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PubMed2006

Effect of facemask use on respiratory patterns of women in speech and singing.

PURPOSE: Research into respiratory behavior during singing and speech makes extensive use of standard respiratory and vented pneumotachograph facemasks. This study investigated whether the use of such facemasks would affect respiratory behavior in terms of lung volume (excursion, at initiation and at termination) or duration (of inspiration and of expiration) during speech or singing. METHOD: The respiratory patterns of 6 females were recorded using uniaxial surface magnetometry during 4 tasks: quiet breathing, a /pa/ syllabic train, reading ("The Rainbow Passage"), and singing a Christmas carol ("Silent night"). Each task was performed in 4 facemask conditions: wearing no facemask, wearing a facemask rim only, wearing a standard respiratory facemask, and wearing a vented pneumotachograph facemask. RESULTS: No significant effect was found for any of the facemask conditions on lung volume or duration measures during any tasks. CONCLUSION: The results confirm earlier studies that the vented pneumotachograph facemask does not affect breathing behavior in speech research studies and extends the finding to the study of breathing behavior in singing and to the use of a standard respiratory facemask.

Adult↗
PubMed2002

Alcohol sales and fatal alcohol poisonings: a time-series analysis.

AIMS: To discover whether the number of fatal alcohol peaks during festivities characterized by unrestrained drinking and relates to sales of alcoholic beverages. DESIGN: Time-series and cross-sectional. DATA: Fatal alcohol poisonings and retail alcohol sales in Finland in 1983-99. FINDINGS: Fatal alcohol poisonings were found to peak during weekends and in the May Day, Midsummer Day and Christmas celebrations. Regression analysis of quarterly series lead to a model showing that 1% increase in the sales of spirits increases the number of fatal alcohol poisonings by 0.4%. CONCLUSIONS: At the population level, increases in the sales of spirits and periods of hard drinking seem to increase deaths from alcohol poisoning. The findings could be of use in efforts to decrease hard drinking.

Alcohol Drinking↗
PubMed2003

Supply control and harm reduction: lessons from the Australian heroin 'drought'.

AIMS: To examine the effects of supply-side drug law enforcement on the dynamics of the Australian heroin market and the harms associated with heroin. SETTING: Around Christmas 2000, heroin users in Sydney and other large capital cities in Australia began reporting sudden and significant reductions in the availability of heroin. The changes, which appear to have been caused at least in part by drug law enforcement, provided a rare opportunity to examine the potential impact of such enforcement on the harm associated with heroin. DESIGN: Data were drawn from a survey of 165 heroin users in South-Western Sydney, Australia; from the Drug Use Monitoring in Australia (DUMA) project; from NSW Health records of heroin overdoses; and from the Computerized Operational Policing System (COPS) database. FINDINGS: Heroin price increased, while purity, consumption and expenditure on the drug decreased as a result of the shortage. The fall in overall heroin use was accompanied by a significant reduction in the rate of overdose in NSW. However, the health benefits associated with the fall in overdose may have been offset by an increase in the use of other drugs (mainly cocaine) since the onset of the heroin shortage. There does not appear to have been any enduring impact on crime rates as a result of the heroin 'drought'. CONCLUSION: Supply control has an important part to play in harm reduction; however, proponents of supply-side drug law enforcement need to be mindful of the unintended adverse consequences that might flow from successfully disrupting the market for a particular illegal drug.

Adult↗
PubMed2003

Guttate morphoea in human T-cell lymphoma/lymphotrophic virus type-1 (HTLV-1) infection.

A 62-year-old Japanese man presented with multiple small atrophic macules on the trunk and extremities. The lesions were discrete, oval in shape and enclosed by lilac ring. They were distributed in a Christmas tree distribution, reminiscent of pityriasis rosea. Skin biopsy showed increased collagen fibres in the dermis and invading subcutaneous tissue. The clinico-pathological features were consistent with guttate morphoea, a rare variant of localized scleroderma. Serological tests revealed a positive reaction to human T-cell lymphoma/lymphotropic virus type-1 infection.

