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Thelly ASS, Rose MJ, Rana S. Epilogue: Reflections from Stakeholders of a Facilitated Community Partnership Developed to Provide Palliative Care to a Vulnerable Population in Kerala. Indian J Palliat Care 2023; 29:94-99. [PMID: 36846278 PMCID: PMC9944653 DOI: 10.25259/ijpc_81_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 08/15/2022] [Indexed: 11/04/2022] Open
Abstract
Introduction In mid-March 2020, the Kerala government implemented additional preventive measures to the steps already taken to reduce the transmission of COVID-19. Strategies were taken by a non-governmental palliative care organisation (Pallium India) with Coastal Students Cultural Forum - a coastal area-based collective of young educated people in the coastal region to address the medical needs of people living in this community. The facilitated partnership lasted 6 months (July-December 2020) and addressed the palliative care needs of the community in the selected coastal regions during the first wave of the pandemic. Volunteers sensitised by the NGO identified more than 209 patients. The current article highlights the reflective narratives of key players in this facilitated community partnership. Materials and Method The current article is dedicated to highlighting the reflective narratives of key players in this facilitate community partnership to the readers of this journal. The palliative care team's overall experience was collected from selected key participants to understand the program's impact, identify areas of improvement, and discuss possible solutions if there were any challenges. The contents below are their statements on the experience of the entire program. Conclusion Palliative care delivery programmes must be configured to respond to local needs and customs, be community-based and integrated with local health and social care and have accessible referral pathways between and across services. They must also be responsive to changing individual and population needs and shifts in local and national health structures.
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Affiliation(s)
- Anu Savio Savio Thelly
- Department of Palliative Medicine, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - M. Jima Rose
- Coastal Students Cultural Forum, Thiruvananthapuram, Kerala, India
| | - Smriti Rana
- Pallium India Trust, Aisha Memorial Hospital Building, Thiruvananthapuram, Kerala, India
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Sumitha TS, Thelly AS, Medona B, Lijimol AS, Rose MJ, Rajagopal MR. Response to COVID-19 Crisis with Facilitated Community Partnership among a Vulnerable Population in Kerala, India – A Short Report. Indian J Palliat Care 2022; 28:115-119. [PMID: 35673379 PMCID: PMC9165449 DOI: 10.25259/ijpc_62_2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 01/17/2022] [Indexed: 11/17/2022] Open
Abstract
The unexpected lockdown announced by the Government of India in March 2020 in response to the pandemic left the coastal community in Kerala deprived of not only essential amenities but also healthcare. Some poverty-ridden, over-crowded coastal regions had been declared as critical containment zones with severe restriction of movement, adding to their vulnerability. People with serious health-related suffering (SHS) in this community required urgent relief. A group of educated youth in the community joined hands with a non-governmental organisation specialised in palliative care (PC) services and strived to find the best possible solutions to address the healthcare needs in their community. This paper reports the collaborative activities done during the pandemic in the coastal region and compares the activities with steps proposed by the WHO to develop community-based PC (CBPC). By engaging, empowering, educating, and coordinating a volunteer network and providing the required medical and nursing support, the programme was able to provide needed services to improve the quality of life of 209 patients and their families who would have been left with next-to-no healthcare during the pandemic. We conclude that even in the context of much poverty, delivery of CBPC with the engagement of compassionate people in the community can successfully reduce SHS.
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Affiliation(s)
- TS Sumitha
- Health Action by People, Trivandrum, Kerala, India,
| | - Anu Savio Thelly
- Department of Palliative Medicine, Mahatma Gandhi Medical College and Research Institute, Puducherry, India,
| | - Bessy Medona
- Pallium India Trust, Aisha Memorial Hospital Building, Thiruvananthapuram, Kerala, India,
| | - A. S. Lijimol
- Pallium India Trust, Aisha Memorial Hospital Building, Thiruvananthapuram, Kerala, India,
| | - M. Jima Rose
- Coastal Students Cultural Forum, Thiruvananthapuram, Kerala, India,
| | - M. R. Rajagopal
- Pallium India Trust, Aisha Memorial Hospital Building, Thiruvananthapuram, Kerala, India,
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Hashem H, Abu-Arja R, Auletta JJ, Rangarajan HG, Varga E, Rose MJ, Bajwa RPS. Successful second hematopoietic cell transplantation in severe congenital neutropenia. Pediatr Transplant 2018; 22. [PMID: 29076228 DOI: 10.1111/petr.13078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/28/2017] [Indexed: 12/18/2022]
Abstract
Allogeneic HCT is curative for SCN; however, a standard conditioning regimen or intensity has not been established. We describe a patient with SCN associated with c.1A>G (M1V) mutation in ELANE gene resulting in refractoriness to G-CSF, who received reduced-intensity HCT and developed secondary graft failure requiring a second myeloablative HCT. This case suggests that M1V mutation confers a poor G-CSF response and HCT using the best available donor is beneficial.
