Biomedical subjects

K Webb

Publications and source records attributed to K Webb.

At least 19 recordsLinked to original sources

PubMed2006

The effects of Scaphoid and Colles casts on hand function.

Although necessary for bone healing, immobilisation temporarily prevents hand function and may necessitate corrective physiotherapy later. Scaphoid and Colles casts are both commonly used to immobilize scaphoid fractures. Non-union rates are comparable with both casts. The Scaphoid cast incorporates the thumb, whereas the Colles cast leaves the thumb free. We compared the effect of the two casts on hand function in 20 healthy right-hand-dominant volunteers using the Jebsen-Taylor Hand Function Test. Data were obtained through a mixed between and within subject design. Both casts prolonged the time taken to complete the hand function test compared to controls. Testing in the Scaphoid cast took significantly longer than in the Colles cast.

Adult↗

PubMed2006

Knowledge about sepsis among training-grade doctors.

BACKGROUND: Prescribing of antibiotics, often in the empirical setting, frequently falls on training-grade or junior doctors, who are often the least experienced in this. Indeed, improving the knowledge base of training-grade doctors or senior medical students through education has been identified as one of the key measures to improve antibiotic prescribing behaviour. METHODOLOGY: We undertook two descriptive questionnaire- and interview-based surveys (1999 and 2003) of prescribing training-grade doctors in a teaching hospital in north-east Scotland to determine their knowledge level regarding various sepsis definitions, sources of local information used when prescribing an antimicrobial, and awareness of the cost difference between intravenous and oral antibiotics. A total of 55 junior doctors in a large teaching hospital participated in the survey in 1999 and 78 participated in 2003. INTERVENTIONS: Between the two audits, which were conducted 4 years apart, several initiatives were introduced to improve the education and support related to antibiotic prescription. RESULTS: There has been a significant improvement in doctors' knowledge regarding various sepsis definitions, whether the infection was hospital or community acquired, empirical choice, dose, route of administration and monitoring of the antibiotic, and options for drug hypersensitivity. More training-grade doctors (approximately 29%) used the desired locally derived sepsis protocol, which guides the prescriber through sepsis recognition. There was no significant improvement in the percentage of doctors who recognized that parenteral antimicrobials were more expensive (approximately 10-fold) than oral antimicrobials (63.7% in 1999, 64.2% in 2003). CONCLUSIONS: Overall, there was a significant improvement in doctors' understanding of sepsis and knowledge of the source of information that they utilized to select the antibiotic of choice, although the majority did not acknowledge the price difference between intravenous and oral forms of antibiotics.

Anti-Bacterial Agents↗

PubMed2005

Delayed diagnosis of cystic fibrosis associated with R117H on a background of 7T polythymidine tract at intron 8.

We report late diagnoses of cystic fibrosis (CF) in two men aged 61 and 65 years. At the time of presentation, both patients had significant pulmonary disease. In each case two CFTR gene mutations were identified, including R117H on a background of a poly T genotype of 7T/9T. Patients with two identified CFTR mutations which include the R117H/7T anomaly should be followed up routinely as they remain susceptible to severe lung disease.

Cystic Fibrosis↗

PubMed2004

Effects of tiotropium on lung hyperinflation, dyspnoea and exercise tolerance in COPD.

The aim of this study was to test the hypothesis that use of tiotropium, a new long-acting anticholinergic bronchodilator, would be associated with sustained reduction in lung hyperinflation and, thereby, would improve exertional dyspnoea and exercise performance in patients with chronic obstructive pulmonary disease. A randomised, double-blind, placebo-controlled, parallel-group study was conducted in 187 patients (forced expiratory volume in one second 44 +/- 13% pred): 96 patients received 18 microg tiotropium and 91 patients received placebo once daily for 42 days. Spirometry, plethysmographic lung volumes, cycle exercise endurance and exertional dyspnoea intensity at 75% of each patient's maximal work capacity were compared. On day 42, the use of tiotropium was associated with the following effects at pre-dose and post-dose measurements as compared to placebo: vital capacity and inspiratory capacity (IC) increased, with inverse decreases in residual volume and functional residual capacity. Tiotropium increased post-dose exercise endurance time by 105 +/- 40 s (21%) as compared to placebo on day 42. At a standardised time near end-exercise (isotime), IC, tidal volume and minute ventilation all increased, whilst dyspnoea decreased by 0.9 +/- 0.3 Borg scale units. In conclusion, the use of tiotropium was associated with sustained reductions of lung hyperinflation at rest and during exercise. Resultant increases in inspiratory capacity permitted greater expansion of tidal volume and contributed to improvements in both exertional dyspnoea and exercise endurance.