Biopsy↗
PubMed2001

The use of acute hospital services by elderly residents of nursing and residential care homes.

The objective of this study was to compare hospitalisation rates by cause of admission, hospital death rates and length of stay for residents from nursing and residential care homes with those in the community. This is a retrospective study of acute hospital emergency admissions in one health district, Merton, Sutton and Wandsworth between April 1996 and March 1997. Data linkage and manual look up were used to derive emergency hospital admissions for residents of care homes aged 65 and over. Admission rates were calculated for cause, length of stay and hospital death for residents of care homes and in the community with relative risks. The relative risk of emergency admission from a care home compared with the community was 1.39 for all diagnoses, 2.68 for all injuries, and 3.96 for fracture of neck of femur. The relative risk of dying in hospital for care home residents was 2.58 overall, and 3.64 in the first 48 hours of a hospital stay (all P-values <0.0001). Admission rates were higher from residential than from nursing homes. There was some increase in admissions from homes during holiday periods and over Christmas. In conclusion, there are major difficulties in monitoring admissions from nursing and residential care homes due to poor quality recording and inaccuracies in NHS coding. This was compounded by an absence of data on the age and sex profile and healthcare needs of the resident population in care homes. Prospective studies are required to ascertain when admission is avoidable and when it is appropriate. The information strategy needs to ensure that routine data sources are capable of monitoring the use of hospital services by residents of care homes.

Aged↗
PubMed2000

Comparison of left ventricular ejection fraction and volumes in heart failure by echocardiography, radionuclide ventriculography and cardiovascular magnetic resonance; are they interchangeable?

AIMS: To prospectively compare the agreement of left ventricular volumes and ejection fraction by M-mode echocardiography (echo), 2D echo, radionuclide ventriculography and cardiovascular magnetic resonance performed in patients with chronic stable heart failure. It is important to know whether the results of each technique are interchangable, and thereby how the results of large studies in heart failure utilizing one technique can be applied using another. Some studies have compared cardiovascular magnetic resonance with echo or radionuclude ventriculography but few contain patients with heart failure and none have compared these techniques with the current fast breath-hold acquisition cardiovascular magnetic resonance. METHODS AND RESULTS: Fifty two patients with chronic stable heart failure taking part in the CHRISTMAS Study, underwent M-mode echo, 2D echo, radionuclude ventriculography and cardiovascular magnetic resonance within 4 weeks. The scans were analysed independently in blinded fashion by a single investigator at three core laboratories. Of the echocardiograms, 86% had sufficient image quality to obtain left ventricular ejection fraction by M-mode method, but only 69% by 2D Simpson's biplane analysis. All 52 patients tolerated the radionuclude ventriculography and cardiovascular magnetic resonance, and all these scans were analysable. The mean left ventricular ejection fraction by M-mode cube method was 39+/-16% and 29+/-15% by Teichholz M-mode method. The mean left ventricular ejection fraction by 2D echo Simpson's biplane was 31+/-10%, by radionuclude ventriculography was 24+/-9% and by cardiovascular magnetic resonance was 30+/-11. All the mean left ventricular ejection fractions by each technique were significantly different from all other techniques (P<0.001), except for cardiovascular magnetic resonance ejection fraction and 2D echo ejection fraction by Simpson's rule (P=0.23). The Bland-Altman limits of agreement encompassing four standard deviations was widest for both cardiovascular magnetic resonance vs cube M-mode echo and cardiovascular magnetic resonance vs Teichholz M-mode echo at 66% each, and was 58% for radionuclude ventriculography vs cube M-mode echo, 44% for cardiovascular magnetic resonance vs Simpson's 2D echo, 39% for radionuclide ventriculography vs Simpson's 2D echo, and smallest at 31% for cardiovascular magnetic resonance-radionuclide ventriculography. Similarly, the end-diastolic volume and end-systolic volume by 2D echo and cardiovascular magnetic resonance revealed wide limits of agreement (52 ml to 216 ml and 11 ml to 188 ml, respectively). CONCLUSION: These results suggest that ejection fraction measurements by various techniques are not interchangeable. The conclusions and recommendations of research studies in heart failure should therefore be interpreted in the context of locally available techniques. In addition, there are very wide variances in volumes and ejection fraction between techniques, which are most marked in comparisons using echocardiography. This suggests that cardiovascular magnetic resonance is the preferred technique for volume and ejection fraction estimation in heart failure patients, because of its 3D approach for non-symmetric ventricles and superior image quality.

