A case-control study of domestic kitchen microbiology and sporadic Salmonella infection.

The microbiology of domestic kitchens in the homes of subjects who had suffered sporadic Salmonella infection (cases) was compared with control domestic kitchens. Case and control dishcloths and refrigerator swabs were examined for the presence of Salmonella spp., total Enterobacteriaceae counts and total aerobic colony counts.

The dental treatment needs and oral side effects of patients undergoing outpatient cancer chemotherapy.

An increasing number of patients receive cancer chemotherapy on an out-patient basis. Dentists therefore need to be aware of the consequences of cancer chemotherapy. Two hundred and eighteen patients attending a specialist oncology centre were examined and the oral side effects recorded.

TGFbeta-1 and the development of chronic graft nephropathy: relative roles of gene, mRNA and protein.

The exact relationship between transforming growth factor beta-1 (TGFbeta-1) and the development of chronic graft nephropathy remains uncertain; however, it would appear that TGFbeta-1 is up-regulated at the protein and mRNA levels during the first year following cadaveric renal transplantation and the effect of 'high producer' gene polymorphisms may also be important. This up-regulation of TGFbeta-1 in plasma may provide a novel. non-invasive means of identifying early fibrotic damage before it becomes clinically apparent thus allowing an opportunity for intervention for grafts that may otherwise fail.

Correlation of abnormal second trimester maternal serum alpha-fetoprotein (MSAFP) levels and adverse pregnancy outcome.

This study investigated the relationship between abnormal second trimester MSAFP levels and adverse pregnancy outcome. The findings revealed an association between low birth weight, prematurity and antepartum haemorrhage with abnormal unexplained high levels of second trimester MSAFP levels. However, macrosomia and increased gestational age at delivery were reported in relation to unexplained low levels of MSAFP in the second trimester.

The uterine compression suture--a valuable approach to control major haemorrhage at lower segment caesarean section.

The aim of this article is to review the efficacy of a modified uterine compression suture in controlling major haemorrhage at lower segment caesarean section. This is a descriptive study of patients who had major obstetric haemorrhage where a compression suture was used to control bleeding at the two obstetrics unit in Cardiff between January 1998 and December 2003 (n = 11).

An evaluation of the efficacy of methods used in screening for lower-limb arterial disease in diabetes.

Objective: Foot-related disease is the most common cause for hospital admission among the diabetic population. Lower-limb peripheral arterial occlusive disease (PAOD) is a major risk factor in diabetic foot disease. Screening for PAOD commonly includes foot pulses and the ankle-brachial pressure index (ABPI) and/or the toe-brachial pressure index (TBI), but concerns persist regarding their accuracy.

The effects of interleukin-7 on the lymphangiogenic properties of human endothelial cells.

Lymphangiogenesis (growth of new lymphatic vessels) is thought to play an important role in cancer lymphatic spread to the regional lymph nodes. However, the molecular pathways involved in lymphangiogenesis and their regulation are still unclear. Recently, there has been a significant advance in the studies of the lymphatic system and lymphangiogenesis as several novel specific lymphatic markers are discovered.

The teaching of clinical skills in the context of children's nursing: a UK survey.

The teaching of clinical skills within nursing is currently enjoying a resurgence following the implementation of the 'Fitness for Practice Curriculum'. However, the teaching of clinical skills specifically within children's nursing has received little attention within the research arena. This article presents the data of a national postal survey sent to United Kingdom institutions providing pre-registration child branch studies, to ascertain the current provision of clinical skills teaching.

Rapid and sensitive detection of internal tandem duplication and activating loop mutations of FLT3.

Mutations of the FLT3 gene, a receptor tyrosine kinase, are the most frequent genetic alteration reported in acute myeloid leukaemia, with internal tandem duplications (ITD) or mutations within the activating loop (AL) reported at a frequency of around 24% and 6%, respectively. ITD mutations have associated with a poor prognosis. In this study we have used polymerase chain reaction (PCR), combined with restriction enzyme digestion for the detection of AL mutations, with the DNA products separated on the Agilent 2100 Bioanalyser using a DNA-500 kit.

Low utilization and wide interhospital variation in investigation of patients after acute myocardial infarction: inadequate resources or insufficient evidence?

Background: Guidelines for the management of patients with acute myocardial infarction are available, but implementation may be difficult when resources are limited.

Objective: The aim of this study was to investigate whether resources, manpower or access to specialist facilities affect care following myocardial infarction.

Patients And Methods: A representative sample of 1595 patients in all 19 district general hospitals in Wales was analysed for differences in use of investigations and prescription of secondary prevention and how these factors were related to provision of cardiologists and coronary care beds and distance from specialist cardiac services.

Factors influencing the effectiveness of clinical supervision.

Clinical supervision is widely accepted as an essential prerequisite for high quality nursing care. This paper reports findings from a study that aims to identify the factors that may influence the effectiveness of clinical supervision for community mental health nurses (CMHNs) in Wales, UK. Two hundred and sixty (32%) CMHNs from an estimated total population of 817 completed the Manchester Clinical Supervision Scale (MCCS) and a demographic questionnaire.

