Telling the right patient.
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Biomedical subjects
Publications and source records attributed to J Jones.
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Forty women with uncomplicated urinary tract infections owing to susceptible organisms were assigned randomly to 500 mg. cinoxacin or 160--800 mg. trimethoprim-sulfamethoxazole twice daily for 10 days. Of 20 patients receiving cinoxacin none had bacteriuria during or 7 days after therapy, and 2 of 15 (13 per cent) were reinfected within 30 days. Of 20 patients receiving trimethoprim-sulfamethoxazole 1 (5 per cent) had bacteriuria during therapy, 19 were uninfected during and 7 days after therapy, and 3 of 15 (20 per cent) were reinfected within 30 days. Adverse reactions occurred in 2 patients (10 per cent) in each group. Anal and vaginal Enterobacteriaceae maintained their sensitivity to cinoxacin. Three patients (20 per cent) on trimethoprim-sulfamethoxazole presented with and 3 acquired anal Enterobacteriaceae resistant to the drug and 2 (13 per cent) acquired vaginal Enterobacteriaceae that were resistant. Cinoxacin was as effective as trimethoprim-sulfamethoxazole without the emergence of resistant bacteria associated with trimethoprim-sulfamethoxazole.
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Plasma luteinising hormone (LH) and follicle-stimulating hormone (FSH) concentrations were measured before and after intravenous luteinising hormone-releasing hormone (LH-RH) in 33 boys with growth delay. Eighteen were prepubertal and 15 pubertal. Basal LH and FSH levels were low in both groups with mean increments after LH-RH of 3.2 +/- 0.8 U/l (mean +/- SEM) and 2.6 +/- 0.4 U/l respectively in the prepubertal and 7.4 +/- 0.7 U/l and 2.0 +/- 0.3 U/l in the pubertal boys. The LH increment showed a positive correlation with increasing bone age (r = 0.71, P less than 0.001); FSH did not. The LH-RH response thus appeared normal in relation to the stage of maturity.
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Dried citrus waste was fed to dairy cows, their milk was extracted, and aflatoxin M1 was quantitated by using both high pressure liquid chromatography (HPLC) and thin layer chromatography (TLC). Results indicate that a compound from the citrus waste, which is excreted into the milk, interferes with the HPLC determination of aflatoxin M1 in milk and causes a false positive test. This interference can be overcome by using TLC with proper selection of developing solvents.
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Tonsillectomy prevalences, using questionnaires, were determined on series of school pupils (total number 10,271), aged 16-18 years, in four South African ethnic groups. Prevalence were, approximately: rural Blacks 2%, urban Blacks 3%, Indians 8%, Coloureds (Eur-African-Malay) 9% and Whites 44%. The inter-ethnic profile of differences is similar to the inter-ethnic profiles of other differences (e.g. in appendicectomy prevalences).
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Recombinant plasmids carrying part of the leucine operon of Salmonella typhimurium were isolated following transformation of an Escherichia coli leucine auxotroph to prototrophy with a ligated mixture of EcoRI-treated Salmonella DNA and plasmid pSC101 DNA. Plasmids pCV11 and pCV13, containing a 3.4-10(6) dalton DNA fragment ligated to the vector, had the leu operon oriented in opposite directions. The orientation of the leu operon relative to plasmid genes was determined. The 3.4-10(6) dalton fragment was ligated in to the EcoRI site of plasmid pMB9 yielding plasmids pCV12 (orientation as in pCV11) and pCV14 (orientation as in pCV13). The results of enzyme assays and complementation tests indicated that these plasmids carry functional leuA, leuB, and leuC genes but not a functional leuD gene. Furthermore, the following results indicated that they have a functional leu control region and promoter. Expression of plasmid leu genes was markedly enhanced under conditions of leucine limitation whereas introduction of a leu promoter mutation into the operon oriented in either direction with respect to plasmid genes had a strong negative effect upon leu operon expression. Transcriptional readthrough from plasmid promoters, if it occurs at all, must be small in comparison with transcription initiated at the leu promoter. RNA was isolated from leucine auxotrophs grown under conditions of repression and derepression and from prototrophic strains derepressed for the leucine operon as a result of mutations in leuO, leuS, and flrB. The rate of synthesis of leu mRNA, measured by hybridization to plasmid pCV12 DNA, was proportional in each case to leu enzyme levels.
Starting with cloned NIH 3T3 mouse cells we have isolated a series of related lines infected with the Kirsten murine sarcoma/leukaemia (MSV/MLV) virus complex. These lines exhibit all three possible infected cell phenotopes: (i) transformed MSV/MLV producers; (ii) non-transformed MLV producers; (iii) transformed non-producers. We have also selected non-transformed revertants from one of the non-producer clones. This series of lines allows the study of the expression of the virus genome against a constant background of cellular gene expression. We have further characterized the lines with regard to anchorage dependence of growth, tumorigenicity and the presence of a rescuable sarcoma genome. The non-producer clones are uniform in their transformed properties. The revertants contain rescuable sarcoma virus, biologically indistinguishable from the original transforming virus, implying that the reversion is due to a change in cellular rather than viurs genetic information.
Total plasma androgens (PA) were measured in 9 hypogonadal males aged between 13 and 21 1/2 years after a single oral dose of testosterone undecanoate (TU). With the exception of one patient, all showed a rise in PA with peak values between 7.7 and 38.0 nmol/l at 2 to 7 hours. A further patient aged 15.7 years who was given an 80-mg dose had a peak PA level of 71.2 nmol/l. In all patients PA returned to basal levels at 24 hours. In 4 patients plasma testosterone and dihydrotestosterone were measured, both rose after oral TU, and relatively high plasma dihydrotestosterone values were obtained. While these results indicate that TU is effective in young people, the very high peak androgen levels found in several of them after 40 mg TU suggest that this dose may be excessive in patients in whom growth is not complete.
Radiographic procedures performed at a 100-bed pediatric hospital were reviewed jointly by a radiologist and the primary physician staff. The reviewers judged several procedures to be performed unnecessarily, with undue patient risk or cost. Low efficacy examinations were divided into two categories: (1) low-yield examinations with significant gonadal radiation as well as significant cost, and (2) low-yield examinations with low gonadal radiation but significant cost. A joint policy recommendation was then delivered to the house staff concerning appropriate indications for the performance of these low-yield procedures. This active review process is submitted as a model for other medical facilities that seek to reduce risk and cost to the pediatric patient.
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