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Biomedical subjects

P McArdle

Publications and source records attributed to P McArdle.

At least 19 recordsLinked to original sources

One-pot synthesis of fluorescent 2,5-dihydro-1,2,3-triazine derivatives from a cascade rearrangement sequence in the reactions of 1,2,3-triazolium-1-aminide 1,3-dipoles with propiolate esters.

The reactions of 1,2,3-triazolium-1-aminides 1 (readily available from benzil bishydrazones) with propiolate esters leads to fluorescent 2,5-dihydro-1,2,3-triazine derivatives 2, 3 in one pot. These synthetic reactions can be carried out in acetone, in water, or under solvent-free conditions. The reactions involve a Huisgen cycloaddition followed by a sequence of rearrangements. The final ring-expansion step was blocked by linking a six-methylene hydrocarbon chain between the prospective 1,2,3-triazine C-4 and C-6 atoms, using substrate 8 which gave the fused tricyclic azapropellane product 9 exclusively. X-ray crystal structures were determined for two 2,5-dihydro-1,2,3-triazine derivatives and for compound 9. The UV absorption of the 1,2,3-triazine derivatives showed a dual absorption at ca. 310 and ca. 390 nm with fluorescent emission at ca. 480 and 528 nm (for excitation at 317 nm). The significant Stokes shift of ca. 200 nm shows the potential for biological fluorescent labeling experiments.

Catalysis↗

Donor properties of the vanadyl ion: reactions of vanadyl salicylaldimine beta-ketimine and acetylacetonato complexes with groups 14 and 15 Lewis acids.

Reactions of organosilicon, -germanium, -tin, -lead, -antimony, and -tin tetrahalide Lewis acids with VO(salen) [H(2)salen = N,N'-bis(salicylidene)ethane-1,2-diamine], related vanadyl salicylaldimines, VO(acacen) [H(2)acacen = N,N'-bis(acetylacetonato)ethane-1,2-diamine], and VO(acac)(2) (acac = acetylacetonato) have been investigated, revealing VO(salen) and VO(acacen) to be significantly stronger vanadyl donors than VO(acac)(2). The vanadyl donor strength of VO(salen) significantly diminishes with the introduction of electron-withdrawing substituents on the salicylaldimine ligand, and the introduction of methyl substituents on the imine carbon atoms can result in a preference for phenolic over vanadyl oxygen donation. Vanadyl donation results in an increase in the vanadyl bond length, while it leaves the distance of vanadium from the basal plane relatively unaffected. Coordination of water trans to a vanadyl oxygen that is involved in a donor bond to tin or lead has little or no effect on the vanadyl bond length but results in a marked movement of vanadium toward the basal plane and a decrease of the V=O-D (D = Sn or Pb) bond angle by as much as 13 degrees, the latter reflecting a loss of multiple bond character of the vanadyl bond. Formation of a vanadyl donor bond results in a decrease in both the vanadyl stretching frequency (infrared spectrum) and energy of the e(pi) <-- b(2) transition (electronic spectrum), the latter being intimately related to the strength of the vanadyl donor bond, while the shift of the b(1) <-- b(2) transition to higher or lower energy is relatively small for vanadyl salicylaldimine and beta-ketimine complexes. Donation through the phenolic oxygen atoms results in an increase in the vanadyl stretching frequency and energy of the e(pi) <-- b(2) transition, which can result in e(pi) <-- b(2)/b(1) <-- b(2) energy crossover.

Journal Article↗

The role of disability living allowance in the management of attention-deficit/hyperactivity disorder.

OBJECTIVE: To explore the use of Disability Living Allowance (DLA) by families of children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD), and to discuss the implications for clinicians involved in their treatment. STUDY DESIGN: Opportunistic survey of patients attending ADHD clinic. SETTING: Urban area in the north-east of England. SUBJECTS: A total of 32 carers of children being treated for ADHD with methylphenidate. INTERVENTION: Semi-structured telephone interviews about receipt and use of DLA. This involved open and closed questions and a multiple-choice section. RESULTS: In total, 19 out of the 32 families were receiving DLA. They chose to use it mainly to replace clothes and furniture and to provide diversions and activities for the children concerned. Some families were unaware of potential eligibility for DLA, whereas a few had chosen not to apply. Only one family's application for DLA had been unsuccessful. Carers were unanimously positive about the extra income. CONCLUSIONS: Families view DLA as an important means to replace damaged items and to fund recreational activities to contain over-activity. Families receive little formal guidance on ways of using DLA money to support children with ADHD. Virtually no specific training in benefits awareness is provided to general practitioners and child health specialists, who are often asked to judge the child's level of impairment or incapacity. Applying for DLA may affect the therapeutic relationship for good or ill. There is a need for professionals in contact with children with ADHD to inform families of the possibility of receiving DLA and support them in applications. As diagnosis and treatment of ADHD becomes more commonplace, more families are likely to be entitled to claim DLA. This has definite implications for the social security budget.

