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Biomedical subjects

D Wilson

Publications and source records attributed to D Wilson.

At least 397 records · Page 22Linked to original sources
PubMed1989

Sex worker, client sex behaviour and condom use in Harare, Zimbabwe.

One-hundred sex workers and 100 clients were interviewed at a bar/disco complex in Harare, Zimbabwe in 1989. Sociodemographic characteristics of sex workers and clients were examined. Almost a third of sex workers and nearly 90% of clients had engaged in commercial sex over 5 or more years. Sex workers reported that they worked an average of 4.6 nights a week, averaged 2.2 clients a night and charged a mean of Z$8.7 per session and Z$19.8 per night. Clients reported that they averaged 7.4 visits a month to a sex worker and paid a mean of Z$6.2 per session and Z$17.2 per night. Over half the sex workers said their last client was drunk and nearly two-thirds said he was a repeat client. Sex workers and clients were asked about the sex behaviours completed in their last paid sex act. Vaginal intercourse was reported by 98% of sex workers and clients alike. Manual stimulation of the sex worker's and client's genitalia was reported by roughly 80% of sex workers and clients. Oral and anal sex were rarely reported. Fifty-four percent of sex workers and 44% of clients reported using a condom in their last paid sex act. Client reports thus suggest that sex worker reports of sex acts and condom use with the last client possess considerable validity. Ethnographic approaches were used to study the social and work environment of sex workers. Ethnographic analysis demonstrated a lack of organisation among sex workers and a need to develop cohesive groups for successful health interventions. The study also highlighted the need to include clients in health interventions, the possible role of alcohol as an impediment to health interventions and the feasibility of using bar/disco security and the bar personnel as health educators.

Adolescent↗
PubMed1989

The effects of intradermal bradykinin are potentiated by angiotensin converting enzyme inhibitors in hypertensive patients.

1. To test the hypothesis that angiotensin converting enzyme (ACE) inhibitors potentiate the tissue effects of bradykinin, the thickness of weals produced by intradermal injections of bradykinin was measured in 17 hypertensive subjects whose antihypertensive regimen included an ACE inhibitor, and in 12 whose treatment did not. 2. Weal thickness increased linearly with the logarithm of the bradykinin dose in both groups (P less than 0.0001). 3. The patients receiving ACE inhibitors showed a mean response of 1.18 +/- 0.08 mm (mean +/- s.e. mean), compared with a mean response of 0.75 +/- 0.08 mm for patients not receiving an ACE inhibitor (P = 0.002). Mean weal response (1.08 +/- 0.9 mm) was not significantly different in patients taking captopril (n = 11) compared with that (1.29 +/- 0.12 mm) in patients taking enalapril (n = 9). 4. Facial flushing during the experiment occurred in six patients taking ACE inhibitors but none who were not. 5. Dermal responses to bradykinin are enhanced in patients taking ACE inhibitors as routine antihypertensive therapy. This study supports the hypothesis that bradykinin may be responsible for some of the adverse effects of these drugs.

Adult↗
PubMed1989

Biological and clinical evaluation of the transmandibular implant.

The transmandibular implant has been shown to be a successful clinical solution to prosthetic rehabilitation of patients with gross mandibular atrophy. Aspects of the biocompatibility of the implant material including the component metals in the alloy have been tested in an animal model utilizing sheep. The initial Adelaide results in the clinical multicentre trial are presented. These were generally excellent and the reasons for the few failures are presented.

Aged↗
PubMed1989

Reversible treatment-related leukoencephalopathy.

We present two children with acute lymphocytic leukemia who developed leukoencephalopathy following administration of a combination of intravenous ara = C and methotrexate during the consolidation phase of chemotherapy. Cranial magnetic resonance imaging showed widespread, abnormally high signal intensity in the deep white matter in both patients, though one patient had normal cranial computed tomographic scan. Treatment was modified, symptoms resolved in 1 to 2 weeks, and the white-matter changes resolved over 6 to 12 months. Intravenous cytarabine and methotrexate appear to act synergistically to enhance the potential for central nervous system toxicity. Awareness of this potentially serious complication of chemotherapy can facilitate timely recognition of leukoencephalopathy with the use of magnetic resonance imaging.

Child↗
PubMed1989

[Dyslipidemia and some risk factors in the population outside of the metropolitan region of São Paulo, SP-Brazil. A pilot study].

