Biomedical subjects
Publications and source records attributed to D M Allen.
In-111 labeled leukocyte scintigraphy is a sensitive test for the diagnosis of prosthetic vascular graft infections. However, several causes of false-positive results have been reported. The authors describe a case of uninfected lymphocele around a synthetic vascular graft in a patient who showed an infected graft on In-111 labeled leukocyte scintigraphy.
BACKGROUND: Intravenous drug use has played a key role in the human immunodeficiency virus (HIV) epidemic. Standardized surveillance of HIV infection among intravenous drug users (IVDUs) is needed to determine HIV prevalence rates, to monitor changes in prevalence over time, and to describe behaviors associated with HIV infection. METHODS: In 1987, the Centers for Disease Control began collaborating with state and local health departments to conduct a national program of HIV seroprevalence surveys in a variety of populations and settings. This program includes unlinked HIV seroprevalence surveys in IVDUs entering sentinel drug treatment programs. RESULTS: From April 1988 through December 1989, annual studies were completed in 59 drug treatment centers in 33 US cities. Center-specific seroprevalence rates ranged from 0% to 48.2%, with a median of 4.6%. HIV seroprevalence rates varied widely by geographic area, with rates highest in the Northeast, intermediate in the Middle Atlantic cities of Baltimore and Washington, DC, and lower in other parts of the country. Median rates were 15.6% among African Americans, 3.2% among Hispanics, and 3.3% among Whites. CONCLUSIONS: Intravenous drug use is likely to remain an important factor in HIV transmission. This study supports the need to develop or expand programs to prevent the further introduction and spread of HIV among IVDUs and to prevent HIV transmission to their sexual partners.
A retrospective study of patients admitted to the Singapore General Hospital Burn Unit with > 30% total body surface area burns was performed to establish the prevalence of fungal colonisation and invasive fungal disease (IFD). Forty-eight percent of patients surviving at least ten days following thermal injury had fungi isolated. IFD was documented in ten patients. Risk factors associated with the development of IFD, clues to assist in diagnosing IFD, and therapeutic options for managing IFD are reviewed.
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Respiratory infections occur commonly in patients with advanced human immunodeficiency virus (HIV) infection. Prompt accurate diagnosis is essential as many of the various available therapies have significant toxicities. We describe a patient previously diagnosed with the acquired immunodeficiency syndrome (AIDS) who was found to have cytomegalovirus (CMV) pneumonitis on bronchoscopy. His pneumonitis responded to treatment with the nucleoside analogue ganciclovir. Our patient is the first documented CMV pneumonitis in the Singapore HIV seropositive population.
Cases of AIDS among women of reproductive age have increased dramatically since 1981; nearly a third of all cases among females were reported in 1990 alone. Surveillance of human immunodeficiency virus (HIV) infection among women is essential for monitoring the spread of HIV over time and identifying specific populations and geographic areas in need of HIV counseling, testing, and prevention services. Blinded (unlinked) serologic surveys were conducted in the United States and Puerto Rico in sentinel clinics providing reproductive health services to women, including family planning, prenatal care, and abortion services. Seventy-eight of 94 clinics (83%) in 30 cities conducting surveys during 1988 and 1989 detected at least one HIV-positive woman. Clinic-specific prevalence ranged from 0-2.28% (median 0.22%), with rates over 1% occurring in clinics predominantly on the East Coast and in Puerto Rico. Seroprevalence varied by primary type of service, race-ethnicity, and age group. Median rates were higher in clinics offering prenatal services and lower in abortion and family planning clinics in the same cities. In general, women 25-29 years of age showed the highest median rate of infection (0.32%), and rates were higher among black women (median 0.34%) than among Hispanic (median 0.11%) and white women (median 0%). Our data indicate the need to educate women about recognizing and reducing their risk of HIV infection. Reproductive health clinics with high seroprevalence should implement voluntary HIV counseling and testing with appropriate follow-up clinical evaluation and referral for infected women. Clinics with low prevalence should seize the opportunity to enhance HIV education and prevention efforts.
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Infections are a leading cause of morbidity and mortality in the elderly. Altered host defences, a senescent immune system, chronic illnesses, and environmental factors all contribute to the aged's predisposition to infection. Infections can present in atypical fashion contributing to diagnostic and therapeutic delays. Awareness of altered antibiotic absorption, metabolism, and excretion in the elderly is essential to correct antibiotic selection and dosing. Additionally, antibiotic interactions with medications commonly used to treat chronic illnesses should be taken into consideration prior to antibiotic prescribing. Prevention of infectious complications in the elderly requires interest, education, vaccination, and early intervention.