Echocardiography↗
PubMed2002

Management of splenic trauma in the pediatric hemophiliac patient: Case series and review of the literature.

In July and August 1998, 3 patients who attend the Hemophilia Treatment Center required emergency admission to the authors' hospital for management of hemorrhagic shock caused by splenic injury. Computed tomography was used to diagnose and grade the splenic injuries, which ranged from II to IV on the organ injury scale. Two patients had Christmas disease (Factor IX deficiency) and were treated with splenorrhaphy and factor IX replacement. One patient who has severe von Willebrand disease (Type 3) had grade II splenic injury that required splenectomy to secure hemostasis. The coagulopathic deficiency was aggressively treated in each patient. All patients required operative intervention with attempted splenorrhaphy. All patients survived their operative experience, and none suffered a rebleeding episode. With correction of the coagulopathy throughout the perioperative period and local hemostatic control by operative techniques, salvage procedures for splenic injury were successful for 2 of these 3 patients.

Adolescent↗
PubMed1979

Inhibitory spectrum of alpha 2-plasmin inhibitor.

alpha 2-Plasmin inhibitor (alpha 2PI) has been recently characterized as a fast-reacting inhibitor of plasmin in human plasma and appears to play an important role in the regulation of fibrinolysis in vivo. We have studied the effect of purified alpha 2PI upon various proteases participating in human blood coagulation and kinin generation. At physiological concentration (50 microgram/ml), alpha 2PI inhibited the clot-promoting and prekallikrein-activating activity of Hageman factor fragments, the amidolytic, kininogenase, and clot-promoting activities of plasma kallikrein, and the clot-promoting properties of activated plasma thromboplastin antecedent (PTA, Factor XIa) and thrombin. alpha 2PI had minimal inhibitory effect on surface-bound activated PTA and activated Stuart factor (Factor Xa). alpha 2PI did not inhibit the activity of activated Christmas factor (Factor IXa) or urinary kallikrein. Heparin (1.5-2.0 units/ml) did not enhance the inhibitory function of alpha 2PI. These results suggest that, like other plasma protease inhibitors, alpha 2PI possesses a broad in vitro spectrum of inhibitory properties.

Blood Coagulation Factors↗
PubMed1982

Isolation and characterization of a cDNA coding for human factor IX.

A cDNA library prepared from human liver has been screened for factor IX (Christmas factor), a clotting factor that participates in the middle phase of blood coagulation. The library was screened with a single-stranded DNA prepared from enriched mRNA for baboon factor IX and a synthetic oligonucleotide mixture. A plasmid was identified that contained a cDNA insert of 1,466 base pairs coding for human factor IX. The insert is flanked by G-C tails of 11 and 18 base pairs at the 5' and 3' ends, respectively. It also included 138 base pairs that code for an amino-terminal leader sequence, 1,248 base pairs that code for the mature protein, a stop codon, and 48 base pairs of noncoding sequence at the 3' end. The leader sequence contains 46 amino acid residues, and it is proposed that this sequence includes both a signal sequence and a pro sequence for the mature protein that circulates in plasma. The 1,248 base pairs code for a polypeptide chain composed of 416 amino acids. The amino-terminal region for this protein contains 12 glutamic acid residues that are converted to gamma-carboxyglutamic acid in the mature protein. These glutamic acid residues are coded for by both GAA and GAG. The arginyl peptide bonds that are cleaved in the conversion of human factor IX to factor IXa by factor XIa were identified as Arg145-Ala146 and Arg180-Val181. The cleavage of these two internal peptide bonds results in the formation of an activation peptide (35 amino acids) and factor IXa, a serine protease composed of a light chain (145 amino acids) and a heavy chain (236 amino acids), and these two chains are held together by a disulfide bond(s). The active site residues including histidine, aspartate, and serine are located in the heavy chain at positions 221, 270, and 366, respectively. These amino acids are homologous with His57, Asp102, and Ser195 in the active site of chymotrypsin. Two potential carbohydrate binding sites (Asn-X-Thr) were identified in the activation peptide, and these were located at Asn157 and Asn167. The homology in the amino acid sequence between human and bovine factor IX was found to be 83%.

