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Biomedical subjects

M Boyle

Publications and source records attributed to M Boyle.

At least 19 recordsLinked to original sources
PubMed2006

Are burns photographs useful?

UNLABELLED: Routine photography of all patients admitted to the West of Scotland Regional Burns Unit was introduced in 2003. To date, there are few burns units to evaluate the usefulness of photographs taken. AIM: To assess the usefulness of photographs of patients admitted to the burns unit to various members of the multidisciplinary team. METHOD: A questionnaire was completed by hospital staff involved in the management of burns patients over a 3-month period. A total of 43 questionnaires were completed. RESULTS: The majority of questionnaires were completed by nursing staff (55%) followed by medical staff (23%); physiotherapy (5%); anaesthetists (7%); theatre staff (5%); students (2%); dietician (2%). About 98% of respondents agreed that photographs were useful overall, particularly for teaching purposes. About 9% disagreed that photographs were useful for assessment due to difficulty in assessing depth of burn. About 72% agreed that the photographs were useful for patient management and improve patient care. About 88% agreed that all patients should have photographs available in future. Advantages of photographs include; moving and handling of patients; patient positioning in theatre; reviewing wound healing and complications. They are useful for assessing site, size and type of burn. Disadvantages include difficulty in assessing depth of burn, technical factors, and unavailability out of hours. CONCLUSIONS: Photographs of burns patients are useful overall to all members of the multidisciplinary team.

Attitude of Health Personnel↗
PubMed2006

Batch solar disinfection inactivates oocysts of Cryptosporidium parvum and cysts of Giardia muris in drinking water.

AIM: To determine whether batch solar disinfection (SODIS) can be used to inactivate oocysts of Cryptosporidium parvum and cysts of Giardia muris in experimentally contaminated water. METHODS AND RESULTS: Suspensions of oocysts and cysts were exposed to simulated global solar irradiation of 830 W m(-2) for different exposure times at a constant temperature of 40 degrees C. Infectivity tests were carried out using CD-1 suckling mice in the Cryptosporidium experiments and newly weaned CD-1 mice in the Giardia experiments. Exposure times of > or =10 h (total optical dose c. 30 kJ) rendered C. parvum oocysts noninfective. Giardia muris cysts were rendered completely noninfective within 4 h (total optical dose >12 kJ). Scanning electron microscopy and viability (4',6-diamidino-2-phenylindole/propidium iodide fluorogenic dyes and excystation) studies on oocysts of C. parvum suggest that inactivation is caused by damage to the oocyst wall. CONCLUSIONS: Results show that cysts of G. muris and oocysts of C. parvum are rendered completely noninfective after batch SODIS exposures of 4 and 10 h (respectively) and is also likely to be effective against waterborne cysts of Giardia lamblia. SIGNIFICANCE AND IMPACT OF THE STUDY: These results demonstrate that SODIS is an appropriate household water treatment technology for use as an emergency intervention in aftermath of natural or man-made disasters against not only bacterial but also protozoan pathogens.

Animals↗
PubMed2005

Childhood and early adult predictors of risk of incident back pain: Ontario Child Health Study 2001 follow-up.

Musculoskeletal disorders of the back and spine are a leading cause of disability in working-age populations. There is limited information on the potential consequences of childhood socioeconomic and health status on the risk of incident back pain in early adulthood. The authors describe factors associated with having had a first episode of back pain during the past year in the Ontario Child Health Study, a prospective cohort study of children who were aged 4-16 years at the time of enrollment in 1983 and were resurveyed in 2001. Respondents reporting a first episode of back pain (n=143) were compared with respondents who had never experienced back pain (n=896). The annual incidence of a first episode of back pain in this sample of young adults was 74.7/1,000. Following adjustment for age, sex, childhood conditions, childhood health status, and measures of early adult health, behavior, socioeconomic status, and work environment, the risk of incident back pain was associated with both low (odds ratio (OR)=1.86, 95% confidence interval (CI): 1.14, 3.03) and moderate/high (OR=1.85, 95% CI: 1.07, 3.02) levels of psychological distress, current heavy smoking (OR=1.85, 95% CI: 1.10, 3.10), lower levels of parental education in childhood (OR=1.72, 95% CI: 1.06, 2.80), and emotional or behavioral disorders in childhood (OR=1.87, 95% CI: 1.02, 3.41). The associations of low childhood socioeconomic status and childhood emotional and behavioral disorders with risk of incident back pain in early adulthood are important findings with implications for better understanding the etiology of soft-tissue disorders.

Adolescent↗
PubMed2005

Fragmentation dynamics of fullerenes in intense femtosecond-laser fields: loss of small neutral fragments on a picosecond time scale.

