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Biomedical subjects

A Gupta

Publications and source records attributed to A Gupta.

At least 667 records · Page 37Linked to original sources
PubMed1993

Safety of nonsteroidal anti-inflammatory drugs with respect to acute liver disease.

OBJECTIVE: To examine the magnitude of the risk of acute hepatitis associated with the use of nonsteroidal antiinflammatory drugs. METHODS: We calculated the annual incidence rate of hepatitis resulting in hospitalization and then performed a case-control study using 1980 to 1987 Medicaid billing data from Michigan and Florida. The 107 cases included patients with symptomatic acute hepatitis without an identifiable cause of liver disease. Four controls per case were randomly selected and were matched for age, sex, and state. Antecedent drug exposure was assessed 30 days prior to the onset of the disease in the cases and during the same period in the controls. RESULTS: The annual incidence rate (95% confidence interval) of acute idiopathic symptomatic hepatitis resulting in hospitalization was 2.2 (2.0 to 2.4) per 100,000 persons per year. Nine cases (8.4%) and 26 controls (6.1%) were exposed to nonsteroidal anti-inflammatory drugs, yielding an odds ratio of 1.4 (0.6 to 3.1). After adjustment for potential confounding variables, the odds ratio was 1.2 (0.5 to 2.8). CONCLUSIONS: Acute symptomatic idiopathic liver disease severe enough to result in hospitalization is uncommon, and no association was evident between nonsteroidal anti-inflammatory drugs and acute hepatitis. This study was large enough to exclude a relative risk of 2.8. These data suggest that acute symptomatic liver disease from nonsteroidal anti-inflammatory drugs is not a frequent clinical problem.

Abdominal Pain↗
PubMed1993

Effect of insulin therapy on progression of retinopathy in noninsulin-dependent diabetes mellitus.

In a six-month prospective study involving 60 noninsulin-dependent diabetics, we evaluated the effect of change to conventional insulin therapy on the pre-existing retinopathy. Ten of 15 patients in group 1 (background or preproliferative diabetic retinopathy treated with insulin) compared to one of 15 patients in group 2 (background or preproliferative diabetic retinopathy treated with hypoglycemic agents) had progression of retinopathy. Worsening of retinopathy was related significantly only to the age of the patients (r = .752, P < .001). None of the 15 patients each in groups 3 and 4 (no retinopathy treated with insulin injections [group 3] or oral hypoglycemic agents [group 4]) developed retinopathy.

Blood Glucose↗
PubMed1993

Construction of Zn2+/Cd2+ hypersensitive cyanobacterial mutants lacking a functional metallothionein locus.

Eukaryotic metallothioneins (MTs) have been extensively studied, but the precise functions of most of these molecules are not yet fully understood. Prokaryotes are often more tractable for the analysis of gene function and we report here the generation of mutants of Synechococcus PCC 7942 (strain R2-PIM8) deficient in the MT locus, smt. Viability of these mutants, designated R2-PIM8 (smt), reveals that prokaryotic MT performs no "vital" role (such as donation of metals to metallo-proteins) in Synechococcus. R2-PIM8 (smt) has reduced (approximately 5-fold) tolerance to elevated Zn2+, with detectable hypersensitivity to Cd2+. Restoration of Zn2+ tolerance was used as a selectable marker to isolate recombinants derived from R2-PIM8(smt) after reintroduction of a linear DNA fragment containing an uninterrupted smt locus. These smt-complemented cells also exhibited restored Cd2+ tolerance. Hypersensitivity to Cu2+ was not detected in R2-PIM8(smt) indicating independence of Cu2+ resistance from smt mediated metal (Zn2+/Cd2+) tolerance.

Cadmium↗
PubMed1993

Synaptic repression at crayfish neuromuscular junctions. II. Evidence for calcium involvement.

The inability of synaptic junctions to generate normalisized postsynaptic potentials under normal physiological conditions was studied at crayfish neuromuscular synapses. Synaptic repression in the superficial flexor muscle system of the crayfish was induced by surgery: the nerve was cut in the middle of the target field, and the lateral muscle fibers were removed. After this surgery, the remaining medial synapses were unable to generate normal-sized junction potentials (jp) over the medial muscle population. In an attempt to study the mechanisms underlying this response, we varied the extracellular calcium concentration of the Ringers solution bathing the preparation, in both repressed and control animals, while monitoring the size of the same junction potential. The junction potential generated by the spontaneous activity of the nerve increased in size with increasing calcium concentrations in control animals, but failed to do so in repressed animals, that is, changes in external calcium concentrations did not affect repressed synapses. However, in the presence of the calcium ionophore A23187, control and repressed synapses both show an increase in the junction potential sizes they generate. Our data suggest that calcium is involved in the mechanisms that underlie synaptic repression in this crustacean neuromuscular system.

