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Biomedical subjects

Michael Burke

Publications and source records attributed to Michael Burke.

35 records · Page 2Linked to original sources
PubMed2004

Clinical and laboratory characteristics of patients with atherothrombotic risk factors presenting with low concentrations of highly sensitive C-reactive protein.

AIMS: To clarify whether individuals with low concentrations of highly sensitive C-reactive protein (hs-CRP) are free of atherothrombotic risk factors or low-grade inflammation. METHODS AND RESULTS: This cross-sectional study included 1266 individuals with risk factors (diabetes, hypertension, hyperlipidemia, smoking, obesity). Eighty percent of women and the same percentage of men with a low concentration (0.8 +/- 0.4 mg/l) of hs-CRP had at least one atherothrombotic risk factor. About one-fourth of the females and a one-third of the males with a low concentration of hs-CRP had at least one laboratory marker of chronic inflammation (erythrocyte sedimentation rate (ESR), white blood cell count (WBCC) or fibrinogen concentration) in the upper 75th percentile. CONCLUSION: Individuals presenting with low concentrations of hs-CRP are not necessarily free of atherothrombotic risk factors. One-fourth of the females and a third of the males in this group presented laboratory evidence of a low-grade inflammation as detected by increased erythrocyte sedimentation rate, white blood cell count or fibrinogen concentration.

Adult↗
PubMed2004

Functional magnetic resonance imaging and somatosensory evoked potentials in rats with a neonatally induced freeze lesion of the somatosensory cortex.

Brain plasticity is an important mechanism for functional recovery from a cerebral lesion. The authors aimed to visualize plasticity in adult rats with a neonatal freeze lesion in the somatosensory cortex using functional magnetic resonance imaging (fMRI), and hypothesized activation outside the primary projection area. A freeze lesion was induced in the right somatosensory cortex of newborn Wistar rats (n = 12). Sham-operated animals (n = 7) served as controls. After 6 or 7 months, a neurologic examination was followed by recording of somatosensory evoked potentials (SSEPs) and magnetic resonance experiments (anatomical images, fMRI with blood oxygen level-dependent contrast and perfusion-weighted imaging) with electrical forepaw stimulation under alpha-chloralose anesthesia. Lesioned animals had no obvious neurologic deficits. Anatomical magnetic resonance images showed a malformed cortex or hyperintense areas (cysts) in the lesioned hemisphere. SSEPs were distorted and smaller in amplitude, and fMRI activation was significantly weaker in the lesioned hemisphere. Only in a few animals were cortical areas outside the primary sensory cortex activated. The results are discussed in respect to an apparent absence of plasticity, loss of excitable tissue, the excitability of the lesioned hemisphere, altered connectivity, and a disturbed coupling of increased neuronal activity to the hemodynamic response.

Animals↗
PubMed2004

Undiagnosed systemic lupus erythematosus in a cohort of infertile women.

PROBLEM: Systemic lupus erythematosous (SLE) is a chronic disease with a broad spectrum of clinical and immunological manifestations, therefore, this condition may be frequently misdiagnosed. The current study was conducted to determine the prevalence of undiagnosed SLE among a cohort of infertile women. METHOD OF STUDY: Screening was performed using sequential (two stage) testing, which included a self-completed questionnaire followed by an antinuclear antibody (ANA) test. The Liang screening questionnaire was distributed to 143 consecutive infertile patients, aged 24-42 years (mean, 33.6 +/- 4.7 years), who were receiving in-vitro fertilization (IVF) treatment. Patients who completed the questionnaire with three or more positive answers, were sent for ANA testing; those who tested positive (>or=1:40) were referred to the Clinical Immunology Unit for anti-double-stranded DNA (dsDNA) antibody test and clinical assessment. RESULTS: A total of 136 women (95.1%) completed the questionnaire. Thirteen patients (9.6%) answered yes to three or more questions. Of these, five patients (3.7%) were ANA-positive and two (1.5%) had undiagnosed SLE. CONCLUSIONS: A 1.5% prevalence of undiagnosed SLE was found in our cohort of infertile women. Additional investigations should be performed as to the role of SLE screening in infertile female population; a high-risk group with regard to ovulation induction treatments.

Adult↗
PubMed2004

Intramuscular haloperidol or lorazepam and QT intervals in schizophrenia.

