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Biomedical subjects

T Kemp

Publications and source records attributed to T Kemp.

At least 19 recordsLinked to original sources
PubMed2006

Effect on hematologic risk factors for coronary heart disease of a cholesterol reducing diet.

BACKGROUND: A dietary portfolio of cholesterol-lowering ingredients has proved effective in reducing serum cholesterol. However, it is not known whether this dietary combination will also affect hematologic risk factors for coronary heart disease (CHD). Reductions in hematocrit and polymorphonuclear leukocytes have been reported to improve cardiovascular risk. We, therefore, report changes in hematological indices, which have been linked to cardiovascular health, in a 1-year assessment of subjects taking an effective dietary combination (portfolio) of cholesterol-lowering foods. METHODS: For 12 months, 66 hyperlipidemic subjects were prescribed diets high in plant sterols (1.0 g/1000 kcal), soy protein (22.5 g/1000 kcal), viscous fibers (10 g/1000 kcal) and almonds (23 g/1000 kcal). Fifty-five subjects completed the study. RESULTS: Over the 1 year, data on completers indicated small but significant reductions in hemoglobin (-1.5+/-0.6 g/l, P=0.013), hematocrit (-0.007+/-0.002 l/l, P<0.001), red cell number (-0.07+/-0.02 10(9)/l, P<0.001) and neutrophils (-0.34+/-0.13 10(9)/l, P=0.014). Mean platelet volume was also increased (0.16+/-0.07 fl, P=0.033). The increase in red cell osmotic fragility (0.05+/-0.03 g/l, P=0.107) did not reach significance. CONCLUSIONS: These small changes in hematological indices after a cholesterol-lowering diet are in the direction, which would be predicted to reduce CHD risk. Further research is needed to clarify whether the changes observed will contribute directly or indirectly to cardiovascular benefits beyond those expected from reductions previously seen in serum lipids and blood pressure.

Adult↗
PubMed2003

Tetracycline-inducible transgene expression mediated by a single AAV vector.

Regulated gene delivery systems are usually made of two elements: an inducible promoter and a transactivator. In order to optimize gene delivery and regulation, a single viral vector ensuring adequate stoichiometry of the two elements is required. However, efficient regulation is hampered by interferences between the inducible promoter and (i) the promoter used to express the transactivator and/or (ii) promoter/enhancer elements present in the viral vector backbone. We describe a single AAV vector in which transcription of both the reverse tetracycline transactivator (rtTA) and the transgene is initiated from a bidirectional tetracycline-responsive promoter and terminated at bidirectional SV40 polyadenylation sites flanking both ITRs. Up to 50-fold induction of gene expression in human tumor cell lines and 100-fold in primary cultures of rat Schwann cells was demonstrated. In addition an 80-fold induction in vivo in the rat brain has been obtained. In vitro, the autoregulatory vector exhibits an induced expression level superior to that obtained using the constitutive CMV promoter. Although extinction of the transgene after removal of tetracycline was rapid (less than 3 days), inducibility after addition of tetracycline was slow (about 14 days). This kinetics is suitable for therapeutic gene expression in slowly progressive diseases while allowing rapid switch-off in case of undesirable effects. As compared to previously described autoregulatory tet-repressible (tetOFF) AAV vectors, the tet-inducible (tetON) vector prevents chronic antibiotic administration in the uninduced state.

Animals↗
PubMed2003

Compensating for the effect of inlet gas temperature on heated humidifier performance.

The humidity output of heated humidifiers may be compromised by inlet gas temperatures exceeding approximately 26 degrees C, with humidity dropping below the recommended levels for intubated patients. A new version of the Fisher & Paykel MR850 humidifier claims to deal with this problem by offering a humidity compensation option. The present study tested this feature by measuring humidity output using the gravimetric method and a hygrometer at different inlet gas temperatures (16.6 degrees C to 40.0 degrees C) with compensation on and off. It was found that the compensation is effective in maintaining humidity levels despite high inlet gas temperatures.

Critical Care↗
PubMed2001

A case-control study of risk factors for asthma in New Zealand children.