Animals↗
PubMed1993

Maternal respiratory function following normal vaginal delivery.

Forced expiratory volume (FEV(1)) forced vital capacity (FVC), peak expiratory flow (PEF) and maximum expiratory pressure (P(E)max) were measured in 11 healthy women 2, 4, 8, 24, 48 and 72 hours after normal vaginal delivery and repeated after 6-8 weeks. There was a significant (P<0.05) reduction in the P(E)max up to 4 hours after delivery. In contrast, there was no significant reduction in FEV(1) or FVC at any of the time periods, and PEF showed a significant reduction only at 2 hours after delivery. This indicates that P(E)max is a more sensitive measure of respiratory muscle strength and that this is reduced for at least 4 hours after delivery. Any anaesthetic given during this period should take into consideration that the ability to cough effectively may be impaired.

Journal Article↗
PubMed1993

Cardiac arrest during caesarean section.

A case is described of a previously healthy obese woman in her fourth pregnancy who presented for caesarean section due to cephalopelvic disproportion (CPD). Forty minutes after a spinal anaesthetic a healthy child was delivered. Shortly after the injection of ergometrine and Syntocinon into the uterus, the patient described a general feeling of discomfort which was followed by convulsions and cardiac arrest. Resuscitation was successful and the circulation was restored. However, it was difficult to maintain oxygenation and the patient was mechanically ventilated for 24 hours and subsequently supplementary oxygen therapy was given for three days. A pulmonary scintigram on the fourth day after delivery showed large uptake defects indicative of pulmonary embolism. The patient recovered completely and was discharged home after two weeks. Differential diagnosis and measures to reduce the risk of deep vein thrombosis (DVT) are discussed.

Journal Article↗
PubMed1993

Epidural anaesthesia for caesarean section in a patient with a cerebral artery aneurysm.

A case is described of a 30-year-old insulin-dependent diabetic woman who presented at 25 weeks gestation with frontal headache. Contrast tomography revealed an aneurysm of the middle cerebral artery with no evidence of subarachnoid bleeding. Although elective caesarean section at term was planned, it was performed at gestational week 38 due to the onset of vaginal bleeding and premature labour. In contrast to previous reports, the cerebral aneurysm was not managed surgically at the same time as the delivery, but was treated conservatively. An epidural anaesthetic was performed successfully and postoperative analgesia maintained with a continuous infusion of local anaesthetic in the epidural space. Literature is reviewed and advantages of regional versus general anaesthesia are discussed.

Journal Article↗
PubMed1993

Transplacental passage of fluorides.

Transplacental passage of fluorides was studied in 25 randomly selected neonates. Blood samples collected simultaneously from the mother and the umbilical cord showed that average fluoride concentration in the cord blood was 60% of that in mother's blood. When concentration in the mother's blood exceeded 0.4 ppm, the placenta acted as a selective barrier.

Adult↗
PubMed1993

Reversal of lipaemia retinalis with dietary control.

Lipaemia retinalis occurs as the result of a marked elevation of serum lipids. Combined hyperlipidaemia may occur as a primary familial or secondary acquired abnormality. A case of lipaemia retinalis is described, documented by fundus photographs. A complete lipid profile of the patient revealed marked hyperlipidaemia. The lipoprotein lipase level was found to be reduced 0.3 cu (normal 0.5-2.0 cu). The patient was put on a low-fat diet, after which serial fundus photographs showed an improvement in the fundus appearance. Follow-up lipid profile estimations showed a decrease in triglyceride and cholesterol levels. After 6 months of follow-up complete reversal of lipaemia retinalis was documented. In this case, reversal of lipaemia retinalis occurred with dietary therapy alone.

Adolescent↗
PubMed1993

Ischaemic central retinal vein occlusion in the young.

