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Biomedical subjects

S Kerr

Publications and source records attributed to S Kerr.

At least 55 records · Page 3Linked to original sources

Diagnostic application of monoclonal antibodies to outer membrane protein for rapid detection of Salmonella.

Monoclonal antibodies produced to Salmonella enteritidis outer membrane proteins were screened against 57 Salmonella serovars and several related enterobacteria. Those detecting all Salmonella serovars and none of the related enterobacteria were used in a microtitre plate antigen capture ELISA to screen clinical samples. Sixty-one of 2100 samples yielded salmonellas after incubation for 24 h in selective media by conventional culture. Of these 58 were detected by the ELISA. Sixty-five false positives by ELISA were found to be Enterobacter spp. The results show the potential of this ELISA to eliminate a large proportion of the salmonella-negative cultures at an early stage.

Antibodies, Monoclonal↗

ECMO in newborn infants: the New South Wales experience.

Extracorporeal membrane oxygenation (ECMO) has been used at the Prince of Wales Children's Hospital, Sydney for the treatment of newborn infants with life-threatening respiratory or cardiac failure since August 1989. The main indications are that the disease is reversible, the surviving infant is likely to be normal and there is an 80% likelihood of death without ECMO. Eighteen of 19 newborn infants have survived at least 2 months after ECMO. The 15 infants receiving ECMO (nine with meconium aspiration, six with persisting pulmonary hypertension) who did not have a congenital diaphragmatic hernia were normal survivors. One death occurred at 5 months of age from chronic lung disease. Three of four infants with congenital diaphragmatic hernia were discharged following ECMO and appeared normal at 6, 9 and 18 months of age. These results are similar to results from other centres internationally. It appears that ECMO is a useful therapy for near-term newborn infants with otherwise fatal cardiorespiratory failure.

Extracorporeal Membrane Oxygenation↗

Studies on Australian snake venoms, Part II: The haematological effects of brown snake (Pseudonaja) species in the dog.

The haematological effects of Brown Snake (Pseudonaja) species (textilis, affinis, nuchalis) were studied in anaesthetised, mechanically ventilated dogs. Marked thrombocytopenia, depletion of serum fibrinogen and prolonged prothrombin and activated partial thromboplastin time, were recorded at 5 to 10 and 30 to 40 minutes after intravenous envenomation. Fibrin degradation products were not elevated. Because these haematological effects occurred simultaneously with cardiovascular depression (previously reported), we postulate that hypotension sometimes observed in human envenomation may be due to intravascular coagulation with myocardial ischaemia.

Animals↗

HIV testing in patients with end stage renal disease.

One hundred and twenty eight British and Irish nephrologists were questioned about their policy for HIV testing of patients with end stage renal failure being considered for renal replacement therapy. A total of 101 (79%) replied. In the case of candidates for dialysis roughly one third of respondents tested only people they considered at risk of infection with HIV and nearly one fifth considered testing unnecessary. In the case of candidates for transplantation routine HIV testing was carried out by 68 of 100 nephrologists; 22 tested only patients "at risk" and 10 did not test. A positive HIV test result was considered by most but not all respondents (63/86) to exclude patients from transplantation. Twenty four of 88 nephrologists considered that HIV positivity should exclude patients from haemodialysis, but only seven of 87 would exclude such patients from peritoneal dialysis. Similar attitudes pertained for patients with end stage renal failure who refused HIV testing. Testing with the patient's knowledge and consent was the policy of two thirds of nephrologists, but a patient's signature was obtained by only 24 of 88. There should be a consensus on practice for HIV testing of patients with end stage renal failure.

AIDS Serodiagnosis↗

A survey of methicillin-resistant Staphylococcus aureus affecting patients in England and Wales.

For a six-month period between October 1987 and March 1988, 660 isolates of methicillin-resistant Staphylococcus aureus (MRSA) from 570 patients were sent to the Staphylococcus Reference Laboratory at Colindale to supplement the National reporting survey of MRSA in England and Wales. The isolates were characterized by phage typing, antibiotic susceptibility and by selected biochemical tests. Patient details were also surveyed. Fourteen strains affected more than one hospital and were called multi-hospital epidemic strains. One strain, EMRSA-1, accounted for more than 40% of isolates and of patients. Other epidemic strains were defined. Ten additional strains were restricted to single hospitals. Only 25 primary isolates were non-typable but 67 sporadic typable strains occurred. The patients affected were approximately equally either infected or colonized. The sexes were represented equally. Orthopaedic and geriatric wards were over-represented. Epidemic strains were clumping factor positive while some sporadic strains were weak producers. Urea alkalinization and protein A production could supplement phage typing and antibiotic resistance in strain recognition.

