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Biomedical subjects

K Watson

Publications and source records attributed to K Watson.

At least 19 recordsLinked to original sources
PubMed2026

Genomic characterisation of Enterococcus cecorum isolated from broiler chickens in the United Kingdom.

Enterococcus cecorum is an important poultry pathogen associated with lameness and increased mortality, leading to major welfare and economic impacts. Treatment is often challenging because disease is frequently detected late and the organism can localise in bone and joints, limiting antimicrobial efficacy. Presence of antimicrobial resistance (AMR) genes may further complicate treatment. Despite increasing global genomic research, only one recent study has investigated the phylogeny of E. cecorum from conventional UK broiler farms, using limited samples and a restricted time frame. In this study, 283 E. cecorum isolates were analysed, including 158 from the United Kingdom and 125 global non‑UK isolates. UK isolates comprised 123 archived by the Animal and Plant Health Agency (APHA) between 2003 and 2022, predominantly from clinical outbreaks with increased welfare culling and mortality, and 35 isolates from a UK study including clinical and environmental samples. Genome sequencing was used to assess phylogeny, AMR determinants and virulence factors (VFs). Single nucleotide polymorphism phylogenetic analysis identified eight major UK lineages with limited intra‑lineage diversity, indicating that UK isolates were genetically distinct from non‑UK populations. Using a 60‑SNP threshold, APHA isolates formed 18 subclusters, consistent with long‑term persistence and recurrent farm transmission, while multiple subclusters detected on some farms suggested repeated introductions. UK isolates carried fewer AMR genes than non‑UK isolates, with erm(B), lnu(C), tet(M) and tet(L) most prevalent. Screening of VF genes identified nine genes present in all isolates, with the remainder variably distributed. A subset of 60 UK isolates was examined for 13 previously described virulence‑associated genes, with phylogenetic clustering indicating associations between gene presence or absence and clinical status or mortality classification. The capsular polysaccharide gene cpsO was assessed in this subset and most non‑clinical or environmental isolates were cpsO‑negative, although several isolates from high‑mortality outbreaks also lacked this gene. Overall, this study provides insight into the phylogeny, AMR profiles and virulence gene diversity of E. cecorum within the UK broiler sector, supporting targeted surveillance and investigation of pathogenic mechanisms.

Antimicrobial resistance↗
PubMed2006

Pleasure or pain? A profile of smokers in Northern England.

OBJECTIVE: To construct a profile of smokers using multiple indices of physical, mental and social health. STUDY DESIGN: Cross-sectional study. METHODS: The setting was Wigan and Bolton Health Authority, an urban district in the North West of England. A random sample of over 15000 adults from the Health Authority adult population completed a written questionnaire. Prevalence ratios were calculated for physical, mental and social health indicators for smokers compared with non-smokers, adjusted for borough, age and deprivation score of place of residence. RESULTS: Smokers were less likely to report their current health as good, and reported a significantly higher prevalence of arthritis, bronchitis, backache and respiratory symptoms. Smokers had more mobility problems and recent severe pain. Smokers had less healthy lifestyles across many behaviours (e.g. poorer diet, taking less regular exercise and more problem drinking). Depression and the proportion of people with a high psychiatric morbidity score were increased. More women smokers reported a lack of social support, and smokers more often reported financial difficulties. Differences were exaggerated by comparing heavy smokers with non-smokers. CONCLUSIONS: Independent of the level of deprivation of their area of residence, smokers have poorer physical, social and mental health, with a dose-response effect. Smoking creates considerable pain, but little evidence of pleasure.

Adult↗
PubMed2006

Sub-Tenon anaesthesia: reduction in subconjunctival haemorrhage with controlled bipolar conjunctival cautery.

PURPOSE: To evaluate the effect of controlled conjunctival cautery on the frequency and extent of subconjunctival haemorrhage (SCH) associated with sub-Tenon anaesthetic (STA) injection in patients with various clotting states. METHODS: One hundred forty-four patients suitable for cataract surgery with STA were prospectively divided into four groups: group A (n=36) were on warfarin (INR 1.8-4.2); group B (n=48) on aspirin (75 mg); group C (n=12) on clopidogrel (75 mg); and group D (n=48) on no anticoagulant or antiplatelet agents. All patients had no other known coagulopathy. Each group was randomly divided into two subgroups, one of which received localised bipolar cautery under microscope control to the STA conjunctival entry site before tissue dissection, whereas the other served as a control. chi(2) and Fisher's exact tests were used to analyse the data with the SPSS package (v11.0). RESULTS: Conjunctival cautery reduced the frequency of SCH from 67 to 6% in group A (P=0.0001); from 37.5 to 4% in group B (P=0.005); from 50 to 0% in group C (P=0.9); and from 17 to 0% in group D (P=0.55). This overall reduction in SCH was highly significant (P<0.0001), especially in groups A and B. No statistically significant reduction in the extent of SCH was found. CONCLUSIONS: Controlled localised bipolar conjunctival cautery before STA injection may significantly reduce the frequency of SCH, especially in patients on warfarin or aspirin.

