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Biomedical subjects

P Kelly

Publications and source records attributed to P Kelly.

At least 109 records · Page 6Linked to original sources
PubMed1997

Superovulation in cattle: effect of FSH type and method of administration on follicular growth, ovulatory response and endocrine patterns.

Although different FSH preparations and injection regimens are used to superovulate cattle, the optimum treatment regimen and blood concentrations of FSH to induce effective superovulatory responses are currently not known. The current objective was to evaluate the pattern of follicular growth, oestradiol-17 beta(E2) concentrations and yield of embryos in heifers following superovulation with two different pFSH preparations reportedly differing in LH content. In experiment 1, 90 synchronised heifers were superovulated at mid-cycle using a 2 x 2 factorial design comparing Folltropin (Vetrepharm; low LH) with Pluset (Serovet; FSH:LH ratio 1:1) administered either as a single or multiple (8 for Folltropin, MF and 10 for Pluset, MP) injections. Animals were inseminated during oestrus which was induced with prostaglandin F2 alpha analogue and embryos were recovered 7 days later. Overall, Pluset treatments compared with Folltropin resulted in more ovulations and unfertilized or degenerate embryos (P < 0.05). Multiple injections resulted in more (P < 0.05) freezable (MF = 55 +/- 1.2; MP = 3.8 +/- 1.0) and transferable embryos (MF = 2.68 +/- 0.9; MP = 2.71 +/- 0.9) than single injections (SF = 2.2 +/- 0.5 and 1.0 +/- 0.3 respectively; SP = 2.6 +/- 0.8 and 1.3 +/- 0.4 respectively); there was also a higher (P < 0.05) percentage embryo recovery rate. In two subsequent experiments, animals (n = 17) were superovulated with either single or multiple injections of Folltropin or Pluset as described and blood samples were collected and analysed for E2 concentrations. Ovarian scanning was carried out until 72 h after the first FSH injection, to count medium (5-9 mm) and large (> or = 10 mm) follicles. Heifers treated with SP had higher E2 concentrations in comparison with heifers treated with SF at 18, 36-48 and 84-96 h after the FSH injection. There were no differences in E2 concentrations in heifers treated with MF or MP treatments. Heifers treated with SP had greater numbers of follicles compared to SF treated heifers (21.0 +/- 3.1 vs 13.9 +/- 2.2; P = 0.089) on the third day after FSH injection. There were no differences between the numbers of medium and large follicles in heifers treated with MF or MP at any time throughout the experimental period. These data indicate that a single injection of Folltropin or Pluset can result in multiple ovulations and that the E2 profiles are different following single injections of either Folltropin or Pluset.

Animals↗
PubMed1997

Paramyotonia congenita and hyperkalemic periodic paralysis associated with a Met 1592 Val substitution in the skeletal muscle sodium channel alpha subunit--a large kindred with a novel phenotype.

Paramyotonia congenita (PC) and Hyperkalemic periodic paralysis (HyperPP) are caused by amino acid substitutions in the alpha subunit of the human skeletal muscle sodium channel. One such substitution, methionine for valine at position 1592, has been associated with HyperPP with myotonia and cold sensitivity. We report clinical, electromyographic (EMG), genetic and pathological features of a large kindred with the Met1592Val substitution. Affected members were phenotypically heterogenous and had episodic potassium-sensitive paralysis, and stiffness and weakness induced by exercise and cold, which was confirmed by EMG studies. These features indicate a combined PC-HyperPP phenotype not previously described with this mutation.

Adult↗
PubMed1997

Exposure of cats in southern Africa to Coxiella burnetii, the agent of Q fever.

Recently, the domestic cat has been implicated in numerous outbreaks of Q fever in humans. To determine if cats in southern Africa are infected with the agent of Q fever we tested sera from cats in South Africa and Zimbabwe by indirect fluorescence for antibodies reactive with phase II Coxiella burnetii antigen (Nine Mile strain). Reactive antibodies were detected at titres of > or = 1/40 in sera from cats in South Africa (1/52, 2%) and Zimbabwe (15/119, 13%). Our results indicate that cats in southern Africa are infected with C. burnetii and should be considered as sources of infection for humans.

Animals↗
PubMed1997

Domestic cats as indicators of the presence of spotted fever and typhus group rickettsiae.

