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Biomedical subjects

D Smith

Publications and source records attributed to D Smith.

At least 829 records · Page 46Linked to original sources
PubMed1990

The significance of the detection of cytomegalovirus in the bronchoalveolar lavage fluid in AIDS patients with pneumonia.

We performed a retrospective study on 112 patients with AIDS-related pneumonias who underwent bronchoscopy and in whom Pneumocystis carinii pneumonia (PCP) and/or cytomegalovirus (CMV) were identified in bronchoalveolar fluid (BAL). CMV was identified by detection of early antigen fluorescent foci (DEAFF) testing in cell cultures of BAL fluid. The short- and long-term survival of all patients was similar regardless of whether PCP, CMV or both were detected at bronchoscopy. Ten out of 14 patients with CMV alone and 13 out of 26 with both CMV and PCP were treated with anti-CMV therapy, but the short- and long-term mortality was similar to that in patients who had no specific antiviral therapy. Extrapulmonary recurrence of CMV (retinitis or gastrointestinal disease) occurred in 22% of patients with evidence of CMV in BAL compared with 16% of those with PCP alone, but this difference was not statistically significant and this recurrence rate was independent of anti-CMV therapy. Detection of CMV shedding from more than one site (BAL, urine, throat or blood) was associated with a worse prognosis at 3 months than in patients in whom CMV was detected in BAL alone. It does not appear that finding CMV shedding is a guide to the cause of pneumonia or an indication for treatment in AIDS patients.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Pneumocystis carinii pneumonia treated with eflornithine in AIDS patients resistant to conventional therapy.

Eflornithine (DFMO) was used to treat 31 AIDS patients with confirmed Pneumocystis carinii pneumonia who had clinically failed treatment with pentamidine, sulphamethoxazole-trimethoprim or both agents as their first-line therapy. Twenty-one of 31 (68%) responded to second-line treatment with 400mg/kg per day of eflornithine. Five patients discontinued treatment because of bone marrow toxicity. Eflornithine appears to be a useful salvage therapy in patients failing first-line treatments.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Association of entropion with cataract surgery.

Ptosis may develop after cataract surgery because of a dehiscence of the levator aponeurosis. A series of patients undergoing entropion repair was examined in order to determine the mechanism of entropion and the correlation with cataract surgery. It is suggested that involutional senile entropion may develop related to cataract surgery, on the same basis as ptosis, due to disinsertion of the capsulopalpebral fascia. It is suggested that the cataract surgeon should examine the patient closely for preoperative entropion to prevent or anticipate the development of frank entropion after the cataract surgery.

Adult↗
PubMed1990

Ampicillin/sulbactam versus clindamycin in the treatment of postpartum endomyometritis.

Sixty-eight patients with postpartum endomyometritis were enrolled in this open randomized comparative study. Forty-two patients received ampicillin/sulbactam and 26 received clindamycin. The cure rates were similar in the two groups: 83% in the ampicillin/sulbactam group and 88% in the clindamycin group. The most frequent endometrial bacterial isolates were Bacteroides bivius, Streptococcus faecalis, Escherichia coli, and Ureaplasma urealyticum. Bacteremia was present in 15 of 68 (22%), the most frequent isolates being Mycoplasma (four cases) and B bivius (three cases). Clindamycin-resistant species were S faecalis, E coli, and Proteus mirabilis. There were seven treatment failures in the ampicillin/sulbactam group; only one isolate (an E coli) was resistant to ampicillin/sulbactam. In a significant number of these failures, Mycoplasma was isolated. Ampicillin/sulbactam and clindamycin were found to be equally efficacious in the treatment of postpartum endometritis.

Adult↗
PubMed1990

Evaluation of public education campaigns in cutaneous melanoma: the King's College Hospital experience.

The effects of a public education campaign directed at earlier self-recognition of malignant melanoma were assessed at King's College Hospital by reviewing the pathology of all melanomas seen between 1970 and 1987. During the campaign years (1986 and 1987) the number of patients with melanomas nearly doubled, and there was an increase in the proportion of thin, good prognosis lesions, and a fall in the proportion and absolute number of thick lesions. Data from the earlier years showed that median melanoma thickness had been decreasing throughout the series, well before the introduction of the campaign. A greater proportion of tumours of the superficial spreading variety was seen and also an increase in patients below the age of 40. These findings suggest that the biological characteristics of melanomas might be changing in addition to increased public and professional awareness.

