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Biomedical subjects

G Adams

Publications and source records attributed to G Adams.

At least 127 records · Page 7Linked to original sources
PubMed1988

Varicella exposure in a neonatal intensive care unit: case report and control measures.

Forty-six infants in a neonatal intensive care unit and 138 health care workers were exposed to a pediatric medical resident during the prodromal period and the early days of unrecognized varicella. An attempt was made to prevent an outbreak of additional cases by the institution of emergency control measures. These measures included rapid identification of varicella antibody status in exposed neonates, varicella antibody testing of health care workers with unknown or uncertain history of varicella, prompt administration of varicella zoster immune globulin to potentially susceptible persons, and cohorting neonates on the basis of exposure and antibody status. Passive maternal antibody was detected in 44 of the neonates. Of 27 health care workers who reported either a negative or an uncertain history of varicella, 26 had detectable antibody. No overt cases of varicella occurred in exposed patients or personnel.

Adult↗
PubMed1987

Quantification of kininogen in human renal medulla.

Renal kininogen was detected in human medullary tissue as well as human medullary tubule suspensions. After treatment with pig pancreatic kallikrein or human renal cortical homogenate liberated kinin was measured by bradykinin radioimmunoassay. In the absence of inhibitors kinins were degraded by kininases located in the same part of the kidney. Several known inhibitors of kininase I and II did not inhibit this activity. Endogenous medullary kininase was inhibited by preincubation of homogenates at 56 degrees C for one hour or by addition of 0.25 mmol/l HgCl2. Under these conditions endogenous medullary kinin release amounted to 9-26 nmol/g protein. The action of renal cortical kininogenase on kinin formation from papillary kininogen was completely inhibited by addition of 1 mumol/l aprotinin. Kininogen examined in renal tubule suspensions revealed an increase in amount per g protein compared to homogenates, confirming the tubular localization of renal kininogen.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1986

The epidemiology of inflammatory bowel disease in Cape Town 1980-1984.

Patients with inflammatory bowel disease diagnosed in the greater Cape Town area between the years 1980 and 1984 inclusive were studied to establish the incidence and presenting features of these diseases. Case details were obtained from the records of the Groote Schuur Hospital group and Tygerberg Hospital as well as from questionnaires completed by 97% of 731 medical practitioners in the area. There were 134 patients with Crohn's disease, 197 with ulcerative colitis and 16 with indeterminate colitis. The incidences of Crohn's disease in the coloured, white and black population groups were calculated to be 1.8, 2.6 and 0.3/100 000 per year respectively and those for ulcerative colitis 1.9, 5.0 and 0.6/100 000 respectively. Among Jews the incidence was higher for both Crohn's disease (10.4/100 000) and ulcerative colitis (17.0/100 000). Of patients with ulcerative colitis 35% had limited proctitis, 26% proctosigmoiditis, 12% left-sided disease and 27% total colitis. Of patients with Crohn's disease 27% had colonic involvement alone, 37% ileocolitis and 36% small-bowel involvement alone. The incidence of inflammatory bowel disease has increased in the greater Cape Town area over the last 10 years, while the pattern of disease has remained similar to that previously reported for this geographical area.

Adolescent↗
PubMed1986

Eosinophilic granuloma of the stomach.

Two patients with eosinophilic granuloma of the stomach are discussed. The first patient had extensive and time-consuming investigations before the diagnosis was confirmed after surgery, while the second patient's presentation corresponded so closely to the first that a correct preoperative diagnosis was entertained with a minimum of investigations and delay. The barium-meal examinations in both patients were very typical of the condition, but the endoscopy findings and biopsy histology reports were noncontributory. Neither of the patients had a history of allergy or eosinophilia. The lesions were localized to the distal part of the stomach and the resected specimens were microscopically typical of eosinophilic granuloma of the stomach.

Adolescent↗
PubMed1986

[Iodine burden in premature infants in roentgenologically controlled positioning of central venous silastic catheters].

