Search PubMed⌕ Search

Biomedical subjects

R Adair

Publications and source records attributed to R Adair.

At least 19 recordsLinked to original sources
PubMed2006

Prognostic influence of multiple hepatic metastases from colorectal cancer.

AIMS: The aim of this study was to report the results of surgery for multiple colorectal liver metastases on patient outcome. METHODS: This was a review of 484 consecutive patients who underwent liver resection for colorectal liver metastases between 1993 and 2003. The cohort was divided into 2 groups, those with 1-3 metastases and those with "multiple" metastases, namely 4 or more lesions. The later group was subdivided into those with less than 8 ("several") or 8 or more ("numerous") separate lesions. MAIN OUTCOME MEASURES: the post-operative hospital stay was calculated and morbidity and mortality were assessed. RESULTS: On multivariate analysis the presence of multiple metastases was the only predictor for both poorer overall survival (p=0.007) and disease-free survival (p=0.031). However, when patients with multiple metastases are analysed in detail this survival disadvantage appears to be only present in patients with numerous (8 or more) lesions. CONCLUSION: Although patients with multiple metastases appear to have a poorer outcome, significant number of patients with multiple metastases survive to 5 years or more and should not be denied surgery. Patients with numerous (8 or more) metastases showed a poorer survival disadvantage. These patients need alternative treatment speculatives.

Adult↗
PubMed2001

Effect of excess degradable intake protein on early embryonic development, ovarian steroids, and blood urea nitrogen on days 2, 3, 4, and 5 of the estrous cycle in mature ewes.

Two trials were conducted to determine whether feeding excess degradable intake protein (DIP) during a synchronized estrous cycle and the first 5 d after breeding alters early embryonic development, ovarian steroids, or BUN concentrations in ewes. Ewes were group-fed in Trial 1 (T1) and individually fed in Trial 2 (T2) either 100 (control; T1, n = 15; T2, n = 12) or 200% (high-protein; T1, n = 16; T2, n = 12) of the NRC protein recommendation for maintenance during a synchronized estrous cycle until surgery in the next cycle. Ampullae (AMP), isthmi (IST), and uterine horns (UT) of high-protein and control ewes were removed on d 2 (T1), 3 (T2), 4 (T1), or 5 (T2) after breeding. In T1, jugular blood samples were taken once daily starting on d 2 of the synchronized cycle, and in T2 on d 2, 9, 15, 16, and 17, and in both trials from estrus (d 0) to the day of surgery. Ampullae, IST, and UT flushings were examined microscopically for the presence of embryos, embryo condition, and embryo cell number. There was no trial x treatment interaction (P > or = 0.10), so data for both trials were pooled. Concentrations of BUN were higher (P < 0.05) in high-protein-fed ewes than in control ewes during the synchronized cycle and the first 5 d of the next cycle. Progesterone concentrations of the synchronized cycle did not differ (P > 0.10) between treatments. During the first 5 d of the next cycle, estradiol-17beta concentrations were lower (P = 0.06) in high-protein-fed than in control ewes. Progesterone increased (P < 0.05) to higher concentrations by d 5 in high-protein-fed ewes than in control ewes. More (P < 0.05) embryos were found in AMP of high-protein-fed ewes than in AMP of control ewes on d 4. Fewer (P = 0.05) embryos were found in UT of high-protein-fed ewes than in UT of control ewes on d 4. More embryos were found in UT of high-protein-fed ewes than in UT of control ewes on d 5. Fewer (P = 0.05) embryos were found in IST of high-protein ewes than in the IST of control ewes on d 5. Embryos of high-protein-fed ewes had more (P < 0.05) cells than embryos from control fed ewes on d 5. Feeding ewes excess DIP protein during an estrous cycle and the first 5 d after breeding initially impeded embryo transport; thereafter, embryo transport and development through the oviduct was accelerated.

Animals↗
PubMed2001

Amniotic fluid index in the uncomplicated term pregnancy. Prediction of outcome.