The objective of this study was to estimate the effects of intramuscular haloperidol and lorazepam on the QT interval in volunteers with schizophrenia. Intramuscular haloperidol and intramuscular lorazepam are standard treatments in the acute management of agitation and aggression. Although prolongation of the QT interval and sequelae, including torsade de pointes and death, have been reported for haloperidol (but not lorazepam), formal studies have been lacking. Volunteers with schizophrenia (n = 12) were administered a single intramuscular injection of 7.5 mg haloperidol or 4 mg lorazepam in a blinded, randomized, placebo-controlled crossover design. Serial EKGs and concurrent blood samples were obtained over 6 hours following each injection. Changes in the QT interval were evaluated, as were plasma drug and prolactin concentrations. Haloperidol injection increased the heart rate-corrected QT interval an average of 5.1 msec using Bazett's correction (QTb 90% confidence interval [CI]: 0.3, 9.8), 3.6 msec using Fridericia's correction (QTf 90% CI: 0.02, 7.2), and 4.2 msec using an empirically derived "baseline correction" (QT(ii) 90% CI: 0.3, 8.0). Effects of lorazepam on QT were nullified by correction for the heart rate elevation (QTb 3.8 msec, 90% CI: 0.6, 7.1; QTf 0.0 msec, 90% CI: -3.2, 3.4; QTii -2.3 msec, 90% CI: -6.6, 2.0). An association between QT prolongation and occurrence of extrapyramidal symptoms was observed. On average, intramuscular haloperidol led to minimal prolongation of the QT interval. This propensity is of theoretical concern in individuals with risk factors for torsade de pointes but seems unlikely to be a problem in the vast majority of patients.

Adult↗
PubMed2004

A comparison of the MCMI-III personality disorder and modifier indices with the MMPI-2 clinical and validity scales.

In this study, we examined the relationship of the MCMI-III (Millon, Davis, & Millon, 1997; Millon, Millon, & Davis, 1994) modifier indices and personality disorder scales to the validity and basic clinical scales of the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). The MCMI-III modifier indices highly correlated with all of the MMPI-2 validity scales except for the F(p) scale. Similarly, the MCMI-III personality disorder scales strongly covaried with the MMPI-2 validity and clinical scales except for the F(p) and 5 (Mf) scales. A factor analysis with Promax rotation revealed substantial relationships between the MMPI-2 and MCMI-III. However, the MMPI-2 F(p) scale did not tend to correlate with MMPI-2 or MCMI-III scales, indicating that F(p) scale variance was largely independent of other scales. The results suggest that clinicians should consider the interrelationship between personality characteristics and dissimulation.

Adolescent↗
PubMed2004

Is discharge home with drains after breast surgery producing satisfactory outcomes?

AIM: To assess whether discharging patients after breast cancer surgery with drains in situ and specialist nurse support is producing satisfactory outcomes. PATIENTS AND METHODS: A retrospective study assessing outcome subjectively and objectively in patients treated at the Breast Unit. The full population of patients (124) operated for breast cancer and discharged with drains in situ, comprising 84 mastectomies and 40 wide local excisions with axillary clearance (WLE). Patients were asked to complete a postal questionnaire, and complication and activity data were analysed. RESULTS: The questionnaire response rate was 60%. Only 10% of patients felt the care received at home was 'worse' than that received in hospital. Over a quarter of locally-conservative surgery patients described not being informed of the plan to discharge them with a drain in situ compared to only 9% of mastectomy patients. Only 6% of patients felt 'confident' going home early from hospital. On their first day at home, two-thirds of patients admitted feeling anxious and this was halved by the second day. Lack of confidence emptying drains was significantly worse in older patients. Complication rates were low and mean bed-days saved per patient was 4.7 days (SD 2.3). CONCLUSIONS: Overall patient satisfaction, hospital bed-days saved and low complication rates showed the efficacy of this early discharge policy. There were specific areas needing improvement. Patients should be more clearly informed of the early discharge plan. Greater attention should be paid to allaying patient anxiety during the first day at home, especially in older patients.

Adult↗
PubMed2004

Advances in pharmacotherapy for tobacco dependence.

The discovery that bupropion is an effective treatment for tobacco dependence has triggered a rapid increase in development of potential new non-nicotine pharmacotherapies, including bromocriptine, glucose, GTS-21, reboxetine, rimonabant, selegeline and varenicline. Successful new products will need to have excellent side-effect profiles in addition to proven efficacy. New faster delivery nicotine replacement products have the promise of addressing a broader list of indications, including treatment of nicotine withdrawal during temporary abstinence and long-term nicotine maintenance. Nicotine vaccines will need to demonstrate efficacy and also improve certain consumer acceptability characteristics (e.g., frequency of injections required) before they can become widely used and successful therapies. The best hope of improved treatment comes from combining existing and new pharmacotherapies with effective behavioural therapy.