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Affiliation(s)
- H Hashem
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - R Abu-Arja
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - J J Auletta
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - H G Rangarajan
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - E Varga
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - M J Rose
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - R P S Bajwa
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
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Poliacek I, Rose MJ, Pitts TE, Mortensen A, Corrie LW, Davenport PW, Bolser DC. Central administration of nicotine suppresses tracheobronchial cough in anesthetized cats. J Appl Physiol (1985) 2014; 118:265-72. [PMID: 25477349 DOI: 10.1152/japplphysiol.00075.2014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
We tested the hypothesis that nicotine, which acts peripherally to promote coughing, might inhibit reflex cough at a central site. Nicotine was administered via the vertebral artery [intra-arterial (ia)] to the brain stem circulation and by microinjections into a restricted area of the caudal ventral respiratory column in 33 pentobarbital anesthetized, spontaneously breathing cats. The number of coughs induced by mechanical stimulation of the tracheobronchial airways; amplitudes of the diaphragm, abdominal muscle, and laryngeal muscles EMGs; and several temporal characteristics of cough were analyzed after administration of nicotine and compared with those during control and recovery period. (-)Nicotine (ia) reduced cough number, cough expiratory efforts, blood pressure, and heart rate in a dose-dependent manner. (-)Nicotine did not alter temporal characteristics of the cough motor pattern. Pretreatment with mecamylamine prevented the effect of (-)nicotine on blood pressure and heart rate, but did not block the antitussive action of this drug. (+)Nicotine was less potent than (-)nicotine for inhibition of cough. Microinjections of (-)nicotine into the caudal ventral respiratory column produced similar inhibitory effects on cough as administration of this isomer by the ia route. Mecamylamine microinjected in the region just before nicotine did not significantly reduce the cough suppressant effect of nicotine. Nicotinic acetylcholine receptors significantly modulate functions of brain stem and in particular caudal ventral respiratory column neurons involved in expression of the tracheobronchial cough reflex by a mecamylamine-insensitive mechanism.
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Affiliation(s)
- I Poliacek
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida; and Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Institute of Medical Biophysics, Martin, Slovak Republic
| | - M J Rose
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida; and
| | - T E Pitts
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida; and
| | - A Mortensen
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida; and
| | - L W Corrie
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida; and
| | - P W Davenport
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida; and
| | - D C Bolser
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida; and
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Poliacek I, Corrie LW, Rose MJ, Wang C, Bolser DC. Influence of microinjections of D,L-homocysteic acid into the Botzinger complex area on the cough reflex in the cat. J Physiol Pharmacol 2008; 59 Suppl 6:585-596. [PMID: 19218685 PMCID: PMC2921637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 05/13/2008] [Accepted: 07/22/2008] [Indexed: 05/27/2023]
Abstract
Microinjections of D,L-homocysteic acid (DLH) were used to test the hypothesis that neuronal activation within the Botzinger complex area can modify the spatiotemporal characteristics of the cough reflex in 17 spontaneously breathing pentobarbitone anesthetized cats. DLH (50 mM, 1.25-1.75 nmol, 9 cats) reduced the number (P<0.01) of coughs and expiratory amplitude of abdominal electromyographic activity (P<0.01), and also esophageal pressure (P<0.001) during mechanically induced tracheobronchial cough. The duration of cough abdominal activity was shortened by 48% (P<0.05). DLH microinjections also temporarily reduced the respiratory rate (P<0.01) and increased the mean arterial blood pressure (P<0.001), baseline of esophageal pressure (P<0.01), and end tidal CO(2) concentrations (P<0.01). Lower doses of DLH (0.27-0.35 nmol, 7 cats) or vehicle (25-35 nl, 8 cats) induced few alterations in cardiorespiratory or cough characteristics. The results support predominantly inhibitory effects of neurons in the region of the Bötzinger complex on cough abdominal activity and cough number.
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Affiliation(s)
- I Poliacek
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.
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Merschman SA, Rose MJ, Pearce GES, Woolf EJ, Schaefer BH, Huber AC, Musson DG, Perry KJ, Rush DJ, Varsolona RJ, Matuszewski BK. Characterization of the solubility of a poorly soluble hydroxylated metabolite in human urine and its implications for potential renal toxicity. Pharmazie 2005; 60:359-63. [PMID: 15918586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The solubility, in human urine, of the major hydroxylated metabolite (M1) of an experimental cognition enhancer was characterized through a series of in vitro experiments in an effort to estimate the probability of crystalluria occurring following oral administration of the parent compound. The aim of these experiments was to determine if a safety margin existed between clinically observed urine concentrations and the solubility of M1. The mean urine concentrations of M1 in young and elderly subjects following oral administration of the parent compound at the highest doses tested, were 4865 +/- 2368 ng/mL and 2764 +/- 791 ng/mL, respectively. In vitro solubility experiments with M1 were conducted in drug-free human urine (37 degrees C) from four male and four female healthy subjects under conditions of high and low urine osmolality. Mean concentrations (n = 16) of M1 in human urine to which solid M1 was added, were 3656 +/- 621 ng/mL, 4678 +/- 1169 ng/mL and 5378 +/- 2474 ng/mL after stirring for 24, 48 and 72 h, respectively, indicating that the ex vivo mean solubility of M1 in human urine is no greater then approximately 5 microg/mL. Addition of solid M1 to urine from human subjects dosed with the parent compound resulted in mean urine M1 concentrations 23.5% greater than those observed in vivo. The results from both experiments indicated a significant overlap between urine concentrations of M1 in vivo following the highest oral administration of the parent drug and M1 solubility measured in vitro, suggesting a high potential for in vivo saturation of urine with M1 with subsequent precipitation, crystalluria, and nephrotoxicity. Consequently, the results of these studies have placed restrictions on the dose that could be administered during clinical development of this compound.