Adolescent↗

Children's play.

This paper draws upon research from a number of disciplines to examine the significance of children's play. It concludes that play may well be central to normal personality development. However, its place in contemporary Western society is not secure, perhaps risking the development and well-being of urban and disadvantaged children in particular.

Child↗

Pain in the intensive care unit: recognition, measurement, management.

There has been a resurgence in interest in the in-hospital management of pain, largely related to results of investigations into the role of analgesia in outcome and cost-efficiency. The traditional aim of analgesia as simply an altruistic goal has been supplanted by the goal of impacting on the altered physiology accompanying critical illness and trauma. Elucidation of the effect of pain and the accompanying stress response on pulmonary dysfunction in particular, but also on myocardial ischemia and coagulation, has suggested that the provision of adequate analgesia by time-honored methods may not in itself effect a reduction in morbidity without attention to the method of analgesic delivery and choice of agent.

Journal Article↗

Students' conceptual model of a good community attachment.

BACKGROUND: In 1994, Manchester University Medical School introduced a new integrated curriculum using problem-based learning and which places an increased emphasis on community-based education. AIMS: Students commonly use a particular label ("a good GP" (general practitioner)) to describe a positive experience in the community. The purpose of the study was to explore what students mean by "a good GP" and how this relates to their perceptions of the value of the community aspect of the course. METHOD: Three single-year focus groups were run with year 3, 4 and 5 students. A model was then derived which was explored and checked against the views of a cross-year focus group. RESULTS: A theoretical model based on student conceptualization of "a good GP" was developed. "A good GP" was found to consist of the GP as a teacher, as a role model and as an indicator of a positive learning environment. With regard to "good teacher", students felt that the GP's enthusiasm about teaching and involving the student in an active learning process was important. For "good role model", students emphasized communication skills and non-judgmental attitudes. With regard to "good learning environment", a friendly atmosphere, variety of activities, and flexibility shown by the staff of the health centre were important. CONCLUSIONS: Students hold a complex conceptual model of "a good GP" which the label does not convey. We suggest that for evaluations of student experiences it is important to explore in depth what students mean by particular terms or labels.

Attitude of Health Personnel↗

Adduct formation between alkali metal ions and divalent metal salicylaldimine complexes having methoxy substituents. A structural investigation.

Sodium, potassium, and cesium salts (iodides, nitrates, acetates, and tetraphenylborates) form 1/1, 1/2 and 2/3 adducts with MLn [M = Co, Ni, Cu, and Zn; n = 1-4; H2L1 = N,N'-(3-methoxysalicyliden)ethane-1,2-diamine; H2L2, H2L3, and H2L4 are the -propane-1,2-diamine, -o-phenylenediamine, and -propane-1,3-diamine analogues of H2L1). Metal salicyladimine, alkali metal, and anion all exert influence on stoichiometry and reactivity. Sodium ions tend to reside within the planes of the salicylaldimine oxygens, as in Na(NO3)(MeOH).NiL4 (1), Na(NO3)(MeOH).CuL1 (2; both with unusual seven-coordinated sodium), and Na.(NiL4)2I.EtOH.H2O (3; with dodecahedral sodium coordination geometry). Potassium and cesium tend to locate between salicylaldimine ligands as in KI.NiL4 (4) and [Cs(NO3).NiL4]3.MeOH (5; structures with infinite sandwich assemblies), CsI.(NiL2)2.H2O (6), CsI3.(NiL4)2 (7; simple sandwich structures), and [K(MeCN)]2.(NiL4)3 (8; a triple-decker sandwich structure). Crystal data for 1 are the following: triclinic, P1, a = 7.3554(6) A, b = 11.2778(10) A, c = 13.562(2) A, alpha = 96.364(10) degrees, beta = 101.924(9) degrees, gamma = 96.809(10) degrees, Z = 2. For 2, triclinic, P1, a = 7.2247(7) A, b = 11.0427(6) A, c = 13.5610(12) A, alpha = 94.804(5) degrees, beta = 98.669(7) degrees, gamma = 99.26(6) Z = 2. For 3, orthorhombic, Pbca, a = 14.4648(19) A, b = 20.968(3) A, c = 28.404(3) A, Z = 8. For 4, triclinic, P1, a = 12.4904(17) A, b = 13.9363(13) A, c = 14.1060(12) A, alpha = 61.033(7) degrees, beta = 89.567(9) degrees, gamma = 71.579(10) degrees, Z = 2. For 5, monoclinic. P2(1)/n, a = 12.5910(2) A, b = 23.4880(2) A, c = 22.6660(2) A, beta = 99.3500(1) degree, Z = 4. For 6, orthorhombic, Pbca, a = 15.752(3) A, b = 23.276(8) A, c = 25.206(6) A, Z = 8. For 7, triclinic, P1, a = 9.6809(11) A, b = 10.0015(13) A, c = 11.2686(13) A, alpha = 101.03 degrees, beta = 90.97 degrees, gamma = 100.55 degrees, Z = 2. For 8, monoclinic, C2/c, a = 29.573(5) A, b = 18.047(3) A, c = 23.184(3) A, beta = 122.860(10) degrees, Z = 8.

