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Biomedical subjects

M Ellis

Publications and source records attributed to M Ellis.

At least 73 records · Page 4Linked to original sources
PubMed1999

The association between anxiety and psychopathy dimensions in children.

Although several theoretical models posit that low levels of anxiety are a risk factor for psychopathy and antisocial behavior, a number of studies have reported elevated levels of anxiety among antisocial individuals. Nevertheless, most investigators in this literature have not distinguished between fearfulness and trait anxiety or attempted to separate the antisocial lifestyle dimension from the callous and unemotional dimension of psychopathy. In a study of clinically referred children (N = 143), we found that (a) measures of trait anxiety and fearlessness (low fearfulness) exhibited low correlations; (b) conduct problems tended to be positively correlated with trait anxiety, whereas callous and unemotional traits tended to be negatively correlated with trait anxiety; and (c) controlling statistically for the effects of one dimension increased the divergent correlations of the other dimension with both trait anxiety and fearful inhibition. These findings bear potentially important implications for the diagnosis and etiology of psychopathy and antisocial behavior and suggest that distinctions between trait anxiety and fearful inhibition, as well as between the two dimensions of psychopathy, may help to clarify longstanding confusion in this literature.

Adolescent↗
PubMed1999

A comparative study of the postoperative allogeneic blood-sparing effect of tranexamic acid versus acute normovolemic hemodilution after total knee replacement.

UNLABELLED: Both acute normovolemic hemodilution (NVHD) and tranexamic acid (TA) are potentially useful allogeneic blood conservation strategies after total knee replacement. However, the relative efficacy of these blood-sparing techniques is unknown. Therefore, to compare the postoperative allogeneic blood sparing of NVHD and TA after total knee replacement, we investigated 40 patients in a prospective, single-blinded study protocol. In Group TA, 30 min before deflating the limb tourniquet, an IV infusion of TA, 15 mg/kg, was administered over a 30-min period. Thereafter, a constant IV infusion of 10 mg x kg(-1) x hr(-1) was administered until 12 h after deflation of the limb tourniquet. Before induction of anesthesia, NVHD patients were bled to a target hematocrit of approximately 28%. Intravascular blood volume was maintained with lactated Ringer's solution. All autologous blood was transfused at the end of the surgery. Postoperatively, hematocrit was measured daily. In all cases, a hematocrit <27% was the postoperative transfusion trigger. Before discharge, deep vein thrombosis was excluded by Echo Doppler. Three months after surgery, the incidence of delayed thromboembolic events was assessed. The two groups were demographically comparable. In Group NVHD, 843 mL+/-289 of autologous blood was removed. Despite autologous blood transfusion, during the early postoperative period and until the third postoperative day, the NVHD group had significantly (P < 0.01) lower mean hematocrits when compared with the TA group. Thereafter, because of a significantly (P < 0.0008) greater allogeneic blood requirement in the NVHD group, no statistically significant difference in mean hematocrit recordings was noted among the groups. Blood accumulation in the surgical drain 12 h postoperatively, was significantly (P < 0.0008) higher in the NVHD group (259 mL+/-156) when compared with the TA group (110 mL+/-62). Significantly (P < 0.0008) more allogeneic blood was transfused in the NVHD group (19 U/13 patients) when compared with the TA group (2 U/2 patients). No abnormal Echo Doppler studies were reported. During the 3-mo follow-up period, a deep vein thrombosis and pulmonary embolus were documented in one patient in the NVHD group. We conclude that perioperative hemodynamic stability and allogeneic blood sparing is superior after tranexamic acid administration when compared with normovolemic hemodilution. IMPLICATIONS: For total knee replacement, when compared with normovolemic hemodilution, tranexamic acid administration is associated with superior perioperative hemodynamic stability and allogeneic blood sparing.

Aged↗
PubMed1999

Outcome of femoropopliteal angioplasty.