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Affiliation(s)
- S A Merschman
- Sheila A. Merschman, Merck Research Laboratories, Department of Drug Metabolism, West Point, PA 19486, USA.
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Dey P, Simpson CWR, Collins SI, Hodgson G, Dowrick CF, Simison AJM, Rose MJ. Implementation of RCGP guidelines for acute low back pain: a cluster randomised controlled trial. Br J Gen Pract 2004; 54:33-7. [PMID: 14965404 PMCID: PMC1314775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND The Royal College of General Practitioners (RCGP) has produced guidelines for the management of acute low back pain in primary care. AIM To investigate the impact on patient management of an educational strategy to promote these guidelines among general practitioners (GPs). DESIGN OF STUDY Group randomised controlled trial, using the health centre as the unit of randomisation. SETTING Primary care teams in north-west England. METHOD Twenty-four health centres were randomly allocated to an intervention or control arm. Practices in the intervention arm were offered outreach visits to promote national guidelines on acute low back pain, as well as access to fast-track physiotherapy and to a triage service for patients with persistent symptoms. RESULTS Twenty-four centres were randomised. Two thousand, one hundred and eighty-seven eligible patients presented with acute low back pain during the study period: 1049 in the intervention group and 1138 in the control group. There were no significant differences between study groups in the proportion of patients who were referred for X-ray, issued with a sickness certificate, prescribed opioids or muscle relaxants, or who were referred to secondary care, but significantly more patients in the intervention group were referred to physiotherapy or the back pain unit (difference in proportion = 12.2%, 95% confidence interval [CI] = 2.8% to 21.6%). CONCLUSION The management of patients presenting with low back pain to primary care was mostly unchanged by an outreach educational strategy to promote greater adherence to RCGP guidelines among GPs. An increase in referral to physiotherapy or educational programmes followed the provision of a triage service.
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Affiliation(s)
- Paola Dey
- Centre for Cancer Epidemiology, University of Manchester, Withington
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8
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Rose MJ, Agrawal N, Woolf EJ, Matuszewski BK. Simultaneous determination of unlabeled and carbon-13-labeled etoricoxib, a new cyclooxygenase-2 inhibitor, in human plasma using HPLC-MS/MS. J Pharm Sci 2002; 91:405-16. [PMID: 11835200 DOI: 10.1002/jps.10038] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A method for the simultaneous determination of etoricoxib and its carbon-13 analog ((13)C(6)-etoricoxib) from human plasma has been developed and used to support bioavailability studies. Plasma samples (0.5 mL) were extracted by using a 3M Empore 96-well plate (C(8)) and the resulting extracts were analyzed by using a PE-Sciex API-3000 HPLC-MS/MS with a heated nebulizer interface (500 degrees C). The method was validated with two different calibration curve ranges, one for etoricoxib (5 to 2500 ng/mL) determined in the presence of lower concentrations of (13)C(6)-etoricoxib (0.5 to 250 ng/mL), and a second curve for the quantitation of similar concentrations of both etoricoxib and (13)C(6)-etoricoxib (0.5 to 250 ng/mL). Extraction recoveries of etoricoxib, (13)C(6)-etoricoxib, and a methylated internal standard were >70% over the range of concentrations included in both calibration curves. Intraday precision and accuracy for the quantitation of etoricoxib were 7.8% relative standard deviation (RSD) or less and within 3.4% respectively over the range of 5 to 2500 ng/mL, and 10.8% RSD or less and within 4 % respectively over the range of 0.5 to 250 ng/mL. Within-batch precision and accuracy for the quantitation of (13)C(6)-etoricoxib over the range of 0.5 to 250 ng/mL were 8.3% RSD or less and within 2.3%, respectively. The validated assay was used in support of human clinical trials.
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Affiliation(s)
- M J Rose
- Merck Research Laboratories, Department of Drug Metabolism, West Point, Pennsylvania 19486, USA.
