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K Bray

Publications and source records attributed to K Bray.

At least 19 recordsLinked to original sources
PubMed2005

UK guidance for non-heart-beating donation.

This guidance offers consensus opinion on the optimum management of non-heart-beating organ donation in adult critical care units. The guidance is not meant to dictate practice but rather to offer suggestions as to what might be considered reasonable practice. The following sections mainly relate to the medical aspects of non-heart-beating organ donation. Fuller guidance on other aspects of organ and tissue donation is available on the Society's website (www.ics.ac.uk). There are a number of parallel areas of work, such as the law on consent, the definition of death and revision of the original Code of Practice describing brainstem testing, which means that many aspects of organ donation are changing rapidly. This guidance is designed to help critical care practitioners while these issues are resolved.

Adult↗
PubMed2004

The effects of dietary supplementation with isoflavones from red clover on cognitive function in postmenopausal women.

OBJECTIVE: To examine the effects of dietary isoflavone supplementation with an extract from red clover on cognitive function in postmenopausal women. DESIGN: Thirty postmenopausal women aged greater than 60 years received either two tablets of an extract of aglycone isoflavones from red clover (each containing formononetin 25 mg, biochanin 2.5 mg and less than 1 mg of daidzein and genistein) for 6 months in a randomized, controlled clinical trial. Cognitive function tests were performed at baseline and at the end of isoflavone or placebo therapy. RESULTS: Isoflavone supplementation was associated with an apparent improvement in block design (a test of visual-spatial intelligence) compared to placebo (isoflavone +12%, placebo -3%; p = 0.03), no improvement in verbal memory compared to an improvement on placebo (isoflavone +1%, placebo +29%; p = 0.023) and a deterioration in digit recall compared to placebo (isoflavone -6%, placebo +12%; p = 0.029). However, these findings were not statistically significant when corrections were made for potential chance findings due to multiple comparisons. CONCLUSION: Isoflavone supplementation does not appear to have major short-term effects on cognitive function in postmenopausal women. However, further clinical trials are required to determine whether small effects or long-term effects on cognitive function occur during isoflavone supplementation.

Cognition↗
PubMed2001

Treatment of periodontitis by local administration of minocycline microspheres: a controlled trial.

BACKGROUND: Periodontitis is an inflammatory condition of tooth-supporting tissues that is usually treated by mechanical removal of plaque and microorganisms that adhere to teeth. This treatment, known as scaling and root planing, is not optimally effective. Adjunctive therapy with locally delivered antimicrobials has resulted in improved clinical outcomes such as probing depth reduction. This article reports on the efficacy and safety of locally administered microencapsulated minocycline. METHODS: Seven hundred forty-eight (748) patients with moderate to advanced periodontitis were enrolled in a multi-center trial and randomized to 1 of 3 treatment arms: 1) scaling and root planing (SRP) alone; 2) SRP plus vehicle; or 3) SRP plus minocycline microspheres. The primary outcome measure was probing depth reduction at 9 months. Clinical assessments were performed at baseline and 1, 3, 6, and 9 months. RESULTS: Minocycline microspheres plus scaling and root planing provided substantially more probing depth reduction than either SRP alone or SRP plus vehicle. The difference reached statistical significance after the first month and was maintained throughout the trial. The improved outcome was observed to be independent of patients' smoking status, age, gender, or baseline disease level. There was no difference in the incidence of adverse effects among treatment groups. CONCLUSIONS: Scaling and root planing plus minocycline microspheres is more effective than scaling and root planing alone in reducing probing depths in periodontitis patients.

Administration, Topical↗
PubMed2001

Suicide trends in Wisconsin 1984-1998: good news for young and old.

PROBLEM: In Wisconsin, suicide is the eighth leading cause of death. Subgroups identified as being at higher risk are the elderly (> age 65) and young adults (aged 15-24). OBJECTIVES: 1) To compare overall national trends in suicide rates to Wisconsin trends in suicide rates from 1984 to 1998; 2) to examine suicide rates in Wisconsin sub-groups (age, gender and race) 1984-1998; and 3) to assess progress toward Wisconsin's Public Health Agenda for the Year 2000 suicide mortality goals. METHODS: National Center for Injury Control and Prevention data on suicide mortality were accessed for the United States and Wisconsin using WISQARS data extraction system. Mean suicide rates were calculated for two 5-year spans (1984-1988 and 1994-1998). Average numbers of deaths and percent change between mortality rates were calculated for the two 5-year spans. RESULTS: From 1984-1998, mean suicide mortality rates decreased 8% nationally and 14% in Wisconsin. Various trends are occurring between genders and ages. The current declines in teens 15-19 and elderly 75-84 may indicate reversals of previous trends. Rates for women decreased for nearly all age groups, continuing previously documented declines. While it appears progress has been made toward Wisconsin Public Health Agenda goals, it appears unlikely the overall objective of 8 per 100,000 will be met.

