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Biomedical subjects

L Clarke

Publications and source records attributed to L Clarke.

At least 19 recordsLinked to original sources

Ensembl 2007.

The Ensembl (http://www.ensembl.org/) project provides a comprehensive and integrated source of annotation of chordate genome sequences. Over the past year the number of genomes available from Ensembl has increased from 15 to 33, with the addition of sites for the mammalian genomes of elephant, rabbit, armadillo, tenrec, platypus, pig, cat, bush baby, common shrew, microbat and european hedgehog; the fish genomes of stickleback and medaka and the second example of the genomes of the sea squirt (Ciona savignyi) and the mosquito (Aedes aegypti). Some of the major features added during the year include the first complete gene sets for genomes with low-sequence coverage, the introduction of new strain variation data and the introduction of new orthology/paralog annotations based on gene trees.

Animals↗

The approval process for hyperthermic intraoperative intraperitoneal chemotherapy.

AIMS: To clarify the requirements for Food and Drug Administration approval in the United States for hyperthermic intraoperative intraperitoneal chemotherapy administration. Also, to review the status of the approval process in Europe. METHODS: The obstacles to be overcome for approval by the Food and Drug Administration for a new drug approval and for a new device approval were reviewed. Drugs approved in the past were examined for their potential for current application in this technology. RESULTS: The likelihood that the approval of a heater circulator along with the approval for specific chemotherapy agents for heated intraoperative intraperitoneal chemotherapy was judged to be remote. Rather, the continued use of "homemade heater circulators" and the off-label use of appropriate chemotherapy agents augmented by heat will continue to be the standard of care. The European community currently has several heater circulators approved for hyperthermic intraoperative intraperitoneal chemotherapy administration. These devices have been specifically approved for oncologic indications. CONCLUSIONS: Continued research and development of heated intraoperative intraperitoneal chemotherapy is necessary. As the requirement for prevention and treatment of the peritoneal surface component of gastrointestinal and gynecologic oncology expands, new investigations into the approval process in the United States will be necessary. Publication of results from institutions pioneering these new treatment strategies will, of necessity, continue.

Antineoplastic Agents↗

Ensembl 2006.

The Ensembl (http://www.ensembl.org/) project provides a comprehensive and integrated source of annotation of large genome sequences. Over the last year the number of genomes available from the Ensembl site has increased from 4 to 19, with the addition of the mammalian genomes of Rhesus macaque and Opossum, the chordate genome of Ciona intestinalis and the import and integration of the yeast genome. The year has also seen extensive improvements to both data analysis and presentation, with the introduction of a redesigned website, the addition of RNA gene and regulatory annotation and substantial improvements to the integration of human genome variation data.

Animals↗

So what exactly is a nurse?

The problematic nature of defining nursing is examined. Contrasts are set out in respect of the work of different grades of practitioner and how these do or do not constitute nursing care. A concept of caring and caring profession is utilized as a backdrop by which it is argued that caring can be defended as an ethical position independently of its objects of care. The paper asserts the existence of different perspectives within mental health nursing and demonstrates how these are influenced by extraneous forces. It concludes by (1) defending universal moral rules that operate independently of situations or the objects to which they apply and (2) that the usefulness of invoking a nursing identity may be less rather than more illuminative in exposing what mental health (psychiatric) 'nursing' is.

Attitude of Health Personnel↗

Submicroscopic deletions and duplications in individuals with intellectual disability detected by array-CGH.

Intellectual disability (ID) affects about 3% of the population (IQ < 70), and in about 40% of moderate (IQ 35-49) to severe ID (IQ < 34), and 70% of cases of mild ID (IQ 50-70), the etiology of the disease remains unknown. It has long been suspected that chromosomal gains and losses undetectable by routine cytogenetic analysis (i.e., less than 5-10 Mb in size) are implicated in ID of unknown etiology. Array CGH has recently been used to perform a genome-wide screen for submicroscopic gains and losses in individuals with a normal karyotype but with features suggestive of a chromosome abnormality. In two recent studies, the technique has demonstrated a approximately 15% detection rate for de novo copy number changes of individual clones or groups of clones. Here, we describe a study of 22 individuals with mild to moderate ID and nonsyndromic pattern of dysmorphic features suspicious of an underlying chromosome abnormality, using the 3 Mb and 1 Mb commercial arrays (Spectral Genomics). Deletions and duplications of 16 clones, previously described to show copy number variability in normal individuals [Iafrate et al., 2004; Lapierre et al., 2004; Schoumans et al., 2004; Vermeesch et al., 2005] were seen in 21/22 subjects and were considered polymorphisms. In addition, three subjects showed submicroscopic deletions and duplications not previously reported as normal variants. Two of these submicroscopic changes were of de novo origin (microdeletions at 7q36.3 and a microduplication at 11q12.3-13.1) and one was of unknown origin as parental testing of origin could not be performed (microduplication of Xp22.3). The clinical description of the three subjects with submicroscopic chromosomal changes at 7q36.3, 11q12.3-13.1, Xp22.3 is provided.

