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Biomedical subjects

A G Bird

Publications and source records attributed to A G Bird.

At least 73 records · Page 4Linked to original sources
PubMed1992

Anonymous HIV surveillance in Saughton Prison, Edinburgh.

OBJECTIVES: To estimate the prevalence of HIV by anonymous saliva testing in Her Majesty's Prison, Saughton (Saughton Prison), Edinburgh, UK. To elicit linked anonymous risk factor information from which to estimate risk scores for those who had taken an HIV blood test and, among drug injectors, for those who were HIV-1-antibody-positive on saliva testing. SETTING: Saughton Prison on 15 and 16 August 1991; HIV Immunology and Regional Virus Laboratories, Edinburgh, and the Medical Research Council Biostatistics Unit, Cambridge, UK. PARTICIPANTS: Male inmates (378 out of a total of 499) of Saughton Prison. MAIN OUTCOME MEASURES: Answers to a brief questionnaire about age, usual residence, present and past custodial sentences, drug injecting and sexual behaviour prior to and in prison, HIV testing and history of acute hepatitis. HIV-1-antibody status was established by saliva testing. RESULTS: Eighteen per cent of participants were injecting drug users (IDU), of whom approximately one-half (47%) had injected while inside prison. Ninety men (26%), including 40 (14%) of 278 participants who had never injected drugs and 77% of IDU participants, had taken an HIV blood test. Nine per cent of all participants and 35% of IDU participants had had an acute attack of hepatitis. Forty-one (62%) of 66 IDU had been imprisoned five or more times before their current prison sentence. After taking account of region of residence, injecting drug history and acute hepatitis, aspects of sentencing and sexual behaviour were not determinants of those who had been tested for HIV. On the study days, 18 out of 499 (3.6%) participants were known to prison medical officers to be HIV-infected. Following saliva testing, HIV prevalence was 17 out of 375 (4.5%) inmates tested. All 17 had at some time 'taken the blood test for HIV' and all had injected non-medically prescribed drugs. Edinburgh residence, age 26-30 years, have injected in prison and having first injected before 1983 all contributed to the risk score for whether an IDU was HIV-1-antibody-positive on saliva testing. CONCLUSIONS: Documented HIV prevalence in saliva was 4.5%, which--assuming no volunteer bias (as supported by questionnaire returns)--suggests that actual HIV prevalence was 25% greater than revealed to Saughton's prison medical service. All 17 inmates who were HIV-1-antibody-positive on saliva testing had injected non-medically prescribed drugs. The high reported frequency by inmates of injecting in prison highlights the urgent requirement for drug reduction and rehabilitation programmes for injecting inmates. Linked anonymous voluntary HIV testing of saliva can provide valuable information about HIV prevalence for the planning of prison resources and policy.

Adult↗
PubMed1992

Myocardial dysfunction in patients infected with HIV: prevalence and risk factors.

OBJECTIVES: To determine the prevalence of and risk factors for myocardial dysfunction in HIV infection. SUBJECTS: 173 patients infected with HIV underwent echocardiography. 119 were current or previous injection drug users, 38 were homosexuals, 10 were haemophiliac patients, and six were heterosexual. MAIN OUTCOME MEASURE: Detection of impaired ventricular function. RESULTS: 26 patients with abnormalities of ventricular size or function or both were identified. The abnormality was (a) dilated cardiomyopathy in 13 patients (eight homosexuals, three drug users, and two haemophiliacs) with a mean CD4 count of 38 cells/mm3, which accords with end-stage disease (in addition, three patients were identified as having borderline impairment of left ventricular function); (b) left ventricular dilatation without loss of function in a further six patients; and (c) isolated right ventricular dilation in seven patients. Follow up echocardiograms were obtained in 71 patients, 18 of whom had myocardial dysfunction (103 echocardiograms, mean (SD) 2.5 (0.6) scans per patient, mean interval 200 (116) days, range 14-538 days). These showed that in four cases of isolated right ventricular dilatation, one of isolated left ventricular dilatation, and two with borderline left ventricular dysfunction myocardial function subsequently reverted to normal. There was no excess of exposure to zidovudine in the patients with myocardial dysfunction. Similarly, patients with myocardial dysfunction had no serological evidence of excess secondary infection with Toxoplasma gondii and cytomegalovirus. CONCLUSIONS: There was a high prevalence and wide range of myocardial dysfunction in HIV positive patients. Dilated cardiomyopathy was a feature of advanced HIV disease and affected all major risk groups for HIV infection. In contrast, isolated dilatation of either ventricle occurred at an earlier stage of HIV infection and, particularly in the case of the right ventricle, often was transient. Neither treatment with zidovudine nor infection with Toxoplasma gondii or cytomegalovirus seemed to be responsible for these findings.

