Bone density and tissue lead accretion in growing rats fed low high calcium with or without supplemental clinoptilolite.
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Administration, Oral↗
Biomedical subjects
H Ho
Publications and source records attributed to H Ho.
Prevalence of associated infections in community-acquired spontaneous bacterial peritonitis.
OBJECTIVES: The frequency with which other infections occur in association with spontaneous bacterial peritonitis is not known, but has implications for both pathogenesis and management. Spontaneous bacterial peritonitis that occurs in hospitalized patients is mainly a nosocomial infection, the study of which must take into account multiple confounding factors. We conducted a prospective study to compare the clinical features and the frequency of associated infections in patients with community-acquired spontaneous bacterial peritonitis to those of cirrhotic patients with ascites but without spontaneous bacterial peritonitis. Previous studies of spontaneous bacterial peritonitis have not found an infection consistently present at some other site, but those studies did not separate community-acquired from hospital-acquired spontaneous bacterial peritonitis. METHODS: Over a 5-yr study period, 176 cirrhotic patients with ascites were enrolled and were followed. There were 68 patients who had 83 admissions with spontaneous bacterial peritonitis and 108 patients with 124 admissions without spontaneous bacterial peritonitis. Of the 68 patients with spontaneous bacterial peritonitis, 56 had single episodes of peritonitis and 12 had 27 episodes of recurrent bacterial peritonitis. All episodes of spontaneous bacterial peritonitis were diagnosed within 24 h of admission. All subjects had cultures of ascitic fluid, blood, and urine. RESULTS: Patients with spontaneous bacterial peritonitis were more often symptomatic than the nonspontaneous bacterial peritonitis patients. Ascites cultures were positive in 63 (76%) episodes of spontaneous bacterial peritonitis. The frequency of bacteremia in the spontaneous bacterial peritonitis group was significantly higher than that of the nonspontaneous bacterial peritonitis (56.6% vs. 4.8%, p < 0.0001). Bacteriuria occurred in 51 episodes of spontaneous bacterial peritonitis compared with only nine in nonspontaneous bacterial peritonitis patients (61.4% vs. 7.3%, p < 0.0001). Bacteriuria was observed even more often in recurrent bacterial peritonitis patients than in single episode bacterial peritonitis patients (77.8% vs. 53.6%, p < 0.0001). Most patients with bacteriuria had no urinary tract symptoms. There was no significant difference between the frequency of pneumonia in spontaneous bacterial peritonitis patients compared with nonspontaneous bacterial peritonitis patients (8.4% vs. 10.5%, p = 0.17). CONCLUSIONS: Asymptomatic bacteriuria occurs often in association with community-acquired spontaneous bacterial peritonitis.
Bacteremia↗
Profile of HIV disease in an American border city.
A previous study on patterns of migration of HIV-infected persons suggested that most patients in a rural setting in eastern Tennessee acquired their disease in an urban area, typically during a period of prolonged residence. Disease and disability were the most common reasons for returning to their hometown. We studied our urban, border-city HIV clinic population to see whether similar patterns of migration were discernible. Fifty-one of the 103 patients studied lived outside the El Paso/Juarez area when they contracted HIV infection. The major reason cited for returning home was a desire to return to family (25%). Those who returned and those who had never left showed no statistically significant difference in age, race, or risk factors. This study suggests that migration of HIV-infected patients back to their hometown does not appear to be an exclusively rural phenomenon.
Acquired Immunodeficiency Syndrome↗
A sensitive and semi-quantitative pediatric myoclonus evaluation scale.