Aged↗

PubMed2004

Portal drained visceral flux, hepatic metabolism, and mammary uptake of free and peptide-bound amino acids and milk amino acid output in dairy cows fed diets containing corn grain steam flaked at 360 or steam rolled at 490 g/L.

Objectives were to measure net fluxes of free (FAA) and peptide bound amino acids (AA) (PBAA) across portal-drained viscera (PDV), liver, splanchnic, and mammary tissues, and of milk AA output of lactating Holstein cows (n = 6, 109 +/- 9 d in milk) as influenced by flaking density of corn grain. Cows were fed alfalfa-based total mixed ration (TMR) containing 40% steam-flaked (SFC) or steam-rolled corn (SRC) grain. The TMR were offered at 12-h intervals in a crossover design. Six sets of blood samples were obtained from indwelling catheters in portal, hepatic, and mammary veins and mesenteric or costoabdominal arteries every 2 h from each cow and diet. Intake of dry matter (18.4 +/- 0.4 kg/d), N, and net energy for lactation were not altered by corn processing. Milk and milk crude protein yields (kg/12-h sampling) were 14.2 vs. 13.5 and 0.43 vs. 0.39 for cows fed SFC or SRC, respectively. The PDV flux of total essential FAA was greater (571.2 vs. 366.4 g/12 h, SEM 51.4) in cows fed SFC. The PDV flux of total essential PBAA was 69.3 +/- 10.8 and 51.5 +/- 13.2 g/12 h for cows fed SFC and SRC, respectively, and differed from zero, but fluxes of individual PBAA rarely differed between treatments. Liver flux of essential FAA was greater in cows fed SRC, but only the PBAA flux in cows fed SRC differed from zero. Splanchnic flux of FAA and PBAA followed the pattern of PDV flux, but variation was greater. Mammary uptake (g/12 h) of total essential FAA was greater in cows fed SFC than SRC (224.6 vs. 198.3, SEM 7.03). Mammary uptake of essential PBAA was 25.0 vs. 15.1, SEM 5.2, g/12 h for cows fed SFC or SRC, respectively, and differed from zero in half of the PBAA. Milk output of EAA was 187.8 vs 175.4, SEM 4.4 g/12 h in cows fed SFC and SRC, respectively, and output of most essential AA consistently tended to be greater in cows fed SFC. It is apparent that PBAA comprise a portion of total AA flux across PDV and are affected by grain processing. Further, this pool supplies an important component of AA taken up by the mammary gland. Quantifying the contribution of PBAA may improve diet formulation with respect to intestinal absorption and mammary uptake of AA.

Amino Acids↗

PubMed2003

Early antibiotic selection and efficient rooting and acclimatization improve the production of transgenic plum plants (Prunus domestica L.).

We describe here an improved system for routinely developing transgenic plum plants (Prunus domestica L.) through the use of Agrobacterium tumefaciens. The production of non-transformed "escapes" has been virtually eliminated, and rates of plant establishment in the greenhouse have been dramatically improved. The system is based on the regeneration of shoots from hypocotyls extracted from mature seed. The shoot regeneration medium is Murashige and Skoog (MS) salts and vitamins supplemented with 7.5 microM thidiazuron and 0.25 microM indole-butyric acid. Transferring the explants after co-cultivation to shoot regeneration medium containing 80 mg l(-1) of kanamycin and 300 mg l(-1) of Timentin reduced the total number of regenerated shoots without affecting the transformation rate. Transformation rates using the described system averaged 1.2% of the hypocotyl slices producing transgenic plants, with a range of 0-4.2%. The transgenic shoots rooted at a rate of 90% on half-strength MS salts and vitamins supplemented with 5 microM alpha-naphthaleneacetic acid and 0.01 microM kinetin. Plantlets were transferred to a greenhouse directly from culture tubes with a 90% average survival.