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Rose MJ, Lunte SM, Carlson RG, Stobaugh JF. Transformation of analytes for electrochemical detection: a review of chemical and physical approaches. Adv Chromatogr 2001; 41:203-48. [PMID: 11263068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- M J Rose
- Department of Pharmaceutical Chemistry, University of Kansas, Lawrence, Kansas
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Tang C, Shou M, Rushmore TH, Mei Q, Sandhu P, Woolf EJ, Rose MJ, Gelmann A, Greenberg HE, De Lepeleire I, Van Hecken A, De Schepper PJ, Ebel DL, Schwartz JI, Rodrigues AD. In-vitro metabolism of celecoxib, a cyclooxygenase-2 inhibitor, by allelic variant forms of human liver microsomal cytochrome P450 2C9: correlation with CYP2C9 genotype and in-vivo pharmacokinetics. Pharmacogenetics 2001; 11:223-35. [PMID: 11337938 DOI: 10.1097/00008571-200104000-00006] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In-vitro studies were conducted to assess the impact of CYP2C9 genotype on the metabolism (methyl hydroxylation) and pharmacokinetics of celecoxib, a novel cyclooxygenase-2 inhibitor and CYP2C9 substrate. When compared to cDNA-expressed wild-type CYP2C9 (CYP2C9*1), the Vmax/Km ratio for celecoxib methyl hydroxylation was reduced by 34% and 90% in the presence of recombinant CYP2C9*2 and CYP2C9*3, respectively. These data indicated that the amino acid substitution at position 359 (Ile to Leu) elicited a more pronounced effect on the metabolism of celecoxib than did a substitution at position 144 (Arg to Cys). The Vmax/Km ratio was also decreased in microsomes of livers genotyped CYP2C9*1/*2 (47% decrease, mean of two livers), or CYP2C9*1/*3 (59% decrease, one liver). In all cases, these changes were largely reflective of a decrease in Vmax, with a minimal change in Km. Based on simulations of the in-vitro data obtained with the recombinant CYP2C9 proteins, it was anticipated that the pharmacokinetics of celecoxib (as a much as a five-fold increase in plasma AUC) would be altered (versus CYP2C9*1/*1 subjects) in subjects genotyped heterozygous or homozygous for the CYP2C9*2 (Cys144) or CYP2C9*3 (Leu359) allele. In a subsequent clinical study, the AUC of celecoxib was increased (versus CYP2C9*1/*1 subjects) approximately 2.2-fold (range, 1.6-3-fold) in two CYP2C9*1/*3 subjects and one CYP2C9*3/*3 subject receiving a single oral dose (200 mg) of the drug. In contrast, there was no significant change in celecoxib AUC in two subjects genotyped CYP2C9*1/*2.
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Affiliation(s)
- C Tang
- Drug Metabolism, Merck Research Laboratories, West Point, PA, USA.
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Pinnington MA, Stanley IM, Miller JM, Rose MJ, Rose GM. New Episodes of Low Back Pain. Physiotherapy 2001. [DOI: 10.1016/s0031-9406(05)60461-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Rose MJ, Merschman SA, Eisenhandler R, Woolf EJ, Yeh KC, Lin L, Fang W, Hsieh J, Braun MP, Gatto GJ, Matuszewski BK. High-throughput simultaneous determination of the HIV protease inhibitors indinavir and L-756423 in human plasma using semi-automated 96-well solid phase extraction and LC-MS/MS. J Pharm Biomed Anal 2000; 24:291-305. [PMID: 11130208 DOI: 10.1016/s0731-7085(00)00420-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A method for the simultaneous determination of the HIV protease inhibitors indinavir and L-756423, in human plasma has been developed. Plasma samples (0.5 ml) were extracted using a 3M Empore 96-well plate in the mixed phase cation exchange (MPC) format. The extraction method was automated through the application of both the Packard 204DT and TOMTEC Quadra 96 work stations, and the resulting extracts were analyzed using a PE-Sciex API-3000 LC-MS/MS with a heated nebulizer interface (500 degrees C). The assay was linear in the concentration range 1-2500 ng/ml for indinavir and 5 2500 ng/ml for L-756423 when 0.5-ml aliquots of plasma were extracted. Recoveries of indinavir and L-756423 were greater than 76 and 80%, respectively, over the calibration curve range when using the described sample preparation method. Within-batch precision and accuracy for the quantitation of indinavir over the range 1-2500 ng/ml were 5.4% R.S.D. or less and within 4.0%, respectively. Within-batch precision and accuracy for the quantitation of L-756423 over the range 5-2500 ng/ml were 5.3% R.S.D. or less and within 3.4%, respectively. Interbatch variability for the analysis of indinavir QC samples at low (3 ng/ml), middle (250 ng/ml) and high (2250 ng/ml) were 3.2, 2.9, and 1.9%, respectively. Interbatch variability for the analysis of L-756423 QC samples at low (15 ng/ml), middle (250 ng/ml) and high (2250 ng/ml) concentration were 2.0, 2.5, and 3.3%, respectively. The validated assay was used in support of human clinical trials.
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Affiliation(s)
- M J Rose
- Department of Drug Metabolism, Merck Research Laboratories, West Point, PA 19486, USA.
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Abstract
OBJECTIVE To explore the ways that persons with long standing chronic low back pain respond to the problem of medical doubt about the presence of organic pathology. METHOD Qualitative analysis of accounts provided by 12 persons attending a back pain rehabilitation clinic in NW England. RESULTS Subjects rejected the notion that they were culpable for their pain. They were not culpable for the onset of their pain. They argued that despite their cooperation, no sensible explanation of their pain was forthcoming from health professionals. Finally, they asserted that medical scepticism had been damaging and dispiriting. CONCLUSION Patients dealt with clinical doubt by stressing their own expertise. They constituted their beliefs about the cause and trajectory of their pain and disability as accurate accounts of their disability. They resisted the suggestion that there might be psychological factors involved in their ill-health by locating culpability among clinicians, who were confused or uncertain about diagnosis and treatment.
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Affiliation(s)
- C R May
- Rusholme Health Centre, School of Primary Care, University of Manchester, Walmer Street, Manchester M14 5NP, UK.
