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PubMedDate not supplied

Latex allergy: implications for healthcare personnel and infusion therapy patients.

The health care arena has been dramatically impacted by the implementation of universal precautions and OSHA standards, mandating the use of disposable gloves. These directives promote the judicious use of gloves as a barrier against contact with blood and body fluids. An increasing number of hypersensitivity reactions to latex are being reported by the medical community. The FDA cites that 6%-7% of surgical personnel are latex sensitive as well as 18%-40% of spina bifida patients. Sensitivity reactions range from mild delayed symptomatology in the form of eczematous contact dermatitis, to severe systemic reactions including death. Besides gloves, latex is found in catheters, i.v. tubing, injection caps and anesthesia masks. Latex sensitivity creates yet another infusion therapy challenge for the i.v. clinician.

Drug Hypersensitivity↗
PubMed2006

Impact of missing data in evaluating artificial neural networks trained on complete data.

This study investigated the impact of missing data in the evaluation of artificial neural network (ANN) models trained on complete data for the task of predicting whether breast lesions are benign or malignant from their mammographic Breast Imaging and Reporting Data System (BI-RADS) descriptors. A feed-forward, back-propagation ANN was tested with three methods for estimating the missing values. Similar results were achieved with a constraint satisfaction ANN, which can accommodate missing values without a separate estimation step. This empirical study highlights the need for additional research on developing robust clinical decision support systems for realistic environments in which key information may be unknown or inaccessible.

Area Under Curve↗
PubMed2000

Base- and acid-catalyzed interconversions of O-acyl- and N-acyl-ethanolamines: a cautionary note for lipid analyses.

The isolation and quantification of ethanolamine containing lipids from animal tissues may expose neutral lipid extracts to acidic or basic conditions during chromatographic separations or derivatization chemistry. While investigating the acid- and base-catalyzed production of anandamide in chromatographic fractions of rat brain extracts not containing anandamide, we observed that O,N-acyl migrations are facile. O,N-acyl migrations are well documented in synthetic organic chemistry literature, but are not well described or recognized with regard to methods in lipid isolation or lipid enzyme studies. We report here the synthesis and characterization of O- and N-acyl (palmitoyl- or arachidonoyl-)ethanolamines. Their rearrangements in base and acid are quantified by liquid chromatography;-electrospray ionization mass spectrometry. The rearrangements proceed through a cyclic intermediate that is also formed during chemical reactions commonly used for derivatization of acylethanolamines for gas chromatography-mass spectrometry. The isolation and characterization of N- or O-acylethanolamines and their enzymatic formation requires awareness and consideration of the proclivity of these compounds to chemically rearrange.

Acids↗
PubMed2002

LC/MS analysis of NAD biosynthesis using stable isotope pyridine precursors.

A liquid chromatographic-electrospray ionization ion trap mass spectrometry (LC/MS) method has been developed to measure the biosynthetic incorporation of specific precursors into NAD. The stable isotope-labeled precursors tryptophan, quinolinic acid, nicotinic acid, and nicotinamide were added to the media of human liver tumor cells (SK-HEP) grown in culture. The cells were harvested, the NAD was extracted, and the ratio of labeled to unlabeled NAD was measured using the newly developed LC/MS assay. The quantity of NAD formed from each precursor relative to an internal standard (fully labeled 13C, 15N-labeled NAD prepared from baker's yeast) was measured. The detection limit (signal-to-noise ratio 5:1) of the LC/MS method was 37 fmol (25 pg) of NAD and was linear from 20.0 ng to 25 pg. All reported NAD levels were normalized relative to cellular protein measurements. At 50 microM precursor concentrations, nicotinamide was the dominant precursor and NAD levels in the cell rose well above normal levels. Other precursors were minimally incorporated. The same methods were applied to NAD biosynthesized by macrophages derived from peripheral blood monocytes. However, the NAD concentration in macrophages was about 5% of that in SK-HEP cells and the incorporation of stable isotope-labeled substrates remained below measurable levels.

Carbon Isotopes↗
PubMed1996

Treatment of proliferative haemangiomas with the 585 nm pulsed dye laser.

Haemangiomas usually develop within the first few weeks of life, most regressing spontaneously before the age of 7 years. Some may ulcerate or compromise a vital function, in which case systemic corticosteroids, surgery or radiotherapy may be helpful. All of these treatment modalities are associated with significant morbidity. Treatment with the 585 nm flashlamp pulsed dye laser is safe and effective in the management of superficial vascular malformations. We report seven patients, under 12 months of age, who presented with proliferative haemangiomas, causing functional impairment. Ulcerated lesions were present in four patients. The patients were treated with the 585 nm pulsed dye laser (fluences 7.0-9.25 J/cm2), at intervals of 4-8 weeks. All of the lesions showed a significant reduction in size, together with improvement in the colour and integrity of the overlying skin. Treatment with the 585 nm pulsed dye laser should be considered in the management of infants with early proliferative haemangiomas, in whom intervention is indicated.

