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Biomedical subjects

John Campbell

Publications and source records attributed to John Campbell.

At least 19 recordsLinked to original sources

Evaluation of risk factors for Cryptococcus gattii infection in dogs and cats.

OBJECTIVE: To determine risk factors associated with Cryptococcus gattii infection in dogs and cats residing on Vancouver Island in British Columbia, Canada. DESIGN: Matched case-control study. ANIMALS: 20 dogs and 29 cats with C gattii infection and matched controls. PROCEDURE: Dogs and cats with a confirmed or probable diagnosis of cryptococcosis resulting from infection with C gattii were enrolled by veterinarians, and owners completed a questionnaire designed to obtain information pertaining to potential risk factors for the disease. Owners of matched control animals were also interviewed. Odds ratios and 95% confidence intervals or paired t tests were calculated to determine significant associations. RESULTS: Animals were enrolled during 2 noncontiguous periods in August 2001 to February 2002 (8 dogs and 9 cats enrolled) and May to December 2003 (12 dogs and 20 cats enrolled). Risk factors significantly associated with development of cryptococcosis included residing within 10 km of a logging site or other area of commercial soil disturbance, above-average level of activity of the animal, travelling of the animal on Vancouver Island, hunting by the animal, and owners hiking or visiting a botanic garden. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that dogs and cats that were active or that lived near a site of commercial environmental disturbance had a significantly increased risk of developing C gattii infection. Veterinarians should communicate these risks to owners in context because cryptococcosis was an uncommon disease in this population.

Animal Husbandry↗

What is eHealth (5): a research agenda for eHealth through stakeholder consultation and policy context review.

BACKGROUND: In 2003, the National Health Service in England and Wales, despite its large investment in information and communication technology, had not set a national research agenda. The National Health Service has three main research and development programs: one is the Service Delivery and Organisation program, commissioned in 2003, and the others are two parallel "scoping exercises" to help set a research agenda. This paper reports on one of those projects. A parallel literature review was carried out by others and has been reported elsewhere. OBJECTIVE: The objective was to explore the concerns of stakeholders and to review relevant policy in order to produce recommendations and a conceptual map of eHealth research. METHODS: There were two parallel strands. For the stakeholder consultation, 37 professionals representing 12 "stakeholder" groups participated in focus groups or interviews. Discussion was prompted by eHealth "scenarios" and analyzed using thematic content analysis. Subsequently, 17 lay participants, in three focus groups, discussed and prioritized these themes. For the policy review, 26 policy makers were interviewed, and 95 policy documents were reviewed. Recommendations were subsequently reviewed in a conference workshop. Recommendations for research from both strands were combined into a conceptual map. RESULTS: Themes from stakeholder consultation and policy review were combined as 43 recommendations under six headings. Four of these headings (using, processing, sharing, and controlling information) describe the scope of eHealth research. The other two relate to how research should be carried out (ensuring best practice is first identified and disseminated) and to the values considered important by stakeholders (in particular, measuring improvement in health). CONCLUSIONS: The scope of eHealth research (using, processing, sharing, controlling information) derived empirically from this study corresponds with "textbook" descriptions of informatics. Stakeholders would like eHealth research to include outcomes such as improved health or quality of life, but such research may be long term while changes in information technology are rapid. Longer-term research questions need to be concerned with human behavior and our use of information, rather than particular technologies. In some cases, "modelling" longer-term costs and benefits (in terms of health) may be desirable.

Delivery of Health Care↗

Emergent stent graft isolation of a knife-related subclavian arterial venous fistula: lessons learned during long-term follow-up.

We present the unusual case of a 42-year-old gentleman who entered the trauma center with a hemothorax and intermittent bright red pulsatile blood from three stab wounds in the ipsilateral supraclavicular fossa. The patient was found on emergent angiography to have a large right subclavian artery to vein fistula that was treated successfully with a Dacron-covered stent. Angiography, 2 years following stent-graft isolation, confirmed a durable result with evidence of hemodynamically insignificant neointimal growth through the pores of the graft material. This case provides insight into the long-term effects of a Dacron-covered stent in patients with traumatic arterial injury. We discussed the advantages and disadvantages of different graft materials based on these angiographic findings.

