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Biomedical subjects

M Newton

Publications and source records attributed to M Newton.

At least 37 records · Page 2Linked to original sources
PubMed2000

Examination of the psychometric properties of the perceived motivational climate in sport questionnaire-2 in a sample of female athletes.

We undertook two studies to determine the validity and reliability of the revised Perceived Motivational Climate in Sport Questionnaire (PMCSQ-2). In Study 1, 201 female athletes (mean age 16.4 years) were administered the initial version of the PMCSQ-2 and a measure of reported tension and pressure experienced in sport. Exploratory principal component analysis suggested that the PMCSQ-2 contained two higher-order scales (Task-Involving and Ego-Involving climates), each with three subscales (Task: Cooperative Learning, Effort/ Improvement, Important Role; Ego: Intra-Team Member Rivalry, Unequal Recognition, Punishment for Mistakes). In Study 2, 385 female volleyball players (mean age 15.2 years) completed the PMCSQ-2, the Intrinsic Motivation Inventory and a measure of Team Satisfaction. Confirmatory factor analysis was applied to six competing models. The oblique six-factor model and oblique hierarchical model provided comparable fit to the data. Acceptable fit was reached based on model respecification. Across Studies 1 and 2, internal consistency was found to be acceptable for the higher-order scales and subscales (with the exception of the Intra-Team Member Rivalry subscale). We found evidence for the concurrent validity of the instrument.

Adolescent↗
PubMed2000

Morbidity, mortality, and risk factors for esophagitis in hospital inpatients.

Esophagitis is a common endoscopic finding, although its prevalence and contribution to morbidity and mortality in hospital inpatients has not been systematically evaluated. This study aimed to determine the prevalence of esophagitis among hospital inpatients referred for upper gastrointestinal endoscopy, to assess factors associated with the presence of esophagitis, and to determine the mortality of patients with esophagitis. All inpatients referred for upper gastrointestinal endoscopy in a district general hospital were assessed prospectively for one year. The reason for referral, endoscopy findings, and one-month mortality were determined together with a history of nasogastric intubation, periods spent supine, and drug use. Of 595 inpatients who underwent gastroscopy, 58% were referred for investigation of acute upper gastrointestinal bleeding. Esophagitis was found in 196 (33%). Esophagitis was significantly associated with wide-bore nasogastric intubation (p = 0.021; relative risk, 2.61; 95% CI, 0.64-6.06) but not with fine-bore nasogastric intubation. Esophagitis was also significantly associated with being nursed supine (p = 0.015; relative risk, 1.41; 95% CI, -1.75-6.72). There was no association between esophagitis and specific drug therapy. Mortality among patients with esophagitis was higher than those without esophagitis (p = 0.04; relative risk, 1.38; 95% CI, 0.34-3.22). Reflux esophagitis is common in hospital inpatients who are endoscoped. Although the underlying diseases are likely to account for the high mortality, the associations of wide-bore nasogastric intubation and being nursed supine should alert caregivers to an increased risk. If nasogastric intubation is required for feeding only, fine-bore tubes should be considered.

Adolescent↗
PubMed2000

APACHE II scores and deaths after upper gastrointestinal endoscopy in hospital inpatients.

Advanced age and comorbidity as well as gastrointestinal (GI) disease contribute to the increased mortality after upper GI endoscopy in inpatients when compared to outpatients. The aim of this study was to measure comorbidity in inpatients undergoing endoscopy using the Acute Physiology and Chronic Health Evaluation (APACHE) II severity of disease classification and to assess the usefulness of the APACHE II system in predicting outcome. During a 10-week period, 155 consecutive inpatients undergoing upper GI endoscopy were prospectively scored using APACHE II. They were followed up for 30 days, the measured endpoint being death. Of these, 92 (59%) inpatients were admitted with GI hemorrhage, 14 (9%) were admitted for other reasons but subsequently bled, and 49 (32%) were endoscoped for reasons other than bleeding. The mean (SEM) APACHE II score in patients with GI bleeding was 8.0 (0.5), and in patients without bleeding was 6.5 (0.6; p = 0.07). Eighteen patients (12%) died within 30 days of endoscopy. APACHE scores were higher at 10.5 (1.2) in patients who died, compared to 7.1 (0.4) in those who lived (p < 0.01). Increased acute physiology scores led to this difference. Age and chronic health scores were similar in both groups. In the 18 patients who died, 9 had GI bleeding and their mean APACHE score was 13.8 (1.5); 9 had been endoscoped for other reasons and had a lower score of 7.2 (1.3; p < 0.01). These latter 9 deaths amounted to a 18% mortality in the nonbleeding group, which was greater than expected. APACHE II scores can help predict poor outcome in inpatients referred for endoscopy. However, the APACHE II system has limitations and failed to identify (by means of a high score) some patients without GI bleeding who subsequently died. A tool to measure comorbidity, such as the APACHE II system, is necessary when comparing groups of patients in different settings.