Adolescent↗
PubMed2000

Assessing interdisciplinary education in U.S. dental hygiene programs.

This study was done to examine the role of interdisciplinary education in dental hygiene curricula, identify factors associated with its implementation, explore the perceptions of dental hygiene educators related to interdisciplinary education, and explore these educators' perception of its validity and barriers to implementation. A 36-item questionnaire mailed to directors of all 216 dental hygiene programs in the United States elicited program demographics and information about participation in clinical and didactic interdisciplinary educational experience as well as attitudes regarding such experiences. The response rate was 63% (n = 136). Of the 136 respondents, 31% (n = 69) indicated that the dental hygiene curricula at their institutions included interdisciplinary activities; 15% (n = 33) indicated participation in both clinical and didactic interdisciplinary course work. Student participation was minimal, with most interdisciplinary activities taking place in didactic course work, but 74% (n = 160) of the respondents felt their students should be participating in interdisciplinary educational experiences. Chi-square analysis identified no consistent association among interdisciplinary activity variables. Many respondents felt that interdisciplinary educational experiences would benefit their students, but very few had incorporated them into their curricula, citing lack of resources and time as reasons. In addition, the term interdisciplinary was interpreted variably.

Administrative Personnel↗
PubMed1993

Synthesis of and radioligand binding studies with a tritiated pinacidil analogue: receptor interactions of structurally different classes of potassium channel openers and blockers.

The synthesis of N-cyano-N'-[1,1-dimethyl-[2,2,3,3-3H]propyl]-N"-(3- pyridinyl)guanidine, [3H]-15, is described. The utility of this tritiated radioligand in characterizing the interactions of potassium channel openers and blockers with their receptors is demonstrated. Potassium channel openers of the pinacidil, cromakalim, aprikalim, diazoxide, and minoxidil types, as well as KATP channel blockers of the glibenclamide and eosine types, are all capable of displacing [3H]-15 from its receptor. The results indicate that all of these compounds interact with the same target protein, but that several different allosterically coupled receptor binding sites are probably involved. The highly significant correlation between the ability of the structurally diverse potassium channel openers to inhibit [3H]-15 binding and to relax vascular smooth muscle is consistent with their receptor binding sites being closely associated with the potassium channel protein which is the functional target of this class of drugs.

Animals↗
PubMed1993

Synthesis of peptidoglycan and membrane during the division cycle of rod-shaped, gram-negative bacteria.

A modified procedure for determining the pattern of peptidoglycan synthesis during the division cycle has allowed the measurement of the rate of side wall synthesis during the division cycle without the contribution due to pole formation. As predicted by a model proposing that the surface growth of the cell is regulated by mass increase, we find a decrease in side wall synthesis in the latter half of the division cycle. This supports the proposal that, upon invagination, pole growth accommodates a significant proportion of the increasing cell mass and that residual side wall growth occurs in response to the residual mass increase not accommodated by pole volume. The observed side wall synthesis patterns support the proposal that mass increase is a major, and possibly sole, regulator of bacterial surface increase. Membrane synthesis during the division cycle of the gram-negative, rod-shaped bacteria Escherichia coli and Salmonella typhimurium has also been measured with similar methods. The rate of membrane synthesis--measured by incorporation of radioactive glycerol or palmitate relative to simultaneous labeling with radioactive leucine--exhibits the same pattern as peptidoglycan synthesis. The results are compatible with a model of cell surface growth containing the following elements. (i) During the period of the division cycle prior to invagination, growth of the cell occurs predominantly in the side wall and the cell grows only in length. (ii) When invagination begins, pole growth accommodates some cytoplasmic increase, leading to a concomitant decrease in side wall synthesis. (iii) Surface synthesis increases relative to mass synthesis during the last part of the division cycle because of pole formation. It is proposed here that membrane synthesis passively follows the pattern of peptidoglycan synthesis during the division cycle.

