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Biomedical subjects

P M Scott

Publications and source records attributed to P M Scott.

At least 19 recordsLinked to original sources
PubMed1995

Screening surgeons for HIV infection. A cost-effectiveness analysis.

UNLABELLED: OBJECTIVE. To determine the cost-effectiveness of a policy to screen surgeons for human immunodeficiency virus (HIV) infection to prevent transmission of HIV to patients having invasive procedures. DESIGN: Cost-effectiveness analysis. RESULTS: A one-time national screening program would identify approximately 137 surgeons with HIV infection (range, 28 to 423 surgeons) and would prevent approximately 4.3 infections (range, 1.9 to 21.3 infections) in patients treated by infected surgeons and 0.9 infections (range, 0 to 12.9 infections) in sexual partners of infected surgeons at a direct cost of $8.1 million and an induced cost of approximately $44 million. It would result in expenditures of $458,000 per year of life saved (range, $147,000 to $687,000 per year of life saved), whereas an annual screening program would result in expenditures of approximately $1.1 million per year of life saved (range, $338,000 to $1,886,000 per year of life saved). If the prevalence of HIV infection in surgeons is estimated to be three times our base-case estimate (an increase from 0.1% to 0.3%), annual screening would result in expenditures of approximately $741,000 per year of life saved. If the probability of seroconversion after a patient is exposed to a contaminated instrument is increased to 5.0% from our base-case estimate of 0.29%, an annual screening program would still cost more than $228,000 per year of life saved. CONCLUSION: Screening surgeons for HIV to prevent transmission of HIV to patients having invasive procedures requires expenditures per year of life saved that are considerably in excess of those of most accepted health interventions. Surveillance studies of patients treated by surgeons infected with HIV should be continued to confirm that transmission of HIV to patients having invasive procedures is rare.

Cost-Benefit Analysis↗
PubMed1994

Cervical necrotizing fasciitis and tonsillitis.

We present a case of cervical necrotizing fasciitis following quinsy in a previously fit and healthy man. This is a potentially fatal condition with few specific clinical signs that requires early diagnosis and surgical debridement. Other features of the disease are discussed.

Anti-Bacterial Agents↗
PubMed1994

Determination of fumonisins in milk.

Fumonisin B1 (FB1) and fumonisin B2 (FB2) were determined in milk by liquid chromatography (LC) following immunoaffinity column cleanup. Recoveries from milk spiked with 5-50 ng each fumonisin/ml averaged 79-109%. The aminopentol hydrolysis product of FB1 (AP1) was determined by LC after cleanup on a C18 solid phase phase extraction column; mean recoveries were 69-83% at spiking levels of 50-100 ng AP1/ml milk. Detection limits were of the order 3-7 ng/ml for FB1 and FB2, and 20-25 ng/ml for AP1. A stability study showed no losses of FB1 and FB2 in milk under conditions of freezing, refrigeration and boiling. A transmission study using four cows dosed with pure FB1 either orally (1.0 and 5.0 mg FB1/kg b.w.) or by i.v. injection (0.05 and 0.20 mg FB1/kg b.w.) showed no detectable residues of FB1 or AP1 in the milk, with or without hydrolytic treatment with beta-glucuronidase/sulfatase to liberate any conjugates.

Administration, Oral↗
PubMed1992

Augmentation rhinoplasty in nasal sarcoidosis.

We present a case of nasal deformity due to sarcoidosis. The surgical management is discussed. The risk of secondary involvement of implanted autologous cartilage by the disease is emphasized. For this reason an inert allograft (silastic) is recommended for augmentation in this group of patients.

Female↗
PubMed1991

Determination of patulin by capillary gas chromatography of the heptafluorobutyrate derivative.

Formation and capillary gas chromatography of patulin heptafluorobutyrate is reported for the first time. The derivative was identified by gas chromatography-mass spectrometry (M+ = 350). Electron-capture detector response for patulin heptafluorobutyrate was linear in the range 0.05 to 0.5 ng. This sensitive and reproducible derivatization technique was applied to the determination of patulin in apple juice by capillary gas chromatography-electron-capture detection. The overall method recovery averaged 84% and less than or equal to 10 micrograms/l could be detected.

Beverages↗
PubMed1991

Effect of weight on claudication distance.

