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Lunsky Y, Albaum C, Baskin A, Hastings RP, Hutton S, Steel L, Wang W, Weiss J. Group Virtual Mindfulness-Based Intervention for Parents of Autistic Adolescents and Adults. J Autism Dev Disord 2021; 51:3959-3969. [PMID: 33420938 PMCID: PMC7796683 DOI: 10.1007/s10803-020-04835-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2020] [Indexed: 12/05/2022]
Abstract
Mindfulness-based approaches have been shown to be effective in improving the mental health of parents of youth and adults with autism and other developmental disabilities, but prior work suggests that geography and caregiving demands can make in-person attendance challenging. The purpose of this study was to evaluate the feasibility, acceptability and preliminary outcomes of a mindfulness-based group intervention delivered to parents virtually. It was feasible to deliver this manualized intervention. Twenty-one of 39 parents completed the intervention and completers reported high satisfaction ratings. Parents reported reduced levels of distress, maintained at 3-month follow-up, and increased mindfulness. Changes reported following intervention were similar to changes reported in a prior study of parents competing an in person mindfulness group.
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Affiliation(s)
- Y Lunsky
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Medical Sciences Building, 1 King's College Cir, Toronto, ON, Canada.
| | - C Albaum
- Department of Psychology, York University, Department of Psychology Room 291. Behavioural Sciences Building 4700 Keele Street, Toronto, ON, Canada
| | - A Baskin
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, ON, Canada
| | - R P Hastings
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, CV4 7AL, UK
- Department of Psychiatry, Centre for Developmental Psychiatry and Psychology, Monash University, Clayton, VIC, 3168, Australia
| | - S Hutton
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, ON, Canada
| | - L Steel
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, ON, Canada
| | - W Wang
- Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON, Canada
| | - J Weiss
- Department of Psychology, York University, Department of Psychology Room 291. Behavioural Sciences Building 4700 Keele Street, Toronto, ON, Canada
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Aktuerk D, Ali J, Badran A, Balmforth D, Bleetman D, Brown C, Suelo-Calanao R, Cartwright J, Casey L, Chiwera L, Fudulu D, Garner M, Gradinariu G, Harky A, Hussain A, Hutton S, Kew E, Loubani M, Mani K, Martin J, Rochon M, Moawad N, Mohamed S, Muretti M, Murphy G, Olivieri G, Paglinawan I, Quijano-Campos J, Rizzo V, Robertson S, Rogers L, Roman M, Salmon K, Sanders J, Talukder S, Tanner J, Vaja R, Zientara A, Green S, Miles R, Lamagni T, Harrington P. National survey of variations in practice in the prevention of surgical site infections in adult cardiac surgery, United Kingdom and Republic of Ireland. J Hosp Infect 2020; 106:812-819. [DOI: 10.1016/j.jhin.2020.09.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 09/11/2020] [Indexed: 11/25/2022]
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Beverstock J, Park T, Song CCA, Alston R, Claxton A, Sharkey T, Hutton S, Fathers J, Cawley W. A comparison of volatile anaesthesia and total intravenous anaesthesia (tiva) on outcome from cardiac surgery: a systematic review and meta-analysis. J Cardiothorac Vasc Anesth 2020. [DOI: 10.1053/j.jvca.2020.09.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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D’Alessio A, Hutton S, Krasopoulos G. RF62 PREVENTION OF STERNAL WOUND INFECTION WITH PREVENA DRESSING. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000550084.89696.f8] [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: 11/05/2022]
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Graham R, Owens M, Priest H, Hutton S. Constructions of Decision Making for Risk-Reducing Mastectomy. Qual Health Res 2018; 28:1595-1609. [PMID: 30016926 DOI: 10.1177/1049732318785372] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This research article explores constructions of the decision-making process for risk-reducing mastectomy and considers the consequent role and responsibility of clinical psychologists. Using a Foucauldian discourse analysis approach, three online newspaper articles, five online forums, and four semi-structured interviews were analyzed. Seven discursive constructions are identified and discussed within three broader discourses of mental illness, risk, and embodied selves. Primary conclusions highlight the role for clinical psychologists and health professionals to incorporate the multiple social and political factors involved in discourses that shape decision making. The role of power is critically considered and there is a need for further analysis of "talk" among health professionals.
