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Biomedical subjects

C Childs

Publications and source records attributed to C Childs.

At least 37 records · Page 2Linked to original sources
PubMed1994

Patterns of Staphylococcus aureus colonization, toxin production, immunity and illness in burned children.

Toxic shock syndrome toxin-one (TSST-1) produced from some but not all strains of Staphylococcus aureus is considered to be responsible for the development of the serious illness, toxic shock syndrome (TSS). The aim of this study was to establish the importance of S. aureus in the aetiology of suspected cases of TSS in acutely burned children. The pattern of colonization of S. aureus, and in particular toxic shock syndrome toxin-one (TSST-1) producing isolates, was studied in 53 burned children admitted as consecutive cases. S. aureus was not normally present on admission. Although it was the most common wound pathogen, it was acquired during the first few days after admission. Antibody status to TSST-1 on admission and at discharge was determined. Only half (49 per cent) of the children had antibodies to TSST-1. When it was possible to obtain paired admission and discharge samples in patients who had been given blood products, an assessment of seroconversion could be made. Two of the four patients given blood products during the resuscitation and postoperative period were antibody negative on admission (the other two were TSST-1 antibody positive). By discharge they had antibodies to TSST-1. Whilst the majority of donated blood products had antibodies to TSST-1 (76 per cent), some (24 per cent) did not. Seven of 53 children (13 per cent) developed a toxic shock-like illness which caused clinical concern.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Bacterial↗
PubMed1994

Acute changes in oxygen consumption and body temperature after burn injury.

This study describes the pattern of oxygen consumption (VO2), rectal temperature (Tr), and acral skin temperature (Tac) in sleeping and resting (awake) burned children nursed in a thermoneutral environment. Measurements of respiratory gas exchange (VO2 and carbon dioxide production (VCO2)) were made using an open circuit, flow through system of indirect calorimetry. Tr and Tac were monitored continuously. Sixteen patients were studied during the first 18 hours after being burned. Three phases of change in VO2, Tr, and Tac are described. The first was a stable period and there was little change from admission values. The second (7-10 hours after burn) was a phase of rapid heat storage. It started with a fall in Tac. Peak values of Tr (38.8-41.1, median 40.0 degrees C) and VO2 (8.5-11.8 ml/min/kg) occurred either in phase 2 or in the later phase 3. At its peak VO2 was 12-61% above values in phase 1. In phase 3, Tac returned towards admission values but Tr and VO2 were variable. These changes suggest that both an increase in metabolic heat production as well as heat conservation at the extremities may be involved in the generation of early fever after a burn.

Body Temperature↗
PubMed1993

Metabolic rate at rest and during sleep in a thermoneutral environment.

This study characterised the pattern of oxygen consumption (VO2) in healthy infants and children asleep and awake (at rest) in a thermoneutral environment. Measurement of respiratory gas exchange (VO2 and VCO2) was made using an open circuit flow through system of indirect calorimetry with a specially designed facemask for the collection of exhaled breath. Fifty two healthy subjects aged 4.5 months to 12.8 years were studied for 15-20 minutes; 18 during sleep and 34 at rest (awake). There was a curvilinear relation between VO2 and age in the two groups and children aged 2 years or less had the highest values. The value of VO2 was significantly higher in the awake subjects (12.5-15.0 ml/min/kg compared with 7.5-9.0 ml/min/kg in sleeping children). Comparison of the regression lines after log transformation of these data showed a significant difference in VO2 of resting and sleeping subjects up to the age of 9.5 years.

Bandages↗
PubMed1992

Cutaneous heat loss shortly after burn injury in children.

1. Total heat loss and its components have been studied in cool (20 degrees C) and warm (30 degrees C) environments in 30 healthy children and 21 children who had been burned (10-17% body surface area) 0.5-29 h previously. 2. In healthy naked children at 20 degrees C, the partition of total heat loss was: radiation, 64%; convection, 32%; evaporation, 4%. On transfer to the warm, total heat loss was reduced by approximately 50%, with disproportionate reductions in the contributions from radiation and convection being offset, to some extent, by an increase in evaporative heat loss. 3. In patients during the first 5.5h after injury, the magnitude and pattern of heat loss at 20 degrees C and 30 degrees C were similar to those in control subjects and were unaffected by bandaging. 4. Ten to twenty-nine hours after injury, when the patients were bandaged and body temperature and heat content were significantly higher than in control subjects, radiant and convective heat losses were increased, but as evaporative heat loss tended to be reduced; total heat loss in the warm was unchanged. However, at this time at 20 degrees C, total heat loss was reduced compared with healthy children at the same ambient temperature. 5. The findings of unchanged or reduced total heat loss and reduced evaporative heat loss in injured patients are interpreted as inappropriate responses to an increased body temperature and heat content in children after burn injury.

