Search PubMed⌕ Search

Biomedical subjects

J Keating

Publications and source records attributed to J Keating.

At least 19 recordsLinked to original sources

Immune function, stress response, and body condition in arctic-breeding common eiders in relation to cadmium, mercury, and selenium concentrations.

We examined relationships between trace metal concentrations in tissues of common eider ducks (cadmium, mercury, and selenium) and selected biomarkers of health (stress response, immune function, and body condition). This study was conducted at an eider nesting colony in the Canadian arctic in 1998 and 1999. Capture-induced stress, measured as the rise in corticosterone concentrations following capture, was positively related (P=0.03) to renal cadmium concentration in 1998 when incubating eiders were sampled, but not in 1999 when prenesting eiders were sampled. Stress response was inversely related (P=0.02) to selenium concentrations in 1999. Following capture and blood sampling in 1999, eiders were placed in a flight pen on-site for eight days in order to examine immune function. Cell-mediated immunity, measured as the skin-swelling response to an intradermal injection of phytohemagglutinin-P, (PHA-P), was positively related (P=0.003) to hepatic selenium. The heterophil:lymphocyte ratio was inversely related (P=0.08) to hepatic selenium. In 1998, selenium was positively related to body mass (P=0.01), abdominal fat mass (P=0.07), kidney mass (P=0.03), and liver mass (P=0.07). In 1999, hepatic mercury was negatively related to abdominal fat mass (P=0.01), spleen mass (P=0.07) and body mass at capture (P=0.09) in prenesting eiders.

Animals↗

The prevalence of faecal incontinence and constipation in a general New Zealand population; a postal survey.

AIMS: To determine the prevalence of constipation and faecal incontinence in the community. METHODS: A 20-question multi-field postal questionnaire was sent to 1500 adults (over 18 years) randomly selected from the electoral roll in the Canterbury region. Questions detailed frequency of bowel function, time spent at the toilet, incidence and severity of faecal incontinence, constipation, and the effect of disordered bowel function. RESULTS: Of 1500 questionnaires, 717 (48%) were returned (male: female 388:329). The median age was 46 years (range 18-70). 24 (4%) had self-reported gastrointestinal disease. There was a median frequency of seven bowel motions per week (BM/wk) (range 1 to 70) with 89% having between two motions a day and one every two days. Faecal incontinence affected lifestyle in 58 (8.1%). Incontinence of solid stool at least once a month occurred in 70 (9.8%), of liquid stool in 91 (12.7%), of gas in 459 (64%), while 12 (2%) regularly wore a pad. Those with self-reported gastrointestinal disease had a significantly higher (p<0.05) bowel motion frequency (17 vs 7 BM/wk) and median faecal incontinence score (2.5 vs 0). Laxatives were used by 4.9% of the population, while 26.2% increased fibre to avoid constipation. CONCLUSIONS: The normal frequency of bowel motions (+/- 2SD) was 2-17 per week. Faecal incontinence affecting life style affected 8.1%, while constipation requiring regular laxative use affected 4.9% of people. There is acceptance in the community that a moderate degree of bowel dysfunction is normal. Stool frequency and faecal incontinence scores can be used to predict those most likely to have organic gastrointestinal disease.

Adolescent↗

Identifying feigned isokinetic trunk extension effort in normal subjects: an efficiency study of the DEC.

STUDY DESIGN: A test-retest comparison of maximal and feigned trunk extension effort in normal subjects was performed. OBJECTIVE: To test the robustness of an index termed DEC for differentiating maximal from feigned effort in normal subjects. SUMMARY OF BACKGROUND DATA: Previous studies have indicated that the DEC, which is the difference between the eccentric to concentric strength ratio at two test velocities, is a powerful identifier of feigned effort. This has been found for various muscle groups including the trunk extensors. However, whether this efficiency is affected by exposure to the protocol, learning, or other factors had not been examined. METHODS: Using a KinCom isokinetic dynamometer, 18 men and 17 women were tested twice within 1 to 2 weeks. Concentric and eccentric efforts of the trunk extensors were exerted using a short range of motion (20 degrees ) and two test velocities (10 degrees and 40 degrees per second). In the first part of each test, participants exerted maximal force against the lever arm, whereas in the second part they were to feign their maximal capability, pretending the presence of injury. RESULTS: In both Tests I and II, the feigned DEC scores (DECf) of all the participants were greater than the maximal DEC (DECm) scores (P = 0.0001). Repeated measurement analysis showed that neither DECm nor DECf varied systematically from Test 1 to Test 2. On the basis of the individual male scores, the DEC cutoff score of 0.41 was 100% efficient in Test 1 at differentiating feigned from maximal effort, with neither false-positive nor false-negative cases. Test 2 had a single false-positive case (efficiency 95%), and the optimal cutoff score was 0.275. In the female group, the corresponding efficiency of the DEC was 82% (optimal cutoff, 0.35) for Test 1 and 70% (optimal cutoff, 0.25-0.35) for Test 2. A statistical model for tolerance intervals at 90%, 95% and 99% indicated higher cutoff values for women than men. CONCLUSION: In healthy subjects, the DEC effectively differentiates feigned from maximal performance.