Chromosome Aberrations↗

Ensembl 2005.

The Ensembl (http://www.ensembl.org/) project provides a comprehensive and integrated source of annotation of large genome sequences. Over the last year the number of genomes available from the Ensembl site has increased by 7 to 16, with the addition of the six vertebrate genomes of chimpanzee, dog, cow, chicken, tetraodon and frog and the insect genome of honeybee. The majority have been annotated automatically using the Ensembl gene build system, showing its flexibility to reliably annotate a wide variety of genomes. With the increased number of vertebrate genomes, the comparative analysis provided to users has been greatly improved, with new website interfaces allowing annotation of different genomes to be directly compared. The Ensembl software system is being increasingly widely reused in different projects showing the benefits of a completely open approach to software development and distribution.

Animals↗

Unintentional injury depictions in popular children's television programs.

OBJECTIVES: The frequency and magnitude of depictions of risky events and unintentional injuries in top ranked children's animated and live action television programs was assessed. METHODS: Qualitative and quantitative media content analysis were used. Scenes from television episodes were examined for the depiction of risky events and unintentional injuries. RESULTS: A total of 201 actual and potential injury related events were tabulated in 99 episodes aired in 2003 and 2004. Only 26% of the risky events depicted led to an injury or physical consequence. More than 80% of the events involved behavioral or environmental risk factors. Safety factors were not present in over 90% of risky events depicted. The general tone and context of events was humor or indifference rather than concern or action, with little or no relevance to the plot. CONCLUSION: Unintentional injuries are the leading cause of death and disability for children, yet animated and live action television programs marketed to children continue to portray injury risk inaccurately. Working with the children's television production industry to improve injury depiction is a much needed advocacy activity.

Child↗

Effect of administration of recombinant human leptin during the neonatal period on the plasma concentration and gene expression of leptin in the piglet.

Leptin is produced predominantly by white adipocytes and in adults it regulates both appetite and energy expenditure but its role in the neonate remains to be fully established. The aim of this, the first study of leptin administration to Meishan piglets, was to examine the effects of chronic leptin administration to neonatal pigs on their endocrine profile, growth and development. Six Meishan sows gave birth normally at term and 6 pairs of siblings (n = 12), matched by birth weight and gender (male, n = 6; female, n = 6) were randomly allocated to leptin (L: n = 6) or placebo (P: n = 6) administration groups. Piglets remained with their mother throughout the study and from day 3 to 8 of neonatal life each pig received either 4 microg ml(-1) kg(-1) body weight recombinant human leptin or a saline placebo. Plasma concentrations of key hormones and metabolites were determined in conjunction with messenger RNA (mRNA) for leptin, which was assessed by PCR. Recombinant leptin treatment improved growth performance and promoted skeletal growth in favour of adipose tissue accretion. Circulating plasma leptin concentrations were higher on days 4 and 7 in L pigs. Leptin administration altered the endocrine profile of the neonatal pig, although these changes were not maintained. There were no relationships between plasma leptin and body weight or mRNA leptin abundance, irrespective of treatment. Chronic leptin administration appeared to have a beneficial influence on growth rate and body conformation, which may in part be attributed to alterations in metabolism and nutrient partitioning.

Adipose Tissue↗

Ensembl 2004.

