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Biomedical subjects

M Dunne

Publications and source records attributed to M Dunne.

At least 55 records · Page 3Linked to original sources

A community screening test for high alcohol consumption using biochemical and haematological measures.

A discriminant function based on a number of biochemical and haematological tests from an extended multiple biochemical analysis and full blood count, together with weight, smoking status and systolic blood pressure is developed. The function was far more effective at detecting high alcohol use (greater than 40 g ethanol per day) than serum gamma-glutamyl transpeptidase (GGT) or the Short Michigan Alcoholism Screening Test (SMAST) in a community sample of adult males. When classifying high alcohol consumption by GGT only, several division criteria were considered, the most effective being at 40 i.u./l. In terms of identifying high alcohol consumers, rather than alcoholics, the SMAST was no better than GGT, and both had unacceptably low sensitivity (49%, 51%) and poor performance on other measures, thus limiting their use as community screening tools. The discriminant function, however, had an estimated community sensitivity of 78%, was similarly high on other performance measures, and would perform satisfactorily as a community screening tool, particularly in situations where there was a tendency for individuals to under-report their alcohol consumption.

Adult↗

The relationship between children's treatment-related behaviour problems, age and clinical status in cystic fibrosis.

This study examined the relationship between parents' and physicians' reports of treatment-related behaviour and adjustment problems of children with cystic fibrosis (CF), and children's clinical status as assessed by measures of pulmonary functioning and global ratings of clinical status. Parents completed a Cystic Fibrosis Problem Checklist which measures the extent to which children experience behaviour and adjustment difficulties with different aspects of treatment, including chest physiotherapy, medication taking and diet. A high proportion of parents in each age group reported at least some treatment-related behaviour difficulties, with significantly more problems being reported with younger children. There was no significant relationship, however, between the child's age, sex and clinicians' ratings of compliance. A stepwise multiple regression showed that the only variables which significantly predicted clinicians' ratings of the severity of the child's disease were forced expired volume and height. Clinicians' ratings of compliance explained a small amount of extra variance (2.4%). It was found that parental reports of treatment-related behaviour problems were not related to clinical status. The implications of the findings for clinical practice are discussed.

Adolescent↗

Relationships between mental adjustment to HIV diagnosis, psychological morbidity and sexual behaviour.

This paper examines patterns of psychological adjustment in a small sample of asymptomatic HIV antibody positive men. Comparison is made with data available on male cancer patients. HIV positive men reported greater degrees of anxious preoccupation and hopelessness, and lower levels of the more adaptive 'fighting spirit' response. In HIV-infected men, depression correlated positively with frequency of high risk sexual practices.

Adaptation, Psychological↗

Risk management in dentistry.

Risk management continues to define itself as an integral element in quality dental care. Issues reviewed range from periodontal record keeping to assessment of temporomandibular joint dysfunction and from cosmetic patients to after-hours emergency care. Two common denominators emerge throughout the articles reviewed. First, thorough and accurate documentation of all phases of patient contact and treatment remains at the heart of risk management. Communication, as a system of relationships between physician, staff, and patients, ensures understanding and agreement toward a common goal. Risk management remains a unifying principle that joins legal responsibilities with sound clinical practice.

Dental Records↗

Prospective study of the effect of safety belts in motor vehicle crashes.

Trauma resulting from motor vehicle crashes (MVCs) is the leading cause of death in persons 1 to 38 years old. The following prospective study was undertaken to assess the effect of safety belts on the types of injuries sustained in MVCs. A total of 1,364 patients from four Chicago-area hospitals were evaluated prospectively during a six-month period. Safety belts reduced the incidence of head, facial, thoracic, abdominal, and extremity injuries sustained in MVCs. Spinal injuries comprised the only group in which safety belt wearers sustained injuries more frequently than safety belt nonwearers. Further research on the different safety belt designs and effects of air bags is needed to reduce the incidence of cervical and lumbar strain in restrained patients.

Abbreviated Injury Scale↗

Polymorphonuclear leukocyte- and Pseudomonas aeruginosa-induced damage to a human pulmonary epithelial cell line.

