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Biomedical subjects

M McHugh

Publications and source records attributed to M McHugh.

At least 19 recordsLinked to original sources
PubMed2001

Augmentation of apoptosis and interferon-gamma production at sites of active Mycobacterium tuberculosis infection in human tuberculosis.

Pleural tuberculosis (TB) was employed as a model to study T cell apoptosis at sites of active Mycobacterium tuberculosis (MTB) infection in human immunodeficiency virus (HIV)-coinfected (HIV/TB) patients and patients infected with TB alone. Apoptosis in blood and in pleural fluid mononuclear cells and cytokine immunoreactivities in plasma and in pleural fluid were evaluated. T cells were expanded at the site of MTB infection, irrespective of HIV status. Apoptosis of CD4 and non-CD4 T cells in the pleural space occurred in both HIV/TB and TB. Interferon (IFN)-gamma levels were increased in pleural fluid, compared with plasma. Spontaneous apoptosis correlated with specific loss of MTB-reactive, IFN-gamma-producing pleural T cells. Immunoreactivities of molecules potentially involved in apoptosis, such as tumor necrosis factor-alpha, Fas-ligand, and Fas, were increased in pleural fluid, compared with plasma. These data suggest that continued exposure of immunoreactive cells to MTB at sites of infection may initiate a vicious cycle in which immune activation and loss of antigen-responsive T cells occur concomitantly, thus favoring persistence of MTB infection.

AIDS-Related Opportunistic Infections↗
PubMed2001

Phosphorus availability for beneficial use in biosolids products.

It has become necessary to identify accurately the availability of phosphorus in biosolids products applied to land. The fertiliser value of these products must be quantified not only to satisfy the customer but also to ensure the best use of phosphorus when considering the need to avoid excess concentrations in the wider environment, With the advent of chemical phosphorus removal at more wastewater treatment works, the impact of iron and phosphate availability is particularly important. Existing research has indicated that there is a correlation between phosphate availability, and factors such as biosolids pH and iron concentration. However, it has not yet been possible to draw any firm conclusions, which can be used as a tool to manage the availability of phosphate in practice. Through a joint research programme for Anglian Water, involving literature investigation, laboratory tests on biosolid/soil interactions, and benchmarking phosphate availability over time, the study uses the best available input and output data to indicate the parts of the land bank most at risk from over-enrichment.

Agriculture↗
PubMed2000

The Children's PTSD Inventory: development and reliability.

Information involving the development of the DSM-IV version of the Children's PTSD Inventory is described. Independent ratings by highly experienced judges denote that the instrument encompassed the universe of definition that it was intended to measure (i.e., the DSM-IV criteria for PTSD). The instrument was administered to 82 traumatized and 22 nontraumatized youths at Bellevue Hospital. Moderate to high Cronbach alphas (.53-.89) were evident at the subtest level. An alpha of .95 was evident at the diagnostic level. In terms of inter-rater reliability, 98.1% agreement was evident at the diagnostic level. Inter-rater intraclass correlation coefficients (ICCs) ranged from .88 to .96 at the subtest level and .98 at the diagnostic level. Good to excellent kappas (.66-1.00) were reported for inter-rater reliability at the subtest level. An inter-rater reliability kappa of .96 was evident at the diagnostic level. In terms of test-retest reliability, 97.6% agreement was evident at the diagnostic level. Good to excellent test-retest kappas (.66-1.00) and ICCs (.66-.94) were observed. A test-retest kappa of .91 and an ICC of .88 was observed at the diagnostic level.

Adolescent↗
PubMed2000

A cluster of necrotizing enterocolitis in term infants undergoing open heart surgery.

