption of custard cake. However, case follow-up identified another cohort of people who had attended a birthday party in February at which 8/27 people who consumed a continental custard cake were ill compared to 0/10 who did not (P = 0.07). A revised case control study found illness was strongly associated with consumption of a particular continental custard cake (Mantel-Haenszel matched OR infinity, P = 0.00004). This report highlights the epidemiological value of using sequential study types, and persisting with the investigation of apparently sporadic food-borne outbreaks.

Anti-Bacterial Agents↗
PubMed2002

Selenium status and associated factors in a British National Diet and Nutrition Survey: young people aged 4-18 y.

OBJECTIVE: Assessment of selenium status to provide normative reference values, and investigation of associated socio-demographic factors, in a national sample of British young people aged 4-18 y. SETTING: National Diet and Nutrition Survey-a nationwide cross-sectional sample of young people aged 4-18 y living in mainland Britain in 1997. METHODS: Selenium status was measured, mainly in fasting blood samples, by plasma selenium concentration in 1127 participants, by red blood cell (RBC) selenium concentration in 1112, and by whole-blood glutathione peroxidase (GPx) activity in 658. RESULTS: No evidence of severe selenium deficiency or toxicity was observed. Plasma selenium concentration was directly correlated with RBC selenium concentration, and both were associated directly, although less strongly, with GPx activity. Plasma and RBC selenium concentrations increased significantly with age, with RBC concentrations significantly higher in older girls than boys. Region of domicile exhibited a significant relationship. Associations also occurred with parental occupational social class, selenium concentrations being higher in more socially advantaged children. Black and Indian children had considerably higher concentrations than Caucasian children. Concentrations, especially of plasma selenium, were significantly lower in children either (or both) of whose parents were smokers, although, unexpectedly, there was no evidence that children who themselves smoked had lower levels. CONCLUSIONS: The observed associations between selenium status indices and age, gender, social class, parental smoking and ethnic group indicate a complex network of biological factors which determine selenium concentrations in blood components, and which thus need to be controlled for when using these indices to assess selenium status in young people. SPONSORSHIP: The survey was commissioned jointly by the Department of Health and the Ministry of Agriculture, Fisheries and Food, whose responsibility has since been transferred to the Food Standards Agency. Support for the further analysis presented in this paper was provided by the Department of Health.

Adolescent↗
PubMed2001

The interaction of humic substances with cationic polyelectrolytes.

The anionic charge carried by aquatic humic substances plays a major part in their interaction with metal ions and other cationic species. Removal of such substances by coagulation and flocculation can be, at least partly, determined by charge neutralisation. In this work, the charge densities of a commercial humic acid and an aquatic humic extract have been investigated by studying their interactions with a series of synthetic cationic polyelectrolytes. These covered a range of charge densities and molecular weights. The techniques used were colloid titration by spectrophotometry and streaming current detection, and flocculation determined by colour removal and by an optical monitoring method. For a given cationic polyelectrolyte, all four methods gave charge densities for humic substances which were in good agreement. However, systematic differences in the apparent humic charge density were found, depending on the charge density of the cationic polyelectrolyte used. With low charge density polyelectrolytes, the apparent anionic charge of the humic substances was found to be low. With higher polyelectrolyte charge densities, the apparent humic substance charge density increases and reaches a limiting value when the polyelectrolyte charge is greater than about 3 meq/g. This indicates a non-stoichiometric interaction between the anionic sites of the humic substances and the cationic charges of the low-charge polyelectrolytes. Optimum flocculation of humics occurred with less cationic charge in the case of low-charge polyelectrolytes than those with higher charge density. However, the degree of removal was considerably better in the latter case. In all cases, the molecular weight of the cationic polyelectrolytes (over a range from about 50,000 to 15 million) appeared to have no effect on the results.

Cations↗
PubMed2001

Multiple outbreaks of Norwalk-like virus gastro-enteritis associated with a Mediterranean-style restaurant.

