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Biomedical subjects

J Dudley

Publications and source records attributed to J Dudley.

At least 37 records · Page 2Linked to original sources
PubMed1992

Endogenous Mtv-8 or a closely linked sequence stimulates rearrangement of the downstream V kappa 9 gene.

Mtv-8 is an endogenous retrovirus located 4.6 kb upstream of a V kappa region gene (called V kappa 9M) within the kappa-Ig locus. The proximity of these two genes resulted in several effects. Using a newly developed RNase protection assay for measuring transcription from a single endogenous provirus, we found that Mtv-8 transcription could be detected after juxtaposition of the kappa-enhancers to the normally silent provirus. Reciprocally, using the polymerase chain reaction we observed that the frequency of V kappa 9M rearrangement was 5- to 10-fold higher in spleens from Mtv-8-positive mice (BALB/c, C58.C, A/J, and B6) compared to spleens from mice that lacked the Mtv-8 provirus (C58, C.C58, NZB, and PERA/Ei). Molecular cloning and sequencing of the V kappa 9M gene from C.C58 mice (containing the kappa-locus from C58 mice on a BALB/c background) indicated that at least some Mtv-8-negative strains have a functional V kappa 9M gene. Together these data suggest that Mtv-8 or a closely linked gene enhances V kappa 9M rearrangement. Since Mtv-8 also reportedly produces a superantigen, it appears that Mtv-8 may influence both the T cell and B cell repertoires.

Amino Acid Sequence↗
PubMed1992

Homosexual and bisexual men's perceptions of discrimination in health services.

Questionnaires were distributed to homosexual and bisexual male participants in the Multicenter AIDS Cohort Study and to homosexual and bisexual male patients with acquired immunodeficiency syndrome (AIDS) to determine whether the men believed they had been refused medical or dental treatment because of their sexual orientation or a condition related to the human immunodeficiency virus (HIV). Men with AIDS were significantly more likely (18%) to report being refused treatment by a doctor or dentist on the basis of a known or suspected HIV-related condition than were men who were seropositive (5%) or seronegative (1%). Significantly more respondents reported refusal of dental care than of medical care.

Baltimore↗
PubMed1991

Evaluation of the efficacy and safety of Diamicron in non-insulin-dependent diabetic patients.

The efficacy and safety of gliclazide (Diamicron) were studied in 29 NIDDM patients (19 men and 10 women aged 25-68 years) who failed to improve with diet or with diet plus a sulfonylurea. All patients were overweight and had fasting blood glucose levels consistently above 150 mg/dl (8.24 mmol/l). After withdrawal of oral hypoglycemics where applicable, they received 40 mg Diamicron three times daily with meals. The dose was increased by 40-80 mg/day until optimum control was obtained or up to a maximum of 320 mg/day. Treatment lasted for 12 months. At the end of this period the mean fasting blood glucose level had fallen by 35% from 238 to 154 mg/dl and the mean 2-h postprandial blood glucose level had fallen by 28% from 237.7 to 195 mg/dl. The mean glycosylated hemoglobin level also fell by 30% from 10.10 to 7.02%, i.e. within the normal range. In addition, there was a 19% fall in triglyceride and a 10% fall in cholesterol levels, with no change in body weight. No changes were observed for serum insulin, C-peptide and glucagon levels, thyroid function tests, blood counts, liver and kidney function tests, uric acid, electrolytes, blood pressure or heart rate. No clinical or ECG abnormalities were observed in patients with or without cardiovascular disease. There were two presumptive hypoglycemic reactions, but these did not require treatment. Adverse effects were reported by 22 patients, including dizziness and light-headedness, diarrhea, nausea, palpitations and pruritus, but none required modification of Diamicron therapy. The results therefore show that Diamicron is safe, effective and well tolerated in suitably selected NIDDM patients.

Adult↗
PubMed1991

Factor influencing suicide intent in gay and bisexual suicide ideators: differing models for men with and without human immunodeficiency virus.