One of the difficulties in evaluating myoclonus in childhood is the lack of a standardized scale which addresses the constraints of pediatric scoring. The scale needs to be simple and rapid as well as sensitive and semi-quantitative and applicable across different ages. We videotaped children and young adults with myoclonus of various etiologies, such as progressive myoclonus epilepsy, opsoclonus-myoclonus and other acquired etiologies, and scored the videotapes using a new scale. Each clinical type of myoclonus (spontaneous, action and sensory-evoked myoclonus) was graded separately on a five-point scale for severity, intensity and distribution. Data were evaluated as separate scores and also combined for a total score. Validity and reliability were tested using a judge panel of three blinded, trained observers. Action myoclonus was the predominant form of myoclonus in our patients, and was significantly greater than spontaneous and sensory-evoked myoclonus in frequency, intensity and distribution. Separate statistical analysis performed for progressive myoclonus epilepsy and for opsoclonus-myoclonus showed the same pattern. Total scores between etiologies of myoclonus for frequency and distribution categories were significantly different. Subscores and total scores were highly correlated. We found the new scale to be flexible and adaptable for children and there were few missing values due to non-applicability of a scale item. It was useful for all pediatric age groups. The scale and videotape instructions provide a reliable tool for use in pediatric myoclonic disorders.
Adolescent↗
Effects of low sodium diet and unilateral nephrectomy on the development of carbohydrate-induced hypertension.
Since there appear to be important interactions between mechanisms of salt-sensitive and carbohydrate-sensitive hypertension, the goal of this study was to evaluate the effects of greatly reducing dietary salt intake and removal of one kidney (to increase salt sensitivity) on the hemodynamic and metabolic responses to carbohydrate-enriched diets in three different rat strains. All three strains of laboratory rat developed significant increases in fasting plasma insulin (1-2 fold, p < 0.03) and triglyceride (2-3 fold, p < 0.01) concentrations in response to fructose (or sucrose) enriched diets, irrespective of salt content. Blood pressure increased significantly in response to carbohydrate feeding in both Sprague-Dawley (S-D) and Dahl salt-sensitive rats, but not in Fischer 344 rats, and decreasing salt intake had no effect on the development of carbohydrate-induced hypertension: e.g., delta BP in S-D rats was +20 mmHg after the fructose-0.5% NaCl diet as compared with +19 mmHg after fructose-0.02% NaCl, and delta BP in Dahl salt-sensitive rats was +22 mmHg after fructose-0.02% NaCl. Finally, nephrectomy neither accentuated the degree of hypertension in fructose-fed S-D rats, nor increased blood pressure in fructose-fed Fischer 344 rats. These results emphasize the strain specific characteristics of carbohydrate-induced hypertension in rats, and indicate that the hemodynamic responses of different rat strains to dietary carbohydrate are not modified by either decreasing salt intake or removing one kidney.
Animals↗
Hypercalcaemia in a patient with fatal adenosquamous carcinoma of the colon.
OBJECTIVE: To report a rare manifestation of metastatic adenosquamous carcinoma of the colon in a patient presenting with humoral hypercalcaemia of malignancy mediated by parathyroid hormone related peptide (PTHrP). CLINICAL FEATURES: A 58-year-old man with metastatic adenosquamous carcinoma of the colon presented with hypercalcaemia. A technetium bone scan excluded osteolytic bone secondaries. A negative parathyroid subtraction scan and a low serum immunoreactive parathyroid hormone level (1-34 [amino acid fragment]) made the diagnosis of primary hyperparathyroidism unlikely. The diagnosis of humoral hypercalcaemia of malignancy was considered on the basis of an elevated serum PTHrP level and positive tumour immunoreactivity to PTHrP antiserum. INTERVENTION AND OUTCOME: The hypercalcaemia was effectively treated on two occasions with intravenous administration of aminohydroxy propilidene diphosphonate. Despite interventional chemotherapy, the patient died of progressive carcinomatosis. CONCLUSION: Hypercalcaemia is an extremely rare occurrence in carcinoma of the colon. This is the first documented case of humoral hypercalcaemia of malignancy associated with adenosquamous carcinoma of the colon mediated by PTHrP.
Carcinoma, Adenosquamous↗
New pathogens in pneumonia.