Animals↗
PubMed2003

Characterization of new monoclonal antibodies that discriminate between soluble and membrane CD4 and compete with human anti-CD4 autoimmune sera.

In this report we present results on immunization of hu-CD4 C57Black/6J transgenic mice with HIV-1 gp120(451) complexed with its receptor protein, CD4. In addition to development of anti-gp120 antibodies, these mice also produced two anti-CD4 monoclonal antibodies, designated T6 and T9. Both these antibodies recognize soluble CD4 but not membrane associated CD4. Their corresponding epitopes map to the D3-D4 domains of CD4. These characteristics are very similar to the HIV related anti-CD4 autoimmunity found in 10-15% of HIV-1 infected people. Therefore, 208 HIV-1 positive patients were screened for anti-CD4 humoral response of which 27 were found positive (13%). Sixteen of these patients were then tested for their ability to compete with the T6 and T9 anti-CD4 monoclonal antibodies. In such experiments saturating amounts of either T6 or T9 antibodies were able to prevent 20-80% of the human serum binding to immobilized soluble CD4 in competitive ELISA tests. The T6 and T9 antibodies therefore help to define distinct CD4 epitopes associated with clinical anti-CD4 autoimmunity.

Animals↗
PubMed2003

Understanding college students' salient attitudes and beliefs about smoking: distinctions between smokers, nonsmokers, and ex-smokers.

This research examines the salient attitudes and beliefs that college students hold about cigarette smoking. An exploratory survey was employed that contained a combination of semantic differential items and open-ended questions. The data indicated that smoking status (i.e., whether a student is a nonsmoker, smoker, or ex-smoker) was related to attitudes about the attractiveness, riskiness, and intelligence of cigarette smoking. Additionally, salient beliefs about smoking include that nonsmokers report never smoking due to health reasons, smokers and ex-smokers both report peer pressure as the primary reason for starting to smoke, and the main reason smokers continue to smoke is because they are addicted. The best thing reported about smoking was that it relieves stress, and the worst thing reported about smoking was the smell. Several suggestions are made for future interventions targeted toward college students.

Adolescent↗
PubMed2002

Acute intestinal obstruction: diagnosis and management.

In acute intestinal obstruction, the clinician must distinguish between acute small bowel obstruction (ASBO) and acute colonic obstruction (ACO). In cases of ASBO, management depends on whether the patient has had previous abdominal surgery. Most cases of ACO require surgery, although mechanical causes must be distinguished from pseudo-obstruction for different management techniques.

Acute Disease↗
PubMedDate not supplied

Gender difference in C-reactive protein concentrations in individuals with atherothrombotic risk factors and apparently healthy ones.

Recent studies have shown that C-reactive proteins have a pathogenetic role in atherothrombosis and concentrations of these substances could be used as a marker for future vascular events. The objective of this study was to determine gender differences in highly sensitive C-reactive protein (hs-CRP) in individuals with atherothrombotic risk factors and apparently healthy ones. We have presently matched 469 females and 469 males having the same age and body mass index (BMI). Of these, 210 men and 210 women had no atherothrombotic risk factors. In this group the hs-CRP concentrations were 1.6+/-3.4 mg l(-1) in women and 1.0+/-2.7 mg l(-1) in men (p<0.0005). These values were 2.1+/-3.4 mg l(-1) and 1.5+/-2.8 mg l(-1), respectively, in the entire cohort (p<0.0005), which included also individuals with atherothrombotic risk factors. We conclude that significant gender differences exist in hs-CRP concentrations despite perfect matching for age and BMI. These differences should be reflected in guidelines that suggest hs-CRP cut-off points for the stratification of vascular risk.

Arteriosclerosis↗
PubMedDate not supplied

Using information technology to improve the public health system.

Information technology can be both a vital tool and critical link in the modern public health system. This article discusses the role of information technology in public health and the activities of the Information Technology Collaborative, one of the collaboratives that comprise the national Turning Point initiative. Data are presented from a nationwide survey investigating local health department information technology needs and information technology use. This data, and data from an investigation of state-level public health information technology, will be presented in a more complete format on the Information Technology Collaborative's online Public Health Information Systems Catalog, a free resource for individuals interested in public health informatics. Recommendations for future initiatives, policy changes, and information technology standards are discussed.

Catalogs as Topic↗