Aged↗
PubMed2006

Rates of serious infection, including site-specific and bacterial intracellular infection, in rheumatoid arthritis patients receiving anti-tumor necrosis factor therapy: results from the British Society for Rheumatology Biologics Register.

OBJECTIVE: To determine whether the rate of serious infection is higher in anti-tumor necrosis factor (anti-TNF)-treated rheumatoid arthritis (RA) patients compared with RA patients treated with traditional disease-modifying antirheumatic drugs (DMARDs). METHODS: This was a national prospective observational study of 7,664 anti-TNF-treated and 1,354 DMARD-treated patients with severe RA from the British Society for Rheumatology Biologics Register. All serious infections, stratified by site and organism, were included in the analysis. RESULTS: Between December 2001 and September 2005, there were 525 serious infections in the anti-TNF-treated cohort and 56 in the comparison cohort (9,868 and 1,352 person-years of followup, respectively). The incidence rate ratio (IRR), adjusted for baseline risk, for the anti-TNF-treated cohort compared with the comparison cohort was 1.03 (95% confidence interval 0.68-1.57). However, the frequency of serious skin and soft tissue infections was increased in anti-TNF-treated patients, with an adjusted IRR of 4.28 (95% confidence interval 1.06-17.17). There was no difference in infection risk between the 3 main anti-TNF drugs. Nineteen serious bacterial intracellular infections occurred, exclusively in patients in the anti-TNF-treated cohort. CONCLUSION: In patients with active RA, anti-TNF therapy was not associated with increased risk of overall serious infection compared with DMARD treatment, after adjustment for baseline risk. In contrast, the rate of serious skin and soft tissue infections was increased, suggesting an important physiologic role of TNF in host defense in the skin and soft tissues beyond that in other tissues.

Adalimumab↗
PubMed2005

Baseline comorbidity levels in biologic and standard DMARD treated patients with rheumatoid arthritis: results from a national patient register.

OBJECTIVE: To describe the occurrence of baseline comorbidity in subjects with active rheumatoid arthritis starting treatment with biological agents. Such data are necessary to interpret the reported occurrence of adverse events following treatment. METHODS: Baseline comorbidity was recorded in a large national cohort of patients with rheumatoid arthritis newly starting biological agents. The distribution of the number and types of comorbidities is presented. RESULTS: In all, 7818 patients treated with biological agents (infliximab 3332, etanercept 3302, adalimumab 1059, anakinra 132) were included in the analysis. Comorbidity was common, with 58% of patients having at least one comorbid condition and 25% having more than one. The most frequent comorbid conditions were hypertension, depression, peptic ulcer disease, and respiratory disease. CONCLUSIONS: In routine use, patients treated with biological agents have high levels of baseline comorbidity, which should influence the interpretation of reported adverse events.

Adult↗
PubMed2005

Circadian function in patients with advanced non-small-cell lung cancer.

This study aimed to evaluate whether patients with advanced non-small-cell lung cancer experience disrupted rest-activity daily rhythms, poor sleep quality, weakness, and maintain attributes that are linked to circadian function such as fatigue. This report describes the rest-activity patterns of 33 non-small-cell lung cancer patients who participated in a randomised clinical trial evaluating the benefits of melatonin. Data are reported on circadian function, health-related quality of life (QoL), subjective sleep quality, and anxiety/depression levels prior to randomisation and treatment. Actigraphy data, an objective measure of circadian function, demonstrated that patients' rest-activity circadian function differs significantly from control subjects. Our patients reported poor sleep quality and high levels of fatigue. Ferrans and Powers QoL Index instrument found a high level of dissatisfaction with health-related QoL. Data from the European Organization for Research and Treatment for Cancer reported poor capacity to fulfil the activities of daily living. Patients studied in the hospital during or near chemotherapy had significantly more abnormal circadian function than those studied in the ambulatory setting. Our data indicate that measurement of circadian sleep/activity dynamics should be accomplished in the outpatient/home setting for a minimum of 4-7 circadian cycles to assure that they are most representative of the patients' true condition. We conclude that the daily sleep/activity patterns of patients with advanced lung cancer are disturbed. These are accompanied by marked disruption of QoL and function. These data argue for investigating how much of this poor functioning and QoL are actually caused by this circadian disruption, and, whether behavioural, light-based, and or pharmacologic strategies to correct the circadian/sleep activity patterns can improve function and QoL.

