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Biomedical subjects

S Murray

Publications and source records attributed to S Murray.

At least 73 records · Page 4Linked to original sources

Anesthesia in female white-tailed deer using Telazol and xylazine.

Thirty two free-ranging female white-tailed deer (Odocoileus virginianus) were anesthesized with varying Telazol and xylazine HCl combinations in Front Royal (Virginia, USA) between August 1992 and September 1992. All animals were caught in baited box traps, manually restrained, and hand injected with a combination of Telazol and xylazine administered intramuscularly. Deer received mean +/- SE dosages of 2.53+/-0.16 mg/kg Telazol and 0.69+/-0.05 mg/kg of xylazine. These dosages achieved a rapid and effective anesthetic plane for short-term procedures such as weighing, blood collection, and translocation. Eight of 32 deer (25%) required an intravenous (i.v.) supplement of ketamine HCl (100 mg) to maintain a safe plane of anesthesia. Ketamine supplementation provided an average of 11.8+/-2.0 min additional safe handling. Satisfactory reversals were achieved in all deer by administering yohimbine HCl 16 mg i.v. (dose range, 0.22 to 0.48 mg/kg) to all animals.

Adrenergic alpha-Agonists↗

Diverticulitis with rupture and fatal peritonitis in a Sumatran orangutan (Pongo pygmaeus).

A 30-year-old male Sumatran orangutan (Pongo pygmaeus) presented with signs of depression, lethargy, anorexia, and diarrhea that progressed to acute colic. Exploratory laparotomy revealed fibrinopurulent peritonitis and 50 cm of devitalized small intestine. The surgically resected small intestine contained several mucosal diverticula along the mesenteric attachment; one had ruptured, resulting in peritonitis. Fifteen days after surgery, the orangutan's abdominal incision dehisced. Repeated laparotomy revealed dehiscence of the distal intestinal anastomosis site, as well as extensive adhesions and purulent exudate. The defect was repaired, and the abdomen was extensively irrigated and closed, but the animal died within 24 hours. To our knowledge, this is the first report of diverticulitis in a great ape. Diverticulosis should be considered in the differential diagnosis for great apes that present with signs of depression, lethargy, anorexia, and/or diarrhea.

Animals↗

IL-7 enhances Ag-specific human T cell response by increasing expression of IL-2R alpha and gamma chains.

Interleukin-7 has demonstrated potent enhancing effects on the growth and differentiation of several immature cell types, including thymocytes, and on survival of resting and antigen activated T cells. In this study, we evaluated the effects of IL-7 on post-thymic antigen-specific T cells from human blood. IL-7 was found to enhance proliferation responses and IFN-gamma secretion of myelin or recall Ag-specific Th1 cells through the selective up-regulation of the IL-2Ralpha and gamma but not beta chains in both an Ag-dependent and Ag-independent manner, but did not affect monocytes, B cells, or NK cells. These functions of IL-7 enhanced the detection of Th1 but not Th2 cell frequency by >2.5 fold, and promoted selection of Ag-specific Th1 cells by the limiting dilution method. Moreover, IL-7 pretreatment conferred increased resistance of CD4+ T cells to CD8+ cell lysis. These studies demonstrate that IL-7 promotes the growth and survival of circulating Ag-specific human Th1 cells through a mechanism that probably involves the gammac common receptor for IL-2 family members that includes IL-7.

Antigens, CD19↗

Effects of Alzheimer's disease and gender on the hypothalamic-pituitary-adrenal axis response to lumbar puncture stress.

Differences in hypothalamic-pituitary-adrenal (HPA) axis responsiveness to lumbar puncture (LP) stress were studied in normal elderly subjects and Alzheimer's disease (AD) patients of both genders. Elderly normal subjects had larger peak cortisol and ACTH responses than AD patients. These results contrast with some previous reports of increased HPA-axis responsivity associated with AD and suggest that AD-related changes in HPA responsiveness depend on the type of stressor involved and are mediated 'upstream' to the final common pathway to ACTH secretion. HPA-axis responsiveness also differed by gender, with higher peaks and prolonged elevations in elderly female subjects than in elderly males.