Journal Article↗

The peer relations of disruptive children with reference to hyperactivity and conduct disorder.

Literature reviews indicate that children with disruptive behaviour disorders have peer relationship problems, but little information is available concerning the differential effects of hyperactivity and conduct disorder on peer relationships. Using a database from North of England research, this paper uses standard frequency analysis complemented by multivariate analyses to explore the independent effects of pervasive hyperactivity and conduct disorder on the sociometry of peer relations among 7- to 8- and 11- to 12-year-olds. The findings suggest that (a) social isolation in 7-8-year-olds shows no significant association with hyperactivity. However there is a significant association with conduct disorder in 11-12-year-olds. (b) Rejection is not significantly associated with hyperactivity alone nor with conduct disorder alone in 7-8-year-olds. However, it is associated with a combination of hyperactivity and conduct disorder. In 11-12-year-olds rejection is associated with conduct disorder alone and with conduct disorder and hyperactivity in combination. It is also associated with low cognitive ability alone and in combination with conduct disorder. Overall, these findings provide some limited evidence of adverse sociometric responses to both hyperactivity and below average cognitive ability. However, in the at-risk samples analysed here, conduct disorder emerges as the most powerful independent predictor of isolation and rejection, and this is especially so among older children.

Attention Deficit Disorder with Hyperactivity↗

International variations in youth drug use: the effect of individual behaviours, peer and family influences, and geographical location.

This international study investigates factors underlying international variations in rates of youth drug use among representative samples of 15-year-olds in five cities (Bremen, n = 871; Dublin, n = 983; Groningen, n = 487; Newcastle upon Tyne, n = 880; Rome, n = 666). It reveals a higher level of drug use in English-speaking compared to continental populations. Drug use was associated with peer, family and individual factors. Logistic regression showed that family structure and sport were associated with lower rates and delinquent behaviour with higher rates of drug use in all cities and among males and females. Among males, city of residence also independently predicted drug use. The effect of traditional families and studiousness in reducing drug use was most evident for male drug use in low-use cities: higher rates of use in English-speaking cities appear partially due to the drug use of low-risk males.

Adolescent↗

Intravenous analgesia.

Pain and its treatment are known to have adverse effects on the organism, including deterioration in myocardial, diaphragmatic, and small bowel function. The provision of adequate intravenous analgesia, and the choice of agent, can ameliorate or exacerbate these manifestations of the stress response. The choice of agent, opioid or non-opioid, has in some respects become more difficult as more information has become available regarding the merits and adverse effects of each. Increased awareness of the frequency of hypoxemia secondary to the opioids' ability to cause an obstructive sleep apnea picture, and the cost efficiency of ketorolac through a reduction in opioid toxicity, contrast with recent studies which suggest that the gastrotoxic and nephrotoxic effects of ketorolac may occur earlier than previously suspected. The suitability of using the dissociative anesthetic agent ketamine in critically ill patients remains to be proven. Ketamine provides intense analgesia at subanesthetic doses. Its centrally mediated sympathomimetic action encourages hemodynamic stability, and it is relatively devoid of respiratory depressant activity. Increasing experience with ketamine outside the operating room has resulted in its successful use in cases of severe bronchospasm and status epilepticus.

Analgesics, Non-Narcotic↗

X-ray crystal structure of the Desulfovibrio vulgaris (Hildenborough) apoflavodoxin-riboflavin complex.