Adult↗
PubMed1990

Antigen challenge induces pulmonary airway eosinophil accumulation and airway hyperreactivity in sensitized guinea-pigs: the effect of anti-asthma drugs.

1. Guinea-pigs were sensitized with 3 injections of ovalbumin (OA) (1 or 10 micrograms per animal) using Al(OH)3 and pertussis vaccine as adjuvants at two week intervals. 2. Sensitized guinea-pigs were challenged with an aerosol of OA (0.1%) over a one hour period and both airway reactivity and cellular content of bronchoalveolar lavage (BAL) fluid were assessed at intervals for up to 7 days. 3. Guinea-pigs sensitized with 1 microgram of ovalbumin responded to an aerosol of OA with increased pulmonary airway eosinophilia, which was evident 1 day after challenge and was present for up to 7 days. Airway hyperreactivity was not detectable in these animals. 4. Guinea-pigs sensitized with 10 micrograms of ovalbumin responded to an aerosol of OA with increased pulmonary airway neutrophilia and eosinophilia and with increased airway reactivity which was maximal between 8 and 24 h after exposure to OA. 5. Depletion of circulating platelets or neutrophils, by use of selective antisera, did not alter either the magnitude of eosinophilia or the intensity of airway reactivity in sensitized guinea-pigs (10 micrograms) exposed to an aerosol of OA. 6. Pretreatment of sensitized guinea-pigs (10 micrograms) for 6 days with AH 21-132, aminophylline, dexamethasone or ketotifen inhibited pulmonary airway eosinophilia, but did not diminish airway hyperreactivity. Neither eosinophil accumulation nor development of airway hyperreactivity was influenced by treatment with mepyramine or salbutamol over a 6 day period before OA inhalation. 7. Although eosinophilia may occur in association with increased airway reactivity in this animal model, there is no evidence of a causal relationship.

Animals↗
PubMed1990

Eosinophil accumulation in pulmonary airways of guinea-pigs induced by exposure to an aerosol of platelet-activating factor: effect of anti-asthma drugs.

1. Exposure of guinea-pigs to aerosols of platelet activating factor (PAF) (0.01 to 100 micrograms ml-1) induced a dose-dependent increased incidence of eosinophils in bronchoalveolar lavage fluid (BAL) at 48 h. Total leucocyte numbers and the percentages of lymphocytes and neutrophils were unchanged in BAL fluid. 2. Increased numbers of eosinophils were detected in BAL 1 h after exposure to PAF but eosinophilia was not maximal until 48 h. One week after exposure to PAF, the percentage of eosinophils in BAL was within the normal range. 3. Depletion of circulating platelets or neutrophils by intravenous injection of specific antisera did not modify accumulation of eosinophils in the airway lumen following inhalation of PAF (10 micrograms ml-1). 4. PAF-induced pulmonary airway eosinophil accumulation was inhibited by treatment with SDZ 64-412, a selective PAF-antagonist, whether the compound was administered before, or 30 min after, inhalation of PAF. 5. Pulmonary airway eosinophil accumulation due to inhaled PAF (10 micrograms ml-1) was inhibited by prior treatment with aminophylline, cromoglycate, ketotifen, dexamethasone and AH 21-132. 6. Pulmonary airway eosinophil accumulation due to inhaled PAF (10 micrograms ml-1) was not inhibited by prior treatment with indomethacin, salbutamol or mepyramine.

Aerosols↗
PubMed1990

Pretreatment with rh-GMCSF, but not rh-IL3, enhances PAF-induced eosinophil accumulation in guinea-pig airways.

