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Biomedical subjects

A Mayor

Publications and source records attributed to A Mayor.

17 recordsLinked to original sources
PubMed2002

Diagnostic value of molecular markers in chloroquine-resistant falciparum malaria in Southern Mauritania.

Despite its diminishing efficacy because of increased resistance, chloroquine remains the primary antimalarial agent in many endemic areas. Evidence is mounting that point mutations on the Pfcrt and possibly the Pfmdr1 genes are conferring plasmodial resistance to chloroquine. In 1998, atypically strong rainfalls led to an increased activity of falciparum malaria in Mauritania that affected non-endemic regions bordering the Saharan desert. An in vivo study on chloroqine resistance was combined with studies for molecular markers of drug resistance. Detection of Pfmdr1-76-tyrosine showed an increased odds ratio (2.91) for resistance (P = 0.0195). However, by use of this codon alone, sensitivity for detection of resistance was 60.6%, and specificity was 65.3%. In comparison, detection of the K76T mutation at Pfcrt showed a very high sensitivity (100%) while specificity remained relatively low (65.4%). For the combination of mutations on both genes, the odds ratio for detection of resistance increased to 5.31 (P = 0.0005). Here, sensitivity was again decreased to 60.6% while specificity increased to 76.9%. The results of this study suggest that detection of Pfcrt T76 can be applied for predicting chloroquine resistance in epidemiologic settings with sufficiently high sensitivity to make it an attractive alternative to time- and labor-consuming in vivo trials. Additional testing for Pfmdr Y76 provides increased specificity to this approach.

Adult↗
PubMed2001

A prospective randomized controlled study of the efficacy of ketamine for postoperative pain relief in children after adenotonsillectomy.

BACKGROUND: Adenotonsillectomy is commonly needed by children with obstructive sleep apnoea syndrome. This population is at high risk of life threatening airway obstruction in the postoperative period. METHODS: Fifty children were studied to test the efficacy of an alternative analgesic to the use of opioids in providing analgesia in the immediate postoperative period. Patients were randomized to receive either 0.1 mg.kg-1 morphine or 0.5 mg.kg-1 ketamine at induction. RESULTS: Ketamine was as effective as morphine with no additional side-effects. CONCLUSIONS: Ketamine is a safe and effective alternative to morphine to provide analgesia in the immediate postoperative period after tonsillectomy.

Adenoidectomy↗
PubMed2000

Analgesic requirements for appendicectomy: the differences between adults and children.

AIM: The analgesia provided for children is often less than for adults with the same underlying pathology. This paper attempts to quantify the postoperative analgesic requirements of patients undergoing appendicectomy. METHODS: Patients between 6 and 30 years of age who underwent an unscheduled appendicectomy were prospectively recruited. Regular non-opiate analgesia, calculated according to weight, was administered. Hourly visual analogue pain scores and morphine patient controlled analgesia (mPCA) usage were recorded for 24 h following surgery. RESULTS: 19 children (6-16 years) and 23 adults (17-30 years) were recruited. There was no significant difference in the pain scores following appendicectomy between the two groups. Significantly more mPCA was demanded (t = 2.02, P < 0.02) and morphine received (t = 2.02, P < 0.005) by adults than children following appendicectomy. CONCLUSION: Children appear to require and do demand less analgesia than adults following appendicectomy to maintain similar postoperative pain scores. Acceptable pain scores may be achieved by the administration of regular analgesia to these patients.

Adolescent↗
PubMed1992

Seroepidemiological survey of hepatitis B infection in a cohort of military recruits in Barcelona, Spain.

The prevalence of HBsAg and anti-HBs in a representative sample of 839 recruits from a cohort of 17-18 year-old males living in Barcelona has been determined by radioimmunoassay of eluates of finger-prick dried blood. It was 0.48% for HBsAg, and 3.22% for anti-HBs. All carriers of HBsAg were anti-HBe positive and had normal liver function tests. Half of them had antecedents suggestive of a materno-fetal acquisition of the infection. A relationship between educational level and the risk of infection was also demonstrated.

Adolescent↗
PubMed1990

[Immunogenicity and long-term effectiveness of the hepatitis B vaccine in newborns from HBsAg-positive mothers].

We have followed up until age 2 years 25 infants who had received the hepatitis B vaccine to prevent being infected from their mothers who were HBsAg carriers. All had developed antibodies. At 2 years of age, 24% of infants had antiHBsAg titers lower than 10 mU/ml. The geometric mean of antiHBsAg titer in those infants who had received plasma derived vaccine was 660 mU/ml and in those having received recombinant vaccine was 903 mU/ml. HBsAg was negative in all the studied samples. In two infants positive antiHBc were detected.

Carrier State↗
PubMed1990

[Hepatitis B and hepatitis delta in young inmates].

The prevalence of infection by hepatitis B (HBV) and delta (HDV) viruses and presumably related variables were evaluated in a prison for young male convicts, aged 16-21 years (n = 686), 55.1% of convicts were positive for one or more VHB markers, and 7.1% were positive for HBsAg; 89.7% of these were negative for IgM anti-HBc (chronic carriers), while 36.6% were positive for HBeAg. Anti-delta antibodies were detected in 37.5% of chronic carriers. The seropositivity of HVB markers was much higher in parenteral drug abusers (PDA) as compared with non PDA (76.3% vs 26.7%, p less than 0.0000001, OR = 8.82). Among PDA, it was higher in regular users than in occasional ones (83.3% vs 62.9%, p = 0.0001, OR = 2.95) and in those who had acquired the habit at an early age (p = 0.035). The stratified analysis also showed an association of VHB infection with other variables, basically ethical and prison-related. The possibility to develop active immunization programs is evaluated.

