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C S Bradbeer

Publications and source records attributed to C S Bradbeer.

At least 19 recordsLinked to original sources
PubMed1997

Greater emotional distress is associated with accelerated CD4+ cell decline in HIV infection.

An investigation was conducted to explore the relationship between emotional distress and HIV progression. One hundred twenty-five homosexual, HIV-positive males participated in a 12-month longitudinal investigation. Psychosocial data were collected at 6-month intervals and CD4+ data were collected from diagnosis to the end of the investigation. Principal component analyses were performed initially to identify factors of emotional distress and health status. In addition, CD4+ reliability assessments were performed to ensure the validity of the prognostic assessments made. As a result of these analyses, 47 individuals were eligible for the main analyses. The results from a stepwise regression revealed that disease progression was significantly predicted by CD4+ count at diagnosis (32% of variance) and emotional distress (17% of variance), but was unrelated to subjective perceptions of health. The data suggest that some of the variability in HIV progression can be attributed to emotional distress.

Adult↗
PubMed1997

Disposition of intravenous 123iodopentamidine in man.

This study compared the disposition of the radiopharmaceutical [123I]iodopentamidine with that of pentamidine after intravenous infusion by measuring plasma concentrations of each using scintilation counting and high-performance liquid chromatography (HPLC), respectively. There was rapid hepatic uptake and biliary excretion of the 123I label. Distribution kinetics of the 123I label were similar to those of pentamidine, but its elimination half-life (41 +/- 27 h) was longer than that of pentamidine measured by HPLC (11 +/- 8 h). [123I]iodopentamidine distribution reflects that of pentamidine, but elimination of the radiopharmaceutical appears slower.

Adult↗
PubMed1997

PET scanning and the human immunodeficiency virus-positive patient.

UNLABELLED: The use of PET scanning in patients with human immunodeficiency virus infection and fever of unknown origin, confusion and/or weight loss was investigated. METHODS: Eighty patients were examined using PET. Fifty-seven patients had half-body scans with [18F]fluorodeoxyglucose (FDG), and 23 patients had brain studies performed with FDG. Fourteen patients also had [11C]methionine studies (2 chest, 1 abdomen and 11 brain) performed. RESULTS: Thirteen patients with lymphoma had the extent of the disease clearly identified in both nodal and extranodal sites. Patients with a variety of infections (Cryptococcus neoformans, Pseudomonas aeruginosa, Mycobacterium tuberculosis and Mycobacterium avium intracellulare) had disease localized for appropriate biopsy or sampling procedures. A half-body FDG-PET scan had a sensitivity of 92% and a specificity of 94% for localization of focal pathology that needed treatment. High uptake of FDG (greater than liver) had a positive predictive value for pathology needing treatment of 95%. FDG brain studies showed that 16 patients with CD4 T-lymphocyte counts less than 200 cells/ml had reduced cortical uptake compared with that in basal ganglia. FDG scans were abnormal in all 19 patients with focal space occupying lesions identified by magnetic resonance scans. The standardized uptake values (SUVs) over cerebral lesions due to toxoplasma were in the range of 0.14-3.7 (13 patients) and due to lymphoma were in the range of 3.9-8.7 (6 patients). Three more patients with progressive multifocal leukoencephalopathy had SUVs in the range of 1.0-1.5 over the lesions. Another patient had a low-grade oligodendroglioma (SUV = 2.9). Carbon-11-methionine uptake also was high in patients with cerebral lymphoma but did not add to the discrimination between toxoplasmosis and lymphoma in these patients obtained with the FDG scan. CONCLUSION: In hospitals with access to PET facilities, FDG scanning allows the rapid evaluation of the whole body, including the brain, of patients with human immunodeficiency virus infection, with a report potentially available within 4 hr of injection. Sites of infection and tumor were identified, and discrimination between cerebral pathologies was possible.

AIDS-Related Opportunistic Infections↗
PubMed1995

AIDS in Africans living in London.

OBJECTIVES: To investigate the presentation of HIV infection and AIDS amongst Africans diagnosed with AIDS living in London. METHODS: Identification of all AIDS cases of African origin attending four HIV specialist centres in South London--Guy's, King's, St George's and St Thomas' Hospitals--up to March 1994, by retrospective review of case notes of all HIV positive patients. RESULTS: Of 86 patients (53 women, 33 men) studied, 59 (69%) were from Uganda. The most frequent AIDS-defining diagnoses were: Pneumocystis carinii pneumonia (PCP) 21%, tuberculosis (TB) 20% (extrapulmonary TB 14%, pulmonary TB 6%), cerebral toxoplasmosis 14%, oesophageal candida 13%, cryptococcal meningitis 11%, wasting 6%, herpes simplex infection > 1 month 5%, Kaposi's sarcoma 5%, other 6%. Cytomegalovirus retinitis was diagnosed in one case. Late presentation was common; 70% were diagnosed HIV positive when admitted to hospital. The diagnosis of AIDS was coincident with a first positive HIV test result in 61%. The mean CD4 counts at both HIV and AIDS diagnoses were similar in both men and women: 87 x 10(6)/l and 74 x 10(6)/l in men and 99 x 10(6)/l and 93 x 10(6)/l in women respectively. Overall, TB 21 (24%) (extrapulmonary TB 12, pulmonary TB 9) was either the AIDS-defining diagnosis or was detected within three months of this event. Sixty-two per cent of TB cases were diagnosed within twelve months of entry to the UK compared to 34% of all other AIDS cases. The prevalence of STD was very low; genital herpes was the commonest STD: 17% of the women, 9% men; 28% of the men and 11% of the women tested had a positive TPHA test. In cases known to be HIV-positive prior to an AIDS diagnosis, 41% took prophylaxis for PCP and 45% had taken zidovudine (ZDV). Forty two of the study participants had 89 children: 59 of these children had mothers in the study. Overall, 37 (42%) of the children had lost at least one parent at the time of data assessment. CONCLUSIONS: PCP and TB were the most common initial AIDS-defining diagnoses. The majority of TB cases were diagnosed within 12 months of entry to the UK. An AIDS-defining diagnosis was the first manifestation of HIV-related illness in the majority of patients. Because of late presentation to medical services, access to treatments for HIV infection and prophylaxis against opportunistic infections was limited. Extending the role of clinics and staff into the community might facilitate both earlier presentation and access to services. Future provision of local services will need to be sensitive to the requirements of individuals from different cultures and backgrounds.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Chronic verrucous varicella-zoster infection in a patient with AIDS.