Of 778 gay and bisexual men (none with acquired immunodeficiency syndrome [AIDS]), 27% (n = 212) reported suicidal ideation over the previous 6 months. Covariance structure models were used to explore predictors of suicide intent among (n = 112) suicide ideators with (n = 100) and without (n = 112) human immunodeficiency virus (HIV). Current AIDS-related stressors (deaths and illnesses and perceived AIDS risk) and past levels of adaptive functioning (social isolation and depression) were significantly more powerful predictors of suicide intent among HIV-positive than among HIV-negative ideators. Biological AIDS risk predicted neither suicide intent, current distress, nor perceived AIDS risk. Pathways to suicide intent appear to be psychologically, rather than biologically, mediated. Among HIV-positive ideators, AIDS-related death and illness events predicted suicide intent but not current distress symptoms. Some suicidal ideation in response to AIDS-related events may be an effort to cope rather than a manifestation of psychological distress.

Adaptation, Psychological↗
PubMed1991

Amniocentesis in the management of preterm premature rupture of the membranes.

A retrospective analysis has been performed of perinatal outcome in 81 pregnancies in which preterm premature rupture of membranes (PPROM) was managed using amniocentesis to diagnose intrauterine infection and lung maturity. Ten patients (13%) had a positive Gram stain on microscopy whilst 29 (37%) had a positive culture. Forty-one patients (58%) had a mature lecithin:sphingomyelin ratio. There was evidence of sepsis in 13 neonates (16%), with a further 16 (20%) being colonized. Both Gram stain and amniotic fluid culture were relatively poor predictors of neonatal sepsis. For Gram stain the sensitivity was low at only 15%. Although the sensitivity for culture was higher (69%), the specificity (71%) was too low to be clinically useful. It is recommended that a randomized controlled trial of amniocentesis in PPROM is needed to define the role of this diagnostic test.

Amniocentesis↗
PubMed1991

Loss of private health insurance among homosexual men with AIDS.

In this study we analyze information on self-reported health insurance coverage, HIV screening by insurers, and loss of health insurance. We distributed questionnaires to gay male participants in the Baltimore and Los Angeles sites of the Multicenter AIDS Cohort Study and to leukemia patients and gay AIDS patients seen at the Johns Hopkins Hospital. In this unusually well-educated and well-insured group, 90% of participants without AIDS had private health insurance coverage, compared with only 64% of participants with AIDS. Persons with AIDS (PWAs) were 33 times as likely to have Medicaid as persons without AIDS, and PWAs were 5 times as likely to have lost health coverage altogether as persons without AIDS.

AIDS Serodiagnosis↗
PubMed1990

The microbiology of chronic sinus disease in children with respiratory allergy.

Chronic maxillary sinusitis is common in children with respiratory allergy and is associated with increased morbidity. The bacteriology of chronic sinus disease in these children has not been adequately evaluated. Between May 1987 and January 1988, 12 children (aged 3 to 9 years), all with documented respiratory allergy and chronic respiratory symptoms consistent with chronic sinusitis (greater than 30 days), were fully evaluated. History, physical examination, complete blood count, nasal smear, and Waters x-ray were done. All patients had opacification of one or both maxillary sinuses, failed to respond to multiple courses of antibiotics, and subsequently underwent maxillary sinus aspiration and irrigation. Specimens were cultured for aerobic and anaerobic organisms with standard technique, and sensitivities were obtained. Culture results revealed a single organism (Moraxella [Branhamella] catarrhalis) in five patients, one patient yielded M. catarrhalis plus Streptococcus species, three were negative, and three patients grew multiple organisms (two with multiple aerobic streptococcal species and one patient with aerobic streptococci and Peptostreptococcus). All children received appropriate culture-directed antimicrobial therapy. Sequential biweekly follow-up revealed progressive radiographic clearing and significant symptomatic improvement. M. catarrhalis is a common pathogen, whereas anaerobic organisms are unusual as a cause of chronic maxillary sinusitis in allergic children. Some children, despite negative cultures, may benefit from maxillary sinus irrigation.

