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Biomedical subjects

D Wilson

Publications and source records attributed to D Wilson.

At least 415 records · Page 23Linked to original sources

Urinary tract infections in the pediatric patient.

Urinary tract infections (UTIs) can be difficult to diagnose positively in the pediatric patient. The patient with such an infection, however, is at risk for subsequent morbidity such as recurrence, renal damage and hypertension. Accurate diagnosis in the very young child may require multiple urine specimens involving repeating bag specimens, catheterization, or suprapubic aspiration. Septic children and those with pyelonephritis must be hospitalized. Children younger than 6 years old need follow-up with radiographic studies to rule out reflux and congenital anomalies. The clinician plays a significant role in detecting possible UTIs, and providing patient education and support.

Anti-Bacterial Agents↗

Knowledge about AIDS among Zimbabwean teacher-trainees before and during the public awareness campaign.

Knowledge about AIDS was studied among 4,189 Zimbabwean teacher-trainees from January to March, 1988, about six months after a national AIDS awareness campaign began. Knowledge about AIDS among part of this sample of teacher-trainees surveyed after the AIDS campaign began was also compared with that displayed by 630 teacher-trainees studied in January, 1987, roughly six months before the AIDS campaign began. Over 85 percent of 1988 subjects knew that AIDS is fatal and incurable. More than 80 percent of 1988 respondents knew that a condom is an effective precaution against AIDS. However, among 1988 participants, 35 percent did not know that many people carrying the AIDS virus look healthy, 36 percent believed that many AIDS victims in Africa are homosexual, 36 percent did not know that one cannot contract AIDS from a toilet seat, 40 percent believed that kissing transmits AIDS and nearly half believed that mosquitoes transmit AIDS. Males and subjects from urban homes were better informed about AIDS than females and those from rural homes, respectively. Teacher-trainees surveyed in 1988 were generally more knowledgeable about AIDS than those studied in 1987. The implications of these results for further educational efforts are considered.

Acquired Immunodeficiency Syndrome↗

Promoting driving safety for teens and adults.

Traffic accidents are a major cause of death and disability, accounting for significant numbers of brain injuries. The purpose of this article is to discuss those conditions that can affect driver safety. The role of the nurse practitioner in primary prevention involves assessing the health status of drivers, including risk-taking behavior, age-related factors, use of alcohol and medications, and chronic illnesses and physical conditions that can result in driver impairment. Interventions can include patient education, anticipatory guidance, role-playing, referral for skill-building or driver evaluation, and reporting potentially unsafe drivers in keeping with state guidelines. Practitioner involvement in grass-roots community groups is encouraged.

Accidents, Traffic↗

The role of the diphtheria toxin receptor in cytosol translocation.

The role of the receptor in the transport of diphtheria toxin (DT) to the cytosol was examined. A point-mutant form of DT, CRM 107 (CRM represents cross-reacting material), that has an 8,000-fold lower affinity for the DT receptor than native toxin was conjugated to transferrin and monoclonal antibodies specific for the cell-surface receptors T3 and Thy1. Conjugating the binding site-inactivated CRM 107 to new binding moieties reconstituted full toxicity, indistinguishable from native DT linked to the same ligand, indicating that the entry activity of the DT B chain can be fully separated from the receptor binding function. Like DT, the toxin conjugates exhibited a dose-dependent lag period before first-order inactivation of protein synthesis. Inactivation of the binding site of the toxin portion of the conjugate was found to have no effect on the kinetics of protein synthesis inactivation. The receptor used by the toxin determined the length of the lag period relative to the killing rate. Comparing the potency of CRM 107 conjugates with native DT, standardized for receptor occupancy, shows that new receptors can be as or more efficient than the DT receptor in transporting DT to the cytosol. The transferrin-CRM 107 conjugate, unlike native DT, was highly toxic to murine cells. All the data presented are consistent with a model that the DT receptor, other than initiating rapid internalization of the toxin to low pH compartments, is unnecessary for transport of the toxin to the cytosol and that membrane translocation activity is expressed by the DT B subunit independent of the receptor-binding site.

4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfo↗

Placental transfer of thiamine in the human subject: in vitro perfusion studies and maternal-cord plasma concentrations.

The transfer of thiamine across human placenta has been studied in an in vitro perfusion system. With the maternal and fetal perfusates not recirculated, the transfer index (ratio of clearance of thiamine to that of L-glucose) toward the fetus was 2.09 +/- 0.36, suggesting a mediated transport system. In the reverse direction, the transfer rate approximates that expected from simple diffusion (transfer index 0.78 +/- 0.25). Stepwise increases in thiamine concentration in the maternal perfusate were associated with parallel increases in transfer rates up to 500 nmol/L. Above that concentration, the rate of increase declined and the transfer index fell. When the maternal perfusate was recirculated and the fetal circulation was kept open, the thiamine concentration rapidly decreased, reaching a plateau in 30 to 40 minutes at a level about 0.1 to 0.2 of the fetal perfusate. In contrast, the concentration within the placenta greatly exceeded those in the perfusates. The observations indicate an effective transport system directed toward the fetus, saturable at low concentrations and capable of establishing a transplacental gradient. Measurement of thiamine concentrations in 20 paired samples of plasma obtained at term demonstrated a mean (+/- SD) cord:maternal ratio of 2.5 +/- 1.4. Differential protein binding was excluded as a cause of the gradient. The in vivo gradient is probably attributable to placental transport.

