To evaluate the profile of hepatitis D virus replication and the corresponding immunoresponse after acute hepatitis D virus infection, sera from 50 patients with acute hepatitis D (36 with acute hepatitis B virus-hepatitis D virus coinfection and 14 HBsAg carriers with hepatitis D virus superinfection) were investigated for the presence of hepatitis D virus RNA and other serological hepatitis D virus markers. During the first week after onset of symptoms, hepatitis D virus RNA was detected by spot hybridization with a similar frequency among patients with coinfection (64%) and those with superinfection (71%). The presence of hepatitis D virus RNA in the first serum sample correlated with that of circulating hepatitis D antigen in both groups of patients. The presence of hepatitis D virus RNA was transient and its clearance paralleled that of serum hepatitis D antigen among patients with coinfection, so that 1 month after the onset of symptoms serum hepatitis D virus RNA was no longer detectable in any of these patients. Conversely, serum hepatitis D virus RNA was still present in 78% of those with superinfection, all of whom developed chronic liver disease, thus suggesting that the persistence of hepatitis D virus RNA in the serum for more than 4 weeks might indicate progression to chronicity. In nine of the 14 patients (64%) with hepatitis D virus superinfection progressing to chronicity, hepatitis D virus RNA was persistently detected throughout the follow-up, whereas in five patients it was detected occasionally. In four superinfected patients hepatitis D virus RNA and hepatitis B virus DNA were detected simultaneously in serial samples, thus suggesting that, at least during early stages of chronic hepatitis D virus infection, both viruses may replicate at the same time.

Acute Disease↗

PubMedDate not supplied

Management of localized non-Hodgkin's lymphoma: the experience at St. Bartholomew's Hospital 1972-1985.

A retrospective study of 202 patients with clinical stage I and II non-Hodgkin's lymphoma managed at St. Bartholomew's Hospital between 1972 and 1985 was conducted. Patients were treated either with radiotherapy alone, radiotherapy and adjuvant chemotherapy, or chemotherapy (with or without adjuvant radiotherapy). At the onset of the study it was intended that all patients with localized NHL should be treated with involved field radiotherapy and adjuvant 'CVP'. As it became apparent that this was inadequate for some patients and too toxic for others a flexible approach was later adopted. Treatment selection depended on age, volume, distribution of disease and histological subtype. The actuarial 5 year overall survival for the whole group was 70 per cent. Death from lymphoma after 5 years was very rare. Increasing age and high grade histology were highly significant adverse prognostic factors by multivariate analysis. The results for patients with high grade and low grade histology were therefore analysed separately, as was the outcome for patients presenting with either gastrointestinal or skin lymphomas. During the latter part of the study period intensive chemotherapy was given as the initial treatment to patients with high grade histology and bulky, or stage II disease. Twenty out of 24 patients so treated achieved complete remission and only one has relapsed to date. These results are encouraging and probably explain the absence of a difference in prognosis between patients with stage I and IE disease and those with stage II and IIE disease observed over the whole period of the study. Remission was achieved in the overwhelming majority of patients with low grade histology for whom radiotherapy was selected as primary therapy. Duration of remission was better in patients who received adjuvant chemotherapy than in those treated with radiation alone, but no difference in overall survival was observed between these groups. Neither stage nor the presence of a follicular histological pattern correlated with prolonged survival in patients with low grade histology.

Antineoplastic Combined Chemotherapy Protocols↗

PubMedDate not supplied

HLA antigens in Spanish type 1 diabetic population. Correlations with clinical, biological and autoimmune markers.

The HLA haplotype and its relationships with clinical, biological and immunological parameters were analyzed in a group of 87 Spanish type 1 diabetic patients at the clinical onset of the disease. The frequency of HLA-B18, DR3 and DR4 antigens was significantly increased whereas DR2, DR5 and DR7 were decreased in comparison with 189 healthy unrelated controls without family history of diabetes. DR3 showed a maximum relative risk for diabetes (5.5) whereas DR4 had a lower one (4.0). HLA-DR4 patients were younger at the time of diagnosis than DR4 negative (16.7 vs 21.4 years). We found no statistically significant relationship between HLA antigens and the other variables studied including the presence of islet cell antibodies, complement fixing islet cell antibodies, insulin autoantibodies, organ-specific antibodies, fasting and maximal glucagon stimulated C-peptide levels, initial glycemia and glycosylated hemoglobin.

Adult↗

PubMedDate not supplied

Fibrinogen Logroño. A new case of congenital dysfibrinogenemia.

An abnormal fibrinogen was discovered in a 9-year-old male subject without history of hemorrhagic diathesis. Coagulation time, prothrombin time and Reptilase time were prolonged. The thrombin time was corrected using increasing concentrations of normal plasma and bovine thrombin; there was a partial correction at pH 6.5 and ionic strength 0.05. A study of the family showed that the mother and a brother of the propositus presented the same abnormalities. Analysis of the purified fibrinogen showed normal fibrinopeptide release and normal levels of sialic acid and hexosamines. However, coagulation index, polymerization of fibrin monomers, isoelectric point and sedimentation coefficient were abnormal. In view of the abnormalities described and by comparison with the data reported in the literature, we believe that this should be considered a new variant of the fibrinogen molecule and we have designated it 'fibrinogen Logroño'.

