Biomedical subjects

R Joseph

Publications and source records attributed to R Joseph.

At least 19 recordsLinked to original sources

PubMed2007

Sick notes, general practitioners, emergency departments and fracture clinics.

BACKGROUND: General practitioner waiting times are increasing. The two national surveys regarding general practice showed that the number of patients waiting for >or=2 days for an appointment rose from 63% to 72% between 1998 and 2002, with 25% waiting for >or=4 days. The Department of Health recognised that many patients discharged from hospitals and outpatient clinics required to visit their general practitioner for the sole purpose of obtaining a sick note. The report entitled Making a difference: reducing general practitioner paperwork estimated that 518 000 appointments (and 42 000 GP h) could be saved by ensuring that these patients were issued with a sick note directly from hospital rather than being referred to their general practitioner. This practice was to be adopted from July 2001 and included patients discharged from wards as well as those seen in outpatient departments. METHOD: 50 emergency departments and fracture clinics in Scotland and England were contacted to assess whether these guidelines had been adopted. Only hospitals with both accident and emergency and fracture clinics were included; nurse-led and paediatric departments were excluded. RESULTS: Of the 25 Scottish emergency hospitals contacted, 4 (16%) accident and emergency departments and 8 (32%) fracture clinics issued sick notes. This was compared with 5 of 25 (20%) accident and emergency departments and 12 of 25 (48%) fracture clinics in England. Four Scottish and five English accident and emergency departments stated that it was policy to give sick notes, three Scottish and four English departments said that it was policy not to give them and the rest (72% in Scotland and 64% in England) stated that they had no clear policy but "just don't give them". CONCLUSION: The 2001 guidance from the joint Cabinet Office/Department of Health has not been fully incorporated into standard practice in Scotland and England. If all emergency departments and fracture clinics were to issue sick notes to patients requiring >7 days absence from work, this could reduce general practitioner consultations and improve waiting times.

Emergency Service, Hospital↗

PubMed2006

Once daily MMX mesalazine for the treatment of mild-to-moderate ulcerative colitis: a phase II, dose-ranging study.

BACKGROUND: SPD476 (MMX mesalazine), is a novel, once daily, high-strength mesalazine formulation (1.2 g/tablet) that utilizes Multi Matrix System (MMX) technology to delay and extend delivery of the active drug throughout the colon. AIM: To assess the safety and efficacy of MMX mesalazine in patients with mild-to-moderately active ulcerative colitis, in a pilot, phase II, randomized, multicentre, double-blind, parallel-group, dose-ranging study (SPD476-202). METHODS: Thirty-eight patients with mild-to-moderately active ulcerative colitis were randomized to MMX mesalazine 1.2, 2.4 or 4.8 g/day given once daily for 8 weeks. Remission ulcerative colitis-disease activity index (UC-DAI) < or =1, a score of 0 for rectal bleeding and stool frequency, and > or =1 -point reduction in sigmoidoscopy score from baseline was the primary end point. RESULTS: Week 8 remission rates were 0%, 31% and 18% of patients receiving MMX mesalazine 1.2, 2.4 and 4.8 g/day respectively. No statistically significant difference in remission was observed between treatment groups. MMX mesalazine 2.4 and 4.8 g/day groups demonstrated greater improvement in overall UC-DAI and component scores from baseline, compared with the 1.2 g/day group. CONCLUSION: MMX mesalazine given as 2.4 or 4.8 g/day once daily is well tolerated and effective for the treatment of mild-to-moderately active ulcerative colitis.

Adolescent↗

PubMed2006

New phage type among methicillin-resistant Staphylococcus aureus associated with a local outbreak in Belgium during 2002.

In total, 150 methicillin-resistant Staphylococcus aureus (MRSA) isolates collected during 2002 from a general Belgian hospital were phage-typed at routine test dilution x 100. The majority (45%) belonged to phage group (J)*, while 10% were classified as a new phage type 29/(42E)/54/(D11)*. The isolates belonging to this new type carried the aac(6')-aph(2'') and the aph(3') aminoglycoside resistance genes and showed high-level resistance to oxacillin. Molecular typing revealed that they belonged to the multiresistant clonal pulsed-field gel electrophoresis (PFGE) type D8. PFGE group D, characterised as genotype ST228-MRSA-I, has been present in Belgian hospitals since 1999.