Adult↗

Mechanical ventilation of paediatric patients with asthma: short and long term outcome.

In the 7 years from 1982 to 1988, 10,639 children with acute asthma were admitted to the Royal Children's Hospital, Melbourne. Of these, 262 children (2%) were treated in the Intensive Care Unit. Twenty-seven required mechanical ventilation on 34 occasions, being 0.3% of hospital asthma admissions. Five patients died, four due to brain death following respiratory arrest prior to intubation. The main complications were (i) barotrauma, which occurred in five patients on seven occasions (20%); (ii) a reversible myopathy which occurred in three patients treated with high dose corticosteroids and muscle relaxants. Follow-up of patients ventilated in intensive care revealed that all but one of the initial survivors was alive 1-5 years later, all patients required subsequent readmission to hospital for treatment of acute asthma and 78% had persistent rather than episodic asthma. Although uncommon, an episode of ventilation has a major impact on the family's understanding and future management of acute asthma.

Adolescent↗

Knowledge of HIV infection and AIDS, and attitudes to testing and counselling among general practitioners in Northern Ireland.

All 922 general practitioners in Northern Ireland were sent a questionnaire on human immunodeficiency virus (HIV) infection and the acquired immune deficiency syndrome (AIDS). Five hundred and ninety four general practitioners (64.4%) returned the questionnaire. Thirty eight respondents (6.4%) knew of an HIV positive patient in their practice and 93.3% felt they should be informed if one of their patients was found to be HIV positive at a genitourinary medicine clinic, even without the patient's consent. Of the respondents, 76.8% were willing to be involved in the management of AIDS patients in their practice in cooperation with hospital colleagues but only 37.5% felt confident to provide AIDS counselling and advice. Of the 368 general practitioners who did not feel confident to provide AIDS counselling and advice, 41.3% felt that they had insufficient knowledge and 79.6% felt uncertain of their counselling skills. The information gathered on the administration of injections, taking blood samples and disposal of needles indicated that further education for general practitioners is required to ensure safety at work.

Acquired Immunodeficiency Syndrome↗

Antiemetic therapy for chemotherapy-induced vomiting: metoclopramide, benztropine, dexamethasone, and lorazepam regimen compared with chlorpromazine alone.

Twenty-six children aged 4 to 15 years who were to receive cancer chemotherapy were enrolled in a double-blind, randomized, crossover trial that compared the antiemetic efficacy of a four-drug regimen (the MBDL regimen: metoclopramide, 8 mg/kg; benztropine, 0.04 mg/kg; dexamethasone, 0.7 mg/kg; lorazepam, 0.1 mg/kg), given over 24 hours, with the efficacy of chlorpromazine, 3.3 mg/kg, given in four doses over 24 hours. The MBDL regimen was more effective than chlorpromazine in both objective and subjective measures of antiemetic control. Of 26 children, 23 (89%) had less vomiting on the MBDL regimen, and 20 (77%) of 26 patients or parents preferred this regimen (p less than 0.01). The MBDL regimen reduced the number of vomiting episodes by a mean of 4.0 (p less than 0.01) and reduced the duration of vomiting by a mean of 3.7 hours (p less than 0.01). A moderate level of sedation was documented at some stage in the 24-hour period of observation in 27% on the MBDL regimen and in 35% receiving chlorpromazine. Dystonia was seen in 1 (4%) of 26 children. We conclude that the MBDL regimen is safe in children and more effective than chlorpromazine.

Adolescent↗

Studies on Australian snake venoms. Part 1: The haemodynamic effects of brown snake (Pseudonaja) species in the dog.

The haemodynamic effects of Brown Snake (Pseudonaja) species (textilis, nuchalis, affinis) were investigated in anaesthetised, mechanically ventilated dogs. Blood pressure decreased to minimal levels five minutes after intravenous envenomation. Hypotension was accompanied by significant decrements in cardiac output and stroke volume and a rise in peripheral vascular resistance. Heart rate increased transiently during 0.5-2.0 minutes after envenomation but had declined below resting levels five minutes after envenomation. No statistically significant change was recorded in central venous pressure. Depression of myocardial contractility is postulated as the mechanism of venom induced hypotension.

