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Biomedical subjects

J Taylor

Publications and source records attributed to J Taylor.

At least 55 records · Page 3Linked to original sources
PubMed2003

A dissection and computer tomograph study of tarsal coalitions in 100 cadaver feet.

Most of the clinical studies report the incidence of tarsal coalitions (TC) as less than 1% but they disregard the asymptomatic coalitions. TC have been associated with degenerative arthritic changes. After X-rays, computer tomography (CT) is the most commonly used diagnostic test in the detection of TC. The aims of our study were to establish the incidence of TC; the association between TC and accessory tarsal bones and between TC and tarsal arthritis; and to assess the sensitivity of CT as a diagnostic tool in TC. We performed spiral CT scans of 100 cadaver feet (mean age at death 77.7+/-10.4), which were subsequently dissected. The dissections identified nine non-osseous TC: two talocalcaneal and seven calcaneonavicular. There was no osseous coalition. Tarsal arthritis was identified in 31 cases. Both talocalcaneal coalitions were associated with arthritis while none of the calcaneonavicular coalitions were associated with tarsal arthritis. The CT diagnosed an osseous talocalcaneal coalition and was suspicious of fibrocartilaginous coalitions in eight cases. There was correlation between dissection and CT in two talocalcaneal coalitions and three calcaneonavicular coalitions thus CT identifying 55.5% of the coalitions. CT did not diagnose four non-osseous coalitions and diagnosed errouresly four possible coalitions. In conclusion our study demonstrated that the incidence of non-osseous TC is higher than previously thought (12.72%). The calcaneonavicular coalitions are the most common single type (9.09%) and they do not seem to be associated with arthritic changes in the tarsal bones. Our CT results suggest that spiral CT has a low sensitivity in the detection of non-osseous coalitions and questions if multislice CT should be used routinely when TC are suspected.

Adult↗
PubMed2003

Predictors of prolonged dysphagia following acute stroke.

Dysphagia following acute stroke frequently necessitates prolonged enteral feeding. There is evidence that early enteral feeding via percutaneous endoscopic gastrostomy (PEG) is both beneficial and safe. The aim of this study was to identify predictors of prolonged dysphagia. The subjects were 149 consecutive patients admitted with acute stroke. Clinical findings and imaging results were prospectively collected, and subsequent progress recorded. Subjects were divided into 3 groups for analysis: no dysphagia; transient dysphagia (< or =14 days); or prolonged dysphagia (>14 days). Validity of the water swallow test as a predictor of aspiration pneumonia was confirmed. Significant associations for prolonged dysphagia were seen with stroke severity, dysphasia and lesions of the frontal and insular cortex on brain imaging. These results indicate that it may be possible to predict patients who will develop prolonged significant dysphagia following acute stroke thereby facilitating referral for insertion of PEG at an earlier time point.

Acute Disease↗
PubMed2003

The effect of cervical rotation on blood flow in the contralateral vertebral artery.

Twenty asymptomatic volunteers (mean age 33 years, range 26 - 54 years) underwent investigation using duplex Doppler ultrasound with real-time imaging and colour flow enhancement. With the subjects seated, peak velocity at C1-2 and volume flow rate at C5-6 were measured in the artery contralateral to the direction of rotation, in the four positions of neutral, 45 degrees and end range rotation, plus a subsequent neutral position. No change in peak velocity at C1-2 between the initial neutral measurement and the measurements at 45 degrees and end range rotation was found (P>0.05). Peak velocity was less in both vertebral arteries on return to the neutral position as compared with end range rotation, however the difference was significant for the left vertebral artery only (P=0.005). This lends support for the rest period, which is taken between cervical movement tests when conducting pre-manipulative testing, to allow for any latent effect on blood flow of the tests themselves. There was no change in volume flow rate between any of the test positions (P=0.349). There was no indication of a cumulative effect of the test procedure (P>0.05).

Adult↗
PubMed2003

Is magnetic resonance angiography useful in renovascular disease?

