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PubMed1986

Severity of sleep apnea as a predictor of successful treatment by palatopharyngoplasty.

As awareness and understanding of obstructive sleep apnea has increased so has the number of treatments for this disorder. Options include surgical procedures: tracheostomy, palatopharyngoplasty (PPP), and mandibular advancement. Other treatments are medication, nasal CPAP, Tongue Retaining Device, and a position alarm. With these numerous choices available, it is important that reliable indicators be developed to guide treatment choice. And although PPP surgery is a one-time intervention with possibility of permanent correction, reports of percentages of successful treatment have varied widely from 85% to 0%. This has led us to investigate predictors of successful treatment. Twenty-two patients treated with PPP following their diagnosis by standard clinical polysomnography were restudied an average of 8 weeks later. When 11 successful cases were compared to 11 unsuccessful cases, successes were found to be initially more severely apneic (mean AI = 90.55 versus 49.45). Palatopharyngoplasty appears to be most appropriate for the sleep apnea patient whose apnea index is 70 or above and less effective for milder cases.

Adult↗
PubMed2006

Trypanosoma brucei: a survey of pyrimidine transport activities.

Purine uptake has been studied in many protozoan parasites in the last few years, and several of the purine transporters have been cloned. In contrast, very little is known about the salvage of preformed pyrimidines by protozoa, and no pyrimidine transporters have been cloned, yet chemotherapy based on pyrimidine nucleobases and nucleosides has been as effective as purine antimetabolites in the treatment of infectious and neoplastic disease. Here, we surveyed the presence of pyrimidine transporters in Trypanosoma brucei brucei. We could not detect any mediated uptake of thymine, thymidine or cytidine, but identified a very high-affinity transporter for cytosine, designated C1, with a K(m) value of 0.048+/-0.009 microM. We also confirmed the presence of the previously reported U1 uracil transporter and found it capable of mediating uridine uptake as well, with a K(m) of 33+/-5 microM. A higher-affinity U2 uridine transporter (K(m)=4.1+/-2.1 microM) was also identified, but efficiency of the C1 and U2-mediated transport was low. Pyrimidine antimetabolites were tested as potential trypanocidal agents and only 5-fluorouracil was found to be effective. This drug was efficiently taken up by bloodstream forms of T. b. brucei.

Animals↗
PubMed2005

Use of sequence data generated in the Bayer Tru Gene genotyping assay to recognize and characterize non-subtype-b human immunodeficiency virus type 1 strains.

Human immunodeficiency virus type 1 (HIV-1) protease (PR) and reverse transcriptase (RT) gene sequences obtained during antiretroviral resistance testing with a commercial genotyping assay (Tru Gene; Bayer Corp.) were analyzed to assess the utility of these data for detecting and characterizing non-subtype-B HIV-1 strains. A total of 125 viral sequences obtained from patients believed to have acquired their HIV-1 infection in Africa were analyzed, of which 121 were determined to belong to non-B subtypes. Utilizing Tru Gene sequence data alone, 92 (76%) of these viruses could be subtyped by conventional phylogenetic analysis. The addition of supplemental RT sequence data enabled a further 28 (23.1%) viruses to be classified, while one (0.9%) sample could not be classified conclusively. Two internet-accessible databases that generate HIV-1 subtypes from PR and RT sequences (HIV-SEQ and Geno 2 Pheno) were also evaluated, and both achieved 88% concordance (106/120) with phylogenetic analysis. Non-subtype-B and B-subtype HIV-1 sequences could be readily discriminated by tallying silent polymorphisms listed on the Tru Gene research report. The mean number of silent polymorphisms in the non-B HIV-1 sequences identified in this study was 58.3 (95% confidence interval [CI], 41.1 to 75.5), compared with 20.7 (95% CI, 9.9 to 31.5) for the four subtype B viruses in the study cohort and 118 case-matched B-subtype controls. Sequence data generated in the Tru Gene HIV-1 genotyping assay could, therefore, provide a ready means of tracking the prevalence and identity of non-B subtypes in HIV-1-infected populations undergoing routine antiretroviral resistance testing.

