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Biomedical subjects

P Galea

Publications and source records attributed to P Galea.

At least 19 recordsLinked to original sources
PubMed2004

A randomised controlled trial of morphine versus phenobarbitone for neonatal abstinence syndrome.

BACKGROUND: The incidence of neonatal abstinence syndrome (NAS) has increased 10-fold over the last decade in Glasgow. In the Princess Royal Maternity Hospital, it now accounts for 17% of special care baby unit (SCBU) admissions. OBJECTIVE: To compare opiate replacement therapy (morphine sulphate) with the present standard treatment (phenobarbitone) for management of NAS. The primary study end point was duration of pharmaceutical treatment. Secondary end points were the requirement for additional drugs and the requirement for SCBU admission. DESIGN: Double blind, randomised controlled clinical trial. METHODS: Differential diagnoses were excluded, and two consecutive Lipsitz scores > 4 defined NAS requiring treatment. Infants were randomised to receive morphine sulphate or phenobarbitone. Treatments were identical in appearance, odour, and volume. Increments, decrements, and discontinuation of treatments were protocol driven. RESULTS: Seventy five infants participated. All mothers received opiate replacement therapy (methadone) during pregnancy and most used other drugs (n = 62, 83%). No significant difference in maternal drug use patterns was observed between treatment groups. Median treatment duration was four days shorter with opiate replacement (8 v 12 days, Mann-Whitney U test, p = 0.02). Phenobarbitone treated infants tended to require second line treatment (47% v 35%, chi(2) test, p = 0.11) and SCBU admission (62% v 30%, chi(2) test, p = 0.04) more often. CONCLUSIONS: Opiate replacement therapy appears to be superior for management of symptomatic NAS when maternal opiate use is prevalent. The shorter treatment duration and lower requirement for higher intensity nursing may have significant cost implications. Tailoring NAS treatment to local maternal drug use may result in similar benefits.

Double-Blind Method↗
PubMed1999

New bicyclam-AZT conjugates: design, synthesis, anti-HIV evaluation, and their interaction with CXCR-4 coreceptor.

We report the synthesis of mono- and bis-tetraazamacrocycle-AZT conjugates. All new compounds were screened for their ability to inhibit HIV-1 replication in MT4 cell line and were compared to AZT alone. It appears that N-protected covalent prodrugs are equipotent to AZT as inhibitor of HIV replication, while N-deprotected analogues exhibit both higher activity and selectivity against HIV-infected cells. The most active antiviral compounds 27, 28, 34, and 35 were then tested for their binding capability to CXCR-4 receptor. N-Boc analogues 27 and 34 were only weakly effective; in contrast, N-deprotected conjugates 28 and 35 were antagonists to 12G5 mAb binding until 0.05 and 5 microg/mL, respectively. The stability of compound 28 in human plasma was evaluated, and half-life was found to be approximately 8 h in the described conditions. All these results seem to demonstrate the confidence of our prodrug approach, with analogue 28 emerging as the best candidate as lead compound in HIV-1 polytherapy perspective.

Anti-HIV Agents↗
PubMed1999

Neonatal abstinence syndrome at Glasgow Royal maternity hospital.

OBJECTIVE: To get a clearer idea of the magnitude of the problem of Neonatal Abstinence Syndrome and, in particular, the number of cases and the severity and length of any withdrawal symptoms. DESIGN: Retrospective review of casenotes. SETTING: GRMH, Rottenrow Neonatal Unit Jan 1994-Aug. 1996. SUBJECTS: Infants admitted to the Neonatal Unit with the label "Infant of a Drug Abusing Mother" and their mothers. RESULTS: Sixty-four infants qualified for the audit i.e. on average two children per month. Most mothers had a polydrug habit taking both opiates and benzodiazepines. Thirty per cent of infants were premature and, as a group they were lighter and had a smaller OFC than the national average. Fifty-three infants suffered NEONATAL ABSTINENCE SYNDROME, 50 of these being "jittery, restless or irritable". Only four had convulsions. Most infants' withdrawal presented within 72 hours (median 24 hours) and lasted for less than six days. Infants exposed to methadone had symptoms for longer but required less treatment than infants exposed to heroin. Forty infants needed treatment with phenobarbitone for a median of four days. Only six infants needed other drugs. Median age of discharge was 11 days and 49 out of 53 went home with their mothers. CONCLUSIONS: The Glaswegian polydrug pattern would make morphine/methadone unsuitable treatment. If these infants are not showing signs of withdrawal at 72 hours it is, in our opinion, reasonable to discharge them. Infants should not be discharged with outstanding problems, as follow-up is usually unsuccessful.

Hospitals, Maternity↗
PubMed1997

Circulating cell adhesion molecules in HIV1-infected patients as indicator markers for AIDS progression.