APACHE↗
PubMed2000

Fluorescent in situ hybridizaton evaluation of p53 gene deletions at a tumor interface of lingual carcinoma.

OBJECTIVE/HYPOTHESIS: To evaluate the ability of fluorescent in situ hybridization (FISH) to detect malignant cells missed by standard histological assessment at an interface between malignant and normal tissue in lingual squamous cell carcinoma (SCC) and to correlate findings of FISH assessment with patients' clinical stages. STUDY DESIGN: Retrospective assessment of archival tissue from 31 patients with lingual SCC treated at University of Wisconsin Hospital and Clinics in Madison. METHODS: An assay combining standard histological and FISH techniques was used to assess a tumor interface tissue section and allow identification of each tumor's ploidy characteristics and p53 gene deletions and the presence or absence of malignant cells within tissue viewed as "normal" on histological review. RESULTS: Forty-five percent of tumors (14 of 31) demonstrated ploidy changes and 84% (26 of 31) showed p53 deletions. Of these 26 tumors with p53 deletions, 14 were found to have "microfoci" with p53 deletions within tissue that appeared normal on histological examination. These microfoci were found in 75% of late-stage tumors and in only 35% of early-stage tumors. CONCLUSIONS: FISH allowed identification of malignant cells in tissue viewed as normal on standard histological assessment, and this finding occurred more frequently in late-stage tumors.

Adult↗
PubMed2000

Phototherapeutic keratectomy for anterior scarring in an epikeratophakia lenticule.

PURPOSE: To present a case of anterior scarring in an epikeratophakia lenticule and its partially successful treatment with the excimer laser. METHODS: Excimer laser phototherapeutic keratectomy (PTK) was used to reduce corneal scarring in an epikeratophakia lenticule. RESULTS: Visual acuity improved after two sessions of PTK. CONCLUSIONS: PTK is an alternative to epikeratophakia lenticule removal.

Adult↗
PubMed1999

Symptomatic gastroesophageal reflux in acutely hospitalized patients.

Patients admitted acutely to hospital may be at risk of increased morbidity and mortality as a result of gastroesophageal reflux and its complications. The recognized association of gastroesophageal reflux with cardiac and respiratory disease, the use of drugs that reduce lower esophageal sphincter pressure, and the supine position in which many patients are nursed may increase the risk of gastroesophageal reflux. This study aimed to determine the prevalence and severity of refluxlike symptoms in a series of consecutive unselected patients admitted acutely through the accident and emergency department of a district general hospital and to study the effect of hospitalization on these symptoms. Patients were interviewed by questionnaire on two occasions: immediately following admission and again 7-10 days later. The frequency of symptoms of heartburn, acid regurgitation, dysphagia, nausea, and belching were recorded on a 6-point scale, in addition to whether these symptoms occurred at night. Medication history, the number of days spent on bed rest, nasogastric intubation, and operation history were also recorded. In all, 275 patients were interviewed, of whom 229 had a second interview; 27% (62) had symptoms at least once a week (49% reported symptoms at least once a month) prior to admission, of whom 4% (9) had daily heartburn and/or acid regurgitation. Following admission to hospital there was a significant (P < 0.001) fall in the prevalence and frequency of refluxlike symptoms. There was a significant association of refluxlike symptoms with number of days spent in bed (P < 0.05) and with the use of nonsteroidal antiinflammatory drugs in hospital (P < 0.0001). Logistic regression analysis confirmed the association of NSAIDs with refluxlike symptoms. Nasogastric intubation and surgery were not associated with heartburn. In conclusion, symptoms of heartburn and acid regurgitation become less frequent following admission to hospital. This probably relates to a reduction in physical exertion following hospital admission but may reflect a reduction in anxiety levels or treatment of underlying disease. Patients on prolonged bed rest and those given non-steroidal anti-inflammatory drugs are at increased risk of refluxlike symptoms and may require antireflux measures.

Acute Disease↗
PubMed1999

Oesophageal epithelial innervation in health and reflux oesophagitis.

BACKGROUND: The response of the oesophagus to refluxed gastric contents is likely to depend on intact neural mechanisms in the oesophageal mucosa. The epithelial innervation has not been systematically evaluated in health or reflux disease. AIMS: To study oesophageal epithelial innervation in controls, and also inflamed and non-inflamed mucosa in patients with reflux oesophagitis and healed oesophagitis. PATIENTS: Ten controls, nine patients with reflux oesophagitis, and five patients with healed oesophagitis. METHODS: Oesophageal epithelial biopsy specimens were obtained at endoscopy. The distribution of the neuronal marker protein gene product 9.5 (PGP), and the neuropeptides calcitonin gene related peptide (CGRP), neuropeptide Y (NPY), substance P (SP), and vasoactive intestinal peptide (VIP) were investigated by immunohistochemistry. Density of innervation was assessed by the proportion of papillae in each oesophageal epithelial biopsy specimen containing immunoreactive fibres (found in the subepithelium and epithelial papillae, but not penetrating the epithelium). RESULTS: The proportion of papillae positive for PGP immunoreactive nerve fibres was significantly increased in inflamed tissue when compared with controls, and non-inflamed and healed tissue. There was also a significant increase in VIP immunoreactive fibres within epithelial papillae. Other neuropeptides showed no proportional changes in inflammation. CONCLUSIONS: Epithelial biopsy specimens can be used to assess innervation in the oesophagus. The innervation of the oesophageal mucosa is not altered in non-inflamed tissue of patients with oesophagitis but alters in response to inflammation, where there is a selective increase (about three- to fourfold) in VIP containing nerves.