Acclimatization↗

PubMed2001

Cross cultural differences in health related quality of life in adolescents with cystic fibrosis.

PURPOSE: Quality of Life (QoL) is an important outcome measure in health care and pharmacological trials. The trend towards multinational clinical trials may be problematic because it is unclear as to whether, or to what extent, QoL-measures are comparable across cultures. This study compared QoL between English and German adolescents with Cystic Fibrosis (CF) and their healthy peers. METHOD: The study comprised a cross-sectional design. The English subjects formed two groups; 58 adolescents with CF and 49 healthy controls. The German subjects consisted of 26 adolescents with CF and 75 healthy controls. Quality of life was measured using the English and German versions of the SF-36. Demographic (age and gender) and clinical data (FEV1% predicted and BMI) were also recorded. RESULTS: The English and German CF groups had similar age-adjusted lung function and body mass index. Both the English CF and control groups reported a poorer quality of life than their respective German counterparts across several domains of the SF-36. These were limitations in activities due to physical health problems and emotional difficulties, social functioning, energy and vitality and pain. CONCLUSIONS: The differences in quality of life between English and German adolescents with CF appear to be either culturally determined or due to idiosyncrasies in the translations of the SF-36. rather than a consequence of their disease or its management.

Adolescent↗

PubMed2001

Ways of coping with cystic fibrosis: implications for treatment adherence.

PURPOSE: How individuals cope with aspects of cystic fibrosis (CF) has the potential to influence their self management and the course of their disease. To evaluate how individuals cope with CF, a disease specific coping scale was developed and validated. A second objective of the work was to examine the relationship between coping styles and treatment adherence. METHODS: The development of the coping scale constituted a longitudinal design. A cross-sectional questionnaire design was used to examine the coping-adherence relationship. The development and validation of the coping scale comprised three phases: (1) Initially, 60 patients were interviewed to identify CF concerns. From this information a list of 23 concerns were recorded; (2) Eighty-three patients were interviewed to identify CF coping responses. For each concern, they were asked what they did or thought to ease the worry. A list of 24 coping strategies were recorded that formed a comprehensive set of items as to how people with CF act, feel and think about aspects of their disease; and (3) Further development and testing of the questionnaire involved 174 patients completing the measure. Four distinct ways of coping with CF were identified by factor analysis. These were termed optimistic acceptance, hopefulness, distraction and avoidance. The cronbach alpha coefficients were 0.74 (optimistic acceptance), 0.69 (hopefulness). 0.71 (distraction) and 0.76 (avoidance). To evaluate the relationship between coping and treatment adherence 60 patients completed the CF Coping Questionnaire and the Manchester Adult Cystic Fibrosis Compliance Questionnaire. RESULTS: Compared with patients who were non-adherent, those who were adherent scored higher on the optimistic acceptance scale (physiotherapy p < 0.05, enzymes p < 0.003, vitamins p < 0.05) and hopefulness scale (physiotherapy p < 0.002, enzymes p < 0.001). Those who were partially adherent reported using distraction as a way of coping to a greater extent than adherent or non-adherent patients (all p's < 0.05). Non-adherent patients used avoidance strategies to a greater extent than those who were adherent (physiotherapy p < 0.05, enzymes p < 0.04), although interestingly, adherence with exercise was associated with avoidant coping (p < 0.004). CONCLUSIONS: The degree of adherence to treatments was influenced by a person's style of coping. The identification of effective coping strategies to aid both long-term psychological and clinical well-being should improve the management of non-adherence.

Adaptation, Psychological↗

PubMed2001

A novel surfactant-based immobilization method for varying substrate-bound fibronectin.

