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Biomedical subjects

M Cleary

Publications and source records attributed to M Cleary.

At least 55 records · Page 3Linked to original sources
PubMed1999

Identification of a novel strain of Borrelia hermsii in a previously undescribed northern California focus.

An epizootiologic investigation testing for the presence of tick-borne relapsing fever spirochetes in rodent and tick hosts was conducted at Eagle Lake in Lassen County, California. Six of 211 O. hermsii ticks and none of 180 rodents were polymerase chain reaction (PCR)-positive for Borrelia spirochetes. Sequencing of the PCR-amplified flagellin gene fragment suggests that the spirochetes from Eagle Lake represent a previously undescribed strain of Borrelia hermsii.

Animals↗
PubMed1998

Decreased lesion formation in CCR2-/- mice reveals a role for chemokines in the initiation of atherosclerosis.

Chemokines are proinflammatory cytokines that function in leukocyte chemoattraction and activation and have recently been shown to block the HIV-1 infection of target cells through interactions with chemokine receptors. In addition to their function in viral disease, chemokines have been implicated in the pathogenesis of atherosclerosis. Expression of the CC chemokine monocyte chemoattractant protein-1 (MCP-1) is upregulated in human atherosclerotic plaques, in arteries of primates on a hypercholesterolaemic diet; and in vascular endothelial and smooth muscle cells exposed to minimally modified lipids. To determine whether MCP-1 is causally related to the development of atherosclerosis, we generated mice that lack CCR2, the receptor for MCP-1 (ref. 7), and crossed them with apolipoprotein (apo) E-null mice which develop severe atherosclerosis. Here we show that the selective absence of CCR2 decreases lesion formation markedly in apoE-/- mice but has no effect on plasma lipid or lipoprotein concentrations. These data reveal a role for MCP-1 in the development of early atherosclerotic lesions and suggest that upregulation of this chemokine by minimally oxidized lipids is an important link between hyperlipidaemia and fatty streak formation.

Animals↗
PubMed1998

Clinical characteristics of microtropia--is microtropia a fixed phenomenon?

BACKGROUND/AIMS: Microtropia is believed to be a static condition, in which accepted achievable levels of vision are those of 6/12-6/9 maximum, with the inability to achieve "normal" levels of stereopsis. The aim of this paper was to present the results of treatment of 30 consecutively presenting primary microtropes, and assess their outcomes using a more active treatment strategy than that conventionally used. METHODS: Visual acuity, stereoacuity, fixation, and the presence of a central suppression scotoma were assessed in all patients before, during, and after treatment, which comprised wearing maximum refractive correction, and an occlusion strategy aiming for equal visual acuity. RESULTS: Equal visual acuity of 6/5 Snellen was achieved in 43% of the 30 patients, while 87% achieved 6/9 Snellen or better visual acuity in the microtropic eye. Stereoacuity of better than 60" of arc was attained in 37%, and foveal fixation on visuscopy in 55%. The treatment outcome was not affected by the patient's age, initial visual acuity, or the amount of anisometropia. A change in the patient's diagnosis was noted in 50%, with nine patients recovering completely. CONCLUSIONS: The results show that microtropia is not static. Equal 6/5 vision is attainable, as is high grade stereoacuity. The pattern of fixation may change during treatment and elimination of the microtropia is possible in some cases. There is a requirement for management protocols to be changed in order to treat this condition more effectively.

Bandages↗
PubMed1998

Recovery in microtropia: implications for aetiology and neurophysiology.

AIMS/BACKGROUND: The basis of binocular single vision in microtropia remains a matter of contention. This paper discusses the implications of recovery, in a group of primary microtropes following treatment, in relation to current concepts on the aetiology of the condition and proposed retinocortical correspondence. METHODS: Nine previously untreated primary microtropes whose condition resolved, were reviewed in detail to assess the patterns of change in retinal correspondence, uniocular fixation, stereoacuity, and visual acuity in response to treatment. RESULTS: Anomalous retinal correspondence (ARC), a central scotoma, reduced or absent stereoacuity, amblyopia, and uniocular eccentric fixation were present in all patients before treatment. Following treatment, all cases attained normal retinal correspondence (NRC), elimination of the central scotoma, stereo acuity levels of between 20 and 40 seconds of arc, 6/5 Snellen visual acuity in both eyes, and foveal fixation in both eyes. CONCLUSION: A hypothesis is put forward that for the patients described, a period of normal development is likely to have preceded the onset of microtropia, during which the retinocortical "foundations" for NRC were established. Precise pairing of foveo-foveal receptive fields was not abolished by the presence of amblyopia and a central scotoma, but this relation was temporarily suspended and binocular single vision was sustained via the neural substrate of paired receptive fields over a wide retinocortical area.