How mammillary fistulas should be managed.

Mammillary fistulas are uncommon, but when they occur they cause prolonged morbidity. The etiology and management strategies are less well established. The purpose of this study is to evaluate the etiologic factors and assess the results of surgical treatment.

Service utilization in 1896 and 1996: morbidity and mortality data from North Wales.

The 1896 and 1996 populations of North-West Wales are similar in number, ethnic and social mix and rurality, enabling a study of the comparative prevalence of service utilization, as well as the morbidity and mortality associated with mental illness in 1894-96 and 1996. The 1996 data reveal a 15 times greater prevalence of admissions for all diagnoses, and three times greater prevalence of admissions by detention, compared with 1896. Patients now spend more time in a service bed than they did 100 years ago.

In vivo aspirin supplementation inhibits nitric oxide consumption by human platelets.

Antiplatelet therapies improve endothelial function in atherosclerosis, suggesting that platelets regulate vascular nitric oxide (NO) bioactivity in vivo. Herein, washed platelets consumed NO on activation in an aspirin-sensitive manner, and aspirin enhanced platelet NO responses in vitro. To examine whether in vivo aspirin can inhibit platelet NO consumption, a double-blind placebo-controlled study was conducted.

Operation of the schizophrenia susceptibility gene, neuregulin 1, across traditional diagnostic boundaries to increase risk for bipolar disorder.

Context: Family and twin data suggest that, in addition to susceptibility genes specific for bipolar disorder or schizophrenia, genes exist that contribute to susceptibility across the traditional kraepelinian divide. Several studies have provided evidence that variation at the neuregulin 1 (NRG1) gene on chromosome 8p12 influences susceptibility to schizophrenia. The most consistent finding has been that one particular haplotype (the "core" haplotype) is overrepresented in cases compared with control subjects.

A pilot study of spatial patterns in referrals to a multicentre cancer genetics service.

Objectives: To analyse spatial and temporal patterns in patients referred to a cancer genetics service in order to monitor service utilization and accessibility.

Methods: Postcodes of patients during a 4-year period were used to examine spatial patterns using a Geographical Information System (GIS). Referral rates were compared visually and statistically to explore yearly variation for administrative areas in Wales.

"Pure" diastolic dysfunction is associated with long-axis systolic dysfunction. Implications for the diagnosis and classification of heart failure.

Aims: To investigate regional systolic function of the left ventricle, to test the hypothesis that "pure" diastolic dysfunction (impaired global diastolic filling, with a preserved ejection fraction > or = 50%) is associated with longitudinal systolic dysfunction.

Methods And Results: One hundred thirty subjects (31 patients with asymptomatic diastolic dysfunction, 30 with diastolic heart failure, 30 with systolic heart failure; and 39 age-matched normal volunteers) were studied by conventional and tissue Doppler echocardiography. Global diastolic function was assessed using the flow propagation velocity, and by estimating left ventricular filling pressure from the ratio of transmitral E and mitral annular E(TDE) velocities (E/E(TDE)); and global systolic function by measurement of ejection fraction.

Reduced myocardial velocities of left ventricular long-axis contraction identify both systolic and diastolic heart failure-a comparison with brain natriuretic peptide.

Background: Echocardiographic diagnosis of radial fractional shortening or global ejection fraction fails to diagnose all patients with heart failure; about 40%, with apparently normal global systolic function, will have elevated brain natriuretic peptide (BNP) concentrations and "pure" diastolic dysfunction. Screening methods do not include assessment of left ventricular (LV) longitudinal function, however, which is a more sensitive marker of subclinical disease.

Aims: We investigated the diagnostic potential of assessment of LV longitudinal function in suspected heart failure, in a comparison against BNP.

Cost effectiveness analysis of using quantitative ultrasound as a selective pre-screen for bone densitometry.

It has been suggested that quantitative ultrasound (QUS) could be used as a selective population pre-screen, to maximise the cost effectiveness of referral for dual energy X-ray absorptiometry (DXA) assessment of bone mineral density (BMD). We set out to examine how such an approach might perform in the assessment of women who were referred by general practitioners for DXA via the open access service in Cardiff. In 115 women aged 40-80 (mean 69) years we used DXA to measure BMD at lumbar spine and hip, and QUS to measure broadband ultrasound attenuation (BUA) in the heel.

Sevoflurane (12% and 8%) inhalational induction in children.

Background: Sevoflurane induction of anesthesia is frequently used in children. Rapidly performed inhalational induction may reduce excitation during early anesthesia. Increasing the total anesthetic MAC delivered to patients can be achieved by increasing volatile concentration or adding nitrous oxide.

A preliminary study of experimental polyacid-modified composite resins ('compomers') containing vinyl phosphonic acid.

Objectives: The aim of this investigation was to determine the properties of two novel compomers formulated with the monomer vinyl phosphonic acid (VPA). The setting properties, mechanical strength, wear characteristics and fluoride release of two experimental unshaded compomers containing VPA were determined, and compared with the commercial compomer Dyract A (shade C3).

Methods: Two novel compomers were prepared, containing, respectively, 0.