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Biomedical subjects

David Hunter

Publications and source records attributed to David Hunter.

65 records · Page 4Linked to original sources
PubMed2002

Pelvic pain scores in women without pelvic pathology.

STUDY OBJECTIVE: To assess the presence of and quantify pelvic pain in a group of women without demonstrable pelvic pathology as confirmed by laparoscopy. DESIGN: Prospective observational study (Canadian Task force classification II-2). SETTING: District general hospital. PATIENTS: One hundred forty-three consecutive women undergoing laparoscopy for sterilization, infertility investigation, or assessment of pelvic pain. INTERVENTION: Laparoscopy. MEASUREMENTS AND MAIN RESULTS: Women were asked to complete a questionnaire including a visual analog score for four different types of pelvic pain (dysmenorrhea, pelvic pain, dyspareunia, rectal pain) and three quality of life assessments. Forty-three women were excluded due to pelvic pathology. In the 100 remaining women, mean pain scores (maximum 10) were dysmenorrhea 3.77, pelvic pain 1.75, dyspareunia 1.54, and rectal pain 1.07. Quality of life assessment was no different from that in a healthy population in whom the instruments were validated. CONCLUSION: Pelvic pain, principally dysmenorrhea, is common in women of reproductive age. Pain scores may be used to compare treatments for pelvic pain and provide useful information for preoperative counseling.

Adolescent↗
PubMed2002

Noninvasive diagnosis by Doppler ultrasonography of fetal anemia resulting from parvovirus infection.

OBJECTIVE: The purpose of this study was to evaluate the feasibility of the middle cerebral artery peak systolic velocity for the detection of fetal anemia in pregnancies that are complicated by parvovirus B19 infection. STUDY DESIGN: Doppler measurements of the middle cerebral artery peak systolic velocity were performed weekly in 32 fetuses at risk for anemia because of maternal parvovirus infection documented by the presence of serum immunoglobulin M antibody. The values of the middle cerebral artery peak systolic velocity and hemoglobin were expressed as multiples of the median. These values were plotted on reference ranges that had been established previously. A cordocentesis was performed either because of fetal ascites or when the middle cerebral artery peak systolic velocity values suggested anemia (middle cerebral artery peak systolic velocity, >1.50 multiples of the median). RESULTS: Gestational age at study entry ranged from 15.1 to 37 weeks. There were 17 fetuses with middle cerebral artery peak systolic velocity of >1.50 MoM (group 1). Sixteen cordocenteses were performed in these fetuses. All 16 fetuses were anemic (15 severely and 1 mildly). Thirteen fetuses had signs of hydrops (12 with severe and 1 with mild anemia). Group 2 included 15 fetuses with the middle cerebral artery peak systolic velocity values <1.50 MoM. Two cordocenteses were performed. One fetus was mildly anemic; the second fetus was not anemic. The remaining 13 fetuses of this group did not have any complications and were not anemic at birth. The sensitivity of the middle cerebral artery peak systolic velocity (>1.50 MoM) for the prediction of anemia because of parvovirus infection was 94.1%; the specificity was 93.3 %; the positive and negative predictive values were 94.1% and 93.3%, respectively. CONCLUSION: Fetal anemia caused by parvovirus infection can be detected noninvasively by Doppler ultrasonography on the basis of an increase in the peak velocity of systolic blood flow in the middle cerebral artery.

Anemia↗
PubMed2002

Active and passive smoking in breast cancer: prospective results from the Nurses' Health Study.

BACKGROUND: The role of active and passive smoking in breast cancer remains controversial. METHODS: Using data collected in the prospective Nurses' Health Study, we examined the influence of active and passive smoking on the incidence of invasive breast cancer. The analysis was based on women responding to the 1982 questionnaire, which included questions on passive smoking exposure. Information on active smoking was collected in biennial questionnaires. A total of 78,206 women were followed prospectively from 1982 until June 1996. RESULTS: Of these women, 3,140 reported a diagnosis of invasive breast cancer during follow-up. Compared with never active smoking, relative risks (RR) of breast cancer were 1.04 (95% CI = 0.94-1.15) for current active smoking and 1.09 (95% CI = 1.00-1.18) for past active smoking. The RR for regular passive exposure at work and at home was 0.90 (95% CI = 0.67-1.22). For active smoking, a modest increase in risk was confined to women who began smoking before the age of 17 (RR = 1.19; 95% CI = 1.03-1.37). CONCLUSION: Results suggest that passive smoking is unrelated to breast cancer. However, results for active smoking are compatible with a small increase in risk when smoking is initiated at young ages.