The expression of herpes varicella zoster virus in patients already infected with the human immunodeficiency virus (HIV) provides the perfect illustration of an opportunist microbe at work. There is an increased incidence of herpes zoster which may be more severe, recurrent or disseminated. Likewise, varicella may be more severe and recurrent. In both patterns of infection atypical lesions in the form of persistent ulcerative or verrucous lesions have been seen. An HIV-positive patient is described who developed verrucous lesions de novo, 4 months after her child had varicella.

AIDS-Related Opportunistic Infections↗
PubMed1993

Tine testing in HIV positive patients.

BACKGROUND: The incidence of tuberculosis is increased in HIV positive patients. Purified protein derivative (PPD, tuberculin) testing has not been performed routinely on patients infected with HIV in the UK and its usefulness in diagnosing tuberculosis in these patients is unclear. METHODS: 198 HIV positive patients were Tine tested and a CD4+ lymphocyte count and chest radiograph were performed. Of the 179 male patients 164 were homosexual or bisexual, 11 were injecting drug users (IDUs), and four were both homosexual and IDUs. Of 19 women 14 were heterosexual and five were IDUs. Patients assessed their own skin reactions at 72 hours, recording the grade on a card which was returned by post. Patients with a grade 0 reaction were requested to have a second test one month later. RESULTS: Details were available on 168 of the 198 patients. Grade 0 reactions occurred in 89 of the 168 patients, requiring a second Tine test, and 73 completed Tine 2 results were received. Of 57 patients with CD4+ lymphocyte counts below 200/mm3, low grade PPD reactivity was seen in 18 on Tine 1 and nine on Tine 2. No history of BCG immunisation of tuberculosis was found in 33 Tine positive patients. Two patients treated for tuberculosis in the previous six months were PPD positive with CD4+ counts of 60/mm3 and 4/mm3 respectively. CONCLUSIONS: PPD reactivity may be maintained despite a CD4+ count of 100/mm3 or less when there is a history of tuberculosis or BCG immunisation.

AIDS-Related Opportunistic Infections↗
PubMed1990

Parvovirus infection and anaemia in a patient with AIDS: case report.

Opportunistic infections such as Pneumocystis carinii pneumonia are well-recognised in patients with the acquired immune deficiency syndrome (AIDS). Anaemia due to a variety of causes also occurs in AIDS. Persistent infection with parvovirus (B19) causing severe anaemia has been reported in patients with leukaemia and congenital immunodeficiency. A case is now reported of parvovirus infection and anaemia, in an adult with AIDS, which responded dramatically to immunoglobulin therapy.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Mothers with HIV.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1989

The place of lung 99mTc DTPA aerosol transfer in the investigation of lung infections in HIV positive patients.

Pneumocystis carinii pneumonia (PCP) is the most common cause of pneumonia in HIV antibody positive patients, but other pneumonias remain important, i.e. streptococcal and mycobacterial infections. A definitive diagnosis relies on obtaining samples from the lung either noninvasively (induced sputum), or invasively (bronchoalveolar lavage, transbronchial or open lung biopsy). We have used the noninvasive technique of nebulized 99mTc DTPA transfer, to assess patients with PCP (n = 30) and other lung infections (n = 20) to see whether this test will distinguish between the various infections. The presence of a biphasic, rapid transfer curve indicates severe extensive alveolar damage and is seen in PCP or legionella pneumonia. The mean transfer time (T50 +/- SEM) for patients with PCP (whether smokers or nonsmokers) was 2.1 +/- 0.2 min, and for two of the patients with legionella 3.2 min. In PCP effective treatment causes the transfer to slow (mean T50 22.7 +/- 3.3 min, n = 24) and become monoexponential. Other causes of these changes in transfer are discussed. The other pneumonias (streptococcal, mycobacterial, and staphylococcal) did not result in biphasic curves or very rapid times, their T50 values are indistinguishable from cigarette smokers. In this patient group the DTPA transfer is a useful noninvasive investigation with a very rapid, biphasic curve indicating a high probability of PCP.

Adult↗
PubMed1988

Prophylaxis against infection in Singaporean prostitutes.

One hundred prostitutes were interviewed about the prophylactic measures they took against infection. The use of contraceptive diaphragms and clandestine antibiotics correlated significantly with fewer gonococcal infections.

Anti-Bacterial Agents↗
PubMed1988

Penicillin treatment for gonorrhoea in relation to early syphilis in prostitutes.

A retrospective study of prostitutes in Singapore showed that they had received less antigonorrhoeal treatment with penicillin derivatives during the three month period before early syphilis was diagnosed than in other three month periods when they had not developed syphilis. This suggests that penicillin derivatives in doses sufficient to treat gonorrhoea will abort coincidental early syphilis.

Female↗