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Biomedical subjects

P Hackett

Publications and source records attributed to P Hackett.

At least 19 recordsLinked to original sources
PubMed2001

Effects of insert size on transposition efficiency of the sleeping beauty transposon in mouse cells.

Transposon vectors are widely used in prokaryotic and lower eukaryotic systems. However, they were not available for use in vertebrate animals until the recent reconstitution of a synthetic fish transposon, Sleeping Beauty ( SB). The reacquisition of transposability of the SB transposase fostered great enthusiasm for using transposon vectors as tools in vertebrate animals, particularly for gene transfer to facilitate accelerated integration of transgenes into chromosomes. Here, we report the effects of insert sizes on transposition efficiency of SB. A significant effect of insert size on efficiency of transposition by SB was found. The SB transposase enhanced the integration efficiency effectively for SB transposon up to approximately 5.6 kb, but lost its ability to enhance the integration efficiency when the transposon size was increased to 9.1 kb. This result indicates that the SB transposon system is highly applicable for transferring small genes, but may not be applicable for transferring very large genes.

Journal Article↗
PubMed2000

Pharmacokinetics of ropivacaine following caudal analgesia in children.

Ropivacaine has a favourable toxicity profile for epidural anaesthesia in adults, so it may also be an appropriate agent for epidural analgesia in children. We therefore designed this study to determine the pharmacokinetic variables of ropivacaine relevant to the risk of toxicity, after caudal administration in children. We studied nine healthy children, aged 1-6 years who received 1 ml.kg-1 of ropivacaine 0.25% for caudal analgesia. Venous blood samples were collected at intervals for 12 h after injection. Total plasma concentration of ropivacaine was assayed by high performance liquid chromatography, and pharmacokinetic descriptors were estimated from the plasma concentration-time data. The median peak venous plasma concentration was 799 microg.l-1 [interquartile range (IQR) 707-1044 microg.l-1], and was reached at a median time of 1.5 h (IQR 0.5-2 h). The mean elimination half-life was 3.9 h (95% CI 2.7-5.0 h), and the mean apparent clearance and volume of distribution were 7.6+/-1. 6 ml.min-1.kg-1 (95% CI 6.1-9.1 ml.min-1.kg-1) and 2.4+/-0.6 l.kg-1 (95% CI 1.9-3.0 l.kg-1), respectively. Analgesia was satisfactory in all cases and no systemic ropivacaine toxicity was observed. Caudal administration of weight-adjusted doses of ropivacaine to children resulted in systemic exposure similar to that reported for adults. No systemic toxicity was observed. The findings strengthen predictions that the relative systemic safety of epidural ropivacaine in adults will apply to children. However, the pharmacokinetics and safety of epidural ropivacaine need to be studied further in children with circumstances that affect drug disposition and systemic tolerance.

Adult↗
PubMed1996

Professional responses to innovation in clinical method: diabetes care and negotiating skills.

OBJECTIVE: To describe the responses of family doctors and nurses to applying an innovative clinical technique and technology in the context of a randomised controlled trial. DESIGN: Multi-faceted descriptive analysis of professional responses in the experimental arm of the trial. SUBJECTS AND SETTING: 29 family practices involving 30 doctors and 33 nurses over a 3-year time scale and 200 patients with type II diabetes. INTERVENTION: A new visual agenda-setting technology and other visual aids applied using the techniques of negotiation and motivational interviewing. OUTCOME MEASURES: Uptake of training, use of the method, group discussions, willingness to accept consultation recordings. RESULTS: 100% of clinicians welcomed two or more formal training sessions. The agenda-setting technology was used frequently by 71% of clinicians and occasionally by a further 22%. High levels of engagement with the method occurred among nurses but many doctors also reported benefits. CONCLUSIONS: Family doctors and nurses in Wales have found a new technology to facilitate negotiation in diabetes consultation acceptable and useful. Analysis of outcome is now awaited.

Attitude of Health Personnel↗
PubMed1996

A comparison of methods for measuring patient satisfaction with consultations in primary care.

