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Biomedical subjects

S Brandon

Publications and source records attributed to S Brandon.

At least 19 recordsLinked to original sources
PubMed2001

A survey of attitudes to parent-doctor conflicts over treatment for children.

AIMS: To investigate professional and public attitudes to the intervention of the law when parents and doctors disagree about the medical treatment of children. METHODS: A cross-sectional survey of academic staff at the University of Otago. Random samples of academic medical practitioners and non-Health Sciences academic staff completed written questionnaires, including open and closed questions. Questions focussed on the Liam Williams-Holloway (W-H) and Tovia Laufau (TL) cases. RESULTS: The response rate was 107/164 (65%) of eligible staff. Support for doctors seeking treatment orders was strong (77% in the W-H case, and in the TL case, 70% believed an order should have been sought). Women were less likely than men to support a treatment order, significantly in the W-H case. There were no significant differences between medical and non-medical respondents. Court processes were viewed as confrontational and a last resort only after mediation failed. Scientific evidence was rated as the most important consideration in treatment decisions, followed by likely outcome, establishment of trust between parents and doctors, and the age of the child. CONCLUSIONS: Among this highly educated group there was strong support for seeking treatment orders in the child's best interests. But various mediation options were preferred and should be explored further. More evidence is needed on the success of treatment orders and on the attitudes of a more representative sample of the population.

Attitude of Health Personnel↗
PubMed2001

Does excretion of secondary metabolites always involve a measurable metabolic cost? Fate of plant antifeedant salicin in common brushtail possum, Trichosurus vulpecula.

Salicin was administered orally to six brushtail possums by incorporation in food for six days at three dose levels (0.05, 0.5, and 1.5% wet weight), giving mean +/- SD daily intakes of 0.31 +/- 0.09, 2.76 +/- 0.75, and 6.04 +/- 1.12 mmol salicin. Metabolites were identified by mass spectrometry and assayed by HPLC. Salicyl alcohol glucuronide accounted for 56-64% of urinary metabolites over the three doses, salicyluric acid 15-26%, salicin 10-18%, and there were smaller amounts of free (2-4%) and conjugated (0-6%) salicylic acid. beta,2-Dihydroxyphenylpropionic acid was a minor metabolite. The hydrolysis of dietary salicin enabled reconjugation of its aglycone, salicyl alcohol, with a more polar sugar, glucuronic acid, thus enhancing its renal excretion and resulting in little net loss of substrates for conjugation and a low measurable metabolic cost of excretion.

Administration, Oral↗
PubMed2000

Panic in a general practice population: prevalence, psychiatric comorbidity and associated disability.

BACKGROUND: Panic disorder and simple panic are known to be common disorders associated with various physical and psychological difficulties, but their prevalence rates as reported in the literature vary widely. This paper is the result of a survey of panic in a general practice population, and discusses prevalence rates, screening for panic and psychiatric comorbidity. Comparisons are made between subjects with and without panic with regard to their self-reported disability. METHODS: A random sample of 2000 individuals from the patient list of a group general practice were sent a questionnaire screening for panic attacks and asking for levels of everyday functioning and disability. Patients who screened positive for panic were interviewed using the Structured Clinical Interview for DSM III R. RESULTS: A total of 1152 people responded to the questionnaire. In this sample, the lifetime prevalence of panic was 8.6%, and well over half of these had single or multiple additional psychiatric diagnoses. People with panic were found to perceive themselves as significantly less physically and psychologically healthy. It was found that screening questions that focussed on the psychological symptoms of panic missed a significant proportion of subjects with panic, particularly men. CONCLUSION: The level of psychiatric comorbidity in this study mirrors that found by other investigators. The amount of perceived disability suffered by individuals with panic is considerable. This study may contribute to the argument that people with panic should be identified at an early stage, to prevent unnecessary investigation and ensure adequate treatment.

Adolescent↗
PubMed2000

Screening for osteoporosis using easily obtainable biometrical data: diagnostic accuracy of measured, self-reported and recalled BMI, and related costs of bone mineral density measurements.