Body Temperature Regulation↗
PubMed1992

KBM-3, an in vitro model of human acute myelomonocytic leukemia.

A human acute myelomonocytic leukemia cell line, KBM-3, was developed to study the pathophysiology of human acute myeloid leukemia. This cell line was characterized by morphology, immunophenotype, Giemsa-banding pattern, in vitro proliferation capacity, and tumorigenicity in nude mice. The KBM-3 cell line was established in the presence of exogenous lymphokines (human placenta-conditioned medium, HPCM), but medium for later passages did not contain HPCM. We found high cellular expression of the mRNA message for granulocyte-macrophage colony-stimulating factor (GM-CSF), which we suggest may be important for the immortalization of the cell line. KBM-3 cells have an immature myelomonocytic phenotype. Cytogenetic analysis revealed a pseudodiploid karyotype with five characteristic marker chromosomes and ranging in total number from 45 to 49. In suspension cultures, the cells had a doubling time of 23 h and a cloning efficiency of about 30% in soft agar independent of exogenous lymphokines. Two-thirds of nude mice injected with 1 x 10(4) KBM-3 cells and all animals injected with 1 x 10(5) cells developed S.C. granulocytic sarcomas within 6-8 weeks. These tumors were locally invasive but did not give rise to distant metastases. When transplanted to a new set of nude mice, all tumors formed secondary sarcomas at the site of implant. We conclude that the KBM-3 cell line may have value for studying the molecular events that underlie the neoplastic transformation in human myeloid leukemia.

Adult↗
PubMed1991

The role of gene rearrangements for antigen receptors in the diagnosis of lymphoma obtained by fine-needle aspiration. A study of 63 cases with concomitant immunophenotyping.

To assess the efficacy of performing genotyping in addition to immunophenotyping as an adjunct to cytologic diagnosis, 63 consecutive patients with fine-needle aspirates of lymphoproliferative lesions who had concurrent immunophenotyping and genotyping performed on fine-needle aspirate cell suspensions were studied. Thirty-nine of 63 specimens (62%) that appeared to contain non-Hodgkin's lymphoma and that proved to be of B-cell lineage by genotyping were accurately phenotyped and shown to be monotypic for immunoglobulin light chains by cell suspension immunocytochemistry. Genotyping facilitated lineage assignment and/or confirmed clonality in 17 of 63 specimens (27%) that were difficult to determine based on morphologic data. These include cases of atypical lymphoid proliferations with polyclonal or inconclusive markers (n = 6), peripheral T-cell lymphoma (n = 3), extracutaneous mycosis fungoides (n = 1), lymphoblastic lymphoma (n = 4), null cell lymphoma (n = 1), and specimens with equivocal or technically unsatisfactory markers (n = 2). Based on these results, it is proposed that genotyping for lineage assignment and/or clonality be performed to include cases of atypical lymphoid proliferations, T-cell malignant neoplasms, lymphoid malignant neoplasms with equivocal markers, and differentiation of lymphoid from nonlymphoid neoplasms. Genotyping by antigen-receptor gene rearrangement appears to be redundant in cases with mature B-cell phenotypes that demonstrate monoclonality by immunophenotyping.

Adult↗
PubMed1991

Efficacy of fludarabine, a new adenine nucleoside analogue, in patients with prolymphocytic leukemia and the prolymphocytoid variant of chronic lymphocytic leukemia.

PURPOSE: To describe the results of fludarabine therapy in patients with prolymphocytic leukemia (PLL) and the prolymphocytoid variant of chronic lymphocytic leukemia (CLL-Pro). PATIENTS AND METHODS: Seventeen patients with a diagnosis of PLL or CLL-Pro received fludarabine 30 mg/m2 over 30 minutes daily for 5 days every 4 weeks alone (12 patients), or with prednisone (five patients). Previously defined criteria for response were used. Differences in response rates according to various characteristics were evaluated by chi-square test. RESULTS: Three patients (18%) achieved complete remission, and three (18%) had a partial remission, for an overall response rate of 35%. Responses were durable and occurred in all involved organ sites. Lower response rates were observed in patients with anemia, thrombocytopenia, advanced Rai stages, and primary resistance to prior therapy. Toxicities were minimal except for febrile episodes associated with therapy. CONCLUSION: Fludarabine has shown encouraging results in these patients and deserves further investigation in combination with other active agents, and in the setting of front-line therapy.

Aged↗
PubMed1990

Dietary intake and changes in body weight in burned children.