BACKGROUND: Magnetic resonance angiography (MRA) of renal vessels correlates well with conventional angiography (CA) and enables non-invasive assessment of renal vessels without nephrotoxic contrast. AIMS: We aimed to identify the referral source and nature of the patient group undergoing renal MRA, and the impact of this test on their management. METHODS: All renal MRA scans performed at the Royal Adelaide Hospital from 1 November 1997 to 31 December 2000 were reviewed (n = 121). Clinical data were obtained by case-note review or from treating physicians. MRA scans were with gadolinium enhancement, using a Siemens Vision 1.5 Tesla machine (Siemens, New York), with Visual Basic 33 software and 3D reconstruction. RESULTS: Nephrologists ordered the majority of renal MRA studies (64.5%). Indications for MRA included: (i). hypertension (91.3%), (ii). abnormal renal function (78.3%), (iii). other imaging suggesting renovascular disease (64.3%) and (iv) renal impairment with angiotensin-converting enzyme inhibition (18.3%). Eighty-seven MRA studies revealed renovascular abnormalities ('positive'). Over 50% of patients had three or more risk factors associated with vascular disease, with MRA positive in 76%. Localized renal artery stenosis was identified in 65 cases. In 40 of these, CA and further intervention was not undertaken, mainly due to presence of features of irreversible renal damage, low-grade stenosis or stable clinical parameters. CA was performed in 25 patients, all of whom had moderate- to high-grade (>60%)-stenosis on MRA. Revascularization was attempted in 21 of the 25 patients, with technical success in 17. In 22 patients, MRA identified non-localized abnormalities, most commonly diffuse arterial disease. None went on to angiography. CONCLUSIONS: Selective use of renal MRA in high-risk patients (identified by vascular risk factors or with standard renal imaging) can assist in avoidance of invasive, potentially nephrotoxic conventional angiography in up to 80% of cases. Those with lesions warranting treatment can then be selected for further intervention.

Adult↗
PubMed2003

The effect of ball carrying method on sprint speed in rugby union football players.

Different methods of ball carrying can be used when a player runs with the ball in rugby union. We examined how three methods of ball carrying influenced sprinting speed: using both hands, under the left arm and under the right arm. These methods were compared with running without the ball. Our aim was to determine which method of ball carrying optimizes sprinting speed. Altogether, 48 rugby union players (age 21 +/- 2 years, height 1.83 +/- 0.1 m, body mass 85.3 +/- 12 kg, body fat 14 +/- 5%; mean +/- s) were recruited. The players performed twelve 30-m sprints in total (each player performed three trials under each of three methods of carrying the ball and sprinting without the ball). The design of the study was a form of Latin rectangle, balanced across the trial order for each of the methods and for pairwise combinations of the methods in blocks of four per trial. Each sprint consisted of a 10-m rolling start, followed by a 20-m timed section using electronic timing gates. Compared with sprinting 20 m without the ball (2.58 +/- 0.16 s), using both hands (2.62 +/- 0.16 s) led to a significantly slower time (P < 0.05). Sprinting 20 m with the ball under the left arm (2.61 +/- 0.15 s) or under the right arm (2.60 +/- 0.17 s) was significantly quicker than when using 'both hands' (P < 0.05), and both these methods were significantly slower than when running without the ball (P < 0.05). Accordingly, running with the ball in both hands led to the greatest decrement in sprinting performance, although carrying the ball under one arm also reduced the players' sprinting ability. Our results indicate that to gain a speed advantage players should carry the ball under one arm.

Acceleration↗
PubMed2003

Is HSV serology useful for the management of first episode genital herpes?

BACKGROUND: First episode genital herpes simplex virus (HSV) infections can be classified into three groups, primary genital herpes (no previous exposure to HSV), non-primary first episode (IgG antibody to HSV of the non-presenting type), and first episode with pre-existing IgG HSV antibodies. The use of IgM to classify first episode genital herpes has not been evaluated. OBJECTIVE: To evaluate the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of HSV-1 and HSV-2 IgM antibodies for the diagnosis of first episode genital herpes, when compared with clinical diagnosis. METHODS: Patients with a first clinical episode of genital herpes were recruited. Sera were tested for IgG antibodies to HSV-2 using an indirect enzyme linked immunosorbent assay (ELISA). Equivocal results were resolved by western blot. HSV-1 IgG and IgM and HSV-2 IgM antibodies were detected using western blot. RESULTS: 157 patients were recruited. 31 were excluded (missing data or no detectable antibodies and negative viral isolation). Therefore, 126 patients were included in the analysis. 23 (18.3%) had primary genital herpes, 34 (27.0%) non-primary first episode, and 69 (54.8%) had pre-existing genital herpes. The specificity and PPV of HSV IgM was 100%; the sensitivity was 79% and the NPV 85%. CONCLUSION: IgM HSV serology may be useful in the management of some patients with first episode genital herpes and provide an indication of the source of infection. Drawbacks include the low sensitivity and NPV, lack of availability, IgM antibodies may occasionally be produced in response to recurrent infection and, finally, IgM antibodies may take up to 10 days to develop and last 7-10 days.