OBJECTIVE: As in other English-speaking countries, asthma is a major and increasing health problem in New Zealand. This study examined the risk factors for asthma in children aged 7-9. METHODS: Cases and controls were randomly selected from participants in the Wellington arm of the International Study of Asthma and Allergies in Childhood (ISAAC). Cases were children with a previous diagnosis of asthma and current medication use (n=233), and controls were children with no history of wheezing and no diagnosis of asthma (n=241). RESULTS: After controlling for confounders, factors significantly associated with asthma were maternal (OR=3.36, 95% CI 1.88-5.99) and paternal asthma (OR-2.67, 95% CI 1.42-5.02), and male sex (OR=1.81, 95% CI 1.17-2.81). Children from social classes 5 and 6 or with unemployed parents (OR=2.32, 95% CI 1.22-4.44) were significantly more likely to have asthma than children in social classes 1 and 2. There was no significant association between having polio vaccination (OR=2.48, 95% CI 0.83-7.41), hepatitis B vaccination (OR=0.66, 95% CI 0.42-1.04) or measles/mumps/rubella vaccination (OR=1.43, 95% CI 0.85-2.41) and asthma. CONCLUSIONS: This study has confirmed the associations of family history and lower socio-economic status with current asthma in 7-9 year old children. The role of vaccinations requires further research.

Asthma↗
PubMed1998

Biologic pollution in infant bedding in New Zealand: high allergen exposure during a vulnerable period.

BACKGROUND: High exposure to house dust mite and cat allergens in early life predisposes to allergic sensitization and to the development and persistence of asthma. Prevalence and severity of asthma are high in New Zealand. OBJECTIVE: The objective of this study was to determine the concentrations of Der p 1 and Fel d 1 in infant bedding in Wellington, New Zealand. METHODS: Infants were visited at home at a mean age of 11 weeks and again at 15 months. The concentration (microgram/g fine dust) and content (microgram/m2) of Der p 1 (154 infants) and Fel d 1 (75 infants) were measured in dust samples taken from each infant's bed. RESULTS: At 11 weeks, geometric mean (95% confidence intervals) Der p 1 levels were 18.3 micrograms/g (13.8 to 24.1) and 3.51 micrograms/m2 (2.4 to 5.2). By 15 months, Der p 1 had risen significantly to 44.0 micrograms/g (35.0 to 55. 3) and 49.0 micrograms/m2 (36.0 to 66.8). Bedding that included a sheepskin was used by a third of the infants and contained higher concentrations (microgram/g) and content (microgram/m2) of Der p 1 than beds without sheepskins. Cat ownership was the major determinant of Fel d 1 levels, with 48% of infants living with cats. At the first visit, the mean concentration of Fel d 1 in bedding was 44.6 micrograms/g (23.5 to 84.9) for houses with cats and 3.0 micrograms/g (2.1 to 4.3) for those without cats, remaining essentially unchanged at the second visit. When expressed as micrograms per square meter, there was a significant increase between visits, from 8.1 (3.9 to 16. 6) to 39.6 (19.9 to 78.5) in the cat-inclusive households. CONCLUSIONS: Extremely high levels of house dust mite allergen have been found in these infants' environments, which, together with the high levels of cat allergen in almost half who kept cats, are likely to be a major determinant of asthma prevalence and severity in New Zealand.

Allergens↗
PubMed1997

Respiratory questionnaire responses: how they change with time.

AIM: Responses to respiratory questionnaires are often used to identify individuals with asthma symptoms and may also be used to identify asymptomatic individuals. This study investigates the repeat responses over four years to such a questionnaire in a population of adult New Zealanders. METHODS: Seven hundred and twenty three asthmatics were sent two almost identical questionnaires in three areas of New Zealand, separated by approximately four years. All of them had answered yes to at least one of the three questions under study in the first survey. RESULTS: Following the second asthma questionnaire only 487 (67.4%) answered yes to at least one of the survey questions. Similarly, 51.1% of those who had reported having nocturnal shortness of breath in the first survey did so in the second survey, 69.9% of those who reported having had an asthma attack in the first survey did so in the second survey, and finally 74.8% of those who reported using asthma medication in the first survey did so in the second survey. CONCLUSION: Even in a previously identified symptomatic asthmatic group, a large proportion did not report respiratory symptoms and asthma medication use four years later. This implies that the true prevalence pool of susceptibles is likely to be far greater than is identified in surveys of the 12-month period prevalence of asthma symptoms. This has implications not only for the design of epidemiological studies (e.g., it poses problems for the selection of a control group of non-asthmatics in prevalence case-control studies), but also for the planning of health services and educational programmes for people with asthma.