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Affiliation(s)
- Ruth Graham
- 1 Staffordshire and Keele Universities, Staffordshire, United Kingdom
| | - Marilyn Owens
- 2 Midlands Partnership NHS Foundation Trust, Stafford, United Kingdom
| | - Helena Priest
- 1 Staffordshire and Keele Universities, Staffordshire, United Kingdom
| | - Stephanie Hutton
- 3 North Staffordshire Combined Healthcare NHS Trust, Staffordshire, United Kingdom
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Hutton S, Bettridge J, Christley R, Habte T, Ganapathy K. Detection of infectious bronchitis virus 793B, avian metapneumovirus, Mycoplasma gallisepticum and Mycoplasma synoviae in poultry in Ethiopia. Trop Anim Health Prod 2017; 49:317-322. [PMID: 27924415 PMCID: PMC5253144 DOI: 10.1007/s11250-016-1195-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 11/24/2016] [Indexed: 12/16/2022]
Abstract
A survey was conducted into respiratory infectious diseases of poultry on a chicken breeder farm run by the Ethiopian Institute of Agricultural Research (EIAR), located in Debre Zeit, Ethiopia. Oropharyngeal swabs were collected from 117 randomly selected birds, and blood was taken from a subset of 73 of these birds. A combination of serological and molecular methods was used for detection of pathogens. For the first time in Ethiopia, we report the detection of variant infectious bronchitis virus (793B genotype), avian metapneumovirus subtype B and Mycoplasma synoviae in poultry. Mycoplasma gallisepticum was also found to be present; however, infectious laryngotracheitis virus was not detected by PCR. Newcastle disease virus (NDV) was not detected by PCR, but variable levels of anti-NDV HI antibody titres shows possible exposure to virulent strains or poor vaccine take, or both. For the burgeoning-intensive industry in Ethiopia, this study highlights several circulating infectious respiratory pathogens that can impact on poultry welfare and productivity.
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Affiliation(s)
- S Hutton
- Institute of Infection and Global Health, School of Veterinary Science, University of Liverpool, Leahurst Campus, Neston, Cheshire, CH64 7TE, UK
| | - J Bettridge
- Institute of Infection and Global Health, School of Veterinary Science, University of Liverpool, Leahurst Campus, Neston, Cheshire, CH64 7TE, UK
| | - R Christley
- Institute of Infection and Global Health, School of Veterinary Science, University of Liverpool, Leahurst Campus, Neston, Cheshire, CH64 7TE, UK
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Liverpool, UK
| | - T Habte
- Ethiopian Institute of Agricultural Research, Debre Zeit, Ethiopia
| | - K Ganapathy
- Institute of Infection and Global Health, School of Veterinary Science, University of Liverpool, Leahurst Campus, Neston, Cheshire, CH64 7TE, UK.
