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Biomedical subjects

M Coleman

Publications and source records attributed to M Coleman.

At least 55 records · Page 3Linked to original sources
PubMed2000

Treatment of nonlaparotomized (clinical) stage I and II Hodgkin's disease patients by extended field and splenic irradiation.

PURPOSE: At the New York Presbyterian Hospital-Cornell Medical Center, patients with unequivocal clinical stage I and IIA Hodgkin's disease (HD) have been treated with mantle, splenic, and extended field radiation therapy (EFRT) (without surgical staging). A 24-year retrospective review was conducted to determine the effectiveness of our patient selection on the outcome of patients treated with this modality. METHODS AND MATERIALS: During the period 1971 to 1994, 94 patients with clinically staged HD, with favorable prognostic factors, were retrospectively reviewed. Patients with pathological or equivocal staging, "B" symptoms, bulk disease, history of previous chemotherapy, and/or Stage III or IV disease were excluded from our analysis. There were 27 Stage IA and 67 Stage IIA patients. All patients were treated to 3600 cGy with a 400 cGy boost to the involved field. The median follow-up was 52 months, mean of 62.1 months. RESULTS: Ten of 94 patients (10.5%) relapsed. Seven of the relapses were in the pelvis, one submandibularily, one in the tonsil, and one in the axilla. Nine of the relapses had nodular sclerosis histology, one had lymphocyte predominance, and none had mixed cellularity. The median time to relapse was 38 months; mean time 42. 3 months. All patients are alive, well and free of disease, including nine who received subsequent chemotherapy and one who underwent autotransplantation. CONCLUSIONS: Careful clinical staging of early, asymptomatic HD patients treated with mantle, splenic, and EFRT may obviate the need for exploratory laparotomy.

Adolescent↗
PubMed2000

Extent of misclassification of death from Creutzfeldt-Jakob disease in England 1979-96: retrospective examination of clinical records.

OBJECTIVE: To investigate the extent to which deaths from Creutzfeldt-Jakob disease were misclassified during 1979-96. DESIGN: Structured review of clinical records based on predetermined criteria to determine whether death could have been due to sporadic or variant Creutzfeldt-Jakob disease. SETTING: 100 health authorities and 275 NHS trusts in England. SUBJECTS: 1485 people who died aged 15-44 years from selected neurological disorders in England during 1979-96. MAIN OUTCOME MEASURE: Cause of death. RESULTS: The clinical records of 705 (48%) subjects were successfully traced. Tracing of clinical records was highest in subjects who died during 1990-6. There was sufficient information in the records of 640 (91%) of the 705 subjects to exclude Creutzfeldt-Jakob disease as a cause of death. In 61 (9%) subjects, there was insufficient information to reach any conclusion about the validity of the cause of death recorded on the death certificate. The clinical records of four subjects were examined further by the National Creutzfeldt-Jakob Disease Surveillance Unit; none was thought to have died from Creutzfeldt-Jakob disease. CONCLUSIONS: No new cases of sporadic or variant Creutzfeldt-Jakob disease were detected in a sample of deaths most likely to have included misclassified cases. This suggests that the surveillance system is unlikely to have missed a significant number of cases among people aged 15-44 years. Hence, any rapid increase in the number of cases of variant Creutzfeldt-Jakob disease in this age group is likely to be real not artefactual.

Adolescent↗
PubMed2000

Ligand-dependent regulation of vascular endothelial growth factor and erythropoietin expression by a plasmid-based autoinducible GeneSwitch system.

We investigated the ability of an improved mifepristone-dependent GeneSwitch system to regulate the expression of genes for two therapeutic proteins: vascular endothelial growth factor (VEGF) and erythropoietin. The GeneSwitch system consisted of two plasmids, one encoding the chimeric GeneSwitch protein, the other an inducible transgene. When the constitutive CMV promoter of the GeneSwitch plasmid was replaced by an autoinducible promoter consisting of four copies of GAL4 DNA binding sites linked to a minimal thymidine kinase promoter, the tightness of transgene regulation was improved by an order of magnitude. Quantitative RT-PCR analysis of GeneSwitch mRNA confirmed that the autoinducible promoter was responsive to mifepristone. We demonstrated the ability of the improved GeneSwitch system to regulate the expression of VEGF or erythropoietin in a biologically relevant manner after delivery of plasmids to the hind-limb muscle of adult mice. This ability of the autoinducible GeneSwitch system to regulate the expression of therapeutic proteins in mice indicates its potential for use in human gene therapy applications.

Animals↗
PubMed2000

Aggressive behavior in patients with Sotos syndrome.

