Search PubMed⌕ Search

Biomedical subjects

C Colp

Publications and source records attributed to C Colp.

At least 19 recordsLinked to original sources

Gallium scanning in the 'new' tuberculosis.

PURPOSE: To evaluate the findings and usefulness of Ga-67 scanning in recent cases of tuberculosis (TB). MATERIALS AND METHODS: The authors reviewed chest x-ray films and Ga-67 citrate scans of 52 patients with culture-confirmed infection caused by Mycobacterium tuberculosis treated after 1988. RESULTS: Ga-67 scans were positive in every case, delineating upper lobe lung lesions in 6 patients, diffuse involvement or lower lobe disease in 34 patients, and intrathoracic adenopathy in 15 patients. Pulmonary parenchymal lesions were not detected on x-ray films in 3 patients, and nodal lesions were not apparent in 3 patients. In addition, in 6 patients cervical adenopathy was detected by Ga-67 scintigraphy; 4 underwent biopsy with culture confirmation. CONCLUSIONS: Ga-67 scanning is more sensitive than routine chest radiography for detection of both TB parenchymal lung involvement and adenopathy. Ga-67 imaging facilitates the choice of biopsy sites by identifying accessible peripheral nodes. Typical patterns in recent cases of TB differ significantly from the upper lobe predilection of classical TB.

Adult↗

Patient's self-interpretation of tuberculin skin tests.

BACKGROUND: In the outpatient use of tuberculin skin testing (purified protein derivative [PPD]), it is at times inconvenient to have a patient revisit for interpretation. Therefore, we assessed patients' ability to self-interpret these test results. METHODS: In keeping with prior custom, patients were seen by an experienced nurse, who performed skin testing with PPD intermediate strength as well as mumps and Candida anergy control tests in some cases, and explained the procedure. The patients were asked to return 48 to 72 h later, at which time one of the researchers recorded their test interpretations before they were again evaluated by the nurse. RESULTS: Sixty-eight patients were studied, of whom 59 returned at appropriate interval. Eighteen patients had a positive PPD test reaction of 10 to 20 mm induration, which only one patient correctly identified as a positive test result. However, positive anergy control tests were correctly interpreted in 10 of 27 cases. CONCLUSION: The small number of positive PPD test result recognition by these patients may be partially attributed to their lack of education, as well as foreign birth and denial of illness. PPD results should be checked by an experienced professional.

Ambulatory Care↗

Ventilation-perfusion imaging in sarcoidosis: potential for nonembolic segmental mismatch.

We report a case of a postpartum female on oral contraceptives who presented with chest pain and was initially treated for pulmonary embolism on the basis of a lobar mismatch on ventilation-perfusion imaging. Subsequent angiography revealed that the pulmonary artery was extrinsically compressed. Gallium-67-citrate imaging documented sarcoidosis with uptake in bilateral hilar nodes, both lungs and parotid and salivary glands.

Adult↗

Variants of alpha 1-antitrypsin in Puerto Rican children with asthma.

A survey of 393 Puerto Rican and 354 non-Hispanic pediatric patients at Beth Israel Hospital, New York, revealed a significantly larger percentage of asthmatic subjects among Puerto Ricans, confirming findings of a study of Puerto Rican adults in New York. Assays of alpha 1-antitrypsin (AAT) concentration and phenotypes in 61 Puerto Rican asthmatic children revealed a significantly larger number with an S or Z variant in AAT phenotype. The AAT concentration was not a significant variable in this relationship, since four of five subjects with intermediate deficient AAT concentrations and a PiM phenotype were among control nonasthmatic Puerto Rican subjects. A family history of asthma was more common among asthmatic than control subjects and was most common for variant AAT phenotypes in either asthmatic or control subjects. We speculate that the S or Z variant of AAT affects the inflammatory response in such a way as to predispose to asthma.

Adolescent↗

Profile of bronchospastic disease in Puerto Rican patients in New York City. A possible relationship to alpha 1-antitrypsin variants.

