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Biomedical subjects

P Patel

Publications and source records attributed to P Patel.

At least 145 records · Page 8Linked to original sources
PubMed1995

Psychiatric symptoms associated with dementia in older people with learning disability.

BACKGROUND: This paper describes a study of non-cognitive features of dementia in a population of 105 people over 50 years of age, with learning disability. METHOD: The study involved psychiatric assessment using the Psychiatric Assessment Schedule for Adults with a Developmental Disability (PAS-ADD), a semi-structured psychiatric interview developed specifically for people who have learning disability. Dementia was diagnosed using a combination of informant interviewing and observation of cognitive change over a three year period. RESULTS: Sample members with definite dementia had higher levels of sleep difficulty, hypersomnia, irritability, inefficient thought, loss of interest and anhedonia. Discriminant function analysis showed that non-cognitive features could help discriminate between definite and probable cases. CONCLUSIONS: Results support the previously reported observation for the general population that cognitive and non-cognitive features are only weakly related. The study suggests that psychiatric symptom information may be useful in screening for dementia in people with learning disability.

Activities of Daily Living↗
PubMed1995

HIV-1 gp120/160 expressing cells upregulate HIV-1 LTR directed gene expression in a cell line transfected with HIV-1 LTR-reporter gene constructs.

The results described in this paper demonstrate that HIV-1 gp120 can upregulate gene expression directed by the HIV-1 LTR. Briefly, exposing responder CD4+CEM-T4 ID5 cells to stimulator CEMgp120/160 expressing cells (stably transfected with HIV-1 LTR-CAT and HIV-1 gp160, respectively) resulted in the increased synthesis of the CAT enzyme. Control non-transfected CEM-T4 cells did not induce the synthesis of CAT. In addition, when the responder cell line, U937-1C5 which also contains stably transfected HIV-1 LTR-CAT plasmid was exposed to irradiated CEM gp120/160 cells, there was no synthesis of the CAT enzyme. Neither recombinant gp120 nor gp160 were able to stimulate the synthesis of CAT in the responder cells. These results indicate that the mechanism by which gp120/160 expressed on transfected cells increase CAT synthesis in responder cells may be dependent on the manner which the protein is presented in association with accessory molecules. Moreover, recombinant soluble CD4 and anti-CD4 monoclonal antibodies inhibited CEM gp120/160 induced expression of HIV-1 LTR-directed expression in CEM-1D5 cells. Based on these results we hypothesize that HIV or its envelope protein, gp120, upon interaction with its receptor, the CD4 molecule on T helper cells, transduces a signal which translates into the upregulation of the gene expression directed by the HIV-1 LTR.

Antibodies, Monoclonal↗
PubMed1994

Helicobacter pylori infection in childhood: risk factors and effect on growth.

OBJECTIVE: To investigate the current prevalence of Helicobacter pylori infection in childhood, the risk factors for infection, and the effect of infection on growth in preadolescent schoolchildren. DESIGN: Population based sample of 7 year old schoolchildren followed up at age 11; data on risk factors for infection collected at age 7; presence of infection at age 11 determined by measurement of salivary IgG against H pylori by a newly developed enzyme linked immunosorbent assay (ELISA). Height was measured at 7 and 11 years of age. SUBJECTS: 554 schoolchildren from Edinburgh. RESULTS: 62 (11%) children had H pylori infection. Independent risk factors for infection were single parent families (adjusted odds ratio = 2.5; 95% confidence interval 1.1 to 5.7), the 10% most crowded homes (3.1; 1.3 to 7.2), and schools serving predominantly rented housing estates (2.5; 1.0 to 6.5). School catchment area was more important than parental social class or housing tenure. Growth in height between 7 and 11 was diminished in infected children by a mean of 1.1 cm (0.3 to 2.0 cm) over four years. This growth reduction was largely confined to girls (1.6 cm over four years), among whom it correlated with salivary IgG (P = 0.015). CONCLUSION: Data from salivary assay to investigate the epidemiology of H pylori suggest that factors relating to the type of community in which the child lives may now be as important for acquisition of this infection as features of the family home. The greater reduction of growth among infected girls raises the possibility that H pylori infection may delay or diminish the pubertal growth spurt.