The Ensembl (http://www.ensembl.org/) database project provides a bioinformatics framework to organize biology around the sequences of large genomes. It is a comprehensive and integrated source of annotation of large genome sequences, available via interactive website, web services or flat files. As well as being one of the leading sources of genome annotation, Ensembl is an open source software engineering project to develop a portable system able to handle very large genomes and associated requirements. The facilities of the system range from sequence analysis to data storage and visualization and installations exist around the world both in companies and at academic sites. With a total of nine genome sequences available from Ensembl and more genomes to follow, recent developments have focused mainly on closer integration between genomes and external data.

Animals↗

Pseudo-lysosomal storage disease caused by EMLA cream.

Prilocaine-lidocaine emulsion (EMLA cream) is a topical anaesthetic commonly used prior to diagnostic and therapeutic procedures. While undergoing clinical investigation for the suspicion of a metabolic disorder, a series of children underwent skin biopsy with EMLA cream pretreatment. In each case, the pathologist identified ultrastructural features consistent with a lysosomal storage disorder, yet the clinical features were not consistent with the pathological findings. Ultrastructural artefact was suspected, resulting from the use of the EMLA cream. All patients underwent repeat skin biopsy without EMLA cream. Biopsies were reviewed by two pathologists blinded to the previous biopsy findings. Electron microscopy repeated without the use of EMLA cream was normal. It is concluded that the use of EMLA cream causes ultrastructural artefact and should be avoided prior to skin biopsy for electron microscopy.

Anesthetics, Local↗

The incidence and outcome of photodynamic therapy for macular degeneration in the Northern region of the UK.

PURPOSE: To assess the patients who have had photodynamic therapy (PDT) in the Northern region of the UK, in relation to the eligibility criteria found to benefit in the TAP study (treatment of age-related macular degeneration with photodynamic therapy study), so as to make an estimate of the number of patients who might benefit from this treatment and to present the outcome of the treatment so far. METHOD: The records and fluorescein angiograms (FFAs) of all patients who had had PDT in the Northern region between 2001 and 2002 were reviewed for compliance with the TAP criteria of >50% classic choroidal neovascularization and >34 letters on the 2 m logMAR Early Treatment Diabetic Retinopathy Study chart. NHS funding has been available in the Northern Region since January 2001 for 'second eye' involvement. A review of all the angiograms performed for exudative macular degeneration in 1 year was also performed. The visual outcome of those patients 1 year from baseline was measured. RESULTS: A total of 82 'second eye' patients were treated between January 2001 and December 2002. This gives an incidence of 65 per 3 million and so about 1300 in the whole of the UK (population 60 million). In all, 238 FFAs were performed on exudative macular degeneration, with 21% being found eligible for PDT. As of February 2003, 54 TAP criteria, macular degeneration patients were 1 year from initial treatment. Of these, 12 had incomplete follow-up and 13 patients had lost more than 15 letters. The responder rate defined as losing <15 letters was 42-13/42=69%. Seven of those who did not make 1-year follow-up had lost more than 15 letters when last seen, giving a responder rate of 54-20/54=63%. CONCLUSION: There may not be as many patients eligible for PDT, using the TAP criteria, as previously hoped. The outcome of treatment appears similar to that found in the TAP study.

Aged↗

Spasms in children with definite and probable mitochondrial disease.

The diagnosis of mitochondrial encephalomyopathies is complex and a system for classification of the diagnosis as definite, probable, and possible has been proposed. The objective of this study was to explore the spectrum of epileptic disorders associated with probable and definite mitochondrial disease in children using this classification system. The patient population with mitochondrial disease and epilepsy was selected from a tertiary care children's hospital. Interictal electroencephalograms and video-EEG recordings were used to characterize seizure types. Ten children fulfilled the criteria for probable or definite mitochondrial disease and had epilepsy. Four had siblings with a similar clinical phenotype. Spasms were the most common seizure type and were the initial seizure type in seven patients and two siblings. Four patients had only partial seizures, with or without generalization, and one patient had seizures that were difficult to classify. Blood lactate concentrations were elevated consistently in patients with partial seizures alone but were occasionally normal in children with spasms. Spasms were the most common presenting seizure type in children with probable and definite mitochondrial disease.

Child↗

Use of colour duplex ultrasound to diagnose giant cell arteritis in a case of visual loss of uncertain aetiology.