The fragmentation dynamics of C60 irradiated with intense femtosecond laser pulses is studied with one-color pump-probe spectroscopy. Small neutral fragments (C, C2, and C3) are formed by an 800-nm pump pulse which are then postionized by a delayed probe pulse. The respective ion signals detected by the time-of-flight mass spectrometry dramatically increase on a time scale of 10-20 ps.

Journal Article↗
PubMed2004

Primary meningioma of the scalp as a late complication of skull fracture: case report and literature review.

A case of primary meningioma of the scalp is presented in which the anatomical association with a previous skull fracture is demonstrated and pathogenesis discussed. The investigations and surgical treatment are briefly described. Review of the literature reveals a strong association between trauma of the central nervous system and intracranial meningioma. Occasional reports also exist of extra-cranial meningioma following trauma. This is, however, the first report of such an association in the scalp.

Adult↗
PubMed2003

An easy method of mentally estimating the metabolic component of acid/base balance using the Fencl-Stewart approach.

The Stewart approach defines acid/base abnormalities as resulting from changes in PCO2, strong ion difference (SID), and weak acids (mainly albumin) but needs a computer for calculation. The base excess (BE) is a measure of the net effect of changes in SID and weak acids, therefore, metabolic acid/base balance can be described as BE effects of their change from normal. We compared our mental estimation of BE effects with the more complex calculation. Acid/base abnormalities were identified in 44 critically ill patients. The BE effects of change in strong ions, change in albumin, and the BE-gap ("other species" or unmeasured anion effect) were calculated using standard equations. An estimate of the BE effects was determined. The difference between SID (using [Na+] + [K+] - ([Cl-] + lactate)) and normal SID (42 mEq/l) estimated the effect of a change in SID. The effect of a change of albumin from normal was estimated as 0.25 x (normal albumin-measured albumin). The predicted BE was defined as estimated change in SID plus albumin effect. The estimated BE-gap (BE-gap(est)) was actual BE minus predicted BE. The Bland-Altman method was used to test agreement. Calculations were made on 46 data sets from 44 individuals. The bias (limits of agreement) for calculated and estimated strong ion effects, calculated and estimated albumin effect, and calculated and estimated BE-gap were -1.26 (-3.14 to 0.66) mEq/l, 0.5 (-0.05 to 1.05) mEq/l, and 0.76 (-1.27 to 2.79) mEq/l respectively. However the bias (limits of agreement) for BE-gap and BE-gap(est) and strong ion gap were poor, being 1.1 (-4 to 14) mEq/l and 0.4 (-9.2 to 10) mEq/l respectively. The BE-gap and BE-gap(est) are unsuitable to quantify gap ions. However, our easy-to-perform estimation has a clinically acceptable bias compared to calculated BE effects and is a simple method for identifying the components of acid/base abnormalities.

Acid-Base Imbalance↗
PubMed2003

Induced sputum IL-8 gene expression, neutrophil influx and MMP-9 in allergic bronchopulmonary aspergillosis.

Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to the fungus Aspergillus fumigatus, causing severe asthma that may progress to bronchiectasis. Sputum neutrophilia can occur in association with sputum eosinophilia and correlates with the degree of bronchiectasis. The mechanisms of sputum neutrophilia in ABPA are not known. The aim of this study was to investigate the role of the chemokine interleukin (IL)-8 in sputum neutrophilia in ABPA. Induced sputum was obtained from subjects with ABPA (n=29), and compared to nonsensitised asthma (n=9) and healthy controls (n=21). Semiquantitative polymerase chain reaction was used to assess IL-8 gene expression in induced sputum and IL-8 protein was measured by enzyme-linked immunosorbent assay. Sputum IL-8 protein was significantly higher in ABPA compared to asthma and controls. IL-8 messenger ribonucleic acid/glyceraldehyde-3-phosphate dehydrogenase ratio was elevated in ABPA compared to asthma and controls. Sputum IL-8 correlated with sputum neutrophils, matrix metalloproteinase-9 levels and forced expiratory volume in one second. Interleukin-8 gene expression and protein release were increased in allergic bronchopulmonary aspergillosis and correlated with airway neutrophilia and airway obstruction. The interleukin-8-mediated neutrophil influx in allergic bronchopulmonary aspergillosis may induce lung damage via release of matrix metalloproteinase-9, potentially leading to bronchiectasis.

Adult↗
PubMed2001

Excitation of Rydberg series in C60.

Rydberg series of C60 are reported for the first time. The Rydberg states are seen in photoelectron spectra using ultrashort pulsed-laser excitation, where the excited states formed are ionized with one further photon from the same laser pulse. The structure is observed for pulse durations as short as 100 fs with indications of residual structure for even shorter pulse excitation. The production mechanism is discussed and the Rydberg states are modeled by analytically solving the Schrödinger equation with a simple jelliumlike potential for C60.