Intraperitoneal injections of recombinant human granulocyte-macrophage colony stimulating factor (rh-GMCSF, 50 micrograms/kg-1 daily) or interleukin-3 (rh-IL3, 50 micrograms kg-1 daily) for two days, induced an increase in the percentage of bone marrow and pulmonary airway eosinophils in the guinea-pig. In addition, rh-IL3-treated animals exhibited an increase (21%) in blood neutrophils. Exposure of guinea-pigs to an aerosol of platelet activating factor (PAF) gives rise to a selective pulmonary eosinophil accumulation, maximal at 48 h. The eosinophilic response to PAF was significantly enhanced in rh-GMCSF-treated guinea-pigs but was suppressed in rh-IL3-treated animals.

Aerosols↗
PubMed1990

Preschool sarcoidosis masquerading as juvenile rheumatoid arthritis: two case reports and a review of the literature.

Preschool sarcoidosis is characterized by the triad of skin, joint, and eye disease without pulmonary involvement. Arthritis and uveitis are also frequently seen together in juvenile rheumatoid arthritis. We report two patients with preschool sarcoidosis, both of whom were initially diagnosed and treated as having juvenile rheumatoid arthritis. Skin biopsy is an important early diagnostic procedure to differentiate the conditions. The uveitis in both diseases can have serious sequelae.

Arthritis, Juvenile↗
PubMed1990

Urban black and white adolescents' physical fitness status and perceptions of exercise.

The modified Harvard Step Test and a 70-item questionnaire based on the Health Belief Model (HBM) were given to 257 high school students, 154 blacks, and 93 whites. Mean age of students was 16.0 years (SD = 1.1) for whites and 15.8 years (SD = 1.1) for blacks. Though more blacks than whites were in poor physical condition (51% females and 27% males vs. 35% females and 16% males, respectively), the difference was not statistically significant. A high level of concurrence existed between individuals in good physical condition and those who stated they regularly exercised, but this agreement was more pronounced among white students (73% vs. 62% for black students). White students were significantly more knowledgeable than black students on the exercise knowledge subscale. No significant differences existed between black and white students on any other HBM subscales. When subscale scores for those in good versus poor physical condition were compared, significant differences were found on all subscales except the perceived benefits subscale. Analysis of individual questionnaire items which best predicted whether one was in poor or good physical condition found four items accounted for 38% of variance in black students, and seven items accounted for 52% of variance in white students.

Adolescent↗
PubMed1990

Sequence analysis and expression of the two genes for elongation factor 1 alpha from the dimorphic yeast Candida albicans.

Two Candida albicans genes that encode the protein synthesis factor elongation factor 1 alpha (EF-1 alpha) were cloned by using a heterologous TEF1 probe from Mucor racemosus to screen libraries of C. albicans genomic DNA. Sequence analysis of the two clones showed that regions of DNA flanking the coding regions of the two genes were not homologous, verifying the presence of two genes, called TEF1 and TEF2, for EF-1 alpha in C. albicans. The coding regions of TEF1 and TEF2 differed by only five nucleotides and encoded identical EF-1 alpha proteins of 458 amino acids. Both genes were transcribed into mRNA in vivo, as shown by hybridization of oligonucleotide probes, which bound specifically to the 3' nontranslated regions of TEF1 and TEF2, respectively, to C. albicans total RNA in Northern (RNA) blot analysis. The predicted EF-1 alpha protein of C. albicans was more similar to Saccharomyces cerevisiae EF-1 alpha than to M. racemosus EF-1 alpha. Furthermore, codon bias and the promoter and termination signals of the C. albicans EF-1 alpha proteins were remarkably similar to those of S. cerevisiae EF-1 alpha. Taken together, these results suggest that C. albicans is more closely related to the ascomycete S. cerevisiae than to the zygomycete M. racemosus.

Amino Acid Sequence↗
PubMed1990

Training-induced alterations in muscle glycogen utilization in fibre-specific types during prolonged exercise.