Amino Acid Sequence↗
PubMed1990

Expression of human factor IX in rabbit hepatocytes by retrovirus-mediated gene transfer: potential for gene therapy of hemophilia B.

Hemophilia B (Christmas disease) is a chromosome X-linked blood clotting disorder which results when factor IX is deficient or functionally defective. The enzyme is synthesized in the liver, and the existence of animal models for this genetic disease will permit the development of somatic gene therapy protocols aimed at transfer of the functional gene into the liver. We report the construction of an N2-based recombinant retroviral vector, NCMVFIX, for efficient transfer and expression of human factor IX cDNA in primary rabbit hepatocytes. In this construct the human cytomegalovirus immediate early promoter directs the expression of factor IX. Hepatocytes were isolated from 3-week-old New Zealand White rabbits, infected with the recombinant virus, and analyzed for secretion of active factor IX. The infected rabbit hepatocytes produced human factor IX that is indistinguishable from enzyme derived from normal human plasma. The recombinant protein is sufficiently gamma-carboxylated and is functionally active in clotting assays. These results establish the feasibility of using infected hepatocytes for the expression of this protein and are a step toward the goal of correcting hemophilia B by hepatic gene transfer.

Animals↗
PubMed1991

Somatic mosaicism and female-to-female transmission in a kindred with hemophilia B (factor IX deficiency).

Studies have shown that hemophilia B (Christmas disease; factor IX deficiency) results from many different mutations in the factor IX gene, of which greater than 95% are single nucleotide substitutions. This study has identified a previously unreported form of hemophilia B in a patient who was a somatic mosaic for a guanine-to-cytosine transversion at nucleotide 31,170 in the factor IX gene. This point mutation changes the codon for residue 350 in the catalytic domain of factor IX from a cysteine to a serine. We used differential termination of primer extension to confirm and measure the degree of mosaicism. Our study shows that a varying proportion of cells from hepatic, renal, smooth muscle, and hematopoietic populations possessed normal as well as mutant factor IX sequences. These results indicate that the mutation in this patient occurred either as an uncorrected half-chromatid mutation in the female gamete or as a replication or postreplication error in the initial mitotic divisions of the zygote preceding implantation. In addition, this kindred also contains two females in successive generations who have moderately severe factor IX deficiency. The molecular pathogenesis of this latter phenomenon has been studied and seems to relate to the unaccompanied expression of the mutant factor IX gene consequent upon a second, as yet undefined, genetic event that has prevented inactivation of sequences including the mutant factor IX gene on the X chromosome inherited from the affected male.

Base Sequence↗
PubMed2004

Greek Orthodox fasting rituals: a hidden characteristic of the Mediterranean diet of Crete.

The longevity and excellent health status of the population of Crete has been attributed to its lifestyle and dietary habits. The impact of Greek Orthodox Christian Church fasting on these dietary habits has never been studied. One hundred and twenty Greek Orthodox Christians living in Crete participated in a 1-year prospective study. One half of the subjects, who fasted regularly (fasters), and sixty non-faster controls were followed longitudinally for the three main fasting periods over 1 year; Christmas (40 d), Lent (48 d) and the Assumption (15 d). Pre- and end-holy days measurements were performed in each fasting period including: 24 h dietary recall, blood collection and anthropometric measurements. Based on the 24 h recall, fasters as compared with controls had lower intakes of end-holy days dietary cholesterol, total fat, saturated fatty acids, trans-fatty acids and protein (P < 0.001). Fasters presented a decrease of 753 kJ (180 kcal) in end-holy days energy intake (P < 0.05) compared with an increase of 573 kJ (137 kcal) in the controls (P < 0.05). Fasters had a decrease in end-holy days Ca intake (P < 0.001) and an increase in end-holy days total dietary fibre (P < 0.001) and folate (P < 0.05), attributed to their higher consumption of fruit and vegetables in end-holy periods (P < 0.001). There were no differences for other vitamins or minerals between pre- and end-holy periods in both groups except for vitamin B2. The Orthodox Christian dietary regulations are an important component of the Mediterranean diet of Crete characterised by low levels of dietary saturated fatty acids, high levels of fibre and folate, and a high consumption of fruit, vegetables and legumes.