Adolescent↗
PubMed1990

[Hepatitis B at an open institution for the mentally retarded. Immunogenic effect of a recombinant anti-hepatitis-B vaccine].

The diffusion of hepatitis B virus was investigated in an open institution for mentally retarded patients, where 24 patients with Down's syndrome (DS) and 94 with other types of mental retardation (OMR) were being cared for. The immunogenic response to a recombinant vaccine intramuscularly injected to the deltoid muscle at a dosage of 20 mcg in the months 0, 1 and 6 was also evaluated. Seropositivity for some hepatitis B serum marker was found in 19.4% of patients (12.5% of those with DS and 21.2% of those with OMR). HBsAg was found in 8.3% of patients with DS and in 4.2% of those with OMR. The seroconversion to antiHBs induced by the vaccine 8 months after the first dose was found in 72.3% of DS and in 100% of OMR. The poor immunogenic response in DS was attributed to age, as in patients younger than 20 years it was 91.6% while in those over that age it was only 33.3%. It was concluded that in open institutions for mentally retarded patients there is a risk of hepatitis B infection, also shown in closed institutions, and that recombinant hepatitis B vaccine is highly immunogenic in this population, although it has been found that in patients with DS the age has a very marked negative influence on the response to the vaccine.

Adolescent↗
PubMed1989

[Recombinant hepatitis B vaccine in health personnel. Immunogenicity of a rapid vaccination schedule].

The immunogenic effect of a recombinant hepatitis B vaccine, administered in a dosage of 20 micrograms intramuscularly in the deltoid muscle on the months 0, 1 and 2, was evaluated in 185 employers of a general hospital. The influence of sex, age, overweight and smoking habit on the antibody response induced by the vaccine was also assessed. The seroconversion rate 40-60 days after the third dose in the 160 health professionals who completed the vaccination schedule was 88% (83% in males and 90% in females). It was 97% in individuals less than 30 years of age, 89% in those between 30 and 50 years, and 69% in those over 50 years. It was 97% in non obese and 66% in obese individuals (p less than 0.0001). No differences in seroconversion rate were found between nonsmokers, moderate smokers and heavy smokers. Untoward reactions were minimal. The rate of vaccinated individuals developing anti-HBs titers higher than 10 mIU/ml was 68%. This rate was lower than that found in most studies after vaccination in the months 0, 1 and 6, the difference being probably due to the use of a rapid schedule with a short interval between the second and third doses. Nevertheless, this schedule facilitates the vaccination programs in health staff and reduces the failure rate due to poor compliance.

Adult↗
PubMed1988

Serological survey of hepatitis B in northern Rwanda.

To assess the importance of perinatal transmission of hepatitis B virus and the risk of infection in different age groups in Northern Rwanda, filter paper dried blood samples from 350 subjects were examined for HBsAg and anti HBs. The study shows that vertical transmission is not very frequent in this area, and that the risk of infection increases with age. These results indicate that vaccination against hepatitis B in children could be delayed and included in the standard immunization programme.

Adult↗
PubMed1987

Recombinant alpha 2c-interferon therapy in fulminant viral hepatitis.

Recombinant alpha 2c-interferon was administered to 12 consecutive patients with fulminant viral hepatitis. The disease was caused by coinfection by HBV and HDV in seven patients, by HDV superinfection of a chronic HBV carrier in two, by HBV alone in two and by HAV in one. Eight patients were drug addicts. Interferon administration was initiated shortly after the onset of hepatic encephalopathy and no patient was in grade IV coma at the beginning of therapy. Ten patients died and only two survived. One of the survivors was an asymptomatic HBV carrier superinfected by HDV in whom treatment with interferon for 3 months did not prevent the development of chronic delta infection and liver cirrhosis. These results show that alpha 2c-interferon does not have significant therapeutic value in fulminant viral hepatitis, particularly if it is caused by HDV.

Adolescent↗
PubMed1987

Immunogenicity of a recombinant hepatitis B vaccine in haemodialysis patients.

The immunogenicity of a recombinant yeast-derived hepatitis B vaccine was evaluated in a randomized trial involving 80 haemodialysis patients in which three 40 microgram doses were administered according to either a 0, 1, 2 month, or a 0, 1, 6 month vaccination schedule. The vaccine induced an anti-HBs seroconversion in 54% of patients who received the three doses at intervals of one month (Group A) and in 55% of those who were vaccinated at months 0, 1, and 6 (Group B). The geometric mean titres (GMT) seven months after the first injection were 37.7 IU/l in Group A and 91 IU/l in Group B. The seroconversion rate in men (53.6%) was slightly lower than in women (60%), and the respective GMTs were 33.3 and 78.5 IU/l. An age-dependent effect was noted in the anti-HBs response, but the type of renal disease and length of time on dialysis did not influence the antibody response. A 0, 1, and 2 month vaccination schedule seems preferable for haemodialysis patients as it induces more rapid protection.

Age Factors↗