BACKGROUND: Necrotizing enterocolitis (NEC) is a serious gastrointestinal disease of unknown cause that predominantly affects premature infants, but it has been reported in term infants with congenital heart disease. METHODS: In August and September of 1997, 4 cases of NEC in term infants with congenital heart disease were identified among 24 infants undergoing cardiac surgical procedures at our institution. Because nosocomial NEC had not previously been identified among infants in our pediatric intensive care unit, a case-control study was conducted to identify risk factors for NEC. All infants less than 4 months old undergoing cardiac surgery without development of NEC during the epidemic period were selected as controls. RESULTS: The only significant risk factor associated with case-infants was a higher mean temperature gradient (rectal/toe) during the immediate 12-hour postoperative period (4.0 degrees C vs 2.0 degrees C, P <.01). Urine output was higher in control-infants in this postoperative period, although not statistically significant (11.9 mL/h vs 6.1 mL/h, P =.15). CONCLUSION: Although an infectious etiology cannot be ruled out, the cases of NEC in infants with congenital heart disease after cardiac procedures may have resulted from mesenteric ischemia associated with a low perfusion state in the perioperative period.

Anti-Bacterial Agents↗
PubMed1999

The relationship of motor unit size, firing rate and force.

OBJECTIVE: Using a clinical electromyographic (EMG) protocol, motor units were sampled from the quadriceps femoris during isometric contractions at fixed force levels to examine how average motor unit size and firing rate relate to force generation. METHODS: Mean firing rates (mFRs) and sizes (mean surface-detected motor unit action potential (mS-MUAP) area) of samples of active motor units were assessed at various force levels in 79 subjects. RESULTS: MS-MUAP size increased linearly with increased force generation, while mFR remained relatively constant up to 30% of a maximal force and increased appreciably only at higher force levels. A relationship was found between muscle force and mS-MUAP area (r2 = 0.67), mFR (r2 = 0.38), and the product of mS-MUAP area and mFR (mS-MUAP x mFR) (r2 = 0.70). CONCLUSIONS: The results support the hypothesis that motor units are recruited in an orderly manner during forceful contractions, and that in large muscles only at higher levels of contraction ( > 30% MVC) do mFRs increase appreciably. MS-MUAP and mFR can be assessed using clinical EMG techniques and they may provide a physiological basis for analyzing the role of motor units during muscle force generation.

Action Potentials↗
PubMed1998

Firing rate analysis using decompostion-enhanced spike triggered averaging in the quadriceps femoris.

Electromyographic signals detected from the quadriceps femoris during various constant force contractions were decomposed to identify individual motor unit discharges and mean firing rates (FRs). Subject and group mean FRs were calculated for each force level. Mean FR values and FR variability increased with force. Individual, subject, and group mean FRs showed slight increases until 30% of maximum voluntary contraction and larger increases thereafter. Findings are discussed in relation to motor unit recruitment, frequency modulation, and fatigue.

Action Potentials↗
PubMed1998

Rationalization as a key stressor for public sector employees: an organizational case study.

Public sector organizations throughout Europe have been subject to cuts in Government spending, allied to demands for enhanced efficiency and effectiveness. Consequently, many have embarked upon radical programmes of change which potentially have an adverse effect upon the psychological well-being of employees. This study aimed to assess linkages between organization change and the psychological well-being of employees within the Swedish social insurance organization Försäkringskassan. A case study approach was adopted for the investigation which was carried out within the Halland region between February and June 1995. A questionnaire which included the Cultural Audit and the General Well Being Questionnaire was distributed to the organization's 456 employees in Halland. Questionnaire were returned by 246 employees (54.6%), reflecting the employment structure of the organization. The findings revealed that many issues associated with the process of rationalization and change were of concern to employees. Statistical analyses revealed that these were linked to their relatively high levels of 'anxiety' and their symptoms of being 'worn out'. This study indicates that the process of organization change is stressful for employees within Försäkringskassan. As public sector organizations throughout Europe are subject to similar pressure and are being forced to embark upon change programmes, it is suggested that they take cognizance of the findings of this investigation when making decisions regarding the planning and implementation of organization change.

Adolescent↗
PubMed1997

Molecular determination of the malignant potential of smooth muscle neoplasms.

