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Biomedical subjects

J Gallagher

Publications and source records attributed to J Gallagher.

At least 109 records · Page 6Linked to original sources

The occurrence of Actinobacillus actinomycetemcomitans, Bacteroides gingivalis, Bacteroides intermedius and spirochaetes in the subgingival microflora in relation to the early onset of periodontitis in a group of adolescents.

Subgingival samples were obtained from mesial and distal surfaces of first molars in 100 subjects aged 14 years at baseline. Sites were monitored at 6-monthly intervals for clinical loss of attachment. Six subjects showed greater than 1 mm loss of attachment at one site 18-24 months later. Further samples were obtained from these sites together with a comparison sample from the contralateral site and equivalent sites in a matched control subject. Actinobacillus actinomycetemcomitans was more frequently isolated from sites following loss of attachment, but it was also found in one comparison site and one control subject. Bacteroides gingivalis was found in only one subject at a site which subsequently experienced loss of attachment. A higher median proportion of spirochaetes was observed in sites after diagnosis of loss of attachment. The median proportion of Bacteroides intermedius was higher at both the baseline and 12-month examinations in subjects who subsequently lost attachment. Further work is required to substantiate the differences which preceded diagnosis of loss of attachment.

Actinobacillus↗

A controlled study of combined hormonal and psychological treatment for sexual unresponsiveness in women.

Thirty couples, whose presenting complaint was general sexual unresponsiveness in the female partner, were randomly allocated to one of three treatment groups: testosterone plus sexual counselling; placebo plus the same form of counselling; or testosterone alone. Therapy was time-limited to 16 weeks, and assessments were conducted pre-treatment, at the end of treatment and at a four-month follow-up. There were no notable differences in outcome between the two counselling groups, both of which showed significantly greater improvement on a number of measures of sexual and general interpersonal adjustment and attitude change than the group that received testosterone alone. Although a significant improvement with testosterone alone was found on ratings of vaginal lubrication, frequency of sexual interest and coital pleasure, significant changes on the same variables were also apparent in the other two groups. On no measure was testosterone alone shown to be significantly superior to either of the other two treatments. These results, in accordance with those of other recent related research, therefore indicate no significant advantages in using testosterone with an otherwise unselected sample of sexually unresponsive women.

Administration, Sublingual↗

Heparan sulphate bound growth factors: a mechanism for stromal cell mediated haemopoiesis.

The proliferation and development of haemopoietic stem cells takes place in close association with marrow stromal cells. This intimate cell contact presumably enables the stem cells and their progeny to respond to stimuli present on the stromal cell surface. While the nature of these stimuli has not been determined, it is likely that growth factors play some role. Recently, it was demonstrated that the natural and the recombinant haemopoietic growth factor, granulocyte/macrophage colony stimulating factor (GM-CSF), could be adsorbed out of solution by an extract of human marrow stromal extracellular matrix (ECM) with retention of biological activity. However, the precise ECM molecules involved were not identified. Here, we clearly demonstrate that the major sulphated glycosaminoglycan of mouse marrow stroma, heparan sulphate, possesses the ability to adsorb both GM-CSF and the multilineage haemopoietic growth factor, Interleukin 3 (IL-3). Furthermore, these growth factors, once bound, can be presented in the biologically active form to haemopoietic cells.

Adsorption↗

Recombinant interferon alpha-2a for treatment of herpes zoster in immunosuppressed patients with cancer.

PURPOSE: Acyclovir and high doses of intramuscular leukocyte interferon have been shown to prevent dissemination of herpes zoster in cancer patients with localized herpes zoster. With the availability of recombinant interferon, we decided to conduct a multicenter, placebo-controlled, double-blind trial of intramuscular recombinant interferon alpha-2a to assess its efficacy and safety in the treatment of localized herpes zoster in immunosuppressed patients with cancer. PATIENTS AND METHODS: Immunosuppressed cancer patients with localized herpes zoster were randomly assigned to receive placebo, 36 X 10(6) units of recombinant interferon alpha-2a per day, or 68 X 10(6) units of recombinant interferon alpha-2a per day. Due to frequent adverse effects, the 68 X 10(6) unit dose of interferon was discontinued prior to conclusion of the trial. RESULTS: Dissemination of herpes zoster occurred in 14 of the 24 patients (58 percent) who received placebo but in only four of 24 recipients (17 percent) of 36 X 10(6) units of interferon per day (p = 0.003). Adverse effects (fever, chills, headaches, gastrointestinal irritability, fatigue, and myalgias) were more common or severe in interferon-treated patients. CONCLUSION: These results suggest that interferon modifies the severity of herpes zoster in immunosuppressed patients with cancer but is associated with frequent side effects.