OBJECTIVE: To assess prospectively the outcome of femoropopliteal angioplasty and investigate prognostic indicators of success. BACKGROUND: Percutaneous transluminal angioplasty is commonly used to treat symptomatic femoropopliteal stenoses or occlusions, but the durability of the procedure is uncertain. METHODS: Seventy-four consecutive patients treated by femoropopliteal angioplasty for intermittent claudication (43), rest pain (4), and tissue loss (27) were followed by assessment of symptoms, ankle-brachial pressure index (ABPI) to measure hemodynamic outcome, and duplex monitoring of velocity gradient at the angioplasty site to identify restenosis at 1 day and 3, 6, 9, and 12 months. Univariate comparisons, life table analysis, and backward stepwise regression were used to investigate factors predicting the symptomatic and hemodynamic outcome and restenosis. RESULTS: Technical success was obtained in 67 patients (91%); failure occurred in 7 patients. At 1 year, a successful symptomatic outcome was achieved in 35 patients (51%), hemodynamic success was achieved in 41 patients (58%), and restenosis developed in 39%. ABPI at 24 hours after angioplasty was the most significant variable predicting a symptomatic outcome, hemodynamic outcome, and restenosis at 12 months. Life table analysis demonstrated that in 24% of patients with a 24-hour ABPI > or =0.9, restenosis developed by 12 months, compared with 64% of patients with a 24-hour ABPI <0.9. CONCLUSION: Only half of the patients treated by femoropopliteal angioplasty had symptomatic improvement at 1 year, raising concern about the cost-benefit ratio of this procedure. Restoration of ABPI to >0.9 predicted a favorable outcome.

Angioplasty, Balloon↗
PubMed1999

Effect of room temperature and dietary amino acid concentration on performance of lactating sows. NCR-89 Committee on Swine Management.

Mixed-parity sows (n = 267) from five research stations were used to investigate whether a reduction of excess dietary amino acids would improve feed intake and performance of lactating sows experiencing heat stress. Experimental treatments included effects of room temperature (warm or hot) and diet (adequate protein [AP] or low protein [LP]). The corn-soybean meal AP diet was formulated to contain 16.5% CP, .8% lysine, and .67% digestible lysine. The LP diet was formulated to contain 13.7% CP, .76% lysine, and .66% digestible lysine using corn, soybean meal, and synthetic lysine. Feed intake during gestation was standardized at 1.8 kg x sow(-1) x d(-1). At parturition, litter size was adjusted to no fewer than nine pigs. Mean high temperature in the warm and hot rooms was 20.4 and 29.2 degrees C and mean low temperature was 17.7 and 27.1 degrees C, respectively. The hot environment reduced (P < .01) feed intake of sows (4.19 vs 6.38 kg/d) during lactation, weaning weight of sows (176.2 vs 193.6 kg), percentage of sows displaying estrus (79.2 vs 93.4%) by d 15 postweaning, and litter growth rate (1.74 vs 2.11 kg/d) and increased (P < .01) respiration rate of sows on d 10 postpartum (71.9 vs 36.5 breaths/min) compared with the warm environment. Litter size and backfat loss of sows were not affected by treatments. No significant diet x room temperature interactions were observed for voluntary feed intake, body weight loss, backfat loss, or respiration rate of sows. Litter growth rate was depressed by feeding the LP diet in the warm room but was improved by feeding the LP diet in the hot room (warm-AP, 2.17; warm-LP, 2.05; hot-AP, 1.71; hot-LP, 1.77 kg/d; P < .05). Reduction of dietary crude protein combined with supplementation of crystalline lysine to reduce concentrations of excess dietary amino acids did not significantly reduce heat stress of sows, but it did support slight improvements in weight gain of litters nursing heat-stressed sows.

Amino Acids↗
PubMed1999

Binding of bis-substituted 2-aza-anthracenedione regioisomers to DNA: effects of the relative positioning of the side chains.