Aged↗
PubMed2005

Echinacea intake induces an immune response through altered expression of leucocyte hsp70, increased white cell counts and improved erythrocyte antioxidant defences.

OBJECTIVE: To study the effect of Echinacea tablets on the expression of leucocyte heat shock protein 70 (hsp70), erythrocyte haemolysis, plasma antioxidant status, serum chemistry, haematological values and plasma alkylamide concentrations. METHOD: Eleven healthy individuals (26-61 years of age) were evaluated at baseline (day 1) and on day 15 after consuming two commercially blended Echinacea tablets daily for 14 days. RESULTS: Echinacea supplementation enhanced the fold increase in leucocyte hsp70 expression after a mild heat shock (P=0.029). White cell counts (WCC) were also increased (P=0.043). We also observed a preventative effect against free radical induced erythrocyte haemolysis (P=0.006) indicative of an antioxidant effect. CONCLUSION: The pilot study suggests that Echinacea may invoke an immune response through altered expression of hsp70 and increased WCC.

Administration, Oral↗
PubMed2005

The British Society for Rheumatology biologics register.

The British Society for Rheumatology (BSR) established a nationwide register for patients with rheumatological disorders treated with biologic agents. The register is designed as a national prospective study whose primary purpose is to assess long term toxicity from the use of these agents in routine practice. In addition, the data will be capable of addressing the benefits from their use in relation to their toxicity. One specific feature of the BSR register is the recruitment and collection of data from a parallel comparison group, comprising patients with active rheumatoid arthritis treated with conventional disease modifying agents. Both class specific and drug specific analyses of the group treated with biologicals are planned.

Adverse Drug Reaction Reporting Systems↗
PubMed2004

Arsenic-induced keratoses and Bowen's disease.

We report a patient with arsenic-induced keratoses and Bowen's disease. Chronic arsenicism may lead to both cutaneous and systemic neoplasms and patients should undergo regular long-term examination. Our patient had widespread cutaneous disease, which responded well to acitretin.

Acitretin↗
PubMed2003

Feasibility and compliance of automated measurement of quality of life in oncology practice.

PURPOSE: Systematic quality-of-life (QOL) assessment may have value in oncology practice by increasing awareness of a wide range of issues, possibly increasing detection of psychologic morbidity, social problems, and changes in physical status, and improving care and its outcomes. However, logistic problems are substantial. Automated systems solve many of these problems. We field-tested the feasibility and compliance that can be achieved using a computer touchscreen system in two consecutive studies. PATIENTS AND METHODS: In study 1, a prospective cohort of 272 patients was offered QOL assessment at each clinic appointment for 6 months. In study 2, all patients (N = 1,291) were offered QOL assessment as part of clinic routine during a 12-week period. RESULTS: In study 1, 82% of patients agreed to take part, but over time, compliance was poor (median, 40%; mean, 43%) and deteriorated with longer follow-up. In study 2, the overall compliance was greatly increased (median, 100%; mean, 70%), and compliance was retained over multiple visits. In study 1, compliance was better in younger patients, males, and socially advantaged patients, but was not affected by the presence of depression or anxiety, or QOL. In the second study, building on experience in the first study, data collection and storage in the computer system was excellent, achieving 98% of collected data stored in one center. In general, patients were comfortable with the computers and the approach. Data collection on the wards was more difficult and less complete than in clinics, especially for patients undergoing acute admissions. CONCLUSION: Feasibility with higher compliance was demonstrated in study 2, in which the data collection was integrated into routine care, and can be improved with further technical initiatives and education of staff.

Adult↗
PubMed2003

Haemorrhagic bullae in a case of paroxysmal nocturnal haemoglobinuria.