Adult↗

A predictive model of mercury fish tissue concentrations for the southeastern United States.

We developed a statistical model for predicting mercury concentrations in fish tissue in four southeastern states in the United States with an emphasis on identifying important predictor variables. A number of variables that could influence mercury fish tissue concentration, including proximity to sources of mercury, environmental factors affecting mercury movement and transformation, and factors affecting mercury accumulation, were considered. The model consists of three components using classification and regression three modeling, generalized additive modeling, and universal kriging, respectively. Each modeling component accounts for a different level of variation in fish tissue mercury concentration. Important factors for predicting mercury fish tissue concentrations are: (1) location, (2) species, (3) water body pH, and (4) fish weight. South central Arkansas and southeast Mississippi are the two "hot spots" with high fish tissue mercury concentrations. In addition, relatively high mercury levels were found near the Arkansas-Louisiana border and the mid-section of Mississippi.

Animals↗

Trace elements in king eiders and common eiders in the Canadian arctic.

We determined concentrations of selected trace elements in tissues of king and common eiders at three locations in the Canadian arctic. Renal and hepatic cadmium concentrations in king eiders at a location in the eastern arctic were among the highest ever recorded in eider ducks: there, they were higher in king eiders than in common eiders. Cadmium concentrations were lower in king eiders from the western arctic than in those from the east. In the western arctic, cadmium concentrations did not differ between species. Hepatic mercury and zinc were higher in king eiders than in common eiders. Zinc and selenium were higher in eiders from the western arctic than in those from the eastern arctic. Trace element concentrations in these two duck species were below published toxicity thresholds. Positive correlations in trace element concentrations in both species were found between total and organic hepatic mercury, renal and hepatic cadmium as well as hepatic zinc, copper, mercury, and cadmium. Body mass of common but not king eiders and spleen mass of both species were negatively correlated with mercury concentrations. In common eiders, the number of nematode parasites was positively correlated with total and organic mercury. Histopathological evidence of kidney or liver lesions that are typical of trace metal poisoning was not found. We did not find evidence to support the hypothesis that trace metal exposure may be contributing to adverse effects on the health of individuals of these species.

Animals↗

Reproducibility and validity of a new test protocol for measuring isokinetic trunk extension strength.

OBJECTIVE: To investigate the reproducibility and validity of isokinetic trunk extension strength scores obtained using a range of motion of 20 degrees and velocities of 10 and 40 degrees /s. BACKGROUND: Common protocols for testing trunk extension strength incorporate a range of motion of 40 degrees or more and test velocities of between 30 and 180 degrees/s. These test parameters may be neither necessary for portraying the strength profile of the muscles involved nor suitable for patients impaired with low back dysfunction. DESIGN: Test-retest of maximal concentric and eccentric isokinetic trunk extension strength in healthy subjects. METHODS: 17 women and 18 men were tested twice within 1-2 weeks. Tests were performed with subjects positioned in sitting. RESULTS: The trunk extension strength scores revealed excellent agreement with the expected physiological moment-velocity curve. On average women's trunk extension strength was 62% that of men (range: 59.3-64.4%). The test-retest correlation coefficients were generally higher in women (0.70-0.87) than in men (0.52-0.78) and significant at P=0.01. The standard error of measurement ranged between 13 and 21 N m for women and between 35 and 50 N m for men, which were equivalent to 9% and 15% of the mean strength in women and men, respectively. CONCLUSION: This study indicates that the present protocol may be validly applied in assessing trunk extension strength in normal women. RELEVANCE: Reproducible and valid trunk extension strength findings are essential if measurable strength deficiency of the extensors is to be formally accepted as an impairment. The present protocol incorporates or meets most of the relevant problems associated with trunk concentric and eccentric strength testing, and hence has the potential of becoming a standard method for clinical applications.

