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Biomedical subjects

J M Pearson

Publications and source records attributed to J M Pearson.

At least 55 records · Page 3Linked to original sources
PubMed1983

The distribution of Mycobacterium leprae in the hair follicle of the eyebrow.

Longitudinal sections of hair follicles from the eyebrows of patients with active, untreated, lepromatous leprosy were studied. Mycobacterium leprae were found in the dermal papilla and outer root sheath of both anagen and telogen hair follicles. Bacilli were rarely found in those cell lines continuous with the environment, i.e., the hair shaft and the inner root sheath. The biochemical fate of these cell lines is such that they would not provide a suitable medium for the survival and transport of bacilli into the environment. We conclude that it is unlikely that the hair follicle plays a significant role in the dissemination of M. leprae but it may be important in providing a suitable site for the incubation of the bacillus within the dermis.

Eyebrows↗
PubMed1983

A clinical and immunological study of four babies of mothers with lepromatous leprosy, two of whom developed leprosy in infancy.

One hundred thirteen women and 27 healthy controls were studied throughout pregnancy, at delivery, and followed up with their babies during lactation. Thirty-eight of the mothers with lepromatous leprosy were found to have solid-staining bacilli in skin smears or biopsies, and hence were considered potentially highly infectious to their unborn children by hematogenous spread via the placenta. Two babies of mothers within this group were diagnosed as having leprosy on clinical and histological grounds. A third baby could well have had leprosy, but the case was not proven. The fourth baby did not have leprosy and, although it did have ringworm, was thus deemed to be a reasonable control. The leprosy skin lesions were first observed at a special followup clinic when the children were between the aged of 9 and 17 months. The demonstration of IgA and IgM anti-M. leprae antibodies in cord sera was taken as an indication of intrauterine immunologic stimulation, and hence transplacental transmission of M. leprae. The two babies with proven leprosy showed an early and significant increase in serum IgA and in particular serum IgM anti-M. leprae antibody activity. A third baby, suspected of having leprosy but in whom the diagnosis was not proven, showed a similar but less marked increase in serum IgA and IgM activity. The fourth baby showed no such rise in anti-M. leprae activity. A decrease in serum IgG anti-M. leprae antibody activity could be demonstrated in one of the babies with leprosy after healing of the leprosy lesions, but not in the second baby.

Antibodies, Bacterial↗
PubMed1982

Neuritis in pregnancy and lactation.

One hundred and forty-six women were studied during and after 153 pregnancies (31 healthy contacts: 34 pregnancies; 115 leprosy patients: 119 pregnancies). One healthy contact and 51 leprosy patients developed neuritis during the study period. All leprosy patients, including those who were considered to be cured and had stopped treatment, were at risk. Neuritis was accompanied by Type 1 and Type 2 lepra skin reactions and/or deterioration of the patients' leprosy status; this was particularly the case when neuritis was associated with nerve pain or tenderness (overt neuritis). Neuritis without nerve pain or tenderness (silent neuritis), preceded by the complaint of "rheumatism" and the clinical finding of enlarged peripheral nerves, was seen more frequently than overt neuritis (48:37 episodes). Insidious silent neuritis with loss of sensory and motor function during lactation was a particularly dangerous and hitherto undescribed risk of pregnancy.

Female↗
PubMed1982

Pregnancy and leprosy: the consequences of alterations of cell-mediated and humoral immunity during pregnancy and lactation.

One hundred fourteen Ethiopian women with leprosy and 33 healthy women without leprosy were studied prospectively throughout 119 and 37 pregnancies, respectively, and followed up during lactation. Fifty-five women showed worsening of their leprosy status; in 31 (56%) this was observed during the third trimester of pregnancy. Forty women were diagnosed as having Type 1 lepra reaction; in 20 (50%) the first occurrence was during the first six months of lactation. Twenty-eight women had Type 2 lepra reaction, which in 19 (68%) first occurred during the third trimester of pregnancy or the first six months of lactation. These adverse effects of pregnancy on leprosy are thought to be associated with suppression of maternal cell-mediated immunity during gestation and recovery postpartum. Implications for the obstetrician, physician and leprosy health worker are discussed.

Antibody Formation↗
PubMed1979

Reoperation for disruption and recurrence after Nissen fundoplication.

This report deals with 25 failed Nissen operations. A method of classifying the type of failure is presented. Manometric studies document disordered motor activity in ten of these patients with return to normal activity after repair. With these difficult patients, intraoperative manometrics allowed a satisfactory antireflux barrier to be created with posterior gastropexy. Good to excellent results were achieved in 22 of 24 patients. A search of the world literature is presented with complications ranging from the well-known "gas-bloat" syndrome to potentially lethal fistulas.

Bronchial Fistula↗
PubMed1979

Reversal reaction: the prevention of permanent nerve damage. Comparison of short and long-term steroid treatment.

Borderline leprosy patients with a reversal reaction were studied and short-term steroid treatment compared with prolonged steroid treatment using voluntary muscle testing (VMT) to assess the results. Prolonged steroid treatment was shown to be superior to short-term treatment and free of harmful effects. It is concluded that with the described antireaction treatment, permanent nerve damage can be prevented, provided that the reversal reaction is detected in time (within 3-4 months).

Humans↗
PubMed1978

Rifampicin for lepromatous leprosy: nine years' experience.

Over 100 patients with lepromatous leprosy were treated with rifampicin in a series of pilot, uncontrolled, and controlled trials in 1968-77. The rapid bactericidal effect of rifampicin on Mycobacterium leprae was confirmed. Clinical improvement became apparent sometimes as early as 14 days after the start of treatment. Nevertheless, a few persisting viable M leprae were detected as long as five years after the start of treatment with rifampicin either by itself or in combination with the bacteriostatic drug thiambutosine. Treatment with rifampicin and dapsone for six months reduced the number of persisting leprosy bacteria more than treatment with dapsone alone. Although rifampicin proved more effective than dapsone, it is unlikely that used by itself if can significantly shorten the length of treatment in lepromatous leprosy. Therefore initial intensive combined treatment with two or more bactericidal drugs (including rifampicin) warrants further investigation in both untreated leprosy and lepromatous leprosy resistant to dapsone.

Animals↗