Child↗
PubMed1990

Recreational drug use and sexual behavior change in a cohort of homosexual men. The Multicenter AIDS Cohort Study (MACS).

The relationship between use of recreational drugs and high-risk (HIV-transmitting) homosexual behavior was examined in the Multicenter AIDS Cohort Study (MACS) population. Among the 3916 men who completed both the baseline (1984) and first 6-month follow-up evaluations and were sexually active during the 6 months prior to enrollment, self-reported use of each of 10 classes of recreational drugs in conjunction with sexual activity was analyzed for both cross-sectional and prospective relationships with pattern of sexual behavior using a four-level sexual risk behavior index. At baseline, the proportion of men in the highest risk category (unprotected anal exposures with multiple partners) increased from 36 to 85% when men not using any drugs to men using three or more drugs plus volatile nitrites were examined. In multivariate logistical analyses, volatile nitrite use was significantly associated with failure to maintain or attain lower sexual risk levels after controlling for the effects of age, educational level and numbers of high-risk partners. These results suggest that volatile nitrite use may play an important role in the association between recreational drug use and high-risk sexual behavior among homosexual/bisexual men.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Incidence of Kaposi's sarcoma in a cohort of homosexual men infected with the human immunodeficiency virus type 1. The Multicenter AIDS Cohort Study Group.

Longitudinal data on 2,125 participants in the Multicenter AIDS Cohort Study (MACS) with documented antibodies to the human immunodeficiency virus type 1 (HIV-1) were used to examine the incidence of acquired immune deficiency syndrome (AIDS)-related Kaposi's sarcoma (KS) over time and to determine if sexual practices and hematologic variables prior to diagnosis differed for participants who develop KS vs. non-KS AIDS (NKS). In the first 4 years of the study, 84 seropositive men were observed to develop KS and 307 presented with an AIDS diagnosis other than KS. A systematic trend in the incidence of KS over time was not apparent in this population. The number of anal-receptive intercourse partners prior to diagnosis declined in a similar fashion for both AIDS groups. Although the number of partners with whom the men performed rimming decreased prior to diagnosis for both AIDS groups, a greater proportion of the KS AIDS group had performed this activity with multiple partners than had the non-KS AIDS group. Furthermore, history of oral gonorrhea was significantly (p = 0.027) more prevalent in the KS group. In addition, the KS AIDS group had lower cytomegalovirus antibody levels prior to diagnosis and higher levels of total immunoglobulin G. The groups did not differ with respect to baseline hematological measures, temporal trends in helper and suppressor T cells, or hepatitis B surface antigen or antibody. Given this profile of factors associated with the occurrence of KS, an infectious agent, in addition to HIV-1, is plausible as a proposed cofactor in the development of KS.

Acquired Immunodeficiency Syndrome↗
PubMed1989

HIV-related symptoms and psychological functioning in a cohort of homosexual men.

The authors administered the Center for Epidemiological Studies Depression (CES-D) Scale to 4,954 homosexual men in the Multicenter AIDS Cohort Study. HIV antibody status at enrollment was a less important predictor of psychological distress than were reported physical symptoms. Multivariate analysis showed an association between a high score on each CES-D Scale component and the number of self-reported possible AIDS- or HIV-related symptoms, perceived lymphadenopathy, and absence of "someone to talk to about serious problems." This relationship between self-reported physical symptoms and psychological distress suggests a possible etiologic relationship between perceived AIDS risk and psychological symptoms in men at risk of AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1989

The relationship between oral sensation and drooling in persons with cerebral palsy.