Adult↗

An investigation into the cyclical incidence of dengue fever.

The purpose of this research was to review the topic of dengue fever transmission and investigate the relationship between seasonal temperature fluctuations and cyclical dengue fever incidence. Data from Puerto Rico (1988-1992) were used to test the model proposed. Dengue fever is a viral disease caused by any one of four antigenically distinct serotypes. It is transmitted by Aedes mosquitoes and infects 80 million people per year. Currently, dengue is endemic in specific tropical and subtropical regions worldwide and epidemic dengue has been reported in the Americas, Asia and some Pacific Islands. Data for Puerto Rico were collected from the NCDC/NOAA and a study conducted by Perez et al. (1994). Multivariate linear regression analysis was used to determine if a relationship exists between the monthly mean temperature lagged and the monthly incidence of dengue fever in Puerto Rico. Statistical significance was achieved and a second-order model produced an R2 of 0.71. A residual analysis reveals positive autocorrelation, thus weakening the model's power to predict monthly dengue incidence. This suggests that other forces or factors related to the history of the herd immunity, the introduction of a new serotype, or demographic transitions are also influencing the cyclical transmission of dengue fever. Case clustering information, regional dengue distributions, and population density transformations must also be obtained in order to assess the forecasting ability of this model. Additional research is needed to avoid oversimplifying the problem. Without such attempts at establishing significant correlations, dengue prevention and control will remain a formidable task for many developing and developed countries.

Aedes↗

Mechanical environment affects allograft incorporation.

In a bilateral canine tibial model, the mechanical, radiologic, and histologic characteristics of intercalary allografts stabilized with locked intramedullary nails were compared with those of allografts fixed with compression plates. Both methods of fixation achieved healing to host bone. Tibiae that were plated had more callus with statistically greater mean torsional rigidity and strength than those treated with nails (paired t-test, p </= 0.05). On average, tibiae which had been plated had much higher bending rigidity than those fixed with locked nails; however, the difference in means was not statistically significant. Histomorphometric analysis showed an overall greater total bone formation in those limbs treated with plates compared to nails (paired t-test, p </= 0.04). The mechanical environment created by the different fixation methods are thought to be responsible for the observed differences in healing pattern. The traditional concept of fixation for allografts to achieve maximum rigidity of the construct may not necessarily promote the most appropriate host healing response in all situations. A less rigid fixation method (plates) produced more callus resulting in superior torsional and bending properties. These data show that in this canine intercalary allograft model, limbs fixed with plates produced more external callus resulting in stronger, more rigid healing.

Animals↗

Comparison of five cyclosporin immunoassays with HPLC.

High performance liquid chromatography (HPLC) is the reference method for cyclosporin (CyA) measurements but therapeutic monitoring of the drug is frequently made using the more practical immunoassays. Cross-reactivity with CyA metabolites may compromise the specificity of immunoassays, particularly in liver graft recipients where metabolites may accumulate. The aim of this study was to compare with HPLC the performance of two recently introduced CyA immunoassays (the AxSYM fluorescent polarisation immunoassay (FPIA) and non-extraction CEDIA assay). The comparison was extended to the well-established TDx monoclonal FPIA (TDx mono) and the enzyme multiplied (EMIT)-specific assays and to the polyclonal FPIA (TDx poly), in which metabolite cross-reactivity is extensive. Assays were performed on 106 blood samples (taken 6 days to 118 months post-liver transplant) and results were compared by non-parametric regression analysis and difference plots. AxSYM and CEDIA showed both constant and proportional bias against HPLC (unlike EMIT) but the mean difference from HPLC was least for AxSYM (2.7 microg/l vs. 11.7, 9.4 and 54 microg/l for CEDIA, EMIT and TDx mono, respectively. (TDx poly - HPLC) values were proportional to all immunoassay results, with slopes of 0.33, 0.38 and 0.45 for EMIT, AxSYM and CEDIA, respectively. Our data suggest close agreement between AxSYM, CEDIA and EMIT results.

Chromatography, High Pressure Liquid↗

Substance misuse in early pregnancy and relationship to fetal outcome.

