Search PubMed⌕ Search

Biomedical subjects

C A Hart

Publications and source records attributed to C A Hart.

At least 235 records · Page 13Linked to original sources
PubMed1995

Reproductive tract infections and abortion among adolescent girls in rural Nigeria.

Few studies from developing countries have investigated reproductive tract infections or other indicators of sexual health among unmarried adolescent girls in rural areas. We have obtained baseline demographic, clinical, and microbiological data on reproductive tract infections and induced abortion in girls in a rural area of southeast Nigeria, in order to assess the need for health care for adolescents. 868 females attended for interview and examination: 458 aged 20 and above and 410 aged 12-19, the latter representing 93.4%of the adolescent population. 43.6% of those < 17 and 80.1% aged 17-19 years were sexually active and at least 24.1% had undergone an induced abortion; only 5.3% had ever used a modern contraceptive. Vaginal discharge was reported by 82.4%, though few sought treatment. 94.1% of sexually active adolescents and 97.6% of sexually active women 20 years old or over were gynaecologically examined and screened for reproductive tract infections. Of those aged less than 17, 19.8% had symptomatic candida and 11.1% trichomonas infections. Among those aged 17-19 years, chlamydia was detected in 10.5%, and symptomatic candidosis in 25.6%; this was the group most likely to have any infection (43.8%). 42.1% of sexually active adolescents had experienced either an abortion or a sexually transmitted disease. Syphilis was the only infection for which the incidence clearly increased with age. Health-care services for adolescents in this community are needed and should include sex education, contraceptive provision (especially barrier methods), and access to treatment for reproductive tract infections. Investments in health for this age group will have an effect on subsequent reproductive health.

Abortion, Induced↗
PubMed1995

The changing presentations of meningococcal disease.

UNLABELLED: Meningococcal disease (MCD) can present as meningitis, meningitis plus septicaemia or septicaemia alone. This 17-year retrospective study sought to determine if the proportion of cases presenting as septicaemia alone was increasing. Four hundred and forty-nine children with MCD were admitted between 1977 and 1993, 50 children died (11%). The proportion of cases with septicaemia alone increased from 7% in 1977-1985 to 36% in 1990-1993 (P < 0.0005). Mortality was highest in children with septicaemia alone (19%). Despite the increase in septicaemia, overall mortality did not alter over the 17 years. CONCLUSION: MCD should not be thought of as "meningitis", since 33% of cases now present as septicaemia alone. Nearly one in five children with septicaemia alone die. Information and publicity about MCD should focus on septicaemia, characterised by a petechial rash, as the life-threatening presentation.

Bacteremia↗
PubMed1995

Effects of concanavalin A and pokeweed lectins on microvillar membrane proteins during the organ culture of rabbit intestinal mucosa.

The effects of pokeweed lectin (PWL) and concanavalin A (Con A) on microvillar membrane (MVM) proteins during the organ culture of rabbit ileal explants for 24 hours were compared with the known effects of enteropathogenic Escherichia coli (EPEC). PWL resulted in the accelerated release of brush border enzymes into the culture medium, accompanied by decreased tissue activities and an increase in the total activity present in the tissue and culture medium. Con A had less effect on the release and tissue activities of brush border enzymes and the total activity was not increased. Sucrose density gradient centrifugation of the culture medium showed that MVM enzymes were predominantly particulate, consistent with their release as vesicles. Centrifugation of ileal explants showed that PWL, but not Con A, resulted in a decrease in the modal density of the brush border which was consistent with a lower glycoprotein-to-lipid ratio. These findings suggest that PWL, in common with EPEC, may cause the disruption and vesiculation of microvilli and the compensatory stimulation of MVM protein synthesis.

Animals↗
PubMed1995

Stimulation of rotavirus IgA, IgG and neutralising antibodies in baboon milk by parenteral vaccination.

A rhesus rotavirus vaccine adjuvanted with ISCOMs was injected intramuscularly to 5 pregnant baboons, with repeated doses 1-2 and 14 weeks after delivery. Maternal blood and milk samples and blood samples from their babies were collected at 2-weekly intervals until 26 weeks after parturition. Samples were assayed for rotavirus antibodies by ELISAs and neutralisation tests. Vaccination produced statistically significant increases in maternal serum IgG and neutralising antibodies, and in milk IgA, IgG, and neutralising antibodies. Control baboon mothers sampled from 12 weeks after delivery had lower serum and milk antibody titres, but responded to vaccination at 16 weeks by producing a similar antibody profile in serum and milk to those previously vaccinated. Because of the endemic nature of human rotaviral infections, similar maternal vaccinations have potential as a means of increasing milk antibodies to a level at which they may be protective to infants.

