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Biomedical subjects

J Main

Publications and source records attributed to J Main.

133 records · Page 8Linked to original sources
PubMedDate not supplied

Tuberculosis in HIV seropositive individuals--a retrospective analysis.

A retrospective analysis of all culture-positive cases of Mycobacterium tuberculosis infection in HIV positive individuals, over a 5 year period, revealed 18 cases, drawn from a population of approximately 1500. The prevalence of culture proven M. tuberculosis over the 5 year period was therefore 1.2% and was strongly associated with either a concomitant, or a subsequent, AIDS diagnosis. Sixty-one per cent had pulmonary tuberculosis, 17% had both extra-pulmonary and pulmonary infection and 22% had extra-pulmonary infection alone. Although a wide range of radiological abnormalities was seen, segmental consolidation was the commonest, occurring in 57% of cases. Only 55% of the specimens were positive on initial stains for M. tuberculosis, with a mean duration of 4 weeks to become culture positive, emphasizing that early diagnosis rests on clinical suspicion.

Adult↗
PubMedDate not supplied

Ondansetron usage in HIV positive patients: a pilot study on the control of nausea and vomiting in patients on high dose co-trimoxazole for Pneumocystis carinii pneumonia.

This was an open, single centre study, to evaluate the safety and efficacy of ondansetron in the treatment of co-trimoxazole associated nausea and vomiting in AIDS patients. Sixteen patients presenting with their first episode of HIV-associated Pneumocystis carinii pneumonia (PCP) on high dose co-trimoxazole were given ondansetron 8 mg orally, every 8 h. Measurements were made from data recorded by each patient on diary cards. In this study 11 out of 16 (69%) patients on ondansetron experienced good control of emesis (2 or less emetic episodes) on their 'worst day' of therapy and 8 out of 16 (50%) of patients demonstrated good control of emesis throughout their treatment with co-trimoxazole. Good control of nausea (mild or none) was achieved in 7 out of 16 (47%) patients. A total of 7 patients were able to complete the full course of co-trimoxazole whilst on ondansetron. One serious adverse event (Stevens-Johnson syndrome) was reported and felt to be unrelated to ondansetron. If conventional anti-emetics fail to achieve control of symptoms or have unacceptable side effects, ondansetron may represent a possible alternative.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Neuromythology.

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Brain↗
PubMedDate not supplied

Deciding not to start dialysis--a one year prospective study in Teesside.

OBJECTIVES: To study the number and type of patients in whom it was decided not to commence dialysis for presumed irreversible renal failure, and the reasons for those decisions. DESIGN: A prospective twelve-month observational study. Information, regarding the decision making process, was obtained by proforma from the doctors involved. Patient details were retrieved from case notes. SETTING: The South Cleveland Hospital Renal Unit, which is the sole provider of chronic dialysis for a catchment population of 900,000 in Teesside and parts of South Durham and North Yorkshire. SUBJECTS: Patients referred for consideration for dialysis for presumed irreversible renal failure in whom it was decided not to commence dialysis. Data are included regarding all patients who did commence renal replacement therapy for end-stage renal failure over the same time period for demographic comparison. RESULTS: Eleven patients did not start dialysis, compared with 88 commencing RRT. In the undialysed patients, age range was 56 to 90, but six were 80 or over. Only one had previously attended a renal clinic, none had a specific renal diagnosis. Only 3 had no immediate indications for dialysis. Six patients were thought likely to die soon with or without dialysis. All 11 had significant co-morbidity, and 6 were recorded as housebound. Four patients were totally incapable of making a decision regarding dialysis; only one of the other seven was offered the choice. During the study period, both the acceptance rate and the early death rate for dialysis were higher than in previous years. CONCLUSIONS: A small number of patients with multiple medical and social problems are not selected for dialysis. Although some would have had their life prolonged by dialysis, about half were thought to be about to die from non-renal causes. The patients were rarely involved in the decision making process. The process of being studied may have altered either decision making or classification of patients being offered dialysis.

Aged↗