Most biomaterials can be rendered adhesive for anchorage-dependent cells by adsorption of serum, isolated extracellular matrix proteins, or immobilization of peptide sequences. However, difficulties are frequently encountered in characterizing the adsorbed layer due to conformational changes in the molecules following adsorption and interference from nonspecifically adsorbed molecules. In this study, we have investigated a technique for covalently immobilizing fibronectin to the PEO-containing triblock copolymer Pluronic F108 ("F108"). We have compared this technique to solution adsorption of fibronectin for its ability to provide controlled variation of bound fibronectin and regulation of fibroblast behavior. Both simple adsorption and covalent immobilization were effective for varying substrate-bound fibronectin. However, adsorption of fibronectin did not effectively regulate fibroblast attachment or spreading in either serum-free or serum-containing media. Fibroblast attachment, spreading, cytoskeletal organization, and proliferation were effectively regulated in response to fibronectin immobilized to F108. Furthermore, F108-treated surfaces without immobilized fibronectin did not support nonspecific fibroblast attachment, even in the presence of serum-containing medium. Fibroblasts were observed to only proliferate on surfaces with high levels of immobilized fibronectin that supported extensive cell spreading and cytoskeletal organization. In summary, covalent immobilization of fibronectin to F108 provided controlled regulation of fibroblast behavior without interference from nonspecific protein adsorption, even in the presence of serum-containing medium.

3T3 Cells↗

PubMed2001

Surfactant-immobilized fibronectin enhances bioactivity and regulates sensory neurite outgrowth.

A PEO-containing surface coating was investigated as a means to control neurite outgrowth in the presence of serum. Various ratios of end-group-activated tri-block copolymer Pluronic F108 were used to immobilize the extracellular matrix protein fibronectin (FN). Primary cultures of dorsal root ganglion neurons were cultured on F108-immobilized FN or, as a control, on FN adsorbed from solution directly to polystyrene. Although FN surface concentration could be controlled in a dose-dependent manner by either technique, dose-dependent control of neuronal behaviors was best achieved on F108-immobilized FN. This effect was similar regardless of the presence of serum in the culture medium. F108-immobilized FN supported twofold greater maximal neurite outgrowth than did directly adsorbed FN. Furthermore, at similar surface concentrations, F108-FN was significantly more active in promoting neurite outgrowth. Polypropylene filament bundles treated with F108-immobilized FN supported robust outgrowth from explants of dorsal root ganglia, demonstrating the utility of the surface coating on clinically relevant materials with more complex shapes. The ability to control neuronal behaviors in a serum-resistant manner, coupled with enhanced biologic activity, demonstrates the potential for surfactant-based immobilization as a method for generating biointeractive materials for tissue engineering.

Adsorption↗

PubMed2001

Substrate-bound human recombinant L1 selectively promotes neuronal attachment and outgrowth in the presence of astrocytes and fibroblasts.

Axonal pathfinding is a complex process that is mediated through cell-matrix and cell-cell interactions. A large number of studies have demonstrated that ECM and ECM-derived proteins and peptides are potent promoters of neurite outgrowth, however much less attention is given to the fact that these same ligands also elicit responses in a wide variety of non-neuronal cell types. We examined the use of a substrate-bound recombinant form of human L1, an integral membrane protein, as a ligand for bridging materials for repairing the CNS by studying its effectiveness in promoting specific responses of neuronal cells in the presence of astrocytes and fibroblasts. L1, a cell adhesion molecule expressed in the developing CNS and PNS, has strong neurite promoting activity, and contributes to axonal guidance and axonal fasciculation during development. In this study, substrates treated with L1-Fc were compared to subtrates treated with fibronectin and poly-lysine (PDL) with respect to their interaction with a variety of cell types, including three types of neurons (DRG neurons, cerebellar granule neurons, and hippocampal neurons), astrocytes, dermal fibroblasts, and meningeal cells. L1-Fc-treated substrates supported significantly higher levels of neurite outgrowth relative to fibronectin and PDL, while inhibiting the attachment of astrocytes, meningeal cells, and fibroblasts. We also show that neuronal cells attach to and extend neurites on 30 microm diameter L1-Fc-treated filaments as an example of a potentially useful bridging substrate. The high level of biological specificity displayed by surface-bound L1, along with the fact that it is a potent promoter of neurite outgrowth, is normally expressed on axons and regulates axonal fasciculation during normal development bodes well for its use on bridging materials for the repair of the CNS, and suggests that cell adhesion molecules, in general, may be useful for biomaterial modification. Moreover, small diameter filaments coated with L1-Fc may function in an analogous way to pioneering axons that guide the growth of axons to distal targets during development.