Journal Article↗
PubMed2001

Safety of aerosolized INS 365 in patients with mild to moderate cystic fibrosis: results of a phase I multi-center study.

Cystic fibrosis (CF) is characterized by defective cystic fibrosis transmembrane regulator (CFTR) expression and function, associated with abnormal ion transport and mucociliary clearance, and clinical lung disease. Triphosphate nucleotides such as uridine-5'-triphosphate (UTP) and INS 365, may be useful for CF through actions, mediated via P2Y(2) extracellular receptors, on chloride and liquid secretion, and ciliary beat frequency. INS 365 may offer chemical stability advantages over UTP. In a randomized, double-blind, multicenter phase I study, we studied the safety and maximally tolerated dose of escalating, single doses of aerosolized INS 365, in adult and pediatric patients with mild to moderate CF lung disease (FEV(1) > or = 45% predicted). In four successive dose cohorts of adult patients (n = 12 per cohort, age > or = 18 years) and four successive pediatric dose cohorts (n = 12 per cohort, age 5-12 years), patients were randomized 3:1 active/placebo (0.9% saline) to evaluate doses of 20, 40, 80, and 100 mg INS 365 delivered by nebulizer (Pari Star ). Sputum was collected pre- and post-dosing to obtain preliminary results on clinical efficacy. After each dose cohort, a Data Safety Monitoring Committee (DSMC) reviewed the data. Forty-eight adult and 36 pediatric patients completed the protocol (up to 100 mg for adults, 80 mg for pediatric patients). The predominant adverse events were cough, wheezing, chest tightness, and a decrease in FEV(1) (occurring in 8/48 adults, and 5/36 pediatric patients), which occurred predominantly in the 80-mg and 100-mg dose cohorts. Though a few adult patients had a tendency to increase sputum production, there was little consistent effect noted on sputum production in this acute, single-dose study. The data suggest that aerosolized INS 365 is safe when delivered at single doses of up to 40 mg in adults and children with CF, but that higher doses are unlikely to be tolerated.

Adolescent↗
PubMed2001

Pressure sores in intensive care: defining their incidence and associated factors and assessing the utility of two pressure sore risk assessment tools.

Patients in intensive care units (ICU) are at high risk of developing pressure sores and the use of pressure sore risk tools has been advocated as a means of identifying patients at risk. A prospective multi-site observational study was conducted to define the incidence of pressure sores, assess two pressure sore risk scales and to define risk factors relevant to intensive care. Patients (n = 534) were assessed for the presence of pressure sores. The Waterlow and Jackson/Cubbin risk scales were completed each day for 314 and 188 of these patients respectively. A total of 75 pressure sores were recorded. Of these, 34 were present on admission. Of the remaining 41, 16 were classified as Grade 1 and 24 as Grade 2 sores. The pressure sore (PS) incidence was 5.2 per cent. Expressed as PS/1000 patient days there were 18.48 pressure sores per 1000 patient days. The ability of the risk scores to predict pressure sores was tested using a Receiver Operating Characteristic (ROC) analysis. The association of risk score with pressure sores was analysed using a survival function (Kaplan Meier) and variables compared using a logrank test (Mantel-Cox). Factors associated with pressure sore occurrence were developed and tested using a survival regression model. Both risk scales were poor predictors of pressure sores (ROC curve area approximately 70 per cent for both). The factors, coma/unresponsiveness/paralysed & sedated and cardiovascular instability were significantly associated with pressure sores with relative risks of 4.2 and 2.5 respectively. Risk increased as a function of time such that the cumulative risk was 50 per cent at 20 days.

Adolescent↗
PubMed2001

Long-term outcome of patients surviving for more than ten years following treatment for acute leukaemia.

Between 1972 and 1988, 832 consecutive patients were treated for acute leukaemia at St. Bartholomew's Hospital; a retrospective analysis has been conducted to determine the clinical course and outcome for 101 who have survived > or = 10 years following treatment. At a median follow-up of 16 years (range 10-28 years), 86 patients (86 out of 834 total, 11%) were still alive. Long-term follow-up of patients who have survived > or = 10 years following treatment for acute leukaemia revealed that most patients were in normal health, although a significant number of complications had occurred.

Acute Disease↗
PubMed2001

Comparison of the lower inflection point on the static total respiratory compliance curve with outcomes in postoperative cardiothoracic patients.