Cell Cycle↗
PubMed1992

Differential inhibition by tedisamil (KC 8857) and glibenclamide of the responses to cromakalim and minoxidil sulphate in rat isolated aorta.

The effects of the K+ channel blockers tedisamil and glibenclamide on cromakalim- and minoxidil sulphate-induced 42K+ and 86Rb+ efflux and vasorelaxation in rat aorta, were investigated. In aortic strips preloaded with 42K+ or 86Rb+, cromakalim (1 mumol/l) induced increases in tracer efflux, which were concentration-dependently inhibited by tedisamil with similar potencies (pD2 approximately 7.3) but different amplitudes (maximum inhibition of 86Rb+ efflux to 0% of control, 42K+ efflux to 10 +/- 1%). The 42K+ efflux elicited by a low concentration of cromakalim (100 nmol/l) was, however, fully inhibited by tedisamil. The tracer effluxes induced by minoxidil sulphate were fully inhibited by tedisamil and glibenclamide (300 nM). Cromakalim and minoxidil sulphate, produced a concentration-dependent inhibition of noradrenaline (100 nmol/l)-induced tone, with pD2 values of approximately 7.3. Tedisamil (300 nmol/l) and glibenclamide (300 nmol/l), which inhibited cromakalim- and minoxidil sulphate-induced 42K+ and 86Rb+ efflux by greater than or equal to 80%, produced 2-fold and 40-fold shifts in the concentration-relaxation curve for cromakalim, and 3.5-fold and 2200-fold shifts in the concentration-relaxation curve for minoxidil sulphate, respectively. Similar shifts of the cromakalim concentration-relaxation curve in the presence of tedisamil and glibenclamide were also observed when the tissues were precontracted with potassium chloride (25 mmol/l). The results show that tedisamil and glibenclamide inhibit the cromakalim- and minoxidil sulphate-induced tracer effluxes with similar potencies whereas they differ greatly in their ability to inhibit the vasorelaxant effects of the two K+ channel openers.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

Spontaneous amplification of the ADH4 gene in Saccharomyces cerevisiae.

Five spontaneous amplifications of the ADH4 gene were identified among 1,894 antimycin A-resistant mutants isolated from a diploid strain after growth at 15 degrees. Four of these amplifications are approximately 40-kb linear extrachromosomal palindromes carrying telomere homologous sequences at each end similar to a previously isolated amplification. ADH4 is located at the extreme left end of chromosome VII, and the extrachromosomal fragments appear to be the fusion of two copies of the end of this chromosome. The fifth amplification is a chromosomal amplification carrying an extra copy of ADH4 on both homologs of chromosome VII. These results suggest that the ADH system can be used to study amplification in Saccharomyces cerevisiae.

Alcohol Dehydrogenase↗
PubMed1991

Tedisamil (KC 8857) differentially inhibits the 86Rb+ efflux-stimulating and vasorelaxant properties of cromakalim.

Tedisamil, a blocker of cardiac K+ channels, potently inhibited cromakalim-induced 86Rb+ efflux from rat aorta with a pIC50 = 7.3, a value similar to that obtained with the sulphonylurea glibenclamide. However, tedisamil was approximately 30 times less potent than glibenclamide in inhibiting the vasorelaxant effects of cromakalim. The data suggest that tedisamil can dissociate between the efflux-inducing and vasorelaxant effects of cromakalim and may therefore prove to be an important tool in elucidating the mechanism of action of this vasorelaxant.

Animals↗
PubMed1991

Some degree of overlap exists between the K(+)-channels opened by cromakalim and those opened by minoxidil sulphate in rat isolated aorta.