Using indirect immunofluorescence assays, sera from cats in Zimbabwe (n = 119) and South Africa (n = 52) were found to contain antibodies reactive with Rickettsia conorii (34% and 19% respectively) and R. typhi (7% and 10% respectively). These results indicate that cats may become infected with members of the spotted fever and typhus groups of rickettsiae and that cats can, therefore, be used as indicators of the presence of these organisms.

Animals↗
PubMed1997

Cryptosporidiosis in adults in Lusaka, Zambia, and its relationship to oocyst contamination of drinking water.

In Lusaka, where human immunodeficiency virus seroprevalence in young adults is approximately 25%, four townships were studied to establish the prevalence of persistent diarrhea in adults and the etiologic importance of cryptosporidiosis in adults with persistent diarrhea. Cryptosporidium parvum oocyst contamination of urban water supplies was measured and the results used to categorize these populations into high or low exposure. In total, 506 adults were reported as having had diarrhea in the 2 weeks prior to the survey; 101 of these episodes were persistent. Adults with persistent diarrhea in the high-exposure areas were more likely to have cryptosporidiosis (odds ratio, 5.14; 95% confidence interval, 1.57-17.2; risk ratio, 1.83; 95% confidence interval, 1.04-3.21; P = .003) although overall prevalence of persistent diarrhea was not greater in these areas. This association was not confounded by animal exposure, travel, or boiling water. Within these urban populations, water contamination with C. parvum was a major influence on the prevalence of infection.

Adult↗
PubMed1997

Unmetabolized folic acid in serum: acute studies in subjects consuming fortified food and supplements.

Periconceptual consumption of folic acid has been shown to decrease the incidence of neural tube defects. The strategy of universal fortification of staple foodstuffs with folic acid presents the possibility of life-long exposure to unmetabolized folic acid. Chief among the risks of exposure to folic acid in the circulation is that of masking the diagnosis of cobalamin deficiency in pernicious anemia and the progression of neurologic disease. Other effects are unknown. For instance, the effect of in vivo chronic exposure of adult and fetal cells to the synthetic form of the vitamin has never been investigated at the population level. This study examined the acute appearance of unmetabolized folic acid in serum in response to the consumption of some fortified foodstuffs by young and elderly volunteers. Subjects on a 5-d regimen of fortified ready-to-eat-cereal and bread in addition to their normal diet had a threshold intake of 266 micrograms folic acid per meal at which unaltered folic acid appeared in the serum. Subjects given folic acid in either isotonic saline, milk, or white bread also had a threshold > 200 micrograms. From patterns of food consumption in the United States, the implementation of flour fortification at 1.4 mg/kg is unlikely to lead to folic acid appearance in serum, assuming that consumption is spread throughout the day. Increasing this level of fortification, however, as has been advocated by some agencies, may result in the repeated appearance of folic acid in serum over many years, particularly in consumers in nontargeted populations of large amounts of fortified foods. The "safe level of intake" of 1 mg folate/d set by the US Food and Drug Administration may cause a serum folic acid effect. Furthermore, a repeated serum folic acid response is likely to be found in many women complying with the advice to take 400 micrograms folic acid/d to prevent the occurrence of neural tube defects.

Adolescent↗
PubMed1997

Sclerosing cholangitis, race and sex.

BACKGROUND: Primary sclerosing cholangitis develops in 3-10% of patients with ulcerative colitis, and may be associated with an increased cancer risk. Ulcerative colitis is probably less common in people of African origin than in populations of European descent. AIMS AND METHODS: To review the records of all patients under regular follow up for ulcerative colitis at St Bartholomew's Hospital (London, UK), a tertiary referral centre, prompted by discovering a cluster of cases with common features. RESULTS AND CONCLUSIONS: Among 166 patients with ulcerative colitis under regular follow up, only four (all women) are of African or Caribbean genetic origin, and three of these have developed sclerosing cholangitis within three years of presentation with colitis, compared with four of 162 patients of European or Asian descent (odds ratio 119, 95% confidence interval 8-3837; p = 0.0002). This cluster, which is not explained by common HLA DR or DQ type, suggests that Africans and Afro-Caribbeans, especially women, may be at increased risk of sclerosing cholangitis. This may reflect genetic influences on the development of enteric and hepatobiliary inflammatory disease.

Adolescent↗
PubMed1997

Enteropathy in Zambians with HIV related diarrhoea: regression modelling of potential determinants of mucosal damage.