Blood Proteins↗

In vitro transepidermal water loss: differences between black and white human skin.

In vivo transepidermal water loss studies are characterized by large inter-individual variability and biased by environmental effects and eccrine sweating. An in vitro technique for measuring transepidermal water loss (TEWL) was used to compare TEWL in two racial groups--blacks and whites. In both groups a significant correlation between skin temperature and increased TEWL was found (P less than 0.01). Furthermore, black skin had a significantly higher mean TEWL than white skin, corrected log TEWL 2.79 and 2.61 micrograms/cm2/h, respectively. The difference in TEWL between the groups could because measurements were made in the absence of eccrine sweating and other vital functions. The higher TEWL in black skin could be explained on the basis of a thermoregulatory mechanism. The anatomical and physiological differences in the stratum corneum between different races are discussed.

Adolescent↗

Susceptibility to cumulative and acute irritant dermatitis. An experimental approach in human volunteers.

Reactivity to repeated daily sodium lauryl sulfate (SLS) applications and patch test reactivity to SLS was studied in 23 females. Skin changes were quantified by transepidermal water loss (TEWL), dielectric water content (DEWC), laser Doppler velocimetry (LDV) and visual scoring (VS). Dermatologic histories (HS) and susceptibility to sunburn (ST) were obtained and clinical skin dryness evaluated (DS). Great interindividual variation occurred in the degrees of changes in the biophysical parameters measured: the variation was most apparent in TEWL. The subjects with HS 1 or more developed greatest TEWL increase after open SLS applications (p less than 0.05). DS showed poor correlation with SLS reactivity and only minor DEWC alterations were seen. ST showed some non-significant correlation with erythema reactivity in the patch test.

Adult↗

Autoradiographic analysis of hepatocytes in mirex-induced adaptive liver growth.

The relationships between [3H]thymidine incorporation into hepatocyte nuclei, cell enlargement, and mitotic index were studied in intact (INT) and adrenalectomized (ADX) mirex-dosed rats. In INT mirex-dosed rats the sequence of events included the following: a biphasic response in nuclear labeling of mononuclear hepatocytes with peaks at 48 and 66 h postmirex dose, a peak in mitotic activity 66 h postmirex dose, and a significant increase in binuclear hepatocyte size 48 h postmirex dose. In ADX mirex-dosed rats the sequence of events included the following: a biphasic response in nuclear labeling of mononuclear hepatocytes with peaks at 24 and 48 h postmirex dose, a peak in mitotic activity 60 h postmirex dose, and a marginal increase in binuclear hepatocyte size 48 h postmirex dose. Corticosterone supplements to ADX mirex-dosed rats significantly reduced nuclear labeling of the mononuclear hepatocytes and increased the size of binuclear hepatocytes to that observed in INT mirex-dosed rats. This study demonstrates that adaptive liver growth consists of a hyperplastic response that involves mononuclear hepatocytes and a hypertrophic response that involves binuclear hepatocytes. Both responses appear to be modulated by corticosterone.

Adaptation, Physiological↗

Use of sodium restriction and enalapril in persons with moderate to severe hypertension.

One hundred and seventy-four patients who were receiving drug therapy for hypertension were asked to restrict their sodium intake for three months. At the end of that time their drug therapy was replaced with enalapril and the dose of the drug "titrated" to obtain a diastolic blood pressure of less than 90 mmHg. Sodium restriction caused a small fall in blood pressure and could be used as sole therapy in only 6% of patients. Enalapril therapy was instituted without problems and control of blood pressure below 90 mmHg was achieved in 62% of persons with monotherapy. The number of tablets of enalapril that were taken was reduced from 5.9 to 2.7; in most patients these were taken once a day. There were few side-effects and no depression of white cell count, no proteinuria and no deterioration of renal function. Seventy-six per cent of patients preferred the new regimen either because they felt better than with their previous therapy (52%) or because of the more simple regimen (24%). Enalapril was an effective, well tolerated antihypertensive agent and potentially has a major role to play in the management of patients with high blood pressure.

Antihypertensive Agents↗

Pars plana vitrectomy for vitreous amyloidosis.

Thirty-six pars plana vitrectomies were performed on 30 eyes of 17 patients with biopsy-proven vitreous amyloidosis. Reopacification of the retrolental vitreous was the most common reason for vitrectomy revision, required in 24% of patients. Complications of amyloid or vitrectomy included retinal detachment requiring scleral buckling in 17% of eyes and glaucoma requiring filtering surgery in 17% of eyes. After a mean 35-month post-vitrectomy follow-up, 48% of eyes had visual acuities of 20/40 or better, and 32% of eyes had visual acuities between 20/50 and 20/100. Twenty percent of eyes had visual acuities of 20/200 or worse due either to persistent retinal detachment, open angle glaucoma, or residual opacification of the vitreous.

Amyloidosis↗

Surgicel: macrophage processing of the fibrous component.

Previous reports have demonstrated that Surgicel, a local haemostatic agent, is absorbed from implantation sites. In an earlier study, it was shown that the material consists of a uronic acid component and a fibrous residue. A chemically quantified loss of the uronic acid component within 18 h of implantation was demonstrated. The aim of the present study was to examine the fate of the fibrous residue in rat tissues, using both light and electron microscopy. Results indicated that this fibrous component is phagocytosed by macrophages at the site of implantation. A model for the clearance of Surgicel from tissue implantation sites is presented.

Animals↗