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Biomedical subjects

C Winter

Publications and source records attributed to C Winter.

At least 91 records · Page 5Linked to original sources
PubMed1991

Single-dose and three-day regimens of ofloxacin versus trimethoprim-sulfamethoxazole for acute cystitis in women.

We compared the safety and efficacy of a single 400-mg dose of ofloxacin, ofloxacin (200 mg) once daily for 3 days, and trimethoprim-sulfamethoxazole (160:800 mg) twice daily for 7 days for the treatment of acute uncomplicated cystitis (urinary tract infection [UTI]) in women. At 5 weeks posttreatment, 35 (81%) of 43 patients treated with single-dose ofloxacin, 40 (89%) of 45 treated with 3 days of ofloxacin, and 41 (98%) of 42 treated with trimethoprim-sulfamethoxazole were cured (P = 0.03, single-dose ofloxacin group versus trimethoprim-sulfamethoxazole group). Retreatment for symptomatic recurrent UTI was given to 7 (16%) of 43 patients initially treated with single-dose ofloxacin, 3 (7%) of 45 patients treated with 3 days of ofloxacin, and 0 of 42 patients treated with trimethoprim-sulfamethoxazole (P = 0.01, single-dose ofloxacin group versus trimethoprim-sulfamethoxazole group). There was a trend in each of the three treatment groups toward an association between persistent or recurrent episodes of significant bacteriuria and a history of UTI in the past year and with diaphragm use. Ofloxacin was more effective than trimethoprim-sulfamethoxazole in eradicating Escherichia coli from rectal cultures during or soon after therapy, but there were no differences at later follow-up visits. Adverse effects were equally common among the three treatment groups. We conclude that single-dose ofloxacin was less effective than 7 days of trimethoprim-sulfamethoxazole for treatment of uncomplicated cystitis in women, while the 3-day ofloxacin regimen and the trimethoprim-sulfamethoxazole regimen were not significantly different in efficacy.

Acute Disease↗
PubMed1991

The Acute Infarction Ramipril Efficacy (AIRE) Study: rationale, design, organization, and outcome definitions.

The rationale, design, organization, and outcome definitions of the Acute Infarction Ramipril Efficacy (AIRE) Study are described prospectively. A total of 2,000 patients (1,000 per treatment group) will be recruited to this multicenter, multinational, double-blind, randomized, placebo-controlled study investigating the effect of oral treatment with ramipril (2.5 or 5 mg twice daily) on the total mortality of survivors of an acute myocardial infarction (AMI) with early clinical evidence of heart failure. Secondary outcomes of the study include progression to severe/resistant heart failure (at which time the patient will be withdrawn from the study treatment), reinfarction, and stroke. Treatment will be initiated in hospital between day 3 and day 10 following AMI, and follow-up continued for an average of 15 months and a minimum of 6 months. The study data will be analyzed on an intention-to-treat basis: a single formal interim analysis will be conducted after 175 deaths. An Independent Adjudicating Panel will act as the overall ethical supervisory body for the study and will retain the randomization code. An International Steering Committee will be responsible for the clinical definitions of the secondary study outcomes, and will regularly review progress of the study. We believe that early treatment with ramipril may reduce the total mortality of patients surviving an AMI with clinical evidence of heart failure.

Acute Disease↗
PubMed1990

Heterogenic mRNAs with an identical protein-coding region of the human embryonic myosin alkali light chain in skeletal muscle cells.

The formation of human myotubes in culture is accompanied by the induction of developmentally regulated, muscle-specific genes. We have studied the expression of human myosin light chain proteins and mRNAs during myogenesis in culture, in particular the skeletal embryonic myosin light chain 1 (MC1emb), which is indistinguishable from MLC1 of adult atrial cardiac muscle (MLC1A) as has been shown for rodent and bovine MLC1emb. We have identified distinct MLC1emb/MLC1A mRNAs in cultured human skeletal muscle cells that differ in their 5' and 3' untranslated regions but contain identical protein-coding regions. The alternative 3' untranslated region is detectable also in RNA of human atria. The different MLC1emb RNAs are likely to be encoded by one gene. It appears that the two MLC1emb 5' untranslated regions of the human gene are specific for man. In the mouse, only one 5' untranslated region of the MLC1emb gene has been detected.