Bacteriophage Typing↗

PubMed2005

Universal newborn hearing screening in Singapore: the need, implementation and challenges.

With about 1 in 1000 born with severe to profound hearing loss and about 5 in 1000 with lesser degrees of loss, congenital deafness is the commonest major birth defect. It is the recommended standard that hearing loss in newborns be detected by 3 months of age and intervention implemented by 6 months of age. Delayed detection and intervention may affect speech, language and psychosocial development, resulting in poor academic achievements. Universal newborn hearing screening (UNHS) is the only effective way of detecting all babies with hearing loss, within the recommended time frame. A survey in Singapore revealed that traditional childhood hearing screening programmes resulted in late detection (mean age, 20.8 months; range, 0 to 86 months) and late intervention (mean age, 42.4 months; range, 1 to 120 months). Increasingly, UNHS is becoming standard medical care in developed countries. In Singapore, UNHS has been implemented in all hospitals with obstetric services. Although a screening rate of more than 99% has been achieved in public hospitals, private hospitals have a screening rate of only about 77%. Parents' awareness and acceptance of early detection is still lacking, and this needs to be addressed by appropriate public education. Support from obstetricians and paediatricians will significantly contribute towards this objective. Effective programme management is essential; this includes the use of data management systems, the maintenance of a team of experienced screeners, and efficient coordination between screening and diagnostic services. Early detection of childhood deafness, together with early and effective intervention, maximises the chances of successful integration into mainstream education and society.

Audiometry, Evoked Response↗

PubMed2004

Amphidial neurons ADL and ASH initiate sodium dodecyl sulphate avoidance responses in the infective larva of the dog hookworm Anclyostoma caninum.

Ablations of specific amphidial neuron pairs with a laser microbeam were conducted to understand better the neurological basis of the behaviours of larval parasitic nematodes. To date, the functions of the amphidial neurons of Caenorhabditis elegans and their counterparts in parasitic nematodes have been found to be remarkably conserved allowing the possibility to predict the relationships between neurons and their functions. Therefore, we anticipated that ablation of neuron pairs ASH and ASK would abrogate avoidance of sodium dodecyl sulphate (SDS) by infective larvae (L3i) of Anclyostoma caninum. Instead, we have found that laser microbeam ablation of these neuron pairs did not eliminate SDS avoidance in A. caninum, but that neuron pairs ASH and ADL are the amphidial neurons responsible for SDS repulsion. When a droplet of the repellent is placed in the direct path of a normal A. caninum L3i, a strong backward avoidance response is triggered. However, when the ASH and ADL neurons are ablated, the nematodes demonstrate the opposite reaction, increasing their movement in a forward direction.

Ancylostoma↗

PubMed2004

Effect of particle morphology and polyethylene molecular weight on the fracture toughness of hydroxyapatite reinforced polyethylene composite.

Fracture toughness testing has been performed on hydroxyapatite-polyethylene composites. Sintered and unsintered grades of hydroxyapatite and two grades of high-density polyethylene were used to make 40 vol % hydroxyapatite composites. Compact tension testing was performed at both room temperature and at 37 degrees C and at three strain rates. The effect of increasing the loading rate from 2 to 200 microm s(-1) was to increase the fracture toughness. Increasing the testing temperature or decreasing the surface area of the reinforcing particles also increased the fracture toughness. However, using a lower molecular weight, injection moulding, grade of polyethylene reduced the fracture toughness. Thus for higher fracture toughness, a low surface area sintered hydroxyapatite in a high-molecular weight polyethylene is required.

Biocompatible Materials↗

PubMed2003

Chemical RNA labeling without 3' end bias using fluorescent cis-platin compounds.

Recently, fluorescent, monofunctional cis-platin derivatives have been developed to chemically label nucleic acids for use in fluorescent hybridization assays. Here we show by hybridizations to microarrays containing oligonucleotide probes for the 3' ends, middle parts, and 5' ends of mRNAs, that this labeling methodology bypasses the problem of the 3' end bias that is characteristic of the conventional enzymatic oligo(dT)-primed, reverse transcription labeling of mRNAs.

DNA↗

PubMed2003

Mass newborn screening in Singapore--position and projections.