Conservative measures to improve claudication distance include advice on smoking, exercise, diet and weight reduction. Although the effects of smoking, exercise and diet are established, the effect of weight is less clear. The aim of this study was to investigate the effect of carrying extra weight on the maximum walking distance in stable claudicants. Twenty stable claudicants were exercised on a treadmill (3.5 km/h, 0 degrees slope) carrying 0, 2.5, 5, 7.5 and 10 kg weights in randomized sequence. Maximum claudication distance and ankle: brachial pressure indices were recorded. Patients were categorized into mild or severe claudicants depending on their ability to walk 200 m. A response index (RI) was calculated as the reduction in claudication distance per kilogram load; RI = [CD0-CD10]/10 m/kg, where CD0 and CD10 represent claudication distance with 0 and 10 kg weights, respectively. Claudication distance was significantly reduced in subjects carrying 5 kg or more (P less than 0.01). A linear relationship was demonstrated between the mean claudication distance and the load carried (r = 0.98, P less than 0.01) with a mean response index of 10.2 m/kg. The mean(s.e.m.) RI in mild claudicants (25.9(9.5) m/kg) was greater than the value observed in the severe claudicants (3.3(0.8) m/kg; P less than 0.01, Mann-Whitney U test). This study demonstrates that weight adversely affects claudication distance and suggests that weight reduction may deserve greater emphasis in the management of some patients with intermittent claudication.

Adult↗
PubMed1991

Seasonal variation in the incidence of congenital talipes equinovarus.

A review of 77 neonates who presented with congenital talipes equinovarus over a seven-year period revealed an increase in the condition amongst babies born in the winter quarter. This finding was particularly apparent among the less severe cases of club-foot. Possible reasons for this seasonal variation are discussed.

Birth Rate↗
PubMed1990

Minimal transmission of zearalenone to milk of dairy cows.

Milk and plasma levels of zearalenone (ZEN), alpha-zearalenol (alpha-ZEL), beta-zearalenol (beta-ZEL) and conjugated metabolites were determined after feeding lactating cows with ZEN. In those instances where ZEN and alpha- and beta-ZEL were detected in milk or plasma, they occurred only as conjugates hydrolysable by treatment with a mixture of beta-glucuronidase and aryl sulfatase. With studies where 50 or 165 mg was fed daily to three cows for 21 day periods, neither dosage showed the presence of ZEN or metabolites in either milk or plasma (detection limits: milk, 0.5 ng/ml, ZEN, alpha-ZEL; 1.5 ng/ml, beta-ZEL; plasma, 2-3 times higher). A dose of 544.5 mg zearalenone per day given to a single cow for 21 days yielded maximum concentrations of only 2.5 ng ZEN/ml and 3.0 ng alpha-ZEL/ml in the milk. In plasma, up to 3 ng ZEN/ml could be detected during the initial 4 days of treatment. At a dose of 1.8 g of zearalenone given over a one day feeding period, maximum milk levels of 4.0 ng ZEN/ml, 1.5 ng alpha-ZEL/ml, and 4.1 ng beta-ZEL/ml were observed during the initial 2 days; corresponding maximum levels after a one day dose of 6.0 g zearalenone were 6.1, 4.0 and 6.6 ng/ml milk on days 2-3. In plasma, peak ZEN concentrations (9 and 13 ng/ml at the lower and higher one-day doses, respectively) occurred 12 hr after initial dosing, and declined to negligible levels by days 5-7. Neither alpha- nor beta-ZEL were detected in plasma. Since measurable levels required very high oral doses of ZEN, milk would not normally pose a human health hazard as a result of feeding rations containing ZEN to lactating dairy cows.

Animal Feed↗
PubMed1989

Risk assessment of the mycotoxin ochratoxin A.