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Affiliation(s)
| | | | | | | | - Alan Lough
- Department of Chemistry, University of Toronto
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Hutton S. Philip William Hutton. West J Med 2010. [DOI: 10.1136/bmj.c5085] [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: 11/03/2022]
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Dring GJ, Singlehurst P, Hutton S. Can adolescents' perceptions of their weight be used in screening for eating disorders? A pilot study of a short screening questionnaire. Eur Eat Disorders Rev 2004. [DOI: 10.1002/erv.598] [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: 11/09/2022]
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West RH, Odlyha M, Pratt K, Roberts A, Hutton S. Monitoring the environmental degradation of paint dosimeters used to assess risk for fine art paintings on display by XPS. SURF INTERFACE ANAL 2004. [DOI: 10.1002/sia.1787] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Ünveren E, Kemnitz E, Hutton S, Lippitz A, Unger WES. Analysis of highly resolved x-ray photoelectron Cr 2p spectra obtained with a Cr2
O3
powder sample prepared with adhesive tape. SURF INTERFACE ANAL 2004. [DOI: 10.1002/sia.1655] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Moe CL, Turf E, Oldach D, Bell P, Hutton S, Savitz D, Koltai D, Turf M, Ingsrisawang L, Hart R, Ball JD, Stutts M, McCarter R, Wilson L, Haselow D, Grattan L, Morris JG, Weber DJ. Cohort studies of health effects among people exposed to estuarine waters: North Carolina, Virginia, and Maryland. Environ Health Perspect 2001; 109 Suppl 5:781-786. [PMID: 11677189 PMCID: PMC1240611 DOI: 10.1289/ehp.01109s5781] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
A variety of human symptoms have been associated with exposure to the dinoflagellate Pfiesteria and have been grouped together into a syndrome termed "possible estuary-associated syndrome." Prospective cohort studies of health effects associated with exposure to estuarine waters that may contain Pfiesteria spp. and related organisms are in progress in North Carolina, Virginia, and Maryland. The three studies recruited cohorts of 118-238 subjects who work or engaged in recreation in estuary waters. Baseline health and neuropsychological evaluations are conducted, and study subjects are followed prospectively for 2-5 years with periodic assessments of health and performance on a battery of neuropsychological tests. Health symptoms and estuary water exposure are recorded by telephone interviews or diaries every 1-2 weeks. Water quality information, including measurements of Pfiesteria spp., is collected in the areas where the subjects are working. Because it is not possible to measure individual exposure to Pfiesteria or a toxin produced by this organism, these studies examine surrogate exposure measures (e.g., time spent in estuary waters, in a fish kill area, or in waters where Pfiesteria DNA was detected by molecular amplification). Preliminary analyses of the first 2 years (1998-2000) of data indicate that none of the three ongoing cohorts have detected adverse health effects. However, there have not been any reported fish kills associated with Pfiesteria since the studies began, so it is possible that none of the study subjects have been exposed to toxin-producing Pfiesteria spp.
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Affiliation(s)
- C L Moe
- Department of Epidemiology, University of North Carolina at Chapel Hill, USA.
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Bayliss MT, Hutton S, Hayward J, Maciewicz RA. Distribution of aggrecanase (ADAMts 4/5) cleavage products in normal and osteoarthritic human articular cartilage: the influence of age, topography and zone of tissue. Osteoarthritis Cartilage 2001; 9:553-60. [PMID: 11520169 DOI: 10.1053/joca.2001.0425] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [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: 02/02/2023]
Abstract
OBJECTIVE To develop and characterize a polyclonal antiserum (RAM 3.2), which recognizes the neo-C terminal cleavage product generated by the action of aggrecanase (ADAMts 4/5) on the G1-domain of human aggrecan. We also intend to use this antiserum to investigate normal, age-related changes in human articular cartilage. METHOD The antiserum was raised in rabbits and its localization in cryosections of normal articular cartilage was investigated by immunohistochemistry. The concentration of the aggrecanase neo-epitope was also investigated in extracts of the tissue using SDS-PAGE and electrophoresis in large pore/agarose gels. RESULTS The product of aggrecanase action appears to accumulate in the extracellular matrix during normal aging of the tissue. Furthermore, the concentration of the fragment depended on the topographical site on the femoral condyle from which the sample was selected. Electrophoretic and immunohistochemical analysis of the fragment in normal cartilage showed that in immature cartilage it was deposited mainly in the surface layers, whereas in mature samples it was distributed throughout the depth of the tissue. In contrast, immunoreactivity of osteoarthritic cartilage was always less and the distribution was more variable than in normal cartilage of the same age. CONCLUSIONS (1) The proteolytic cleavage of aggrecan by aggrecanase is a normal homeostatic event and much of the neo-C terminal fragment produced by the enzyme is retained in the tissue. (2) The presence of this immunoreactive product in normal cartilage can be used as an indication of aggrecan turnover. (3) That in osteoarthritic cartilage there is a reduction in the concentration of the G1-fragments.
