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Biomedical subjects

J D Ross

Publications and source records attributed to J D Ross.

At least 91 records · Page 5Linked to original sources
PubMedDate not supplied

Delayed awakening due to lidocaine overdose.

An 86-year-old man receiving antiarrhythmic treatment with an intravenous (IV) lidocaine infusion experienced a prolonged emergence from general anesthesia. A venous blood sample was sent for determination of the lidocaine concentration, the infusion was stopped, and the patient awakened 15 minutes later. The circulating lidocaine concentration was 15.6 micrograms/ml, three times the upper limit of therapeutic range for arrhythmia treatment. The overdose was the result of a miscalculated infusion rate, plus an underestimation of effects of age, cardiac disease, and general anesthesia on the rate of lidocaine biotransformation. Infusion of any drug during and after general anesthesia requires scrupulous attention to dosage determination and to the clinical condition of the patient receiving the infusion.

Aged↗
PubMedDate not supplied

A comparison of AIDS-defining events and subsequent CDC stage IV events in IDUs and gay men.

The two major risk groups for acquisition of HIV in the UK are gay men and IDUs. Individuals from these risk groups vary in a number of respects in their life-style, which have the potential to affect the course of their HIV disease. This study compares gay men and IDUs from the Lothian Region of Scotland with respect to their AIDS defining diagnosis and subsequent CDC (Centers for Disease Control) stage IV events. Comparisons were made between the two risk groups for their AIDS defining diagnosis by performing chi square tests, Mann-Whitney tests and logistic regression. Subsequent CDC stage IV events were analysed using ordinal logistic regression and Cox regression. 89 IDUs and 56 gay men were included in the analysis. Oesophageal candida was a commoner AIDS-defining diagnosis in IDUs than gay men and Kaposi's sarcoma was diagnosed more frequently in gay men than IDUs. Subsequently oesophageal candida was also commoner in IDUs and CMV retinitis was seen more frequently in gay men. The role of prophylaxis and differences in diet are discussed as possible causes of the observed differences in the incidence of oesophageal candida. The higher incidence of CMV retinitis in gay men probably reflects the high level of sexual acquisition of CMV.

AIDS-Related Complex↗
PubMedDate not supplied

Markers of past syphilis in HIV infection comparing Captia Syphilis G anti-treponemal IgG enzyme immunoassay with other treponemal antigen tests.

The sensitivity of the Captia Syphilis G anti-treponemal IgG enzyme immunoassay (EIA-IgG) was compared with the Treponema pallidum haemagglutination assay (TPHA) and the Fluorescent Treponemal Antibody Absorbed (FTA-Abs) test as a marker for past syphilis in 28 HIV-infected and 31 HIV-negative patients with a past history of syphilis. The specificity of EIA-IgG was compared in 89 patients without a history of syphilis who were known to be HIV antibody positive with a control group of 89 patients who had tested HIV negative. In patients with a past history of syphilis each treponemal test (EIA-IgG, TPHA and FTA-Abs) gave a lower sensitivity (82%, 86%, 79%) in the HIV-positive group than in the HIV-negative group (97%) but the difference was significant only in the case of the FTA-Abs test (P < 0.05). In the HIV-positive patients 11% (3/28) were negative in all 3 treponemal tests while 25% (7/28) were negative in at least one treponemal test. In patients without a past history of syphilis the EIA-IgG antibody index in the HIV-positive group (0.436) was significantly higher than in the HIV-negative group (0.378): the specificity, however, was similar in the HIV-positive (100%) and HIV-negative group (99%). We conclude that the Captia Syphilis G anti-treponemal IgG enzyme immunoassay is of similar specificity in HIV-positive and HIV-negative patients and is of similar sensitivity to the TPHA and FTA-Abs as a marker of past syphilis in HIV-infected patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Bacterial↗
PubMedDate not supplied

Temporal changes in the sensitivity of Neisseria gonorrhoeae to penicillin in Edinburgh, Scotland.

Increased resistance of Neisseria gonorrhoeae to penicillin has been reported from many centres around the world since the introduction of antibiotic therapy in the 1940s. This study reports the temporal changes in gonococcal penicillin sensitivity over a 3-year period. All patients with a diagnosis of gonorrhoea in the city of Edinburgh, Scotland between 1990 and 1992 were included in the study. Penicillin sensitivity of isolates was analysed in relation to the sex and sexual orientation of the patient and the antibiotic therapy given. Four hundred and twenty-seven new patient episodes of infection occurred of which penicillin sensitivities were available in 426. Eleven episodes of PPNG infection occurred. Chromosomally mediated penicillin resistance did not increase over the study period. No differences were evident in the sensitivity of isolates from homosexual and heterosexual patients. Unlike many other areas the relative resistance of N. gonorrhoeae is not increasing in Edinburgh at present. This may relate to local antibiotic policies combined with intrinsic characteristics of N. gonorrhoeae itself. Unlike previous reports there did not appear to be any increased resistance to penicillin in isolates from gay men.

Female↗
PubMedDate not supplied

Characterizing patients with multiple sexually acquired infections: a multivariate analysis.

It has long been recognized that sexually transmitted diseases (STDs) may occur concurrently hence necessitating screening in individuals attending Genito-Urinary Medicine (GUM) clinics. However there are few data on individuals with more than one concurrent STD. Individuals attending the GUM Department in the Royal Infirmary of Edinburgh between 1990 and 1994 with the diagnosis of HIV infection, genital warts, genital herpes, non-specific genital infection (NSGI), gonorrhoea and syphilis were included in the study. A multivariate comparison was made between those presenting with multiple concurrent STDs and a control group comprising individuals with a solitary STD with respect to year of attendance, social class, location of acquisition of infection, sex, sexual orientation and age using a logistic regression model. A total of 680 of 9265 patients in the study period had more than one concurrent STD. Individuals in lower socio-economic class were at higher risk and older individuals at lower risk of multiple concurrent STDs. Multiple sexually acquired infections are common in individuals who attend GUM clinics. Age and socio-economic class were the only significant variables. Identification of populations at highest risk for multiple infection can direct interventions against all STDs.

Adult↗