The aims of the present study were: to determine the diagnostic accuracy of objectively measured, self-reported and recalled body mass index (BMI) for osteoporosis and osteopenia; to determine the diagnostic costs, in terms of bone mineral density (BMD) measurements, per osteoporotic or osteopenic patient detected, using different BMI tests; and to determine the extent to which the results can be used within the framework of the current screening program for breast cancer in The Netherlands. Within the framework of a cross-sectional study on the prevalence of osteoporosis in the south of The Netherlands, 1155 postmenopausal women aged 50-80 years were asked for their present height and their weight at age 20-30 years. Subsequently their actual weight, height and BMD of the lumbar spine (DXA) were measured. The BMD cutoff was 0.800 g/cm2 for osteoporosis and 0.970 g/cm2 for low BMD (osteoporosis + osteopenia). After receiver operating characteristic analysis, age was cut off at 60 years and BMI at 27 kg/m2. Diagnostic accuracies of objectively measured, self-reported and recalled BMI were evaluated using predictive values (PV) and odds ratios. The resulting 'true positive' and 'false positive' rates were used to calculate diagnostic costs (i.e., DXA) for each osteoporotic patient or low-BMD patient detected. The prevalence of osteoporosis in the study population was 25%, that of low BMD 65%. Only the age-BMI tests 'age > or = 60, BMI < or = 27' showed PVs for osteoporosis (31-41%) and for low BMD (71-81%) that were higher than the prior probabilities for these conditions. Related odds ratios were 2.14-3.18 (osteoporosis) and 1.87-3.04 (low BMD). The objective BMI test detected 50% of the osteoporotic patients. Using the self-reported BMI test and the recalled BMI test, detection rates increased to 55% and 69%, respectively. Concomitant costs per osteoporotic patient detected rose by 24%. Detection of patients with a low BMD increased from 38% for objective BMI and 42% for self-reported BMI to 60% for recalled BMI. Related costs increased by 11%. If all women over 50 years of age (irrespective of their BMI) were to be referred for BMD measurement, costs per osteoporotic patient or low-BMD patient detected would be 304 and 116 Euros, respectively. Only in women over 60 years does a BMI below 27 kg/m2 provide a better prediction of the presence of osteoporosis or low BMD than could be expected solely on the basis of the relevant prevalences in postmenopausal women aged 50-80 years. If the use of BMI for the detection of osteoporotic or low-BMD patients is still considered, measuring weight and just asking for a person's height will do. Although age and BMI are the strongest risk factors for osteoporosis, they are of less significance when used for screening the population for osteoporosis. More research is needed before age and BMI can be included in any screening program. As regards practical considerations alone, measurements of BMD could be implemented within the screening program for breast cancer.

Absorptiometry, Photon↗
PubMed2000

Characterization of murine vasopressor and vasodepressor prostaglandin E(2) receptors.

Four E-prostanoid (EP) receptors, designated EP(1), EP(2), EP(3), and EP(4), mediate the cellular effects of prostaglandin E(2) (PGE(2)). The present studies pharmacologically characterize the vasopressor and vasodepressor EP receptors in wild-type mice (EP(2)(+/+) mice) and mice with targeted disruption of the EP(2) receptor (EP(2)(-/-) mice). Mean arterial pressure (MAP) was measured via a carotid artery catheter in anesthetized male mice. Intravenous infusion of PGE(2) decreased MAP in EP(2)(+/+) mice but increased MAP in EP(2)(-/-) mice. Infusion of EP(3)-selective agonists, including MB28767, SC46275, and sulprostone, increased MAP in both EP(2)(+/+) and EP(2)(-/-) mice. Pretreatment with SC46275 desensitized mice to the subsequent pressor effect of sulprostone, but the vasodepressor effect of PGE(2) in EP(2)(+/+) mice remained intact. Although PGE(2) alone increased MAP in EP(2)(-/-) mice, prior desensitization of the pressor effect with SC46275 allowed a residual vasodepressor effect of PGE(2) to be seen in the EP(2)(-/-) mice. An EP(4)-selective agonist (prostaglandin E(1)-OH) functioned also as a vasodepressor in both EP(2)(-/-) and EP(2)(+/+) mice. High levels of EP(3) receptor mRNA were detected in mouse aortas and rabbit preglomerular arterioles by nuclease protection, with lower expressions of EP(1), EP(2), and EP(4) mRNA. The findings suggest that combined vasodepressor effects of EP(2) and EP(4) receptors normally dominate, accounting for the depressor effects of PGE(2). In contrast, in EP(2)(-/-) mice, EP(4) receptor activity alone is insufficient to overcome the EP(3) vasopressor effect. These findings suggest that a balance between pressor and depressor PGE(2) receptors determines its net effect on arterial pressure and that these receptors may be important therapeutic targets.