Female↗
PubMed2004

Prevalence and number of Salmonella in irish retail pork sausages.

A national Salmonella control program in the pork industry was enacted in Ireland in August 2002. This study was undertaken as part of a larger project investigating the role of pork as a source of human salmonellosis in Ireland. The objective of this survey was to assess the prevalence of Salmonella in Irish pork sausage at retail level. Samples, comprising branded prepacked sausages and loose sausages from supermarket meat counters and butcher shops, were collected from selected retail sites in four cities from October to December 2001 and from June to August 2002. A three-tube most-probable-number method was used to enumerate Salmonella in a selected number of samples that were positive by enrichment. Salmonella serotypes were detected in 4.4 and 1.7% of samples at each of the respective sampling periods, a level similar to those reported in other U.S. and U.K. studies. Isolates were characterized by serotype, phage type, and antimicrobial susceptibility. Eighteen (70%) were resistant to at least one antimicrobial, and 15 (58%) were resistant to four or more antimicrobials. Most of the isolates exhibited resistance to tetracycline. Five different phage types were detected. DT104 was the predominant phage type among Salmonella Typhimurium isolates. This study revealed that multidrug-resistant salmonellae are present in a proportion of Irish sausages and that further risk analysis work is necessary in order to quantify the risk posed to public health.

Animals↗
PubMedDate not supplied

Mammalian development in a changing environment: exposure to endocrine disruptors reveals the developmental plasticity of steroid-hormone target organs.

Recent findings in the field of environmental endocrine disruption have revealed that developmental exposure to estrogenic chemicals induces morphological, functional, and behavioral anomalies associated with reproduction. The aim of the present study was to determine the effects of in utero exposure to low doses of the estrogenic chemical bisphenol A (BPA) on the development of the female reproductive tissues and mammary glands in CD-1 mice. Humans are exposed to BPA, which leaches from dental materials and plastic food and beverage containers. Here we report that prenatal exposure to BPA induces alterations in tissue organization within the ovaries and mammary glands and disrupts estrous cyclicity in adulthood. Because estrogen receptors are expressed developmentally in these estrogen-target organs, we propose that BPA may directly affect the expression of genes involved in their morphogenesis. In addition, alterations in the sexual differentiation of the brain, and thus the hypothalamic-pituitary-gonadal axis, may further contribute to the observed phenotype. The emerging field of endocrine disruptors promises to provide new insights into the mechanisms underlying the development of hormone-target organs and demonstrates that the environment plays important roles in the making of phenotypes.

Animals↗
PubMed2001

Copper trafficking: the solution structure of Bacillus subtilis CopZ.

A sequence with a high homology (39% residue identity) with that of the copper-transport CopZ protein from Enterococcus hirae and with the same MXCXXC metal-binding motif has been identified in the genome of Bacillus subtilis, and the corresponding protein has been expressed. The protein, constituted by 73 amino acids, does bind copper(I) under reducing conditions and fully folded in both copper-bound and copper-free forms under the present experimental conditions. The solution structure of the copper-bound form was determined through NMR spectroscopy on an 15N-labeled sample. A total of 1508 meaningful nuclear Overhauser effects, 38 dihedral phi angles, and 48 dihedral psi angles were used in the structural calculations, which lead to a family of 30 conformers with an average rmsd to the mean structure of 0.32 +/- 0.06 A for the backbone and of 0.85 +/- 0.07 A for the heavy atoms. NMR data on the apoprotein also show that, also in this form, the protein is in a folded state and essentially maintains the complete secondary structure. Some disorder is observed in the loop devoted to copper binding. These results are compared with those reported for CopZ from E. hirae whose structure is well-defined only in the apo form. The different behaviors of copper-loaded E. hirae and B. subtilis are tentatively accounted for on the basis of the presence of dithiothreitol used in the latter case, which would stabilize the monomeric form. The comparison is extended to other similar proteins, with particular attention to the copper-binding loop. The nature and the location of conserved residues around the metal-binding site are discussed with respect to their relevance for the metal-binding process. Proposals for the role of CopZ are also presented.

Amino Acid Sequence↗
PubMed2006

Completing a life: comfort level and ease of use of a CD-ROM among seriously ill patients.

