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Biomedical subjects

A Shah

Publications and source records attributed to A Shah.

At least 325 records · Page 18Linked to original sources

Sensitization to Aspergillus antigens in perennial rhinitis.

This study was conducted to determine the frequency of sensitization to Aspergillus antigens in 27 patients with perennial rhinitis. Immediate cutaneous reactivity was observed in 7 (26%) patients. In 3 of these 7 patients, hypersensitivity was restricted to Aspergillus antigens alone. One patient had an isolated late cutaneous reaction. Hypersensitivity was observed most commonly with A. flavus. Serum precipitins to A. flavus were detected in one patient. It is possible that sensitization to Aspergillus antigens may play an important role in the causation of perennial rhinitis and could also increase the risk of developing other Aspergillus associated hypersensitivity respiratory disorders subsequently.

Adolescent↗

A study of colorectal adenocarcinoma.

One hundred and seven patients with resected colorectal adenocarcinoma were studied between 1983 and 1987. These formed 3.3% of all cancer cases and 19.4% of gastrointestinal malignancies seen during the period. A majority of patients (68.7%) were between 41 and 60 years of age; 31.8% were below the age of 40 years. There was a male preponderance (62.6%). Left sided cancers were more common (65.4%). The predominant histologic patterns were well differentiated adenocarcinoma (72%) and mucinous carcinoma (20.6%). Mucinous carcinoma was more common on the left side. A majority of cases (95.3%) were in Duke's stages B and C. Only 2.8% of cases were confined to the mucosa.

Adenocarcinoma↗

Recurrent anaphylaxis to a depot form of GnRH analogue.

Experience with depot forms of hormonal preparations suggests that severe adverse reactions are infrequent and immediate hypersensitivity reactions are rare. We report a case of recurrent anaphylaxis to a depot form of GnRH analogue requiring both acute and chronic management.

Adult↗

The impact of pulmonary infections on the survival of lung cancer patients.

To determine the impact of pulmonary infections on survival in patients with lung cancer, a retrospective review of the records of 121 such patients treated at Howard University Hospital in Washington, DC, was done. There were 77 men and 44 women; 118 were black. The mean age was 63.5 years. Forty-three patients had squamous cell carcinoma, 31 had adenocarcinoma, 18 had large cell carcinoma, 19 had small cell carcinoma, and ten were unclassified. The stages were as follows: two patients in Stage 0, 15 in Stage I, seven in Stage II, 45 in Stage III, and 44 in Stage IV. Eight patients could not be staged at diagnosis. Eighty-five patients (70%) had documented infections; 37 had single episodes; and 48 had more than one. The five most common organisms recovered were alpha/gamma streptococci, Staphylococcus aureus, Klebsiella pneumoniae, Enterobacter aerogenes, and Pseudomonas aeruginosa. The median survival of all infected patients was 4.2 months which was significantly shorter than that of uninfected patients who had a median survival of 12.9 months (P less than 0.05). When Stage III patients were analyzed separately, infected patients lived a median of 5.8 months and uninfected patients, 13.4 months (P less than 0.05). This study indicated that pulmonary infections frequently occur in patients with lung cancer and suggested that they may adversely affect survival.

Bacterial Infections↗

Magnetic resonance imaging of bone marrow in sickle cell disease: clinical, hematologic, and pathologic correlations.

A longitudinal, prospective, controlled evaluation of magnetic resonance images (MRI) of long bones in sickle cell patients was undertaken simultaneously with assessment of clinical status and hematologic parameters, including dense erythrocytes. MRI of bone marrow in sickle cell patients during steady states appeared patchy and were markedly different from those in matched controls (P approximately 0). Patients with severe patchiness were older than those with mild or moderate patchiness (P less than .03). Sixty-nine MRI were performed during 28 painful episodes occurring in 14 subjects with sickle cell disease (SCD). Increased signals on intermediate and T2-weighted images were detected in 35.7% of painful episodes. These abnormalities were distinct and not observed to occur spontaneously during the steady-state examinations (P approximately 0). Bone marrow infarcts were confirmed by biopsy in two instances and autopsy in one instance. Dense red cells decreased by 40.81% of baseline during pain crises (P = .00005), more remarkably in those who had pain in the lower extremities (P = .0145). Patients with change in MRI during pain crises had a greater percentage change in the dense cells than those without the change in MRI (69.7% v 31.3%, P = .0120).

Anemia, Sickle Cell↗

Striatal function in normal aging: implications for Parkinson's disease.

Central to several current theories of the etiology of Parkinson's disease is the premise that the nigrostriatal dopaminergic system degenerates with normal aging. Much of the evidence for this assertion has come from postmortem neurochemical studies. We have used L-6-[18F] fluoro-Dopa and positron emission tomography in 26 healthy volunteers (age range, 27-76 years) to examine striatal and frontal cortical tracer uptake. Data have been analyzed by using a graphical approach to calculate an influx constant (Ki) for L-6-[18F]fluoro-Dopa uptake into the caudate, putamen, and medial frontal cortex of each subject. In the population studied, there was no decline in Ki with age for any of these structures. A series of physiological measurements made on the older subjects also showed few significant changes with age. The positron emission tomographic findings demonstrate preservation of nigrostriatal dopaminergic function in normal aging. The pathological process causing Parkinson's disease may operate closer to the time of presentation than has been suggested.

Adult↗

Ito-cell gene expression and collagen regulation.