UNLABELLED: To establish the frequency of substance misuse in early pregnancy in an urban UK population, 807 consecutive positive pregnancy test urine samples were screened for a range of drugs, including cotinine as an indicator of maternal smoking habits. A positive test for cannabinoids was found in 117 (14.5%) samples. Smaller numbers of samples were positive for other drugs:- opiates (11), benzodiazepines (4), cocaine (3) and one each for amphetamines and methadone. Polydrug use was detected in nine individuals. Only two samples tested positive for ethanol. The proportion with a urine cotinine level indicative of active smoking was 34.3%. The outcome of the pregnancy was traced for 288 subjects. Cannabis use was associated with a lower gestational age at delivery (P < 0.005), an increased risk of prematurity (P < 0.02) and reduction in birth weight (P < 0.002). Whilst maternal smoking was associated with a reduction in infant birth weight (P < 0.05), this was less pronounced than the effect of other substance misuse. CONCLUSION: This study suggests that one in six women in South London are using drugs in early pregnancy and that cannabinoid use is associated with a poorer pregnancy outcome.

Female↗

Phase II trial of high-dose liposome-encapsulated doxorubicin with granulocyte colony-stimulating factor in metastatic breast cancer. TLC D-99 Study Group.

PURPOSE: To estimate the toxicity and response rate of high-dose liposome-encapsulated doxorubicin (TLC D-99, Evacet, The Liposome Company Inc, Princeton, NJ) in patients with advanced breast cancer. PATIENTS AND METHODS: Fifty-two breast cancer patients with bidimensionally measurable metastatic disease and no prior chemotherapy for metastatic disease received a 135 mg/m2 intravenous (i.v.) bolus of TLC D-99 with 5 microg/kg of granulocyte colony-stimulating factor via subcutaneous injection every 21 days. RESULTS: The median number of treatment cycles of TLC D-99 was three (range, one to 10 cycles), and the median total cumulative dose of TLC D-99 was 405 mg/m2 (range, 135 to 1,065 mg/m2). Grade IV neutropenia, thrombocytopenia, and mucositis were experienced by 48 (92%), 46 (88%), and 10 (19%) patients, respectively. Twenty (38%) of patients experienced cardiac toxicity: four (8%) experienced a decrease of 20% or more in left ventricular ejection fraction (LVEF) to a final value > or = 50%, nine (17%) experienced a decrease of 10% or more in LVEF to a final value less than 50%, and seven (13%) developed symptomatic congestive heart failure (CHF), including one patient who died of cardiomyopathy after receiving a total dose of 1,035 mg/m2. In a stepwise logistic regression model, the significant risk factors for the development of CHF were the cumulative dose of prior adjuvant doxorubicin (P = .007) and the total cumulative dose of TLC D-99 (P = .032). The overall response rate was 46% (95% confidence interval [CI], 32% to 61%) on an intent-to-treat basis. The median duration of response was 7.4 months (95% CI, 6.1 to 19.6 months) and the median progression-free survival was 6.1 months (95% CI, 5.4 to 7.5 months). CONCLUSION: There was no added therapeutic benefit to the dose escalation of TLC D-99 in this study. A high rate of cardiotoxicity was also observed, especially among patients who had received prior adjuvant doxorubicin. This was probably attributable to the dose and schedule of TLC D-99 used in this trial, as well as the patient's lifetime cumulative doxorubicin dose. Administration of high-dose TLC D-99 at 135 mg/m2 every 3 weeks by i.v. bolus infusion does not warrant further investigation.

Adult↗

Monitoring therapeutic response in skeletal metastases using dual-energy x-ray absorptiometry: a prospective feasibility study in breast cancer patients.

Response to systemic therapy in breast cancer patients with lytic skeletal metastases manifests as a shift from increased bone resorption to new bone formation. We hypothesized that dual-energy x-ray absorptiometry (DXA) could be used to prospectively quantitate changes in bone mineral density (BMD) in metastatic skeletal lesions in breast cancer patients receiving systemic therapy. Nine metastatic breast cancer patients with one or more assessable lytic skeletal metastases receiving systemic therapy were prospectively evaluated with DXA, skeletal radiographs, computed tomography (CT), and radionuclide bone scans at baseline (t = 0 months, 2 months, and 6 months). The median (range) percentage change in BMD in skeletal lesions among patients responding to systemic therapy was 10.7% (0.1-21.85), 5.0% (-1.3-23.8), and 16.7% (-2.0-50.8) at 0-2, 2-6, and 0-6 months, respectively. Changes in BMD between 0-2, and 0-6 months were significant (Wilcoxin signed rank test; p = 0.013 and p = 0.017, respectively). The percentage change in BMD skeletal lesions between 0-2 and 2-6 months correlated with the changes imaged on skeletal x-rays (Spearman rank order correlation coefficient [Rs] = 0.511, p = 0.011) and CTs (Rs = 0.416, p = 0.046) but less so with bone scans (Rs = 0.293, p = 0.189). It is technically feasible to use DXA to prospectively monitor changes in lytic skeletal metastases in breast cancer patients receiving systemic therapy. The BMD of skeletal metastases increases in patients responding to treatment and was significantly correlated with the changes imaged on skeletal x-rays and CTs. Additional studies of DXA to evaluate response in skeletal metastasis are warranted.