Giant cell arteritis is a common condition that can result in permanent visual loss. It has traditionally been diagnosed by invasive temporal artery biopsy in cases of clinical suspicion. The findings of colour duplex ultrasound have recently been described. We report the use of duplex ultrasound to diagnose temporal arteritis, with clinicopathological correlation, and discuss the possible application of this non-invasive technique to the management of giant cell arteritis.

Aged↗

Influence of genotype on the differential ontogeny of uncoupling protein 2 and 3 in subcutaneous adipose tissue and muscle in neonatal pigs.

The present study aimed to determine whether porcine genotype and/or postnatal age influenced mRNA abundance or protein expression of uncoupling protein (UCP)2 or 3 in subcutaneous adipose tissue (AT) and skeletal muscle (SM) and the extent to which these differences are associated with breed-specific discordance in endocrine and metabolic profiles. Piglets from commercial and Meishan litters were ranked according to birth weight. Tissue samples were obtained from the three median piglets from each litter on either day 0, 4, 7, 14 or 21 of neonatal life. UCP2 protein abundance in AT was similar between genotypes on the first day of life, but it was elevated at all subsequent postnatal ages (P<0.05) in AT of Meishan piglets. In contrast, UCP2 mRNA abundance was lower in Meishans up to 14 days of age. UCP2 mRNA expression was not correlated with protein abundance in either breed at any age. UCP3 mRNA in AT was similar between breeds up to day 7; thereafter, expression was higher (general linear model, P<0.05) in Meishan piglets. Conversely, UCP3 mRNA expression in SM was higher in commercial piglets after day 7. Colonic temperature remained lower in Meishan than commercial piglets throughout the study; this was most obvious in the immediate post-partum period when Meishan piglets had lower (P<0.05) plasma triiodothyronine. In conclusion, we have demonstrated that porcine genotype influences the expression and abundance of UCP2 and 3, an influence which may, in part, be due to the distinctive endocrine profiles associated with each genotype.

Adipose Tissue↗

Acoustic streaming: a new technique for assessing adnexal cysts.

OBJECTIVES: To determine whether acoustic streaming has clinical value in the differentiation between various ovarian and adnexal cysts. METHODS: We assessed 29 adnexal cysts, for which pathological diagnosis was available, for the presence of acoustic streaming during B-mode and color sonographic evaluation. RESULTS: Acoustic streaming was detected in 15 (52%) of the cysts. The most common cyst, endometrioma (n = 7), did not exhibit acoustic streaming in any case, while of the remaining 22 cysts, 15 exhibited acoustic streaming (P = 0.0017). Dermoid cysts exhibited acoustic streaming in two of six (33%) cases. In addition acoustic streaming was noted in two of two (100%) hemorrhagic cysts, eight of ten (80%) cystadenomas, two of three (67%) malignant cysts and in the one abscess. CONCLUSIONS: Acoustic streaming is the first sonographic feature that may be able to completely exclude endometrioma as a possible diagnosis for an adnexal cyst.

Adnexa Uteri↗

A nocturnal enuresis service for a deprived inner city.

AIM: Glasgow is a city where 80% of the most deprived children in Scotland live within 20% of the overall population. Of 168,000 children in Glasgow, an estimated 5000 aged 5-15 y have primary nocturnal enuresis. The aim of this study was to establish a nocturnal enuresis service for Glasgow. METHODS: Needs assessment was performed and the incident cases were documented at school entry healthcare appraisal, at the age of 5 y. A cohort of these children was followed up at 8 y of age and symptom resolution was no better than natural remission. Parents, general practitioners, clinical medical officers and a hospital paediatrician were interviewed face-to-face about their need for a service. RESULTS: Ten of 11 general practitioners expressed a need for a specialist service. Ten school nurse-led local nocturnal enuresis clinics were established. Accommodation, funding, default and managing alarms were major problems. School nurses enjoyed extra training and quickly became skilled therapists. Two research projects highlighted that most children at first attendance did not believe they could ever be dry, which predicted outcome. Deprived families, once motivated, could successfully undertake complex behavioural therapies. CONCLUSION: A comprehensive nocturnal enuresis service begins when children stop using night nappies at the age of 3-4 y. Appropriate waterproof mattress, duvet and pillow coverings should be advocated until 5 y, when desmopressin may be helpful. For continued wetting at the age of 7 y, a local service should be led by a team of well-trained nurses using enuretic alarms.

Behavior Therapy↗