BACKGROUND: AIDS is characterised by small intestinal mucosal damage, but its aetiopathogenesis is poorly understood. Enteric infections in Africa differ from those in northern countries, where protozoan infections have been associated with severe enteropathy in AIDS patients. AIMS: To characterise enteropathy in Zambian AIDS patients compared with local controls, and to assess relative contributions of enteric infection, nutritional impairment, and immune dysfunction. METHODS: Computer aided mucosal morphometry of small intestinal biopsy specimens from 56 HIV infected Zambians with persistent diarrhoea and 26 diarrhoea free controls, followed by regression modelling. RESULTS: Patients with HIV related diarrhoea had reduced villous height and increased crypt depth compared with controls. There was no difference between HIV positive and negative controls. In regression models applied to AIDS mucosal measurements, villous height and crypt depth were related to nutritional parameters and to serum soluble tumour necrosis factor receptor p55 concentration. Crypt depth was also related to lamina propria plasma cell count. Intestinal infection was found in 79%, which consisted predominantly of microsporidia in 34%, Isospora belli in 24%, and Cryptosporidium parvum in 21%, but detection of these enteropathogens was not related to severity of enteropathy. CONCLUSIONS: Nutritional and immune disturbances were associated with enteropathy, accounting for over one third of the variation in mucosal morphometric parameters.

Adolescent↗
PubMed1997

Left-right differences in motor thresholds after stimulation of the globus pallidus before pallidotomy.

Left-right upper limb motor threshold differences were found after electrical stimulation of the globus pallidus administered as a neuroprotective measure to avoid lesioning of the internal capsule during stereotactic pallidotomy for treatment of Parkinson's disease. Left sided stimulation resulted in lower thresholds in right handed patients compared with left handed patients. These differences were significant in women, but no significant differences were found in men. In patients undergoing bilateral pallidotomy, the stimulation produced more significant left-right motor threshold differences. In the absence of known sex-related anatomical left-right corticospinal tract differences, the variability was the result of spinal excitability modulations most likely related to handedness.

Electric Stimulation↗
PubMed1997

Preoperative indicators of clinical outcome following stereotaxic pallidotomy.

We assessed the utility of preoperative clinical assessment and functional brain imaging with 18F-fluorodeoxyglucose (FDG) and positron emission tomography (PET) in predicting the clinical outcome of stereotaxic pallidotomy for the treatment of advanced Parkinson's disease (PD). Twenty-two PD patients undergoing posteroventral pallidotomy were assessed preoperatively with the Core Assessment Program for Intracerebral Transplantation (CAPIT) ratings measured on and off levodopa; quantitative FDG/PET was also performed before surgery. Preoperative clinical and metabolic measurements were correlated with changes in off-state CAPIT ratings determined 3 months after surgery. Clinical outcome following pallidotomy was also correlated with intraoperative measures of spontaneous pallidal single-unit activity as well as postoperative MRI measurements of lesion volume and location. We found that unilateral pallidotomy resulted in variable clinical improvement in off-state CAPIT scores for the contralateral limbs (mean change 30.9 +/- 15.5%). Postoperative MRI revealed that pallidotomy lesions were comparable in location and volume across the patients. Clinical outcome following surgery correlated significantly with preoperative measures of CAPIT score change with levodopa administration (r = 0.60, p < 0.005) and with preoperative FDG/PET measurements of lentiform glucose metabolism (r = 0.71, p < 0.0005). Operative outcome did not correlate with intraoperative measures of spontaneous pallidal neuronal firing rate. We conclude that preoperative measurements of lentiform glucose metabolism and levodopa responsiveness may be useful indicators of motor improvement following pallidotomy. Both preoperative quantitative measures, either singly or in combination, may be helpful in selecting optimal candidates for surgery.

Aged↗
PubMed1997

Expediting the turnaround of radiology reports in a teaching hospital setting.

