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Biomedical subjects

B J Hudson

Publications and source records attributed to B J Hudson.

At least 19 recordsLinked to original sources
PubMed1998

Culture-positive Lyme borreliosis.

We report a case of Lyme borreliosis. Culture of skin biopsy was positive for Borrelia garinii, despite repeated prior treatment with antibiotics. The patient had travelled in Europe 17 months before the onset of symptoms, but the clinical details indicate that the organism could have been acquired in Australia. The results of conventional serological and histopathological tests were negative, despite an illness duration of at least two years.

Adult↗
PubMed1998

Failure of penicillin treatment of yaws on Karkar Island, Papua New Guinea.

The endemic treponematosis yaws remains a significant cause of morbidity in many tropical countries, despite mass treatment campaigns to eradicate it. An outbreak of yaws in Marup village on Karkar Island, Papua New Guinea in 1988 provided an opportunity to monitor the outcome of treatment with penicillin over an extended period. Thirty-nine children with clinical yaws (6% of 632 examined) were monitored clinically and serologically, for nearly two years after mass treatment of all villagers with the World Health Organization recommended dosages of benzathine penicillin. Lesions resolved within one month of treatment in all but four (10%) children, three of whom were initially successfully retreated. Before treatment, the Venereal Disease Research Laboratory (VDRL) test result was reactive in 67% of the children and treponema-specific IgM antibody test results were reactive in 41%. Within six months of treatment, of those reactive, the VDRL titer decreased significantly in 25 (96%) of 26 and IgM antibody test results became negative in 13 (81%) of 16 children. However, by the end of follow-up, 11 (28%) of the 39 children had developed clinical and/or serologic evidence of relapse. In these children, response to further treatment was slow and, in three, evidence of active infection persisted or recurred, despite repeated courses. Exogenous reinfection was unlikely in this isolated community, in which the occurrence of yaws was closely monitored after universal treatment. Treatment failure was most likely to have been due to reduced susceptibility to penicillin of Treponema pallidum subsp. pertenue.

Adolescent↗
PubMed1997

Glomerulonephritis secondary to Barmah Forest virus infection.

Clinical infection with Barmah Forest virus (BFV) is becoming increasingly recognised with serological testing. We report the first case of glomerulonephritis after BFV infection. The patient required diuretic and antihypertensive therapy, but made an almost complete recovery. BFV infection should be considered in the differential diagnosis of glomerulonephritis.

Adult↗
PubMed1996

The emerging syndrome of envenoming by the New Guinea small-eyed snake Micropechis ikaheka.

The New Guinea small-eyed or ikaheka snake, Micropechis ikaheka, which occurs throughout New Guinea and some adjacent islands, is feared by the indigenes. The first proven human fatality was in the 1950s and this species has since been implicated in many other cases of severe and fatal envenoming. Reliable attribution of envenoming to this species in victims unable to capture or kill the snake recently became possible by the use of enzyme immunoassay. Eleven cases of proven envenoming by M. ikaheka, with two fatalities, were identified in Papua New Guinea and Irian Jaya. Five patients showed no clinical signs of envenoming. The other six patients showed symptoms typical of envenoming by other Australasian elapids: mild local swelling, local lymphadenopathy, neurotoxicity, generalized myalgia, spontaneous systemic bleeding, incoagulable blood and passage of dark urine (haemoglobinuria or myoglobinuria). Two patients developed hypotension and two died of respiratory paralysis 19 and 38 h after being bitten. In vitro studies indicate that the venom is rich in phospholipase A2, is indirectly haemolytic, anticoagulant and inhibits platelets, but is not procoagulant or fibrinolytic. It shows predominantly post-synaptic neurotoxic and myotoxic activity. Anecdotally, Commonwealth Serum Laboratories' (CSL) death adder antivenom has proved ineffective whereas CSL polyvalent antivenom may be beneficial. Anticholinesterase drugs might prove effective in improving neuromuscular transmission and should be tested in patients with neurotoxic envenoming.

Adult↗
PubMed1995

Evaluation of immunoglobulin G enzyme immunoassay for serodiagnosis of yaws.