Adrenal Glands↗

Community-oriented medical education in Glasgow: developing a community diagnosis exercise.

OBJECTIVES: Recent NHS changes have included an increasing emphasis on primary care settings, and hence community needs assessment. This has led to suggestions that medical education should become more community-oriented if today's medical students are to become effective medical practitioners. Recent curriculum reforms in a number of medical schools frequently involve a more student-centred approach, which encourages students to learn by intellectual discovery and critical thinking. We describe one such exercise in community diagnosis that has been developed in Glasgow's new undergraduate medical curriculum. DESIGN: The exercise has been developed as three teaching sessions, each with specific learning objectives. The first session explores the strengths and weaknesses of routine statistics, and reveals the lack of information regarding individual's and community's health and health care needs. The second session is a community-based rapid participatory appraisal arranged by general practitioners. Students interview patients, carers, and local key informants and health care professionals about their perceptions of health and health needs. In the final campus-based session, students combine and present their findings. Development included two pilot exercises involving detailed evaluation. SETTING: University of Glasgow. SUBJECTS: Medical students. RESULTS: Students valued the contrasting perspectives and information provided by different sources. After completing the three sessions, most students and tutors considered it an interesting, enjoyable and educational experience. CONCLUSIONS: This innovative community-oriented teaching programme gave students some insight into how health, morbidity and mortality are measured, why these might vary between different communities, and how different community members' perspectives might differ regarding perceived health and social needs.

Curriculum↗

White coat hypertension and carotid atherosclerosis.

To investigate further the relationship between atherosclerotic vascular disease and blood pressure, and the phenomenon of white coat hypertension, we performed a cross-sectional study of patients referred for carotid Doppler scanning, to determine the relationship between ambulatory blood pressure monitoring (ABPM) and carotid atherosclerosis. We studied 79 patients (51 men, 28 women) undergoing Doppler ultrasound examination of the carotid arteries: 44 (56%) had evidence of carotid atherosclerosis on Doppler ultrasound examination ("disease group"), whilst 35 (44%) had normal carotid arteries ("controls"). "Adequate" ABPM recordings, defined by > 90% of recordings over the 24 h, were available in 51 patients (30 positive, 21 negative). There were no significant differences in mean daytime, mean night-time or mean 24 h ABPM recordings between those with and without carotid atherosclerosis. Mean manual clinic systolic blood pressure was significantly greater in those with carotid atherosclerosis than in controls (146.7 +/- 25.2 vs 131.1 +/- 35 mmHg, p < 0.005). In patients with carotid atherosclerosis, the first systolic blood pressure ABPM recording was not significantly different from the mean manual clinic recording (mean difference -1.5 mmHg, 95% confidence interval (CI) -7.9 to 4.8 mmHg). The initial diastolic blood pressure ABPM recording was significantly higher than the mean manual recording. Carotid atherosclerosis was identified in 53% of normotensive controls compared with 56% of white coat hypertensives and 75% of persistent hypertensives. One-third (9/27) of the patients with normal carotid arteries did not have nocturnal dipping ("non-dippers") compared with 50% (12/24) of the atherosclerotic patients. This study suggests that carotid atherosclerosis may be associated with white coat hypertension. Our study adds to the body of evidence that white coat hypertension is associated with end-organ damage and is not simply a benign disease. Such patients should be screened for other cardiovascular risk factors and should be monitored for the development of persistent hypertension.

Aged↗

Secretion of pancreatic digestive enzymes induced in rats by first-time oral exposure to kidney bean E2L2 lectin is mediated only in part by cholecystokinin (CCK).