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14
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Rose MJ, Woolf EJ, Matuszewski BK. Determination of celecoxib in human plasma by normal-phase high-performance liquid chromatography with column switching and ultraviolet absorbance detection. J Chromatogr B Biomed Sci Appl 2000; 738:377-85. [PMID: 10718655 DOI: 10.1016/s0378-4347(99)00552-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A method is described for the determination of celecoxib in human plasma. Samples were extracted using 3M Empore membrane extraction cartridges and separated under normal-phase HPLC conditions using a Nucleosil-NO2 (150x4.6 mm, 5 microm) column. Detection was accomplished using UV absorbance at 260 nm. The HPLC method included a column switching procedure, in which late eluting compounds were diverted to waste, to reduce run-time to 12 min. The assay was linear in the concentration range of 25-2000 ng/ml when 1-ml aliquots of plasma were extracted. Recoveries of celecoxib were greater than 91% over the calibration curve range. Intraday precision and accuracy for this assay were 5.7% C.V. or better and within 2.3% of nominal, respectively. The assay was used to analyze samples collected during human clinical studies.
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Affiliation(s)
- M J Rose
- Department of Drug Metabolism, Merck Research Laboratories, West Point, PA 19486, USA
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15
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Rose MJ, Merschman SA, Woolf EJ, Matuszewski BK. Determination of L-756 423, a novel HIV protease inhibitor, in human plasma and urine using high-performance liquid chromatography with fluorescence detection. J Chromatogr B Biomed Sci Appl 1999; 732:425-35. [PMID: 10517365 DOI: 10.1016/s0378-4347(99)00315-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
A method for the determination of L-756 423, a novel HIV protease inhibitor, in human plasma and urine is described. Plasma and urine samples were extracted using 3M Empore extraction disk cartridges in the C18 and MPC (mixed-phase cation-exchange) formats, respectively. The extract was analyzed using HPLC with fluorescence detection (ex 248 nm, em 300 nm), and included a column switching procedure to reduce run-time. The assay was linear in the concentration range 5 to 1000 ng/ml when 1-ml aliquots of plasma and urine were extracted. Recoveries of L-756 423 were greater than 84% over the calibration curve range using the described sample preparation procedures. Intra-day precision and accuracy for this assay was less than 9% RSD and within 7%, respectively. Inter-day variabilities for the plasma (n=17) and urine (n= 10) were less than 5% and 3% for low (15 ng/ml) and high (750 ng/ml) quality control samples. Bovine serum albumin (0.5%) was used as an additive to urine to prevent precipitation of L-756 423 during the storage of clinical samples. The assay was used in support of human clinical trials.
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Affiliation(s)
- M J Rose
- Merck Research Laboratories, Department of Drug Metabolism, West Point, PA 19486, USA.
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Rose MJ, Lunte SM, Carlson RG, Stobaugh JF. Hydroquinone-based derivatization reagents for the quantitation of amines using electrochemical detection. Anal Chem 1999; 71:2221-30. [PMID: 10366893 DOI: 10.1021/ac981236c] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Two new reagents, NDTE (2,5-dihydroxyphenylacetic acid, 2,5-bis-tetrahydropyranyl ether p-nitrophenyl ester) and HLTE (homogentisic gamma-lactone tetrahydropyranyl ether), are described for the chemical derivatization of primary and/or secondary amines to form an electrochemically active product. These reagents undergo reaction with the aforementioned analytes to form a product possessing the hydroquinone moiety, thus allowing for reversible electrochemical detection at mild oxidation potentials. The reactivity of each reagent was demonstrated by using N-ethylbenzylamine (EBzA) and the dipeptide isoleucine leucine methyl ester as model analytes. The investigation included the isolation and identification of the intermediates and final products from derivatization of EBzA. These isolated standards were subsequently characterized with respect to electrochemical properties by means of cyclic voltammetry. In LC-EC experiments, the concentration limit of detection (CLOD) of the purified EBzA product was determined to be 5 nM (100 fmol) at a detection potential of +200 mV vs Ag/AgCl ([Cl-] = 3 M). The CLOD values obtained by LC-EC after derivatization of aqueous solutions of EBzA and Ile-Leu-OMe with NDTE were 25 nM (250 fmol) and 250 nM (2.5 pmol), respectively.
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Affiliation(s)
- M J Rose
- Department of Pharmaceutical Chemistry, University of Kansas, Lawrence 66047, USA
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Rose MJ, Reilly JP, Pennie B, Bowen-Jones K, Stanley IM, Slade PD. Chronic low back pain rehabilitation programs: a study of the optimum duration of treatment and a comparison of group and individual therapy. Spine (Phila Pa 1976) 1997; 22:2246-51; discussion 2252-3. [PMID: 9346145 DOI: 10.1097/00007632-199710010-00009] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
STUDY DESIGN Eighty-four patients with chronic low back pain were treated using cognitive behavioral principles on a pain management program. Outcome data were collected at four points: 10 weeks before treatment, immediately before and immediately after treatment, and 6 months after treatment. In part 1 of the study, patients were assigned randomly to group or individual treatment contexts. In part 2 of the study, patients were assigned randomly to programs of 15, 30, or 60 hours duration. OBJECTIVES To identify the differences in outcome between programs that treated patients as part of a group and those that treated patients individually and the effects of duration of treatment on outcome. SUMMARY OF BACKGROUND DATA Cognitive behavioral programs have been shown to be an effective means of managing chronic low back pain. The literature is concerned with group programs, however, the duration of which vary widely. METHOD Psychological and functional variables were measured before and after treatment and at the 6-month follow-up visit. Changes in these variables were measured, and comparisons were made between group and individual programs and between 15-, 30-, and 60-hour programs. RESULTS Data analysis showed a significant, beneficial effect of intervention in terms of the majority of variables; however, these changes were generally independent of whether patients were treated as part of a group or individually and whether patients completed a 15-, 30-, or 60-hour program. CONCLUSIONS Cognitive behavioral rehabilitation programs have been demonstrated to be an effective means of reducing psychological distress, of changing cognition, and of improving the function of patients with chronic low back pain; however, the length of program and whether patients were treated individually or as part of a group did not affect outcome. This finding has clinical and economic implications.