Amino Acid Sequence↗
PubMed1990

[A comparison of conventional tomography and computed tomography in cases of diseases of the sacroiliac joint].

16 patients with diseases of the sacroiliac joints were examined both with computer tomography and with conventional tomography. Both techniques were characterized by a high sensitivity. Computer tomography was superior in exactly delineating the extent of the pathologic changes. In conventional tomography the joint surface was more blurred, erosions were larger, and signs of ankylosis were more expanded, so that the joints seemed to be more altered in 8 cases than demonstrated by computer tomography. Very accurate changes like subchondral cysts were recognized only in the computer tomograms. In all cases in which anteroposterior radiographs revealed no clear result, the authors recommend to additionally employ computer tomography.

Adult↗
PubMed1990

Wheelchair-mounted robot manipulators. Long term use by patients with Duchenne muscular dystrophy.

This report relays practical clinical information about the modification and use of commercially available training robot manipulators. Such manipulators were used to increase independence in the activities of daily living of patients with advanced Duchenne muscular dystrophy. The control panels of five industrial robot manipulator training devices were modified for use by advanced Duchenne muscular dystrophy patients. Six patients with only residual finger movement, three of whom were dependent on respiratory support, mastered the use of these devices. The four patients with long-term access employed their manipulators for facilitation of activities of daily living an average of 8 h a day for 3 +/- 1.8 yr. There was approximately 3 h of estimated attendant care time saved per patient per day.

Activities of Daily Living↗
PubMed1989

Development of clinically recognizable genital lesions among women previously identified as having "asymptomatic" herpes simplex virus type 2 infection.

STUDY OBJECTIVE: To determine if patients initially identified by history, clinical examination, and serologic status as having asymptomatic herpes simplex virus type 2 infection report clinically recognizable genital lesions after having a detailed instructional session on the clinical signs and symptoms of genital herpes. DESIGN: Prospective follow-up of two groups of women. SETTING: Outpatient clinic of an urban city-county hospital. PATIENTS: Two populations of women were recruited. One group was referred because they had documented asymptomatic genital herpes or were suspected of asymptomatically transmitting genital herpes to a sex partner. The other group was recruited from the hospital's general gynecologic clinic and consisted of women with herpes simplex virus type 2 antibodies who denied a history of genital herpes. INTERVENTION: Patients had a one-on-one interview describing the clinical symptoms of genital herpes. MEASUREMENTS AND MAIN RESULTS: Twelve of nineteen women with herpes simplex virus type 2 antibodies who had documented asymptomatic genital herpes or were suspected of asymptomatically transmitting infection to a sex partner, and 18 of 43 women with herpes simplex virus type 2 antibodies who were recruited from the gynecologic clinic developed clinically recognizable genital lesions during a 5-month follow-up. Symptomatic genital herpes was the most frequent gynecologic complaint identified during follow-up. CONCLUSIONS: Approximately 50% of women with herpes simplex virus type 2 antibodies who do not initially report a history of genital lesions do indeed have clinically symptomatic genital herpes. These women can be accurately counseled and taught to distinguish genital herpes from other genitourinary infections. Identification of symptomatic recurrences and counseling to avoid sexual activity during these episodes may help reduce transmission of genital herpes.

Adolescent↗
PubMed1988

Double-blind, placebo-controlled trial comparing long-term suppressive with short-term oral acyclovir therapy for management of recurrent genital herpes.

