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Biomedical subjects

A Porter

Publications and source records attributed to A Porter.

At least 91 records · Page 5Linked to original sources
PubMed1990

AIDS--the leading cause of adult death in the West African City of Abidjan, Ivory Coast.

In 1988 to 1989, 698 adult cadavers in Abidjan's two largest morgues were studied, representing 38 to 43% of all adult deaths in the city over the study period, and 6 to 7% of annual deaths. Forty-one percent of male and 32% of female cadavers were infected with human immunodeficiency virus (HIV). Fifteen percent of adult male and 13% of adult female annual deaths are due to acquired immunodeficiency syndrome (AIDS). In Abidjan, AIDS is the leading cause of death and years of potential life lost in adult men, followed by unintentional injuries and tuberculosis. In women, AIDS is the second leading cause of death and premature mortality, after deaths related to pregnancy and abortion. AIDS-specific and AIDS-proportional mortality rates may be higher in other African cities where AIDS has been found for a longer time than in Abidjan.

Acquired Immunodeficiency Syndrome↗
PubMed1990

A comparison of HIV-1 and HIV-2 infections in hospitalized patients in Abidjan, Côte d'Ivoire.

In late 1988, a cross-sectional study of 1715 adult medical patients hospitalized in Abidjan, Côte d'Ivoire, west Africa, showed an overall prevalence of HIV infection of 46% in men and 28% in women. On the basis of specific testing by whole virus enzyme-linked immunosorbent assay (ELISA), Western blot and synthetic peptide ELISA, HIV-1 infection was found in 25%, HIV-2 infection in 4%, and reactivity to both viruses in 11% of male and female patients combined. People infected with HIV-2, as well as those who were reactive to both HIV-1 and HIV-2, had a frequency of AIDS-associated symptoms and signs similar to that in HIV-1-infected patients, and significantly greater than that in seronegative patients. The significance of dual reactivity, and the natural history and disease spectrum of HIV-2 infection, require further study. Synthetic peptide ELISA is valuable for specific serodiagnosis of HIV-1 and HIV-2 infections. Advanced HIV-2 infection in hospitalized patients in Abidjan is associated with the same symptoms and signs as HIV-1 infection.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Rapid and specific diagnosis of HIV-1 and HIV-2 infections: an evaluation of testing strategies.

To identify cost-effective testing strategies for HIV-1 and HIV-2 infections, we evaluated different combinations of tests on serum specimens from 1134 consecutive patients attending tuberculosis treatment centers in Abidjan, Côte d'lvoire. Virus-specific whole-virus enzyme-linked immunosorbent assay (WVE), Western blot (WB) and synthetic peptide enzyme-linked immunosorbent assay (SPE) were used in sequential fashion to determine the true prevalence of infection; 27% were reactive to HIV-1, 5% to HIV-2, and 10% to both viruses. Of 239 specimens positive on WB for both HIV-1 and HIV-2, SPE diagnosed 38% as HIV-1-reactive and 16% as HIV-2-reactive, while 46% remained reactive to both viruses. Using WVE or one of two rapid (5-10 min) mixed (HIV-1 and HIV-2) antigen tests (RMATs) as a screening test, followed by SPE as a supplemental test, gave results with sensitivity of 97.3-99.2%, specificity of 99.5-99.7%, and positive predictive value for diagnosing HIV infection of 99.4-99.6%, with important savings in time and reagent costs. SPE allows more specific distinction between HIV-1 and HIV-2 infections than WB, and could replace it as a supplemental test in many settings. WB may be required for specimens reactive on screening tests but negative on SPE, until sensitivity of the SPE is further evaluated. A mixed antigen screening test followed by SPE seems to be an efficient testing strategy for diagnosing HIV-1 and HIV-2 infections.

Blotting, Western↗
PubMed1989

Rapid emergence of AIDS in Abidjan, Ivory Coast.