Ochratoxin A (OA) is a mycotoxin which has been found to occur in foods of plant origin, in edible animal tissues, as well as in human blood sera and tissues. The ability of OA to move up the food chain is aided by its long half-life in certain edible animal species. In this report, an evaluation of the health risks to Canadians due to the presence of OA in food products is presented. The first part of the report deals with the physicochemical aspects, mycology, laboratory production, analytical methods, and natural occurrence in plant products, animal products, and human tissues. The stability of OA in foods and feeds, the effects of food processing, and the removal from foods and feeds by physiochemical means are also discussed. From these data, the worst case estimate for the daily exposure of Canadians to OA, from the consumption of pork-based food products and cereal foods, is approximately 5 ng OA/kg body wt (mean of eaters) for young children, the highest consumption group on a body weight basis. The second part of the report deals with the metabolic disposition as well as the available toxicity database for OA in laboratory animals, farm animals, and humans. The major target for OA toxicity in all mammalian species tested is the kidney, and endemic nephropathies affecting livestock as well as humans have been attributed to OA. OA is also teratogenic, and in the fetus the major target is the developing central nervous system. Recent studies have provided "clear evidence" of the carcinogenicity of OA in two rodent species. OA was found to be nonmutagenic in various microbial and mammalian gene mutation assays, but weak genotoxic activity to mammalian cells was noted. In addition, OA was found to suppress immune function. Based on the NTP carcinogenicity study with OA in rats, the estimated tolerable daily intake in humans ranges from 0.2 to 4.2 ng OA/kg body wt, depending on the method of extrapolation used. In view of the toxic properties of OA, it is recommended that exposure to OA be kept to a minimum. In Canada, further monitoring programs are required to better define the overall residue profile of OA in cereal grains, animal feeds, animal food products, and human blood. Such data are required to better assess dietary exposure and to ascertain the need for regulatory controls or other control mechanisms.

Abnormalities, Drug-Induced↗
PubMed1988

Production of moniliformin by Canadian isolates of Fusarium.

Twenty-eight Canadian isolates of Fusarium were tested for their ability to produce moniliformin in corn. Both F. moniliforme (2/6 isolates) and F. subglutinans (11/15 isolates) produced the mycotoxin, while F. graminearum did not. Field-corn inoculated with F. moniliforme M3783 was able to support production of both moniliformin and fusarin C.

Canada↗
PubMed1988

Mycotoxin-producing potential of fungi isolated from red kidney beans.

The predominant fungi present in samples of reject and retail red kidney beans were Aspergillus glaucus, Penicillium spp. and Alternaria spp. Together with A. ochraceus, A. flavus, Fusarium spp., and Trichoderma, these isolates from the reject beans were screened for numerous mycotoxins by TLC. The most consistently produced mycotoxins were penicillic acid (from A. ochraceus and Penicillium spp.) and Alternaria toxins (tenuazonic acid and alternariol). A. glaucus strains were tested for cytotoxicity in three tissue culture cell lines with positive results.

Aspergillus↗
PubMed1987

Risk assessment of the mycotoxin zearalenone.

Trans-zearalenone, a resorcylic acid lactone, also known as F-2 toxin, is a nonsteroidal estrogenic mycotoxin produced by numerous species of Fusarium. As a result zearalenone is found in a number of cereal crops and their derived food products. A closely related substance "zeranol" (zearalanol) is at present being used in the United States and Canada as an anabolic agent in beef cattle. Zearalenone has been implicated in numerous incidences of mycotoxicosis in farm animals, especially pigs. In this report the health risks to Canadians due to the presence of zearalenone in food products have been evaluated. The first part of the report deals with the physicochemical aspects, mycology, laboratory production, and natural occurrence in plant products and animal products of zearalenone. The stability of zearalenone in foods and feeds, the effects of food processing, and the removal from foods and feeds by physicochemical means are also discussed. From these data the daily exposure of Canadians to zearalenone from food consumption has been estimated to be in the range of 0.05-0.10 microgram/kg b.w./day (mean and 90th percentile of eaters, respectfully) for young children, the highest consumption group on a body weight basis. The second part of the report deals with the metabolic disposition of zearalenone as well as the available toxicity data base of zearalenone in laboratory animals, farm animals, and humans. Studies in various species (rodents, rabbits, pigs, monkeys) including man have shown that zearalenone has estrogenic and anabolic activity. Its major effects are on reproduction, including reproductive organs and their function, leading to hyperestrogenism. Zearalenone has been implicated in numerous incidences of hyperestrogenism in farm animals, especially pigs. For reproductive effects a no adverse effect level (NOAEL) of 0.06 mg/kg b.w./day was estimated for the pubertal pig, the most sensitive species tested. Important differences in the biotransformation of zearalenone were noted, with greater amounts of alpha-zearalenol, the more estrogenic metabolite, formed in man and the pig compared to rodents. In addition, the biological half-life of these substances was longer in man than in other species tested. The binding of zearalenone to estrogen receptors was approximately 20-fold lower than that seen with 17 beta-estradiol in several assays.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