Algorithms↗
PubMed1994

Early REM sleep: a compensatory change in depression?

To test for a possible mood-regulatory function of dreaming, the dream reports of 61 subjects undergoing divorce were scored for their dream-like quality (DLQ), and a difference score (DLQd) was computed between the content of rapid eye movement (REM) period 1 and the mean of the subsequent dreams of the night. Subjects with reduced latency to the first REM period had enhanced first dream DLQ scores in relation to the mean of later dreams (DLQd+ score). Those with DLQd+ had significantly higher scores on the Beck Depression Inventory (BDI). Depressed subjects with DLQd+ showed significantly lower mean BDI scores at followup assessment. Implications for a psychological function of dreaming are discussed.

Adult↗
PubMed1981

Occupational bladder cancer and cigarette smoking in West Yorkshire.

This paper reports the preliminary findings of a case-controlled study of bladder cancer in parts of West Yorkshire. The first 991 cases have been analysed and the results of the occupational exposure for 5 occupations are reported. There is an increased risk of bladder cancer associated with smoking cigarettes in both males and females. These results take both the age and the year of diagnosis into account and are statistically significant. Chemical industry workers and printers have been shown statistically to have a high risk ratio, whereas leather workers, hairdressers and dye-users have a statistically insignificant risk ratio. For process workers in the dye manufacturing industry the length of service is significantly correlated with the risk of bladder cancer and so is the age at which a man first becomes a process worker.

Adult↗
PubMed1995

Identification of microsporidia in stool specimens by using PCR and restriction endonucleases.

We report the development of a PCR-based assay for the detection of microsporidia in clinical specimens. A single primer pair complementary to conserved sequences of the small-subunit rRNA enabled amplification of DNA from the four major microsporidian pathogens of humans: Encephalitozoon cuniculi, Encephalitozoon hellem, Enterocytozoon bieneusi, and Septata intestinalis. The extraction method allowed PCR amplification of E. bieneusi and S. intestinalis DNA from sodium hypochlorite-treated stool specimens. Differentiation of the microsporidian gastrointestinal pathogens E. bieneusi and S. intestinalis could be accomplished by restriction endonuclease digestion of PCR products using PstI and HaeIII.

Animals↗
PubMed1991

Parental occupations of children with leukaemia in west Cumbria, north Humberside, and Gateshead.

OBJECTIVE: To determine whether parental occupations and chemical and other specific exposures are risk factors for childhood leukaemia. DESIGN: Case-control study. Information on parents was obtained by home interview. SETTING: Three areas in north England: Copeland and South Lakeland (west Cumbria); Kingston upon Hull, Beverley, East Yorkshire, and Holderness (north Humberside), and Gateshead. SUBJECTS: 109 children aged 0-14 born and diagnosed as having leukaemia or non-Hodgkin's lymphoma in study areas during 1974-88. Two controls matched for sex and date and district of birth were obtained for each child. MAIN OUTCOME MEASURES: Occupations of parents and specific exposure of parents before the children's conception, during gestation, and after birth. Other adults living with the children were included in the postnatal analysis. RESULTS: Few risk factors were identified for mothers, although preconceptional association with the food industry was significantly increased in case mothers (odds ratio 2.56; 95% confidence interval 1.32 to 5.00). Significant associations were found between childhood leukaemia and reported preconceptional exposure of fathers to wood dust (2.73, 1.44 to 5.16), radiation (3.23, 1.36 to 7.72), and benzene (5.81, 1.67 to 26.44); ionising radiation alone gave an odds ratio of 2.35 (0.92 to 6.22). Raised odds ratios were found for paternal exposure during gestation, but no independent postnatal effect was evident. CONCLUSION: These results should be interpreted cautiously because of the small numbers, overlap with another study, and multiple exposure of some parents. It is important to distinguish periods of parental exposures; identified risk factors were almost exclusively restricted to the time before the child's birth.

Adolescent↗
PubMed2002

Neisseria lactamica protects against experimental meningococcal infection.