PURPOSE/OBJECTIVES: To evaluate use of a CD-ROM titled Completing a Life among patients diagnosed with serious illnesses for comfort level with content and ease of computer use. DESIGN: A prospective pilot study collected a convenience sample of 50 people diagnosed with life-limiting illnesses during a six-month period. SETTING: The hematology/oncology department of a large healthcare system located in a metropolitan area in the midwestern United States. SAMPLE: Convenience sample of 50 patients diagnosed with life-limiting illnesses. Of the patients enrolled (age range = 38-93 years), 72% were female, 68% were Caucasian, 50% were diagnosed with breast cancer or nonsolid tumors, and 40% were newly diagnosed. METHODS: Subjects viewed the CD-ROM and completed pre- and post-intervention surveys. MAIN RESEARCH VARIABLES: Comfort level with educational media, comfort level of information viewed, and areas of CD-ROM viewed compared to age and stage of illness. FINDINGS: Ninety percent of patients reported that they were somewhat or very comfortable with the CD-ROM as a learning tool, and ease of use was rated at 98%. Patients' comfort level with the material increased from 76% to 90% after they viewed the CD-ROM. CONCLUSIONS: The pilot study suggests that the Completing a Life CD-ROM can be used with patients facing serious or life-limiting illnesses as an additional resource tool for information. IMPLICATIONS FOR NURSING: Nurses typically provide the bulk of educational material for their patients. With limited resources available regarding management of life-limiting illnesses, this resource may provide an excellent addition to resources currently available.

Adaptation, Psychological↗
PubMed1993

4-Chloro-3-hydroxyanthranilate, 6-chlorotryptophan and norharmane attenuate quinolinic acid formation by interferon-gamma-stimulated monocytes (THP-1 cells).

Accumulation of quinolinic acid and L-kynurenine occurs in the brain and/or blood following immune activation, and may derive from L-tryptophan following induction of indoleamine 2,3-dioxygenase and other kynurenine-pathway enzymes. In the present study a survey of various cell lines derived from either brain or systemic tissues showed that, while all cells examined responded to interferon-gamma by increased conversion of L-[13C6]tryptophan into L-kynurenine (human: B-lymphocytes, neuroblastoma, glioblastoma, lung, liver, kidney; rat brain: microglia, astrocytes and oligodendrocytes), only macrophage-derived cells (peripheral-blood mononuclear cells; THP-1, U-937) and certain liver cells (SKHep1) synthesized [13C6]quinolinic acid. Tumour necrosis factor-alpha enhanced the effects of interferon-gamma in THP-1 cells. Norharmane, 6-chloro-DL-tryptophan and 4-chloro-3-hydroxyanthranilate attenuated quinolinic acid formation by THP-1 cells with IC50 values of 51 microM, 58 microM and 0.11 microM respectively. Norharmane and 6-chloro-DL-tryptophan attenuated L-kynurenine formation with IC50 values of 43 microM and 51 microM respectively, whereas 4-chloro-3-hydroxyanthranilate had no effect on L-kynurenine accumulation. The reductions in L-kynurenine and quinolinic acid formation are consistent with the reports that norharmane is an inhibitor of indoleamine 2,3-dioxygenase, 6-chloro-DL-tryptophan is metabolized through the kynurenine pathway, and 4-chloro-3-hydroxyanthranilate is an inhibitor of 3-hydroxyanthranilate 3,4-dioxygenase. These results suggest that many tissues may contribute to the production of L-kynurenine following indoleamine 2,3-dioxygenase induction and immune activation. Quinolinic acid may be directly synthesized from L-tryptophan in both macrophages and certain types of liver cells, although uptake of quinolinic acid precursors from blood may contribute to quinolinic acid synthesis in cells that cannot convert L-kynurenine into quinolinic acid.

3-Hydroxyanthranilic Acid↗
PubMed2006

Expanding the concept of parental control: a role for overt and covert control in children's snacking behaviour?

The existing literature on parental control and children's diets is confusing. The present paper reports two studies to explore an expanded conceptualisation of parental control with a focus on overt control which 'can be detected by the child' and covert control which 'cannot be detected by the child'. In study 1, 297 parents of children aged between 4 and 11 completed a measure of overt control and covert control alongside ratings of their child's snacking behaviour as a means to assess who uses either overt or covert control and how these aspects of parental control relate to a child's snacking behaviour. The results showed that lighter parents and those with children perceived as heavier were more likely to use covert control and those from a higher social class were more likely to use overt control. Further, whilst greater covert control predicted a decreased intake of unhealthy snacks, greater overt control predicted an increased intake of healthy snacks. In study 2, 61 parents completed the same measure of overt and covert control alongside the three control subscales of the Child Feeding Questionnaire [Birch, L.L., Fisher, J.O., Grimm-Thomas, Markey, C.N., Sawyer, R. (2001). Confirmatory factor analysis of the Child Feeding Questionnaire: A measure of parental attitudes, beliefs and practices about child feeding and obesity proneness. Appetite, 36, 201-210] to assess degrees of overlap between these measures. The results showed that although these five measures of control were all positively correlated, the correlations between the new and existing measures indicated a maximum of 21% shared variance suggesting that covert and overt control are conceptually and statistically separate from existing measures of control. To conclude, overt and covert control may be a useful expansion of existing ways to measure and conceptualise parental control. Further, these constructs may differentially relate to snacking behaviour which may help to explain some of the confusion in the literature.