Adult↗
PubMed2005

Is religious fasting related to iron status in Greek Orthodox Christians?

The Orthodox Christian diet is unique in regularly interchanging from an omnivore to a vegetarian-type diet, and no study to date has focused on the impact of this on Fe status. Thirty-five Greek Orthodox Christian strict fasters (n 17 male, n 18 female; mean age 43.6+/-13.2 years) and twenty-four controls (n 11 male, n 13 female; mean age 39.8+/-7.6 years) were studied before (pre) and near completion (end) of the Christmas fasting (CF) period (40 d), during which meat and dairy products are prohibited. Fe status was assessed using standard haematological parameters, and Fe deficiency was determined via serum ferritin levels (<12 ng/ml) and the tri-index model. While fasters had marginally poorer pre haematological indicators, values were well above the cut-off levels, suggesting that intermittent fasting for a mean of 22.5+/-15.5 years did not have any substantial adverse effects on Fe status. During the CF period the changes in Fe status indices were more beneficial for fasters than for control subjects. In particular, fasters increased their ferritin levels (P = 0.02) and decreased their total Fe-binding capacity (P < 0.001). Compared with males, the effect of CF was more pronounced in female fasters. No subjects were detected with Fe deficiency at the end of the CF period. End dietary Fe and fibre intake were significantly higher in the fasters as compared with the control group (P = 0.038 and P = 0.001, respectively). Adherence to the Orthodox Christian dietary guidelines does not have a major impact on Fe status and is not associated with a significantly greater degree of Fe deficiency.

Adult↗
PubMed2002

An obesity clinic model.

The high incidence of obesity in Ireland is of growing concern. The Irish Universities Nutrition Alliance North/South Food Consumption Survey found that 18 % of the population are obese and 39% overweight. Obesity and overweight increase the risk of developing CHD, type 2 diabetes, hypertension and some forms of cancer. It is well accepted that the best treatment for obesity is a combination of energy intake reduction and regular exercise. Previously, dietary compliance has been shown to improve when monitored on a regular basis. The lengthy delay between clinic visits to the dietitian has been reported by those who failed to lose weight to be the main reason for poor compliance. A weight monitoring clinic was designed to offer those requiring regular support and encouragement the opportunity to monitor their weights on a more regular basis, while waiting for their return visit to the dietitian in the Outpatient Departments. As resources were limited, an efficient use of time was essential. The clinic design was: 1 h/week; eight to fourteen appointments per clinic; weekly or fortnightly visit; return patients only. The clinic was started on a trial basis in June 1999, and was evaluated in December 2000. Referrals were only taken from other dietitians, and each participant was informed in advance of the necessity of having a return Outpatient Department appointment for full dietary review. Forty-eight participants attended more than three times up to and including December 2000 (seven males, forty-one females). The number of clinic visits ranged from three to twenty-eight. Mean weight at start of clinic was 92.94 kg. Of the group attending, 67 % (thirty-two) successfully lost weight and maintained this weight loss. This ranged from 0.1 kg to 23.5 kg. While in total 31% (fifteen) of attendees had gained weight at December 2000, all attendees, including this fifteen, had lost weight at some point during the clinic. Self-reported reasons given for weight regain included: (1) non-attendance at weight clinic (40%); (2) Christmas or holidays (13%); (3) stress related to family, work (13%); (4) ill-health or medication (13%). The remaining 20% reported no reason. Other findings included better compliance with diet and improved overall balance. There was an overall improvement in other dietary-related problems, e.g. reduced cholesterol, improved glycaemic control, reduced blood pressure. The participants attending the clinic reported decreased clothes size and improved self-image and confidence. They were more enthusiastic about dietary compliance, and all attendees expressed their satisfaction with the clinic and the service.