Sotos syndrome is characterized by peculiar facies, prenatal and postnatal overgrowth, and developmental delay. The course of six patients with psychiatric, neurologic, and magnetic resonance imaging evaluations is reported. Three (50%) of the six patients were observed to have a tendency toward aggressiveness, including one who had pyromania.

Aggression↗
PubMed2000

Transdermal extraction of analytes using low-frequency ultrasound.

PURPOSE: Transdermal extraction of clinically relevant analytes offers a potentially non-invasive method of diagnostics. However, development of such a method is limited by the low skin permeability. In this paper, we report a potential method for non-invasive diagnostics based on ultrasonic skin permeabilization and subsequent extraction of interstitial fluid (ISF) across the skin. METHODS: In vivo experiments were performed using Sprague Dawley rats to assess ultrasound-induced skin permeabilization and subsequent extraction of various analytes. Serum and ISF concentrations of various analytes were measured. RESULTS: Application of low-frequency ultrasound rapidly increased skin permeability. Skin remained in a state of high permeability for at least three hours. During this period, application of vacuum extracted ISF across rat skin in vivo at a rate of 25.7 microl/cm2/hr. We measured concentrations of various analytes including glucose, albumin, calcium, urea, triglycerides, lactate, and dextran in transdermally extracted fluid. The composition of the fluid extracted transdermally is similar to that of ISF. CONCLUSIONS: Application of low-frequency ultrasound allows skin permeabilization and extraction of ISF across the skin.

Animals↗
PubMed2000

Aldehyde oxidase is coamplified with the World's most common Culex mosquito insecticide resistance-associated esterases.

The evolution and spread of insecticide resistance is an important factor in human disease prevention and crop protection. The mosquito Culex quinquefasciatus is the main vector of the disease filariasis and a member of a species complex which is a common biting nuisance worldwide. The common insecticide resistance mechanism in this species involves germline amplification of the esterases estalpha21 and estbeta21. This amplification has arisen once and rapidly spread worldwide. Less common and more variable resistance phenotypes involve coamplification of estalpha3 and estbeta1, or individual amplification of a single estbeta1, different alleles of the same estalpha and estbeta gene loci. Estalpha21 and estbeta21 are on the same large fragment of amplified DNA (amplicon) 2.7 kb apart. We have now shown that this amplicon contains another full-length gene immediately 5' of estalpha21 which codes for a molybdenum-containing hydroxylase, with highest homology to aldehyde oxidase (AO) from other organisms. The full-length putative AO gene is not present on the estalpha3/estbeta1 or estbeta1 amplicons, but multiple truncated 5' ends of this gene are present around the presumed estalpha3/estbeta1 amplicon breakpoint. Polymerase chain reaction (PCR) analysis of insecticide-susceptible genomic DNA demonstrated that a different allele of the putative AO gene in its non-amplified form is immediately 5' of estalpha. The 'AO' gene on the estalpha21/estbeta21 amplicon is expressed and resistant insects have greater AO activity. This AO activity is sensitive to inhibition by an aldehyde-containing herbicide and pesticide. This enzyme may confer a selective advantage to these insects in the presence of insecticide, as AO in mammals is believed to be important in the detoxification process of several environmental pollutants.

Aldehyde Oxidase↗
PubMed2000

An evaluation of the implementation of a liaison service in an A&E department.

This paper describes the results of an evaluation of a multidisciplinary liaison service based in an A&E department of a district general hospital in South Wales. The aims of the services were to increase the rate of referral for psychosocial assessment of individuals who presented at the department following acts of deliberate self-harm and to increase the number of such assessments completed within 24 h. The paper describes the context in which such a service was developed and outlines how this preliminary evaluation was completed. Data were collected from hospital records, over two corresponding five-month time-periods, in the year before the implementation of the service and the year following implementation of the service. The results show that the implementation of the service led to a statistically significant increase in the rate of referral for assessment by accident and emergency staff. Amongst other positive outcomes, the rate of repeat presentations was reduced for the period of one year following initial presentation. The implications of these results are discussed in relation to other research in the area and the suggestion is made that nursing staff may be more clinically and cost effective in completing psychosocial assessments in A&E departments than medical staff.

Adolescent↗
PubMed2000

Stress responses of child care providers to classroom activities and childhood behaviors involving HIV/AIDS.