Adult↗

Human interleukin-19 and its receptor: a potential role in the induction of Th2 responses.

Interleukin-19 (IL-19) is a newly discovered member of the IL-10 family of ligands whose function is presently undefined. We recently described its cloning and initial characterization and in so doing, noted that the induction of IL-19 by LPS in human monocytes was down-regulated by interferon-gamma (IFN-gamma) and up-regulated by IL-4. This preliminary observation led us to speculate that IL-19 may play a role in the Th1/Th2 system and we examined this hypothesis further. Our results suggested that IL-19 is able to influence the maturation of human T-cells. CD4+ T-cells resulting from SEB stimulation in the presence of IL-19 contained a higher proportion of IL-4 producing cells than those developing in the absence of IL-19. This observation was complimented by the observation that fewer IFN-gamma cells accrued in the presence of IL-19, thereby suggesting that IL-19 altered the balance of Th1/Th2 cells in favour of Th2. Furthermore, in whole PBMC cultures, IL-19 up-regulated IL-4 and down-regulated IFNgamma in a dose-dependent manner. These results are presented here in review format, in the context of an overall discussion of IL-19 and its receptor.

Humans↗

Process for improving the integration of care across the primary and acute care settings in rural South Australia: asthma as a case study.

OBJECTIVE: To develop a process for improving the integration of care across the rural acute and primary care settings using asthma as a case study. METHODS: Development of the process on the analysis of case note audit, survey, interviews and a workshop. SETTING: A rural region of South Australia. RESULTS: A work plan for improving general practitioner (GP)-hospital integration was developed that resulted from analysis of the defined problem, GPs and stakeholder involvement, communication between all stakeholders, provision of an incentive to bring all the stakeholders together, and identification of evidence-based solutions. CONCLUSIONS: Managing chronic disease in a community requires the integration of care across the primary and acute care setting. To be successful, GP-hospital integration initiatives require stakeholder involvement, locally developed solutions, engagement of GPs, communication and a well-developed plan. This project provides a process for achieving this.

Acute Disease↗

Commonly used drugs impair oral tolerance in mice.

Ibuprofen and antibiotics are commonly prescribed during early childhood. When given to mice at the time at which oral tolerance is induced, both treatments affect either the induction or the maintenance of oral tolerance. These results suggest that the coadministration of these and similarly acting drugs should be considered cautiously for infants at risk of allergy.

Animals↗

Access to health care prior to suicide: findings from a psychological autopsy study.

Previous research has suggested that progress towards suicide reduction targets may be achieved by improving the ability of general practitioners to recognise and treat mental illness. Using data from a study of suicide completers who were not in contact with specialist mental health services, we found that the rate of detection and treatment of mental health problems in primary care was high. The major barrier to receipt of care for mental health problems prior to suicide was non-consultation. The study also shows that detection and management in primary care does not necessarily result in prevention of suicide. Implications for public education, access to primary care services and the potential for suicide prevention are considered.

Adolescent↗

Shiga toxin-producing Escherichia coli in the feces of Alberta feedlot cattle.

Shiga toxin-producing Escherichia coli (STEC) are a public health concern. Bacterial culture techniques commonly used to detect E. coli O157:H7 will not detect other STEC serotypes. Feces from cattle and other animals are a source of O157:H7 and other pathogenic serotypes of STEC. The objective of this study was to estimate the pen-level prevalence of Shiga toxins and selected STEC serotypes in pre-slaughter feedlot cattle. Composite fecal samples were cultured and a polymerase chain reaction (PCR) was used to detect genes for Shiga toxins (stx1 and stx2) and genes for O157:H7, O111:H8, and O26:H11 serotypes. Evidence of Shiga toxins was found in 23 pens (92%), O157:H7 in 2 (8%), O111:H8 in 5 (20%), and O26:H11 in 20 (80%) of the 25 pens investigated. Although pen-level prevalence estimates for Shiga toxins and non-O157 serotypes seem high relative to O157:H7, further effort is required to determine the human health significance of non-O157 serotypes of STEC in feedlot cattle.