A commercially available enzyme immunoassay (EIA), the Captia Syphilis-G immunoglobulin G (IgG) EIA, for the detection of IgG antibodies to Treponema pallidum was evaluated for use as a screening test for yaws (Treponema pallidum subsp. pertenue). The IgG EIA was compared with the fluorescent treponemal antibody absorption (FTA-ABS) test. All sera were also examined by the T. pallidum hemagglutination test and the Venereal Disease Research Laboratory test. Serum samples from 271 subjects (23 control serum samples from an area nonendemic for yaws, 58 control serum samples from an area endemic for yaws, and 190 serum samples from yaws patients and contacts) were investigated. The overall agreement between the IgG EIA and the FTA-ABS test was 90%, the sensitivity was 99%, and the specificity was 70.2%. The specificity fell as the endemicity of the disease increased: from 94.4% in the nonendemic area controls to 86.4% in the endemic area controls and to 52.3% in the yaws contacts. There was no difference in specificity between children and adults within each of the three groups. Fifteen children with clinical yaws were monitored for 9 months after treatment. The level of treponemal antibody fell consistently in 9 of the 15 children as measured by the antibody index (ratio of absorbance of the test serum to the mean absorbance of the low-titer-positive controls). Reinfection was seen in three children, with the antibody index rising with the Venereal Disease Research Laboratory test titer. The Captia Syphilis-G test is a sensitive assay for the detection of treponemal antibodies in yaws patients. However, the apparent low specificity of the test in the yaws endemic area limits its use as a screening test for yaws.

Adult↗
PubMed1994

A survey of sexually transmitted diseases in five STD clinics in Papua New Guinea.

The first multicentre survey of sexually transmitted diseases (STDs) performed in Papua New Guinea was conducted in STD clinics in five towns, Port Moresby, Goroka, Rabaul, Lae and Daru, from September 1989 to May 1990. Infections with Neisseria gonorrhoeae and Chlamydia trachomatis (alone or in combination) were common. Penicillinase-producing N. gonorrhoeae (PPNG) represented 44% of all gonococcal isolates but significant intrinsic resistance to penicillin was not found. Of the other antibiotics tested, significant elevation of minimum inhibitory concentration (MIC) was common only for tetracycline, although no high-level tetracycline resistance was detected. C. trachomatis was detected by direct immunofluorescence (DIF) in 26% of 210 males and 27% of 64 females. 10% (21/210) of males and 11% (7/64) of females were both DIF positive for C. trachomatis and culture positive for N. gonorrhoeae. Of 203 males and 78 females tested, 5% and 12%, respectively, had serological evidence of current syphilis infection. Clinically, genital ulcer disease was most commonly due to syphilis, donovanosis or genital herpes, while specific vaginal infections were commonly seen in female patients attending Port Moresby and Lae STD clinics.

Anti-Bacterial Agents↗
PubMed1993

Arthritis in the highlands of Papua New Guinea.

Acute polyarthritis is an important cause of morbidity in many tropical countries. Classification has often been difficult, with the term tropical polyarthritis used for those in whom a diagnosis could not be made. The implication that this is a distinct entity is probably incorrect, with likely causes being septic arthritis or post-infective reactive arthritis. This study aimed to determine the types of arthritis found in 43 patients (30 men) presenting consecutively to the Goroka Base Hospital in the Eastern Highlands of Papua New Guinea. Gonococcal arthritis was diagnosed in eight patients (six men) on the basis of isolation of Neisseria gonorrhoeae from the joint aspirate. In all cases the N gonorrhoeae was identified by the closed culture system on chocolate agar, but not always by routine plating. There were no specific clinical features that identified patients with a gonococcal septic arthritis. The remaining 34 patients had an undifferentiated oligoarthritis. The pattern of arthritis in men and women was of a lower limb pauciarticular arthritis with a predilection for the knee and ankle joints. A total of 30% of male patients had a history of urethral discharge and 44% of all patients had preceding diarrhoea. Arthritis was the only feature in 59% of patients and in 32% there was an associated enthesitis. In this study most patients had an oligoarthritis consistent with a reactive arthritis or a septic arthritis due to N gonorrhoeae. Broth inoculation of synovial fluid was the best method to isolate N gonorrhoeae, with standard methods for gonococcal isolation failing in some patients. It is recommended that the term 'tropical polyarthritis' is no longer used as it does not refer to a specific entity but consists of several known arthritides.