INTRODUCTION: This paper describes the development, current position and projected development of mass newborn screening in Singapore. METHODS: A search was conducted through the Medline and through the abstract books of conferences for papers on mass newborn screening in Singapore. This was complemented with the author's own records of the outcome of screening newborns at the National University Hospital. RESULTS: Cord blood screening for glucose-6-phosphate dehydrogenase (G6PD) deficiency began in 1965; through patient isolation, prompt treatment of jaundice and parent education, kernicterus has been eliminated. Pilot screening for congenital hypothyroidism began in 1981 and has become nationwide since 1990. Screening rates are almost 100% and with early treatment, mental retardation has been eliminated in those affected. However, academic difficulties are present in about a third of patients. Screening for hearing impairment now covers 80% of newborns. The incidence of significant impairment is 1 in 1000 births and interventions have been in place before a year of age. Two strategies--measuring automated auditory brainstem responses (AABR) and otoacoustic emissions supplemented with AABR--are being evaluated. CONCLUSIONS: The programme requires refining of screening strategies, creation of a central registry of cases, provision of educational support and expansion to include screening with tandem mass spectrometry for multiple inborn errors of metabolism.

Forecasting↗

PubMed2002

Effect of hydroxyapatite morphology/surface area on the rheology and processability of hydroxyapatite filled polyethylene composites.

The commercial success of hydroxyapatite (HA) filled polyethylene composite has generated growing interest in improving the processability of the composite. A number of synthetic procedures and post synthesis heat treatment of HA has lead to the availability of powders with widely varying morphological features. This paper addresses the effect of morphological features of HA on the rheology and processability of an injection-moulding grade HA-HDPE composite. The results showed that low surface area HA filled composite exhibited better injection processing characteristics through improved rheological responses. The effect of reducing the surface area of the filler is to require less polyethylene to wet the filler and allows more polyethylene to be involved in the flow processes. These changes reduced the temperatures and pressures required for successful processing.

Biocompatible Materials↗

PubMed2002

Maternal thyrotoxicosis causing central hypothyroidism in infants.

We describe three infants born to mothers with poorly controlled Graves' disease, who developed transient central hypothyroidism in the immediate postnatal period. Suppression of the fetal pituitary-thyroid axis may be due to placental transfer of thyroxine from the hyperthyroid mother. This may persist for months postnatally, necessitating treatment to optimise neurodevelopmental outcome.

Adult↗

PubMed2001

Current directions in research on autism.

One of the most active areas of current research in the field of developmental disorders is autism. Since the NIH State of the Science conference, held in 1995 (Bristol et al. [1996] J. Autism Dev. Disorders 26:121-154), funding opportunities for comprehensive research programs addressing genetic, neurobiological, and behavioral aspects of this complex disorder have grown exponentially. Although we are far from having a complete understanding of the causes and deficits that define autism, significant progress has been made over the past few years. In this review, we summarize recent developments across a number of different areas of research in the field of autism, including diagnosis; defining the phenotypic features in individuals with autism; genetic bases; and neurobiological deficits.

Adolescent↗

PubMed2001

A comparative evaluation of coefficient of friction and mechanical properties of commercially available Foley catheters.

Three commercially available urinary catheters were evaluated for their coefficient of friction and mechanical properties, which are two important parameters as far as the intended use is considered. The apparent coefficient of friction was measured from the slope of the force versus normal load graph using an in-house fabricated setup. The mechanical properties like ultimate tensile strength, elongation at break and modulus were evaluated before and after aging in synthetic urine. The swelling behavior of the catheter samples was studied in toluene and found to correlate well with the mechanical properties.

Catheters, Indwelling↗

PubMed2001

Volatile essential oil constituents of Alpinia smithiae (Zingiberaceae).

The composition of leaf and rhizome essential oils of Alpinia smithiae that grow wild in the Western Ghats of Kerala (South India) was analysed by gas chromatography. The major components were beta-caryophyllene, sabinene, myrcene and 1,8-cineole in both samples, but variation in the yield of oil as well as the major components between the two plant parts was observed.

Chromatography, Gas↗

PubMed2000

Inositol polyphosphate 4-phosphatase type I regulates cell growth downstream of transcription factor GATA-1.