The effects of the K+ channel opening drugs minoxidil sulphate and cromakalim, on 42K+ and 86Rb+ efflux and on vasorelaxation in rat isolated aorta, were compared. In rat aortic rings precontracted with noradrenaline (100 nmol/l), minoxidil sulphate and cromakalim concentration-dependently inhibited induced tension by up to 90%, with pD2 values of 7.35 +/- 0.1 and 7.17 +/- 0.1, respectively. Glibenclamide (300 nmol/l), produced 2200- and 19-fold rightward shifts in the concentration-relaxation curves to minoxidil sulphate and cromakalim, respectively, without an effect on the maximum relaxation. Both minoxidil sulphate and cromakalim increased the efflux of 42K+ and 86Rb+ from aorta in a concentration-dependent manner, with midpoints in the mumol/l range; the maximum efflux induced by minoxidil sulphate being approximately one tenth of that induced by cromakalim. The ratio of stimulated 86Rb+/42K+ efflux increased from 0.22 to 0.48 with increasing cromakalim concentrations, but was approximately constant (approximately 0.39) when the minoxidil sulphate concentration was varied. In the presence of minoxidil sulphate, the effects of cromakalim on 42K+ and 86Rb+ efflux were inhibited in a concentration-dependent manner, by up to 60%. In the continuing presence of cromakalim (300 nmol/l), minoxidil sulphate (10 mumol/l)-induced increases in 42K+ and 86Rb+ efflux were inhibited by 45%, whereas conditioning with cromakalim (1 mumol/l) inhibited the 86Rb+ efflux stimulated by additional superfusion of cromakalim (1 mumol/l) by 85%. Glibenclamide inhibited minoxidil sulphate (10 mumol/l)- and cromakalim (1 mumol/l)-induced increases in 42K+ and 86Rb+ efflux in a concentration-dependent manner with IC50 values of approximately 80 nmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Differences in the K(+)-channels opened by cromakalim, acetylcholine and substance P in rat aorta and porcine coronary artery.

1. The effects of acetylcholine and substance P on the efflux of 86Rb+ and 42K+ from rat aorta and pig coronary artery, respectively, were compared with those of the K+ channel opening agent, cromakalim. 2. In rat aorta preloaded with 86Rb+ and/or 42K+, acetylcholine produced transient, concentration-dependent increases in the efflux rate coefficients of these tracers (maximum approximately 35%). These effects were abolished by endothelial cell removal. 3. Donor/acceptor experiments with rat aorta suggested that at least some of the efflux of 86Rb+ seen in the presence of acetylcholine was not derived from the endothelium, but came from the smooth muscle itself. 4. Acetylcholine (10 microM)-induced 86Rb+ efflux was reduced by tetraethylammonium (TEA, 10 mM) to 33% and ouabain (300 microM) to 54% of control. Preincubation with Ba2+ (100 microM) did not significantly inhibit acetylcholine-induced efflux. 5. Acetylcholine-induced 42K+/86Rb+ efflux was unaffected by preincubation with glibenclamide (10 microM). In contrast, the 42K+/86Rb+ efflux induced by cromakalim was inhibited by glibenclamide (50 nM) by 50%. 6. Acetylcholine (0.3-10 microM)-induced inhibition of phenylephrine (1 microM)-induced tone was abolished by endothelial cell removal but unaffected by glibenclamide. Cromakalim-induced relaxations were endothelium-independent and were inhibited by glibenclamide in a concentration-dependent manner. 7. LG-monomethyl L-arginine (L-NMMA, 250 microM) produced a significant (37 +/- 14%) inhibition of acetylcholine-induced 86Rb+ efflux whereas DG-monomethyl L-arginine was without effect. In the tissue bath L-NMMA inhibited relaxations produced by acetylcholine (0.3-10 microM), but was without effect on responses to cromakalim. 8. In the pig coronary artery, substance P induced an endothelium-dependent efflux of 86Rb+ and 42K+, which was unaffected by preincubation with glibenclamide (10 microM) or L-NMMA (250 microM). 9. The present study shows that acetylcholine and substance P each open K(+)-channels in arterial smooth muscle. However, the insensitivity of the stimulated 86Rb/42K+ efflux to inhibition by glibenclamide suggests that the K(+)-channel opened by these agents is different from the K(+)-channel opened by cromakalim. In addition, the inability of L-NMMA to inhibit fully the acetylcholine- and substance P-stimulated 86Rb+ efflux suggests that in rat aorta and pig coronary artery the endothelium-derived hyperpolarizing factor(s) (EDHF) is different from endothelium-derived relaxing factor (EDRF).

Acetylcholine↗
PubMed1989

Serum levels of cancer-associated antigen CA-195 in gastrointestinal cancers and its comparison with CA19-9.