Adult↗

From time to time.

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Health Maintenance Organizations↗

Talk about mysteries.

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Insurance, Physician Services↗

Court-ordered obstetrical interventions.

In a national survey, we investigated the scope and circumstances of court-ordered obstetrical procedures in cases in which the women had refused therapy deemed necessary for the fetus. We also solicited the opinions of leading obstetricians regarding such cases. Court orders have been obtained for cesarean sections in 11 states, for hospital detentions in 2 states, and for intrauterine transfusions in 1 state. Among 21 cases in which court orders were sought, the orders were obtained in 86 percent; in 88 percent of those cases, the orders were received within six hours. Eighty-one percent of the women involved were black, Asian, or Hispanic, 44 percent were unmarried, and 24 percent did not speak English as their primary language. All the women were treated in a teaching-hospital clinic or were receiving public assistance. No important maternal morbidity or mortality was reported. Forty-six percent of the heads of fellowship programs in maternal-fetal medicine thought that women who refused medical advice and thereby endangered the life of the fetus should be detained. Forty-seven percent supported court orders for procedures such as intrauterine transfusions. We conclude from these data that court-ordered obstetrical procedures represent an important and growing problem that evokes sharply divided responses from faculty members in obstetrics. Such procedures are based on dubious legal grounds, and they may have far-reaching implications for obstetrical practice and maternal and infant health.

Attitude of Health Personnel↗

Pregnancy and vaginal delivery following bilateral total hip replacement.

We report a case of pregnancy with spontaneous vaginal delivery in a patient who had bilateral total hip arthroplasty. Guidelines for management of such patients are discussed, as this is a clinical situation which is likely to be seen more frequently. Orthopaedic consultation is important, if possible with the surgeon who performed the operations.

Adult↗

Contamination control in long-term ventilation. A clinical study using a heat- and moisture-exchanging filter.

Twenty-eight patients who required periods of mechanical ventilation for up to 22 days in the intensive therapy unit were studied to evaluate the clinical use of the Pall Ultipor Breathing System Filter (BB50T) as a heat- and moisture-exchanging bacterial filter. Results in this group of patients showed that there was no longer any need to sterilise breathing systems or decontaminate ventilators if these filters were used. They also performed satisfactorily as a heat and moisture exchanger in patients in need of long-term ventilation, and their use appears to offer substantial advantages as regards cost, ease of use and patient safety.

Bacteria↗

Human interferon alpha in malignant lymphoma and Hodgkin's disease. Results of the American Cancer Society trial.

Forty-nine patients with non-Hodgkin's lymphoma or Hodgkin's disease were entered into a multi-institutional phase II trial to evaluate the antitumor activity of human interferon alpha, prepared from buffy coats. Interferon alpha was administered intramuscularly in doses of 1 X 10(6) u, 3 X 10(6) u or 9 X 10(6) u daily for 30 days. Objective partial responses were seen in 3 of 18 patients with nodular lymphoma, all at the 9 X 10(6) u dose. Interferon alpha was not observed to be of therapeutic benefit in the other subtypes of non-Hodgkin's lymphoma or Hodgkin's disease. The major toxicities consisted of fatigue, fever, myalgias and weight loss. Serum interferon levels obtained 3 to 4 hours after injection varied widely, even among patients treated at the same dose level. Despite the relatively low doses of interferon used and the brief period of administration, this study extends the earlier observations of the antitumor effect of interferon in nodular lymphoma. These results are discussed in relation to the cumulative experience in human lymphoma using alpha interferons induced in human leukocytes and those produced in bacteria by recombinant DNA techniques.

Adolescent↗