Adult↗
PubMed1991

Increased expression of the CD45RO (memory) antigen on T cells in HIV-infected children.

Expression of the CD45RO putative memory cell antigen on CD4 (helper) and CD8 (cytotoxic/suppressor) lymphocytes of children born to HIV-infected women was investigated using the UCHL1 antibody. Significantly raised numbers of CD45RO+ CD8 lymphocytes were found in all nine of the infected children compared with uninfected and control children. Expression of CD45RO on CD4 lymphocytes was variable; absolute numbers were not increased, although the percentage was increased in four out of nine infected children. All the infected children except two (who had comparatively low numbers of CD45RO+ CD8 cells) were clinically well, which suggests that an increase in CD45RO+ CD8 cells may be indicative of a functionally active immune response against HIV.

Antigens, CD↗
PubMed1991

Beta 2-microglobulin levels in drug users: the influence of risk behaviour.

beta 2-microglobulin (beta 2M) levels were measured in 217 Edinburgh drug users to assess their usefulness as a marker for HIV-related disease. Eighty HIV-seronegative drug injectors had significantly higher levels than 100 HIV-seronegative blood-donor controls. Amongst 137 asymptomatic HIV-seropositive drug users, those who were defined as continued drug users had significantly higher beta 2M levels and percentages of CD3+ T lymphocytes with DR Class II expression than non-injecting drug users. beta 2M levels correlated with the percentage of activated DR+ CD3+ T lymphocytes. These findings indicate that changes in beta 2M levels may reflect differences in drug-injecting behaviour and are not influenced solely by HIV status or progression. These changes in beta 2M probably represent differing degrees of immunostimulation resulting from the antigenic challenges afforded by continued or frequent drug injection. It is important to establish normal ranges for beta 2M from HIV-seronegative controls who are matched with respect to risk group and behaviour. All these factors should be taken into account if beta 2M is to be used as a marker of HIV progression.

Adult↗
PubMed1990

Antibodies directed against neutrophils (C-ANCA and P-ANCA) are of distinct diagnostic value in systemic vasculitis.

In a prospective study, sera from over 700 patients with suspected vasculitis, including over 200 patients undergoing renal biopsy, were examined for antibodies to neutrophil cytoplasmic antigen (ANCA). An indirect immunofluorescence assay on ethanol fixed human neutrophils identified two types of autoantibody: C-ANCA, which produces diffuse cytoplasmic staining and P-ANCA, which produces an artefactual nuclear/perinuclear staining pattern. The diagnosis of patients in whom ANCA of either form was found was established following case note review according to defined diagnostic criteria. Forty of 45 patients whose sera contained C-ANCA at a titre of greater than or equal to 1/40 satisfied the diagnostic criteria for Wegener's granulomatosis or microscopic polyarteritis. Twelve of 30 patients with P-ANCA at a titre of greater than or equal to 1/40 were also classified as having one of these disorders. Seventeen of the remaining 18 patients had immune-mediated disorders with deep organ damage. Of 47 ANCA-positive patients who underwent renal biopsy, 21 had glomerulonephritis associated with Wegener's glomerulonephritis and a further 22 had a necrotizing or crescentic glomerulonephritis. Ethanol fixation is important for discrimination of C-ANCA and P-ANCA. C-ANCA are highly specific for Wegener's granulomatosis and microscopic polyarteritis. In patients undergoing renal biopsy, the presence of these antibodies is highly specific for a necrotizing or crescentic glomerulonephritis.

Arteritis↗
PubMed1988

AIDS encephalopathy with response to treatment.

A 3 year old boy who had acquired HIV infection transplacentally developed the classical features of AIDS encephalopathy, spastic diplegia and expressive aphasia. His computed tomogram showed cerebral atrophy. Treatment with zidovudine and weekly infusions of gammaglobulin led to considerable clinical improvement and an almost normal computed tomogram nine weeks later.

Antiviral Agents↗
PubMed1988

Occupational asthma due to sodium iso-nonanoyl oxybenzene sulphonate, a newly developed detergent ingredient.

Research with sodium iso-nonanoyl oxybenzene sulphonate (SINOS) for use in a detergent product was complicated by the development of asthma in an atopic 38 year old laboratory technician. Inhalation challenge tests with nebulised SINOS solutions over a dose range of 0.01-32 micrograms gave reproducible late asthmatic reactions after the higher doses and an increase in bronchial responsiveness to methacholine. The magnitude of the late reaction was related to the challenge dose.

Adult↗