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Affiliation(s)
- M T Bayliss
- The Royal Veterinary College, Royal College St., London, NW1 0TU, UK.
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Torzillo P, Dixon J, Manning K, Hutton S, Gratten M, Hueston L, Leinonen M, Morey F, Forsythe S, Num R, Erlich J, Asche V, Cunningham A, Riley I. Etiology of acute lower respiratory tract infection in Central Australian Aboriginal children. Pediatr Infect Dis J 1999; 18:714-21. [PMID: 10462342 DOI: 10.1097/00006454-199908000-00012] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.6] [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: 10/27/2022]
Abstract
BACKGROUND Aboriginal children in central Australia have attack rates for acute lower respiratory tract infection (ALRI) that are similar to those in developing countries. Although mortality rates are much lower than in developing countries, morbidity is high and ALRI is still the leading cause of hospitalization. However, there are no data on the etiology of ALRI in this population. METHODS We prospectively studied 322 cases of ALRI in 280 Aboriginal children admitted to the hospital. Blood, urine and nasopharyngeal aspirate samples were examined for evidence of bacterial, viral and chlamydial infection. RESULTS The combination of blood culture, viral studies and chlamydial serology provided at least 1 etiologic agent in 170 of 322 (52.5%) cases. Assays for pneumolysin immune complex and pneumolysin antibody increased etiologic diagnosis to 219 (68.0%). Blood cultures were positive in 6% but pneumolysin immune complex and pneumolysin antibody studies were positive in one-third of cases. Evidence of viral infection was present in 155 (48%) of cases compared with 12% in controls (P < 001). There were only 7 possible cases and 2 definite cases of Chlamydia trachomatis and 3 cases of Chlamydia pneumoniae. Coinfection was common in these children. CONCLUSION These findings have implications for both standard treatment protocols and vaccine strategies. The high rate of coinfection may make it difficult to develop simple clinical predictors of bacterial infection. In the setting of a developed country with efficient patient evacuation services, management algorithms that focus on disease severity and need for hospital referral will be most useful to health staff in remote communities. Pneumococcal conjugate vaccines will be required to reduce the high attack rate of pneumococcal disease.
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Affiliation(s)
- P Torzillo
- Queensland Institute of Medical Research, Brisbane, Australia
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Abstract
Oculomotor abnormalities, particularly in smooth pursuit tracking, are one of the most widely investigated biological markers of schizophrenia. However, despite the wealth of published data, important questions concerning the exact nature of these abnormalities remain unanswered. Many of the studies use unreliable methodology, and few attempts have been made to interpret the observed oculomotor dysfunction in terms of current understanding of eye movement physiology. Also, the potential effects of antipsychotic medication have been poorly addressed. Recent research, using more reliable measurement techniques and novel saccadic paradigms are producing important results and may provide a more productive framework for future studies of oculomotor abnormalities in schizophrenia.
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Affiliation(s)
- S Hutton
- Division of Neuroscience and Psychological Medicine, Imperial College School of Medicine, Charing Cross Hospital, London, United Kingdom
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Dickinson J, Hutton S, Atkin A. Implementing the British Thoracic Society's guidelines: the effect of a nurse-run asthma clinic on prescribed treatment in an English general practice. Respir Med 1998; 92:264-7. [PMID: 9616523 DOI: 10.1016/s0954-6111(98)90106-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The advent of computer-based prescribing in general practice has made it possible to study a patient's drug use in detail. This study compared the use of inhaled therapy in 100 patients with chronic disease by examining every prescription issued during the year before and the year after initial consultation at a nurse-run asthma clinic. The majority were poorly controlled in that 79% scored high on the Jones Morbidity Index at their first visit. The number of patients on inhaled corticosteroid and salmeterol xinafoate rose from 87 to 100% and 6 to 28%, respectively, while those instructed to take their beta-agonist 'when required' as opposed to a regular dose rose from 26 to 82%. The daily median intake of short-acting beta-agonist fell from 5.0 to 3.8 doses (P < 0.0001). In the 87 patients on inhaled corticosteroid throughout, the mean daily dose increased from 532.1 to 793.1 micrograms (P < 0.0001), and compliance (defined as the total dose issued in 1 year expressed as a percentage of that recommended) increased from 61.5 to 69.3% (P = < 0.05). Attendance at a nurse-run asthma clinic was associated with a number of significant alterations in inhaled therapy. These changes conformed to the British Thoracic Society's guidelines.