Animals↗
PubMed1999

Salt-sensitive hypertension and reduced fertility in mice lacking the prostaglandin EP2 receptor.

Prostaglandins (PGs) are ubiquitous lipid mediators derived from cyclooxygenase metabolism of arachidonic acid that exert a broad range of physiologic activities, including modulation of inflammation, ovulation and arterial blood pressure. PGE2, a chief cyclooxygenase product, modulates blood pressure and fertility, although the specific G protein-coupled receptors mediating these effects remain poorly defined. To evaluate the physiologic role of the PGE2 EP2 receptor subtype, we created mice with targeted disruption of this gene (EP2-/-). EP2-/- mice develop normally but produce small litters and have slightly elevated baseline systolic blood pressure. In EP2-/- mice, the characteristic hypotensive effect of intravenous PGE2 infusion was absent; PGE2 infusion instead produced hypertension. When fed a diet high in salt, the EP2-/- mice developed profound systolic hypertension, whereas wild-type mice showed no change in systolic blood pressure. Analysis of wild-type and EP2-/- mice on day 5 of pregnancy indicated that the reduced litter size of EP2-/- mice is due to a pre-implantation defect. This reduction of implanted embryos could be accounted for by impaired ovulation and dramatic reductions in fertilization observed on day 2 of pregnancy. These data demonstrate that the EP2 receptor mediates arterial dilatation, salt-sensitive hypertension, and also plays an essential part in female fertility.

Animals↗
PubMed1998

Recovered memories of childhood sexual abuse. Implications for clinical practice.

BACKGROUND: The growth in the USA of 'recovered memory therapy' for past sexual abuse has caused great public and professional concern. It became apparent that the polarisation of views and fierce controversy within the American psychiatric community was in danger of bringing psychotherapy into disrepute and it seemed important to examine objectively the scientific evidence before such polarisation developed in the UK. METHOD: A small working group reviewed their own experience, visited meetings and centres with expertise in this field, interviewed 'retractors' and accused parents, and then began a comprehensive review of the literature. RESULTS: There is a vast literature but little acceptable research. Opinions are expressed with great conviction but often unsupported by evidence. CONCLUSIONS: The issue of false or recovered memories should not be allowed to confuse the recognition and treatment of sexually abused children. We concluded that when memories are 'recovered' after long periods of amnesia, particularly when extraordinary means were used to secure the recovery of memory, there is a high probability that the memories are false, i.e. of incidents that had not occurred. Some guidelines which should enable practitioners to avoid the pitfalls of memory recovery are offered.

Art Therapy↗
PubMed1997

Simulated Contact Angle Hysteresis of a Three-Dimensional Drop on a Chemically Heterogeneous Surface: A Numerical Example

A public domain software package is employed in the quasi-steady-state simulation of contact angle hysteresis. Three-dimensional sessile drops in equilibrium with a model chemically heterogeneous smooth solid surface are considered; evolving drop shapes, as a function of incremental changes in their volume, are investigated. Results are presented for a model system in which the intrinsic contact angle is assumed to vary along the surface in a periodic manner. Throughout the simulation, calculated contact angles show reasonable agreement with the local intrinsic contact angle values, and the computed drop shapes are found to be constant mean curvature surfaces. Significant hysteresis in the liquid-fluid interface curvature and average contact angle is found; a complete hysteresis loop is simulated. Advancing and receding contact angles exhibit the "stick-slip" behavior observed in experiments as well as in previous 2-D simulations.