BACKGROUND: Routine use of positive end-expiratory pressure (based on the pressure at the lower inflection point on the static total respiratory compliance curve) along with a maneuver to recruit atelectatic lung has been advocated after cardiothoracic surgery. OBJECTIVES: To determine if the lower inflection point is related to outcomes in patients after sternotomy and cardiopulmonary bypass. METHOD: A prospective observational study involving estimation of the lower inflection point on the inflation pressure-volume plot obtained with a low-flow technique. Duration of intubation, length of stay, respiratory complications, and results of spirometry were compared between patients with a "high " inflection point (> or =10 cm H2O) and patients with a "low" inflection point (< or =5 cm H2O). RESULTS: Ninety-five patients were enrolled. After exclusion for incomplete data, 65 patients (49 men, 16 women; mean age, 66.1 years; SD, 9.5 years) were included. The mean lower inflection point was 6.33 cm H2O (SD, 3.4 cm H2O). A second lower inflection point was observed on 5 plots (mean, 21 cm H2O; SD, 1.4 cm H2O). Nine patients had high inflection points (mean, 13.1 cm H2O; SD, 3.0 cm H2O), and 33 had low inflection points (mean, 3.9 cm H2O; SD, 0.98 cm H2O). No outcome measures differed between groups. CONCLUSIONS: In patients with short intubation times and predictable postoperative course, general use of a lung recruitment strategy involving sustained inflations and adjustment of positive end-expiratory pressure based on the lower inflection point is difficult to justify.

Aged↗
PubMed2000

A modified classification for the maxillectomy defect.

BACKGROUND: At present no widely accepted classification exists for the maxillectomy defect suitable for surgeons and prosthodontists. An acceptable classification that describes the defect and indicates the likely functional and aesthetic outcome is needed. METHODS: The classification is made on the basis of the assessment of 45 consecutive maxillectomy patients derived prospectively from the database (September 1992) and retrospectively from 1989. RESULTS: The classification of the vertical component is as follows: Class 1, maxillectomy without an oro-antral fistula; Class 2, low maxillectomy (not including orbital floor or contents); Class 3, high maxillectomy (involving orbital contents); and Class 4, radical maxillectomy (includes orbital exenteration); Classes 2 to 4 are qualified by adding the letter a, b, or c. The horizontal or palatal component is classified as follows: a, unilateral alveolar maxillectomy; b, bilateral alveolar maxillectomy; and c, total alveolar maxillary resection. CONCLUSION: This practical classification attempts to relate the likely aesthetic and functional outcomes of a maxillectomy to the method of rehabilitation.

Adult↗
PubMed2000

Non-invasive positive pressure ventilation in acute respiratory failure: providing competent care.

Non-invasive positive pressure ventilation (NPPV) has been used as an alternative strategy to provide ventilatory support for patients with acute respiratory failure. Most studies demonstrate that the use of NPPV in acute respiratory failure results in a reduction in the need for endotracheal intubation and an overall survival advantage. However, current evidence, in the form of randomised controlled trials, suggests that these benefits may be restricted to patients suffering from acute exacerbation of chronic obstructive pulmonary disease (COPD). The clinical application of NPPV involves the development of competence in delivering the particular intervention. Clinical outcomes and thus valid comparisons with alternate methods of ventilatory support can only be made if attention is paid to the clinical indications for the application of NPPV and patient subgroups it is used to treat and the level of competence of care givers in its application and delivery. One essential element of competence is the establishment of an appropriate knowledge base and the development of clinical practice guidelines. This literature review identifies the current indications for NPPV and the relevant information for developing clinical practice guidelines for the management of this form of ventilatory support.

Acute Disease↗
PubMed2000

Human immunodeficiency virus-related primary cutaneous aspergillosis.

A 31-year-old Caucasian man with AIDS developed a crusted violaceous plaque under adhesive tape near a central venous catheter insertion site. Histological examination demonstrated a ruptured hair follicle containing collections of fungal hyphae typical of Aspergillus spp. A culture of the biopsy material grew Aspergillus fumigatus. The patient responded to removal of the catheter and the occlusive dressing, in addition to itraconazole therapy. Aspergillosis must be considered in the differential diagnosis of cutaneous lesions in human immunodeficiency virus-infected patients, in particular when the lesion occurs under adhesive tape or an occlusive dressing.

AIDS-Related Opportunistic Infections↗
PubMed2000

Tri-ministry study: correlates of school-based parenting course utilization.

This study examined factors associated with the utilization of universally available school-based parent training. In a randomly selected, prospectively screened, unreferred community sample of 1,498 5- to 8-year-olds, 28% to 46% of families of children with high parent-reported externalizing problems enrolled. Externalizing problems, first-child status, and a high school education were associated with increased enrollment. Single-parent status, immigrant background, and limited extracurricular child activities were associated with lower enrollment. Economic disadvantage, stress, family dysfunction, and parental depressive symptoms were not associated with participation. Most families attributed nonparticipation to busy personal schedules, inconvenient times, and logistical difficulties.

Adult↗