Animals↗
PubMed1995

The use of sputum induction for establishing a diagnosis in patients with suspected pulmonary tuberculosis in Malawi.

SETTING: There has been a marked increase in notified cases of smear-negative pulmonary tuberculosis in Malawi since 1986. One reason for this may be related to the difficulties of getting adequate samples of expectorated sputum from patients. Sputum induction with nebulized hypertonic saline may be a simple way of obtaining a better specimen. OBJECTIVE: To examine the value of sputum induction for detecting cases of smear-positive tuberculosis. DESIGN: Sputum induction was performed on 82 adults presenting to the Queen Elizabeth Central Hospital, Blantyre, Malawi with clinically suspected pulmonary tuberculosis who were expectorated sputum smear-negative or unproductive of sputum. The induced sputum smear was examined for acid-fast bacilli and cultured for mycobacteria. RESULTS: Sputum was successfully induced from 73 of the 82 patients (26 previously smear-negative and 47 previously unproductive). The induced sputum was smear-positive in 18 patients (5 previously smear-negative and 13 unproductive). Cultures were positive for Mycobacterium tuberculosis in the 18 smear-positive patients and a further 12 that had been smear-negative. 94 cases of smear-positive pulmonary tuberculosis were notified during the study period. 18 (19%) were as a result of sputum induction. CONCLUSION: Sputum induction is a useful technique for improving the case detection rate of smear-positive tuberculosis in Malawi.

Adolescent↗
PubMed1995

Tumour necrosis factor, interleukin-6 and C-reactive protein in patients with louse-borne relapsing fever in Ethiopia.

The serum concentrations of tumour necrosis factor (TNF), interleukin-6 (IL-6) and C-reactive protein (CRP) were studied in 25 patients with louse-borne relapsing fever, to evaluate their association with the level of bacteraemia, anti-borrelia chemotherapy and the presence of a Jarish-Herxheimer reaction (JHR). Although there was an association between the level of bacteraemia and the development of JHR and complications during treatment, TNF, IL-6 and CRP concentrations were not associated with the JHR. TNF concentrations increased after the administration of antibiotics and remained high for 24 h. IL-6 was elevated on admission but soon decreased. CRP was high on admission and remained so throughout the illness. The observed elevations in TNF, IL-6 and CRP may be associated more with the administration of antibiotics than with the presence of a JHR.

Adolescent↗
PubMed1995

The prevalence and clinical features of multi-drug resistant Salmonella typhi infections in Baluchistan, Pakistan.

Between January and July 1994, a prospective study of bacteraemia in 692 patients with fever without localizing signs was undertaken at the Quetta Military Hospital in Baluchistan, Pakistan. Salmonella spp. were isolated from 76 (11%) of the patients; 62 had S. typhi and 14 had S. paratyphi A. Significantly more isolations of S. typhi were made in the hot dry months of May and June than in the earlier months. Although multi-drug resistance (to chloramphenicol ampicillin and cotrimoxazole) was detected in 43 (69%) of the S. typhi isolates, it was not found in any of the S. paratyphi A. Defervescence of patients with chloramphenicol-sensitive S. typhi took 7-10 days of chloramphenicol therapy. In contrast, most (91%) of the patients infected with multi-drug resistant S. typhi who were treated with fluoroquinolones achieved defervescence in 1-3 days; the remainder took 4-6 days.

Adolescent↗
PubMed1995

Rotavirus diarrhoea in Thai infants and children.

One hundred and three children aged from 1 month to 5 years were assessed for human rotavirus (HRV) infection over a 5-week period at Children's Hospital, Bangkok. HRV was present in 18% and adenovirus in 10.7% of the children with gastro-enteritis. None of the controls excreted HRV. Vomiting and dehydration were significantly associated with HRV diarrhoea. A comparison of the reliability of the detection methods showed the following sensitivities: RNA-polyacrylamide gel electrophoresis (PAGE) 90%, electron microscopy (EM) 84% and Rotascreen latex particle agglutination (LPA) 80%. PAGE and EM were 100% specific while the Rotascreen LPA was 81% specific. Rotascreen LPA gave 15.5% false positive results. Of the HRV positive samples analyzed by PAGE, 5.3% and 94.7% were of subgroups I and II, respectively. The ID enzyme immunoassay and PAGE are reliable and inexpensive methods which can be recommended for HRV detection, particularly in areas with little technical support.

Agglutination↗
PubMed1995

Eradication of nasopharyngeal carriage of Neisseria meningitidis in children and adults in rural Africa: a comparison of ciprofloxacin and rifampicin.