Paroxysmal nocturnal haemoglobinuria is a clonal stem cell disorder manifesting as haemolysis, bone marrow failure and thrombosis. We report a rare cutaneous manifestation on the trunk of a 40-year-old patient. Skin biopsy revealed the presence of fibrin thrombi in the capillaries. The eruption responded within days after commencing oral corticosteroids.

Adult↗
PubMed2003

Comparative toxicity of permethrin- and bifenthrin-treated cloth fabric for Anopheles farauti and Aedes aegypti.

In this laboratory study, we applied 3 formulations of permethrin (Peregin 500 EC, Dragnet 500 EC, and Dragnet 100 ME) and 2 of bifenthrin (Biflex 10 ME and Talstar 80 SC) to swatches of Australian military shirt fabric. The knockdown and mortality of Anopheles farauti and Aedes aegypti after exposure to treated fabrics were compared. The mortality of An. farauti exposed to permethrin-treated swatches for 3 min in World Health Organization test kits was 94.2-100% after initial treatment and fell to < 28% after 2 cold water washes. and knockdown was < 20% after 3 washes. The mortality of An. farauti exposed to bifenthrin-treated swatches was initially 100% and remained > 55% after 3 washes, whereas knockdown was < 25% after 2 washes. Mortality of Ae. aegypti exposed by tarsal contact to permethrin- and bifenthrin-treated fabrics was 84.8-100% prior to washing and fell to < 21% and < 40%, respectively, after 1 cold water wash. The ability of Ae. aegypti to obtain a blood meal through treated fabrics was variable, and a small percentage (0-6.1%) of mosquitoes obtained a blood meal through fabrics after initial treatment. The effect of cold water washing on the persistence of both chemicals in fabric by chemical assays showed that between 58% and 66% of both chemicals was lost from the test fabric after a single wash.

Aedes↗
PubMed2002

Expression of the filarial nematode phosphorylcholine-containing glycoprotein, ES62, is stage specific.

ES62, an immunomodulatory phosphorylcholine-containing glycoprotein secreted by the rodent filarial nematode Acanthocheilonema viteae, has previously been shown to be produced by L4 larvae and adult worms only. However, homologous sequences to ES62 have recently been found in L1 and L3 cDNA libraries of certain human filarial nematodes. Therefore, the various stages of A. viteae were re-examined and it was again found that only the post-L3 stages secreted ES62. Synthesis but not secretion by earlier stages was ruled out by examination of the protein content of whole worm extracts and by immunoelectron microscopy. However, examination by PCR of the mRNA for ES62 revealed that it was found in the L1 and L3 larvae. This may explain why homologous sequences to ES62 have been found in Brugia malayi and Onchocerca volvulus larval cDNA libraries. It also suggests that filarial nematodes, in general, may secrete ES62. To obtain evidence for this, we investigated production by Brugia pahangi, a close relation of B. malayi. We found that ES62 was indeed secreted but, as with A. viteae, only by the post-L3 stages, although again the mRNA for ES62 could be detected in the earlier stages. Overall our results suggest that production of ES62 is not species specific, that it is indeed stage specific, and that this may be due to post-transcriptional control of expression.

Amino Acid Sequence↗
PubMed2001

Dietary fats and body lipid composition in relation to hibernation in free-ranging echidnas.

Laboratory studies have shown that high levels of dietary unsaturated fatty acids prolong torpor and lower body temperatures in hibernating herbivorous rodents, which may in turn improve winter survival. The importance of nutritional ecology in relation to hibernation in insectivorous hibernators is unknown. We therefore studied fatty acid composition of dietary insects and the depot fat of echidnas Tachyglossus aculeatus (Monotremata) during the pre-hibernation season and compared depot fat fatty acid composition before and after hibernation. Echidna depot fat fatty acid composition during the pre-hibernation season was almost identical to that of the most abundant prey species, the ant Iridomyrmex sp. Oleic acid (C18:1) was by far the most common fatty acid in both Iridomyrmex sp. (60%) and echidna depot fat (62%). After about 5 months of hibernation and an 18% loss of body mass, echidna fatty acid composition had changed significantly. The percentage of the monounsaturated oleic acid (C18:1) and palmitoleic acid (C16:1) had declined, whereas that of the saturated fatty acids (C12:0, C16:0, C18:0) and the polyunsaturated linoleic acid (C18:2) had increased. Our study suggests that, unlike herbivorous rodent hibernators, echidnas rely to a large extent on monounsaturated fatty acids as fuel for hibernation, reflecting the most common fatty acid in their food. Moreover, it appears that the high concentration of monounsaturated fatty acids compensates for the moderate availability of polyunsaturates and enables them to hibernate at low body temperatures.