The DNA-binding properties of a series of 2-aza-anthracenedione (benz[g]isoquinoline-5,10-dione) derivatives bearing two 3-dimethylaminopropylamino side chains at different (6,9, 7,9 and 8,9) positions of the planar ring system have been investigated. The affinity for the nucleic acid is dramatically affected by the substitution pattern, the 6,9-regioisomer being substantially more effective than the 7,9- or the 8,9-congeners. This cannot be ascribed to different binding mechanisms, as all compounds are shown to intercalate into the double helix. Instead, the geometry of intercalation into DNA and the site specificity are extensively affected by the substitution pattern. The site preference is CA (or AC) for the 6,9-regioisomer, whereas it is TA (or AT) for the 8,9-congener, the 7,9-analogue lying in between. Molecular modeling studies are in agreement with the experimental results. Although the 6,9-regioisomer was remarkably cytotoxic, it stimulated topoisomerase II-mediated cleavage of DNA very poorly. Hence, a different mechanism of DNA damage is probably operating in 2-aza-anthracenediones as the main cell-killing event. Changes in affinity for DNA, intercalation geometry and sequence specificity can explain the different cytotoxic responses exhibited by the test drugs.

Animals↗
PubMed1998

pRB phosphorylation mutants reveal role of pRB in regulating S phase completion by a mechanism independent of E2F.

Progression of cells into S phase is controlled by the retinoblastoma protein (pRB) and relies on the functional inactivation of this tumour suppressor in late G1 via protein phosphorylation. We provide evidence here that, besides controlling entry of cells into S phase, pRB can operate to inhibit S phase completion. Differential arrays of phosphorylation appear to regulate these different events, suggesting that cycle progression at these two stages of the cell cycle may be achieved via activation of distinct downstream pRB effector pathways. In agreement with this hypothesis, pRB's ability to prevent S phase entry, but not its ability to inhibit S phase completion, correlates with repression of E2F-regulated promoters. Furthermore, ectopic expression of E2F or the E2F-regulated cyclin E gene promote S phase entry in cells expressing phosphorylation-defective pRB but neither is sufficient to trigger completion of S phase. Our findings raise the possibility that pRB, in addition to its well-established role in controlling a checkpoint in late G1, could be involved in the control of a further checkpoint operating during S phase and that implementation of this checkpoint relies on an as yet unidentified pRB effector distinct from E2F.

Blotting, Western↗
PubMed1998

The effects of postnatal health education for mothers on infant care and family planning practices in Nepal: a randomised controlled trial.

OBJECTIVES: To evaluate impact of postnatal health education for mothers on infant care and postnatal family planning practices in Nepal. DESIGN: Randomised controlled trial with community follow up at 3 and 6 months post partum by interview. Initial household survey of study areas to identify all pregnant women to facilitate follow up. SETTING: Main maternity hospital in Kathmandu, Nepal. Follow up in urban Kathmandu and a periurban area southwest of the city. SUBJECTS: 540 mothers randomly allocated to one of four groups: health education immediately after birth and three months later (group A), at birth only (group B), at three months only (group C), or none (group D). INTERVENTIONS: Structured baseline household questionnaire; 20 minute, one to one health education at birth and three months later. MAIN OUTCOME MEASURES: Duration of exclusive breast feeding, appropriate immunisation of infant, knowledge of oral rehydration solution and need to continue breast feeding in diarrhoea, knowledge of infant signs suggesting pneumonia, uptake of postnatal family planning. RESULTS: Mothers in groups A and B (received health education at birth) were slightly more likely to use contraception at six months after birth compared with mothers in groups C and D (no health education at birth) (odds ratio 1.62, 95% confidence interval 1.06 to 2.5). There were no other significant differences between groups with regards to infant feeding, infant care, or immunisation. CONCLUSIONS: Our findings suggest that the recommended practice of individual health education for postnatal mothers in poor communities has no impact on infant feeding, care, or immunisation, although uptake of family planning may be slightly enhanced.

