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Biomedical subjects

F Thomas

Publications and source records attributed to F Thomas.

At least 217 records · Page 12Linked to original sources

[Somatostatin analogs in oncology].

Somatostatin octapeptide analogues have a longer half-life and are more potent than natural somatostatin (SS-14). Somatostatin analogues are presently approved for the treatment of gastrointestinal (GI) endocrine cancers such as carcinoids, vipomas and glucagonomas. They are also effective in the treatment of inoperable or relapsing acromegaly. Although symptomatic relief is marked and rapidly induced, the inhibitory effect on tumor growth is modest. However, prolonged stabilizations are frequent. Somatostatin analogues may have wider therapeutic indications. Somatostatin octapeptide analogues are also known to interact with growth factors such as epidermal growth factor and insulin-like growth factor, and have shown cytostatic activity in vitro and in vivo in various experimental models of breast, prostate, lung and GI cancers. Neuroendocrine tumors often express somatostatin receptors. Labelled analogues may be useful for tumor assessment and for the prediction of tumor response to therapy. The role of somatostatin analogues in the treatment of the most frequent cancers is currently under investigation.

Adenoma↗

[The urease rapid test (CLO test). Attempt at statistical analysis for the evaluation of Campylobacter colonization in the gastric antrum].

CLO-tests: A statistical analysis for the evaluation of the presence of Campylobacter pylori in antral mucosal biopsies. Antral biopsies taken in a sample of 475 endoscopy patients were positive for CLO on 21% of 77 controls, compared with 39% of non-ulcer dyspepsia (NUD) patients without and 69% with a history of former peptic ulcer. Epigastric pain was associated with a positive CLO-test more frequently than belching or heart burn. Patients with NUD of Turkish or Yugoslavian nationality had a significantly higher rate of positive CLO-reactions compared with Germans or Italians with the same diagnosis. In 96 patients with peptic ulcer, the percentage of positive CLO-test decreased significantly in old persons.

Adult↗

The development of air medical services in Czechoslovakia.

The Czechoslovakian system of centralized dispatch of all emergency medical services prevents competition between ground ambulances and air medical services. Although this program is less than two years old, remarkable progress has pushed Czechoslovakia to the forefront of modern-day air medical transport. However, the future of Czechoslovakian air medical transport will require the acquisition of better-performing EMS helicopters and accessibility to medical equipment using Western technology. As with all current United States helicopter EMS systems, Czechoslovakia will face many of the financial considerations required in funding this extensive and elaborate project.

Aircraft↗

Effectiveness of the kinetic treatment table for preventing and treating pulmonary complications in severely head-injured patients.

The efficacy of using the Kinetic Treatment Table (KTT) to prevent or reduce pulmonary complications in severely head-injured patients is unclear. This study is a prospective, randomized trial using the KTT vs. conventional bed care in severely head-injured patients. Outcome measures were hospital length of stay (LOS), mortality, CNS morbidity at hospital discharge, and rate of improvement of pulmonary status as gauged by chest radiograph, arterial/alveolar PO2 ratio, patient temperature, WBC count, suctioning frequency, sputum volume, and days on ventilator. The KTT group (n = 23) and conventional bed care group (n = 26) were well matched for age, sex, severity of injury, and pulmonary status. There was no significant difference in mortality, CNS morbidity, LOS in ICU or hospital, or rate of pulmonary improvement between the groups. The efficacy of the KTT in reducing pulmonary complications in head-injured patients remains unclear.

Acute Disease↗

The immunosuppressive action of FK506. In vitro induction of allogeneic unresponsiveness in human CTL precursors.

FK506 is an unusually potent new immunosuppressive agent that inhibits T cell-mediated immunity in vivo and in vitro. In these studies we sought to further elucidate the immunosuppressive mechanism of action of FK506 on human allogeneic MLR-induced CTL activation. FK506 induced suppression of cell-mediated lympholysis by PBMC was optimal at 1-2-nM concentrations, if added at the initiation of 6 day CML cultures. The sensitivity to suppression decreased with time, and fully differentiated effectors were resistant to inhibition by FK506. Suppression of CML was not reversed by washing the cultures, adding exogenous IL-2, or restimulating with fresh cells. Pretreatment of unfractionated or adherent allogeneic PBMC with FK506 blocked the stimulating activity of these cells. Furthermore, addition of FK506-treated stimulator cells to cocultures containing untreated responder and stimulator cells resulted in suppression of CML. The inhibition in the cocultures was greatest if the FK506-pretreated cells were autologous to the original stimulator, suggesting a relative specificity in the suppression obtained under these conditions. These studies suggest that, in addition to suppressing the response of alloreactive CTL precursors, FK506 reduces the ability of irradiated allogeneic PBMC to induce CTL generation.