Animals↗
PubMed2001

Does plasma HIV RNA predict outcome in a cohort of treated HIV-infected individuals followed over 3 years?

BACKGROUND: Despite reductions in AIDS illness and mortality, it is increasingly apparent that a significant proportion of individuals treated with combination antiretroviral (cARV) therapy have continuing or recrudescent HIV RNA in plasma. The predictive value of plasma HIV RNA in treated individual remains uncertain and rates of and risk factors for adverse outcomes such as hospitalisation, opportunistic infections and deaths are needed. OBJECTIVES: The objectives of this study were to establish a retrospective cohort of individuals treated with cARVs, to assess factors associated with detectable HIV RNA and to determine rates of and risk factors for hospitalisation, opportunistic infection and mortality over 3 years of follow-up. STUDY DESIGN: All individuals treated at The Alfred Hospital, Melbourne, Victoria between January and June 1997 who had had plasma HIV RNA measured were included in the retrospective cohort. Clinical, virological and hospitalisation data were recorded and validated by cross-reference with electronically stored laboratory, hospital activity and state notification databases. Outcome was assessed at October 2000. RESULTS: Amongst the 555 individuals tested, 438 (60.7%) had detectable (>500 copies/ml) HIV RNA (bDNA assay, version 2) at baseline. The overall mortality rate was 5.5 per 100 person years; the AIDS rate 1.99 per 100 person years and hospitalisation rate 16.4 per 100 person years. Risk factors for death in this population identified by univariate analysis were HIV RNA concentration at baseline and at follow-up October 2000, nadir and most recent CD4 lymphocyte number, not receiving cARV as initial treatment, total number of ARV agents and number of changes in ARV per year, developing AIDS and being hospitalised during follow-up. In a multivariate model, the most recent CD4 lymphocyte number, the number of different ARVs per year and having more than one hospitalisation remained predictive of death. CONCLUSIONS: HIV RNA remained detectable in the majority (60.7%) of this treatment-experienced population over 3 years, yet mortality rate remained relatively low at 5.5 per 100 person years. Factors associated with death were immunological (CD4 lymphocyte number) and treatment related (numbers of changes of ARV and hospitalisation) rather than virological (HIV RNA) in this cohort. We believe hospitalisation rates may be a useful marker of HIV disease in cARV treated populations and may identify groups at risk of poorer outcome and in need of intervention.

Adult↗
PubMed2001

'Transgressing venues': 'health' studies, cultural studies and the media.

This paper looks at how the strategies of media and cultural studies can be applied to the health studies field. This relationship, however, has been met with resistance due to a number of status debates. We argue the importance of fostering links between these 'disciplines' namely because the definition of what constitutes 'health' has been broadened and is inscribed in most forms of popular media. Using the example of the 'health and lifestyle' debate, we argue that the media informs cultural understandings about requirements for living and is therefore a crucial area of analysis for health studies (and cultural/media studies) students. We are also concerned with analysing how the media contributes to the construction and regulation of 'healthy' subjects making links with public health discourses and current debates in the field of media and health.

Anecdotes as Topic↗
PubMed2001

Development and implementation of a web-based evaluation system for an internal medicine residency program.

Evaluation and feedback are fundamental components of graduate medical education. Paper-based evaluation systems are inefficient and costly and the evaluation data they provide are difficult to retrieve and analyze. In view of these problems, in 1996-1997, the authors developed and implemented a World Wide Web-based electronic evaluation system for the internal medicine residency program at the University of Minnesota. Residents were evaluated using the American Board of Internal Medicine Resident Evaluation Form. Custom evaluations were created for the assessment of sites, rotations, and faculty. The evaluations were completed by accessing an evaluation Web site from any location using standard computers and Web browsers. The evaluations were submitted electronically and automatically entered into a database. The system tracked compliance and automatically sent out reminders. Other features of the system included extensive reporting capabilities, automatic notification of substandard performance, and the ability to send confidential information to the program director. The total compliance rate ranged between 81% and 92% during the first 12 months of operation, with no significant difference in compliance observed between faculty and residents. The system was easy to use and could quickly and confidentially identify performance problems of residents and faculty from large numbers of evaluations.

Educational Measurement↗