OBJECTIVE: The purpose of this study was to determine whether total quality management (TQM) techniques that had proved successful in a pilot study in one departmental section of a teaching hospital could be generalized for use by the entire radiology department. MATERIALS AND METHODS: Each departmental section developed interventions to improve its report turnaround time. These interventions were tailored to practice style and habits of each section. Commonly used interventions included electronic signature from the radiologist's home, a report-signing buddy system, elimination of a trainee signature requirement, accelerated transcription, structured reports, faster film delivery to reading desks, and training about the importance of radiology reports for clinical decision making. Specialized programs included computerized form-driven reporting and reports generated directly by computer voice recognition of radiologists' dictation. Our radiology information system provided data on each step in the reporting process. RESULTS: The TQM approach produced significant improvements in departmental total report turnaround time (-55%; p = .001), transcription time (-80%; p = .003), and signature time (-68%; p = .0004). Each section achieved significant gains. The sonography section initiated a computerized, form-driven reporting system and outperformed the rest of the department. CONCLUSIONS: TQM techniques can be expanded and generalized for department-wide projects in teaching hospitals.

Communication↗
PubMed1997

Neonatal BCG vaccination in Ireland: evidence of its efficacy in the prevention of childhood tuberculosis.

Data from the 1986 and 1991 National Tuberculosis Survey were used, together with the Census of Population for those years, to try and determine whether bacille Calmette-Guerin (BCG) vaccination policy had any influence on the reported incidence of tuberculosis in the Republic of Ireland. The age-specific incidence of tuberculosis for the country as a whole and for local areas, was determined with respect to neonatal BCG vaccination. Based on these data, the reported incidence of tuberculosis in people aged 15 yrs or younger in areas without a policy of neonatal BCG was shown to be significantly higher compared to areas that use neonatal BCG vaccination (p = 1.5x10(-5) in 1986; and p = 1.0x10(-7) for 1991). It was estimated that some 646 vaccinations needed to be given to prevent one case of tuberculosis in 1986, and that the figure for 1991 was 551 vaccinations. This evidence supports a policy of continued neonatal bacille Calmette-Guerin vaccination in the population of the Republic of Ireland at present.

Adolescent↗
PubMed1996

Postal questionnaire study of disability in the community associated with psoriasis.

OBJECTIVE: To study the disability caused by psoriasis in patients recorded as having psoriasis by their general practitioner. DESIGN: Postal questionnaire survey using the psoriasis disability index and SF-36. SETTING: Five general practices in Cleveland. SUBJECTS: Of 767 patients identified, 546 completed the questionnaire and 435 were eligible and gave informed consent. MAIN OUTCOME MEASURES: Scores on SF-36 and psoriasis disability index. RESULTS: The psoriasis disability index score was highly negatively correlated with all eight of the SF-36 health measures (P < 0.0001 for each), and the manual social classes scored higher than the non-manual social classes (P < 0.0001). The manual social class group scored significantly lower scores than the controls on all the SF-36 scales, and the non-manual group scored significantly lower for physical and mental role limitation (P < 0.0004 and P = 0.026), mental health (P < 0.0001), energy and vitality (P < 0.0004), and health perception (P < 0.0001). Also, the manual group had poorer health perception on five of the SF-36 variables when compared with the non-manual group. CONCLUSIONS: Patients with psoriasis have an overall lower perception of their quality of life than healthy controls, and those in the lower social classes suffer a greater degree of disability from their disease than the higher social classes.

Attitude to Health↗
PubMed1996

Alcohol and drug use in UK university students.

BACKGROUND: Alcohol and illicit drug use are increasing among school children and young adults in the UK. Such increases have also been noted among university students and there is a need for a large survey across different universities and faculties. We report such a survey. METHODS: Information about drinking, use of cannabis and other illicit drugs, other lifestyle variables, and subjective ratings of anxiety and depression was obtained by questionnaire in a cross-faculty sample of 3075 second-year university students (1610 men, 1447 women, 18 sex not stated) from ten UK universities. The questionnaire was personally administered during scheduled lecture hours and almost all the students participated. The sample reflected the interfaculty and sex distribution and the proportion of non-white students at UK universities. FINDINGS: 11% of the students were non-drinkers. Among drinkers, 61% of the men and 48% of the women exceeded "sensible" limits of 14 units per week for women and 21 for men. Hazardous drinking (> or = 36 units per week for women, > or = 51 for men) was reported by 15% of the drinkers. Binge drinking was declared by 28% of drinkers. 60% of the men and 55% of the women reported having used cannabis once or twice and 20% of the sample reported regular cannabis use (weekly or more often). Experience with other illicit drugs was reported by 33% of the sample, most commonly LSD (lysergic acid diethylamide), amphetamines, Ecstasy (methylenedioxymethamphetamine), and amyl/butyl nitrate which had each been used by 13-18% of students. 34% of these had used several drugs. Drug use had started at school in 46% of the sample; 13% began after entering university. The overwhelming reason given for taking alcohol or drugs was pleasure. Subjective ratings of anxiety on the hospital anxiety depression scale were high, and sleep difficulties were common, but neither related to alcohol or drug use. INTERPRETATION: There is a need for better education about alcohol, drugs, and general health in universities. Such education should include all faculties. It remains unclear whether university students' lifestyles are carried over into later life.