Bandages↗
PubMed1998

Boarding house life for people with mental illness: an exploratory study.

The present study explored residents' perceptions of life in boarding houses within the Central Sydney Area Health Service. A purposeful sample of 14 people with a mental illness participated in semistructured interviews. The transcribed interviews were analysed for lifestyle issues to increase understanding of the factors that impact on quality of life from the consumers' perspective. It was encouraging to find that basic needs were being met, but it would appear that there is considerable room for improvement in quality of life for this vulnerable group of people. The findings of the present study should prove valuable for policy makers and health professionals who provide services to people with mental illness resident in boarding houses.

Adult↗
PubMed1998

Attitudes of mental health personnel towards rating outcome.

Outcome measurement is becoming an integral part of health-care delivery. The attitudes of staff towards this development are important as they may influence ratings themselves, improve the design of measures and indicate how outcome assessment should be introduced into services. In this preliminary study, we surveyed staff from Central Sydney Mental Health Services who had taken part in a Commonwealth-funded project which had required them to rate patient outcome. The major concern expressed by respondents was that rating outcome was too time-consuming. More than half were not in favor of measuring outcome routinely even if it meant providing a better service to patients. The study methodology had limitations. However, if our findings are corroborated, attention will need to be paid to staff attitudes to outcome assessment so that ratings are more reliable and valid, properly inform treatment and meaningfully influence resource allocation.

Attitude of Health Personnel↗
PubMed1998

An exploratory investigation into women's experiences in a mixed sex psychiatric admission unit.

In recent years, expressions of concern about the safety of women in mixed sex wards have been noted. The purpose of this exploratory study was to give hospitalized women with a diagnosis of mental illness the opportunity to describe their experiences in mixed sex wards. A qualitative study, using focus groups, was conducted. The three major themes that emerged from the study were: (i) environment; (ii) gender; and (iii) vulnerability. The study incorporated a feminist and phenomenological perspective. In essence, the study found that although some women had experienced problems with safety, they indicated they would prefer mixed sex to single sex wards.

Adult↗
PubMed1997

Succinic semialdehyde dehydrogenase deficiency: low excretion of metabolites in a neonate.

A neonate at risk for succinic semialdehyde dehydrogenase deficiency was investigated on day 1. The urine level of 4-hydroxybutyrate was only slightly elevated (23 mumol/mmol of creatinine; controls 1.6-14, n = 18). This value was considerably less than those found for older children with succinic semialdehyde dehydrogenase deficiency and made interpretation of the result uncertain. The diagnosis of succinic semialdehyde dehydrogenase deficiency was confirmed by enzyme assay, and repeat urine testing showed a steady increase in the level of 4-hydroxybutyrate to 359 mumol/mmol at 6 months.

Aldehyde Oxidoreductases↗
PubMed1996

DNA-confirmed Taenia solium cysticercosis in black bears (Ursus americanus) from California.

Three cases of cysticercosis in black bears (Ursus americanus) in three northern California counties between 1990 and 1994 have been identified as due to the tapeworm Taenia solium. Both morphologic characteristics as well as the presence of T. solium mitochondria cytochrome oxidase I gene sequences, as detected by the polymerase chain reaction, confirmed the diagnosis. The number and geographic separation of the cases suggests that infection of the bears was not due to a single contamination. Humans infected with the definitive stage of T. solium are the probable source of cysticercosis for bears, as well as other humans. This is the first confirmation of cysticercosis due to T. solium in a black bear in North America.

Animals↗
PubMed1993

Characterization of posttransplant lymphomas that express T-cell-associated markers: immunophenotypes, molecular genetics, cytogenetics, and heterotransplantation in severe combined immunodeficient mice.