Anti-Bacterial Agents↗

Adult respiratory distress syndrome during pregnancy and immediately postpartum.

From 1976 to 1983, the adult respiratory distress syndrome occurred in 14 patients during pregnancy or within a month postpartum. There were 8 survivors, giving a 43% mortality. All but 2 patients had obstetric-related precipitating events--labor problems, infections, eclampsia-toxemia, and obstetric hemorrhages. During emergency cesarean sections, 3 patients had respiratory problems that may have caused their respiratory distress syndrome. The average duration of mechanical ventilatory support was 16 days. Six patients had barotrauma with 1 patient sustaining an irreversible anoxic central nervous system injury. Infections were documented in 8 patients, 6 of whom had obstetric foci. There is a lack of information regarding the adult respiratory distress syndrome in this patient group. Though uncommon, it can cause substantial mortality and morbidity.

Adult↗

Outcome, transport times, and costs of patients evacuated by helicopter versus fixed-wing aircraft.

We determined the differences in transport times and costs for patients transported by fixed-wing aircraft versus helicopter at ranges of 101 to 150 radial miles, where fixed-wing and helicopter in-hospital transports commonly overlap. Statistical analysis failed to show a significant difference between the trauma-care patients transported by helicopter (n = 109) and those transported by fixed-wing (n = 86) for age, injury severity score, hospital length of stay, hospital mortality, or discharge disability score. The times in returning patients to the receiving hospital by helicopter (n = 104) versus fixed-wing (n = 509) did not differ significantly. Helicopter transport costs per mile ($24), however, were 400% higher than those of fixed-wing aircraft with its associated ground ambulance transport costs ($6). Thus, helicopter transport is economically unjustified for interhospital transports exceeding 100 radial miles when an efficient fixed-wing service exists.

Aircraft↗

Pruritic skin lesions. A common initial presentation of acquired immunodeficiency syndrome.

During July 1983 to December 1984, we observed that 62 (46%) of 134 Haitian patients with acquired immunodeficiency syndrome had intensely pruritic eruptions for which neither specific causative nor categoric diagnoses could be established. These lesions were a presenting manifestation of acquired immunodeficiency syndrome in 79% of the patients and appeared a mean of 8 months before the diagnosis of either Kaposi's sarcoma or opportunistic infection. Lesions included erythematous round macules, papules, or nodules that first appeared on the extensor surface of the arms, but subsequently involved the legs, trunk, and face. Histologically, the lesions were characterized by varying degrees of mixed (predominantly eosinophilic) perivascular and perifollicular inflammatory cell infiltrates of the dermis. The lesions did not respond to any therapeutic regimens used and usually persisted throughout the acquired immunodeficiency syndrome illness. Demographic and laboratory data did not distinguish these patients from those without pruritic skin lesions.

Acquired Immunodeficiency Syndrome↗

Avalanche trauma.

Medical aspects of avalanche accidents have apparently not been studied in the American literature. Records from the Utah Avalanche Forecasting Center (UAFC) for the period 1982-1987 were reviewed and compared with similar data from Europe and Canada. One hundred forty-five avalanches involving 188 individuals were reported to the UAFC. Ninety-one (48%) people were caught, of whom 21 required medical attention. Twelve of the 91 died (13%) and nine were injured (10%). Eleven of 12 nonsurvivors and four of nine survivors were completely buried. Evidence of major blunt trauma was present in nine of ten nonsurvivors and all nine survivors. Asphyxia and blunt trauma were the most common causes of death; hypothermia appeared to have played only a minor role. These findings were similar to results obtained in Europe and Canada.

Canada↗

Rapid detection of respiratory syncytial virus by a biotin-enhanced immunoassay: test performance by laboratory technologists and housestaff.

A biotin-enhanced enzyme immunoassay (EIA) for respiratory syncytial virus (RSV) antigen detection (TESTPACK RSV) was prospectively compared with virus isolation in cell culture and immunofluorescence. Of 156 nasopharyngeal swab specimens from infants with respiratory symptoms, 81 (52%) yielded RSV in culture. Compared with culture the sensitivity of the EIA was 95% and specificity was 92%; the specificity increased to 97% with a blocking assay. Compared with immunofluorescence the sensitivity of EIA was 92% and specificity was 93%. In order to assess the performance of TESTPACK RSV as a bedside test, nasopharyngeal swabs from 49 children were tested by EIA at the bedside by housestaff and by immunofluorescence in the laboratory; the sensitivity of the EIA was lower (78%) while specificity remained high (95%). Inclusion of older children may have resulted in diminished sensitivity. The TESTPACK RSV is a simple, rapid test that performs well and is easily adaptable to an office setting. Further evaluation of the test in older children may be required.

Biotin↗