This study examined the relationship between oral sensation and drooling in persons with cerebral palsy. The sample was composed of 40 subjects between 5 and 21 years of age who had a diagnosed condition of cerebral palsy. Twenty of the subjects had a drooling problem and 20 did not. The subjects were randomly selected from two Montreal schools for the disabled. The experimental procedure consisted of the administration of three tests of oral sensation: a test of oral stereognosis, a test of oral form discrimination, and a test of lingual two-point discrimination. In addition, saliva was quantified in those subjects who drooled. The results suggested a relationship between oral stereognosis and drooling in persons with cerebral palsy. The main implication for occupational therapists is that the assessment and treatment of drooling in people with cerebral palsy should address both the sensory and motor elements of oral function.

Adolescent↗
PubMed1988

Mouse mammary tumor virus proviruses in T-cell lymphomas lack a negative regulatory element in the long terminal repeat.

The nucleotide sequences of long terminal repeats (LTRs) from several mouse mammary tumor virus (MMTV) proviruses acquired in mouse T-cell lymphomas were determined. All MMTV proviruses cloned from a C57BL/6 lymphoma contained an identical LTR deletion of 491 base pairs (approximately -655 to -165), whereas an MMTV provirus from a BALB/c T-cell lymphoma had a 430-base-pair deletion in the same U3 region. MMTV proviruses with LTR deletions were acquired in these tumors 10 times more frequently than proviruses with intact LTRs. Because the deletions removed a portion of the glucocorticoid response element or "regulated" enhancer, the transcriptional activity of the deleted MMTV LTRs was assessed in both transient expression and stable transfection experiments. Plasmids were constructed in which the deleted or full-length MMTV LTRs were placed upstream of the chloramphenicol acetyltransferase gene. Results from transfection experiments with these constructs showed that the basal expression of the deleted MMTV LTR in the absence of glucocorticoids was higher than that of the full-length Mtv-17 or C3H MMTV LTRs under the same conditions. Moreover, the C3H LTR with a similar deletion (-637 to -255) also promoted high basal levels of chloramphenicol acetyltransferase activity. These results, coupled with the observation in lymphomas of high basal levels of transcription from MMTV proviruses with deleted LTRs, suggested that these proviruses lack negative regulatory elements in their LTRs. Loss of the negative regulatory element may contribute to the selective propagation of proviruses with deleted LTRs.

Animals↗
PubMed1987

Infection with the human immunodeficiency virus: clinical manifestations and their relationship to immune deficiency. A report from the Multicenter AIDS Cohort Study.

In 1984 a large prospective study of gay and bisexual men was begun to elucidate the natural history of the human immunodeficiency virus (HIV) infection. At two successive semiannual examinations, clinical or hematologic abnormalities were found up to 13 times more often among HIV-seropositive men (n = 1611) than HIV-seronegative men (n = 2646). More than 30% of the seropositive participants had persistent generalized lymphadenopathy, independent of T-helper lymphocyte (CD4) counts and most other signs and symptoms. Other clinical manifestations such as thrush, anemia, thrombocytopenia, neutropenia, fever, and fatigue occurred with only slightly reduced CD4 counts (400 to 700/mm3) and appeared to increase exponentially with progressively lower counts. A simple systematically derived clinical index using these manifestations identified more than 70% of the seropositive men with significant T-helper cell depletion. This kind of clinical index may be useful for assessing groups of HIV-infected persons, especially those whose T-lymphocyte numbers and function cannot be readily measured.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Airway obstruction in childhood thyroid carcinoma.

Thyroid carcinoma is an uncommon but well described childhood malignancy. Obstructive airway symptoms represent an unusual mode of presentation of this disease in childhood. A 5-year-old child with locally invasive follicular thyroid carcinoma had symptomatic wheezing for one year, thought to be asthma. Extrinsic compressive tumor or transtracheal, intraluminal tumor, while rare, should always be a consideration in atypical or medically refractory 'asthma' during childhood.

Adenocarcinoma↗