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Abstract
Although most primary health care teams in the U.K. now offer proactive care for patients with asthma, there is relatively little published evidence showing the effectiveness of such innovations. This may be due in part to lack of targeting of extra care towards those most in need. Therefore, to demonstrate the benefits of targeted nurse-run asthma clinic care in a seven-partner general practice in a mixed urban and rural area of North Lincolnshire in the east of England, a cohort of 173 patients, with asthma selected predominantly by having high morbidity in a postal survey, completed 12 months follow-up in a nurse-run asthma clinic. A longitudinal comparison was conducted in terms of: changes in morbidity index category, inhaler technique score, knowledge score, use of inhaled steroids, use of salmeterol, method of administration of beta(2)-agonist medication and frequent use of peak flow meters. The number with high morbidity fell from 123 (71.1%) at the initial consultation to 14 (8.1%) at the 12-month review. Those with full marks on inhaler technique rose from 28 (16.2%) to 142 (82.1%), and with full marks on asthma knowledge rose from 7 (4.0%) to 98 (56.6%). The numbers of patients using inhaled steroids and salmeterol rose from 127 (73.4%) to 171 (98.9%) and from 5 (2.9%) to 35 (20.2%), respectively. The preferred inhaler device for beta(2)-bronchodilator medication changed from metered dose aerosol to dry powder. Regular use of peak flow meters in 157 subjects aged 5 years and over rose from 43 (27.4%) to 116 (73.9%). These data clearly demonstrate the benefits of targeted proactive nurse-run asthma care in terms of reduced morbidity for patients. The authors recommend the morbidity index targeting concept to other primary health care teams.
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Affiliation(s)
- J Dickinson
- School of Health Sciences, University of Newcastle upon Tyne, U.K
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Carter J, Hutton S, Sriprakash KS, Kemp DJ, Lum G, Savage J, Bowden FJ. Culture of the causative organism of donovanosis (Calymmatobacterium granulomatis) in HEp-2 cells. J Clin Microbiol 1997; 35:2915-7. [PMID: 9350758 PMCID: PMC230086 DOI: 10.1128/jcm.35.11.2915-2917.1997] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.5] [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: 02/05/2023] Open
Abstract
We report successful culture of Calymmatobacterium granulomatis by standard cell culture methods. Swabs were obtained from lesions in three patients with a clinical diagnosis of donovanosis. For two patients, there was histological confirmation of the disease (i.e., the presence of Donovan bodies in Giemsa-stained smears). Specimens were inoculated onto cycloheximide-treated HEp-2 cell monolayers in RPMI 1640 medium (supplemented with fetal calf serum, NaHCO3, vancomycin hydrochloride, and benzylpenicillin). At 48 h, organisms resembling Donovan bodies were identified in monolayer cultures from all three specimens. The organisms appeared as pleomorphic bacilli with characteristic bipolar staining and "safety pin" appearance. Using a PCR designed to differentiate C. granulomatis from the Klebsiella species (which have a high degree of molecular homology), we were able to demonstrate that the cultured organisms produced a PCR product identical to that obtained from the original swab specimens. It is now possible to test in vitro susceptibility of C. granulomatis to antibiotics and to provide a ready source of DNA and antigenic material to enable the development of serological tests and, possibly in the future, a vaccine.