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Affiliation(s)
- M J Rose
- Back Pain Rehabilitation program, Wirral Hospital Trust, England
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Nerurkar MM, Rose MJ, Stobaugh JF, Borchardt RT. Selective fluorogenic derivatization of a peptide nucleic acid trimer with naphthalene-2,3-dicarboxaldehyde. J Pharm Biomed Anal 1997; 15:945-50. [PMID: 9160260 DOI: 10.1016/s0731-7085(96)01927-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The reversed-phase high-performance liquid chromatography of a Peptide Nucleic Acid (PNA) trimer has been studied after its preseparation fluorogenic derivatization with naphthalene-2,3-dicarboxaldehyde in the presence of cyanide (NDA/CN). Trace levels of the PNA trimer were determined in cell homogenate samples containing the PNA trimer at prederivatization concentrations as low as 48.9 ng ml-1. The sample pretreatment operations included a deproteination step, achieved by ultra-filtration, followed by fluorogenic derivatization (NDA/CN). Subsequently, to achieve adequate selectivity, the fluorescently labeled PNA was subjected to high performance anion exchange chromatography prior to quantitation via fluorescence detection. The various problems encountered during sample pretreatment and separation of derivatized PNA trimer in biological samples are presented and discussed.
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Affiliation(s)
- M M Nerurkar
- Department of Pharmaceutical Chemistry, Simons Research Laboratories, University of Kansas, Lawrence 66047, USA
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Towle DW, Rushton ME, Heidysch D, Magnani JJ, Rose MJ, Amstutz A, Jordan MK, Shearer DW, Wu WS. Sodium/proton antiporter in the euryhaline crab Carcinus maenas: molecular cloning, expression and tissue distribution. J Exp Biol 1997; 200:1003-14. [PMID: 9104780 DOI: 10.1242/jeb.200.6.1003] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Gill epithelial cells of euryhaline crustaceans demonstrate net inward transport of sodium ions, possibly via apical Na+/H+ antiporters, Na+/K+/2Cl- cotransporters or Na+ channels working in series with the basolateral Na(+) + K(+)-ATPase. We have identified and sequenced the cDNA coding for a crustacean Na+/H+ antiporter, starting with mRNA isolated from gills of the euryhaline green shore crab Carcinus maenas. The complete 2595-base-pair cDNA includes an open reading frame coding for a 673-amino-acid protein. A search of GenBank revealed more than 20 high-scoring matches, all Na+/H+ antiporter sequences from mammalian, amphibian, teleost and nematode species. Injection of Xenopus laevis oocytes with cRNA transcribed from the cloned crab sequence substantially enhanced Na(+)-dependent H+ efflux from the oocytes. Analysis of crab tissue antiporter mRNA levels by semi-quantitative reverse transcription-polymerase chain reaction revealed that posterior and anterior gills of Carcinus maenas expressed this antiporter the most strongly, followed in decreasing order by skeletal muscle, hepatopancreas, hypodermis and heart. Hydropathy and transmembrane alpha-helix analysis suggested a 10-helix membrane-spanning topology of the antiporter protein. It is clear from this study that Carcinus maenas gills vigorously transcribe a gene coding for a Na+/H+ antiporter. Whether these gills also express a gene coding for an epithelial Na+ channel or Na+/K+/2Cl- cotransporter remains to be demonstrated.
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Affiliation(s)
- D W Towle
- Department of Biology, Lake Forest College, IL 60045, USA.
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Klenerman L, Slade PD, Stanley IM, Pennie B, Reilly JP, Atchison LE, Troup JD, Rose MJ. The prediction of chronicity in patients with an acute attack of low back pain in a general practice setting. Spine (Phila Pa 1976) 1995; 20:478-84. [PMID: 7747233 DOI: 10.1097/00007632-199502001-00012] [Citation(s) in RCA: 340] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Three hundred patients, attending their general practitioners with attacks of acute low back pain, formed the subject population for a study of fear avoidance and other variables in the prediction of chronicity. Follow-up was at 2 and 12 months. OBJECTIVE The hypothesis to be tested was that evidence of psychological morbidity, particularly fear-avoidance behavior, would be manifest from the outset of the presenting attack in susceptible subjects. SUMMARY OF BACKGROUND DATA While back pain is an almost universal human experience, only about 5% of sufferers seek medical advice. Most of these respond to conservative treatment. However, approximately 10% of those who experience an acute attack of low back pain go on to become chronic sufferers. METHODS Psychosocial and physiological data (including fear-avoidance measures) were collected from a sample of 300 acute low back pain patients within 1 week of presentation and at 2 months, to try to predict 12 month outcome. RESULTS Data analysis showed that subjects who had not recovered by 2 months were those who went on to become chronic low back pain patients (7.3%). Using multiple regression analyses, fear-avoidance variables were the most successful in predicting outcome. Using multiple discriminant function analyses, the results suggest that the outcome in terms of the future course of low back pain can be correctly classified in 66% from fear-avoidance variables alone and in 88% of patients from all variables. CONCLUSIONS The results suggest that, at the earliest stage of low back pain, fear of pain should be identified by clinicians and, where this is severe, pain confrontation should arguably form part of the approach to treatment.