OBJECTIVE: To establish whether an association between oligohydramnios and pregnancy outcome is present in the uncomplicated term pregnancy. STUDY DESIGN: Pregnancies with a singleton fetus in cephalic presentation at term (> or = 37 weeks), a reactive non-stress test and an antepartum amniotic fluid index performed within four days of delivery between January 1994 and September 1998 were identified. Excluded were those with any maternal or fetal complication or unavailable outcome information. The primary outcome measure was rate of operative vaginal or abdominal delivery for a nonreassuring fetal heart rate tracing. Statistical analysis included Fisher's exact test and one-way analysis of variance, with a two-tailed P < .05 considered significant. RESULTS: Two hundred thirty-two women met the inclusion criteria; of them, 44 (19%) had an amniotic fluid index < or = 5 cm. There was no difference in the operative delivery rate for a nonreassuring fetal heart tracing between those with a normal amniotic fluid index > 5 cm vs. < or = 5 cm (39 [21%] vs. 5 [11%], P > .05). In addition, there were no differences between the two groups in rates of neonatal intensive care unit admissions or five-minute Apgar scores < 7. Patients with a normal amniotic fluid index had a significantly lower labor induction rate (96 [51%] vs. 42 [98%], P < .001) and higher rate of meconium-stained amniotic fluid (65 [35%] vs. 7 [16%], P = .01) than those with a low amniotic fluid index. CONCLUSION: In the uncomplicated pregnancy at term, an amniotic fluid index < or = 5 cm increases the incidence of labor induction but does not appear to affect the rate of operative delivery for abnormal fetal heart rate tracings.

Adolescent↗
PubMed2000

Enteric parasites in east African immigrants. Symptoms and duration of U.S. residence are not predictive.

The Minnesota Department of Health recommends a health assessment for all refugees within 1 to 3 months of arrival, including screening for enteric parasites. Little information exists, however, to help clinicians decide whether to screen asymptomatic persons who have lived in the United States for a year or more. We questioned 71 immigrants from East Africa now living in Minnesota's Twin Cities about gastrointestinal symptoms and duration of residence in the United States and asked for stool specimens for ova and parasite examination. Fifty-one patients (72%) returned specimens. The prevalence of symptoms was no different in the 14 patients with pathogenic parasites than in the 37 without (71% vs. 76%). Patients with pathogens were likely to have lived in the United States for less time than those without pathogens (median 17 months vs. 32 months), but the groups were not discrete. Clinical data did not identify a group unlikely to have parasites or need screening.

Adolescent↗
PubMed1999

Communicable disease in African immigrants in Minneapolis.

BACKGROUND: Despite increasing numbers of African immigrants to the United States, there is a lack of detailed information about their health problems. METHODS: Data on communicable diseases were obtained from the charts of all 102 patients who had emigrated from Africa in the last 5 years and were seen at an urban clinic in Minneapolis, Minn, during the last 7 months of 1997. RESULTS: Eight patients had active tuberculosis, 10 had hepatitis B, 7 trichuriasis, 2 amebiasis, 1 schistosomiasis, 1 ascariasis, 2 human immunodeficiency virus infection, and 1 malaria. All patients tested had antibodies to hepatitis A, 55% to hepatitis B, and 3% to hepatitis C. Characteristics of these patients are described. CONCLUSIONS: Communicable diseases are common in African immigrants, often despite a healthy appearance and prolonged residence in the United States. Careful screening is warranted.

Adult↗
PubMed1999

The development and validation of an occlusal site-specific plaque index to evaluate the effects of cleaning by tooth brushes and chewing gum.

These studies sought to develop and validate an occlusal site-specific plaque index to be used to measure plaque removal by brushing or chewing gum. The index divides the occlusal surfaces into imaginary zones from which scores are apportioned on a 0-4 basis dependent on the perceived % plaque coverage of each zone. Examiner calibration was conducted over 2 studies assessing inter-examiner reproducibility and intra-examiner repeatibility, respectively. Study 1 involved 2 examiners who recorded scores from the same 3 groups of subjects who had suspended tooth cleaning for 4 days. Analyses for inter-examiner reproducibility showed no significant mean differences between examiners or no significant differences between variances of the 2 examiners scores. Study 2 involved the same 2 examiners individually scoring 3 groups of subjects 2 x (approximately 60 min apart) for occlusal plaque. Analysis for intra-examiner repeatability showed no significant mean differences between the 2 scorings of each examiner. Furthermore, there were no significant differences between the variances of each examiner's scores except for 1 examiner in the repeatability exercise for the 1st group of subjects. Study 3 involved groups of subjects at 2 separate clinical sites (Bristol, England and Berne, Switzerland) being scored for occlusal plaque before and after toothbrushing with water or after no toothbrushing. Data from individual examiners and examiners combined revealed a significant reduction in occlusal plaque with brushing compared to no brushing. Study 4 was the same as study 3 but occlusal plaque was scored before and after chewing gum or not chewing gum. The Bristol examiner recorded a significant reduction in plaque by chewing gum compared to not chewing gum but the Berne examiner did not. The latter may have resulted from a considerable disparity in the number of evaluable occlusal surfaces between the two study sites. The index could be employed as part of the overall assessment or oral hygiene or used in clinical trials to study mechanical and chemical plaque control agents.