The apoprotein of flavodoxin from Desulfovibrio vulgaris forms a complex with riboflavin. The ability to bind riboflavin distinguishes this flavodoxin from other short-chain flavodoxins which require the phosphate of FMN for flavin binding. The redox potential of the semiquinone/hydroquinone couple of the bound riboflavin is 180 mV less negative than the corresponding complex with FMN. To elucidate the binding of riboflavin, the complex has been crystallized and the crystal structure solved by molecular replacement using native flavodoxin as a search model to a resolution of 0.183 nm. Compared to the FMN complex, the hydrogen-bonding network at the isoalloxazine sub-site of the riboflavin complex is severely disrupted by movement of the loop residues Ser58-Ile64 (60-loop) which contact the isoalloxazine by over 0.35 nm, and by a small displacement of the isoalloxazine moiety. The 60-loop movement away from the flavin increases the solvent exposure of the flavin-binding site. The conformation of the site at which 5'-phosphate of FMN normally binds is similar in the two complexes, but in the riboflavin complex a sulphate or phosphate ion from the crystallization buffer occupies the space. This causes small structural perturbations in the phosphate-binding site. The flexibility of the 60-loop in D. vulgaris flavodoxin appears to be a contributing factor to the binding of riboflavin by the apoprotein, and a feature that distinguishes the protein from other 'short chain' flavodoxins. In the absence of the terminal phosphate group, free movement at the 5'-OH group of the ribityl chain can occur. Thus, the 5'-phosphate of FMN secures the cofactor at the binding site and positions it optimally. The structural changes which occur in the 60-loop in the riboflavin complex probably account for most of the positive shift that is observed in the midpoint potential of the semiquinone/hydroquinone couple of the riboflavin complex compared to that of the FMN complex.

Apoproteins↗

Conjugated estrogen reduces transfusion and coagulation factor requirements in orthotopic liver transplantation.

UNLABELLED: We conducted a prospective, randomized study to determine the efficacy of conjugated estrogen in reducing blood product transfusion during orthotopic liver transplantation (OLT). Patients undergoing OLT were included in the study. Only those having a reaction time of more than 30 mm or 15 min (19 -28 mm) on computed thromboelastography (CTEG) at the beginning of surgery were enrolled in the study. Patients were randomized to receive either conjugated estrogen (CE) or placebo. Every patient received a first dose of CE (100 mg i.v.) (20 mL) or placebo (20 mL of isotonic sodium chloride solution) at the beginning of the procedure and a second dose of CE (100 mg i.v.) or 20 mL of placebo (20 mL of isotonic sodium chloride solution) just after reperfusion of the new graft. The two groups were similar in age, weight, requirement for veno-veno bypass, time on veno-veno bypass, CTEG measurement, and preoperative hemoglobin and platelet values. Blood products were given in relation to hematocrit and coagulation (CTEG) variables, which were measured every hour during the surgery. The amount of transfused blood products did not differ in terms of units of cryoprecipitate, but the intraoperative requirements for red blood cells (6 +/- 3 vs 9 +/- 6 U; P = 0.05), platelets (12 +/- 8 U vs 18 +/- 10 U; P = 0.05) and fresh-frozen plasma (3 +/- 3 U vs 6 +/- 4 U; P = 0.001) was significantly less in the estrogen group than in the control group. We conclude that CE is associated with a significant decrease in use of fresh-frozen plasma, platelets, and red blood cells during OLT. IMPLICATIONS: In this study, we prospectively investigated whether i.v. conjugated estrogen could decrease blood product transfusion during orthotopic liver transplantation. Conjugated estrogen-treated patients received less fresh-frozen plasma, red blood cells, and platelets. In this population of patients, conjugated estrogen can be a useful addition in coagulation management during orthotopic liver transplantation.

Blood Coagulation Factors↗

Is there a comorbid relationship between hyperactivity and emotional psychopathology?

Some of the early literature implied that emotional disorders were almost incompatible with hyperactivity in childhood. The paper addresses this issue using a large epidemiological data base--of two cohorts of 7- & 8-year-old and 11- & 12-year-old children from the North of England. There are two themes, first, the paper reports on the prevalence of emotional symptoms and disorder among hyperactive children. Second, it explores co-occurrence of hyperactivity and emotional psychopathology according to whether the hyperactivity is situational or pervasive and according to the age of the child. Hyperactivity proved to have an association with emotional symptoms and disorder at both ages but the links with disorder were most prominent among the older children. Among our high risk or maladjusted samples the strongest links were with home-based situational hyperactivity. However, among the general population cohort, emotional disorder proved to be a function of pervasiveness of hyperactivity and older age.

Attention Deficit Disorder with Hyperactivity↗

Psychiatric in-patient treatment for children and adolescents in the UK: criteria for admission.

There are few published data concerning the clinical criteria that determine admission of children or adolescents to psychiatric in-patient units. This paper reports a case-notes study of the criteria employed by UK clinicians, prior to the introduction of a purchaser-provider health care market into the UK National Health Service. Two child and adolescent psychiatrists rated the case notes of 24 in-patients, and 72 out-patients, matched for age and sex, according to symptomatology, social adversity and severity of behavioral and emotional impairment. The findings indicate that social adversity does not predict admission. Certain symptoms such as sexualized or severe antisocial behavior may even act to diminish the likelihood of admission. However, the principal finding is that, within a non-market, free health care system, the degree of clinical impairment suffered by the child or young person appears to be a prime determinant of the decision to admit.

Child↗