Polymorphonuclear leukocytes (PMNL) or Pseudomonas aeruginosa can damage the lung, but the manner in which they interact to induce toxicity is unclear. An in vitro model of the pulmonary epithelium was used to investigate interactions of PMNL and P. aeruginosa on epithelial cytotoxicity. A low inoculum of P. aeruginosa (10(7) bacteria) was minimally toxic to the epithelial cells (lysis = 9.0 +/- 2.9, detachment = 3.5 +/- 1.4). The addition of PMNL to the low inoculum markedly increased damage to the epithelial cells (lysis = 18.1 +/- 3.9, detachment = 17.6 +/- 3.6). Both the bacterium and a low-molecular-weight exoproduct were able to induce PMNL-mediated damage to epithelial cells. The damage was inhibited by serum or the addition of alpha 1 antiprotease but not by antioxidants. A larger inoculum of P. aeruginosa (10(9) bacteria) was directly toxic to the pulmonary cells (lysis = 44.8 +/- 4.1, detachment = 7.6 +/- 0.7). The damage was mediated by a heat-labile bacterial exoproduct. Pulmonary epithelial damage following pseudomonal infections may be related to either neutrophil or bacterial activity depending on the bacterial inoculum.

Cell Line↗

Academic performance of students admitted after repeating entrance examinations to medical school.

The academic performance of matched groups of students who did, or did not, repeat a year at school so as to achieve the entrance qualifications necessary for admission to medical school was assessed. Repeating students were asked to provide possible reasons for their failure to enter on their first attempt. Better performance was predicted, to a small extent, in those who offered internal attributions as an explanation for their initial failure. It was not predicted by actual entrance examination grades, either at first or second attempt. Repeating students as a group were clearly academically weaker throughout the medical course. The implications for medical school admission policy are examined.

Achievement↗

A research seminar programme for doctoral candidates in psychiatry.

A worldwide trend towards fewer clinician-researchers in the medical specialties has been identified. The ratio of clinicians to non-clinicians in academic departments is declining. Possible responses to these trends are briefly surveyed and an innovative research seminar programme for doctoral students in psychiatry is described.

Curriculum↗

Serum promotes asbestos-induced injury to human pulmonary epithelial cells.

Asbestos exposure causes chronic interstitial pulmonary fibrosis. Injury to human pulmonary epithelial cells (HPEC) is speculated to precede the fibrotic response. We investigated whether asbestos, either alone or in conjunction with serum, injured cultured HPEC as assessed in a standard chromium 51 release assay. Amosite asbestos in serum-free media induced modest HPEC injury (9.4% +/- 3.3% Cr release), which was significantly enhanced (2.7-fold) in the presence of serum (25.5% +/- 4% Cr release). HPEC cytotoxicity was both asbestos and serum dose-dependent. Additionally, we demonstrated that, compared with HPEC injury induced by asbestos plus serum, (1) heat-decomplemented serum or serum fractions of a wide range of molecular weights were equipotent to fresh serum, (2) catalase, superoxide dismutase, or dimethylthiourea was not protective, (3) 3-aminobenzamide, which prevents oxidant-induced adenosine triphosphate depletion by inhibiting poly-adenosine diphosphate-ribose polymerase, afforded significant protection (32% decrease in HPEC injury), and (4) deferoxamine-treated asbestos was significantly less toxic to HPEC compared with untreated asbestos, causing a 57% decrease in HPEC cytotoxicity. Electron microscopic studies revealed that, compared with buffer, serum increased the amount of amosite asbestos along the surface and inside HPEC. Thus, amosite asbestos is cytotoxic to cultured HPEC and serum promotes this injurious effect by augmenting the interaction of asbestos with HPEC. These data suggest that this effect may occur by increasing intracellular oxidant stress mediated in part by the iron in asbestos.

Asbestos↗

The impact of parental loss on adolescents' psychosocial characteristics.

This study examined ten measures of personality, self-image, and emotional and family problems in a sample of 2,158 Australian adolescents, some of whom had suffered parental loss. The data reveal a pattern of poorer adjustment in adolescents who have lost a parent, but clearly demonstrate that type of loss and family reconstitution have no differential effects on psychosocial development. Implications for future research are discussed.

Achievement↗

The interaction of asbestos and neutrophils injures cultured human pulmonary epithelial cells: role of hydrogen peroxide.