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Affiliation(s)
- J Carter
- Menzies School of Health Research, Darwin, Northern Territory, Australia
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Hutton S, Semple E, Leibo S, Betteridge K. Production of frozen Bos indicus × Bos taurus embryos from oocytes recovered from slaughtered Bos taurus cows. Theriogenology 1997. [DOI: 10.1016/s0093-691x(97)82416-8] [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: 11/24/2022]
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Neill AM, Martin IR, Weir R, Anderson R, Chereshsky A, Epton MJ, Jackson R, Schousboe M, Frampton C, Hutton S, Chambers ST, Town GI. Community acquired pneumonia: aetiology and usefulness of severity criteria on admission. Thorax 1996; 51:1010-6. [PMID: 8977602 PMCID: PMC472650 DOI: 10.1136/thx.51.10.1010] [Citation(s) in RCA: 267] [Impact Index Per Article: 9.5] [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: 02/03/2023]
Abstract
BACKGROUND Community acquired pneumonia remains an important cause of hospital admission and carries an appreciable mortality. Criteria for the assessment of severity during admission have been developed by the British Thoracic Society (BTS). A study was performed to determine the sensitivity and specificity of a severity rule based on a modification of the BTS prognostic rules applied on admission, to compare severity as assessed by medical staff with the modified rule, and to determine the microbiological cause of community acquired pneumonia in Christchurch. METHODS A 12 month study of all adults admitted to Christchurch Hospital with community acquired pneumonia was undertaken. Three hundred and sixteen consecutive patients with suspected community acquired pneumonia were screened for inclusion. Variables obtained from the history, examination, investigations, and initial treatment were examined for association with mortality. RESULTS Two hundred and fifty five patients met the inclusion criteria. Their mean age was 58 years (range 18-97). A microbiological diagnosis was made in 181 cases (71%), Streptococcus pneumonia (39%), Mycoplasma pneumoniae (16%), Legionella species (11%), and Haemophilus influenzae (11%) being the most commonly identified organisms. Patients had a 36-fold increased risk of death if any two of the following were present on admission: respiratory rate > or = 30/min, diastolic BP < or = 60 mm Hg, urea > 7 mmol/l, or confusion. The severity rule identified 19 of the 20 patients who died and six of eight patients admitted to the intensive care unit as having life threatening community acquired pneumonia. The sensitivity of the modified rule for predicting death was 0.95 and the specificity 0.71. In 47 cases (21%) the clinical team appeared to underestimate the severity of the illness. CONCLUSIONS The organisms responsible for community acquired pneumonia in Christchurch are similar to those reported from other centres except for Legionella species which were more common than in most studies. The modification of the BTS prognostic rules applied as a severity indicator at admission performed well and could be incorporated into management guidelines.
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Affiliation(s)
- A M Neill
- Canterbury Respiratory Research Group, Christchurch School of Medicine, New Zealand
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Hutton S, Sheppard L, Rusted JM, Ratner HH. Structuring the acquisition and retrieval environment to facilitate learning in individuals with dementia of the Alzheimer type. Memory 1996; 4:113-30. [PMID: 8697032 DOI: 10.1080/096582196388997] [Citation(s) in RCA: 21] [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: 02/01/2023]
Abstract
Three experiments using variations of the Subject Performed Task (SPT) paradigm examined whether structuring the learning and retrieval environment would improve learning in individuals with mild to moderate dementia of the Alzheimer type (DAT). Experiment 1 examined the role of enactment at encoding and retrieval, and found that with appropriate retrieval support DAT volunteers do benefit from enactment at encoding. Experiment 2 showed that recall was further enhanced when the list of SPTs formed a cohesive, goal-directed sequence of actions. In Experiment 3, DAT subjects acquired a more complex action-based sequence and maintained it accurately over a short period of time. It is concluded that the provision of contextual support at encoding and at retrieval can enhance residual memory in individuals with DAT.