Antibodies, Viral↗
PubMed2003

Sexual behaviour and social class in Australian women.

Sexual behaviour is determined by social, cultural and personal factors. Sexual behaviour studies have been conducted in many countries. However, information from Australia is limited. This study was conducted in Obstetrics Department, Westmead Hospital, Sydney. Questionnaire-derived demographic and behavioural characteristics for public and private patients were compared using bivariate and logistic regression analyses. Of the patients, 3036 were public, and 595 private. On bivariate analysis some significant differences were private patients more likely to be born in Australia and have a higher education level whereas public patients were more likely to have had a greater number of lifetime sexual partners and younger age at first sex. Public patients were more likely to be herpes simplex virus type 2 (HSV-2) antibody positive (12%) than private patients (6%). On logistic regression significant variables included country of birth, being HSV-2 antibody positive, and age at first sex. A number of sexual and social variables were significantly different, comparing patients in the public and private sectors. Evaluation of interventions to reduce the sexual risk to women in the public sector should be considered, including encouraging young women to delay their sexual debut, and reducing the number of sexual partners.

Adolescent↗
PubMed2003

Use of active barriers to reduce eutrophication problems in urban lakes.

Excessive concentration of phosphorus is one of the main causes of algal blooms and eutrophic conditions in lakes. In many urban lakes, it appears that a large proportion of the phosphorus in the water column comes from the sediments, particularly when these are anaerobic. Sub-aqueous capping is a relatively new method that has become an attractive option for isolating contaminated sediments from the environment, thus preventing or delaying the release of contaminants into surface waters. Active barrier materials (i.e. capping layers that consist of one or more reactive components) are gaining increasing attention for their greater efficiency in inactivating contaminants held in sediment layers. This paper reports laboratory bioreactor experiments to test the effectiveness of three forms of calcium carbonate (CaCO3) in reducing the release of phosphorus from anaerobic sediment from Lake Carramar, a small urban lake in Melbourne. Two of the CaCO3 active barrier materials tested proved to be quite effective, the most effective materials being the fine particle size, precipitated forms of CaCO3. Over the 20-day experimental period, a 2% layer of the German material SoCal reduced the amount of phosphorus released by almost 100 times over that occurring with no barrier. The Australian product ESCal, while not as effective as the SoCal, still reduced the phosphorus released by around 15 times that with no barrier. A finely ground Lilydale limestone was essentially ineffective in reducing phosphorus release from the sediments. A preliminary cost-benefit analysis suggests that SoCal is unlikely to be attractive for use in Australia, given the estimated application cost of around 3,800 dollars per tonne. However, although the ESCal is slightly less effective in retaining phosphorus, its potential application cost estimated at 2,000 dollars per tonne, makes it an attractive option. On the basis of these most promising preliminary results, we intend to further test the use of the ESCal. Further investigations will include: longer term laboratory studies using ESCal, optimisation of the barrier layer and methods for applying this material, mesocosms and full lake studies, and risk assessment studies to ensure there are no adverse ecological effects from its use.

Australia↗
PubMed2003

Gene expression in the developing embryo and fetus.

Determining the stage- and tissue-specific patterns of gene expression shown by the embryo and fetus will provide information about the control of normal development. Identification of alterations in these patterns associated with specific abnormal phenotypes will also be informative regarding the underlying molecular mechanisms. In addition, qualitative and quantitative changes in gene expression that deviate from the norm may provide a potential marker system for predicting future developmental defects, a system that would be particularly useful in preimplantation embryo technologies before recipient transfer. However, there are a number of important issues regarding the interpretation and relevance of many gene expression studies currently undertaken that are often not considered or are ignored. Even when rigorous methodology is applied to detect differences in gene expression, their functional significance is rarely defined. This review discusses the relevance of gene expression changes as diagnostic markers in relation to protein and epigenetic changes and indicates that gene expression studies should be rigorously designed and interpreted to yield meaningful results.

Animals↗
PubMed2002

Evidence-based rural general practice: barriers and solutions in South Australia.

