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Biomedical subjects

A McLean

Publications and source records attributed to A McLean.

At least 127 records · Page 7Linked to original sources
PubMed1984

Herpes simplex virus type-2 glycoprotein-subunit vaccine: tolerance and humoral and cellular responses in humans.

Twenty-three subjects were administered three doses of inactivated herpes simplex virus (HSV) type 2 (HSV-2) glycoprotein-subunit vaccine, with doses 2 and 3 being given four and 22 weeks after dose 1. Both HSV-neutralizing antibody and antibody effective in antibody-dependent cell-mediated cytotoxicity were detected in serum samples of 12 of the 13 initially seronegative subjects by week 8. The geometric mean titers of both antibody types decreased between weeks 8 and 22 but increased one week after dose 3. HSV-neutralizing antibody remained detectable in serum samples of seven of the 10 initially seronegative subjects assayed seven months after dose 3. Cell-mediated immunity was detected by lymphocyte transformation responses to HSV-2 after vaccine administration in 12 of the 13 initially seronegative subjects. Unlike humoral antibody, which waned over time, in vitro cell-mediated immune responses remained stable over the seven-month follow-up period after dose 3. This HSV-2-subunit vaccine is well tolerated and elicits both humoral and cell-mediated immune responses to HSV.

Adult↗
PubMed1984

Goblet and Clara cells of human distal airways: evidence for smoking induced changes in their numbers.

The goblet cell and Clara cell populations of human distal airway epithelium were examined. The bronchioles, terminal bronchioles, and respiratory bronchioles of 16 smokers and four non-smokers were studied by both light and electron microscopy in surgically resected specimens. A very significantly (p less than 0.001) greater number of goblet cells were found in the bronchioles of smokers compared than in those of non-smokers but no such difference was evident in terminal/respiratory bronchioles. Clara cell numbers in contrast were lower in the bronchioles (p less than 0.01) and terminal and respiratory bronchioles of smokers (p less than 0.01). Both of these alterations in cell frequency may adversely affect small airway function in smokers.

Bronchi↗
PubMed1984

Psychosocial functioning at 1 month after head injury.

The authors examined the psychosocial sequelae of head trauma at 1 month after injury in a group of 102 adult head-injured patients representing a broad range of severity of trauma. One hundred two control subjects selected from friends of the head-injured patients were used for comparison purposes. Outcome was determined with a battery of psychosocial measures assessing a number of different areas of daily functioning. The results support the following conclusions: (a) at 1 month after injury, head-injured patients experience difficulties in a number of areas of psychosocial functioning, especially the resumption of major role activities (i.e., work, school, and home management) and leisure/recreational activities; (b) the relationship between head injury severity level and the adequacy of psychosocial functional differs for the various measures; and (c) in determining the psychosocial consequences of head trauma, the use of an appropriate control group is essential.

Activities of Daily Living↗
PubMed1983

Successful substitution of rectal metronidazole administration for intravenous use.

Wound infection and isolation of anaerobic organisms before and after intravenous and rectal administration of metronidazole were studied in 24 505 surgical patients. In the 6303 patients who underwent "risk" surgery (bowel, biliary, gynaecological, or otolaryngological surgery) introduction of intravenous metronidazole was associated with a striking fall in wound infection and wound anaerobe isolation rates; and the changes were maintained when the majority of metronidazole used was in suppository form. In the 18 202 patients who underwent "clean" surgery (e.g., orthopaedic, ophthalmic, and plastic surgery) metronidazole use was associated with a small formulation-independent change in infection rate without change in anaerobe isolation rates. Without compromising clinical care the use of intravenous metronidazole can be limited to a minority of patients with special needs.

Anaerobiosis↗
PubMed1983

Cimetidine-procainamide pharmacokinetic interaction in man: evidence of competition for tubular secretion of basic drugs.

The hypothesis that basic drugs can compete for active tubular secretion by the kidney was tested in six healthy volunteers by comparing the single dose pharmacokinetics of oral procainamide before and during a daily dose of cimetidine. The area under the procainamide plasma concentration-time curve was increased by cimetidine by an average of 35% from 27.0 +/- 0.3 micrograms/ml X h to 36.5 +/- 3.4 micrograms/ml X h. The elimination half-life increased from an harmonic mean of 2.92 to 3.68 h. The renal clearance of procainamide was reduced by cimetidine from 347 +/- 46 ml/min to 196 +/- 11 ml/min. All these results were statistically significant (p less than 0.016). The area under the plasma concentration-time curve for n-acetylprocainamide was increased by a mean of 25% by cimetidine due to a significant (p less than 0.016) reduction in renal clearance from 258 +/- 60 ml/min to 197 +/- 59 ml/min. The data suggests that cimetidine inhibits the tubular secretion of both procainamide and n-acetylprocainamide, and, if so, represents the first documented evidence for this type of drug interaction in man. The clinical implications from this study necessitate dosage adjustments of procainamide in patients being concomitantly treated with cimetidine. The interaction is pertinent not only for basic drugs that are cleared by the kidney, but also for metabolites of basic drugs and endogenous substances which require active transport into the lumen of the proximal tubule of the kidney for their elimination.

Absorption↗
PubMed1983

Chronic erosive gastritis resulting in cachexia.

Nine patients are reported who presented with severe weight loss of up to 13.6 kg (30 lb) as a result of chronic erosive gastritis. In many the cachexia was sufficient to prompt a search for malignancy but no other lesion was found. The importance of the radiological pursuit of this diagnosis is emphasised. Illustrative case histories are presented.

Adult↗
PubMed1983

The behavioral sequelae of head injury.

Twenty patients with mild and, in a few cases, moderately severe head injuries were examined 3 days and 1 month postinjury. The results indicate that these patients, as compared to appropriate controls, show significant neuropsychological difficulties at 3 days, but not at 1 month postinjury. Postconcussional symptoms are endorsed, on the other hand, at both 3 days and 1 month. Absence of significant neuropsychological findings at 1 month is contrary to some of the previous reports. A number of reasons for this discrepancy were discussed. Some of these included: (a) inappropriate controls used in previous research; (2) failure to screen for pre-existing conditions in prior studies, therefore confounding the effects of the injury with pre-injury factors; (3) possible practice effects in our research; and (4) differences in the neuropsychological measures used across different studies.

Adolescent↗
PubMed1983

Head injury in the Pacific Northwest.

This report describes 451 consecutive patients admitted to a regional trauma center with head injury over 1 year's time. Our results replicate findings from other hospital- and population-based studies of head trauma. Males exceeded females by 3 to 1; the most frequent age of patients was between 15 and 24 years; and motor vehicles were the most common cause of injuries. Mortality was related inversely to Glasgow coma scale (GCS) scores and directly to age. This study also points out two current problems in head trauma research. One is the difficulty in using the GCS in a community with highly sophisticated emergency medical services. In 38% of the patients, one or more GCS components could not be assessed directly. In 17% of cases, GCS scores could not be confidently assigned. This was principally because endotracheal tubes were in place before arrival at the hospital, precluding determination of the verbal response. A second problem is the influence of chronic pre-existing central nervous system conditions on head outcome. Twenty-nine per cent of our patients had one or more such conditions at the time of their injury. Minimal estimates of prevalence ranged from 1% (mental retardation) to 18% (alcoholism).

Adolescent↗
PubMed1983

Demand quality.

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Hospitals↗