Ito cells are perisinusoidal cells thought to be a major source of collagen in normal and fibrotic livers. These cells appear to have features similar to several cell types but when cultured assume a fibroblast-like morphology. In this study we evaluated the phenotype of both freshly isolated and cultured Ito cells by examining their gene expression. To better define the modulators of Ito-cell collagen synthesis, we also examined the effect of transforming growth factor-beta 1, tumor necrosis factor-alpha and dexamethasone on collagen synthesis by these cells. Northern hybridization analysis revealed that cultured Ito cells expressed different types of procollagen mRNAs than did freshly isolated cells. Cultured cells contained large amounts of type I procollagen mRNA and lesser amounts of types III and IV, whereas freshly isolated cells contained more type IV procollagen mRNA than types I and III. Treatment of cultured cells with either transforming growth factor-beta 1 or tumor necrosis factor-alpha resulted in a greater than three-fold increase in total collagen content, and the effects of these cytokines on Ito-cell collagen synthesis involved different levels of gene regulation. Transforming growth factor-beta 1-treated cells had an approximately threefold increase in their type I procollagen mRNA levels, whereas no increase in this mRNA level was found in tumor necrosis factor-alpha-treated cells. Transforming growth factor-beta 1 treatment induced a twofold increase in transforming growth factor-beta 1 mRNA content in cultured cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗

Plasma-level response relationships with fluoxetine and zimelidine.

The results of pharmacokinetic studies of two recent 5-HT uptake inhibitors, zimelidine and fluoxetine, have pointed to the inadequacy of open-dose rising studies for establishing the most appropriate dose of new antidepressants. High plasma concentrations of the active metabolites, norzimelidine and norfluoxetine, were associated with a poorer therapeutic response in patients suffering from major depression. High drug plasma concentrations are also associated with increased side effects. Large fixed-dose placebo controlled studies with fluoxetine have confirmed the findings of the small pharmacokinetic study that lower doses are more effective. Fixed-dose pharmacokinetic studies are recommended as part of the program to establish the best dose of new antidepressants.

Depressive Disorder↗

AIDS education in rural Uganda--a way forward.

A survey of acquired immunodeficiency syndrome (AIDS)-related knowledge and attitudes was conducted during July and August 1988 in rural SW Uganda. The aim was to assess the impact of Uganda's AIDS education programme and to consider how future programmes could be more effectively implemented. Four hundred and seventy-six individuals aged 12-45 years were selected by a quota method, to form a sample stratified by age and sex. Mass AIDS education has successfully raised levels of knowledge but misconceptions persist. However, it has failed, firstly, to stress the urgency of AIDS as a personal issue, and secondly, to change negative attitudes toward people with AIDS: 57% would avoid or stigmatise an individual with AIDS. Unexpectedly, findings show that a correlation exists (P less than 0.05) between high levels of 'correct' beliefs and negative attitudes toward people with AIDS. To achieve future behavioural and attitude changes, possible ways forward for Ugandan AIDS education include involvement of HIV carriers in education, small-scale targetted approaches developed by active participation of the target group and through role playing of people with AIDS.

Acquired Immunodeficiency Syndrome↗

Pulmonary alveolar microlithiasis with pleural calcification and nephrolithiasis.

A case of pulmonary alveolar microlithiasis (PAM) with pleural calcification and nephrolithiasis is reported. The significance of peripheral white lines, a rarely reported observation on chest roentgenogram in PAM, is discussed. Extrapulmonary calcification in multiple sites raises the possibility of PAM being a systemic disorder.

Adult↗

Allergic bronchopulmonary aspergillosis and Candida albicans colonization of the respiratory tract in corticosteroid-dependent asthma.

Fungal studies were conducted on 35 patients with corticosteroid-dependent asthma (CSDA) and 20 asthmatics who had never received prednisolone. Candida albicans was repeatedly cultured from the sputa of 12 patients with CSDA. Isolation was more frequent in those patients who were receiving more than 10 mg prednisolone for more than six months. Nearly half of these patients demonstrated a positive immediate cutaneous reaction and precipitating antibodies against C. albicans. Although no pathological significance, beside colonization, could be attributed to this finding, it was felt that it would be prudent to restrict the daily dose of prednisolone to less than 10 mg, when administered for more than six moths. Two patients with allergic bronchopulmonary aspergillosis (ABPA), were identified, one from each group. The possibility of ABPA, however, remained open in two other patients with CSDA. It is probable that some patients with CSDA may be suffering from ABPA but characteristic features of the disease are masked by costicosteroid therapy, making it difficult to diagnose.

Adolescent↗

Normal versus sickle red blood cells: hemodynamic and permeability characteristics in reperfusion lung injury.

Decreased deformability and increased internal viscosity of the sickle red blood cell (SRBC) contribute to abnormal flow in the microcirculation. Since the lungs are commonly affected in sickle cell disease, we compared the hemodynamics of the normal human red blood cell (NRBC) with the SRBC in the pulmonary circulation. The SRBC has decreased antioxidant enzyme activities compared with the NRBC. Thus, using the capillary filtration coefficient (Kfc), we determined the ability of the NRBC and the SRBC to attenuate the increased permeability and resulting edema seen in the oxidant stress of reperfusion lung injury (RLI). We found that lungs perfused with a 5% SRBC perfusate had higher pulmonary arterial pressures (Ppa) and resistances than lungs perfused with a 5% NRBC perfusate. Lungs made ischemic and reperfused with a physiologic cell-free perfusate resulted in a significant increase (P less than .05) in Kfc compared with the preischemic Kfc (.45 +/- .06 to 1.4 +/- 22 mL.min-1.cm H2O.100 g-1). In lungs reperfused with 5% RBC-containing perfusates, the Kfc did not change from preischemic Kfc with NRBCs and decreased from the preischemic Kfc with SRBCs. These findings suggest that the SRBC causes physiologically significant increases in Ppa and resistances and the SRBC, like the NRBC, offers apparent protection in RLI.

Anemia, Sickle Cell↗