Breast Feeding↗
PubMed1998

Space geodetic observations of nazca-south america convergence across the central andes

Space geodetic data recorded rates and directions of motion across the convergent boundary zone between the oceanic Nazca and continental South American plates in Peru and Bolivia. Roughly half of the overall convergence, about 30 to 40 millimeters per year, accumulated on the locked plate interface and can be released in future earthquakes. About 10 to 15 millimeters per year of crustal shortening occurred inland at the sub-Andean foreland fold and thrust belt, indicating that the Andes are continuing to build. Little (5 to 10 millimeters per year) along-trench motion of coastal forearc slivers was observed, despite the oblique convergence.

Journal Article↗
PubMed1998

Severe juvenile vaginal bleeding due to Glanzmann's thrombasthenia: case report and review of the literature.

Glanzmann's thrombasthenia is a rare inherited hematological disorder defined by deficiency or abnormality of the glycoprotein (GP) IIb-IIIa complex. Presenting symptoms are hemorrhagic events, mainly epistaxis, purpura, or menorrhagia. We describe the clinical course and management of a 14-year-old girl with Glanzmann's thrombasthenia and severe menorrhagia. Following treatment with 20 U of packed red blood cells, 37 U of platelets, 7 U of fresh frozen plasma, cryoprecipitate, intravenous estrogens, and methylergotrine maleate with no improvement, the uterine cavity was packed for 48 hr. This unusual procedure halted the bleeding and avoided the necessity for a hysterectomy. When treating acute menorrhagia in patients with Glanzmann's thrombasthenia, the physician should be familiar with the characteristics and all treatment modalities for this disorder.

Adolescent↗
PubMed1998

An EORTC multicentre prospective survey of invasive aspergillosis in haematological patients: diagnosis and therapeutic outcome. EORTC Invasive Fungal Infections Cooperative Group.

OBJECTIVES: The EORTC Invasive Fungal Infections Cooperative Group (IFICG) conducted a prospective survey by questionnaire of all cases of invasive aspergillosis (IA) in cancer patients to ascertain current diagnostic and therapeutic approaches. METHODS: All members of the IFICG were asked prospectively to complete a detailed questionnaire for each IA case identified in their institution over a 12-month period. RESULTS: One hundred and thirty questionnaires were returned. All cases were independently evaluated (DWD & JC) and 123 were eligible. Cases came from 20 hospitals in eight countries and the number of cases per institution varied from 1-21. Acute myeloid leukaemia (AML) (60, 49%), acute lymphoblastic leukaemia (ALL) (21, 17%) and lymphoma (11, 9%) were the most frequent underlying diseases, and 16 (12%) patients had received an allogeneic bone marrow transplant. Pulmonary involvement was present in 87%, infection of sinuses/nose in 16% and brain in 8%. The chest radiograph was initially normal in 9% of those with primary pulmonary disease. The diagnosis was confirmed in 50%, probable in 31% and possible in 19%. The evidence for IA was on the basis of clinical and radiological features alone in 28%, with culture or histology in another 31% and 9%, respectively, and with both culture and histology in 29%. In three (2%) patients with diagnosis was based on culture or histology alone. Treatment was given to 120 patients (98%)-amphotericin B 75%, lipid-associated amphotericin B 36%, itraconazole 40%, flucytosine 12%, growth factors 33%, lobectomy 5%. At 3 months after diagnosis or first suspicion of IA, 44 (36%) patients were alive and 79 (64%) dead. Outcome was best in those with AML (30% death and 46% with a complete antifungal response or cure). Growth factors (mostly granulocyte colony stimulating factor) appeared not to influence outcome (P = 0.99). CONCLUSION: IA remains a considerable diagnostic and therapeutic challenge. No single diagnostic procedure was universally successful and a multifaceted approach including surgery is necessary. There was no discernable difference in outcome between initial therapy with amphotericin B, itraconazole or lipid-associated amphotericin B, although numbers are limited and the study was retrospective.

