Search PubMed⌕ Search

Biomedical subjects

P Manning

Publications and source records attributed to P Manning.

51 records · Page 3Linked to original sources
PubMed1989

Reversal of mortality for congenital diaphragmatic hernia with ECMO.

Extracorporeal Membrane Oxygenation (ECMO) has been available to neonates with respiratory failure at the University of Michigan School of Medicine since June 1981. In order to evaluate the impact of this type of pulmonary support, a retrospective analysis of 50 neonates with posterolateral congenital diaphragmatic hernia (CDH) who were symptomatic during the first hour of life and were treated between June 1974 and December 1987 was carried out. The patients were divided into two groups, those treated before June 1981 (16 patients) and those treated after June 1981 (34 patients). Overall survival improved from 50% (eight of 16 patients) during the pre-ECMO era to 76% (26 of 34 patients) during the post-ECMO period (p = 0.06). During the period after June 1981, 21 neonates were unresponsive to conventional therapy and were therefore considered for ECMO. Failure of conventional therapy was defined as acute clinical deterioration with an expected mortality of greater than 80% based on an objective formula previously reported. Six patients were excluded on the basis of specific contraindications to ECMO. Thirteen of 15 infants (87%) supported with ECMO survived. Three patients treated before 1981 met criteria for ECMO; all three died while receiving treatment using conventional therapy. These survival differences are significant (p less than 0.01). In addition, the survival of 87% for the infants treated with ECMO versus the expected mortality of greater than 80% for these same patients when treated with conventional therapy is highly significant (p less than 0.005). Based on this data, ECMO appears to be a successful, reliable, and safe method of respiratory support for selected, critically ill infants with CDH.

Evaluation Studies as Topic↗
PubMed1989

Respiration in the cysts and trophozoites of Giardia muris.

Cysts and trophozoites of the parasitic protozoon Giardia muris both showed respiratory activity but respiration in cysts was only 10 to 20% that of trophozoites. The O2 dependence of respiration in cysts and trophozoites showed O2 maxima above which respiration decreased. The O2 concentration at which the respiration rate was greatest was higher for cysts than trophozoites. The effects of various inhibitors on cyst and trophozoite respiration suggested that flavoproteins and quinones play some role in respiration. The substrate specificities and the effects of inhibitors on G. muris trophozoites were similar to those observed for Giardia lamblia. Metronidazole, the drug most commonly used in the treatment of giardiasis completely inhibited respiration and motility in trophozoites; however, it had no effect on either respiration or viability in cysts. Menadione, a redox cycling naphthoquinone, stimulated then completely inhibited respiration in cysts and trophozoites; a complete loss of cyst viability or trophozoite motility was also observed. The effects of menadione on G. muris may indicate that redox cycling compounds have potential as chemotherapeutic agents for the treatment of giardiasis.

Animals↗
PubMed1981

Effects of spaced responding DRL on the stereotyped behavior of profoundly retarded persons.

Stereotypic responding and social behaviors of three profoundly retarded children were measured before and during application of a DRL contingency for stereotypic responding. A variant of the standard DRL procedure, spaced responding DRL, was used, in which reinforcement is delivered following a response if that response has been separated from the previous response by at least a fixed minimum time interval. Three children were treated by using a reversal design. Results showed that: (a) during baseline sessions, the children engaged in high rates of stereotypic responding and very low rates of appropriate social behavior; and (b) during DRL sessions, appropriate behavior increased markedly as stereotypic responding was reduced. The data suggest that spaced responding DRL may be effective in increasing appropriate social behavior as well as in reducing stereotypic responding.

Adolescent↗
PubMed1980

Reduction of mortality due to fighting in a colony of rhesus monkeys (Macaca mulatta).

Mortality resulting from fighting in a breeding colony of rhesus monkeys living in groups was an important management problem. An attempt was made to understand the causes of such fighting and reduce it. It was found that the cause of the fighting was the social disruption resulting from a breeding protocol which required the regular removal of pregnant animals from groups and introduction of nonpregnant females. The basic protocol was not changed; however, social disruption was minimized, and a reduction in mortality was accomplished through alteration of group formation procedures, pregnancy palpation procedures and group composition.

Aggression↗
PubMedDate not supplied

Biochemistry and metabolism of Giardia.