A survey of the prevalence of lipemic disorders and some risk factors associated with them (obesity, hypertension and alcoholism), in a representative sample of the population of 20 years of age and over in a locality typical of the peripheral zone of the Greater S. Paulo Region, Brazil, both in terms of the poverty of the population and with regard to the lack of public sources such as sewage, transport and housing, is undertaken. The following results were obtained: a) the prevalence of one risk factor was about 55%, and of two or more associated risk factors was of approximately 9% in the age group from 20 to 39. There was found to be a prevalence of about 51% and 57%, respectively of two or more associated risk factors for the age groups from 40 to 59 and 60 years of age and over; b) the prevalence of lipemic disorders proper was of about 49%, 58% and 57% respectively, for the age groups of 20 to 39, 40 to 59 and 60 years of age and over. In these cases the most prevalent risk factors among men were alcoholism and hypertension, either isolatedly or associated with obesity, and among women the most prevalent was obesity, alone or associated with hypertension; c) the most prevalent lipemic disorder was due to HDL-cholesterol, mainly among the younger people. The prevalence lower-than-normal HDL-cholesterol, was of about 28% and of "other lipemic disorders" was of 22% in the age group between 20 and 39 years of age.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Improved tumor-specific immunotoxins in the treatment of CNS and leptomeningeal neoplasia.

A novel antibody-toxin conjugate has been developed for use in cancer therapy. This report demonstrates that this new reagent selectively kills glioblastoma- and medulloblastoma-derived cell lines, medulloblastoma cells in primary culture, and cell lines derived from tumors commonly metastatic to the cerebrospinal fluid (CSF). Efficient killing of human tumor cells occurred at concentrations between 3.9 X 10(-13) M and 1.1 X 10(-10) M, whereas guinea pigs and rhesus monkeys tolerated intrathecal levels of 2 X 10(-9) M. Cerebrospinal fluid from normal humans and from brain-tumor patients does not inhibit the in vitro efficacy of this reagent. The wide therapeutic window, extreme potency, and general applicability of this antibody-toxin conjugate against CSF-borne primary or metastatic tumors warrants clinical trials.

Aged↗
PubMed1989

A medical review approach to Medicare outpatient documentation.

Blue Cross of California has recognized the problem of reimbursement delays due to Medicare claims that have been returned or denied. The information in this article applies to the medical review process and suggests an interpretation of the new Medicare outpatient guidelines used by the Blue Cross of California Medicare reviewers. As a solution to the problem of delayed reimbursement, medical reviewers--who are also practicing occupational therapists--offer an explanation of the Medicare review process and suggestions for correcting technical billing errors. Methods for keeping complete and timely medical records are discussed, with the suggestion that clinicians follow these methods from the start of care. A process for documentation is presented that will clearly prove to the medical reviewer the need for the special skills of an occupational therapist. This article also proposes reasons for noncoverage because of insufficient medical necessity. It is important to note, however, that variance between fiscal intermediaries' interpretations and requirements exists nationwide. This article, therefore, represents only one fiscal intermediary's approach to reviewing claims and medical records.

Ambulatory Care↗
PubMed1989

Histopathology of experimental preretinal neovascularization.

Despite the morbidity resulting from abnormal retinal neovascularization, morphological events associated with its development have not been fully described. We therefore studied sequential morphologic events during preretinal neovascularization in an experimental model induced by injection of 250,000 homologous fibroblasts into the vitreous cavity of rabbits. Within 2 days following fibroblast injection, thickening of many venular and capillary endothelial cells resulted in partial obliteration of their lumina. 3H-thymidine incorporation occurred first in the nonvascular cells of the superficial medullary ray and thereafter in the preretinal vessels and extraretinal fibroblasts. Capillary budding was obvious within 3 days, with endothelial cells extending cytoplasmic processes into fragmented extracellular matrix (ECM). Endothelial cells, at the tips of budding vessels, and at more proximal sites in the parent vessel, incorporated 3H-thymidine and did not lose cell contact or migrate individually into the ECM. Lumina were present throughout the entire length of the buds and endothelial cells remained polarized. Neovascular events observed in this experimental model parallel those previously described in diabetic retinopathy and retinopathy of prematurity in humans.

Animals↗
PubMed1989

Choroid plexus cysts in fetuses with trisomy 18.

An association between fetal choroid plexus cysts and trisomy 18 has been suggested. However, the prevalence of such cysts in aneuploid fetuses is unknown. To determine this frequency, we studied 14 fetuses with trisomy 18 examined at the Central Laboratory for Human Embryology. Five fetuses were found to have choroid plexus cysts on postmortem ultrasound examination. All those with cysts were earlier than 26 weeks in gestation, and the prevalence among second-trimester fetuses was 71.4%. In contrast, such cysts are reported in less than 1% of the general population of second-trimester fetuses. Thus, choroid plexus cysts are common in trisomy 18, and the finding of such cysts on a second-trimester ultrasound examination should suggest further evaluation, including chromosome analysis.

Choroid Plexus↗