Animals↗

Sexual attitudes and practices of selected groups in Northern Ireland since the emergence of AIDS.

One hundred and seventeen heterosexual males and females attending a sexually transmitted disease clinic and 57 homosexual males from a local "gay" club were asked to complete a questionnaire regarding their attitudes and sexual practices since the emergence of AIDS. The results show a trend towards increasing partner change rate among heterosexual males. There has been an increase in the practice of insertive anal intercourse by homosexual men with Northern Ireland contacts but no corresponding increase with contacts outside Northern Ireland. The practice of receptive anal intercourse has remained constant. Significant differences in attitudes between homosexual and heterosexual males were expressed with regard to testing of 'at risk groups' (p less than 0.001), in the uptake of testing (p less than 0.01), and in attitudes to sexual practices if they themselves became HIV positive. There was a low level of anxiety amongst heterosexuals regarding risk of HIV infection in the future. Less than 50% of the heterosexual patients attending this clinic use condoms, though more claim to intend to use them in future.

Acquired Immunodeficiency Syndrome↗

Mesolimbic dopamine receptor increases two weeks following hippocampal kindling.

Kindled seizures developed in rats following repeated electrical stimulation of the left CA1 region of the hippocampus. Two weeks after the final kindled seizure, the densities of dopamine (DA) D2 receptors were assayed in the left and right amygdaloid area, nucleus accumbens, and nucleus caudatus. A significant increase (107%) in the density of DA D2-receptors in the ipsilateral nucleus accumbens occurred. This finding may help to define the long-term neurochemical consequences of kindling.

Animals↗

Potential of indium-111 to measure inflammatory arthritis.

Since an objective noninvasive method for measuring inflammation in arthritis is lacking, radioimaging experiments were conducted with 111indium-chloride (111InCl3) in the collagen model. A computer imaging index, reflecting uptake in the feet and ankles, was significantly greater in 16 rats immunized with collagen than in 6 nonimmunized rats (mean +/- SEM 1.18 +/- 0.04 vs 0.39 +/- 0.02, for the 2 groups, respectively, p less than 0.001). Additional analyses provided evidence that the 111InCl3 technique can be used to measure objectively progression of the arthritic response of rats of immunization with collagen, and pilot comparisons with conventional bone scintigraphy in 2 patients with rheumatoid arthritis suggested that the method is applicable to human arthritic disease.

Animals↗

Distribution and mechanism of uptake of 111InCl3 in a tumor model for lymph node metastases.

The localization of 111In activity in the tumor and draining lymph nodes of the H-4-II-E ACI rat hepatoma was investigated following the injection of 111In-chloride. In this tumor model, the tumors metastasize to the regional lymph nodes in male rats only. The following experiments were performed: (a) biodistribution of 111In; (b) correlation of 111In uptake with [3H]thymidine; (c) gamma camera imaging; (d) autoradiography; (e) iron competition and (f) binding of 131I-transferrin to H-4-II-E cells. Tumor-to-muscle ratios of 111In in males were 4.9:1 in the primary tumor and 9.1:1 in the metastatic lymph nodes 24 h post injection. In the lymph node metastases in the males, a significant correlation between 111In uptake and [3H]thymidine was observed (r = 0.737) suggesting that 111In uptake in the metastases is related to cellular proliferation. No such correlation was observed in either primary tumors (both male and female) or in the draining lymph nodes of the females. Metastatic lymph nodes in males could be detected in gamma camera images while draining nodes in females could not be delineated. Injection of ferric citrate prior to 111In administration resulted in a significant reduction of 111In uptake in the liver, spleen and tumor and increased the amount of activity recovered from the kidney. Measurements of the binding of 131I-labeled rat transferrin to H-4-II-E cells in vitro suggest that these cells display transferrin receptors.

Animals↗

Dermatoglyphs and chromosome mosaicism in parents of children with trisomy 18.

Parents of patients with Down's syndrome show dermatoglyphic features intermediate between the affected and the normal population. Dermatoglyphs were studied on the parents of 19 cases of trisomy 18, but no similar "intermediate" traits were discovered. The number of cases studied needs to be enlarged before it can definitely be stated that trisomies 18 and 21 differ in this respect.

Chromosomes, Human, 16-18↗