22 sick preterm infants were enrolled in a prospective study of iodine excretion after intravenous injection of a definite amount of the radiopaque dye Conray. Measurements of TSH and T4 were performed on day 5 and 4 weeks after injection or before dismissal. For comparison iodine excretion was studied in a group of 10 pre-terms without central venous catheters. In most of the babies urinary excretion of iodine was highest on day one with an exponential decline to day three. Transient hypothyroxinemia (T4 less than 60 nmol/l) could be diagnosed in 18 infants, but no one had hypothyroidism in sick prematures after injection of iodine containing contrast agents seems to be lower than expected. Nevertheless this method of radiographic control should be avoided if possible.

Angiography↗
PubMed1985

Superinduction by cycloheximide of mitogen-induced secreted proteins produced by Balb/c 3T3 cells.

We describe here some of the characteristics of the regulation of a group of secretory proteins whose secreted levels rise within 2-4 h of adding fibroblast growth factor (FGF), epidermal growth factor (EGF), or serum to quiescent Balb/c 3T3 cells. The levels of these secretory proteins are regulated similarly to the interferons. When cycloheximide is present during the induction period, the amounts of [35S]methionine incorporated into five of these proteins that we have called "superinducible proteins" (SIPs) is increased 2-5-fold. Superinduction of the SIPs is seen also in response to polyribol-polyriboC, the classical inducer of interferons. None of the SIPs, however, are immuno-precipitated by anti-beta-interferon antibody. Induction and superinduction of the SIPs is inhibited by actinomycin D. Superinduction occurs at concentrations of cycloheximide that inhibit protein synthesis by at least 85%. The SIPs are not major intracellular proteins; they are barely detectable in cellular fractions. Their induction is, however, correlated with the ability of the polypeptide growth factor to stimulate DNA synthesis; EGF, FGF, and serum induce the SIPs, whereas insulin does not, and insulin alone weakly stimulates DNA synthesis in these cells. Because FGF, EGF, and serum cause the SIPs to be produced at concentrations of cycloheximide that inhibit 85% of bulk protein and DNA synthesis, it follows that the SIPs are produced directly from the action of the growth factor and not as a consequence of increased growth. Although probably not interferons, in analogy to the lymphokines, the SIPs could be a set of autocrine or paracrine factors that rapidly convey the growth or differentiation signal between cells.

Animals↗
PubMed1985

Congenital midureteral strictures.

A case is reported of a fifteen-year-old female with left midureteral congenital stricture and a contralateral single blind-ending ureter with a small atrophic right kidney. The possible etiology is presented.

Adolescent↗
PubMed1985

The role of fiberoptic bronchoscopy in the evaluation of immunocompromised hosts with diffuse pulmonary infiltrates.

To define the utility of fiberoptic bronchoscopy in the evaluation of immunocompromised patients with diffuse pulmonary infiltrates, we reviewed our experience between January 1980, and January 1983, with 50 such patients with a wide variety of underlying diseases. Of these, 35 patients underwent bronchoscopy, including brushings, alveolar lavage, and transbronchial biopsy, and 15 underwent open lung biopsy; 8 patients underwent both procedures. All patients with a nondiagnostic bronchoscopy either recovered without specific antibiotic therapy or underwent an open procedure. A diagnosis was made in 29 patients (58%). An infectious process was found in 20 patients (40%). A diagnosis was made bronchoscopically in 19 patients including 18 infections. Transbronchial biopsy was rarely diagnostic of infection when brushings were negative. For all diagnoses, bronchoscopy had a sensitivity of 76.9%. For all pulmonary infections, bronchoscopy had a sensitivity of 90%. Given a negative bronchoscopy, the probability that an infection was not present (i.e., predictive value negative) was 94.4%. Unfortunately, making a specific diagnosis did not appear to greatly improve survival. We conclude that in this setting: (1) fiberoptic bronchoscopy is an extremely sensitive procedure for diagnosing pulmonary infections, (2) bronchial brushings are as useful as transbronchial biopsies for diagnosing nonfungal infections, (3) these procedures are less useful for diagnosing noninfectious conditions, and (4) in the face of a negative bronchoscopic procedure, there is a very low probability that an infectious process will be found with an open biopsy.