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Affiliation(s)
- L Klenerman
- University of Liverpool, Aintree Hospital, England
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Abstract
The microbiological quality of 745 conventionally processed and 745 reprocessed broiler carcasses was determined. Carcasses were taken from the processing line prior to entering the chiller in five commercial processing plants. Each plant was sampled twice during the winter, spring, and summer. Analyses included aerobic bacteria, Enterobacteriaceae , and Escherichia coli counts plus qualitative Salmonella (SAL) prevalence. Differences between overall mean log10 counts for aerobic bacteria, Enterobacteriaceae , and E. coli were not significant. The prevalence of SAL detected on conventionally processed and reprocessed carcasses also was not significantly different. Some variation was observed in microbiological quality of carcasses among processing plants. Although the SAL prevalence appeared to decline from winter to summer replications, no significant trend could be demonstrated. Continuation of the practice of reprocessing carcasses appears justified.
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Affiliation(s)
- L C Blankenship
- Agricultural Research Service, U.S. Department of Agriculture, Retired, 165 Great Oak Drive, Athens, Georgia 30605
| | - J S Bailey
- Agricultural Research Service, U.S. Department of Agriculture, Russell Research Center, P.O. Box 5677, Athens, Georgia 30613
| | - N A Cox
- Agricultural Research Service, U.S. Department of Agriculture, Russell Research Center, P.O. Box 5677, Athens, Georgia 30613
| | - M T Musgrove
- Agricultural Research Service, U.S. Department of Agriculture, Russell Research Center, P.O. Box 5677, Athens, Georgia 30613
| | - M E Berrang
- Agricultural Research Service, U.S. Department of Agriculture, Russell Research Center, P.O. Box 5677, Athens, Georgia 30613
| | - R L Wilson
- Agricultural Research Service, U.S. Department of Agriculture, Russell Research Center, P.O. Box 5677, Athens, Georgia 30613
| | - M J Rose
- Food Safety and Inspection Service, U.S. Department of Agriculture, Sanitation Branch, 12th and Independence Avenue, Washington, DC 20250
| | - S K Dua
- Food Safety and Inspection Service, U.S. Department of Agriculture, Sanitation Branch, 12th and Independence Avenue, Washington, DC 20250
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Abstract
The Fear Avoidance Model of Exaggerated Pain Perception was developed in an attempt to explain how, and why, some individuals develop a more substantial psychological overlay to their low back pain problem than do others. The present paper describes a study in which three chronic pain groups, consisting of Post-Herpetic neuralgia patients, Reflex Sympathetic Dystrophy patients and chronic low back pain patients were compared with three pain-free comparison groups using the Fear Avoidance Model of Exaggerated Pain Perception. The results show statistically significant differences between the chronic groups and the recovered comparison groups. These results demonstrate the usefulness of the Fear Avoidance Model as an explanation of psychological overlay in chronic pain conditions regardless of pathology.
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Affiliation(s)
- M J Rose
- Department of Clinical Psychology, University of Liverpool, England
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Abstract
A substantial proportion of the problems in keyboard operator 'Over-use Syndromes' occur in the wrist and finger extensor muscle group. Biomechanical analysis shows these muscles to be subject to substantial sustained static (isometric) muscle contraction during the work task. This study measured the maximum relaxed finger press forces for 60 subjects in three arm support methods, in order to predict what the minimum keypress force should be to permit finger support sufficient to facilitate relaxation of finger extensor muscles. It was postulated that the minimum key activation force should accommodate the 95 percentile predicted population relaxed finger weights. The predicted force of 0.8 newton is within limits previously proposed for performance criteria, and which have been found practical commercially.
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Affiliation(s)
- M J Rose
- Melbourne & Metropolitan Board of Works, Australia
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Hajto J, Owen AE, Gage SM, Snell AJ, LeComber PG, Rose MJ. Quantized electron transport in amorphous-silicon memory structures. Phys Rev Lett 1991; 66:1918-1921. [PMID: 10043343 DOI: 10.1103/physrevlett.66.1918] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Martin PR, Rose MJ, Nichols PJ, Russell PL, Hughes IG. Physiotherapy exercises for low back pain: process and clinical outcome. Int Rehabil Med 1986; 8:34-8. [PMID: 2942511 DOI: 10.3109/03790798609166509] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This study was designed to assess whether physiotherapy exercises administered for low back pain have the physiological effects that they purport to have (increase spinal mobility and muscle strength) and whether these effects are of clinical relevance (related to changes in pain and function). Thirty-six patients were allocated to three treatment conditions, mobilizing exercises, isometric exercises or an attention-placebo control procedure. The results did not support the hypotheses concerning the effects of physiotherapy exercises, and hence challenge widely held views concerning the mechanism by which some patients suffering from low back pain improve whilst undergoing physiotherapy exercises.