Adult↗
PubMed2002

Early diagnosis of Johne's disease in the American bison by monoclonal antibodies directed against antigen 85.

Several monoclonal antibodies derived from hybridomas from mice that had been immunized with recombinant Mycobacterium bovis antigen 85 (Ag85) were tested for reactivity against antigen 85 (Ag85) from M. bovis and against sera from 100 bison inoculated with M. paratuberculosis and from 100 control bison from a disease-free herd. Monoclonal antibodies mAb85.1, mAb85.44.1, mAb85.44.9, and mAb85.96 reacted against three or four 30-33-kDa bands of the Ag85 complex of M. bovis. Importantly, these mAbs also reacted with bands of similar molecular weight in the sera of bison inoculated with M. paratuberculosis. Additionally, when sera from 198 bison in four herds were reacted against mAb85.1 and mAb85.96, 26 bison reacted positively for the presence of Ag85 by either mAb or by both. These preliminary results indicate that monoclonal antibodies may eventually lead to a reliable diagnostic test for the early detection of M. paratuberculosis infections in ruminants as well as to a means for identifying contaminated dairy products.

Animals↗
PubMed1997

New Trends in Musculoskeletal Interventional Radiology: Percutaneous, MR_Guided Skeletal Biopsy.

Several different types of magnetic resonance (MR) scanners that allow access to the patient during image acquisition and thus permit MR-guided biopsies have been introduced. A variety of MR-compatible biopsy needles and a prototype coaxial drill system, powered either by hand or an optional motor, are presently available for sampling skeletal lesions. In a small study population of 28 patients in our hospital who required a biopsy of a skeletal lesion, all but five biopsy procedures could be completed within the MR unit. In one patient who required a transpedicular approach to a lumbar vertebra, we decided to switch to computed tomography (CT) guidance. Four patients needed general anesthesia, which is currently not available in our interventional MR suite. Those procedures were also performed under CT guidance. In 18 of the 23 MR-guided cases, the samples were sufficient and the histopathologic diagnoses were confirmed by surgery or the clinical course. Three biopsies contained an adequate volume in the sample, but the contents were either unrepresentative of the final pathology or distorted beyond recognition by the biopsy drill. Two others revealed insufficient material. No procedural complications occurred. Percutaneous biopsy of skeletal lesions performed under MR guidance seems to be a safe procedure and reasonably accurate given the fact that it is still in an early stage of development. MR imaging may be used as an alternative to CT, but its role vis-vis CT has yet to be ascertained.

Journal Article↗
PubMedDate not supplied

Local, intrahepatic, and systemic recurrence patterns after radiofrequency ablation of hepatic malignancies.

The objective of this study was to describe the recurrence patterns in patients with unresectable hepatic malignancies treated with radiofrequency ablation (RFA). As RFA is applied more widely to patients with hepatic tumors, a better understanding of the biologic behavior of these tumors and the risk of recurrence, both in the liver and systemically, is needed. A multidisciplinary team evaluated patients referred for RFA and followed them prospectively to assess local, intrahepatic, and extrahepatic disease recurrence and complication rates. Forty-five patients with 143 lesions and a minimum follow-up of 6 months (median 19.5 months) were treated. Overall, 7.7% of treated lesions had local recurrence. New intrahepatic disease was seen in 49% of patients, and 24% had evidence of new systemic tumor progression. Patients with colorectal metastatic lesions > or =4 cm at the time of the first RFA were more likely to present with local recurrence (P = 0.048). Complications occurred in 27% of patients. Although RFA has a satisfactory local failure rate and safety profile, the patient population being treated is at high risk of developing new disease. Multimodality adjuvant therapy will be necessary to realize the full potential of hepatic malignancy control with RFA.

Adult↗