Adult↗
PubMed1999

The effects of mouth rinses and dentifrice-containing magnesium monoperoxyphthalate (mmpp) on oral microflora, plaque reduction, and mucosa.

The effects of a magnesium monoperoxyphthalate (MMPP) mouth-rinse, with or without sodium lauryl sulphate (SLS), and an MMPP dentifrice, on salivary counts of bacterial flora and yeasts, and on supragingival plaque scores were investigated in 131 healthy oral candida carriers over a 9 week double blind study. There were no changes in the salivary counts of bacteria studied (anaerobes, streptococci, fusobacteria, Actinomyces, Viellonella) in the test or placebo groups. A significant increase in salivary candida counts was seen in subjects using an MMPP rinse and dentifrice compared with placebo subjects and this phenomenon was not influenced by the presence of SLS. A significant reduction in plaque was seen in subjects using an MMPP rinse and dentifrice compared with placebo subjects. Frank candidosis was observed in only 2 subjects (1 in the placebo rinse group and 1 in the MMPP dentifrice group) but erythematous lesions, with subjective reports of soreness, dryness or burning sensation, were recorded and observed more frequently in the experimental groups than in the placebos, especially in those also using SLS. The substantial plaque reduction achieved with MMPP in the absence of tooth staining but with the increase in salivary Candida counts suggests that further studies of MMPP are warranted.

Actinomyces↗
PubMed1999

Helicobacter pylori in immigrants from East Africa.

This study determines the prevalence of Helicobacter pylori infection in a group of immigrants from East Africa with dyspepsia symptoms. Costs of treatment (including financial costs, adverse effects of treatment, and complexity of care) are compared for empiric treatment and treatment guided by serologic testing. Of the symptomatic patients, 93% had H. pylori antibodies. Empiric treatment of all patients with dyspepsia could reduce the cost of care by approximately half, with minimal risk to uninfected patients.

Adolescent↗
PubMed1997

A short-term clinical study design to investigate the chemical plaque inhibitory properties of mouthrinses when used as adjuncts to toothpastes: applied to chlorhexidine.

The removal of plaque by toothbrushing with toothpaste is the most common form of plaque control in the developed world. However, the use of chemical adjuncts such as mouthrinses is increasing. In practice mouthrinses and toothpaste are used together, however, in many clinical trials, employed to assess mouthrinse activity, toothpaste use is suspended. This fails to measure the effect of chemical interactions which are known to occur between toothpaste ingredients and mouthrinses. The objective of this trial was to develop a methodology which would assess the adjunctive chemical plaque inhibitory action of mouthrinses, when used with toothpaste but without the indeterminate variable of toothbrushing. The study was a single blind, randomised, 7-way crossover design, based on a variation of a 4 day plaque regrowth model. The 2 x daily rinsing regimens produced increasing plaque scores in the following order: (1) water/chlorhexidine, (2) chlorhexidine/water, (3) chlorhexidine/toothpaste slurry, (4) toothpaste slurry/chlorhexidine, (5) water/toothpaste slurry, (6) toothpaste slurry/water, (7) water/water. Chlorhexidine and water or chlorhexidine and toothpaste slurry combinations produced significantly lower plaque scores than water alone. Slurry and water combinations resulted in less plaque than water alone, but differences were not significant. Toothpaste slurry and chlorhexidine produced significantly increased plaque scores compared to chlorhexidine and water. The study suggests that, outside the Hawthorne effect, chlorhexidine rinses would be less effective in reducing plaque when used with toothpaste than when used alone. The methodology could be employed as a screening tool for the evaluation of mouthrinses expected to be used as adjuncts to normal oral hygiene methods. The same could be used to optimise oral hygiene regimens which include the use of mouthrinses.

Adult↗
PubMed1996

Selective recognition of malaria antigens by human serum antibodies is not genetically determined but demonstrates some features of clonal imprinting.

