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Biomedical subjects

C H Miller

Publications and source records attributed to C H Miller.

At least 55 records · Page 3Linked to original sources
PubMed1995

Induction of adrenal suppression by megestrol acetate in patients with AIDS.

OBJECTIVE: To investigate the development of secondary adrenal suppression in a patient with the acquired immunodeficiency syndrome (AIDS) who was receiving megestrol acetate. DESIGN AND PATIENTS: Case report of one patient abruptly withdrawn from long-term therapy with megestrol acetate; prospective study of four patients with AIDS who were starting therapy with megestrol acetate for cachexia. SETTING: Outpatient clinic of a university hospital. INTERVENTIONS: Study patients received megestrol acetate, 80 mg three times daily. MEASUREMENTS: Study patients had cosyntropin-stimulation testing and oral glucose tolerance testing before and after starting therapy with megestrol acetate. RESULTS: The patient described in the case report developed symptoms of adrenal insufficiency after withdrawal of megestrol acetate after 4 years of treatment. His basal cortisol and adrenocorticotropic hormone (ACTH) levels were low. He showed an abnormally diminished response to a short cosyntropin-stimulation test but did respond to a 3-day cosyntropin-stimulation test. The morning cortisol levels of the study patients decreased significantly (from 11.0 +/- 1.8 micrograms/dL to 1.5 +/- 0.9 micrograms/dL; P < 0.01), and the ACTH levels of these patients decreased to below normal (from 16.6 +/- 5.5 pg/mL to 6.3 +/- 3.3 pg/mL; P = 0.02) during treatment with megestrol acetate. Cortisol levels after administration of cosyntropin decreased significantly (from 27.3 +/- 3.3 pg/mL to 9.3 +/- 6.3 pg/mL; P = 0.01) during treatment with megestrol acetate. The results of oral glucose tolerance testing in two patients were consistent with the development of insulin resistance, and daily insulin requirements increased 10-fold in a patient who had preexisting diabetes. CONCLUSIONS: Prolonged administration of megestrol acetate can induce clinically significant secondary adrenal suppression, and abrupt withdrawal of megestrol acetate after prolonged administration can cause adrenal insufficiency.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Tardive dyskinesia prevalence rates during a ten-year follow-up.

We followed up patients in the State Psychiatric Hospital Mauer-Ohling, Mauer-Ohling, Austria, who had been examined in 1982 to determine the prevalence of tardive dyskinesia (TD). Of the 861 patients examined in 1982, 270 were still in hospital 10 years later. Only these patients were included in our study. The SKAUB (Skala für abnorme unwillkürliche Bewegungen, i.e., The German version of the Abnormal Involuntary Movement Scale) was used to quantify the occurrence of TD. The prevalence rate of TD was 3.7% in 1982 and 12.7% in 1992. The 1992 prevalence rate in patients who had not shown TD symptoms in 1982 was 11.4%. The major risk factor for TD was advanced age.

Adult↗
PubMed1994

Kinetics of lipids, apolipoproteins, and cholesteryl ester transfer protein in plasma after a bicycle marathon.

The short-term effects of prolonged intense exercise on plasma lipid transport parameters including cholesterol, triglycerides (TGs), low-density lipoprotein (LD) cholesterol, high-density lipoprotein (HDL) cholesterol, and its subfractions HDL2 cholesterol and HDL3 cholesterol, on apolipoproteins (apos) A-I, A-II, and B, and on mass and activity of cholesteryl ester transfer protein (CETP) were studied in eight male endurance-trained athletes over the first week after a bicycle marathon. CETP mass concentration in plasma was quantified by a newly developed immunoradiometric assay (IRMA). Plasma concentrations of cholesterol, TGs, LDL cholesterol, apo B, CETP, and cholesteryl ester transfer activity (CETA) were significantly reduced in the recovery period compared with pre-exercise values (cholesterol by 20%, P < .05; TGs by 63%, P < .05; LDL cholesterol by 32%, P < .05; apo B by 18%, P < .05; CETP mass by 29%, P < .05; and CETA by 14%, P < .05). HDL cholesterol and HDL2 cholesterol, in contrast, were significantly increased in the post-exercise period (HDL cholesterol by 12%, P < .05, and HDL2 cholesterol by 96%, P < .05), whereas HDL3 cholesterol showed a tendency to decrease in the late recovery period (by 8%, NS). Although changes in cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, apo B, and CETP mass and activity were already evident in the early recovery period, HDL2 cholesterol showed a delayed response, reaching its maximum 72 hours after initiation of exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Accumulation of interferon gamma-producing TH1 helper T cells in nasal polyps.