It appears that many commonly recognized syndromes such as the ARDS may well be caused by agents that have only recently emerged as respiratory pathogens. HPS represents one such entity. It appears likely that the increasing pressure of antibiotic use as well as the reemergence of certain pathogens will continue to challenge the clinician. Paramount to the identification and treatment of unusual pneumonias will be the degree with which an effort is made to make an etiologic diagnosis through sputum examination, transtracheal aspirate, bronchoscopy, or lung biopsy. Although pneumococcal pneumonia is the most common community-acquired pneumonia seen by practicing physicians, in all likelihood from time to time a physician will encounter pneumonia caused by one of the unusual pathogens described in this article or else by an altogether new pathogen.
Humans↗
Blastocystis hominis infection and intestinal injury.
Blastocystis hominis is an enteric protozoan associated with clinical illness. To determine the prevalence of intestinal injury in patients with B. hominis infection, the authors prospectively evaluated 18 patients with B. hominis infection by endoscopy and a test of intestinal permeability. Seventeen patients had gastrointestinal symptoms. Colonic mucosa appeared normal by lower endoscopy in 12 of 13 patients, and was friable slightly in 1. Duodenal mucosa was normal by upper endoscopy in nine patients. Pathologic examination of mucosal biopsy specimens did not demonstrate evidence of mucosal invasion. 51Cr-edetic acid (51Cr-EDTA) was given to the 18 patients with stools positive for B. hominis and to 32 healthy control subjects. Approximately 100 uCi of 51Cr-EDTA was given orally after an overnight fast, and urine was collected for the following 24 hours. Mean 24-hour urinary excretion of 51Cr-EDTA, calculated as a percent of the administered dose, was 1.31% (0.34-2.76%) in patients with B. hominis infection and 1.99% (0.59-3.48%) in the control subjects. The intestinal permeability to 51Cr-EDTA in blastocystis-infected individuals was not increased, but was decreased significantly compared with healthy subjects (p < 0.005). Therefore, in a group of symptomatic patients with B. hominis infection, endoscopy typically did not show evidence of significant intestinal inflammation, and results of intestinal permeability testing with 51Cr-EDTA did not suggest impaired barrier function of the intestinal mucosa. The clinical literature on B. hominis infection and intestinal injury is reviewed.
Adult↗
Medicine residents' practices in cancer screening in a Hispanic population.
Cancer screening is a valuable intervention to reduce breast cancer mortality and the incidence of invasive cervical carcinoma. We conducted a retrospective survey to determine the residents' compliance with use of mammography and Pap smear in Hispanic women. A total of 280 charts that met the inclusion criteria were reviewed. According to the guidelines, 784 mammograms and 714 Pap smears were indicated. The residents' compliance with mammography was 10.6% (+/- 9.16) and with Pap smear, 6.6% (+/- 7.68). The study demonstrates an unacceptable level of cancer screening practice by the medicine residents caring for this Hispanic population.
Adult↗
Cerebral arterial thrombosis as a complication of paroxysmal nocturnal hemoglobinuria.
Venous thrombosis is a frequent complication in patients with paroxysmal nocturnal hemoglobinuria (PNH). However, arterial thrombosis is rare, and cerebral arterial thrombosis has been reported only in postmortem studies. We discuss the case of a PNH patient in whom both clinical and neuroimaging findings were compatible with cerebral arterial and venous thrombosis.
Cerebral Infarction↗
Salt-sensitive and carbohydrate-sensitive rodent hypertension: evidence of strain differences.
