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Biomedical subjects

A Gupta

Publications and source records attributed to A Gupta.

At least 829 records · Page 46Linked to original sources
PubMed1989

Cord blood lipid levels in low birth weight newborns.

Cord blood cholesterol, triglyceride and FFA levels were estimated in 73 newborns, subdivided into various gestation weight categories (FTAGA, PTAGA, FTSGA and PTSGA). Cholesterol levels were not influenced by birth weight and gestation. Prematurity and growth retardation caused a significant elevation in triglyceride values. FFA levels were not influenced by prematurity, but growth retardation produced a significant increase. Birth weight and gestational age should be taken into consideration before labelling the newborn as hyperlipidemic.

Female↗
PubMed1989

Anaphylactoid reactions to protamine: an often lethal complication in insulin-dependent diabetic patients undergoing vascular surgery.

Protamine is used routinely at our institution during arterial surgery to reverse the anticoagulant effect of heparin. Adverse fatal reactions to protamine are generally believed to be rare. However, major anaphylactoid reactions occurred in 11 of the last 1150 patients receiving this drug at our institution. Nine of these reactions occurred in 325 insulin-dependent diabetic patients (incidence, 3%), whereas only two occurred in the 825 patients not receiving insulin (incidence, 0.2%) (p less than 0.001). Ten of these reactions occurred within 10 minutes of protamine administration (15 to 35 mg), whereas one reaction occurred immediately after administration of a 5 mg test dose of protamine. Systolic blood pressure fell below 60 mm Hg in all of the 11 patients, and three patients had to be resuscitated with closed-chest massage. Initial treatment with epinephrine and steroids was successful in seven cases. Four patients required further resuscitative measures, including closed-chest massage. However, one of the patients died as a result of ventricular fibrillation resistant to treatment. Ten of the 11 patients, including the patient who died, had significant preexisting cardiac disease; six of the surviving 10 patients (60%) had perioperative myocardial infarctions and three died. Thus the total mortality rate was 36% (4/11). These data support the implication that neutral protamine Hagedorn (NPH) insulin produces an adverse reaction through immunologic presensitization of the patient. These data also show that, in the older vascular surgery population with a high incidence of significant cardiac disease, protamine reactions can be potentially lethal. Thus routine use of protamine should be avoided in diabetic patients receiving insulin.

Aged↗
PubMed1989

Skin involvement in leukemia.

Skin infiltration in leukaemia occurs rarely. We describe here four such cases of acute leukaemia. In two, the skin infiltration was evident at presentation; in the other two, it developed while on treatment. The lesions varied from maculopapular to tumorous stage. Complete remission could be achieved with chemotherapy, however, the long term prognosis was poor.

Adolescent↗
PubMed1989

Nephropathy in type 2 diabetes mellitus in Third World countries--Chandigarh study.

We studied the profile of nephropathy in 250 patients, 177 males and 73 females, with type 2 diabetes mellitus. The mean age was 55.9 +/- 8.8 years. Therapy for control of diabetes included diet alone in 1.6%, oral hypoglycaemic agents in 90.6% and insulin in 7.8%. Glycaemic control was satisfactory in 4.8%, fair in 41.2% and poor in 54.0%. Blood sugar values were normal without any therapy in 33 out of the 206 patients (16%) after the onset of renal insufficiency. The mean interval between the onset of diabetes and the appearance of proteinuria was 9.5 +/- 7.05 years. Proteinuria appeared within one year in 23 patients (9.2%), 1-5 years in 32 (12.8%), 6-10 years in 86 (34.4%) and more than 10 years in the remaining 109 patients (43.6%). Proteinuria was of nephrotic range in 17.6% of patients. Renal insufficiency was present in 206 (82.4%) patients and occurred 10.5 +/- 7.5 years after the detection of diabetes. Hypertension was present in 61.2% and was first detected 7.5 +/- 7.4 years after onset of diabetes. Endstage renal disease occurred 11.8 +/- 6.8 years after the onset of diabetes mellitus. Thus, clinical evidence of diabetic nephropathy is present in most patients with type 2 diabetes mellitus within a decade after the detection of diabetes. Subsequent progression to end-stage renal failure is rapid in the face of poorly controlled hypertension and hyperglycemia in the economically poor countries.

Adult↗
PubMed1988

Increased sodium-lithium countertransport activity in red cells of patients with insulin-dependent diabetes and nephropathy.