The antibody against CA-195 binds to an epitope that consists of both Lewis A and sialylated Lewis A blood group antigen, whereas CA19-9 has shown specificity for sialylated Lewis A blood group antigen. CA19-9 and CA-195 levels were measured in the sera of 52 normal subjects; 65 benign disease patients; and 74 non-gastrointestinal, 149 colorectal, and 119 upper gastrointestinal cancer patients to correlate their levels with disease status of the patients. Low incidence and levels were found among normal subjects for both markers; however, in the benign disease group a slightly higher incidence of elevation was seen for CA19-9. Among colorectal cancer patients CA-195 appeared to show higher sensitivity for primary as well as advanced disease. Levels of both markers showed similar incidences of elevation among upper gastrointestinal cancer patients. Based on these results the contribution of Lea specificity of CA-195 cannot be ruled out, and it may be used alone or in combination with other markers for monitoring of patients with colorectal, pancreatic, gastric, gall bladder, bile duct, and liver cancers.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1983

The release of histamine from human basophils by radiological contrast agents.

The capacity of conventional and new low-osmolality contrast agents to stimulate histamine release from human basophils has been studied in vitro. When compared on an iodine concentration basis, the new agents release less histamine than the conventional agents at intermediate and higher concentration. However, the newer compounds exhibit a biphasic histamine release response to increasing iodine concentration with a low concentration peak, a phenomenon not previously described. Among the conventional ionic agents, meglumine salts were confirmed to be more potent histamine releasers than sodium salts. Possible mechanisms of this histamine release and the bearing of the findings on the safety of contrast media are discussed.

Basophils↗
PubMedDate not supplied

Position statement on the role of health care assistants who are involved in direct patient care activities within critical care areas.

Intensive care has developed as a speciality since the 1950s, and during this time, there have been major technological advances in health care provision, leading to a rapid expansion of all areas of critical care. The ongoing problem in recruiting qualified nurses in general has affected, and continues to be a problem for, all aspects of critical care areas. During the past decade, nursing practice has evolved, as qualified nurses have expanded their own scope of practice to develop a more responsive approach to the complex care needs of the critically ill patient. The aim of this paper is to present the British Association of Critical Care Nurses (BACCN) position statement on the role of health care assistants involved in direct patient care activities, and to address some of the key work used to inform the development of the position statement.

Clinical Competence↗
PubMedDate not supplied

Health care assistants' role, function and development: results of a national survey.

Intensive care has developed as a speciality since the 1950s; during this time there have been major technological advances in health care provision leading to a rapid expansion of all areas of critical care. The ongoing problem of recruiting appropriately qualified nurses has affected staffing levels in many units and continues to be a national problem. For many, the answer lies in employing health care assistants to support the work of registered nurses. A key aim of the British Association of Critical Care Nurses is to promote the art and science of critical care nursing by providing representation for its members, by responding to political and professional change and by producing and publishing position statements. A primary component of the work surrounding the development of this second position statement was the gathering of contemporary information in relation to the role of health care assistants within critical care units throughout the UK, through a survey of 645 critical care units within the UK. At present the impact upon the role of the critical care nurse is not fully understood, with research in this area suggesting that although there is a role for the health care assistant in the critical care environment, this should only be undertaken with a full analysis of this impact upon the work of the registered nurse.

Allied Health Personnel↗
PubMedDate not supplied

The validity of adding new tasks to the assessment of motor and process skills.

OBJECTIVE: Twenty-one new activities of daily living (ADL) tasks were evaluated for the validity of their inclusion into the Assessment of Motor and Process Skills (AMPS). METHOD: Data from 1,484 participants who performed at least one new AMPS task were analyzed to determine whether the new tasks (a) fit the AMPS many-faceted Rasch (MFR) model and (b) increase the range of the AMPS motor and process skill scales. RESULTS: Twenty of the 21 new tasks fit the MFR model. The AMPS motor scale was increased by .25 logit at the easier end of the scale and by .30 logit at the more difficult end of the scale. The AMPS process scale was increased by .14 logit at the easier end of the scale. The more difficult end of the AMPS process scale did not increase. CONCLUSION: These findings support the validity of adding 20 new tasks into the AMPS. The new tasks provide the following benefits for testing clients whose ADL ability levels are at the lower or higher ends of the AMPS motor or process skill scales: (a) potential for less error when estimating the ADL ability measures, (b) more task choices, and (c) more face-valid tasks for testing men.

Activities of Daily Living↗