Little is known about the behaviour of central retinal vein occlusion (CRVO) in the young. We studied the course and visual outcome in 25 patients with CRVO aged less than 40 years with special reference to the association with underlying systemic disorders. Eight patients had ischaemic CRVO while 17 had non-ischaemic CRVO. Systemic disorders associated with ischaemic CRVO included end-stage renal disease in 3, and hypercholesterolaemia, beta-thalassaemia and hypertension in 1 each. All patients with ischaemic CRVO had unusually severe disease and a rapid downhill course. Management included panretinal photocoagulation in 7 eyes, trabeculectomy with 5-fluorouracil in 3 eyes and cyclocryopexy in 2 eyes. Despite this 3 eyes became phthisical and the final visual acuity in all eyes ranged from no light perception to 6/60. Three patients with end-stage renal disease died within 15 months of diagnosis of venous occlusion.

Adult↗
PubMed1993

Hereditary nephritis (Alport's syndrome)--clinical profile and inheritance in 28 kindreds.

Sixty-three patients, (52 males and 11 females) from 28 kindreds of hereditary nephritis (Alport's syndrome) were identified over a 14-year period from 1977 to 1991. Group I included 51 patients with (a) positive family history of haematuria with or without chronic renal failure, (b) characteristic GBM changes on electron-microscopy, (c) characteristic ocular signs, and (d) high-frequency sensorineural deafness. Group II included 12 patients with a negative family history. All of them had evidence of renal disease with characteristic ocular signs and deafness and four had characteristic GBM changes on electron-microscopy. The main clinical features were haematuria in 96.8%, deafness in 82.5%, and diminished visual acuity in 66.7% of affected subjects. Hypertension was present in 71.4% patients. Pure tone audiometry revealed high-frequency sensorineural deafness in 96.8%. Ocular examination showed bilateral anterior lenticonus in 37.8%, retinal flecks in 22.2%, cataract in 20%, and keratoconus in 6.7% patients. Proteinuria (> 2.0 g/24 h) was detected in 31.8%. Sixteen (57.1%) of the 28 index patients (all males) were diagnosed for the first time when they presented with end-stage renal disease. Serum creatinine in the overall group ranged from 0.9 to 18.7 mg/dl(7.81 +/- 5.37 mg/dl). Adequate renal tissue was obtained by biopsy in 14 patients. Light-microscopy revealed focal segmental glomerulosclerosis in five, mesangial proliferation in four, chronic interstitial nephritis in three, and mesangiocapillary and crescentic glomerulonephritis in one each. Electron-microscopy showed characteristic changes in the GBM in seven specimens.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Deletion within the metallothionein locus of cadmium-tolerant Synechococcus PCC 6301 involving a highly iterated palindrome (HIP1).

Genomic rearrangements involving amplification of metallothionein (MT) genes have been reported in metal-tolerant eukaryotes. Similarly, we have recently observed amplification and rearrangement of a prokaryotic MT locus, smt, in cells of Synechococcus PCC 6301 selected for Cd tolerance. Following the characterization of this locus, the altered smt region has now been isolated from a Cd-tolerant cell line, C3.2, and its nucleotide sequence determined. This has identified a deletion within smtB, which encodes a trans-acting repressor of smt transcription. Two identical palindromic octanucleotides (5'-GCGATC-GC-3') traverse both borders of the excised element. This palindromic sequence is highly represented in the smt locus (7 occurrences in 1326 nucleotides) and analysis of the GenBank/EMBL/DDBJ DNA Nucleotide Sequence Data Libraries reveals that this is a highly iterated palindrome (HIP1) in other known sequences from Synechococcus strains (estimated to occur at an average frequency of once every c. 664 bp). HIP1 is also abundant in the genomes of other cyanobacteria. The functional significance of smtB deletion and the possible role of HIP1 in genome plasticity and adaptation in cyanobacteria are discussed.

Amino Acid Sequence↗
PubMed1993

Antioxidant enzymes in RBCs as a biological index of age related macular degeneration.

The present study was undertaken to assess the levels of antioxidant enzymes in red blood cells of subjects with age-related macular degeneration and age-matched controls. The results obtained show a significant decrease in activities of superoxide dismutase (p < 0.001) and glutathione peroxidase (p < 0.001) as compared to the controls. A good correlation (r = -0.99) was also observed between age and decreased activity of antioxidant enzymes in controls, and also correlated well with age-related macular degeneration. In conclusion, oxidative stress as assessed by antioxidant enzymes is more pronounced in subjects with age-related macular degeneration as compared to age-matched controls.

Aged↗