We investigated the mechanisms involved in the formation of nasal polyps by examining T-cell clones and their production of soluble mediators in nasal polyps. Recently, the allergic origin of nasal polyps has been challenged. To study this question we characterized T cells from polyp tissue of allergic individuals in terms of their cytokine pattern. Nasal polyp T cells were cloned from allergic individuals undergoing polypectomy. Polyp tissue was dispersed enzymatically, and T cells were stimulated with mitogen and interleukin-2. Control T cells were obtained from peripheral blood of nonallergic donors. Cytokine production of interleukin-4 and interferon was then determined by indirect enzyme-linked immunosorbent assay tests. Polyp T-cell clones were found to produce high interferon but low interleukin-4 levels that were not significantly different from control peripheral blood T-cell clones. In addition, immunoglobulin production by dispersed polyp tissue was investigated. Immunoglobulin levels were higher in polyp tissues than in serum with immunoglobulin A predominating. These results suggest that the inflammatory reaction in nasal polyps is different than that seen in a typical type I hypersensitivity response.

Adult↗
PubMed1994

Educational and research aspects of a school-based sterilization monitoring service.

A dental school-based sterilization monitoring service can offer benefits to both the school and the private practitioner. It can foster the development of bonds between the school and the private practice community. It offers the private practitioner a service and a source for answers to infection-control questions. It offers the school an opportunity to extend the arm of the university into the dental community with newsletters, continuing education in the area of infection control, and other approaches to learning. The school also may be able to involve the service or use the service's facilities/equipment in research with appropriate consent from the clients.

Dental Offices↗
PubMed1994

Sterilization efficacy of a forced-air, dry heat sterilizer.

PURPOSE: To evaluate forced-air, dry heat sterilizer and test its ability to kill spores of Bacillus subtilis during both available cycles using packaged and unpackaged instruments. MATERIALS AND METHODS: A standard set of six orthodontic instruments were processed unpackaged through replicate 6-minute cycles with spore-strips on the top and bottom of each instrument. The spore strips were analyzed by culturing in Trypticase-soy broth for 7 days at 37 degrees C. RESULTS: No sterilization failures from properly placed spore-strips were detected in any of the 18 replicate cycles. Measurements of temperatures at three chamber sites during these cycles yielded only two of 36 instances when any portion of the chamber was at a temperature below the set temperature; however, no sterilization failures occurred during either of the two cycles involved. Also, a set of four orthodontic pliers were packaged and processed through replicate 12-minute cycles with spore-strips placed inside and attached to the outside of each package. None of the total 144 spore-strips processed through six replicate cycles showed growth after culture analysis. The study demonstrated sterilization efficacy for both the wrapped and unwrapped instrument cycles using biological indicators typically used to monitor dental office sterilizers.

Bacillus subtilis↗
PubMed1994

The ability of biological indicators to detect sterilization failures.

The purpose of this study was to determine if a delay in analyzing biological indicators (BI's) after heat-processing prevents detection of sterilization failures. Sets of various types of BI's were processed through sublethal conditions in a steam, chemical vapor or dry heat sterilizer. Portions of each set of BI's were then analyzed for live spores immediately, after a 7-day delay at 27 degrees C, after a 7-day delay at 37 degrees C and in one instance after a 3-day mail delay. Of the 486 BI's exposed for sublethal times in steam at 250 degrees C, 483 (99.4%) exhibited spore growth (sterilization failure) after the 3-7 day delays before analysis. Of the 200 BI's exposed for sublethal times in the chemical vapor sterilizer, 193 (96.5%) exhibited spore growth after 7-day delays before analysis. All of the 120 (100%) BI's exposed for sublethal times in a static air dry heat sterilizer at 320 degrees F showed growth after 7-day delays before analysis. These results indicate that the delays before BI analysis described in this study do not cause any predictable pattern of preventing detection of sterilization failures.