INTRODUCTION: This paper reports on research to ascertain the views of general practitioners (GPs) practising in rural and remote areas of South Australia, on evidence-based medicine (EBM). It follows our previous paper that identified, through a literature search, the key issues in moving towards EBM in general practice in these areas1. The objective of the paper was to identify perceived barriers and potential solutions to evidence-based general practice in rural and remote South Australia. METHODS: An interview survey was conducted in the year 2000 at 89 of 104 GPs' (86%) surgeries in three rural Divisions of General Practice in South Australia. RESULTS: EBM was viewed positively by 85%, and 94% reported practising EBM. However, barriers to EBM were identified by 84% and four key themes were identified. GP-related barriers identified by 60% included difficulty finding, appraising and applying evidence and lack of time to read, reflect and update practice. Patient related barriers (23%) included an apparent conflict between some patients' expectations and evidence. Environmental barriers (43%) related to remoteness included high workload, limited information and poor resources for continued medical education. Resource related barriers included a lack of computer hardware and software and slow, unreliable and expensive Internet access (14%). Potential solutions were suggested by 82%. The most frequent was improved hardware, software and Internet access (41%). Only 19% suggested formal training for GPs, while 26% suggested improved clinical practice guidelines and 23% suggested non-Internet based dissemination of information including a service to provide evidence-based answers to clinical problems. CONCLUSION: EBM was viewed positively by the surveyed GPs and many believed they already practised it. Most identified barriers to full and effective use of EBM but also suggested solutions.

Journal Article↗
PubMed2002

Consensus and comprehensive linkage maps of bovine chromosome 24.

This study describes development of a consensus genetic linkage map of bovine chromosome 24 (BTA24). Eight participating laboratories contributed data for 58 unique markers including a total of 25 409 meioses. Eighteen markers, which were typed in more than one reference population, were used as potential anchors to generate a consensus framework map. The framework map contained 16 loci ordered with odds greater than 1000:1 and spanned 79.3 cM. Remaining markers were included in a comprehensive map relative to these anchors. The resulting BTA24 comprehensive map was 98.3 cM in length. Average marker intervals were 6.1 and 2.5 cM for framework and comprehensive maps, respectively. Marker order was generally consistent with previously reported BTA24 linkage maps. Only one discrepancy was found when comparing the comprehensive map with the published USDA-MARC linkage map. Integration of genetic information from different maps provides a high-resolution BTA24 linkage map.

Animals↗
PubMed2002

A comparative map of bovine chromosome 25 with human chromosomes 7 and 16.

A comparative genome map is necessary for the implementation of comparative positional candidate gene cloning in cattle. We have developed a medium density comparative gene map of bovine chromosome 25 (BTA25). A radiation hybrid (RH) panel was used to map nine microsatellites and nine genes. Eight of the nine comparative loci were also mapped by FISH. These results were combined with data from published articles to create a comprehensive comparative map of BTA25 with human chromosomes 7 (HSA7) and 16 (HSA16). This map should facilitate the cloning of genes of interest on bovine chromosome 25.

Animals↗
PubMed2001

Towards evidence-based general practice in rural and remote Australia: an overview of key issues and a model for practice.

There is an extensive global move towards evidence-based practice intended to increase the quality and effectiveness of health care. However there are barriers and issues when rural general practitioners attempt to incorporate evidence-based medicine in their practice. Key issues affecting the uptake of evidence-based medicine by rural general practitioners include the gaps in the scientific evidence relevant to general practice, time limitations, and the cost of Internet access, geographical isolation from centres of evidence-based practice and limited training opportunities. General practitioner consultations may involve multiple, ill-defined problems and the patients' views about their treatment may conflict with an evidence-based treatment approach. Rural general practitioners may require additional supports to access information from research through Internet-based resources, accessible summaries of evidence or clinical practice guidelines. In addition a model to assist rural general practitioners use evidence-based medicine is suggested. This model may enable the clinical decision-making process to integrate clinical experience, patient preferences and an understanding of the rural context of practice with the best available evidence, to in turn produce best practice.

Journal Article↗
PubMed2001

A structure-based design approach to the development of novel, reversible AChE inhibitors.

Chimeras of tacrine and m-(N,N,N-Trimethylammonio)trifluoroacetophenone (1) were designed as novel, reversible inhibitors of acetylcholinesterase. On the basis of the X-ray structure of the apoenzyme, a molecular modeling study determined the favored attachment positions on the 4-aminoquinoline ring (position 3 and the 4-amino nitrogen) and the favored lengths of a polymethylene link between the two moieties (respectively 5-6 and 4-5 sp(3) atoms). Seven compounds matching these criteria were synthesized, and their inhibitory potencies were determined to be in the low nanomolar range. Activity data for close analogues lacking some of the postulated key features showed that our predictions were correct. In addition, a subsequent crystal structure of acetylcholinesterase complexed with the most active compound 27 was in good agreement with our model. The design strategy is therefore validated and can now be developed further.

Acetophenones↗