Asbestos exposure causes diffuse interstitial pulmonary fibrosis. Since alveolar epithelial cell injury is hypothesized to precede the fibrotic response in asbestosis, we investigated whether asbestos, either alone or in conjunction with neutrophils (PMNs), injured cultured human pulmonary epithelial cells (HPECs). HPEC cytotoxicity was assessed with a standard 51chromium release assay after a 16-hour incubation with asbestos and PMNs. Negligible HPEC cytotoxicity was observed after incubation with either amosite asbestos (500 micrograms/ml) or PMNs alone in serum-free media. However, incubation with both asbestos and PMNs caused significant HPEC injury, which was asbestos dose-dependent; causing 25% +/- 4% detachment and 52% +/- 8% 51chromium release with 500 micrograms/ml asbestos. The cytotoxic effects of asbestos plus PMNs were nearly completely attenuated with serum (20%) or catalase (100 micrograms/ml) but were not prevented with scavengers of superoxide anion, hydroxyl radical, or hypochlorous acid. A role for hydrogen peroxide (H2O2) in mediating HPEC injury was also suggested by the demonstration of asbestos-induced generation of H2O2 by PMNs. Furthermore, H2O2 alone (10(-4)mol/L) caused significant HPEC damage. Intimate contact between asbestos-activated PMNs and HPECs was a necessary requirement for PMN-mediated HPEC cytotoxicity. These data suggest that pulmonary epithelial cell injury is mediated in part by H2O2 release from asbestos-activated PMNs as well as intimate contact between the epithelial cell, PMNs, and asbestos.

Asbestos↗

A new quantitative ultrasonic method for diagnosis of chronic parenchymal liver disease.

The degree of echogenicity of the hepatic parenchyma was measured by an objective method comparing patient's sonograms with a tissue-mimicking phantom obtained with available real-time ultrasound machines. A single sonographic image of the liver and the phantom was taken using identical setting in each case. The ratio of the mean density of the phantom to that of the liver was obtained. The mean of the ratio in 30 normal subjects was 1.04 +/- 0.01, in 26 patients with early alcoholic liver disease 1.23 +/- 0.04, and in 74 cirrhotic subjects 1.54 +/- 0.03, with a significant difference among the three groups (p less than 0.05). A significant correlation was also obtained between the ratio and a modified Child's classification (r = 0.553, p less than 0.05) in cirrhotic subjects. Follow-up studies were available in a limited number of patients with early alcoholic liver disease showing progression or improvement paralleling alcohol use. Using this method, ultrasound may have considerable potential in the diagnosis and follow-up of alcoholic liver disease.

Adult↗

Ultrasonographic findings with bleeding and nonbleeding esophageal varices.

Real time ultrasonography was carried out in 49 cirrhotic patients within 10 days of esophagoscopy, and in 20 normal subjects. Among the cirrhotic patients, 42 had varices and 18 of these had hematemesis within 3 months of study. The varices were graded 0 to 4+ endoscopically; the diameter of the portal vein, the splenic vein, the hepatic artery, and the maximal length of the spleen were determined on ultrasound. In addition, portal collateral veins and the sudden amputation of portal vein branches in the liver were identified when present. There was a significant correlation of the diameter of the portal vein and the maximal spleen length with the magnitude of varices on endoscopy; there was no significant relationship between the splenic vein or the hepatic artery diameter. Less than half the patients with varices had sonographically demonstrated collaterals or portal vein branch amputation. A sonoscore was derived allotting one point each for enlarged portal vein (greater than 1.3 cm), enlarged spleen, collaterals or two or more amputated veins. The sonoscore correlated better with the endoscopic grade of varices than any other marker. The sonoscore among the patients with varices who bled was significantly higher (p less than 0.01) than any of the other measures. It is concluded that real time ultrasound can be used to screen for varices and to identify the need for endoscopy.

Collateral Circulation↗

Gallbladder volume and emptying in insulin-requiring male diabetics.

Gallbladder function was evaluated in 27 healthy male volunteers and 47 male insulin-requiring diabetics from a diabetic clinic. Three groups of patients were studied: 18 patients without neuropathy or retinopathy (A); 17 patients with evidence of peripheral neuropathy (B); and 12 patients with evidence of peripheral and autonomic neuropathy (C). Eleven patients complained of gastrointestinal symptoms (three in group B, eight in group C). Thirty minutes after a standard breakfast, fasting gallbladder volumes and gallbladder emptying rates were measured using a real-time mechanical sector ultrasound scanner. Fasting gallbladder volume in diabetic patients was similar to controls (24.9 +/- 2.7 N; 28.9 +/- 3.9 A; 23.7 +/- 2.2 B; 16.7 +/- 3.4 C ml mean +/- SEM). Postprandial gallbladder emptying was not significantly different in any groups (47.4 +/- 5.1% N; 43.2 +/- 7.7% A; 50.7 +/- 7.7% B; 46.8 +/- 11.1% C). Seven diabetics and two controls had poor gallbladder emptying. One screened patient had cholecystectomy, three patients had stones, and two had sludge with a thickened gallbladder wall for a total of 12.5% gallbladder disease. These data suggest that gallbladder dysfunction in male insulin-requiring diabetics is rare.

Adult↗