Between July and November, 1988, 1501 consecutive adult medical admissions to the two largest hospitals in Abidjan, Ivory Coast, were studied. The overall prevalence of infection with human immunodeficiency virus (HIV) types 1 and 2 was 43% in hospital A and 28% in hospital B. AIDS accounted for 19% and 9%, respectively, of medical admissions to the two hospitals, and for 33% of medical deaths in hospital A. The risk of death was significantly higher in HIV-seropositive patients with acquired immunodeficiency syndrome (AIDS) (risk ratio 2.5, 95% confidence interval [CI] 2.0-3.2) and in HIV-positive patients who did not meet the AIDS case-definition (risk ratio 1.7, 95% CI 1.3-2.3) than HIV-negative patients. The male/female ratio of the 265 cases of AIDS identified was 4.8. 50% of patients with AIDS were seropositive for HIV-1 only, 4% for HIV-2 only, and 46% reacted serologically to both viruses. The minimum incidence of AIDS in adult male and female residents of Abidjan (per million per year) is estimated at 1447 and 340 cases, respectively. AIDS in this West African city has emerged as a major public health problem.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Determinants of exercise capacity in hypertrophic cardiomyopathy.

Exercise capacity in hypertrophic cardiomyopathy is thought to relate to elevated left atrial pressure as a consequence of impaired diastolic function, but this assumption has not previously been evaluated. Twenty-three patients with hypertrophic cardiomyopathy underwent hemodynamic assessment during symptom-limited maximal exercise with objective measurement of exercise capacity by respiratory gas analysis. Maximal oxygen consumption and anaerobic threshold were 28.1 +/- 7.5 and 21.5 +/- 6.1 ml/kg per min, respectively (the lower limit of reference range in our laboratory is 39 and 27 ml/kg per min, respectively). Maximal oxygen consumption was reduced in 11 of 13 patients who were in New York Heart Association functional class I and who denied limitation of exercise capacity and in all 10 patients who were in functional class II or III. Maximal oxygen consumption and anaerobic threshold were related to peak cardiac index (r = 0.650, p less than 0.001 and r = 0.459, p = 0.03, respectively) and to the increase in cardiac index on exercise (r = 0.677, p less than 0.001 and r = 0.509, p = 0.016, respectively), but not to cardiac index at rest, peak and rest pulmonary capillary wedge pressure, pulmonary capillary wedge pressure at an oxygen consumption of 15 ml/kg per min or the rise in pulmonary capillary wedge pressure on exercise. These findings are not consistent with the hypothesis that elevated left atrial pressure is the major determinant of exercise capacity in patients with hypertrophic cardiomyopathy and they suggest that, as in patients with chronic cardiac failure, other mechanisms should be considered.

Adult↗
PubMed1986

Staphylococcus epidermidis in diabetic urological patient.

We present 6 patients in whom prosthetic failure occurred because of sepsis owing to Staphylococcus epidermidis. Such failure occurs in grafts in other areas and is caused by the high resistance of the organism to conventional antibacterial measures. Therapy with appropriate antibiotics, that is aminoglycosides, vancomycin and rifampin, and the need for an early operation are stressed.

Adult↗
PubMed1986

Tobacco and ethics.

Tobacco is both dangerous and addictive. Its production and use thus raise ethical questions which involve the smoker, parents, teachers, producers, distributors and the State. The moral responsibilities of the various parties are examined critically and legal restrictions are considered to be justified.

Ethics↗
PubMed1985

Performance of five thyroid-function tests by radioimmunoassays with antibodies attached to paramagnetic micro-particles.

We have assessed the analytical and clinical performance of five thyroid-function tests by commercially available radioimmunoassays in which antibodies attached to paramagnetic micro-particles are used (Corning MAGIC assays). We evaluated the methods for measuring thyroxin, triiodothyronine, triiodothyronine uptake, thyrotropin (thyroid-stimulating hormone), and free thyroxin. Precision, patients' results, and clinical correlation of the MAGIC assays were similar to those of the well-established RIAs used as the comparative methods in this study; the MAGIC assays, however, are much faster and easier to perform.

Evaluation Studies as Topic↗