Child↗
PubMed1994

Salivary antibodies to Helicobacter pylori: screening dyspeptic patients before endoscopy.

Diagnostic tests on saliva have advantages compared with those on serum. In 119 consecutive dyspeptic patients referred for endoscopy we developed and validated an enzyme-linked immunosorbent assay to detect salivary immunoglobulins to Helicobacter pylori. Salivary IgG distinguished positive and negative cases (p < 0.0001), but salivary IgA did not. The optimum performance of salivary IgG (85%) was similar to that of serum IgG (90%) and better than that of salivary IgA. Using our assay and a history of regular use of non-steroidal anti-inflammatories in screening patients under 45 years, we detected all peptic ulcers while saving 39% of endoscopies.

Adolescent↗
PubMed1994

Carbon dioxide laser vaporization in early glottic carcinoma.

OBJECTIVE: Presently, widely employed treatment modalities for early glottic carcinoma include radiation therapy, surgical excision, and carbon dioxide laser excision. All these treatments have good oncological results, but poor or questionable functional results in terms of quality of voice and mucosal wave patterns as seen via a laryngostroboscope. We assessed the oncological and functional results of carbon dioxide laser vaporization of the diseased mucosa as a more conservative treatment alternative. DESIGN: Case series. SETTING: Department of Otolaryngology-Head and Neck Surgery in a tertiary care center. PATIENTS: Thirty-three patients with early glottic carcinoma (carcinoma in situ and Tla squamous cell carcinoma) who were referred to our center in the period from 1986 through 1990 were selected for carbon dioxide laser vaporization treatment on the criterion of a still recognizable mucosal wave pattern of the affected vocal fold via a laryngostroboscope. MAIN OUTCOME MEASURES: Local tumor control, voice quality, and a good appearance via a laryngostroboscope. RESULTS: Two patients were excluded from evaluation because a simultaneously diagnosed, incurable second primary tumor precluded frequent follow-up. Of the remaining 31 patients seen during a median follow-up period of 58 months, seven patients died of unrelated causes. A local recurrence of disease developed in two patients and was treated by radiation therapy. A recurrence of disease developed again in one of these patients but was successfully treated by total laryngectomy. Overall, local control of disease was achieved in all patients, with a 97% laryngeal preservation rate. Functional results in terms of voice quality were good in 97% of the patients, 75% of whom even retained a normal voice. Normal or near normal laryngostroboscopic appearance was achieved in 68% of all patients. CONCLUSION: Carbon dioxide laser vaporization is a good treatment alternative for early glottic carcinoma in terms of oncological as well as functional results.

Adult↗
PubMed1994

HIV-1 gp120/160 expressing transfected cell clones to evaluate the antibody-dependent cellular cytotoxicity (ADCC) during the course of HIV-1 infection.

Transfection by electroporation of the CEM.NKR cell line with a plasmid containing the HIVNL43 gp160 gene resulted in the establishment of HIV-1 gp120/160 expressing CEM.NKR cell clones. The cell-surface expression of the recombinant viral envelope is stable and does not lead to syncytium formation among a substantial number of cells expressing envelope glycoprotein, suggesting that these cells are suitable as targets to monitor HIV-specific ADCC activities with the stage or the progression of HIV-1 disease. By using these cells, the ability of sera from HIV-1 seropositive individuals to mediate ADCC against HIV-1 gp120/160 transfected cells in an antigen-specific manner was established. Approximately 63% of the HIV-infected individuals representing all stages of infection have virus-specific ADCC antibodies. Moreover, sera from healthy seropositive (CDC class II) subjects mediated substantially higher levels of ADCC activity (25.7 +/- 11.5%) than did sera from individuals in CDC class III (10.3 +/- 8.9%) or IVC1 (6.4 +/- 8.1%). The mean ADCC activity for the sera from the seronegative volunteers was 2 +/- 1.3%. The correlation between the ADCC level and CD4 cell depletion remains uncertain. Therefore, the established transfected cell line may be used to probe the role of gp120/160-specific ADCC activity in the development of AIDS and may also prove useful in screening human and murine monoclonal antibodies with potential ADCC activity. Such monoclonals may be useful for future immunotherapeutic agents in conjunction with antiviral chemotherapy.