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Abstract
Thirty-two transplant recipients with cytomegalovirus (CMV) infection documented by positive culture of blood and/or organs other than the liver were evaluated for hepatic involvement. Thirteen of the 32 (41%) had evidence of hepatic involvement with CMV. Inclusions alone were present in three patients; liver cultures alone were positive for CMV in three; and both were present in seven. Although the presence of CMV inclusions was the only histological feature that clearly separated the groups with and without hepatic involvement, two items helpful in finding inclusions were lobular aggregates of polymorphonuclear cells and portal karyorrhexic debris. The presence of liver involvement had a significant correlation with multiple organ infection, indicating it is a good marker of widely disseminated disease. This study indicates that liver histology and culture are useful and complementary methods for documentation of hepatic involvement (hence, tissue invasion) in immunocompromised patients with CMV infection.
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Affiliation(s)
- D C Snover
- Liver Center, University of Minnesota Medical School, Minneapolis 55455
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Abstract
Twenty-four cases of a lesion characterized by unlined spaces in the colorectal lamina propria are presented. While lesions such as this have been reported previously as "lipomatosis" of the colon, histochemical and ultrastructural examination reveals that they are not, in fact, composed of adipocytes. It appears that they may be composed of gas trapped in the lamina propria. Because of their gross and microscopical similarity to fat, however, the term "pseudolipomatosis" is proposed.
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Snover DC, Weisdorf SA, Vercellotti GM, Rank B, Hutton S, McGlave P. A histopathologic study of gastric and small intestinal graft-versus-host disease following allogeneic bone marrow transplantation. Hum Pathol 1985; 16:387-92. [PMID: 3884482 DOI: 10.1016/s0046-8177(85)80232-x] [Citation(s) in RCA: 131] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Twenty-two stomach and 14 small intestinal biopsy specimens from 24 allogeneic bone marrow transplant recipients were reviewed to evaluate the histopathologic changes of graft-versus-host disease (GVHD) in these organs. Associations between these results and clinical symptoms and other biopsy results were sought. In both organs, single epithelial cell necrosis was found to correlate with GVHD. Gastric GVHD was diagnosed in eight patients and small intestinal GVHD in four. Gastric GVHD was characterized by nausea, vomiting, and upper abdominal pain without diarrhea (the latter being present in only two patients), while all four of the patients with small intestinal GVHD had upper gastrointestinal symptoms and diarrhea. These symptoms correlated with concurrent rectal biopsy findings; pathologic alterations were seen in only one of six specimens from patients with gastric GVHD but in three of four with small intestinal GVHD. These findings suggest that stomach biopsy may be necessary to diagnose GVHD in patients with upper gastrointestinal symptoms but no diarrhea and normal rectal biopsy specimens. Diagnostic problems may arise in the early posttransplantation period, when the effects of cytoreductive therapy may simulate GVHD, and in patients with gastrointestinal cytomegalovirus infection, which may also produce changes identical to those of GVHD.
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Frick MP, O'Leary JF, Salomonowitz E, Stoltenberg P, Hutton S, Gedgaudas E. Pancreas imaging by computed tomography after endoscopic retrograde pancreatography. Radiology 1984; 150:191-4. [PMID: 6689759 DOI: 10.1148/radiology.150.1.6689759] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A method using CT after endoscopic retrograde pancreatography (CT-ERP) is described for pancreatic imaging. When using an ERP technique in the canine model comparable to that used in humans, small amounts of contrast material in peripheral pancreatic radicles resulted in enhancement of the pancreas on CT scans. Nine patients were also studied by CT-ERP. In normal patients (n = 5) there was opacification of the entire pancreas on CT-ERP images. The main pancreatic duct was seen on delayed images. In cases of chronic pancreatitis (n = 2), pancreatic opacification was patchy and heterogeneous. There was no contrast-material enhancement in areas of pancreatic carcinomas (n = 2). CT-ERP showed the true extent of carcinoma better than ERP alone.
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