The role of diverse infectious agents, particularly Norwalk-like viruses (NLV), in three successive gastro-enteritis outbreaks in one setting (a restaurant) was evaluated. Methods included standard bacteriological tests, specific tests for Escherichia coli, tests for verocytotoxins, electron microscopy (EM) for viruses and reverse transcription-PCR (RT-PCR) methodology for NLV. No pathogenic bacteria were detected. Verocytotoxin genes, although detected by PCR in the first outbreak, could not be confirmed in the E. coli isolated, so they did not appear to be of significance. NLV was the main agent detected in each of the three outbreaks. DNA sequencing and phylogenetic analysis of the amplified products obtained from the RT-PCR positive specimens indicated that only one NLV strain was involved in each outbreak, but the NLV strains responsible for the three outbreaks were different from each other. PCR technology for detection of NLV proved highly sensitive, but failed to detect one specimen which was positive by EM. The restaurant associated with the outbreaks is a Mediterranean-style restaurant where food from a common platter is typically eaten with fingers. The findings indicate that NLV was introduced by guests or staff and was not due to a long-term reservoir within the setting.

Caliciviridae Infections↗
PubMed2001

Properties of flocs produced by water treatment coagulants.

Hydrolyzing coagulants are extensively used in water and wastewater treatment, often under conditions where hydroxide precipitation is important, giving "sweep flocculation". Pre-hydrolyzed coagulants, such as polyaluminium chloride (PACl) are also widely used and have several advantages over traditional additives, such as aluminium sulfate. Their action is usually discussed in terms of cationic species and charge neutralization. However, precipitation may also be important and this aspect has not been considered in detail. The present work has compared the action of alum and three commercial PACl products on model clay suspensions. The conventional jar test procedure has been used, along with measurements of settled floc volume and dynamic monitoring of floc formation and break-up by an optical technique. The latter method gives very useful information on the nature of the flocs produced and their response to different shear conditions. It is clear from the results that the PACl products form larger and stronger flocs than alum. With all coagulants floc breakage appears to be essentially irreversible. Sediment volumes are slightly lower for flocs produced by PACl than by alum, but the value is proportional to the dosage in all cases.

Alum Compounds↗
PubMed2000

Novel TSHR germline mutation (Met463Val) masquerading as Graves' disease in a large Welsh kindred with hyperthyroidism.

Hereditary nonautoimmune hyperthyroidism is caused by activating germline mutations in the thyrotropin (TSH) receptor (TSHR) gene. We describe an extended Welsh kindred with toxic thyroid hyperplasia affecting 8 family members in three generations and a history consistent with thyrotoxicosis in a further three generations now deceased. A novel heterozygous germline mutation (ATG --> GTG; Met463Val) was identified in the second membrane spanning TSHR region in 6 relatives with thyrotoxicosis and goiter and absence of TSHR antibodies. Screening of 5 additional family members led to the identification of 2 siblings with the mutation, who were asymptomatic at the time, although subsequent thyroid function tests in these children showed suppressed serum TSH and increased serum free triiodothyronine (FT3) and free thyroxine (FT4) concentrations. Functional studies of the novel TSHR germline mutation demonstrated a constitutive activation of the cAMP pathway, which in the thyroid controls both thyroid hormone production and stimulation of thyroid growth. The molecular diagnosis in this family has clinical implications: genetic counseling is required, and primary thyroid ablation should be advocated as the preferred treatment in the patients with the constitutively activating TSHR germline mutation.

Animals↗
PubMed2000

An outbreak of ciguatera fish poisoning in Victoria.

An outbreak of ciguatera fish poisoning in outer Melbourne in September 1997 was traced to a 16.2 kg Maori Wrasse fish imported into Victoria from Trunk Reef in Queensland. The outbreak involved 46 individuals attending a banquet at an Asian restaurant at which four different dishes prepared from the flesh and viscera of the fish were offered. In all 30 individuals consumed at least one of these dishes and all reported one or more symptoms, in the main gastrointestinal and/or in 18 cases neurological. Seventeen cases were seen in four different hospitals and nine were treated with parenteral mannitol therapy. Nine of 18 cases were still symptomatic 10 weeks after the episode. Education of Asian restaurateurs and the wider community about the risks of ciguatera fish poisoning was undertaken.

Adult↗