Immunological and epidemiological evidence suggests that the development of natural immunity to meningococcal disease results from colonization of the nasopharynx by commensal Neisseria spp., particularly with N. lactamica. We report here that immunization with N. lactamica killed whole cells, outer membrane vesicles, or outer membrane protein (OMP) pools and protected mice against lethal challenge by a number of diverse serogroup B and C meningococcal isolates in a model of bacteremic infection. Sera raised to N. lactamica killed whole cells, OMPs, or protein pools were found to cross-react with meningococcal isolates of a diverse range of genotypes and phenotypes. The results confirm the potential of N. lactamica to form the basis of a vaccine against meningococcal disease.

Animals↗
PubMed2002

How do microbiology consultants undertake their jobs? A survey of consultant time and tasks in South West England.

AIMS: To measure the total consultant medical microbiologist (CMM) weekly workload, to identify time spent on different activities, and to differentiate those tasks that were viewed by a consensus of consultants as core activities from those that could be accorded a lower priority. METHODS: A self administered questionnaire completed by consultant medical microbiologists in the Public Health Laboratory Service South West Group. RESULTS: Reported hours worked by respondents ranged from 41 to 65 hours each week, excluding on call activities. Eleven of 20 respondents reported working in excess of 48 hours each week. There was no correlation between hours worked and laboratory workload as measured by numbers of specimens. Clinical liaison, result authorisation, infection control, and management activities took up most time. Working practices varied widely between individuals, partly reflecting their differing roles in the laboratory. A consensus was reached regarding the relative importance and priority of many regular CMM activities. CONCLUSIONS: Consultant microbiologists can identify, with consensus, both high and lower priority activities in their daily practice. If such clinical priorities can be more widely agreed across the profession, this would provide a rational approach to workload control.

Attitude of Health Personnel↗
PubMed1998

Psychological predictors of good health in three longitudinal samples of educated midlife women.

Concurrent and longitudinal associations between cognitive and affective personality variables--intellectual efficiency (IE), anxiety, and hostility--and observer ratings of physical health were examined in 3 longitudinal samples of women: Mills Longitudinal Study (n = 101); Radcliffe Study (RS, n = 118); and University of California, San Francisco Study (n = 44). Observer ratings of health were based on participants' reports of health problems. The California Psychological Inventory (H. G. Gough, 1996) IE, Hostility, and Anxiety Scales were used in all studies at Times 1 and 2, except in RS, when at Time 1 the Zung Anxiety (W. K. Zung, 1971) and the Profile of Mood States (D. M. McNair, M. Lorr, & L. F. Droppleman, 1971) Hostility Scales were used. In the majority of analyses, IE was positively associated with good health, and Anxiety and Hostility were negatively associated with health. IE was the strongest independent predictor of health, indicating that cognitive characteristics may have an important role in health and should be examined further.

Adult↗
PubMed1995

Pelvic lymph node histiocytosis mimicking metastatic prostatic adenocarcinoma: association with hip prostheses.

PURPOSE: Histological changes in lymph nodes simulating metastatic prostatic adenocarcinoma are reported. MATERIALS AND METHODS: Lymph node frozen sections from 3 patients with prostatic cancer displayed marked histiocytosis. This tissue was subjected to histochemical, immunohistochemical and electron microscopic studies. RESULTS: Only 1 erroneous diagnosis of metastasis was made. All patients had hip prostheses for at least 6 years. Tissue replacing up to 80% of lymph nodes consisted of histiocytes containing large amounts of polyethylene. CONCLUSIONS: Hip replacement predisposes the patient to have pelvic lymph node histiocytosis mimicking metastatic adenocarcinoma. This history should be communicated to the pathologist. Polyethylene is the most important factor in the cause of post-prosthesis lymph node histiocytosis.

Adenocarcinoma↗
PubMed1986

Genital injury and implied consent to alleged rape.

A review of 440 cases of reported rape was undertaken to see if sustaining injury to the genital area was an inevitable consequence of being raped. Injuries to areas other than the genital were taken as objective evidence that the victim did not consent to the encounter, while sperm found in her vagina that could not be accounted for by voluntary coitus was taken as objective evidence that penile penetration of the vagina had occurred. Of the 75 victims with objective evidence of both noncompliance and vaginal penetration, 28% sustained genital injury. The absence of genital injury does not imply consent by the victim or the absence of vaginal penetration by the assailant.