Acute Disease↗
PubMed1992

Modified indirect hemagglutination test for detection of treponemal antibodies in finger-prick blood.

A modified indirect hemagglutination test for the detection of treponemal antibodies was developed for use with finger-prick blood. By using paired serum and absorbed finger-prick blood from 58 patients from an area previously endemic for yaws and 12 patients without yaws, the modified hemagglutination test was compared with a hemagglutination test for Treponema pallidum and the fluorescent treponemal antibody absorption test. The modified hemagglutination test showed 100% specificity and an overall agreement of 96.5% with the hemagglutination test for T. pallidum and 94.8% with the fluorescent treponemal antibody test. The modified hemagglutination test appears to be a simple and economical test that is suitable for use in large epidemiological surveys for yaws.

Adult↗
PubMed1992

Precipitation of asthma attacks in Melanesian adults by sodium metabisulphite.

Seven Melanesian asthmatic patients were challenged with substances that have been shown to precipitate asthma attacks in asthma patients in developed countries. Patients were challenged in a double-blind fashion using placebo and active substances. The active substances were tartrazine, sodium metabisulphite, aspirin and betel nut. All 7 patients were challenged with tartrazine and sodium metabisulphite; 5 were challenged with aspirin also, but only 2 were challenged with betel nut. Asthma attacks were precipitated by sodium metabisulphite in 3 patients. No other substances precipitated asthma. As sodium metabisulphite is a common food additive, these results suggest that processed foods introduced into developing countries may have an important role in precipitating asthma attacks in susceptible persons.

Adult↗
PubMed1991

An epidemiological study of snake bite envenomation in Papua New Guinea.

We report a study of 347 patients with snake bite envenomation in Papua New Guinea. The male: female ratio of the victims was 1.6:1 and their mean age was 24.5 years; 26% were children less than 15 years old. In all cases in which the bite site was known (334) the snake had bitten the extremities of the victim, with 71.3% of these bites being on the ankle or below. The patients came from three regions: urban Papua, rural Papua and (mostly rural) New Guinea. Snake bites occurred more frequently during the daytime in all regions, but this pattern was less obvious in New Guinea (P = 0.004), reflecting the predominance of the death adder (Acanthophis antarcticus) in New Guinea and of the taipan (Oxyuranus scutellatus canni) in Papua. Bites were commoner in the rainy season (November to April) in all groups, but this was less noticeable in rural Papua and New Guinea (P = 0.004). This may relate to seasonal activities of the rural population. The female:male ratio for patients from rural areas was higher for those 30 years of age and over than for those under 30 (P = 0.034), probably reflecting the increased gardening workload of older women. The incidence of envenomation and mortality rates after snake bite in Papua appear to have changed little over 25 years. However, increased relative numbers of taipans seem to be occurring in central Papua possibly related to the cane toad (Bufo marinus) and deforestation. We calculate the annual incidence of envenomation and the mortality rate per 100,000 to be 81.8 and 4.3, respectively, for rural central Papua, 21.8 and 2.1 for urban central Papua, and 3.0 and less than 1.0 for the Madang region of New Guinea. The importance of a standard management protocol and of improved first aid are emphasised.

Adolescent↗
PubMed1991

Preproduction quality assurance: quality intrinsic to design.

The Safe Medical Devices Act of 1990 made important changes to the Federal Food, Drug, and Cosmetic Act's provisions governing medical devices and in vitro diagnostics. Not the least of these changes is the addition of preproduction design validation "including a process to assess the performance of a device but not including an evaluation of the safety or effectiveness of a device," under the good manufacturing practice (GMP) regulation. Combining this new law with the existing GMP regulation on manufacturing operations yields the beginning of total quality management (TQM).

Equipment Design↗