Cell adhesion molecules play an important role during immune responses. Circulating (c) forms of these molecules have been used as monitors of disease progression. In this study, we have investigated serum levels of ICAM1, ICAM2, ICAM3 and VCAM1 in HIV-infected patients. Our results showed that levels of cICAMs and cVCAM1 are increased during HIV infection. Among an HIV-infected population, the cICAM2 level was higher in the asymptomatic group compared to the AIDS group. In contrast, the cICAM1 level was higher in the AIDS group compared to the asymptomatic group. No difference between the two groups was observed in cICAM3 and cVCAM1 levels. A significant correlation was found between cICAM1, cICAM2 and cVCAM1 in both populations. We also showed that the cICAM1/cICAM2 ratio was correlated with the increase in the c beta 2 microglobulin level and the decrease in CD4 T-cell counts in the AIDS group. These results indicate that serum cCAM1 and cICAM2 in HIV infection could be additional markers to discriminate between asymptomatic and progressor patients.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Dominantly inherited cerebral dysplasia: arachnoid cyst associated with mild mental handicap in a mother and her son.

We report a mother and son who each presented in infancy with hypotonia and global developmental delay. Subsequently, in both subjects, mild mental handicap was diagnosed in association with temporal lobe arachnoid cysts. Mendelian inheritance of this phenotype seems likely and macroscopic cerebral dysplasia in general may be underdiagnosed in people with familial, mild mental handicap.

Adult↗
PubMed1996

Familial aplasia cutis congenita.

Two siblings with extensive aplasia cutis congenita of the extremities are described. These lesions healed spontaneously and in the older sibling at four years follow-up there was minimal scar tissue at the affected sites.

Ectodermal Dysplasia↗
PubMed1995

Phenotypic characterization of CD4+ T cells that exhibit a transendothelial migratory capacity.

The phenotype of CD4+ T cells capable of transendothelial migration was determined using an in vitro model system, in which cells migrate through a monolayer of endothelial cells (EC) on collagen gels. A specific subset of resting CD4+ memory T cells was found to migrate. T cells within this subset can be defined by the bright expression of CD11a, CD26, CD44, and CD49d. Additionally, the migratory CD4+ T cell population is largely CD58bright, CD31-, CD62L-, and is also enriched in cells that brightly express CD49c, CD49e, and CD49f. Only a minority of the cells are activated, as indicated by expression of CD69. The EC were found to play a central role in facilitating migration of this subset because selective enrichment of CD11abright, CD26bright, CD44bright, CD4+ T cells was not observed when cells migrated in the absence of EC. Activation of the T cells induced a modest degree of migration of an additional subset of CD45RA+, CD31+ naive T cells. In contrast, TNF-alpha activation of the EC increased the transendothelial migration of an additional subset of activated memory T cells that expressed CD69 and CD62L. Neither activation of the T cells, stimulation of the EC, nor the presence of macrophage inflammatory protein-1 alpha (MIP-1 alpha) or RANTES, however, altered the phenotype of the majority of the migratory CD4+ T cell population, which is characteristic of a particular stage of memory cell differentiation. These results suggest that CD4+ T cells acquire the capacity for transendothelial migration at a specific phase of maturation that is only minimally altered by the activation of either the T cell or the EC, or by the presence of specific chemokines in the subendothelial matrix.

Antigens, CD↗
PubMed1992

Randomised trial of continuous nasogastric, bolus nasogastric, and transpyloric feeding in infants of birth weight under 1400 g.

Forty three infants under 1400 g were fed by a bolus nasogastric, continuous nasogastric, or transpyloric route. There were more complications with transpyloric feeding and no identifiable benefits in the growth rate, oral energy input, or chosen biochemical indices of nutrition. Bolus or continuous nasogastric feeds rather than transpyloric are better routine methods in infants of low birth weight.

Energy Intake↗
PubMed1991

Neonatal listeriosis in Scotland.

Thirty-one cases of neonatal listeriosis occurred in Scotland between 1 January 1987 and 31 August 1989. In each of these, Listeria monocytogenes was cultured from blood, cerebrospinal fluid or both. No case of neonatal listeriosis occurred between 1 September 1989 and 31 July 1990, a statistically significant difference in incidence (p less than 0.001). A possible explanation may be that pregnant women adjusted their diet in accordance with the advice given by the Chief Medical Officer in his letter to General Practitioners of February 1989 entitled 'Food and Listeriosis'. Full clinical features and outcome of nineteen of the thirty-one cases were obtained from the paediatricians responsible for their care. Of these, sixteen were early onset and three late onset cases. There were eight deaths, all early onset cases. Two severely asphyxiated infants could not be resuscitated and of the five infants who required assisted ventilation from birth, four died. Four early onset and three late onset cases presented with pyogenic meningitis and all seven recovered without sequelae. It is concluded that when neonatal listeriosis presents as an asphyxiated infant who, after resuscitation, requires assisted ventilation, a fatal outcome is probable. When neonatal listeriosis presents as pyogenic meningitis, recovery without sequelae is the usual outcome.

Anti-Bacterial Agents↗
PubMed1990

Visceral leishmaniasis in a Scottish child.

A Scottish girl acquired visceral leishmaniasis (kala-azar) while on holiday in Majorca. She presented with the infection, six months later, in Scotland. Because of inexperience with the disease and a degree of scepticism unnecessary investigations were carried out resulting in a delay in treatment.

Female↗