Megakaryocytes lacking transcription factor GATA-1 fail to complete maturation in vivo and hyperproliferate. To define how GATA-1 regulates megakaryocyte cell growth we searched for mRNA transcripts expressed in primary wild-type, but not GATA-1(-), megakaryocytes. One differentially expressed transcript encodes inositol polyphosphate 4-phosphatase type I (4-Ptase I). This enzyme hydrolyses phosphatidylinositol 3,4-bisphosphate and also has lesser activity against soluble analogues of this lipid, inositol 3, 4-bisphosphate and inositol 1,3,4-triphosphate. Reintroduction of 4-Ptase I into both primary GATA-1(-) and wild-type megakaryocytes significantly retards cell growth, suggesting that absence of 4-Ptase I may contribute to the hyperproliferative phenotype of GATA-1(-) megakaryocytes. Overexpression of 4-Ptase I also markedly reduces growth of NIH 3T3 fibroblasts. Taken together, these data indicate that 4-Ptase I is a regulator of cell proliferation.

3T3 Cells↗

PubMed2000

Induction of colony morphology variation in Rhodotorula gracilis by UV irradiation.

Nonlethal UV irradiation induced an unusually high frequency of colony morphology variation in Rhodotorula gracilis. The variation was not fixed but indicated further variability in subsequent platings. Microscopic examination of the cultures indicated that UV-irradiated variants had grossly varying types of shapes and arrangements of cells in contrast to the uniformly shaped and budding cells of the nonirradiated culture. Flow-cytometric analysis of a colony variant suggested a slightly higher proportion of cells with variable DNA content than the nonirradiated culture. Extensive biochemical characterization revealed only one difference in that the nonirradiated culture had a partial requirement for pantothenate while the colony variant was completely independent of this requirement. We speculate that UV triggers a yet unstudied means of variability in R. gracilis with possible accompanying recombinational events.

Flow Cytometry↗

PubMed2000

Bioconversion of alpha pinene to verbenone by resting cells of Aspergillus niger.

Resting cells of a locally isolated strain of Aspergillus niger caused the bioconversion of alpha pinene to verbenone. The formation of verbenone was raised from trace amounts (under screening conditions) to 3.28 mg/100 ml (equivalent to a molar yield of 16.5% conversion of the substrate) by amending the cultivation medium for the fungus. The optimal conditions were: 6 g/100 ml for the glucose concentration, a pH of 7.0, an alpha pinene concentration of 20 mg/100 ml, and a 6-h incubation period for the reaction.

Aspergillus niger↗

PubMed2000

The evolution of sex differences in language, sexuality, and visual-spatial skills.

The evolutionary neurological and physical foundations for human sex differences in language, sexuality, and visual spatial skills are detailed and primate and human studies are reviewed. Trends in the division of labor were established early in evolution and became amplified with the emergence of the "big brained" Homo erectus. A bigger brain necessitated a size increase in the birth canal and female pelvis. These and other physical changes, e.g., the swelling of the breasts and buttocks, may have paralleled the evolution of full-time sexual receptivity, the establishment of the home base, and exaggerated sex differences in the division of labor (hunting vs. gathering), which in turn promoted innate sex differences in visual spatial vs. language skills. For example, female primates produce more social and emotional vocalizations and engage in more tool use and gathering activities, whereas males tend to hunt and kill. Similar labor divisions are evident over the course of human evolution. "Woman's work" such as child rearing, gathering, and domestic tool construction and manipulation contributed to the functional evolution of Broca's speech area and the angular gyrus--which injects temporal sequences and complex concepts into the stream of language and thought. These activities gave rise, therefore, to a female superiority in grammatical (temporal sequential) vocabulary-rich language. Hunting as a way of life does not require speech but requires excellent visual-spatial skills and, thus, contributed to a male visual-spatial superiority and sex difference in the brain. Over the course of evolution males acquired modern human speech through genetic inheritance and because they had mothers who taught them language.

Affect↗

PubMed2000

Dynamic mechanical characterization of hydroxyapatite reinforced polyethylene: effect of particle size.

Dynamic mechanical analysis (DMA) was used to characterize biomedical composites consisting of synthetic hydroxyapatite (HA) particulate reinforced polyethylene (PE). The effects of the HA volume fraction, temperature and HA particle on the storage modulus (E(I)) and damping (tan delta) were investigated. Increasing HA volume fractions increased E(I) and decreased tan delta. E(I) was found to be linearly related to the Young's modulus values obtained from quasi-static tensile tests. Relative modulus and damping studies showed that the viscoelastic behavior of unfilled PE was different to that of the filled matrix due to the presence of thermally induced tensile stresses in the matrix at the filler-matrix interface.

Journal Article↗