Animals↗

PubMed2001

The childhood asthma prevention study (CAPS): design and research protocol of a randomized trial for the primary prevention of asthma.

The Childhood Asthma Prevention Study is a randomized controlled trial to measure whether the incidence of atopy and asthma can be reduced by house dust mite allergen reduction, a diet supplemented with omega-3 fatty acids, or a combination of both interventions. Six hundred and sixteen pregnant women whose unborn children were at high risk of developing asthma because of a family history were randomized prenatally. Study groups are as follows: Group A (placebo diet intervention, no house dust mite reduction), Group B (placebo diet intervention, active house dust mite reduction), Group C (active diet intervention, no house dust mite reduction), and Group D (active diet intervention, active house dust mite reduction). The house dust mite reduction intervention comprises use of physical and chemical methods to reduce allergen contact. The dietary intervention comprises use of a daily oil supplement from 6 months or at onset of bottle-feeding, and use of margarine and cooking oils based on sunflower or canola oils to increase omega-3 dietary intake. Data is collected quarterly until the infant is 1 year old and then half yearly until age 5 years. Questionnaires are used to collect respiratory illness history and information about diet and home environment. Dust is collected from the child's bed and bedroom and playroom floors. Blinded assessments are conducted at 18 months, 3 years, and 5 years. Skin prick tests to common allergens, blood tests, and detailed illness, medication use, and vaccination histories are collected. Primary outcomes will be the development of allergic sensitization and the presence and severity of asthma. This study is designed to measure the effectiveness of allergen reduction and dietary supplementation, both separately and in combination, for the primary prevention of atopy and asthma. The results of this study may have important implications for public health policies to reduce the incidence of childhood asthma. Control Clin Trials 2001;22:333-354

Adult↗

PubMed2001

Post-transcriptional gene silencing in plum pox virus resistant transgenic European plum containing the plum pox potyvirus coat protein gene.

Transgenic plums containing the plum pox potyvirus coat protein (PPV-CP) gene were inoculated with PPV. Infection was monitored by evaluating symptoms, ELISA, and IC-RT-PCR. Transgenic clone C5 was highly resistant to PPV during four years of testing and displayed characteristics typical of post-transcriptional gene silencing (PTGS), including a high level of transgene transcription in the nucleus, low levels of transgene mRNA in the cytoplasm, a complex multicopy transgene insertion with aberrant copies, and methylation of the silenced PPV-CP transgene. The PPV-CP transgene was also methylated in seedlings of C5 and these seedlings were resistant to PPV. Our results show, for the first time, that PTGS functions as a mechanism for virus resistance in a woody perennial species.

Blotting, Southern↗

PubMed2001

Characterisation of waste solutions to determine optimised P recovery.

A number of waste solutions from processes operating in Western Australia (anaerobic digester supernatants, facultative lagoon treated piggery and abattoir waste effluents) were characterised chemically and by automated titration to determine acid-base characteristics. Titrations were over the pH range 2-12 or less. All waste solutions were excess molar ratios of NH3-N to PO4-P (5:1 up to 20:1). The amounts of acid or base reagent required for each waste solution type were in the sequence anaerobic digestor supernatant>>piggery effluent>abattoir effluent. The most efficient removal of N and P of the field samples considered is from piggery effluent. The results indicate conditions for optmising the removal of N and P by precipitation (predominantly struvite) as well as the way forward in determining the full scope of N and P waste streams for which recycling by precipitation (either magnesium or calcium based salts) may be feasible.

Chemical Precipitation↗

PubMed2001

Improved cultural detection of Burkholderia cepacia from sputum in patients with cystic fibrosis.