Antibody-Dependent Cell Cytotoxicity↗
PubMed1994

Segmental localization of mRNAs encoding Na(+)-K(+)-ATPase alpha- and beta-subunit isoforms in rat kidney using RT-PCR.

To characterize the expression of genes encoding the alpha- and beta-subunit isoforms of the Na(+)-K(+)-ATPase in rat kidney, we used reverse transcription (RT)-PCR of microdissected renal structures combined with quantitation of subunit isoform mRNAs in the major renal parenchymal zones. Transcripts for alpha 1, alpha 2, alpha 3, beta 1, and beta 2 subunit isoforms were detected by RT-PCR in microdissected glomeruli, proximal convoluted tubules, medullary thick ascending limbs of Henle, cortical and inner medullary collecting ducts. The truncated alpha 1 (alpha 1-T) isoform was also amplified from cortex, outer and inner medulla and isolated glomeruli, but it was not detected in these nephron segments. The DNA sequence of the renal alpha 1-T PCR product was identical to that of the cDNA previously cloned from aortic smooth muscle cells. RNA dot-blot analysis indicated that the alpha 1, alpha 2, and alpha 3 isoforms contributed approximately 70%, approximately 20%, and approximately 10%, respectively, of the total alpha isoform mRNA in each parenchymal zone. RNase protection assays determined that the beta 1 and beta 2 isoforms accounted for approximately 95% and approximately 5%, respectively, of the beta isoform mRNA in each zone. These data provide definitive evidence for the differential expression of mRNAs encoding all the alpha and beta isoforms in the renal parenchyma, and for the coexpression of these isoforms in the nephron segments examined. The results suggest the potential expression of up to eight different Na(+)-K(+)-ATPase isoenzymes in the kidney, and for multiple molecular levels of regulation of renal Na(+)-K(+)-ATPase expression.

Animals↗
PubMed1994

Epidermal Langerhans cells, HIV-1 infection and psoriasis.

Langerhans cells (LCs) subserve an important antigen-presenting function in the skin immune system. They bear CD4 receptors, which make them potential targets for infection with the human immunodeficiency virus (HIV-1). The observation of reduced numbers of LCs in the skin of patients with the acquired immunodeficiency syndrome (AIDS), and the association of severe psoriasis with HIV-1 infection, raise interesting questions regarding the role of LCs in the skin of HIV-1-positive psoriatic patients. In this study, LCs were quantified in the lesional and non-lesional skin of seven HIV-1-positive psoriatic patients, and the results were compared with age-, sex- and site-matched HIV-1-negative psoriatic patients. The number of LCs was determined by staining skin sections with S-100 polyclonal antibody, using the three-step avidin-biotin immunoperoxidase method. The S-100-positive cells above the basal layer were quantified in two ways: cells/mm2 of epidermal area, and cells/mm of length of basement membrane. HIV-1-positive psoriatic patients showed a reduction in the number of epidermal LCs compared with HIV-1-negative psoriatic patients using both methods of quantification, in both lesional and non-lesional skin (P < 0.05, Mann-Whitney test). In addition, a reduction in the number of LCs in lesional compared with non-lesional skin was observed in both HIV-1-positive and -negative patients when LCs were quantified per mm2 of epidermal area (P < 0.05, Wilcoxon test).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Airborne dissemination of Burkholderia (Pseudomonas) cepacia from adult patients with cystic fibrosis.

BACKGROUND: Burkholderia (Pseudomonas) cepacia is an increasingly important pathogen in patients with cystic fibrosis but it is unclear how it spreads from patient to patient. A study was undertaken to determine whether B cepacia could be recovered from room air occupied by colonised adult patients with cystic fibrosis. METHODS: Air samples were obtained consecutively from an enclosed room or isolation cubicle before, during, and after occupation by six patients on nine occasions using a surface air sampler incorporating contact plates with selective medium. Settle plates were also used and sputum from five patients was cultured. RESULTS: B cepacia was recovered from room air during occupation by five of six patients, the number of bacteria ranging from 1 to 158 cfu/m3 (mean 32 cfu/m3). The number of bacteria isolated was greater when patients were coughing. B cepacia persisted in room air on four occasions after the patient left the room, on one occasion for up to 45 minutes. CONCLUSIONS: The isolation of B cepacia from the air of rooms occupied by colonised patients suggests that dissemination might occur by aerosol as well as by direct physical contact with patients or contaminated environmental sites.