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Informed consent forms are used in biomedical research as a mechanism to convey study information to potential subjects so that they may arrive at a decision concerning their willingness to participate. Although the Department of Health and Human Services Regulations for the Protection of Human Subjects require the presentation of specific study information at a level that is easily understood, according to research concerning adult biomedical consent forms, the typical form is not readily comprehensible. Unfortunately, no data exist concerning the readability of informed consent forms that are used in the context of pediatric biomedical research. In the present study, readability analyses were conducted on a large sample (N = 238) of pediatric biomedical informed consent forms obtained during a 10-year period from a large midwestern children's hospital. For the entire sample, results derived from two readability estimates (Fry grade equivalent and Flesch Reading Ease methods) indicated that the consent forms were written at the college graduate level. Although there was a linear increase in the length of the consent document during the 10-year period evaluated, expanded length was not associated with improved readability. According to analyses, a differential pattern of reading difficulty was associated with specific sections of the informed consent document. Findings are highly consistent with those from studies of adult biomedical consent form and document that the purpose of the informed consent form is being compromised, in part, by a readability factor. Suggestions for solving this critical problem are advanced.
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Physically abused and nonabused children were compared on child-completed measures of depression, hopelessness, self-esteem, and locus of control. Results indicated that, in comparison with nonabused controls, abused children evidenced more depressive symptoms, heightened externality, lower self-esteem, and greater hopelessness about the future. Group differences in depressive symptomatology were not accounted for on the basis of differences in age, sex, race, gender, IQ, or socioeconomic status. Results replicate the results of Kazdin, Moser, Colbus, and Bell (1985) derived from a sample of physically abused psychiatric inpatients and extend the generality of these findings to abused children of nonpatient status. Implications of the findings for clinical interventions, theoretical models of child depression, and future research are discussed.
Fifty-five fall-born, Simmental-crossbred, male calves were allotted at birth to one of five treatments: bulls castrated at 5 mo and implanted from birth to slaughter (ST); bulls implanted from birth to slaughter (BI-BS); bulls implanted from birth to weaning (BI-BW); bulls implanted from weaning to slaughter (BI-WS) and non-implanted control bulls (CB). Implanted calves received 36 mg of zeranol at approximately 100-d intervals. Calves were fed a high-concentrate diet from 8.1 mo of age to an average slaughter age of 17 mo. Longissimus steaks (LS) were evaluated for palatability traits by both a trained sensory panel (TSP) and a take-home consumer panel (CP). Conclusions from both panels were similar. The TSP found LS from ST to be juicier (P less than .05) than LS from all bull groups, and to be more tender (P less than .05) than LS from BI-BW and BI-WS. The CP found LS from ST to be juicier, more tender and more acceptable (P less than .05) than LS from BI-BW, BI-WS and CB. Steaks from BI-BS were more tender (P less than .05) than LS from BI-WS and CB. Steaks from BI-BS and BI-BW had lower (P less than .05) shear values than LS from CB, but LS from ST had lower (P less than .05) shear values than LS from all bull groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Techniques are described for the estimation of parameters in nonlinear models. When implemented in computer programs, these techniques will reduce programming effort, facilitate inference about implicit functions of parameters, and allow a more general variance-covariance structure. The techniques seem particularly useful for the analysis of data from stochastic compartmental models. They are illustrated by an example.
Procedures are described for fractionating cells utilizing a universally applicable cellular affinity chromatography matrix. The affinity matrix consists of immunoabsorption purified goat anti-fluorescein isothiocyanate antibody coupled to large derivatized polyacrylamide beads. This matrix may, in principle, be used to isolate any cell subpopulation provided it has a fluorescein-labeled ligand on its surface. In this report the matrix was used to isolate viable purified fractions of mouse surface Ig-positive cells, Lyt1 cells, and mouse lymphocytes that bind the lectin soybean agglutinin. A preliminary experiment using the anti-FITC beads suggested that this technique can provide a fraction of cells enriched in antigen binding cells. Cell populations isolated by this technique retain their ability to respond to in vitro mitogen stimulation, as well as their ability to be maintained in cell culture following fractionation. Additional experiments using a column consisting of goat anti-rabbit Ig antibody coupled to the same support material are also reported.
A 3-year study of male prostitutes is presented with relevant data about their origin, their social and family background, education, sexuality, drug and alcohol use, and delinquency. A classification has been developed which separates the male prostitutes into four groups: group I, Full-time street and bar hustlers; II, full-time call boys or kept boys; group III, part-time hustlers, usually students or employed; and group IV peer-delinquents, who use prostitution and homosexuality as an extension of other delinquent acts [assault and robbery]. Similarities and differences between the four groups in terms of their psychosocial background, motives, and type of operation are described. Limited follow-up data indicate that only part-time male prostitutes, who continue in education or vocational training, have a reasonable expectation of an eventually stable social adjustment.
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