A high prevalence of asthmalike symptoms was noted among patients of Puerto Rican descent attending Beth Israel and North Central Bronx Medical Centers in New York City, as compared with other ethnic groups. An evaluation of family and medical histories, pulmonary function data, and alpha 1-antitrypsin phenotypes was undertaken in such Puerto Rican patients and control subjects without asthma. The patients showed a higher proportion of MS and MV phenotypes. All the patients in both MM and variant phenotype groups, with the exception of four MM patients, had features indicative of asthma, with labile airway obstruction, and elevated serum immunoglobulin E and eosinophil levels. The latter was significantly higher in the patients with variant phenotypes than in MM patients. Patients with alpha 1-antitrypsin variants also had much shorter smoking histories as compared with the MM group, and all reported histories of asthma in first-degree relatives, as compared with 66% among the MM patients. We conclude that there is an increased incidence of asthma among Puerto Ricans in New York City, and that the antitrypsin variant phenotypes (specifically S and V) play a role in this incidence and its expression.

Asthma↗

Opportunistic infections and immune deficiency in homosexual men.

A syndrome of opportunistic infections and acquired immune deficiency occurred among four previously healthy homosexual men. Fever, leukopenia, and diminished delayed hypersensitivity were accompanied by various degrees of proctitis, perianal ulcerations, and lymphadenopathy. The infectious agents included Pneumocystis carinii, Cryptococcus neoformans, Candida albicans, herpes simplex virus, and cytomegalovirus. The immune deficiency was characterized as a persistent and profound selective decrease in the function as well as number of T lymphocytes of the helper/inducer subset and a possible activation of the suppressor/cytotoxic subset. Three patients died despite aggressive anti-infective therapy.

Adult↗

Vocal cord paralysis in myasthenia gravis following anesthesia.

Our patient demonstrated two unusual features: (1) severe upper airway obstruction due to bilateral vocal cord paralysis at first manifestation of a myasthenic syndrome; and (2) precipitation of this syndrome following surgery and anesthesia with succinylcholine. In addition, this case illustrates use of ventilatory measurements through an endotracheal tube for documenting the patient's progress and response to medications, most dramatically during performance of an edrophonium test.

Adult↗

Pulmonary function studies in ex-heroin users.

Pulmonary function tests were performed on a group of 22-ex-heroin addicts with no known pulmonary disease or symptoms. Vital capacity and total lung capacity were normal in all but four patients. Only two patients had evidence of moderately severe airway obstruction. However, the single breath diffusing capacity (Dco) was significantly reduced in many of the patients and averaged 81 percent of predicted for the entire group. Patients with most severe reduction of Dco also had reduction of lung volumes. In addition, six patients had increased lung recoil force (Pmax) and decreased lung compliance. There was no correlation between degree of functional impairment and duration or amount of durg use, incidence of overdose or intravenous injection of crushed tablets. Followup studies in four patients after several months on methadone maintenance showed improvement in lung volumes and/or Dco. Possible etiologic considerations to explain these abnormalities were previous subclinical pneumonias, foreign body granulomas, previous pulmonary edema or other direct toxic effect on alveolocapillary membrane as the result of use of drugs.

Adult↗

Severe pleural restriction: the maximum static pulmonary recoil pressure as an acid in diagnosis.

Three patients with pleural restriction are presented in detail. One patient had had a right pneumonectomy and died of ventilatory failure due to left-sided restrictive pleurisy. The second patient had neoplastic pleural effusion and inactive tuberculosis. The third patient had systemic lupus erythematosus with bilateral restrictive pleuritis. The physiologic picture was similar in the three cases, with marked decrease of lung volumes, increase of the RV/TLC ratio, absence of airways obstruction, decrease of the Dco and decrease of dynamic lung compliance. In addition, each of these three patients and others with severe pleural restriction had a lower than normal maximum static pulmonary recoil pressure (Pmax). Since in pulmonary restrictive disease, the Pmax was found to be elevated, it was a useful test for distinguishing pulmonary restriction from pleural restriction.

Adenocarcinoma↗