Adolescent↗
PubMed1996

A combined high-performance liquid chromatographic-microbiological assay for serum folic acid.

An assay of folic acid in human serum is described involving HPLC fractionation of deproteinized serum prior to Lactobacillus casei assay. High specific activity [3H]folic acid is added as internal standard to 1 ml serum prior to deproteinization with perchlorate and an aliquot is applied to a C18 reverse-phase HPLC column. The folic acid fraction was assayed by L. casei microtiter plate assay. Intra- and interassay variations (CV) were 5.5 and 7.5% respectively for sera (n = 10) spiked with folic acid. The percentage recovery for folic acid additions of 10 and 20 ng/liter were 105.2 and 103.7%, respectively. The lower limit of detection was 1 ng folic acid/ml serum. Folates other than folic acid and 5-methyltetrahydrofolate were not detected. The assay permitted serial measurements to be made of folates in serum following an oral dose.

Administration, Oral↗
PubMed1996

Albendazole chemotherapy for treatment of diarrhoea in patients with AIDS in Zambia: a randomised double blind controlled trial.

OBJECTIVE: To determine the value of short course, high dose albendazole chemotherapy in the treatment of persistent diarrhoea related to HIV in unselected patients in urban Zambia. DESIGN: A randomised double blind placebo controlled trial of albendazole 800 mg twice daily for two weeks. Patients were monitored intensively for one month and followed for up to six months. SETTING: Home care. AIDS services in Lusaka and Ndola. PATIENTS: 174 HIV seropositive patients with persistent diarrhoea (defined as loose but not bloody stools three or more times a day for three weeks or longer). No investigations were undertaken except HIV testing after counselling. MAIN OUTCOME MEASURES: Proportion of time periods during which diarrhoea was experienced after completion of treatment; proportion of patients with full remission after completion of treatment; mortality. RESULTS: The patients taking albendazole had diarrhoea on 29% fewer days than those taking placebo (P < 0.0001) in the two weeks after treatment. The benefit of albendazole was maintained over six months. In patients with a Karnofsky score of 50 to 70 (needing help with activities of daily living and unable to work, but not needing admission to hospital) diarrhoea was reduced by 50%. Remission was obtained in 26% of all patients who received albendazole (P = 0.004 against 9% receiving placebo), and this difference was maintained over six months (log rank test, P = 0.003). Albendazole had no effect on mortality. Minimal adverse effects were noted. CONCLUSIONS: For HIV infected Zambians with diarrhoea of more than three weeks' duration albendazole offers substantial relief from symptoms and may be used empirically, without prior investigation.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Health-related quality of life of HIV-infected women: evidence for the reliability, validity and responsiveness of the Medical Outcomes Study Short-Form 20.

The purpose of this study was to assess the reliability, validity and responsiveness of a health-related quality of life (HRQOL) instrument, the Medical Outcomes Short-Form 20-Item General Health Survey (MOS SF-20), in a sample of women with the human immunodeficiency virus (HIV). Longitudinal data were collected on 202 HIV-infected women without AIDS who were receiving care at Kings County Hospital or SUNY Health Sciences Center, Brooklyn, New York. Internal consistency results showed acceptable reliability for the four multi-item MOS scales (role function, physical function, general health perceptions and mental health). Symptomatic patients and patients with lower Karnofsky Performance Status (KPS) ratings reported lower HRQOL than those who were asymptomatic or who had higher KPS scores. Patients who were older, unemployed or who had a history of injection drug use (IDU) also reported lower HRQOL than those who were younger, employed or who had no drug use history. Adjusted mean scores on the MOS role and physical functioning scales proved sensitive to differences in clinical status over time. The MOS SF-20 is a reliable and valid instrument of HRQOL for women with HIV infection. Its sensitivity to differences in clinical status over time suggest that it may be useful as an HRQOL indicator for HIV/AIDS clinical trials.

Adult↗