Susceptibility to diabetic nephropathy may be related to a predisposition to arterial hypertension. We have studied the activity of sodium-lithium countertransport in red cells, a marker of risk for essential hypertension, in white European adults with insulin-dependent diabetes and diabetic nephropathy, a matched group of patients with diabetes without renal disease, and nondiabetic patients with renal disease. Measures of metabolic control and concentrations of plasma free insulin and growth hormone were similar in the two diabetic groups. The degree of impairment in renal function was similar in the diabetic and nondiabetic patients with renal disease. Body-mass index and plasma potassium concentrations were similar in all three groups. Diastolic blood pressure was elevated to a similar degree in the two groups with renal disease, as compared with that in the diabetic patients without renal disease. The rates of sodium-lithium countertransport in red cells were significantly higher in the diabetic patients with renal disease (mean +/- SD, 0.55 +/- 0.19 mmol of lithium per liter of red cells per hour) than in the diabetic patients without renal disease (0.33 +/- 0.16; P less than 0.005) and in the nondiabetic patients with renal disease (0.31 +/- 0.14; P less than 0.001). Predisposition to hypertension, as indicated by elevated sodium-lithium countertransport activity in red cells, may serve as a marker for the risk of renal disease in patients with insulin-dependent diabetes.

Adult↗
PubMed1988

Significance of maternal and infant serum antibodies to hepatitis B core antigen in hepatitis B virus infection of infancy.

The significance of IgM and IgG class antibodies to hepatitis B virus (HBV) core component (anti-HBc) was investigated in a study of maternal-fetal HBV transmission. An IgM anti-HBc response was lacking in the majority (49/53) of HBV-infected infants. This antibody thus cannot be used as an indicator of transplacental infection. However, most infants who became HBsAg positive during the first 6 months of life acquire infection in the perinatal period rather than transplacentally. Passively transferred maternal IgG anti-HBc in the infant and additional IgM anti-HBc positively in the carrier mother have no modulating influence on HBV infection of infants born to HBV carrier women.

Age Factors↗
PubMed1988

Pulmonary blastoma in a neonate.

A rare case of pulmonary blastoma in a neonate is reported. Only one other neonate has been documented in the available English literature. The treatment consisted of surgical excision only.

Female↗
PubMed1988

Studies on the cardiovascular effects produced by the spinal action of substance P in the rat.

Administration of 6.5-pmol-6.5-nmol doses of substance P (SP) into the spinal subarachnoid space at T-8-T-10 in urethane-anesthetized rats increases both mean arterial pressure (MAP) and heart rate (HR) in a dose-related manner. However, in rats anesthetized with sodium pentobarbital, an increase in MAP is seen only at low doses of SP (6.5-65 pmol), while a biphasic response is obtained at 650 pmol and only a depressor response at 6.5 nmol SP. These responses also are accompanied by a tachycardia. Depending on the spinal cord level, cardiovascular responses of different time course and magnitude are elicited by SP. The amplitude of the increases in MAP and HR produced by SP (6.5 nmol) are: T-8-T-10 greater than T-1-T-3 greater than L-2-L-4 in rats anesthetized with urethane. In rats anesthetized with sodium pentobarbital, the decrease in MAP levels is greatest at T-1-T-3, while it is similar at T-8-T-10 and L-2-L-4 levels. The effects of SP on HR are more complex. The different cardiovascular responses obtained with the two anesthetics are not attributed to the relative depth of anesthesia but may be due to differential effects of the anesthetics on sympathetic nervous activity. The effect of SP on HR can be blocked by propranolol, but it remains unaffected by the surgical removal of the adrenal glands. We conclude that this cardiovascular response is most likely mediated by the postganglionic noradrenergic fibres and that adrenal medullary catecholamines are not essential. Using several inhibitors of endogenous mediators, two components to the spinal action of SP on MAP are made evident. The pressor response can be explained solely by the activation of sympathetic preganglionic fibres in the intermediolateral nucleus of the spinal cord, while the depressor response, in addition, may involve the release of a vasodilatatory substance in the periphery, the action of which persists in the presence of cholinergic, histaminergic, serotonergic, or opioid antagonists. Moreover, the adrenal glands are excluded as a possible source of this substance.

Adrenalectomy↗
PubMed1988

Use of lymphokines in treatment of experimental intra-abdominal abscess caused by Bacteroides fragilis.

The role of cell-free soluble factors (lymphokines) derived from mitogen-activated splenic cells of mice previously immunized against Bacteroides fragilis was evaluated in the treatment of B. fragilis intra-abdominal abscess (IAA). Neither clindamycin nor lymphokines alone were effective against an established B. fragilis IAA, but the combination of clindamycin and lymphokines decreased the abscess size and bacterial counts in the majority of animals. This suggests that the synergy of lymphokines with clindamycin effects cure of IAA caused by B. fragilis and that lymphokines might have an application as adjuncts to conventional antimicrobial therapy in this setting.

Abdomen↗