Adult↗
PubMed1984

[Chronic splenic abscess : a case report].

A 16-year-old girl had had a splenic abscess for approximately 20 months with minimal symptoms and signs. Progressive elevation of the left hemidiaphragm could be traced on chest radiographs from 20 months before admission, and was shown on ultrasonography, radionuclide scintigraphy and computed tomography to be secondary to massive splenomegaly. The presence of splenic abscesses was confirmed by laparotomy and she was cured by splenectomy. The nonspecific clinical presentation and potential high mortality of this condition are stressed, and the role of diagnostic aids is discussed. Ultrasonography is a good screening procedure in terms of cost and speed, but splenic scintigraphy is more sensitive. Computed tomography is the most sensitive and specific non-invasive procedure for the diagnosis of splenic abscesses.

Abscess↗
PubMed1984

A comparison of 4-week peptic ulcer healing rates following treatment with antacids and ranitidine.

Eighty-eight patients with endoscopically proven gastric and duodenal ulceration were treated with ranitidine ( Zantac ; Glaxo) or an antacid preparation containing aluminium hydroxide and magnesium trisilicate ( Gelusil ; Warner) over a 4-week period to assess healing. Clinical, haematological and biochemical assessment and endoscopy were performed at the beginning and at the end of this period. Of the duodenal ulcers, 74% healed on ranitidine therapy and 63% on Gelusil . This difference was not statistically significant (chi 2(1) = 0,55). Of the gastric ulcers 58% healed on ranitidine therapy and 35% on Gelusil , but this difference did not reach statistical significance (chi 2(1) = 1,79). There was no significant difference between the two therapies with regard to symptomatic relief in the duodenal ulcer group, but ranitidine produced significantly better results in the gastric ulcer group. No side-effects were noted in either group.

Antacids↗
PubMed1984

Effect of penicillin prophylaxis on nasopharyngeal colonization with Streptococcus pneumoniae in children with sickle cell anemia.

Polyvalent pneumococcal vaccine and oral penicillin prophylaxis are frequently used in patients with functional or anatomic asplenia to protect them from fulminant Streptococcus pneumoniae sepsis. We studied nasopharyngeal colonization with pneumococci in 34 patients with sickle cell anemia (aged 6 months to 5 years) receiving penicillin prophylaxis and in 63 age- and race-matched comparison patients. Patients with sickle cell anemia had fewer positive initial pneumococcal nasopharyngeal cultures than did the comparison group (14.5% vs 34.4%, P = 0.03) and significantly lower carriage rates during the respiratory illness season of November to March (8.7% vs 40.5%, P = 0.005). Penicillin prophylaxis did not result in emergence of penicillin-resistant pneumococci or in an increased carriage rate of Haemophilus influenzae type b. Our data suggest a mechanism of action for penicillin prophylaxis and provide some evidence for the relative safety of this regimen.

Anemia, Sickle Cell↗
PubMed1983

Laryngeal pseudosarcoma.

In the past laryngeal pseudosarcomas have been diagnosed as a. carcinosarcomas, b. pleomorphic or spindle cell carcinomas, or c. squamous cell carcinomas with pseudosarcomatous reactive stroma. Arguments have centered around the nature of the sarcomatous stroma. Because of this confusion there is disagreement as to the treatment and prognosis of these tumors. Seven pseudosarcomas were treated between 1969-1979, 4 were pedunculated and 3 exophytic. Treatment consisted of primary CO60 irradiation in 2 patients, surgery in 3 cases and combined therapy in 2 cases with no recurrences. Three of the 7 have died, 1 of a poorly differentiated adenosquamous carcinoma of the right main stem bronchus and the other 2 of natural causes at ages 77 and 85. From a review of the literature as well as our experience, we have reached the following conclusions. 1. Stromal cells are a malignant morphologic variant of the squamous cell and are best termed spindled cells. 2. Neck metastasis at any time is a poor prognostic sign. 3. The pattern of metastasis and survival seems to parallel laryngeal squamous cell carcinoma, and thus treatment should be similar for given stages.

Aged↗