Child care providers in a southeastern state were asked to indicate their level of stress when responding to classroom activities and childhood behaviors involving a child who tests positive for the human immunodeficiency virus (HIV). No significant correlations were found between the providers' stress responses and their professional background. Significant correlations were found between the providers' stress responses and their knowledge of HIV transmission and agreement with HIV child care policies. Follow up chi-square analysis revealed that a majority of providers reported low to slight stress when considering individual classroom activities in association with an HIV-positive (HIV+) child. Likewise, a significant majority of the providers reported low to slight stress when considering low-threat behaviors associated with an HIV+ child. In contrast, a significant majority of the providers reported moderate to great stress when considering high-threat behaviors associated with an HIV+ child. Implications of these findings are addressed for nurse educators who provide training to child care providers regarding young children who are HIV+.

Adult↗
PubMed2000

An audit of psychiatric case notes in relation to antipsychotic medication and information giving.

This paper reports upon a Welsh Office funded "clinical effectiveness" project. The project aimed to produce evidence-based practice guidelines for depot neuroleptic medication. An audit was conducted to establish current practice regarding the provision of illness and treatment specific information to out-patients and their informal carers. Sixty-five patients' case-notes, under the care of a single community mental health team were examined for evidence of the type, nature and frequency of information given to patients receiving typical depot neuroleptic medications. Service guidelines were produced and are presented.

Antipsychotic Agents↗
PubMed2000

Initial symptoms of nicotine dependence in adolescents.

OBJECTIVES: It has been assumed that nicotine dependence has a slow onset and occurs only after prolonged daily use of tobacco. A cohort of young adolescents was followed to determine when the first symptoms of nicotine dependence occur with respect to the duration and frequency of tobacco use. DESIGN: A cohort of 681 seventh grade students (age 12-13 years) from seven schools in two small cities in central Massachusetts was followed over one year. Detailed information regarding tobacco use was obtained in individual confidential interviews conducted in school three times over the year. The latency time to the onset of symptoms of nicotine dependence was measured from the time a subject first smoked at a frequency of at least once per month. RESULTS: 22% of the 95 subjects who had initiated occasional smoking reported a symptom of nicotine dependence within four weeks of initiating monthly smoking. One or more symptoms were reported by 60 (63%) of these 95 subjects. Of the 60 symptomatic subjects, 62% had reported experiencing their first symptom before smoking daily or began smoking daily only upon experiencing their first symptom. DISCUSSION: The first symptoms of nicotine dependence can appear within days to weeks of the onset of occasional use, often before the onset of daily smoking. The existence of three groups of individuals-rapid onset, slower onset, and resistant-distinguishable from one another by their susceptibility to nicotine dependence, is postulated.

Adolescent↗
PubMed2000

Analysis of ultrasonically extracted interstitial fluid as a predictor of blood glucose levels.

Transdermal extraction of clinically relevant analytes offers a potentially noninvasive method of diagnostics. However, development of such a method is limited by the low permeability of skin. In this paper, we present a potential method for noninvasive diagnostics based on ultrasonic skin permeabilization and subsequent extraction of interstitial fluid (ISF) across the skin using vacuum. ISF extracted by this method was collected and analyzed for glucose and other analytes. Glucose concentration in the extracted fluid correlates well with blood glucose concentration over a range of 50-250 mg/dl. A mathematical model describing vacuum-induced transport of ISF through ultrasonically permeabilized skin is presented as well. The model accounts for convective, as well as diffusive, transport processes across blood capillaries, epidermis, and the stratum corneum. The overall predictions of the model compare favorably with the experimental observations.

Animals↗
PubMed2000

[Care dependency of nursing home patients with dementia: assessment from European perspective].

In an international, study psychometric properties of the Care Dependency Scale (in Dutch shortened as: ZAS) were examined by analysing data gathered in nursing homes in Germany, Finland, Italy, The Netherlands, Norway and Wales (UK). For that purpose, from these countries a convenience sample was developed consisting of 832 patients with dementia. The English, Finnish, German, Italian and Norwegian research instruments were translations of the original Dutch ZAS. Psychometric evaluations of the ZAS were carried out for each country separately as well as for the countries combined. High alpha coefficients between 0.93 and 0.97 were calculated. Subsequent interrater and test-retest reliability revealed moderate to substantial kappa values. Factor analysis resulted in a one-factor solution. One of the main outcomes of the cross-cultural comparison was that the findings in the six countries show more similarities than differences, so that the scale can be used appropriately in nursing home practice and for international comparison of care dependency.

Aged↗
PubMed2000

Bereavement practice guidelines for health care professionals in the emergency department.

A panel of multidisciplinary experts in the field of emergency services was convened by the National Association of Social Workers in 1999 to develop Bereavement Practice Guidelines. Funded by the Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, this paper discusses the best practices in supporting the family and staff when a child dies suddenly in the Emergency Department. Critical stages ranging from preparation to follow-up are discussed that help to enhance the quality of care provided to the family. A final stage addresses the support needs of staff.