AIMS: To evaluate the sensitivity and specificity of two selective media for the isolation of Burkholderia cepacia from sputum specimens in patients with cystic fibrosis (CF). METHODS: In total, 149 expectorated sputum specimens from 113 patients with CF (32 cepacia colonised patients and 81 non-cepacia colonised patients) attending three CF centres were examined for the presence of B cepacia on two selective media: (1) MAST selective agar, a commercially available selective medium widely used in the UK and (2) BCSA (B cepacia selective agar), a new medium recently described, which is used predominantly in North America. RESULTS: Burkholderia cepacia was isolated from 53 of 149 (35.6%) specimens examined, representing 32 of 113 (28.3%) patients, using both the MAST and BCSA media. Growth was most rapid on BCSA with all (53 of 53) isolates detectable after 48 hours, compared with 50 of the 53 isolates on MAST agar, with the remaining three isolates detectable at five days. Twenty eight contaminants were identified on MAST agar and 13 on BCSA agar; mainly Alcaligenes xylosoxidans and yeast on MAST agar and Flavobacterium indologenes on BCSA medium. BCSA was equivalent to MAST agar in its ability to isolate B cepacia from patients with CF with a history of B cepacia infection. CONCLUSIONS: The increased selectivity and reduced time to detection of BCSA makes it an attractive alternative to MAST. However, its present limited commercial availability in the UK may delay its use in routine diagnostic laboratories because of complications with media preparation and quality control.

Adult↗

PubMed2001

Collaborative intersectoral approaches to nutrition in a community on the urban fringe.

A case study is presented that describes the 10-year evolution of a local intersectoral project aimed at improving components of a community's food system as an approach to improving nutrition. Aspects of innovation and good contemporary practice in collaborating for health promotion are illustrated. Key initiators of the project were a university public health department, a community health service, and a local government authority. Players brought into the process included the agricultural sector and food retailers. Several strategies have contributed to the success and institutionalization of the project. These include a specific focus on organizational development and capacity building among the key intersectoral partners and the use of formative evaluation methods to hasten the natural phases of collaborative problem solving. The project achieved many policy- and system-level changes. The impact on food consumption patterns is still to be evaluated.

Community Participation↗

PubMed2000

Relationships among cell attachment, spreading, cytoskeletal organization, and migration rate for anchorage-dependent cells on model surfaces.

Many research and commercial applications use a synthetic substrate which is seeded with cells in a serum-containing medium. The surface properties of the material influence the composition of the adsorbed protein layer, which subsequently regulates a variety of cell behaviors such as attachment, spreading, proliferation, migration, and differentiation. In this study, we examined the relationships among cell attachment, spreading, cytoskeletal organization, and migration rate for MC3T3-E1 osteoblasts on glass surfaces modified with -SO(x), -NH(2), -N(+)(CH(3))(3), -SH, and -CH(3) terminal silanes. We also studied the relationship between cell spread area and migration rate for a variety of anchorage-dependent cell types on a model polymeric biomaterial, poly(acrylonitrile-vinylchloride). Our results indicated that MC3T3-E1 osteoblast behavior was surface chemistry dependent, and varied with individual functional groups rather than general surface properties such as wettability. In addition, cell migration rate was inversely related to cell spread area for MC3T3-E1 osteoblasts on a variety of silane-modified surfaces as well as for different anchorage-dependent cell types on a model polymeric biomaterial. Furthermore, the data revealed significant differences in migration rate among different cell types on a common polymeric substrate, suggesting that cell type-specific differences must be considered when using, selecting, or designing a substrate for research and therapeutic applications.

3T3 Cells↗

PubMed2000

Use of self-report to monitor overweight and obesity in populations: some issues for consideration.

OBJECTIVE: To examine the validity of self-reported height and weight data reported over the telephone in the 1997 NSW Health Survey, and to determine its accuracy to monitor overweight and obesity in population surveys. METHOD: Self-reported and measured heights and weights were collected from 227 people living in Western Sydney, who had participated in the NSW Health Survey 1997. RESULTS: Self-reported (SR) weights and heights led to misclassification of relative weight status. BMI, based on measured weights and heights, classified 62% of males and 47% of females as overweight or obese, compared with 39% and 32%, respectively, from self-report. CONCLUSIONS: Caution should be used when interpreting SR height and weight data from surveys, because BMI derived from these is likely to underestimate the true prevalence of overweight and obesity. IMPLICATIONS: SR data have a place in nutrition monitoring because they are relatively inexpensive and easy to collect. However, classifying people into weight categories on the basis of accepted cut-points, using SR heights and weights, yields inaccurate prevalence estimates. Periodic sub-studies of the validity of SR heights and weights are needed to indicate the extent to which the validity of SR is changing.

Adolescent↗