Two groups of children were studied. In the first group serial measurements of body weight were made during the child's stay in hospital. In 11 patients, aged 7 months to 13 years, admitted with 10-58 per cent burns, the maximum weight loss was between 6 and 13 per cent of admission weight. Patients had not regained their admission weight at discharge (8-77 days after injury). In the youngest patients, the discharge weight corresponded with the maximum recorded weight loss. In five of the 11 patients dietary intake was calculated by weighing the foods in meals. This was done on average twice per week. Energy and protein intake was below that recommended for children with burns and often lower than that recommended for healthy children. In the second group of 10 patients, 6 months to 7 years had elapsed since the burn. These children were outpatients attending the Burns Aftercare Clinic. Six of the children were at a lower weight centile position when compared to the position at the time of the accident. The children had not 'caught up' to their original centile position.

Adolescent↗
PubMed1990

Glucose metabolism in children during the first day after burn injury.

Plasma and blood metabolites were measured in 31 children over the first day after burn injury. In 14 of them blood glucose peaked, rising within 1-4h to 10-20 mmol/l and then falling, by 4-8 h, to 5-10 mmol/l. Usually the peak value preceded treatment and the fall occurred during infusion of dextrose-saline. Peak incidence was independent of burn severity. There was no evidence of similar peaks in children or adults with other injuries, or in 8 adults with burn injuries; through high glucose levels have been reported in children with head injuries. Lactate, non-esterified fatty acids, insulin, cortisol, epinephrine and norepinephrine were also measured. Values in the first 4 h were similar to those reported in adults with other injuries, except for lactate, which rose less in the children. Unexpectedly, the hyperglycemia in the children with burns was poorly related to epinephrine concentration at all times to 24h. Insulin resistance probably developed within the first hour or two; but from 8 h did not seem to depend on synergism between epinephrine and cortisol.

Adolescent↗
PubMed1989

Calcium release from aortic sarcoplasmic reticulum.

The ability of ionsitol 1,4,5-trisphosphate (IP3) and other inositol phosphates to induce calcium release from canine aortic sarcoplasmic reticulum vesicles was examined. Using the calcium indicator chlorotetracycline or antipyrylazo III, aortic vesicles were shown to accumulate calcium in the presence of ATP, and then release approximately 25% of the intravesicular calcium upon addition of 7 microM IP3. Inositol 2-phosphate, inositol 1,4-bisphosphate, and inositol 1,3,4,5-tetrakisphosphate did not induce calcium release from these vesicles, and GTP[gamma-S] did not affect the IP3-induced calcium release. Aortic IP3-induced calcium release was not affected by ruthenium red, but was inhibited by Mg2+ and Ca2+, and thus differs from the Mg2+-insensitive IP3-induced calcium release in platelets and the ruthenium red-sensitive IP3-induced calcium pathway in skeletal muscle sarcoplasmic reticulum. Stopped-flow analyses showed that aortic IP3-induced calcium release was much slower than the caffeine-induced calcium release from skeletal muscle sarcoplasmic reticulum. Moreover, the aortic IP3-induced calcium release was biphasic, suggestive of heterogeneity of the putative calcium channels.

Animals↗
PubMed1989

A comparison of some thermoregulatory responses in healthy children and in children with burn injury.

1. Changes in body heat content in five normal adults, in 30 healthy children and in 24 children who had suffered burn injury 1-5 h previously, have been studied in cool (20 degrees C) and warm (30 degrees C) environments. 2. On moving from a cool to a warm environment, the heat content rose in both normal adults and healthy children, but the increase was significantly larger in the children. 3. Much larger changes occurred in the burned children in whom the heat content rose to a new plateau within about 8 h of the accident. 4. The changes after burn injury were unrelated to the bandaging of the burn and were little affected by the environmental temperature.

Adult↗
PubMed1988

Acetaminophen (paracetamol) in the management of burned children with fever.

Acetaminophen (paracetamol 12 mg/kg p.o.) was administered on a total of 33 occasions to 12 children (13-36 months of age) during the first 60 h after burn injury covering 10-44 per cent of the body surface area (BSA). The drug was effective in lowering rectal temperature on most (80 per cent) occasions; failure to elicit a response was not restricted to particular patients or patterns of injury. There was no evidence of tachyphylaxis to the antipyretic effects of acetaminophen. The pattern of change in the rectal and toe temperature after acetaminophen suggested that it may be acting by either increasing heat loss or by lowering heat production, both of which are consistent with a reduction in thermoregulatory setpoint mediated by inhibition of prostaglandin synthetase.

Acetaminophen↗