Adolescent↗
PubMed1998

An EORTC international multicenter randomized trial (EORTC number 19923) comparing two dosages of liposomal amphotericin B for treatment of invasive aspergillosis.

This is the first completed prospective randomized clinical efficacy trial of antifungals in the treatment of invasive aspergillosis (IA) and the first to compare the clinical efficacy of two dosages of liposomal amphotericin B (L-AmB) for IA in neutropenic patients with cancer or those undergoing bone marrow transplantation. Eighty-seven of 120 patients were eligible and evaluable. Clinical responses were documented for 26 (64%) of 41 patients receiving 1 mg/(kg.d) (L-AmB-1) and 22 (48%) of 46 receiving 4 mg/(kg.d) (L-AmB-4). Radiologic response rates were similar: 24 (58%) of the L-AmB-1 recipients and 24(52%) of the L-AmB-4 recipients. The six-month survival rates were 43% (L-AmB-1) and 37% (L-AmB-4). These differences were not significant. The numbers of deaths directly due to IA at 6 months were similar: 9 (22%) of 41 L-AmB-1 recipients and 9 (20%) of 46 L-AmB-4 recipients. No other variable independently influenced survival, apart from central nervous system IA. L-AmB is effective in treating approximately 50%-60% of patients who have IA. A 1-mg/(kg.d) dosage is as effective as a 4-mg/(kg.d) dosage, and no advantages to use of the higher, more expensive, dosage has been observed.

Adult↗
PubMed1998

Factors affecting home delivery in the Kathmandu Valley, Nepal.

This nested case-control study compares the characteristics of mothers having home or institutional deliveries in Kathmandu, Nepal, and explores the reasons given by mothers for a home delivery. The delivery patterns of mothers were identified in a cross-sectional survey of two communities: an urban area of central Kathmandu (Kalimati) and a peri-urban area (Kirtipur and Panga) five kilometres from the city centre. 357 pregnant women were identified from a survey of 6130 households: 183 from 3663 households in Kirtipur and Panga, 174 from 2467 households in Kalimati. Methods involved a structured baseline household questionnaire and detailed follow-up of identified pregnant women with structured and semi-structured interviews in hospital and the community. The main outcome measures were social and economic household details of pregnant women; pregnancy and obstetric details; place of delivery; delivery attendant; and reasons given for home delivery. The delivery place of 334/357 (94%) of the pregnant women identified at the survey was determined. 272 (81%) had an institutional delivery and 62 (19%) delivered at home. In univariate analysis comparing home and institutional deliverers, maternal education, parity, and poverty indicators (income, size of house, ownership of house) were associated with place of delivery. After multivariate analysis, low maternal educational level (no education, OR 5.04 [95% CI 1.61-15.8], class 1-10, OR 3.36 [1.04-10.8] compared to those with higher education) and multiparity (OR 3.1 [1.63-5.74] compared to primiparity) were significant risk factors for a home delivery. Of home deliverers, only 24% used a traditional birth attendant, and over half were unplanned due to precipitate labour or lack of transport. We conclude that poor education and multiparity rather than poverty per se increase the risk of a home delivery in Kathmandu. Training TBAs in this setting would probably not be cost-effective. Community-based midwife-run delivery units could reduce the incidence of unplanned home deliveries.

Adult↗
PubMed1998

Liquid crystal thermometry for the detection of neonatal hypothermia in Nepal.

We assessed the sensitivity, specificity and likelihood ratio of a low cost liquid crystal strip thermometer (LCT) compared with axillary mercury thermometry for the detection of neonatal hypothermia in Nepal. The subjects were 76 healthy newborns in the government maternity hospital of Kathmandu, Nepal in winter. The validity of LCT for the detection of neonatal hypothermia (less than 36 degrees C) showed a sensitivity of 83 per cent, specificity 96 per cent, positive predictive value 98 per cent and a likelihood ratio of 23. Use of LCT on newborns in this setting raises a measured pretest probability of first day hypothermia of 63 per cent to a post-test probability of 97 per cent. Liquid crystal thermometry is a simple, low-cost, and valid method for identifying core hypothermia in newborns. It is ideal for isolated rural communities where LCT strips could be added to delivery kits.