Adult↗
PubMed1994

Effects of DNA topoisomerase II inhibitors on human bone marrow progenitor cells.

Topoisomerase II (topo II) is a target for many cytotoxic agents. Two observations, however, warrant caution in their therapeutic use: first, these agents can inhibit differentiation and second, perturbations in function render the enzyme error-prone. Illegitimate recombination events occurring at sites where topo II acts in differentiation could be particularly important in the development of secondary malignancies (relatively frequent after therapy with agents that target topo II). Topo II inhibitors are heterogeneous in mechanisms of action; in site-specificity of cleavable complex 'entrapment' (where present) and in the relative potency against the two topo II isoforms, all potentially influencing the site of maximum DNA damage. The object of this study was to examine the effect of topo II inhibitors on human haemopoietic precursor cells, to determine which have most impact on differentiation. We selected two which act via cleavable complex entrapment, but with different site preferences (m-AMSA and VP-16), and two acting via other mechanisms (merbarone and fostriecin). VP-16 and m-AMSA showed similar patterns with low dose stimulation of granulocyte-macrophage colony formation and high dose inhibition of all colony types. The stimulation was accompanied by an increase in colony size and blast content, consistent with a low dose inhibition of differentiation. Forstriecin, in contrast, stimulated predominantly mixed and erythroid colonies. Merbarone failed to increase colony formation. Neither produced substantial inhibition of colony formation. The effects on granulocyte-macrophage progenitors were confirmed using 7-day suspension cultures, using nitroblue tetrazolium (NBT) reduction and 3-4,5,dimethylthiazol 2,5-diphenyl tetrazolium bromide (MTT) assays for differentiated cells and total cell mass, respectively. These results demonstrate that the effects of topo II inhibitors on haemopoietic cell proliferation and differentiation are agent-specific and can involve lineage-restricted partial inhibition of differentiation.

Adult↗
PubMed1993

Prenatal sex determination from maternal peripheral blood using the polymerase chain reaction.

We have investigated the use of a nested polymerase chain reaction assay for the detection of a fetal-specific Y-chromosomal sequence (DYS14) from DNA extracted from unsorted maternal peripheral blood. Serial dilutions of male DNA into female cord blood DNA indicated that the assay could detect an equivalent of a single male cell in 300,000 female cells. The assay exhibited absolute specificity for male DNA with no amplification from a DNA panel obtained from 10 female cord blood samples. When used on DNA extracted from unsorted peripheral blood from a series of pregnant women, the predictive values of a positive test for a male fetus were 86%, 67% and 87% in the first, second and third trimesters, respectively. We have also demonstrated that retesting the samples allows the detection of a proportion of male-bearing pregnancies with a high degree of accuracy, in that all 15 women who gave positive signals in two consecutive amplifications had male fetuses. We have also applied the test at 8 weeks postpartum to eight women who had previously delivered male babies; no Y-specific signal could be detected in any of them, suggesting that most women have cleared their circulation of fetal cells by 8 weeks after parturition.

Base Sequence↗
PubMed1993

Physical morbidity in older people with moderate, severe and profound mental handicap, and its relation to psychiatric morbidity.

This report describes a study of physical health problems and their relation to psychiatric morbidity in a community sample of 105 people with severe mental handicap and over the age of 50 years from a Metropolitan Borough. An extensive outreach exercise ensured that almost 100% of people fulfilling the age and ability criteria were included in the study. All the physical and mental health assessments were carried out by a psychiatrist at senior registrar level. Physical assessments used a combination of physical examination and access to the subject's medical records. Results showed that, with minor exceptions, the physical health of the handicapped population was no worse than that of controls. Contrary to expectation, no relationship was demonstrated between physical and psychiatric morbidity. However, this may be due to the greater difficulty in identifying psychiatric morbidity in people who are more severely handicapped. Since physical health problems increase with level of handicap, the potential relation between physical and mental health is masked.

Aged↗