Adult↗
PubMed2002

Differences between computer-aided diagnosis of breast masses and that of calcifications.

PURPOSE: To compare the performance of a computer-aided diagnosis (CAD) system for diagnosis of previously detected lesions, based on radiologist-extracted findings on masses and calcifications. MATERIALS AND METHODS: A feed-forward, back-propagation artificial neural network (BP-ANN) was trained in a round-robin (leave-one-out) manner to predict biopsy outcome from mammographic findings (according to the Breast Imaging Reporting and Data System) and patient age. The BP-ANN was trained by using a large (>1,000 cases) heterogeneous data set containing masses and microcalcifications. The performances of the BP-ANN on masses and microcalcifications were compared with use of receiver operating characteristic analysis and a z test for uncorrelated samples. RESULTS: The BP-ANN performed significantly better on masses than microcalcifications in terms of both the area under the receiver operating characteristic curve and the partial receiver operating characteristic area index. A similar difference in performance was observed with a second model (linear discriminant analysis) and also with a second data set from a similar institution. CONCLUSION: Masses and calcifications should be considered separately when evaluating CAD systems for breast cancer diagnosis.

Adult↗
PubMed1996

Platelet-activating factor in brain regions after transient ischemia in gerbils.

BACKGROUND AND PURPOSE: Platelet-activating factor (PAF) has been reported to be an active mediator in ischemic brain damage on the basis of indirect pharmacological data from PAF antagonists. The direct measurement of PAF in neuronal tissues has not been reported previously in analogous animal models. We have examined regional brain PAF concentration changes during the reperfusion period after ischemia in gerbils to obtain direct evidence for the involvement of PAF with ischemic brain damage and reported gas chromatography/mass spectrometry (GC/MS) methods of PAF quantitative analysis in brain tissues. METHODS: After transient (10 minutes) ischemia followed by controlled periods (0 to 96 hours) of reperfusion and recovery, regional PAF concentrations were determined in gerbil brain tissue. Quantitative analysis of PAF in brain regions is performed using an electron-capture negative chemical ionization GC/MS method, modified for brain tissue. RESULTS: The level of PAF was increased significantly and maximally in hippocampus (211%), cortex (168%), and thalamus (169%) after 1 hour of reperfusion. In contrast, there were no significant changes of PAF in any brain region from 6 hours to 96 hours after reperfusion. CONCLUSIONS: PAF is increased in gerbil brain in response to ischemia at early stages of reperfusion. PAF increases could contribute to the onset and progress of ischemic neuropathology.

Animals↗
PubMed1993

Knowledge based lipid management system for general practitioners.

The aim of this system is to provide computer generated interpretative reports with management advice for General Practitioners (GPs). The lipid domain was chosen because of its importance in preventive medicine. Request forms to elicit extra clinical information were designed and distributed to a group of randomly selected GPs. Interpretation of laboratory and clinical data categorizes patients according to risk of coronary heart disease. The management system is rule based and provides advice on lifestyle modifications, diet and drug intervention. Previous clinical and laboratory results are taken into account in determining a management strategy. To date 435 request forms have been processed: 309 (71%) from first visits and 126 (29%) from follow-up visits. Normal lipid profiles were found in 19% of cases. There was 93% agreement between management advice given by the system and the expert. The system has now been modified and further evaluation is under way.

Artificial Intelligence↗
PubMed2007

Meticillin-resistant Staphylococcus aureus in animals: a review.