It is well-established that diets enriched either with salt or simple sugars are associated with variable increases in blood pressure, but the interrelationship between carbohydrate- and salt-sensitive hypertension has received comparatively little attention. The effects of varying salt intake on blood pressure responses to a fructose-enriched diet were examined in a variety of common laboratory rat strains. Sprague-Dawley, Fischer 344, and Wistar rats were placed on diets enriched in fructose, salt, or a combination of both for 12 days. Measurements of blood pressure (tail-cuff) and fasting plasma insulin concentrations were recorded before and after dietary intervention. In response to the fructose-enriched diet (normal salt), all strains developed a significant increase in plasma insulin (1-2 fold, p < 0.05). However, only Sprague-Dawley rats showed an increase in blood pressure in response to the fructose-enriched diet (21 mmHg, p < 0.05). A high salt diet increased blood pressure only in Fischer 344 rats (10 mmHg, p < 0.05), but the combination of high fructose and high salt increased blood pressure significantly in both Fischer 344 and Wistar rats (mean of 19 mmHg, p < 0.05). In conclusion, the ability of a fructose-enriched diet to increase blood pressure varies as a function of strain, and can be modulated by changes in salt intake.
Animals↗
Monatomic steps on the InAs(110) surface.
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Journal Article↗
Intestinal permeability to [51Cr]EDTA in infectious diarrhea.
Orally administered [51Cr]EDTA was used to measure intestinal permeability in subjects with infectious diarrhea and in those without gastrointestinal complaints. [51Cr]EDTA was given to 87 subjects: 63 controls (32 normal controls, and 31 disease controls), and 24 patients with infectious diarrhea. Approximately 100 microCi of [51Cr]EDTA was given orally after an overnight fast. Urine was collected for the following 24 hr. Intestinal permeability to [51Cr]EDTA in both normal volunteers and in patients with a variety of diseases not associated with intestinal injury was low and results were in a relatively narrow range. Mean 24-hr urinary excretion of [51Cr]EDTA, calculated as a percent of the administered dose, in controls was 1.6% (0.2-3.5%). Patients with infectious diarrhea associated with invasive pathogens and/or intestinal inflammation had increased excretion of [51Cr]EDTA (mean 6.1%, P < 0.0001), with elevated excretions in 75%. These results demonstrate that intestinal infections must be considered as possible causes for increased intestinal permeability as assessed by the [51Cr]EDTA test.
Adult↗
A randomized controlled trial of computerized pharmacokinetic theophylline dosing versus empiric physician dosing.
This study was undertaken to determine if a computerized pharmacokinetic program for adjusting theophylline infusion rates could attain a goal serum theophylline level more accurately than physician-derived adjustments and what clinical impact this would have. Thirty-five patients with diagnoses of asthma or chronic obstructive pulmonary disease were randomized to a control group (empiric) or experimental group (kinetic) after initial theophylline levels were drawn from each group. After second levels were drawn, patients in the kinetic group had their infusion rates adjusted by the computerized pharmacokinetic program to achieve a level of 15 mg/L, whereas patients in the empiric group had their infusions adjusted empirically by the primary care physicians to achieve a serum theophylline level of 15 mg/L. A final theophylline level was obtained just before the infusion was discontinued. The kinetic group was closer to the goal level of 15 mg/L than the empiric group, but this was not statistically significant (14.8 +/- 4.4 versus 12.6 +/- 4.1; p > 0.05). The total number of days that patients were receiving intravenous theophylline was slightly longer for the kinetic group (4.1 +/- 3.3 versus 3.2 +/- 1.5; p > 0.05) as was the total number of hospital days, but neither of these were statistically significant (11.4 +/- 21.6 versus 8.8 +/- 15.4 days; p > 0.05). There were no differences between the two groups in the number of subtherapeutic or toxic levels, and there were no significant differences in arterial blood gas measurements.(ABSTRACT TRUNCATED AT 250 WORDS)
Aged↗
Rapid response of AIDS-related bacillary angiomatosis to azithromycin.
A 28-year-old male with AIDS and a CD4 cell count of 100/mm3 presented with fever, hepatosplenomegaly, weight loss, and multiple, polypoid, angiomatous lesions on his face. It was determined by means of biopsy that the lesions were due to bacillary angiomatosis. The patient was treated with oral azithromycin (1 g daily as a single dose). Rapid resolution of the skin lesions was noted. After 1 week of therapy, diminution in the size of the liver and spleen was noted. The only significant side effect noted was diarrhea, which was controlled with symptomatic therapy.