The acute effects of kidney bean (Phaseolus vulgaris) E2L2 lectins (PHA) given orally to conscious rats or continually infused into the duodenum of anesthetized rats on blood cholecystokinin (CCK), secretin, and gastrin and on secretion of pancreatic digestive enzymes have been evaluated. PHA increased circulating levels of CCK and secretin but did not alter gastrin. In addition, PHA induced dose-dependent secretion of trypsinogen, chymotrypsinogen, and alpha-amylase by the pancreas in vivo. This pancreas output appeared to be modulated only in part through CCK. Thus pretreatment of rats with a CCK-A receptor antagonist (L-364718) attenuated the immediate (< or = 90 min) pancreas secretory response to PHA but could not prevent a PHA-associated increase in digestive enzyme output in the longer term (after 90 min). In contrast, treatment of rats with L-364718 abolished the stimulatory effects of soyabean trypsin inhibitors on digestive enzyme secretion in both the short and long term. Additional mechanisms or hormones, such as secretin, may play a role in modulating later exocrine pancreas responses to PHA.

Animals↗

Sequential methods for comparing years of life saved in the two-sample censored data problem.

This research develops nonparametric strategies for sequentially monitoring clinical trial data where detecting years of life saved is of interest. The recommended test statistic looks at integrated differences in survival estimates during the time frame of interest. In many practical situations, the test statistic presented has an independent increments covariance structure. Hence, with little additional work, we may apply these testing procedures using available methodology. In the case where an independent increments covariance structure is present, we suggest how clinical trial data might be monitored using these statistics in an information-based design. The resulting study design maintains the desired stochastic operating characteristics regardless of the shapes of the survival curves being compared. This offers an advantage over the popular log-rank-based design strategy since more restrictive assumptions relating to the behavior of the hazards are required to guarantee the planned power of the test. Recommendations for how to sequentially monitor clinical trial progress in the nonindependent increments case are also provided along with an example.

Biometry↗

Spinal cord stimulation significantly decreases the need for acute hospital admission for chest pain in patients with refractory angina pectoris.

OBJECTIVE: To assess the impact of spinal cord stimulation (SCS) on the need for acute admissions for chest pain in patients with refractory angina pectoris. DESIGN: Retrospective analysis of case records. PATIENTS: 19 consecutive patients implanted for SCS between 1987 and 1997. All had three vessel coronary disease, and all were in New York Heart Association functional group III/IV. METHODS: Admission rates were calculated for three separate periods: (1) from initial presentation up until last revascularisation; (2) from last revascularisation until SCS implantation; (3) from SCS implantation until the study date. Post-revascularisation rates were then compared with post-SCS rates, without including admissions before revascularisation, as this would bias against revascularisation procedures. RESULTS: Annual admission rate after revascularisation was 0.97/patient/year, compared with 0.27 after SCS (p = 0.02). Mean time in hospital/patient/year after revascularisation was 8.3 days v 2.5 days after SCS (p = 0.04). No unexplained new ECG changes were observed during follow up and patients presented with unstable angina and acute myocardial infarction in the usual way. CONCLUSIONS: SCS is effective in preventing hospital admissions in patients with refractory angina, without masking serious ischaemic symptoms or leading to silent infarction.

Angina Pectoris↗

Xanthomatosis in geckos: five cases.

Five cases of xanthomatosis in geckos were evaluated, one in a northern green gecko (Naultinus grayi) and the remaining four in three species of leaf-tailed geckos (two Uroplatus henkeli, one U. sikorae, one U. fimbriatus). All geckos were females 3-11 yr of age, were clinically ill on presentation, and either died or were euthanized. Necropsies showed emaciation in three geckos, with white nodular foci on coelomic surfaces in two of these geckos. The other two geckos had no gross abnormalities. Histopathologic examination revealed xanthomatosis involving the coelomic surfaces of four geckos and the ventricles of the brain in all geckos. Xanthomas in the brain were associated with various degrees of hydrocephalus. The lesions were comprised of stacks of clear clefts consistent with cholesterol crystals, and these structures were surrounded by epithelioid macrophages, multinucleated giant cells, and lymphocytes. Four geckos had active folliculogenesis, and two had foci of follicular degeneration and localized yolk coelomitis. In all cases, xanthomatosis was believed to have contributed significantly to morbidity and mortality.