Immunosuppressed individuals are at high risk for the development of hematologic malignancies. The typical lymphomas arising in organ transplant recipients are B-cell non-Hodgkin's lymphomas that contain Epstein-Barr virus (EBV) DNA sequences. We investigated the characteristics of posttransplant lymphomas that lacked expression of the usual markers associated with EBV transformation. We describe four large-cell lymphomas seen recently at our institution. Two of these four cases were CD4+, one was CD8+, and in one staining for CD4 and CD8 expression was not performed. One CD4+ lymphoma was a CD30+, EBV- large-cell lymphoma from a 65-year-old kidney transplant recipient, the second was an EBV+ large-cell lymphoma from a 25-year-old heart transplant patient. Two T-cell lymphomas were EBV+ and had clonal T-cell receptor beta gene rearrangements. The other two lymphomas expressed T-cell markers CD4 and CD43, and lacked expression of B-cell markers CD19, CD20, CD21, CD22, CD23, and surface Ig. Both CD4+ lymphomas were tumorigenic after their heterotransplantation into severe combined immunodeficient (SCID) mice. Cytogenetics, immunophenotyping, and genotyping of the secondary tumors from SCID mice showed their clonality and identity with the patients' primary tumors. Novel CD4+ lymphoma cell lines, LH521/4 and LK418/4, were established from tumors that had been passaged in SCID mice. An immunodeficient environment may facilitate the growth of these T-cell or biphenotypic lymphomas; the etiology of their genesis can include transformation with EBV and other, as yet unidentified mechanisms.

Adolescent↗
PubMed1991

Peripheral intravenous cannulation.

The placement of intravenous cannulas can be a difficult task, especially when treating a hypovolaemic or critically ill patient. Often the physician is faced with the problem of being unable to locate a suitable vein or, even more frustrating, finding a vein but not being able to insert the cannula. The author summarises the general principles of peripheral intravenous cannulation and presents some practical tips.

Catheterization, Peripheral↗
PubMed1990

Detection of non-Hodgkin's lymphoma in the peripheral blood by analysis of antigen receptor gene rearrangements: results of a prospective study.

Analysis of immunoglobulin (Ig) and T-cell receptor gene rearrangements, using Southern blot hybridization, has been applied to peripheral blood lymphocytes (PBL) in 335 samples from patients with non-Hodgkin's lymphoma. The incidence of circulating lymphoma cells detected by gene rearrangement analyses is related to the histologic subtype, clinical stage of disease, and clinical status. Among 104 patients studied at diagnosis, the incidence of positive analyses was 34% in low-grade lymphoma and only 8% in intermediate-grade lymphoma. Clonal Ig gene rearrangements were detected nearly universally in the small lymphocytic histologic subtype. PBL studies were related to the initial stage of disease: positive studies were seen in 35% of patients with stage IV disease, 29% of patients with stage III disease, and 12% of patients with stages I-II disease. The incidence of PBL rearrangements at the time of disease recurrence in 32 patients requiring cytoreductive therapy was 48%, somewhat greater than at initial diagnosis. A group of patients with low-grade lymphoma, who had treatment deferred after diagnosis or recurrence, was also studied; the incidence of PBL rearrangements was 38% in this population. Among 157 patients clinically free of disease, DNA analyses of the PBL were positive in only 10%. Subsequent relapse of disease in 26 patients was antedated by PBL rearrangement in only one patient. Clonal rearrangements detected in 15 patients have been followed by recurrence of clinical disease in only one patient over a median of 24 months from the time of analysis. The lack of detectable rearrangements in the peripheral blood in the majority of patients may be due to methodology or the biology of the disease. These issues may be further addressed with alternative methods for assessment of minimal disease. However, rigorous testing of any new molecular tool requires an adequate patient population in which disease status is closely monitored over a sufficient period of time.

Blotting, Southern↗
PubMed1989

Long-term growth of malignant thymocytes in vitro.

We report a new methodology for the long-term growth of malignant T-lymphoblasts from patients with T-cell acute lymphoblastic leukemia (T-ALL) and T-cell lymphoblastic lymphoma (T-LL). When malignant cells were cultured in the presence of insulin-like growth factor I under hypoxic conditions, cellular proliferation occurred that resulted in the establishment of immortal cell lines from ten of 12 patient tumors. Authenticity of each cell line was verified by a direct comparison of the immunophenotype, karyotype, and immunogenotype with the patient's tumor cells. This improved method of cell culture permits frequent establishment of cell lines from patients with T-ALL/T-LL, thereby aiding in analysis of thymocyte transformation and neoplasia.

Adolescent↗
PubMed1984

Congenital rubella syndrome.

Rubella (German measles) is a common viral infection in children and adults. It is usually a mild disease with few complications and resultant sequelae. Maternal infection with rubella, however, can cause severe congenital defects, known as congenital rubella syndrome. Although the incidence of rubella has declined, about 15 percent of women of childbearing age remain at risk for rubella. About one third of fetuses are infected from maternal rubella infection. The risk of fetal damage is directly related to the occurrence of the maternal infection with greater risk present in the first trimester of pregnancy. The most important area of primary health care delivery by the nurse clinician is prevention. Routine rubella serologic testing and immunization, if required, of women of childbearing age is essential to the elimination of congenital rubella syndrome.

Adolescent↗