A randomized comparative study of rifampicin and ciprofloxacin for eradicating nasopharyngeal carriage of meningococci was undertaken in Malawi. Of 1878 contacts of persons with meningococcal meningitis, 1875 were evaluatable for safety and efficacy of the drugs. Rifampicin was given to 836 contacts, ciprofloxacin to 711, and ceftriaxone to 328 (children < 2 years old or pregnant or lactating women). One and 2 weeks after therapy, side effects in those given rifampicin and ciprofloxacin were not significantly different. In the ciprofloxacin group, with 470 subjects < 18 years old, only one event (mild abdominal pain) occurred that was related to the drug. Nasopharyngeal carriage was detected in 88 (10.5%) of those given rifampicin, 79 (11.1%) given ciprofloxacin, and 41 (12.5%) given ceftriaxone. Eradication rates after 1 and 2 weeks of treatment, respectively, were 96.5% and 97.7% for rifampicin, 88.6% and 91.1% for ciprofloxacin, and 95.1% and 97.6% for ceftriaxone. Ciprofloxacin provides a safe and effective alternative to rifampicin for eradication of meningococcal carriage in children 2-18 years old.

Adolescent↗
PubMed1995

Application of organ culture of small intestine to the investigation of enterocyte damage by equine rotavirus.

We used organ culture of jejunal mucosal explants obtained from ponies aged between 2 and 12 months to study enterocyte damage by group A strains of equine rotavirus. Electron microscopy of jejunal explants maintained for < or = 48 h in the presence of organ culture medium alone showed that enterocytes were structurally intact and had a densely packed brush border and overlying mucus. Similarly, examination of explants maintained in the presence of rotavirus for 48 h revealed no apparent ultrastructural abnormalities. However, obvious replication and assembly of virus in enterocytes had occurred following exposure to equine rotavirus strains H2 (three of eight occasions), trypsin-activated H2 (two of four), L338 (five of five), and EQ124 (two of two), although brush borders and intracellular organelles appeared unaltered. Despite the absence of obvious ultrastructural damage, analytical subcellular fractionation showed that rotavirus infection can result in decreased activities of microvillar membrane enzymes, with a particular loss of the main brush border peak of modal density 1.21 g/ml. These findings demonstrate that organ culture of small intestine may be applied to the investigation of rotavirus pathogenicity; they further suggest that certain strains impair enterocyte function by affecting the turnover of microvillar membrane proteins.

Alkaline Phosphatase↗
PubMed1995

Lactobacillus GG promotes recovery from acute nonbloody diarrhea in Pakistan.

A prospective, placebo-controlled, triple blind clinical trial was carried out in Pakistan to determine the effect of Lactobacillus GG on the course of acute diarrhea in hospitalized children. Forty children (mean age, 13 months) were enrolled and after rehydration received either oral Lactobacillus GG (n = 21) or placebo (n = 19) twice daily for 2 days, in addition to the usual diet. The clinical course of diarrhea was followed during the treatment period. Features on admission into the study groups were similar and were characterized by severe diarrhea, malnutrition and inappropriate management before presentation. Response was evident on Day 2 when the frequency of both vomiting and diarrhea was less in the Lactobacillus group. In those who had presented with acute nonbloody diarrhea (n = 32), the percentage of children with persistent watery diarrhea at 48 hours was significantly less in the Lactobacillus group: 31% vs. 75% (P < 0.01). No significant difference was observed by 48 hours in those presenting with bloody diarrhea. The relevance of this finding to the management of diarrhea in the tropics is discussed.

Acute Disease↗
PubMed1995

The production of neuraminidase and fucosidase by Helicobacter pylori: their possible relationship to pathogenicity.

The pathogenicity of enterobacteria often correlates with their production of neuraminidase (sialidase). Forty-nine Helicobacter pylori isolates have therefore been examined for their production of neuraminidase and other glycosidases. All 49 isolates produced considerable neuraminidase (median 228 IU/microg protein, interquartile range 121-370), pH optimum 7.5. Nine of the 49 also produced fucosidase (median 23 IU/microg protein, interquartile range 12-39), pH optimum 7.0. Production of these enzymes did not correlate with bacterial Cag A expression or duodenal ulceration. Neutrophils exposed to neuraminidase show increased adherence to endothelium so the neuraminidase production by H. pylori could partly explain the predominant neutrophil inflammatory infiltrate seen in H. pylori-associated gastritis. Inhibition of this enzyme by use of neuraminidase-inhibitors could be a useful therapeutic approach.

Adult↗