The objectives of this paper are to review published data on the prevalence and epidemiology of meticillin-resistant Staphylococcus aureus (MRSA) infection and colonization in animals and to provide suggestions for preventing and controlling the problem in veterinary practice. MRSA first emerged as a serious pathogen in human medicine during the late 1970s and has been increasingly reported in animals during the past 10 years. The prevalence of MRSA in human infections varies markedly between geographical areas, being as high as 60% in parts of the USA, 40% in southern Europe but <1% in northern Europe. Epidemiological evidence, including phenotypic and molecular typing data, suggests that MRSA isolates from dogs and cats are indistinguishable from human healthcare isolates, whereas strains of MRSA isolated from horses and associated personnel are different. There is evidence that transfer of MRSA strains can occur between animals and humans and vice versa. Guidelines for the control of MRSA in animals have been drawn up by individual institutions based on those available for human MRSA infection. Risk factors for MRSA infection in animals are currently under investigation and such data are essential for the preparation of specific guidelines for control of MRSA in veterinary practice.

Animals↗
PubMed2005

Long-term effects of fetal exposure to low doses of the xenoestrogen bisphenol-A in the female mouse genital tract.

Developmental exposure to estrogenic chemicals induces morphological, functional, and behavioral anomalies associated with reproduction. Humans are routinely exposed to bisphenol-A (BPA), an estrogenic compound that leaches from dental materials and plastic food and beverage containers. The aim of the present study was to determine the effects of in utero exposure to low, environmentally relevant doses of BPA on the development of female reproductive tissues in CD-1 mice. In previous publications, we have shown that this treatment alters the morphology of the mammary gland and affects estrous cyclicity. Here we report that in utero exposure to 25 and 250 ng BPA/ kg of body weight per day via osmotic pumps implanted into pregnant dams at Gestational Day 9 induces alterations in the genital tract of female offspring that are revealed during adulthood. They include decreased wet weight of the vagina, decreased volume of the endometrial lamina propria, increased incorporation of bromodeoxyuridine into the DNA of endometrial gland epithelial cells, and increased expression of estrogen receptor-alpha (ERalpha) and progesterone receptor in the luminal epithelium of the endometrium and subepithelial stroma. Because ERalpha is known to be expressed in these estrogen-target organs at the time of BPA exposure, it is plausible that BPA may directly affect the expression of ER-controlled genes involved in the morphogenesis of these organs. In addition, BPA-induced alterations that specifically affect hypothalamic-pituitary-gonadal axis function may further contribute to the anomalies observed at 3 mo of age, long after the cessation of BPA exposure.

Animals↗
PubMed2006

Breast cancer CADx based on BI-RAds descriptors from two mammographic views.

In this study we compared the performance of computer aided diagnosis (CADx) algorithms based on Breast Imaging Reporting And Data System (BI-RADS) descriptors from one or two views. To select cases for the study with different mediolateral (MLO) and craniocaudal (CC) view descriptors, we assessed the agreement in BI-RADS lesion descriptors, BI-RADS assessment, and subtlety ratings for 1626 cases from the Digital Database for Screening Mammogrpahy (DDSM) using kappa statistics. We used 115 mass caseswith different descriptors for the two views to design linear discriminant analysis (LDA) based CADx algorithms. The CADx algorithms used BI-RADS descriptors and patient age as features. Thealgorithms based on BI-RADS descriptors from both the views performed marginally betterthan algorithms based on BI-RADS descriptors from a single view. A system that averaged theresults of two classifiers trained separately on the MLO and CC views displayed the best performance (Az=0.920 +/- 0.027). Thus, some improvement in performance of BI-RADS based CADx algorithms may be achieved by combining information from two mammographic views.

Breast↗
PubMed1991

Noninvasive carcinoma of the breast presenting in adenosis.

Although sclerosing adenosis is a common abnormality in the female breast, malignant change presenting in this setting is exceedingly rare, as fewer than 20 cases have been reported. Since sclerosing adenosis is a lesion of the mammary lobule, it is not surprising that the majority of reported cases have been lobular carcinoma in situ (LCIS). Nine patients with noninvasive carcinoma, restricted in the initial biopsy specimen to foci of sclerosing adenosis, are reported. Seven of the patients had LCIS, one had intraductal carcinoma (DCIS), and one had both LCIS and DCIS. In six of the nine patients, the carcinoma was an incidental finding in a breast biopsy performed for fibrocystic changes or for a fibroadenoma, and in three patients, the abnormality presented as a grossly discrete lesion due to confluence of foci of adenosis (tumoral adenosis). It is important to recognize this microscopic pattern of neoplasia to prevent its misdiagnosis as invasive carcinoma. Two patients had no further treatment following initial excisional biopsy. No residual carcinoma was found in the breast or in lymph nodes in the four patients who had mastectomy. Eight of these patients have been followed for an average of 3 yr (range, 2 to 7 yr), and all are alive and well, without recurrence. Because of the possibility of multifocality, the rarity of the lesion, and the relatively brief follow-up interval, it seems prudent to treat these patients in a manner comparable to that of patients with more common presentations of noninvasive carcinoma.

Adult↗