BACKGROUND: The determination of the malignant potential of smooth muscle neoplasms remains ambiguous, and yet has far reaching clinical, therapeutic, and social implications. METHODS: In this pilot study, the authors examined smooth muscle isoactin gene expression by polymerase chain reaction in a variety of smooth muscle tumors. RESULTS: A lack of gamma-smooth muscle isoactin gene expression correlated 100% with a pathologic diagnosis of sarcoma. These results suggest that gamma-smooth muscle isoactin gene expression represents a unique molecular marker of oncogenic transformation. CONCLUSIONS: gamma-Smooth muscle isoactin gene expression provides a valuable molecular adjunct to the diagnosis of smooth muscle neoplasms.

Actins↗
PubMed1997

Decomposition-enhanced spike-triggered averaging: contraction level effects.

Decomposition-enhanced spike-triggered averaging (DE-STA) was applied to the vastus medialis muscle to examine size distributions of surface-detected motor-unit action potentials (S-MUAPs) at various force levels. Using DE-STA, 15-20 S-MUAPs were identified during 5%, 10%, 20%, and 30% of maximum voluntary contraction. Average S-MUAPs showed increase in peak to peak (and negative peak) amplitude with force (In microV): 5% = 37.9 +/- 6.1 (16.6 +/- 2.5), 10% = 44.0 +/- 4.0 (20.4 +/- 1.8), 20% = 80.7 +/- 9.3 (41.3 +/- 4.5), and 30% = 102.5 +/- 10.3 (53.6 +/- 5.0). Test-retest variability of peak to peak (and negative peak amplitude) between repeated trials was 0.10 (0.14), 0.14 (0.14), 0.17 (0.15), and 0.21 (0.20) at 5%, 10%, 20%, and 30% respectively. A relationship was found between the S-MUAP amplitude and force (r2 = 0.78, df = 90, F = 160, P < 0.001). Increase in average S-MUAP amplitude with force suggests that STA performed only at low levels of contraction may result in a biased sampling and small average S-MUAP amplitudes.

Action Potentials↗
PubMed1997

Immunohistochemical localization of p21(WAF1/CIP1) in normal, hyperplastic, and neoplastic uterine tissues.

p21WAF1/CIP1 is a nuclear protein that binds to cyclin-dependent kinase complexes (CDKs) and inhibits the activity of multiple kinases. These CDKs are involved in the regulation of cell cycle progression at several checkpoints. In this study, the authors have analyzed by immunohistochemistry the expression of p21WAF1/CIP1 in normal uterine tissues, 12 endometrial hyperplasias, 17 endocervical adenocarcinomas, and 31 endometrial adenocarcinomas. In addition, a group of 10 leiomyomas and 10 uterine leiomyosarcomas were also stained. To evaluate cell proliferation, the monoclonal antibody Ki-67 was used in all of the available cases. Terminally differentiated epithelial endocervical and endometrial cells showed variable expression of p21WAF1/CIP1, whereas the endometrial hyperplasias, and endocervical and endometrial adenocarcinomas showed decreased expression or were negative. All of the cases of cervical squamous dysplasia were positive. Normal smooth muscle cells and 50% of leiomyomas were negative, whereas all leiomyosarcomas showed expression of p21WAF1/CIP1. These results indicate that p21WAF1/CIP1 contributes to differentiation in normal endometrial and endocervical glands. The decreased expression of p21WAF1/CIP1 in endometrial hyperplasias and carcinomas may be important in the process of neoplastic transformation. The role of certain CDK inhibitors, such as p21WAF1/CIP1, is different in epithelial and mesenchymal tumorigenesis in the uterus.

Adenocarcinoma↗
PubMed1997

Comparative analysis of smooth muscle isoactin gene expression in normal and neoplastic tissues.

Monoclonal antibodies derived from the actin multigene family are routinely used as an adjunct to morphologic diagnoses of smooth muscle tumors. Northern blot analysis was performed on 60 surgical resections utilizing isoactin-specific cDNAs. A comparison of this analysis to immunohistochemical studies demonstrated that actin-specific monoclonal antibodies represent reliable markers of the smooth muscle lineage. Smooth muscle neoplasms showed a unique pattern of gamma-smooth muscle isoactin gene expression, providing a potentially valuable molecular adjunct to the morphologic diagnosis of uterine smooth muscle tumors.