Journal Article↗
PubMed1997

Tissue content of alpha-tocopherol and oxidative stability of broilers receiving dietary alpha-tocopheryl acetate supplement for various periods pre-slaughter.

1. The effects of dietary alpha-tocopheryl acetate on the alpha-tocopherol status of chicken plasma and tissues were investigated. The rate of iron-ascorbate-induced lipid peroxidation was also studied. 2. One hundred and forty four chicks were divided into 6 groups: one control group was fed a basal diet of 30 mg alpha-tocopheryl acetate/kg food for the duration of the trial. A supplemental diet of 200 mg alpha-tocopheryl acetate was fed to each of the other 5 groups for 1,2,3,4 or 5 weeks prior to slaughter. 3. Supplementation resulted in an increase in alpha-tocopherol in plasma and all tissues examined. Saturation levels of alpha-tocopherol were observed in plasma after 1 week of feeding and in tissues within 3 to 4 weeks of feeding. 4. Supplementation with alpha-tocopheryl acetate for up to 4 weeks pre-slaughter resulted in significant reductions in susceptibility to induced lipid peroxidation. 5. Overall, the results show that feeding 200 mg alpha-tocopheryl acetate/kg food to chicks for at least 4 weeks prior to slaughter is necessary to optimise muscle content and stability against lipid peroxidation.

Abattoirs↗
PubMed1997

Validation of the Dutch translation of the Inflammatory Bowel Disease Questionnaire (IBDQ): a health-related quality of life questionnaire in inflammatory bowel disease.

Health-related quality of life assessment can benefit several groups involved with health care. The aim of our study was to assess construct validity, reliability, discriminant ability and sensitivity to change of the Dutch translation of the Inflammatory Bowel Disease Questionnaire (IBDQ), a disease-specific quality-of-life questionnaire. A group of 120 IBD patients completed the IBDQ and two Visual Analogue Scales concerning general well-being and bowel function twice. Fifty-two patients also completed the Short-Form 36 twice. Disease activity was assessed once. Correlations between the IBDQ scores and the global assessments were reasonably high and the IBDQ was shown to be discriminative. High intraclass correlation coefficients between both measurements of the IBDQ were observed in patients who reported no change in bowel complaints. In contrast, significant differences were found between both moments in patients who reported change. The Dutch IBDQ proved to be valid, discriminative and reliable.

Adolescent↗
PubMed1996

Simulation of Contact Angle Hysteresis on Chemically Heterogeneous Surfaces

A quasi-steady-state simulation of contact angle hysteresis is presented. The model system consists of a two-dimensional drop on a smooth but chemically heterogeneous solid surface. The changes in the free energy of the system, the contact angle, and the size of the base of the drop are followed as its volume increases or decreases. The simulated contact angle hysteresis, including discontinuous changes in the contact angle and the size of the base of the drop, are shown to be very similar to typical experimental observations. In addition, the dependence of receding and advancing angles on the energy available for overcoming energy barriers is illustrated.

Journal Article↗
PubMed1996

Quantitative urinary excretion of unmetabolised N tau-[Me-14C] methylhistidine by the common ringtail possum (Pseudocheirus peregrinus) marsupialia.

Six common ringtail possums (Pseudocheirus peregrinus) were intravenously injected with a standard dose of radioactive 3-Methylhistidine (N tau-[Me-14C]MeH). The dose was rapidly and quantitatively excreted by the possums. More than 90% of radioactivity was recovered within 3 days. Thin layer chromatography and mass spectroscopy showed that 97% of recovered radioactivity was associated with unmetabolised N tau-[Me-14C]MeH. These data satisfy two key requirements for the validity of urinary 3-Methylhistidine (N tau-3MeH) excretion as an index of muscle protein catabolism, in P. peregrinus.

Animals↗