Attitude to Death↗
PubMed2000

Kinematic magnetic resonance imaging of the effect of bracing on patellar position: qualitative assessment using an extremity magnetic resonance system.

OBJECTIVE: To use an extremity magnetic resonance system to perform kinematic magnetic resonance imaging (MRI) of the patellofemoral joint to qualitatively assess the effect of bracing on patellar position. DESIGN AND SETTING: Subjects underwent kinematic MRI of the symptomatic extremity with a 0.2-Tesla extremity magnetic resonance system. Images were obtained using a knee coil and a T1-weighted, spin echo pulse sequence. SUBJECTS: Seven female patients with patellofemoral joint symptoms. MEASUREMENTS: FOUR DIFFERENT AXIAL SECTIONS WERE OBTAINED FOR EACH POSITION: extension and 3 positions of flexion up to 36 degrees . An appropriate-sized patellofemoral brace was applied, and the kinematic MRI procedure was repeated. RESULTS: Six patients had lateral displacement of the patella, and 1 patient had medial displacement of the patella. After application of the brace, 6 patients (5 with lateral displacement and 1 with medial displacement, 86%) exhibited correction (5) or improvement (1 with lateral displacement) in the abnormal patellar positions, and 1 patient had worsening of the abnormal position of the patella. CONCLUSIONS: We used kinematic MRI to determine the presence of abnormal patellar positioning. Application of the brace counteracted the abnormal patellar positions in most of the patients studied.

Journal Article↗
PubMed1999

A comparison of the advertising and accessibility of cigars, cigarettes, chewing tobacco, and loose tobacco.

BACKGROUND: Tobacco products were compared in regard to their price, point-of-purchase advertising, accessibility to shoplifters, and rate of sale to minors. METHODS: An experimental design compared the rates of illegal sales to minors of cigarettes, chewing tobacco, and cigars. Observational surveys of 102 stores measured the number of advertisements for four tobacco products, the manner in which products were displayed, and their accessibility to shoplifters. RESULTS: Illegal sales rates were similar for cigarettes, chewing tobacco, and cigars. Cigars were the least expensive. Cigarettes were the most heavily advertised product, followed by chewing tobacco, cigars, and loose tobacco. Cigarettes were the most accessible to shoplifters. All types of tobacco products were displayed to permit the package to serve as advertising. CONCLUSIONS: Point-of-purchase advertising for cigars may be increasing, and their lower price makes them more affordable to youths. Food and Drug Administration regulations that limit point-of-purchase advertising for tobacco products should be expanded to include cigars. Manufacturers pay retailers for the placement of product displays that allow the package to be used as an advertisement without the appearance of the Surgeon General's warning. Generic packaging may be necessary to protect children from point-of-purchase advertising.

Adolescent↗
PubMed1999

Cytokine abundance in placental tissues: evidence of inflammatory activation in gestational membranes with term and preterm parturition.

OBJECTIVES: This study of the changes in cytokine concentrations in gestational tissues from women with term and preterm labor was undertaken to assess the extent of inflammatory activation associated with spontaneous labor and delivery. STUDY DESIGN: Extracts of amniotic, chorionic-decidual, and placental tissues from women delivered at term before labor (n = 15), at term after labor (n = 15), and preterm (n = 31) were assayed for interleukin 1beta, interleukin 6, and interleukin 8. RESULTS: In amniotic tissues of women delivered by spontaneous labor at term the median interleukin-6, interleukin-8, and interleukin-1beta concentrations were 3.8 to 5.4 times those of tissues from women delivered at term without labor (P <.05, Mann-Whitney U test). Interleukin-6 and interleukin-8 concentrations were also significantly increased (3. 3-4 times) in chorionic-decidual tissues. Marked increases (approximately 3-6 times) in the concentrations of all 3 cytokines were observed in both amniotic and chorionic-decidual tissues from women with preterm deliveries with respect to those from women with term deliveries after labor. Cytokine concentrations were significantly correlated within amniotic tissues from both women with term delivery after labor and women with preterm delivery and also in preterm chorionic-decidual tissues but not preterm placental tissues. Concentrations of cytokines in the tissues of women delivered preterm were not significantly affected by mode of delivery, treatment with antibiotics, or twin birth. In preterm tissues with evidence of intrauterine infection only amniotic interleukin-1beta concentrations were significantly elevated (P <. 05). Little or no labor-related change in cytokine concentrations was seen within placental tissues. CONCLUSIONS: Increased cytokine abundance in gestational membranes associated with labor supports the view that an inflammatory process is involved in both term and preterm labor. This process does not, however, appear to be evident in the villous placenta.

Cytokines↗