Blood Coagulation Disorders↗

PubMedDate not supplied

A case study of an outbreak of African swine fever in Spain.

This report represents a case study of an outbreak of African swine fever (ASF) that took place in the autonomic region of Extramadura, Badajoz Province, during the month of August, 1992, and aims to describe the Spanish ASF eradication programme as carried out in the field at producer level. Extensive husbandry methods used in the management of Iberian pigs in ASF endemic areas of Spain (about 4% of Spanish territory in 4/52 provinces) makes eradication particularly difficult. Since there is no vaccine available for ASF, the identification and slaughter of carrier animals is crucial to the control of the disease. A case of ASF, which caused one secondary outbreak, was diagnosed on 26 August 1992 and is described in terms of case history, laboratory examination, disease eradication measures and epidemiological observations. Additional evidence is presented in an attempt to evaluate and gain an understanding of the long-term risk of carrier animals, wild European pigs, vector ticks and biting flies as a cause of the persistence in endemic areas of recrudescence of ASF in areas from which the disease was previously eradicated.

African Swine Fever↗

PubMedDate not supplied

Overseas procurement of donor hearts: ischemic time effect on postoperative outcomes.

Explore the source record for details and available documents.

Coronary Circulation↗

PubMedDate not supplied

Range of motion of the wrist: implications for designing computer input devices for the elderly.

PURPOSE: The purpose of this study was to report normative values of the amplitude of joint wrist motions and grip strength for older age groups. METHOD: Volunteers. (N = 147) were divided into four age groups, 60-69, 70-79, 80-89 and 90+ years, with a total of 62 men and 85 women. Maximum range motion values were obtained for wrist flexion, extension and ulnar deviation. In addition, grip strength measures were obtained for each participant. RESULTS: In general, the strength and ROM values for the oldest participants in this study were lower than those of the younger age group (age 60 to 69) and significantly lower than those published for subjects between 25 and 54 years of age. Furthermore, across all age groups males were significantly stronger than females. However, females tended to have greater ROM than males, particularly for wrist extension and ulnar deviations. Joint ROM and grip strength declined significantly with age for both males and females. Comparisons with published data for younger subjects (age 25-35) indicate that a 60-69 year old male, will on average experience a decline in wrist flexion, extension and ulnar deviation of 12%, 41%, and 22% respectively. By age 90, an individual may be expected to have ROM values that are only approximately 60% of an average 30 year old individual. CONCLUSION: The results suggest that the ageing population (particularly men) may face greater difficulty using an input device such as a mouse that relies on motions of the wrist. In addition, the reduced ROM of the wrist may put the elderly at greater risk of developing cumulative trauma disorders. The implications of these findings for the design of input devices are discussed.

Adult↗

PubMedDate not supplied

Messenger RNA isolation using novel PNA analogues.

Homo-Thy hetero-oligomer probes composed of trans-4-hydroxy-L-proline based PNA-like (HypNA) monomers and phosphono PNA (pPNA) monomers demonstrated strong binding to complementary poly A+ RNA strands. We used a mixture of chimeric oligomers containing both "linear" and "clamping" PNA-analogues to develop an mRNA isolation procedure and demonstrate the improved recovery of RNA molecules with secondary structure at the 3'end as well as RNAs with short poly A tails.

DNA↗

PubMedDate not supplied

Events associated with rupture of intra-aortic balloon counterpulsation devices.

Nineteen intra-aortic balloon (IAB) ruptures occurred in sixteen patients during a three-year period. Perforation occurred secondary to abrasion with material failure or mishandling of the device during insertion. To avoid serious sequelae, it is important to be aware of the possibility of IAB rupture and to remove any defective device immediately upon recognition of an event.

Aged↗

PubMedDate not supplied

Ulcer recurrence among Filipino patients: clinical profile and risk factors.

Patients with endoscopic diagnosis of gastric and/or duodenal ulcers who eventually had endoscopic confirmation of ulcer healing after any anti-ulcer medication were entered in a 3 year study to determine ulcer recurrence rate, onset of ulcer recurrence and factors associated with ulcer recurrence. Patients from two participating centres who are not on any maintenance treatment had endoscopic examinations at 3, 6 and 12 months after ulcer healing or at any time of symptom recurrence. There were 144 patients entered into the study. The 1 year recurrence rate observed among 125 Filipino patients who completed the study was 73% wherein 71% occurred within the first six months. This was comparable with those reported in the world literature. Thirty-three per cent of those with recurrent ulcers were asymptomatic. The difference in the recurrence rate between gastric and duodenal ulcers was not statistically significant. The only risk factors found to be associated with ulcer relapse were history of smoking and alcohol intake. CLO test for Helicobacter pylori done in 45 patients with recurrent ulcers were all positive, suggesting a strong association between H. pylori and ulcer recurrence.

Anti-Ulcer Agents↗