BACKGROUND: Attention needs to be paid to comparing and standardizing methods for measuring patient satisfaction with consultations in primary care. OBJECTIVES: To compare the Medical Interview Satisfaction Scale (MISS) and the Consultation Satisfaction Questionnaire (CSQ) in terms of acceptability, distribution of responses, reliability and gather evidence of validity. In addition, to compare the scores of patients completing the questionnaires immediately after the consultation in the general practitioners' surgeries with those completing the questionnaires later at home. METHODS: The two questionnaires were bound as a single instrument with order determined at random. This was given to patients immediately after their consultations in eight practices in South Glamorgan. RESULTS: One hundred and ninety-eight of 316 (63%) patients completed and returned questionnaires. The distributions of patient satisfaction scores for the two questionnaires were very similar. For the MISS: mean 76.6% (SD 11.4); for the CSQ mean 7.2% (SD 12.6). Correlations between sub-scales ranged from 0.58-0.84 for the MISS and from 0.40-0.79 for the CSQ. The correlation between the overall scales was 0.82. Levels of reliability for the scales and sub-scales were fair to good ranging from 0.78-0.96 for the MISS and from 0.73-0.94 for the CSQ. CONCLUSIONS: The study does not identify one scale as being superior in psychometric terms, however by demonstrating consistency of responses it provides support for the scales as measures of patient satisfaction for use in primary care. The level of inter-correlation suggests that the sub-scales may not be clearly independent of each other and suggests that total scores may be preferred. Lower levels of satisfaction are expressed if patients complete questionnaires at home rather than in general practitioners' surgeries.

Adolescent↗
PubMed1991

Importance of the CArG box in regulation of beta-actin-encoding genes.

The beta-actin-encoding gene (Act) in carp is regulated by several cis-acting regulatory elements including the evolutionarily conserved CC(A/T)6GG (CArG box or serum-response element) sequences positioned in the promoter region between the CAAT and TATA boxes and in the first intron. To address the roles of the two CArG boxes on gene expression, we replaced them with linker sequences. The CArG box in the proximal promoter was not required for promoter activity in tissue-cultured cells, but was required in conjunction with a second CArG box in the first intron to give full expression in transgenic embryos. Likewise, the geometry of cis-acting transcriptional elements in the proximal promoter was more important for expression of transgenic constructs in developing embryos than in tissue-cultured fibroblasts. Mobility-shift and exonuclease mapping experiments indicated that the same or similar protein factors bind around the two CArG boxes, suggesting that interactions between the promoter and the first intron are involved in Act regulation.

Actins↗
PubMed1991

The psychological benefit of orthodontic treatment. Its relevance to dental health education.

In March 1989 the third stage of a major longitudinal survey examining the psychological, social and dental effects of malocclusion and the effectiveness of orthodontic treatment was undertaken. The aim of the research was to assess the benefit of receiving dental treatment with a particular interest in orthodontic treatment. The benefits investigated were dental, psychological and social. The project has involved researchers in several professional disciplines from locations in Britain and Europe.

Child↗
PubMed1989

Myoclonus associated with treatment with high doses of morphine: the role of supplemental drugs.

OBJECTIVE: To estimate the prevalence of important side effects in patients with malignant disease who were receiving high doses of morphine as part of their palliative treatment. DESIGN: Data on patients were collected over 12 months. SETTING: Two palliative care units in Western Australia. PATIENTS: 19 Patients with malignant disease who were receiving morphine either subcutaneously or orally as the main analgesic. 10 Patients receiving a total daily dose of morphine of at least 500 mg orally or 250 mg parenterally were enrolled in the study. The other 9 patients were enrolled after an important problem thought to be related to the morphine had been identified. All of the patients were taking drugs to supplement the treatment. INTERVENTIONS: The dose of morphine or route of administration, or both, was changed in three patients. MAIN OUTCOME MEASURE: Determination of the prevalence of side effects in the patients. Assessment of the relation of any side effects with the supplemental drugs taken by the patients. MAIN RESULTS: Plasma morphine and electrolyte concentrations were measured and a full history taken for each patient. Thirteen of the 19 patients had an important side effect; 12 of them had myoclonus and one had hyperalgesia of the skin. Plasma morphine concentrations were similar in patients with and without myoclonus, ranging from 158 to 3465 nmol/l and 39 to 2821 nmol/l respectively. Eight of the patients with side effects were taking an antipsychotic drug concurrently compared with none of those without side effects. A greater proportion of patients with side effects were taking the antinauseant drug thiethylperazine (6/13 v 2/6) and at least one non-steroidal anti-inflammatory drug (10/13 v 2/6), whereas a smaller proportion were taking a glucocorticosteroid (3/13 v 4/6). The estimated prevalence of important side effects in the total population of patients receiving palliative treatment in the two units was 2.7-3.6%. CONCLUSIONS: Myoclonus as a side effect of treatment with morphine is more likely to occur in patients taking antidepressant or antipsychotic drugs as antiemetics or as adjuvant agents or non-steroidal anti-inflammatory drugs for additional analgesia. If a patient develops myoclonus the best approach may be to change the supplemental treatment.