Adult↗
PubMed1997

Under the volcano: fire, ash and asthma?

AIMS: To investigate the prevalence of respiratory symptoms in known asthmatics, following exposure to airborne volcanic ash particles caused by the eruptions of Mount Ruapehu, New Zealand, commencing September 1995. METHOD: A one page postal questionnaire was sent to 1392 previously identified asthmatics 2 months after the first major eruption. RESULTS: Two hundred and thirty seven subjects had moved from the area, died or gone overseas since the original contact 4 years previously; therefore the target population was 1155 subjects of whom 361 lived in the exposed area and 794 in the nonexposed areas. The response rates were 246 (68.1%) in the exposed group and 477 (60.1%) in the nonexposed group making a total of 723 individuals. The prevalence of nocturnal shortness of breath in the last two months was 29.3% in the exposed group and 24.7% in the nonexposed (OR = 1.26, 95% CI; 0.83-1.78). Similarly 30.9% of the exposed group had an asthma attack in the last 2 months compared to 31.9% of the nonexposed group (OR = 0.96, 95% CI; 0.69-1.33). Finally, 48.4% of the exposed group used asthma medication in the 2 months following the eruption in comparison to 53% of the nonexposed group (OR = 0.83, 95%, CI; 0.61-1.12). CONCLUSIONS: The study showed no association between living in an area exposed to volcanic ash particles and either asthma symptoms or the use of asthma medication. There was a small but nonsignificant increase in nocturnal shortness of breath in the exposed group.

Acute Disease↗
PubMed1997

Researching complementary therapies: a Delphi study to identify the views of complementary and orthodox practitioners.

Twenty five participants were invited to a workshop looking at the role of research and development in complementary therapies. These participants took part in a modified Delphi study to ascertain a consensus from their broad spectrum of views and see how those views changed over time. Opinions were sought about respondents' perceptions of complementary therapies, the type and scope of research needed, and how such research should be coordinated. The workshop, arranged by the Regional Health Authority, included orthodox and complementary practitioners, purchasers, providers and academics. Questionnaires were administered at the beginning and end of the workshop and 6 months later. The group was small and potentially positively biased, having both pre-existing knowledge and interest in complementary therapies. In consensus, the more mainstream complementary therapies of osteopathy, acupuncture, and homeopathy were perceived to be the most beneficial to patients, and therefore, most likely to be recommended as treatments. These were also felt to be the priority areas for research. For some unknown reason homeopathy had lost its popularity in ranking 6 months later. The respondents agreed that research into complementary therapies was needed and ideally should be collaborative between practitioners, professional bodies, and academics. The workshop appeared to produce some changes in knowledge that were not always maintained over time. It was, however, formative in the decision of the Regional Health Authority to allocate research funding into complementary therapies.

Adult↗
PubMed1997

Is infant immunization a risk factor for childhood asthma or allergy?

The Christchurch Health and Development Study comprises 1,265 children born in 1977. The 23 children who received no diphtheria/pertussis/tetanus (DPT) and polio immunizations had no recorded asthma episodes or consultations for asthma or other allergic illness before age 10 years; in the immunized children, 23.1% had asthma episodes, 22.5% asthma consultations, and 30.0% consultations for other allergic illness. Similar differences were observed at ages 5 and 16 years. These findings do not appear to be due to differential use of health services (although this possibility cannot be excluded) or con-founding by ethnicity, socioeconomic status, parental atopy, or parental smoking.

Adolescent↗
PubMed1997

The decline in asthma hospitalisations in persons aged 0-34 years in New Zealand.