Malaria infection induces the production of serum antibodies to a variety of malaria antigens but the prevalence of antibodies to any particular antigen is typically much less than 100%. It has been assumed that non-responsiveness to defined antigens in malaria immune subjects is due to HLS-mediated restriction of the immune response. In this study we have investigated the role of HLA and non-HLA genes in the antibody response to two merozoite surface antigens (MSP1 and MSP2) and a sexual stage antigen (Ps260/230) of Plasmodium falciparum, and conclude that host genotype is not a major determinant of responsiveness. Although antibody levels vary in accordance with seasonal variations in malaria transmission in semi-immune children, antibody levels remain stable in clinically immune adults. Antigen recognition is selective with individual donors showing consistent high titre responses to some antigens/epitopes whilst consistently failing to recognize adjacent regions/epitopes of the same protein. An alternative explanation, consistent with the data presented here, is that selective antibody responses to malaria antigens in immune individuals result from a process akin to clonal imprinting (original antigenic sin).

Adult↗
PubMed1996

The New Poor Law and the County Pauper Lunatic Asylum--the Devon experience 1834-1884.

In this article we examine the impact of the policies and practices of the Guardians of the New Poor Law Unions on the management of pauper lunatics in four Devon Poor Law Unions in the critical period 1834-84. The central role of the Victorian Poor Law in provision made for the insane has only recently been recognized in the research literature. Scholars have been much more concerned with the activities of professionalizing physicians and the general project of state management than they have with the micro-politics of the local Poor Law and the magistracy who were responsible for the legal disposition of the insane. In this paper we argue that not only were the Guardians of the Poor Law Unions central in the determination of the lunatic's journey through the institutional systems provided in the mid-nineteenth century, but also that there were significant variations within the Poor Law system which made for contrasting systems of disposal of lunatics as between the Unions themselves. These variations in disposal of lunatics in Devon raise important questions of ideology, policy, and practice which, if repeated elsewhere, point to a need to refine significantly our assumptions regarding the disposal of pauper lunatics in England and Wales in the fifty years following the 1834 Poor Law Amendment Act.

History, 19th Century↗
PubMed1996

Acute and chronic changes in luteinizing hormone secretion and postpartum interval to estrus in first-calf suckled beef cows exposed continuously or intermittently to mature bulls.

The objective of this study was to determine whether patterns of LH secretion are acutely or chronically affected by the presence of mature bulls in postpartum first-calf suckled beef cows exposed to bulls either continuously or intermittently beginning on d 30 after birth. Crossbred cows were assigned randomly to be either continuously exposed to (BE; n = 20) or isolated from bulls (NE; n = 32) at calving, or exposed continuously (NEBE; n = 10) or intermittently (BEI; n = 21) to bulls beginning on d 30. The BEI cows were exposed to bulls for 2 h every 3rd d for 18 d. Ten cows from the NEBE, BEI, and NE treatments only were fitted with indwelling jugular catheters. Intensive blood sampling of NEBE and BEI cows began within 45 min after they were placed with bulls for 2 h on d 30, and for BEI cows on each d after 2 h exposure. Samples were collected at 15-min intervals for 6 h beginning on d 30 for NEBE, BEI, and NE cows; sampling continued at 3-d intervals until d 48. Samples were assayed for LH by RIA. Cows were observed twice daily (am:pm) for estrus. More (P = .07) BE and NEBE (75%) cows showed estrus by the end of the study than BEI and NE cows (48%). Interval to estrus was longer (P < .05) in BEI and NE cows (95.6 +/- 6.1 d) than in BE and NEBE cows (75.9 +/- 6.1 d). Baseline LH and amplitude and interpeak interval of LH peaks during the first 6 h after 2 h of bull exposure did not differ (P > .10) among treatments on d 30 after birth. However, mean LH and LH pulse frequency were higher (P = .06) for NEBE and BEI cows than in NE cows. Baseline LH and amplitude and duration of LH peaks did not differ (P > .10) over the seven sampling periods among NEBE, BEI, or NE cows. Mean LH and LH pulse frequency were higher (P < .05) in NEBE and BEI cows than in NE cows on each sampling period. Exposing first-calf suckled beef cows to bulls on d 30 after birth increased mean LH concentrations by increasing pulse frequency within a short period after a 2-h exposure. Thereafter, mean LH concentrations were higher in cows that were either continuously or intermittently exposed to bulls. Although mean LH and LH pulse frequency in NEBE and BEI cows were similar, intervals to estrus after bull exposure differed between treatments. The mechanism whereby bulls alter postpartum interval to estrus seems to involve other factors that may be related to but not directly linked with LH secretion.

Animals↗
PubMed1996

Linkage of congenital recessive deafness (gene DFNB10) to chromosome 21q22.3.