Using the glycogen depletion technique, we have examined utilization of specific fibre types during prolonged submaximal exercise to investigate the recruitment pattern employed by the central nervous system to sustain force generation in the face of a progressive glycogen depletion. Six male subjects (Vo2 max, 52.8 +/- 2.5 mL.kg-1.min-1, mean +/- SE) cycled at 59% of pretraining Vo2 max (the same absolute power output) for 99.5 +/- 6 min on two occasions, before training and after 10-12 days of intensive training, involving 2 h of cycling per day. Prior to the training, glycogen concentration during exercise in the type I and type IIA fibres of the vastus lateralis muscle as measured by microphotometric techniques was progressively reduced during exercise. The pattern of depletion in both of these fibre types was parallel and showed an early marked depletion amounting to 51 (p less than 0.05) and 35% (p less than 0.05) in the type I and type IIA fibres, respectively, during the first 15 min of exercise. At the end of exercise, glycogen levels in type I and type IIA fibres were reduced to 9 and 44% of initial levels, respectively. In contrast, glycogen concentration in type IIB fibres was not significantly (p less than 0.05) altered throughout the exercise. Following training, a pronounced glycogen sparing occurred that was conspicuous in only the type I and type IIA fibres, which was most pronounced during the first 15 min of the exercise. Similar to pretraining, glycogen concentrations in type IIB fibres were unaffected by either exercise or training.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

The prevalence of posttraumatic stress disorder and its clinical significance among Southeast Asian refugees.

All 322 patients at a psychiatric clinic for Indochinese refugees were surveyed to determine the presence of posttraumatic stress disorder (PTSD). If PTSD was not diagnosed at the time of initial evaluation, a structured reinterview was performed. Seventy percent of the patients (N = 226) met the criteria for a current diagnosis of PTSD, and an additional 5% (N = 15) met the criteria for a past diagnosis. The Mein had the highest rate of PTSD (93%) and the Vietnamese the lowest (54%). Of the patients with PTSD who were enrolled in the clinic before March 1988, 46% (N = 87) were given a diagnosis of PTSD only after the reinterview. PTSD is a common disorder among Indochinese refugees, but the diagnosis is often difficult to make.

Asia, Southeastern↗
PubMed1990

Evaluating understanding of popular press reports of health research.

This research assessed the ability of a sample of persons on a college campus to understand media reports of health research. Three or four articles on each of five contemporary health topics (dietary cholesterol and heart disease, treatment for breast cancer, starch blockers, drug treatment for heart disease, test tube skin) were selected from widely circulated newspapers (e.g., New York Times) and magazines (e.g., Newsweek). A sample of 144 college students responded to content-based and application-based questions derived from photocopies of these popular press articles. The overall rate of reader misunderstanding approached 40% and generally fell between one third and one half for each of 16 articles representing five health topics. Several strengths and weaknesses of the research are considered as they relate to the accuracy of estimated error rates and to the generality of study findings. The implications of these findings for other areas of health (e.g., AIDS risk factor research) are also discussed.

Adolescent↗
PubMed1990

Cat endothelial morphology after corneal transplant.

The cat has been suggested as a superior model to evaluate penetrating keratoplasty and corneal endothelial damage and repair. Morphologic change is felt to be a sensitive indicator of endothelial stress response. We documented corneal thickness and endothelial morphometric parameters of eight cats before and after homograft penetrating keratoplasty using an Eisner contact glass. One-hundred-cell samples from preoperative and 6.18 +/- 0.57 weeks and 9.25 +/- 0.84 months (means +/- standard errors of the means) postoperative photomicrographs were computer analyzed. Cell density (cells/mm2), coefficient of variation of cell area, percent hexagonal cells, and mean figure coefficient were measured. Values are given as means +/- standard errors of the means. Preoperative coefficient of variation for area, 19.1 +/- 0.4, was significantly greater (22.0 +/- 1.0) six weeks after surgery. At nine months, cell density (1487 +/- 114) and percent hexagonal cells (59.6 +/- 2.1) were significantly less than six week values (cell density = 2053 +/- 201, percent hexagonal cells = 68.1 +/- 1.5) and preoperative values (cell density = 2395 +/- 94, percent hexagonal cells = 69.3 +/- 1.1). Thus there is evidence of polymegethism six weeks after surgery and persistent decreased cell density and pleomorphism nine months after surgery.

Analysis of Variance↗
PubMed1990

Erythropoietin.

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Amino Acid Sequence↗