Alberta↗

Upward trends in the incidence of neck of femur fractures in the elderly.

AIM: A recent paper by Fielden and colleagues suggested the incidence of neck of femur fractures among those aged 65 years and older underwent a much smaller increase during the 1990s than had previously been predicted. Given the importance of neck of femur fractures in New Zealand we sought to re-examine the conclusions of Fielden and colleagues, paying close attention to case selection. METHODS: Cases were selected from patients discharged by New Zealand public hospitals, with close attention paid to the inclusion criteria. Readmissions and day patients were excluded. RESULTS: Twenty eight per cent of the cases we identified were excluded as either readmissions or day patients. The resulting yearly incidence estimates were generally lower than those reported by Fielden and colleagues but the upward trends in incidence were stronger. Similarly, our estimates of the trends in age-specific rates for women showed the decline in these rates to be much less significant than that reported by Fielden and colleagues. CONCLUSIONS: Age-group-specific rates of neck of femur fracture have not declined as much as Fielden and colleagues suggested. Case selection can have a significant effect on estimated incidence and trends derived from hospital data.

Aged↗

Psuedoaneurysm of the superficial femoral artery resulting from stingray envenomation.

Stingray envenomations usually result in minor injuries with localized symptoms. In some cases the injury incurred is more serious, resulting in significant morbidity if not adequately treated. We report a case of pseudoaneurysm of the superficial femoral artery resulting from a stingray envenomation in a young female. Stingray venom is known to have necrosing properties in human tissues and in this case this led to graft failure requiring surgical repair. This case emphasizes the insidious nature of stingray venom and the necessity of extensive surgical debridement for more significant envenomations.

Adult↗

Setting standards based on patients' views on access and continuity: secondary analysis of data from the general practice assessment survey.

OBJECTIVES: To examine patients' views on access and continuity in general practice to derive quality standards. DESIGN: Secondary analysis of data from general practice research studies and routine quality assessment activities undertaken by practices and primary care trusts. SETTING: General practice. PARTICIPANTS: General practice patients. RESULTS: Satisfactory standards of access were next day appointments with general practitioners and a 6-10 minute wait for consultations to begin. A satisfactory level of continuity was seeing the same general practitioner "a lot of the time." Standards varied with the analytic method used and by sociodemographic group. CONCLUSIONS: Standards expected by patients in primary care can be derived from linked report-assessment pairs. Patients may have expectations of access that are in excess of government targets. Patients also have high expectations of continuity of care. It is unclear the degree to which such standards are reliable or valid, how conflicts between access and continuity should be resolved, or how these standards relate to other priorities of patients such as high quality interpersonal care.

Adolescent↗

Comparison of the diagnostic sensitivity of a commercially available culture kit and a diagnostic culture test using Diamond's media for diagnosing Tritrichomonas foetus in bulls.

A number of different culture media have been described for use in the diagnosis of Tritrichomonas foetus infection in bulls, and recently, a commercial culture kit has become available. The objective of this study was to compare the sensitivity of 2 culture-based diagnostic tests for T. foetus in bulls. One test used a commercial kit for transport and culture of the samples. The other test used a thioglycollate transport medium (TFTM) for transport and a modified Diamond's medium (MDM) for culture of the samples. Twenty-one bulls infected with T. foetus were sampled repeatedly. On each sampling day, samples collected from the left and right sides of the bull were tested with one of the 2 diagnostic tests being compared. The effect of the type of diagnostic test on the outcome of the test was evaluated with a chi-square test for the calculated odds ratio. Because repeated tests from the same bull cannot be considered independent measures, unadjusted chi-square tests were adjusted for the effect of clustering by bull. Samples tested using the commercial kit were 6.95 times as likely to be positive as samples tested with a diagnostic test using MDM (P < 0.001).

Animals↗