Giardia lamblia, an aerotolerant anaerobe, respires in the presence of oxygen by a flavin, iron-sulfur protein-mediated electron transport system. Glucose appears to be the only sugar catabolized by the Embden-Meyerhof-Parnas and hexose monophosphate pathways, and energy is produced by substrate level phosphorylation. Substrates are incompletely oxidized to CO2, ethanol and acetate by nonsedimentable enzymes. The lack of incorporation of inosine, hypoxanthine, xanthine, formate or glycine into nucleotides indicates an absence of de novo purine synthesis. Only adenine, adenosine, guanine and guanosine are salvaged, and no interconversion of these purines was detected. Salvage of these purines and their nucleosides is accomplished by adenine phosphoribosyltransferase, adenosine hydrolase, guanosine phosphoribosyltransferase and guanine hydrolase. The absence of de novo pyrimidine synthesis was confirmed by the lack of incorporation of bicarbonate, orotate and aspartate into nucleotides, and by the lack of detectable levels of the enzymes of de novo pyrimidine synthesis. Salvage appears to be accomplished by the action of uracil phosphoribosyltransferase, uridine hydrolase, uridine phosphotransferase, cytidine deaminase, cytidine hydrolase, cytosine phosphoribosyltransferase and thymidine phosphotransferase. Nucleotides of uracil may be converted to nucleotides of cytosine by cytidine triphosphate synthetase, but thymidylate synthetase and dihydrofolate reductase activities were not detected. Uptake of pyrmidine nucleosides, and perhaps pyrimidines, appears to be accomplished by carrier-mediated transport, and the common site for uptake of uridine and cytidine is distinct from the site for thymidine. Thymine does not appear to be incorporated into nucleotide pools. Giardia trophozoites appear to rely on preformed lipids rather than synthesizing them de novo.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Carbohydrate and amino acid analyses of Giardia muris cysts.

Intact Giardia muris cysts were subjected to consecutive chloroform/methanol and 2% sodium dodecyl sulfate (SDS) extractions, and to amyloglucosidase treatment. The SDS-insoluble, amyloglucosidase-fast cyst walls (ACW) were further incubated with chymotrypsin, trypsin, papain, or pronase. Low voltage scanning electron microscopy revealed no discernible change in the ultrastructure of the filamentous layer of the cyst wall following any of these treatments. Affinity for cyst wall-specific monoclonal antibody (Meridian Diagnostics, Cincinnati, OH) was also retained after all treatments. Periodic acid-Schiff staining and gas chromatography/mass spectrometry (GC/MS) of intact and treated cyst hydrolysates showed a significant reduction in the amount of glucose associated with the cyst (72 nmoles/10(6) intact cysts vs 1.9 nmoles/10(6) ACW) as a result of amyloglucosidase treatment, indicating that glucose is stored within Giardia as an SDS-insoluble polymer. Galactosamine was identified by GC/MS as the predominant sugar associated with both the ACW and the proteinase treated ACW (42 nmoles/10(6) ACW). High performance liquid chromatographic analysis of amino acids from intact and treated cyst hydrolysates revealed a marked reduction, but not elimination, of detectable quantities of identifiable amino acid residues (255 nmoles/10(6) intact cysts vs 6.8 nmoles/10(6) proteinase treated ACW). These results suggest that the filamentous layer of the cyst wall is primarily a carbohydrate peptide complex.

Amino Acids↗
PubMedDate not supplied

Oxygen uptake in cysts and trophozoites of Giardia lamblia.

Oxygen uptake in cysts and trophozoites of the parasitic protozoan Giardia lamblia was examined. Both showed oxygen uptake activity, but that of cysts was only 10% to 20% that of trophozoites. Oxygen dependence of oxygen uptake in cysts and trophozoites showed oxygen maxima above which oxygen uptake decreased. The oxygen concentration at which the oxygen uptake rate was greatest was higher for trophozoites than for cysts. The effect of various inhibitors on cyst and trophozoite oxygen uptake suggested that flavoproteins and quinones play some role in oxygen uptake. The substrate specificities and the effect of inhibitors on G. lamblia trophozoites were similar to those observed for G. muris. Metronidazole, the drug most commonly used in treatment of giardiasis, inhibited oxygen uptake and motility in trophozoites; however, it had no obvious effect on either oxygen uptake or excystation in cysts. Menadione, a redox cycling naphthaquinone, first stimulated, then completely inhibited, oxygen uptake in cysts and trophozoites; a complete loss of cyst viability and trophozoite motility was also observed. The effect of menadione on G. lamblia may indicate that redox cycling compounds have potential as chemotherapeutic agents for the treatment of giardiasis.