Adult↗
PubMed1986

Repetitive visual images in severe war head injuries.

Out of 20 young inpatients who suffered missile head injuries, two (10%) presented repetitive visual images (RVI). The RVI appeared during wakefulness when relaxed with closed eyes and also at sleep stage I, II and REM, at sleep onset and at sleep end. When the two patients were compared neurologically and psychologically with the other eighteen, the coexistence of combat stress syndrome, diffuse brain lesions, right non-dominant associative area damage and homonymous hemianopia characterised the two RVI patients. RVI do not appear in the absence of the combat stress syndrome even in the presence of the other 3 factors. The sleep may be secondarily contaminated by wakefulness RVI. The presence of disturbed REM temporal distribution and short REM latency indicate the depressive state of these patients. It is hypothesised that a similar brain activity in wakefulness and REM sleep explain the wake dreaming or wakefulness RVI of those patients.

Adult↗
PubMed1982

High altitude retinal hemorrhage: a clinical and pathological case report.

Retinal hemorrhages may occur at high altitudes. They occur more commonly in association with acute mountain sickness and particularly with high-altitude cerebral edema. We describe a 27-year-old man who experienced retinal hemorrhages as well as papilledema and coma at 5,330-m altitude and who died four days later, one day after evacuation to 1,300-m altitude. At autopsy, we found papilledema and hemorrhages in the nerve fiber layer. These were sometimes distant from areas where there were arterioles and venules. There was perivascular red cell infiltration. Deeper layers of the retina were intact. We conclude that the hemorrhages were form both retinal capillaries and veins and we speculate that hypoxia, with or without the Valsalva effect, was the cause of the endothelial damage.

Adult↗
PubMed1980

The value of electroencephalography in prolonged coma: a comparative EEG-computed axial tomography study of two patients one year after trauma.

Interest was aroused in two patients of 16 and 17 years of age and similar craniocerebral trauma, but who had differing EEG's 1 year after injury while their later situation was the reverse of what the EEG would have led one to expect. The patient with an iso-electric EEG showed clinical improvement during the course of the second year, as indicated by a rise in his Glasgow coma rating from 8 to 11. This patient had marked cortical atrophy with discrete central atrophy, shown by computed axial tomography (CT); the isotope cisternogram showed good peripheral absorption of the isotope and no penetration into the ventricles. The other patient showed diffuse slow-wave activity in his EEG but failed to improve clinically or electroencephalographically. His CT-scan showed marked central and discrete cortical atrophy; his isotopic cisternogram showed penetration of isotope into the ventricles with poor peripheral absorption. These two cases illustrate the hazard of relying on an iso-electric EEG after 1 year of coma as an indicator of brain death, and the value of the CT-scan in the initial assessment of such cases.

Adolescent↗
PubMed1980

Rehabilitation outcome of brain damaged patients after severe head injury.

The multidisciplinary team approach to the prolonged treatment of head injured patients in widely discussed. The rehabilitation process of the 147 subjects of this paper started while they were comatose and continued throughout the various stages of their progress towards full integration into society; the assessment of this process was carried out by testing their reintegration into work according to their capacities. Brain damage is classified in four categories: Physical-locomotor, communicative, cognitive and behavioural. The gap between the team's expectations and the patients' factual functioning within the community was found to be proportional to the extent of damage caused by the original injury. Treatment procedures and the influence of various factors on the factual functional state are discussed at length.

Adolescent↗