A total of 156 patients with frequently recurring genital herpes were enrolled in a randomized, double-blind, one-year trial comparing long-term suppressive and intermittent oral acyclovir therapy with placebo in the management of recurrent genital herpes. Subjects received either suppressive treatment with acyclovir, 400 mg twice daily for one year, and 200 mg five times per day for five days, for short-term treatment of recurrences; intermittent treatment with placebo, twice daily for one year, and oral acyclovir, 200 mg five times per day for five days, for short-term treatment of recurrences; or treatment with placebo, twice daily for one year, and five times per day for five days for short-term treatment of recurrences. Median time to first recurrence was 250 days for the suppressive group, 28 days for the intermittent group, and 23 days for the placebo group (p = 0.001). The median number of days per month with active disease was 0.32 for the suppressive group, 4.18 for the intermittent group, and 4.72 for the placebo group (p less than 0.001), with a median recurrence rate per 30-day treatment period of 0.08 recurrences/patient in the suppressive group, 0.70 in the intermittent group, and 0.74 in the placebo group (p less than 0.001). Median duration of recurrence was 5.0 days in the suppressive group compared with 6.0 days in the combined intermittent acyclovir plus placebo group (p = 0.001), and was reduced from 7.0 to 6.0 days when intermittent acyclovir treatment was compared with placebo treatment (p = 0.05). Daily administration of oral acyclovir for one year is superior to intermittent or placebo treatment in the management of patients with frequently recurring genital herpes.

Acyclovir↗
PubMed1988

Vitamin D and retinoblastoma. The presence of receptors and inhibition of growth in vitro.

The vitamin D receptor has been found in several human organs not involved in calcium metabolism and in several malignant neoplasms found in humans. The role of the receptor in these tissues is unclear. There is, however, a relationship between the presence and quantity of the vitamin D receptor in a malignant cell line and the antineoplastic effect of vitamin D on that cell line. We found that Y-79 retinoblastoma cells have receptors specific for calcitriol (1,25-dihydroxycholecalciferol). Scatchard analysis of the receptor data shows a quantity of 56,000 receptors per retinoblastoma cell. These receptors have a dissociation constant of 1.18 nmol/L. Retinoblastoma cells treated with 10(-9) mol/L of calcitriol for nine days had 15% less cell growth than the control cells. Further studies of the effect of vitamin D on retinoblastoma may warrant its inclusion in chemotherapeutic protocols for the treatment of this childhood affliction.

Calcitriol↗
PubMed1988

Comparison between manual and computer measurement of ST-segment amplitude during exercise.

Several studies have shown that the maximal ST/HR slope may be used as a reliable index of myocardial ischemia as assessed by coronary angiography, but this involves laborious training and derivation, particularly with respect to the measurement of ST segment amplitude, which is obtained by averaging values measured in at least 10 cardiac cycles in the steady state. The authors compared manual measurement of ST-segment amplitude with computer-processed beat using cardiac cycles in six consecutive patients with standard 12-lead records obtained over 5 seconds and a beat processed by the recorder to represent each lead (modal beat, over 10 seconds). All recordings were made in the steady state. Two patients had myocardial ischemia, as assessed by means including the maximal ST/HR slope and the occurrence of ST-segment depression at the end of exercise. Comparisons were made between measurements in 324 pairs of ST-segment amplitude obtained, respectively, from manually averaged recorded beats (average beat) and the modal beat during each step of the exercise test. The level of the ST-segment, (80 msec after the end of QRS complex) was independently obtained from the two records in a blinded fashion. The group data showed that the modal beat gave significantly lower values of ST-segment amplitude than the average beat. Similar results were obtained when 286 pairs of positive amplitudes were compared in the range of 0-7.25 mm. In the remaining 38 pairs in which ST-segment depression was found, the amplitude in the modal beats was not significantly different from the average beats.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1988

Transmission of genital herpes in couples with one symptomatic and one asymptomatic partner: a prospective study.

To determine the risk of transmission of genital herpes simplex virus (HSV) infection, we prospectively studied, for a median of six months, 38 couples who had been together for a median of 10 mo. In each couple, one partner had a history of symptomatic genital herpes and one did not. At entry, of the 38 asymptomatic, exposed partners, 21 were seronegative, and results of western blot analysis showed that seven had antibody to HSV type 1 (HSV-1), four to HSV type 2 (HSV-2), and six to both HSV-1 and HSV-2. One of the 28 exposed partners without antibody to HSV-2 at enrollment asymptomatically acquired HSV-2 infection, but four of 10 with antibody to HSV-2 at enrollment developed culture-proven HSV-2 infection during follow-up. Restriction endonuclease analysis of DNA from paired isolates revealed identical strains in three couples and different strains in one. In this group of asymptomatic sex partners of persons with genital herpes, asymptomatic and unrecognized acquisition of HSV-2 infection was common, but more than half of the exposed partners remained free of HSV-2 infection after a median of 16 mo of sexual contact.