AIMS: Hospitalisation rates for asthma for the 0-14 year and five-34 year age ranges have been examined from 1969 to 1993 to determine whether the rise observed between the 1960s and 1980s has continued into the 1990s. RESULTS: In the 0-14 age range, hospitalisations peaked in 1986 then fell by 18.7% by 1993. There was a corresponding rise in hospitalisation rates for acute bronchitis/bronchiolitis and it is possible that the fall in asthma hospitalisations in this age range is at least partly explained by diagnostic transfer. On the other hand, the trends in the five-34 age range appear unlikely to be explained by diagnostic transfer. The rate peaked in 1986 and fell by 34.7% by 1993, with most of the decline occurring after 1989. This in part parallels the trends in mortality in this age range, which saw a sudden fall in the death rate in 1989. CONCLUSIONS: New Zealand is not only benefiting from a marked fall in asthma deaths, but is also benefiting from a marked decline in asthma hospitalisations in young adults, and probably also in children.

Adolescent↗
PubMed1996

The mu-opioid receptor (MOR1) is mainly restricted to neurons that do not contain GABA or glycine in the superficial dorsal horn of the rat spinal cord.

The mu-opioid receptor MOR1 is present on primary afferent axons and a population of neurons in the superficial dorsal horn of the rat spinal cord. In order to determine which types of neuron possess the receptor we carried out pre-embedding immunocytochemistry with antibody to MOR1 and combined this with a post-embedding method to detect GABA and glycine in the rat. MOR1 immunoreactivity was seen on many small neurons in lamina II and a few in the dorsal part of lamina III. Although immunostaining was mainly restricted to the cell bodies and dendrites of these neurons, in some cases it was possible to see their axons, and a few of these entered lamina III. One hundred and thirty-nine MOR1-immunoreactive cells were tested with GABA and glycine antibodies, and the great majority of these (131 of 139; 94%) were not GABA or glycine immunoreactive, while the remainder showed GABA but not glycine immunoreactivity. These results suggest that most of the cells in the superficial dorsal horn which possess MOR1 are excitatory interneurons. They support the hypothesis that part of the action of mu-opioid agonists, such as morphine, involves the inhibition of excitatory interneurons which convey input from nociceptors to neurons in the deep dorsal horn, thus interrupting the flow of nociceptive information through polysynaptic pathways in the spinal cord.

Animals↗
PubMed1996

Problems of measuring asthma prevalence.

This review considers the issues involved in measuring the community prevalence of asthma, particularly in the context of international comparisons. We argue that there is no gold standard definition for measuring asthma prevalence, and discuss the currently available methods of case ascertainment. Prevalence studies, if they are to be generalizable, need to involve large sample sizes with high response rates. This necessitates methods that are simple, inexpensive and practicable, but also as sensitive and specific for asthma as possible. We discuss some of the issues that are specific to comparisons of asthma prevalence between diverse populations, and suggest that large surveys using written or video questionnaires of self reported symptoms validated in all of the target populations are the method of choice.

Asthma↗
PubMed1994

A profile of ICD-9-CM coding staff in NSW and ACT hospitals.

The ICD-9-CM coder workforce is on the brink of major changes given impetus by increasing commitments to casemix-based funding and management strategies within the public and private hospital sectors. A study of the ICD-9-CM coding process in NSW and ACT hospitals was undertaken by the School of Health Information Management, Faculty of Health Sciences, The University of Sydney during 1991. This article profiles the composition of the ICD-9-CM coder workforce in NSW and the ACT based on the findings of this study. Recent developments pertaining to national coder workforce issues are also discussed.

Abstracting and Indexing↗
PubMed1991

Milk-induced malabsorption in malnourished African patients.

Fifty malnourished rural African patients were randomly assigned to whole milk (50 g lactose/L), acidified milk (24 g lactose/L), or a commercial lactose-free diet (LFD) as a constant nasogastric infusion for 3 d, starting at 2 L/d and increasing to 3 L/d if tolerated. During the first 2 d mild symptoms of intolerance developed in 63% of patients on whole milk, 37% on acidified milk, and 54% on LFD whereas severe intolerance, necessitating withdrawal, was encountered in 22% receiving whole milk and none receiving LFD. Stool weights and fat excretion on day 3 were greater (P less than 0.02) in the remaining milk-fed patients whereas nitrogen balance remained strongly positive in all three groups. Eighty-seven percent of patients were methane producers, and high excretion rates were associated with better milk tolerance. The results suggest that although undiluted cow milk will not form a suitable tube feed for malnourished African patients, products such as acidified milk may prove cost effective.

Adult↗