Animals↗

Emergency medical admissions in Glasgow: general practices vary despite adjustment for age, sex, and deprivation.

BACKGROUND: Emergency admission rates have been rising rapidly in Britain. Studies defining the underlying factors are needed. AIM: To determine the principal diagnoses, demographic, and socioeconomic factors associated with emergency medical admissions. METHOD: Cohort study based on the Greater Glasgow Health Board population of 810,423 adults. A fully anonymized dataset linkage of 43,247 adult emergency admissions to Glasgow medical beds in 1997 was obtained. Emergency admission rates were analysed by diagnosis, age, sex, Carstairs' deprivation category, and by individual general practices (after adjustment for other factors). RESULTS: The commonest principal diagnoses were chest pain (9.6%), chronic obstructive airways disease (5.6%), angina (5.4%), heart failure (4.1%), and acute myocardial infarction (3.9%). Twenty-one per cent of patients were coded as having 'ill-defined signs or symptoms'. Emergency medical admission rates rose with the age of the patient, doubling with every two decades' age increase. Admission rates for patients from deprived areas were twice those from affluent areas. Males were more frequently admitted than females (adjusted odds ratio = 1.19). After adjustment for age, sex, and deprivation, the general practices' emergency medical admission rates showed an almost twofold difference between the top and bottom deciles. CONCLUSION: Emergency medical admission rates are higher among the elderly, males, and deprived populations. This has implications for equitable resource distribution in the National Health Service. Admissions for exclusion of myocardial disease were common; however, myocardial infarction was not the final diagnosis in two-thirds of these patients. The large variation between the general practices' admission rates requires further investigation.

Adolescent↗

Improving tumour targeting and decreasing normal tissue uptake by optimizing the stoichiometry of a two-step biotinylated-antibody/streptavidin-based targeting strategy: studies in a nude mouse xenograft model.

We aimed to study in detail the in vivo stoichiometry of the individual elements of the 2-step streptavidin based approach to tumour targeting, in a nude mouse xenograft model, by the administration of a first step consisting of biotinylated anti-tumour specific antibody and a second step consisting of streptavidin. This process was undertaken to identify the optimum conditions for radiotherapeutic tumour targeting using this approach. Antibody was biotinylated to various degrees (1-25 biotins per antibody). Protein stoichiometry of the 2 steps was studied over a range of 2 logs. Both steps, i.e., the biotinylated-antibody (1st step) and streptavidin (2nd step) were radiolabelled (125I and 131I, respectively). A 24-hr interval between 1st and 2nd step was studied, animals being killed 24 hr after the 2nd step. Streptavidin excess led to a decrease in levels of monobiotinylated-antibody in the circulation and in the tumour. Biotinylated-antibody excess led to an increase in circulating levels of streptavidin, a decrease in renal uptake of streptavidin and increased targeting of streptavidin to tumour. At a constant protein molar ratio of biotinylated antibody to streptavidin of 10:1, increasing biotinylation density resulted in an increase in circulating levels, increase in tumour uptake, decrease in renal uptake and increase in liver uptake of streptavidin. As early as 24 hr, the tumour-to-blood ratios of streptavidin already exceeded 1 (max 1.27). Compared with antibody tumour-to-blood ratios, they were better by a factor of between 2 and 3. Tumour-to-normal tissue ratios of radiolabelled streptavidin (with the exception of liver) were also significantly improved when polybiotinylated-antibody was administered first. We have thus shown that the 2-step biotinylated antibody/streptavidin approach can lead to a significant increase in absolute amounts of activity in the tumour under appropriate stoichiometric conditions. This was accompanied by high levels of circulating streptavidin and relatively favourable tumour-to-blood and normal tissue ratios of streptavidin.

Animals↗