Adult↗
PubMed1988

Detection of herpes simplex virus DNA from genital lesions by in situ hybridization.

Lesion specimens from 118 episodes of recurrent genital herpes were used to compare herpes simplex virus (HSV) isolation with a direct specimen test for in situ DNA hybridization utilizing a biotinylated probe. The frequency of detection of HSV was similar with both tests; HSV was isolated from 81% of vesicular lesions, 76% of pustules, and 67% of ulcers, while HSV DNA was detected in 77, 76, and 55% of lesions in these stages, respectively. Utilizing both methods, HSV was identified in 91, 94, and 79%, respectively. The sensitivity and specificity of the DNA probe in comparison to standard viral isolation in tissue culture were 92 and 63%, respectively. Seven DNA-positive, viral isolation-negative specimens were obtained from patients who had positive culture confirmation at some time subsequent or prior to enrollment, suggesting that these were true positive results. The sensitivity of the DNA probe was dependent on cellular content of the specimen, and 36 (28%) of the 127 submitted specimens had fewer than 20 nonsuperficial cells. The DNA probe was rapid and convenient; its major disadvantage was the lack of type-specific information. The performance of the probe in lower-prevalence populations and in asymptomatic shedding of HSV remains to be evaluated.

Cells, Cultured↗
PubMed1988

[Rhinoentomophthoromycosis. Therapeutic aspects of the 2 first Congolese cases].

About the two first cases of rhinoentomophthoromycosis (Conidiobolus coronatus) observed in Congo, the spectacular efficiency of ketoconazole must be pointed out: the second patient who has been treated from the beginning, recovered in two months. This evolution is to be compared with the therapeutic difficulties which had occurred before this antimycotic drug was used, as illustrated by the first patient who had to be hospitalized for almost one year and half and to suffer twice from an upper lip necrosis. However, that patient regained a decent facies due to a treatment with ketoconazole which had been postponed for a long time, and added to an hepatitis, and to plastic surgery.

Adult↗
PubMed1987

Diagnosis of herpes simplex virus by direct immunofluorescence and viral isolation from samples of external genital lesions in a high-prevalence population.

One hundred thirty specimens from 108 consecutive patients with a history of recurrent genital ulcerations were used in a study comparing herpes simplex virus (HSV) isolation with a direct fluorescent-antibody (DFA) technique using mouse monoclonal antibodies. HSV was isolated from 70% of vesicular lesions, 67% of pustular lesions, 32% of ulcerative lesions, and 17% of crusted lesions, whereas the DFA technique detected HSV antigen in 87, 67, 30, and 10% of lesions in similar stages, respectively. When both methods were used, HSV was identified in 97, 79, 45, and 17% of vesicles, pustules, ulcers, and crusted lesions, respectively. The overall sensitivity and specificity of the DFA technique in comparison with virus isolation (VI) were 74 and 85%, respectively. Of the 17 patients from whom DFA-positive, VI-negative samples were obtained, HSV was subsequently isolated from a genital lesion in 14, suggesting that they were not DFA false-positives. Similarly, of the 46 patients whose initial lesion samples were DFA and VI negative, 37 (80%) had HSV identified from subsequent genital lesions during follow-up. Thus, a single sample for VI or DFA testing from a recurrent genital lesion had a sensitivity of only 53 and 51%, respectively. Combining the DFA technique and VI increased the sensitivity of laboratory diagnosis of a single recurrent episode of genital HSV; however, repetitive laboratory testing was often required to confirm the diagnosis of recurrent genital HSV infection.

Antibodies, Monoclonal↗