Energy Intake↗
PubMed1994

Parents' and children's ratings of sleep behavior, excitement, and tiredness: a 10-week longitudinal study.

In a 10-week longitudinal study, 29 parents and their children kept daily records of the children's sleep behaviors, excitement levels, and tiredness levels. Although the hypothesized increase in sleep behaviors such as sleepwalking and restlessness during the week of Christmas did not occur, children rated as more excitable by their parents and themselves exhibited a higher frequency of sleep behaviors. Positive associations were also found between averaged tiredness ratings and sleep scores. The results support previous findings of an association between arousal characteristics of children and their sleep behavior. Moderate validity coefficients were obtained for parents' and children's ratings of excitement, tiredness, and nocturnal waking.

Arousal↗
PubMed2003

Alcoholic, but not biliary, pancreatitis varies seasonally in occurrence.

BACKGROUND: Alcohol is the most common cause of acute pancreatitis in Finland (70%). The amount of alcohol consumed has been shown to be associated with the prevalence of pancreatitis in the country, and also to be an important determinant of the severity of the first episode of acute alcoholic pancreatitis. We have a clinical suspicion that the use of alcohol and the incidence of pancreatitis are increased during holiday periods in summer, although no seasonal variations have been reported in a German population. METHODS: Between 1972 and 1992 a total of 1556 episodes with acute alcoholic pancreatitis were treated at Tampere University Hospital; 552 were first episodes and 1004 were recurrent. For comparison, we investigated 297 episodes of acute biliary pancreatitis treated in that same time period. We investigated the monthly prevalence of acute alcoholic (first and recurrent) pancreatitis and compared this with the monthly absolute alcohol consumption. RESULTS: Taking all alcoholic pancreatitis episodes into account, significant differences can be seen between prevalence and month of onset of the disease (P < 0.0001), whereas among biliary pancreatitis episodes there were no differences (P = 0.3). Prevalence of acute alcoholic pancreatitis was significantly higher than the expected prevalence in July and August, and the amount of alcohol consumption (100% alcohol, litres) was highest during these same months. Also during March, October and December the prevalence was higher than expected. CONCLUSION: Months with holiday seasons, Christmas, Easter, summer and autumn, are associated with the highest alcohol consumption and the highest prevalence of acute alcoholic pancreatitis.

Acute Disease↗
PubMed2003

Weekly antibiotic prescribing and influenza activity in Sweden: a study throughout five influenza seasons.

Influenza often leads to bacterial complications that require treatment. It may also be confused with bacterial respiratory infections, leading to unnecessary prescription of antibiotics. In this first study on the relationship between influenza and antibiotic utilization for a whole country, weekly data on verified influenza cases in Sweden were compared to weekly sales of antibiotics for 5 influenza seasons 1997-2002. The peak of influenza activity occurred during the winter. In 4 out of the 5 monitored influenza seasons it occurred in February-March. The fluctuation of antibiotic utilization was relatively constant over the years with peaks before Christmas and in February-March. There were no obvious differences in the total amount of antibiotics dispensed over the years that could be related to influenza activity, but a coincidental relationship between the peaks of diagnosed influenza cases and the peaks of antibiotic utilization was indicated, especially for older age groups.

Adolescent↗
PubMedDate not supplied

Survey of baked goods for propionic acid and propionates.

One hundred and thirty samples comprising bread (64), hamburger buns (33), pittas (16), cakes (9) and Christmas puddings (8) from various retail outlets in the UK, have been analysed for the preservative propionic acid. Only one sample of bread, two samples of hamburger buns and three samples of pitta contained propionic acid in excess of 1000 mg/kg (range 1110-2625 mg/kg). The three samples of pitta exceeded 2000 mg/kg of propionic acid, which is the maximum amount permitted for these products under a recently adopted European Union directive.

Bread↗