AIDS-Related Opportunistic Infections↗
Renal vascular hypertension does not lead to hyperinsulinemia in Sprague-Dawley rats.
The effect of renal vascular hypertension on blood pressure and plasma glucose, insulin, and triglyceride concentration was studied in Sprague-Dawley rats. Three weeks after the induction of renal artery sterosis, mean (+/- SEM) blood pressure was significantly greater (153 +/- 3 v 117 +/- 2 mm Hg, P less than .001) compared with that in sham-operated rats. However, the two groups were similar in terms of plasma glucose (140 +/- 3 v 140 +/- 2 mg/dL), insulin (27 +/- 3 v 23 +/- 2 microU/mL), and triglyceride (89 +/- 8 v 95 +/- 6 mg/dL) concentrations. Furthermore, blood pressure increased to a similar degree in the two groups of rats (22 +/- 4 v 24 +/- 2 mm Hg), as did plasma insulin (47 +/- 5 v 44 +/- 4 microU/mL) and triglyceride (407 +/- 50 v 381 +/- 46 mg/dL) concentrations, after 2 weeks of a high-fructose diet. These data indicate that experimental induction of renal vascular hypertension in normal rats was not associated with an increase in either plasma insulin or triglyceride concentration. Furthermore, the response of rats with renal vascular hypertension to a high-fructose diet was similar to that of the sham-operated group. These data support the view that hypertension, per se, does not lead to hyperinsulinemia and hypertriglyceridemia in normal rats.
Animals↗
Recurrent Salmonella arizona infection after treatment for metastatic carcinoma.
Serious Salmonella arizona infection may be acquired through the ingestion of rattlesnake meat used as a folk medicine remedy. We report a patient with metastatic carcinoma and a remote history of rattlesnake meat ingestion who developed recurrent S. arizona bacteremia and reactivation of tuberculosis after receiving corticosteroid and radiation therapy. Physicians should be aware of the potential for rattlesnake-associated S. arizona infection to occur as either the presenting manifestation or as a complication in immunosuppressed patients who may take folk remedies, especially Hispanics who live along the United States-Mexico border.
Animals↗
A prospective controlled study of the risk of bacteremia in emergency sclerotherapy of esophageal varices.
Reported incidences of bacteremia after endoscopy with esophageal variceal sclerotherapy are conflicting. A prospective controlled study was conducted to determine the frequency of bacteremia after emergency endoscopy with esophageal variceal sclerotherapy compared with frequency after elective esophageal variceal sclerotherapy and after emergency endoscopy in patients with upper gastrointestinal bleeding from nonvariceal sources. A total of 126 endoscopies were studied in 72 patients. Groups consisted of (a) emergency endoscopy without esophageal variceal sclerotherapy, 37 sessions with 36 patients; (b) elective esophageal variceal sclerotherapy, 33 sessions with 14 patients; and (c) emergency esophageal variceal sclerotherapy, 56 sessions with 36 patients. Blood cultures were obtained before and 5 and 30 minutes after endoscopy. There was a higher frequency of preendoscopic bacteremia in emergency esophageal variceal sclerotherapy (13%) than in emergency endoscopy alone (0%) (P = 0.02). Clinically significant bacteremia in emergency esophageal variceal sclerotherapy was observed in 7 of 56 (13%) sessions, compared with 0 of 33 in elective esophageal variceal sclerotherapy (P = 0.03) and 1 of 36 (3%) in emergency endoscopy alone (P = 0.45). Of these cases, 3 (5.4%) were potentially caused by emergency esophageal variceal sclerotherapy, but not clinically significant postendoscopic bacteremia was attributable to the procedure in the other groups.
Adult↗