Deafness is a heterogeneous trait affecting approximately 1/1,000 newborns. Genetic linkage studies have already implicated more than a dozen distinct loci causing deafness. We conducted a genome search for linkage in a large Palestinian family segregating an autosomal recessive form of nonsyndromic deafness. Our results indicate that in this family the defective gene, DFNB10, is located in a 12-cM region near the telomere of chromosome 21. This genetic distance corresponds to <2.4 Mbp. Five marker loci typed from this region gave maximum LOD scores > or = to 3. Homozygosity of marker alleles was evident for only the most telomeric marker, D21S1259, suggesting that DFNB10 is closest to this locus. To our knowledge, this is the first evidence, at this location, for a gene that is involved in the development or maintenance of hearing. As candidate genes at these and other deafness loci are isolated and characterized, their roles in hearing will be revealed and may lead to development of mechanisms to prevent deafness.

Chromosome Mapping↗
PubMed1995

Linkage of congenital, recessive deafness (DFNB4) to chromosome 7q31 and evidence for genetic heterogeneity in the Middle Eastern Druze population.

Clinically significant hearing loss affects 1 in 1000 infants and it is estimated that at least 50% of these cases are due to a genetic cause. Some forms of inherited deafness are syndromic and affected individuals have a specific pattern of additional features while in other families the deafness is non-syndromic and there is no other recognizable phenotype. Analysis of several large families with syndromic and non-syndromic forms of deafness have been used in genetic linkage analysis to identify genes or gene locations that cause deafness. Here, we describe a large Middle-Eastern Druze family with recessive non-syndromic deafness and demonstrate linkage between deafness in this family and human chromosome 7q31 with a lod score exceeding 5.5. This is the first evidence for a gene at this location that causes deafness. In addition, we found that deafness in three other Druze pedigrees, one related to the linked family, is not linked to this chromosomal location. This suggests that there are multiple nonallelic mutations for deafness in this genetic isolate.

Cell Line↗
PubMed1995

Linkage of early-onset osteoarthritis and chondrocalcinosis to human chromosome 8q.

Calcium pyrophosphate-deposition disease (CPDD), also called "chondrocalcinosis" or "pseudogout," is a disorder characterized by the deposition of calcium-containing crystals in joint tissue, which leads to arthritis-like symptoms. The presence of these crystals in joint tissue is a common finding in the elderly, and, in this population, there is a poor correlation with joint pain. In contrast, early-onset CPDD has been described in several large families in which the disease progresses to severe degenerative osteoarthritis (OA). In these families, an autosomal dominant mode of inheritance is observed, with an age at onset between the 2d and 5th decades of life. In this report, we describe a large New England family with early-onset CPDD and severe degenerative OA. We found genetic linkage between the disease in this family and chromosome 8q, with a multipoint lod score of 4.06. These results suggest that a defective gene at this location causes the disease in this family.

Adult↗
PubMed1994

Histomorphology, oLH and hCG receptors, and testosterone secretion in vitro in Rambouillet rams from lines in which females had been selected for low or high reproductive rate.

The objective of this study was to determine whether gross or histomorphological components of the testes, capacity and dissociation constants (Kd) of testicular oLH and hCG receptors, and gonadotrophin-stimulated testosterone secretion in vitro differed among Rambouillet rams from lines selected for low or high female reproductive rate and from rams of a random-bred control line. Lines had been selected for approximately 20 years. Data were collected from 22-month-old rams during the late breeding season. Rams among lines did not differ (P > 0.05) in gross testicular characteristics or most histomorphological characteristics. However, the percentage volume of interstitial vascular tissue was greater (P < 0.05) for rams from lines selected for low female reproductive rate than for rams from lines selected for high female reproductive rate. Receptor sites per Leydig cell and binding capacities of oLH and hCG receptors per testis, per gram of parenchyma, and per milligram of membrane protein did not differ (P > 0.05) among lines. The Kd values for oLH and hCG receptors did not differ (P > 0.05) among lines; however, receptor sites per Leydig cell, capacities of testicular parenchyma to bind gonadotrophin and Kd values were higher (P < 0.05) for oLH than for hCG receptors. Total oLH- and hCG-stimulated testosterone secretion in vitro did not differ (P < 0.05) among lines. In conclusion, selection for or against reproductive rate in Rambouillet ewes has not altered gross or most histomorphometric characteristics of the testes of male offspring, with the exception that selection against reproductive rate increased the proportion of testicular volume occupied by vascular tissue within the interstitium.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