Animals↗
PubMedDate not supplied

Bronchitis symptoms in young teenagers who actively or passively smoke cigarettes.

This study was undertaken to examine the prevalence of bronchitis (cough with phlegm) symptoms in teenagers who either smoked cigarettes on a regular basis (active smokers) or were non-smokers but who are exposed to passive smoking (passive smokers) in the home. The study was undertaken in 1995 and repeated in 1998. The 1995 study was a cross sectional questionnaire survey of smoking habits in secondary school children aged 13-14 years and was undertaken as part of the ISAAC questionnaire survey. Thirty representative and randomly selected schools from throughout the Republic of Ireland took part in the study. In the 1995 study, 3066 students completed a questionnaire on their current smoking habits and symptoms of cough and phlegm. We found that 634 (20.7%) of these young teenagers actively smoked cigarettes with significantly more females smoking than males with 23.3% of girls compared to 17.6% boys (p = 0.0001). We found that 46.3% of non-smoking children were exposed to smoking in the home (passive smokers) with parental smoking accounting for most of the passive smoking. Bronchitis symptoms were more commonly reported in active smokers compared to non-smokers with an odds ratio of 3.02 (95% CI 2.34-3.88) (p < 0.0001) or in passive smokers compared to those not exposed to smoking with odds ratio of 1.82 (95% CI 1.32-2.52) (p < 0.0001). The 1998 study showed similar results for smoking habits, passive smoking and prevalence of bronchitis symptoms as with the 1995 study. These results document that increased bronchitis symptoms occur in teenagers exposed to active or passive smoking.

Adolescent↗
PubMedDate not supplied

Asthma control and management: a patient's perspective.

Irish asthma guidelines, published in 2000, are based on the Global Initiative for Asthma (GINA) international asthma management guidelines and provide recommendations for optimal asthma management and control. Using the same methodology as employed in the Asthma Insights and Reality in Europe (AIRE) survey, which assessed whether specific goals of asthma management based on GINA were being realised, 400 patients with current asthma in Ireland were interviewed in the Asthma Insights and Reality in Ireland (AIRI) survey to determine their healthcare utilisation, symptom severity, activity limitations and level of asthma control. Of those surveyed, acute services were utilised by a significant number of respondents. Over the previous year, 27% had either an emergency visit to the hospital or their general practitioner (GP) and 7% were hospitalised for asthma. In terms of asthma control, 19% experienced sleep disturbance at least once a week, 29% missed work or school and 37% of respondents experienced symptoms during physical activity over the previous 4-week period. Based on these findings, the level of asthma control and asthma management in Ireland falls short of recommended national and international asthma guidelines.

Adolescent↗
PubMedDate not supplied

An informative case of Graves' disease with implications for schizophrenia.

The aetiology of schizophrenia and the other psychoses is not yet established. The Knight model, based on genetic and other evidence, proposes that schizophrenia is an autoimmune disease, caused by the development of forbidden clones of B lymphocytes that secrete autoantibodies that accidentally stimulate cell surface receptors on certain neurons, affecting the limbic system of the brain. An unusual defect in a Maori man with Graves' disease rendered him unresponsive to the usually effective antithyroid drugs, prompting his being treated with prednisone, a non-specific immunosuppressant agent. This was highly successful, reducing the blood level of the causative thyroid-stimulating autoantibodies with reduction of thyroid hormone levels and thyroid gland size. Unfortunately, high dosage prednisone can be used for only a month, because of steroid toxicity. A research pathway to effective therapy of receptor-mediated autoimmune diseases, which probably include the psychoses, is now apparent. It involves finding the autoantibodies, then cloning of their antigenic targets, as has been done for Graves' disease. This will provide knowledge of the peptide sequences necessary for constructing therapeutic agents for selectively destroying the pathogenic forbidden clones. Meanwhile, usage of short-term therapy with prednisone could be helpful in the management of schizophrenia and should be explored.

Antithyroid Agents↗