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Biomedical subjects

M Knox

Publications and source records attributed to M Knox.

25 records · Page 2Linked to original sources
PubMed1992

Left ventricular systolic and diastolic dysfunction after infusion of tumor necrosis factor-alpha in conscious dogs.

We used a load-insensitive index of systolic left ventricular (LV) function and an analysis of diastolic pressure-dimension relationships to test the hypothesis that recombinant human (rh) tumor necrosis factor-alpha (TNF alpha) impairs LV function in dogs. Animals were studied 7-10 d after aseptic implantation of instrumentation to monitor cardiac output, external anterior-posterior LV diameter, and LV and pleural pressures. Data were analyzed from seven dogs that received active rhTNF alpha (100 micrograms/kg over 60 min) and from five dogs that received heat-inactivated rhTNF alpha. At 24 h after infusion of active rhTNF alpha, the slope of the LV end-diastolic dimension-stroke work relationship decreased significantly, indicating a decrement in LV systolic contractility. Simultaneously, LV unstressed dimension increased significantly, suggesting diastolic myocardial creep. The end-diastolic relationship between LV transmural pressure and normalized LV dimension (strain) was markedly displaced to the left, suggesting increased diastolic elastic stiffness. Despite these changes in LV performance, cardiac index was maintained by tachycardia. The abnormalities in LV function were resolved by 72 h. We conclude that rhTNF alpha reversibly impairs LV systolic and diastolic function in unanesthetized dogs. Because dysfunction occurs greater than 6 h after the infusion of rhTNF alpha and persists for 24-48 h, the mechanism underlying this phenomenon may involve secondary mediators or a change in myocardial gene expression.

6-Ketoprostaglandin F1 alpha↗
PubMed1991

The post-school experiences of young people with a disability.

The transition of young people with disabilities from school to work and adult living has been the focus of attention for the Centre for Educational Research and Innovation (CERI) of OECD for some years. Various member countries of OECD have implemented transition education programmes as a result of community-based educational policies for students with disabilities. To establish a baseline of the post-school experiences of disabled students a follow-up study of a sample of ex-students in New South Wales, Australia, was conducted. While the responses to the survey came essentially from students who had been in special schools and hence may be unrepresentative of the total population of disabled ex-students, the data indicate some interesting trends. Only 42% were in open employment. Those with a moderate or severe intellectual disability were generally in sheltered workshops, activity centres or at home. The majority of respondents indicated that work was an important part of their lives, not so much from an economic perspective, but especially as it afforded them a social outlet. The implications of the findings are discussed in the context of the current emphasis upon community-based rather than sheltered employment for people with disabilities.

Adaptation, Psychological↗
PubMedDate not supplied

Nutritional enhancement of parasite control in small ruminant production systems in developing countries of South-East Asia and the Pacific.

Nutritional insufficiency and gastrointestinal nematode parasitism are major constraints to small ruminant production in south-east Asia and the Pacific Islands. Research on the effects of low cost supplements which supply nitrogen and essential minerals on the ability of small ruminants to resist infection is summarised. In controlled pen studies in young Merino sheep offered a low quality roughage diet of oaten chaff and essential minerals, supplementation with urea reduced the effects of parasitic infection by increasing weight gain and wool production and reducing faecal egg output and parasite burden. In Fiji, field studies have shown that supplementation with urea-molasses blocks can result in increased live-weights of lambs at weaning, increased reproduction rates in maiden ewes and reduction in faecal egg output in grazing sheep. Additional benefits were derived from the inclusion of anthelmintic in the blocks in similar groups of sheep particularly during periods of greater susceptibility to parasites. Pen studies with young goats have shown that urea supplements alone gave no production benefits, but when accompanied by 100 g/d of cotton seed meal beneficial responses were observed. It is expected that parasite control in the small ruminant production systems of developing countries in south-east Asia and the Pacific Islands will benefit from the introduction of low cost nitrogen supplements along with anthelmintic therapy delivered strategically by molasses blocks.

Animal Nutritional Physiological Phenomena↗
PubMedDate not supplied

Case management at what expense? A case study of the emotional costs of case management.

Case management, which has its historical roots in community and public health, seeks to coordinate care, decrease costs, and promote access to appropriate levels of service. The case management system in this case study underscores the potential negative outcomes that can result from ignoring the holistic approach represented by an implemented case management system as a cost control mechanism. These negative outcomes not only include those expenditures of resources usually included when describing costs of care, but include those emotional costs of the system, patient, and care managers. Several needed system changes are identified and recommendations provided.

Case Management↗