Bacillus subtilis↗
PubMed1993

Effects of capsaicin on liver microsomal metabolism of the tobacco-specific nitrosamine NNK.

Chemically-induced mutagenesis and carcinogenesis is modulated by various plant products, some of which are present in the human diet. 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), a potent carcinogen in tobacco and tobacco smoke, is activated by microsomal enzymes. In this study, we investigated the effects of capsaicin on the in vitro metabolism of NNK. Capsaicin is the principal component of Capsicum fruits used widely by humans as a food additive. Liver microsomes from saline-injected, phenobarbital-induced and beta-naphthoflavone-induced hamsters were used. Microsomes from phenobarbital and beta-naphthoflavone-induced animals expressed decreased NNK reduction and enhanced pyridine-N-oxidation, but did not significantly alter alpha-carbon hydroxylation of NNK. Capsaicin (0.5 mM) inhibited the formation of all metabolites of NNK by all microsomal fractions and inhibited alpha-hydroxylation by phenobarbital-induced microsomes more than by either of the other two treatments. Our results suggest that capsaicin, as a naturally occurring dietary constituent, possesses antimutagenic and anticarcinogenic properties through the inhibition of xenobiotic metabolizing enzymes.

Animals↗
PubMed1993

Severe rhabdomyolysis after doxylamine overdose.

Clinicians should be aware of the complications of rhabdomyolysis in patients who ingest doxylamine succinate and other over-the-counter antihistamines. The easy availability of these substances increases the potential not only for intentional overdose by adults but also for inadvertent ingestion by children. Prompt intervention and careful assessment of renal function, urinary output, and serum creatine kinase levels may represent the difference between an uncomplicated course and acute renal failure.

Adult↗
PubMed1993

The effect of activation procedures on neuroleptic-induced akathisia.

Two studies have been performed to evaluate the effect of activation tasks on neuroleptic-induced akathisia (NIA). In the first sample (30 patients) we found a consistent increase of symptoms during mental activation while motor activation led to a decrease. In a second study 34 patients with the same diagnosis were evaluated, using slightly different statistical procedures: while the effects of motor activation were corroborated, mental activation did not change NIA. Since mental and motor activation are usually considered to increase tardive dyskinesia and Parkinsonism, these measures might be helpful in differentiating NIA from other antipsychotic-induced movement disorders.

Adult↗
PubMed1993

Presence of microorganisms in used ultrasonic cleaning solutions.

This study analyzed ultrasonic cleaning solutions for bacterial contamination and for antibacterial activity after the solutions were used for a full day in dental offices. Ten dental offices ultrasonically cleaned their instruments by their standard procedures for a full day using one batch of their normal cleaning solution. The solutions were then quantitatively analyzed for levels of bacterial contamination and for antibacterial activity against Staphylococcus aureus and Pseudomonas aeruginosa. Levels of bacterial contamination ranged from 0 to 10,000 CFU/ml in the used solutions, and the four used cleaning solutions involved exhibited varying levels of activity against the two test bacteria. The four fresh unused cleaning solutions involved were also analyzed for minimal inhibitory concentration (MIC), minimal bacteriocidal concentration (MBC), and killing times against S. aureus, P. aeruginosa and Salmonella choleraesuis. None of the four cleaning solutions involved made any antimicrobial label claims, because they were marketed as cleaners, not antimicrobial agents. Three of the four agents exhibited some antibacterial activity against all three test bacteria but required greater than 10 minutes to kill all three. One solution exhibited high activity and kill times of less than 1 minute against all three test bacteria. Repeat testing of this solution in 17 dental offices confirmed its antimicrobial activity during use. Bacterial contamination may be present in used ultrasonic cleaning solutions. Use of an antimicrobial cleaning solution is one approach to manage this potential for contamination.

Colony Count, Microbial↗