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Biomedical subjects

A Chapman

Publications and source records attributed to A Chapman.

At least 73 records · Page 4Linked to original sources

Urinary trypsin inhibitory activity for the diagnosis of bacterial infection: a prospective study in 690 patients.

OBJECTIVES: During the acute phase response, interleukin-1 induces production of inter-alpha-trypsin inhibitor. The measurement of urinary trypsin inhibitory activity which results from the effects of inter-alpha-trypsin inhibitor degradation products is easy, quick and inexpensive. We conducted a prospective study to investigate its value as a diagnostic tool in comparison with C-reactive protein. METHODS: Comparisons were made in 690 consecutive patients at admission to a department of internal medicine. RESULTS: The level of urinary trypsin inhibitory activity was significantly higher in patients with bacterial infection (mean = 123 IU/g creatinine) than in patients with either viral infection (34 IU), cancer (50 IU), elevated erythrocyte sedimentation rate without infection (45 IU), miscellaneous non-inflammatory diseases (27 IU) or in non-organic controls (19 IU) (Dunnet's test, p << 0.01). The receiver operating characteristic curve showed that sensitivity and specificity of urinary trypsin inhibitory activity were higher than those of C-Reactive protein for the diagnosis of bacterial infection. For levels > or = 60 IU, sensitivity was 75% and specificity 89%. Urinary trypsin inhibitory activity levels fell within 2 days in patients treated for acute bacterial infection. CONCLUSION: Urinary trypsin inhibitory activity could be a useful marker of bacterial infection particularly in patients with fever of unknown origin and/or elevated erythrocyte sedimentation rate.

Alpha-Globulins↗

[Primary Nocardia asteroides deltoid abscess in treated Horton disease].

In a patient treated with high doses of corticosteroids for giant cell arteritis, a renewed rise in sedimentation rate accompanied by painful limitation of mobility of the shoulder led to the discovery of an intra-deltoid fluid collection. Aspiration yielded pus, culture showing the presence of Nocardia asteroides (NA). No portal of entry nor extramuscular sites of infection were found, justifying a diagnosis of primary nocardial muscle abscess. To the best of our knowledge, this is the first reported case. The opportunity is taken to review the epidemiological and clinical characteristics of NA infections as well as new management approaches.

Abscess↗

[Deep phlebitis of the lower limbs. Diagnostic value of D-dimer assays].

D-dimers are specific fibrin degradation products which have been measured in plasma and used as a diagnostic test for deep vein thrombosis of the lower limbs. However, the results published so far have often been conflicting. We compared the results of D-dimer assays by the latex method (positivity threshold: 0.5 microgram/ml) in 3 groups of patients: 22 patients with clinically suspected thrombophlebitis confirmed by doppler ultrasound; 22 patients with clinically suspected thrombophlebitis not confirmed by doppler ultrasound; and 17 hospital patients with other diseases serving as controls. The sensitivity of a D-dimer concentration higher than 0.5 microgram/ml was 96 percent and its specificity 69 percent. In an internal medicine unit where the prevalence of thrombophlebitis was 50 percent, the positive predictive value of a D-dimer concentration higher than 0.5 microgram/ml was 81 percent, and its negative predictive value was 94 percent. Thus, because of its low specificity as compared with imaging methods the D-dimer assay test cannot be used to diagnose deep vein thrombosis, but as it has good sensitivity and is rapidly performed, safe and inexpensive it can be used as an emergency examination which, when negative, makes this diagnosis unlikely.

Fibrin Fibrinogen Degradation Products↗

Physicochemical and immunological characterization of recombinant host-protective antigen (VP2) of infectious bursal disease virus.

Small fusions to the N-terminal end of the host-protective antigen (VP2) of infectious bursal disease virus lead to stable expression of VP2 in Escherichia coli and yeast, and reduce the levels of inclusion body formation in E. coli in comparison to VP2 constructs with larger N-terminal fusions. VP2 produced with small N-terminal fusions, like native viral VP2, can be fractionated into a high molecular weight 'multimeric' form and a monomeric form. A virus-neutralizing monoclonal antibody that only recognizes undenatured VP2 preferentially reacts with multimeric forms of recombinant VP2. Both native and recombinant monomeric forms of VP2 are non-immunogenic. The multimeric forms of viral and yeast-derived VP2 are highly immunogenic, while those produced in E. coli are not.

Antibodies, Monoclonal↗

Bovine retinal explants cultured in collagen gels. A model system for the study of proliferative retinopathy.

We have developed a model system for studying proliferative retinopathy in vitro using bovine retinal explants cultured in collagen gels. Cellular outgrowth from retinal explants occurred after 7 days as single cells from peripapillary explants or as cell sheets and tubular outgrowths from peripheral retinal explants. Single cell outgrowths were shown immunohistochemically to be endothelial cells or macrophages; sheetlike and tubular outgrowths also constituted cords of endothelial cells with stromal macrophages, but in addition glial cells were closely associated with the endothelial cells. Cellular outgrowths were preceded by extensive macrophage activation within the ischemic retinal explant, suggesting that macrophage-derived angiogenic factors may be important in inducing retinal endothelial cell proliferation. In addition, glial cell-derived factors may have a role in the development of vessellike tubular structures from endothelial cell outgrowths.

Animals↗

Chronic perceived work stress and blood pressure among Australian government employees.

Prospective data on 2634 Australian government employees over five years were examined for the effects of chronic perceived work stress on blood pressure change. The study sample (2100 men and 534 women) represented 57% of the original volunteers, or 75% of those eligible after exclusion criteria were met. Data on perceived stress were obtained by questionnaire, and a principal component analysis produced six components: qualitative demands, quantitative demands, job control, future control, work support, and outside stress. Multiple linear regression, which controlled for determinants of blood pressure, tested the main effects and specific two-way interaction effects of the chronicity scores of the six components and 30 items. Many items but only some components were associated with blood pressure change. Sex and age differences were observed. The observed interactions between job demands and control provided equivocal support for the Karasek job-strain model. The women responded to work-based support, but not necessarily as predicted.

Adult↗

Safe staffing.

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Documentation↗

Student grants.

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Education, Nursing↗