Female↗
PubMed1998

Effects of feeder type, space allowance, and mixing on the growth performance and feed intake pattern of growing pigs.

The effect of crowding and mixing on growth performance and feed intake pattern were investigated in growing pigs in a 4-wk study. Feeding pattern was monitored using automated feed intake recording equipment (F.I.R.E.). A total of 256 Yorkshire x Hampshire and purebred Duroc pigs (initial weight 35.8+/-.86 kg) were allocated to one of the eight treatment combinations in a 2x2x2 factorial arrangement (feeder type [conventional feeder vs F.I.R.E. feeder], space allowance [.56 vs .25 m2/pig], and mixing strategy [mixed vs unmixed; mixing at start of wk 1 and 3]). Pigs were housed in groups of eight, balanced for genotype and sex (barrows and gilts), and had free access to a corn-soybean meal diet (17% crude protein, 3,296 kcal ME/kg). There was no difference in growth performance between feeder types. Crowding and mixing had no effect on daily feed intake but they depressed growth rate by 15.7 and 7.1%, respectively, and the effects of the two stressors were additive. Gain:feed ratio was reduced by crowding (10.0%) but not by mixing. Crowded pigs made fewer (11.2 vs 15.7; SEM = .51), and longer (12.5 vs 8.9 min; SEM .41) feeder visits and had higher feed intake per visit (196.2 vs 145.5 g; SEM = 5.94) than uncrowded animals. Mixing produced changes in feeding pattern in the 1st wk after mixing but not over the 4-wk period. This study showed that crowding and mixing depressed growth rates in an additive manner and altered feeding behavior.

Animal Feed↗
PubMed1998

Growth performance of pigs subjected to multiple concurrent environmental stressors.

The effects of many single stressors have been reported, but how pigs perform when subjected to more than one or two stressors at a time, as is common in commercial swine production, has not. To study this, 256 Yorkshire x Hampshire or purebred Duroc pigs (34.7+/-.5 kg) were subjected to one of the eight treatment combinations (2 x 2 x 2 factorial) of ambient temperature (constant thermoneutral [24 degrees C] or high cycling temperature [28 to 34 degrees C]), stocking density (.56 or .25 m2/pig), and social group (static group or regrouped at the start of wk 1 and 3) during a 4-wk experiment. The temperature regimens were imposed in two adjacent mechanically ventilated rooms, and each temperature was imposed in each room across two trials. Four barrows and four gilts were assigned to each of the eight pens in the two rooms, and they always had free access to water and a corn-soybean meal-based diet. Treatments were imposed after a 7-d acclimation period at 24 degrees C and .56 m2/pig. Weight gain and feed intake were measured weekly. The main effects of each of the stressors for 4-wk ADG and ADFI were significant (P < .05). The stress of high temperature, high stocking density, and regrouping depressed 4-wk ADG by 12, 16 and 10% and ADFI by 7, 6, and 5%, respectively. Of the possible 60 stressor interactions for ADG, ADFI, and gain:feed (G:F), there were no significant three-way interactions and only six two-way interactions, suggesting that the effects of the individual stressors were additive. Accordingly, the growth rate of pigs subjected to the single stressor of high cycling temperature, restricted space allowance, or regrouping was depressed 10, 16, and 11%, respectively, and ADG of pigs subjected to all three stressors simultaneously was depressed by 31%. Stressor additivity was further corroborated by examining the effect of stressor order, or the number of stressors imposed simultaneously. As the number of stressors increased from 0 to 3, ADG, ADFI, and G:F decreased linearly. These data suggest that multiple concurrent stressors affect growth performance of pigs in a predictable fashion (i.e., additively) and indicate that avoidance or removal of a given stressor is advantageous even when other uncontrollable stressors persist.

Animal Feed↗