Expert Testimony↗
PubMed1994

Spectacle and contact lens wearing six years after radial keratotomy in the Prospective Evaluation of Radial Keratotomy Study.

BACKGROUND: Patients in the Prospective Evaluation of Radial Keratotomy (PERK) Study stated that a major reason for obtaining radial keratotomy was to see without dependence on corrective lenses. The authors examined lens-wearing patterns 6 years after surgery. METHODS: Of the 435 patients in the PERK Study, the authors analyzed the responses of 328 (75.4%) who elected to have surgery on both eyes, who completed a questionnaire at 6 years, and for whom visual acuity and cycloplegic refraction were available. RESULTS: Sixty-four percent (106/167) of patients younger than 40 years of age and 38% (64/161) of patients older than 40 years of age wore no lenses for distance or near vision. The proportion of time lenses were worn increased with age for those who wore them for close work only (from 18% younger than 40 years of age to 25% older than 40 years of age) and decreased with age for those who wore them for distance only (from 41% to 27%). The authors examined the visual acuity and refractive error criteria for patients to be free of distance lenses. Of the 359 patients who saw 20/20 or better uncorrected in one or both eyes, 77% (n = 198) wore no distance correction, whereas of the 53 patients who saw 20/25 to 20/40 in both eyes or their best eye, only 34% (n = 18) wore no distance correction. Of the 72 patients with a residual refractive error of +/- 0.50 diopters (D) in both eyes, 85% (n = 61) wore no distance correction, whereas of the 87 patients with +/- 1.00 D in both eyes, only 39% (n = 34) wore no distance correction. Of the 328 patients, 60% (n = 197) were highly satisfied with the results of surgery, and satisfaction was primarily predicted by having a visual acuity 20/20 or better in at least one eye and not wearing spectacles for distance vision. Before surgery, 57% of patients reported worrying about their eyesight and 47% reported restrictions in activities because of their eyes; these rates dropped to 31% and 9%, respectively, at 6 years. Of the 328 patients, 74% (n = 243) said their preoperative goals were completely met and 94% (n = 308) said they would have radial keratotomy again. CONCLUSION: The use of 20/40 uncorrected visual acuity and a residual refractive error of +/- 1.00 D were insensitive criteria for evaluating distance spectacle independence. The ability to function without lenses increased substantially only when patients had an uncorrected visual acuity of 20/20 or better in at least one eye, and a refractive error within +/- 0.50 D.

Adult↗
PubMed1996

Respiratory syncytial virus infection and meningococcal disease.

Although viral respiratory tract infections may predispose to meningococcal disease, strong evidence that they do so exists only for influenza. Data on laboratory reported cases of respiratory syncytial virus (RSV) infections and meningococcal disease in England and Wales from mid-1989 to mid-1994 were analysed. Although the rise in RSV cases preceded the rise in meningococcal disease cases each winter, the interval between the rise and fall of the two diseases was inconsistent, no association was found between time series after removal of the seasonal component, and there was no evidence that more cases of meningococcal disease occurred in winters with more RSV disease. RSV may have less effect on the two most likely mechanisms whereby influenza predisposes to meningococcal disease, namely lowered immunity and impaired pharyngeal defences.

Age Factors↗
PubMed1997

Expression of human myometrial G alpha s messenger ribonucleic acid transcript during pregnancy and labour: involvement of alternative splicing pathways.