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Bessette RW, Katzberg R, Natiella JR, Rose MJ. Diagnosis and reconstruction of the human temporomandibular joint after trauma or internal derangement. Plast Reconstr Surg 1985; 75:192-205. [PMID: 3969406 DOI: 10.1097/00006534-198502000-00009] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This study reviewed the standardized records of 1100 patients with the symptoms of temporomandibular joint syndrome. Of these patients, only 4.5 percent required surgical intervention. The remaining patients were found to have masticatory muscle spasm and were treated by conservative dental methods. Over half the surgical patients had significant macrotrauma to the jaws in their past history. In addition, electromyographic measurement of the masseteric silent period duration in these patients did not reveal muscle spasm. These factors further serve to differentiate the surgical patient from the patient with myofascial pain dysfunction. The patients selected for surgery demonstrated moderate to severe joint disease and required arthroplasty with partial meniscectomy. A surgical technique is presented demonstrating the reconstruction of the meniscus with silicone implant. This same surgical technique is studied in 10 monkeys, and their joints are examined histologically. The results of surgery reveal that 87 percent of the patients reported improvement 1 year after surgery. In all patients complaining of temporomandibular joint clicking or crepitus, surgery produced complete alleviation of these symptoms. The results of surgery were also associated with a 62 percent increase of jaw opening. Histologic evaluation of the human meniscal resections revealed that in addition to an anatomic displacement of the meniscus, there are also significant cellular changes. These changes consisted of calcification, a decrease in cellularity, hyperemia, and a decrease in elastin content.
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Abstract
A patient with observed acute collapse of a lumbar vertebral body developed cauda equina compression. He was known to have contracted syphilis some 20 years before and, while he may well have suffered from tabetic spinal neuroarthropathy, histology of the collapsed vertebra showed features which indicate that an intra-osseous gumma could also have been responsible for his vertebral collapse and subsequent neurological deficit.
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Abstract
Gelatinase added to gelatin enrichment broth suspensions decreased viscosity. Salmonellae were not harmed by enzyme. Salmonella isolation procedures can be simplified by eliminating the viscosity problem.
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Rose MJ, Enkiri K, Sulzbacher WL. Substituted diazenes: effect on the growth of enterobacteria and possible use as selective agents for isolation of pseudomonads. Appl Microbiol 1971; 22:1141-6. [PMID: 5002899 PMCID: PMC376500 DOI: 10.1128/am.22.6.1141-1146.1971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Incorporation of various diazenes into Trypticase soy media appeared selectively to permit the growth of pseudomonads while inhibiting the growth of a variety of enterobacteria. One of these diazenes, diamide (diazenedicarboxylic acid bisdimethylamide), was shown to be bactericidal for pure cultures of Escherichia coli, Proteus sp., and Salmonella enteritidis and to cause a 1- to 2-hr delay in the growth of Pseudomonas aeruginosa. When mixtures of these four organisms were inoculated into Trypticase soy broth or Trypticase soy agar (TSA) containing diamide, P. aeruginosa grew in overnight cultures. TSA containing diamide was also used successfully to isolate pseudomonads from soil, clinical urine specimens, fish, ground beef, ground pork, and ground veal.
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Abstract
Rose, Michael J., Jr. (Veterans Administration Hospital, Washington, D.C.), Stephen A. Aron, and Bernard W. Janicki. Effect of various nonionic surfactants on growth of Escherichia coli. J. Bacteriol. 91:1863-1868. 1966.-Escherichia coli cultivated in media containing 0.5, 1.0, 2.0, or 4.0% concentrations of surface-active polyoxyethylene derivatives of formaldehyde polymers of octyl phenol (Triton WR-1339; Macrocyclon) or of sorbitan mono-fatty acid esters (Tween 20, 40, 60, and 80) exhibited significantly retarded growth only at the highest concentration. To determine the mechanism of bacteriostasis, certain derivatives and compounds related to the surfactants were investigated. Experiments with compounds related to the Triton-type agents demonstrated that incorporation of monomeric substances (Triton X-205, X-305, Igepal CA-730, or Dowfax 9N20) into the medium at a concentration of 4.0% did not inhibit the growth of E. coli. It was concluded that the formaldehyde polymer was essential for growth inhibition by the polyoxyethylene derivatives of octyl phenol. The inhibitory activity of the Tween compounds, in contrast, appeared to result from the unesterified fatty acids which contaminate the commercial preparations. Polyol (60), the sorbitan polyoxyethylene derivative of Tween 60 and the basic structural unit of all the Tween-type compounds, and a Tween 80 preparation which was purified by extraction of the unesterified oleic acid, were not inhibitory. Moreover, the amount of free oleic acid present as a contaminant of Tween 80 was found to be sufficient to cause significant growth inhibition. These results and the observation that E. coli does not appear to hydrolyze the esterified fatty acid of Tween 80 led to the conclusion that growth inhibition obtained with various Tween compounds probaby is a function of their respective fatty acid contaminants.
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