Absorptiometry, Photon↗

Carbohydrate deficient transferrin in the assessment of alcohol misuse: absolute or relative measurements? A comparison of two methods with regard to total transferrin concentration.

Carbohydrate deficient transferrin (CDT) is now accepted as a potentially useful marker for the detection of alcohol misuse. It is not clear whether absolute values or values expressed relative to the total transferrin concentration provide the same diagnostic efficiency. CDT was measured in 35 patients with alcohol related liver disease, 35 subjects abusing alcohol without evidence of liver disease and 35 patients with chronic viral hepatitis using two commercial methods (CDTect and %CDT). To compare the methods, results were normalised by dividing the actual result by the upper limit of the reference range. Subtracting normalised %CDT results from the normalised CDTect results demonstrated a linear relationship between CDTect and total transferrin. This linear relationship could be abolished by calculating the CDTect/total transferrin ratio. The sensitivity of the methods was similar with CDTect (43 and 57%) being slightly superior to %CDT (40 and 46%). Specificity was similar (78%) for both methods. Calculation of the CDTect/total transferrin ratio improved the sensitivity and specificity slightly. The linear relationship between CDTect and total transferrin may produce misleading results in populations with a high prevalence of abnormal total transferrin concentrations and could cause difficulties in method comparisons unless taken into account.

Adolescent↗

Psychomotor performance: investigating the dose-response relationship for caffeine and theophylline in elderly volunteers.

OBJECTIVE: The aim of the study was to investigate the dose-response relationship for psychomotor performance, caffeine and theophylline in healthy elderly volunteers. METHODS: In a randomized, double-blind, placebo-controlled, six-period cross-over study we compared the effect of three doses of theophylline (predicted peak concentrations of 3, 6 mg. 1(-1) and 12 mg . 1(-1), two doses of caffeine (predicted peak concentrations of 4.5 mg. 1(-1) and 9 mg. 1 (-1) and placebo on ten healthy elderly volunteers. Psychomotor performance was measured using a continuous attention task, symbol digit substitution test and choice reaction time. Subjective effects were assessed using visual analogue scales. Following drug administration, subjects received the test battery at 30-min intervals, up to 150 min. Maximum and mean effects from baseline on each variable were included in the analysis. RESULTS: Significant improvement on the continuous attention task was seen at the lowest concentration of caffeine and theophylline used, while at higher concentrations there was a non-significant trend towards placebo scores. There was little effect of either drug on the subjective effects measured by visual analogue scales. CONCLUSION: Caffeine and theophylline increase psychomotor performance measures of attention at low plasma concentrations in healthy elderly volunteers. This effect is not increased by higher drug concentrations and there is trend towards a return to placebo scores. The lack of effect of both caffeine and theophylline on subjective measures is consistent with previous studies of caffeine in the elderly.

Aged↗

Identification of a recombination event narrowing the Lafora disease gene region.

Patients affected with progressive myoclonus epilepsy of the Lafora type present during late adolescence with a characteristic EEG pattern and Lafora bodies seen on skin biopsy. The critical region for the Lafora gene has been localised to chromosome 6q24 flanked by the dinucleotide repeat markers D6S292 and D6S420. This study for linkage of markers from the candidate gene region was performed in a previously unpublished family affected with Lafora disease. EEG and skin biopsy evaluation for Lafora bodies were performed on five of eight family members followed for seizure activity. Haplotype and linkage analysis of DNA from five family members were carried out using the nine dinucleotide repeat markers reported in the common region of homozygosity by Serratosa et al in 1995. The present study of an additional family affected by Lafora disease has narrowed the 17 cM critical region for the Lafora disease gene on chromosome 6q24 to a 4 cM region flanked by markers D6S308 and D6S311.

Chromosome Banding↗