Adult↗
PubMed1998

Engineering a change in metal-ion specificity of the iron-dependent superoxide dismutase from Mycobacterium tuberculosis-- X-ray structure analysis of site-directed mutants.

We have refined the X-ray structures of two site-directed mutants of the iron-dependent superoxide dismutase (SOD) from Mycobacterium tuberculosis. These mutations which affect residue 145 in the enzyme (H145Q and H145E) were designed to alter its metal-ion specificity. This residue is either Gln or His in homologous SOD enzymes and has previously been shown to play a role in active-site interactions since its side-chain helps to coordinate the metal ion via a solvent molecule which is thought to be a hydroxide ion. The mutations were based on the observation that in the closely homologous manganese dependent SOD from Mycobacterium leprae, the only significant difference from the M. tuberculosis SOD within 10 A of the metal-binding site is the substitution of Gln for His at position 145. Hence an H145Q mutant of the M. tuberculosis (TB) SOD was engineered to investigate this residue's role in metal ion dependence and an isosteric H145E mutant was also expressed. The X-ray structures of the H145Q and H145E mutants have been solved at resolutions of 4.0 A and 2.5 A, respectively, confirming that neither mutation has any gross effects on the conformation of the enzyme or the structure of the active site. The residue substitutions are accommodated in the enzyme's three-dimensional structure by small local conformational changes. Peroxide inhibition experiments and atomic absorption spectroscopy establish surprisingly the H145E mutant SOD has manganese bound to it whereas the H145Q mutant SOD retains iron as the active-site metal. This alteration in metal specificity may reflect on the preference of manganese ions for anionic ligands.

Amino Acid Sequence↗
PubMed1998

Pre-operative fasting for paediatric anaesthesia. A survey of current practice.

There has recently been much debate about pre-operative fasting for paediatric anaesthesia. There is no consensus about the optimum fasting times for children undergoing elective surgery. In order to establish a standard for paediatric pre-operative fasting times, we undertook a postal survey, targeting members of the Association of Paediatric Anaesthetists resident in the United Kingdom and Ireland in 1995. One hundred and sixty-three questionnaires were dispatched, 131 (80%) were returned and 110 (67%) were complete. The results show that the following guidelines for duration of fast are acceptable to the majority of respondents-neonates: 2 h for clear fluids, 4 h for breast and formula milk; infants: 2 h for clear fluids, 4 h for breast milk, 6 h for formula milk and solids; children: 2 h for clear fluids, 6 h for milk and solids. We suggest that these times be used as guidelines and audited for pre-operative fasting in paediatric anaesthesia.

Adolescent↗
PubMed1998

Speed of onset of oesophageal acid reduction with different proton-pump inhibitors in patients with reflux oesophagitis.

OBJECTIVE: Proton-pump inhibitors are the most effective drug treatment for gastro-oesophageal reflux disease. With the increasing trend toward 'on demand' therapy, it is important to determine how quickly oesophageal acid reflux is reduced, and whether this differs between the available compounds. DESIGN: A 2 x 2 double-blind crossover study. METHOD: Eight patients with Savary-Miller grade II oesophagitis underwent 24 h pre-treatment oesophageal pH monitoring. Each patient was randomly allocated to receive daily omeprazole 20 mg and lansoprazole 30 mg for 2 days, in two separate double-blind periods, with a washout period of 14 days. Two further oesophageal pH recordings were obtained during the second 48 h period of treatment with each drug. RESULTS: Five patients completed the study and their results are presented. Lansoprazole significantly reduced the percentage of total reflux time (P = 0.04) and percentage upright reflux time (P=0.04) on the second day of treatment compared to the pre-treatment, while this was not achieved with omeprazole. There was a significant difference in the reduction of the total reflux time (P= 0.011), upright reflux time (P=0.021) and total reflux episodes (P < 0.001) on day 2 of treatment when comparing lansoprazole with omeprazole. All patients on lansoprazole had a decrease in symptoms of heartburn and regurgitation, with complete resolution in four patients. Three patients had a decrease in these symptoms with omeprazole, including complete resolution in two. CONCLUSION: This study was limited by the small number of patients who underwent this demanding investigation. However, lansoprazole appears to have a more rapid onset of reduction of acid gastro-oesophageal reflux than omeprazole over a 48 h period.

2-Pyridinylmethylsulfinylbenzimidazoles↗