We have shown previously that expression of 46 and 54 kDa human myometrial G alpha s protein isoforms is increased during gestation and then subsequently decreased during labour. These proteins appear to be coded for by G alpha s-Small (with a serine residue at position 72) and G alpha s-Large (with a serine residue at position 87) mRNA splice variants respectively. In the study presented here we have used a G alpha s cDNA template to generate [32P]cytidine cRNA riboprobes for use in RNase protection assays, so as to measure total myometrial G alpha s mRNA levels in relation to the pattern of expression of G alpha s mRNA splice variants during pregnancy and labour. We report that total levels of human myometrial G alpha s mRNA remain similar in non-pregnant and pregnant women but are substantially reduced during parturition. Our data also provide strong evidence that alternative splicing of G alpha s precursor mRNA has a primary role in regulating expression of G alpha s protein isoforms during pregnancy and labour. The inclusion of an additional serine codon in G alpha s mRNAs during pregnancy involves a switch in alternative splicing pathways. We speculate that this switch may be due to a change in specificity of splicing factors that are modulated during pregnancy and labour.

Adult↗
PubMed2006

Mental health literacy in rural Queensland: results of a community survey.

OBJECTIVES: The aim of this study was to assess the awareness of, and attitudes to, mental health issues in rural dwelling Queensland residents. A secondary objective was to provide baseline data of mental health literacy prior to the implementation of Australian Integrated Mental Health Initiative--a health promotion strategy aimed at improving the health outcomes of people with chronic or recurring mental disorders. METHOD: In 2004 a random sample of 2% (2132) of the estimated adult population in each of eight towns in rural Queensland was sent a postal survey and invited to participate in the project. A series of questions were asked based on a vignette describing a person suffering major depression. In addition, questions assessed respondents' awareness and perceptions of community mental health agencies. RESULTS: Approximately one-third (36%) of those surveyed completed and returned the questionnaire. While a higher proportion of respondents (81%) correctly identified and labelled the problem in the vignette as depression than previously reported in Australian community surveys, the majority of respondents (66%) underestimated the prevalence of mental health problems in the community. Furthermore, a substantial number of respondents (37%) were unaware of agencies in their community to assist people with mental health issues while a majority of respondents (57.6%) considered that the services offered by those agencies were poor. CONCLUSION: While mental health literacy in rural Queensland appears to be comparable to other Australian regions, several gaps in knowledge were identified. This is in spite of recent widespread coverage of depression in the media and thus, there is a continuing need for mental health education in rural Queensland.

Adolescent↗
PubMed1999

Chloroquine increases Plasmodium falciparum gametocytogenesis in vitro.

Malaria parasites are capable of modulating the diversion of resources from asexual growth to the production of stages infective to mosquitoes (gametocytes). Increased rates of gametocytogenesis appear to be a general response to stress, both naturally encountered and novel. We have previously reported earlier and greater gametocytogenesis in response to subcurative antimalarial chemotherapy in the rodent malaria, Plasmodium chabaudi, in vivo. Using an immunofluorescent assay to detect parasites that had invaded red blood cell monolayers, we demonstrate a 5-fold increase in gametocytogenesis in the human malaria, P. falciparum, in vitro, in response to treatment with the antimalarial drug chloroquine. In all clones used, gametocytogenesis increased with increasing inhibition of asexual growth by chloroquine. Furthermore, there were clone differences in the relationship between stress and gametocyte production, implying the response was genetically variable. This was not, however, associated with chloroquine resistance. The epidemiological significance of these results is discussed.

Animals↗
PubMed1976

Effects of nonverbal dissimulation on emotional experience and autonomic arousal.

Three studies are reported that examine the relationship between the nonverbal display of emotional affect and indices of the emotional state. Subjects were asked either to conceal or to exaggerate the facial display associated with the anticipation and reception of painful shocks that varied in intensity. Both self-reports of shock painfulness and skin conductance measures of emotional response showed significant changes paralleling the changes induced in expressive behavior; that is, the suppression of expressive responses decreased the magnitude of phasic skin conductance changes and subjective reports of painfulness as compared to the free expression or exaggeration of pain-related expressive response. The effects were obtained for shocks of varying intensities and for both male and female subjects. The findings support theories of emotion that assume that expressive responses serve a self-regulatory as well as a social-communicative function, and further suggest that the self-regulation is mediated neurally, rather than via a process of self-attribution. Finally, the results highlight the need for research on dissimulation in social interaction to consider the effects of acting upon the actor, as well as its effects upon the inferences of observers.

Arousal↗