Actins↗
PubMed1996

Pain relief with low-dose intravenous clonidine in a child with severe burns.

The case of an 11-year-old boy who suffered second and third degree burns to 78% of his body is reported. The large doses of morphine used as analgesia resulted in severe side effects: ventilatory dependence, impairment of gastrointestinal function and psychological disturbance. Intravenous lignocaine was added without benefit. The addition of low-dose intravenous clonidine, however, precipitated a dramatic reduction in morphine consumption with an attendant improvement in ventilatory, gastrointestinal and psychological functions.

Adrenergic alpha-Agonists↗
PubMed1996

A 1-year prospective study of burns in an Irish paediatric burns unit.

Burns are the fourth leading cause of injury death in children in the USA, accounting for 1300 paediatric deaths annually. The majority of paediatric burns mortality and morbidity result from simple domestic accidents that are preventable. A prospective study of paediatric burns from 1 January 1992 to 1 January 1993 was undertaken at our burns unit to outline the profile of the Irish paediatric burns problem. A total of 336 burns were referred to our unit over the 12 months (80 per cent self-referrals, 15 per cent tertiary referrals from district hospitals and 5 per cent GP referrals). Sixteen per cent (57) of the patients required admission and 33 per cent (112) required prolonged dressings as outpatients. Mortality and morbidity rates were comparable to other centres at 1.8 per cent and 39 per cent respectively. The demographic analysis of the patient population was similar to that seen in other studies from developed countries but there were some notable differences. First, there was an alarmingly high incidence of serious sunburn injuries, especially among young infants. Most parents were unaware of the association between childhood sunburn and the development of skin cancer in later life. Second, 90 per cent of the accidents occurred in the home and almost all were preventable. A parent or guardian was present in 87 per cent of cases but parental knowledge of the appropriate first aid measures was poor. It is suggested that a public health education campaign on this issue would help in reducing the incidence and severity of paediatric burn injuries in Ireland.

Accidents, Home↗
PubMed1996

Use of computerized morphometric analyses of endometrial hyperplasias in the prediction of coexistent cancer.

OBJECTIVE: Our purpose was to determine whether computerized morphometric analysis is predictive of coexistent cancer in uteri that show endometrial hyperplasia in curettings or biopsy specimens. STUDY DESIGN: Forty-five patients with endometrial hyperplasia and 10 patients with well-differentiated cancers diagnosed from curettings or biopsy specimens and treated by hysterectomy at Thomas Jefferson University Hospital between 1989 and 1993 were identified from the pathology department archives. Curettings were analyzed by computerized morphometric analysis at the Free University Hospital in Amsterdam. Pathologists performing the morphometric analyses were blinded to the pathologic diagnoses obtained by examining the hysterectomy specimens. The histopathologic classification of the hysterectomy specimens were used as the end point. RESULTS: Twelve of 45 patients with endometrial hyperplasia (26.7%) by preoperative histopathologic classification showed coexistent carcinoma at hysterectomy. All instances of carcinoma occurred in patients with atypical hyperplasia. Sensitivity of morphometric analysis to predict carcinoma was 100%, with a specificity of 88.5%. The positive predictive value was 83.3%, and the negative predictive value was 100%. A blinded reanalysis of the quantitative analysis in 16 patients showed good reproducibility of this technique (r = 0.93). CONCLUSIONS: Morphometric analysis is useful for predicting which patients with endometrial hyperplasia have coexistent carcinomas. Computerized morphometric analysis may be useful in therapeutic decision making for complex atypical hyperplasia.

Aged↗
PubMed1996

Establishing an interdisciplinary patient care team: collaboration at the bedside and beyond.

The authors describe how an interdisciplinary team used skills in communication and collaboration to improve patient care on a busy surgical service. A major goal was to establish and maintain continuity of care in the face of decreasing lengths of stay and increasing patient acuity. The authors share their insight about designing and supporting a successful interdisciplinary patient care team and discuss how their experiences relate to concepts such as case management and career development.

Communication↗