Biomedical subjects
Publications and source records attributed to J Ogden.
The reproductive performance of tamarins (Saguinus mystax mystax) under laboratory conditions was evaluated. Fifteen of 20 male-female pairs were fertile and produced 30 live births during an observation period of 3.5 years. Twenty-six breeders (65%) and 12 offspring (40%) more than 3 years old were alive at the termination of the reporting period.
There are differences of opinion about the pathogenesis of Perthes' disease. All are agreed that it is due to ischaemia, but the cause of this and the size and number of infarctions are in dispute. Through the generosity of the contributors six whole femoral heads and core biopsies of five other cases have been studied radiographically and histologically. The findings ranged from an ischaemic arrest of ossification in the capital articular cartilage without infarction to multiple complete infarctions of the epiphysial bone. The ensuing reparative process contributes to the pathology, which is of a range to warrant grading or grouping.
99mTc-pyrophosphate studies in 21 children with acute hematogenous osteomyelitis were compared with radiographic, clinical and surgical findings. Eleven 99mTc studies revealed obvious abnormalities, four showed subtle abnormalities, two were misleading, and four were normal. No consistent explanation for the lack of positive radionuclide findings was found. We concluded that pediatric osteomyelitis presents a spectrum of scintigraphic appearances and interpretation is often difficult.
Adult common marmosets, inoculated with either of 2 oncogenic Herpesvirus saimiri (HVS) strains, developed fatal lymphoproliferative disease within 23-25 days post inoculation (PI). The disease was identical to HVS-induced lymphoma in cotton-topped and white-lipped marmosets. Common marmosets inoculated with an attenuated HVS strain developed persistent infection; virus has been recovered from cocultivated lymphocytes of these animals for more than 384 days PI.
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Public health has for long been dominated by the notion of 'control'. However, social science research on tuberculosis in the tropics indicates that policies and programmes that take 'control' as their primary focus may fail to meet the health needs of patients and their communities. It is proposed that research and programmes meet the public health goal of lowering the prevalence of disease in populations by forging and cementing partnerships which take the support and care of patients as their focus. These will be partnerships between researchers in the North and the South, between research and programmes/policy, between outside 'experts' and communities themselves and between (public) health and other social service sectors. Social science approaches to operations research in tuberculosis are outlined, and data from a recent project in New Delhi are introduced.
OBJECTIVES: To: (1) develop a pharmaceutical care multicenter outcomes research project using clinical pharmacy residents and preceptors; (2) develop two research protocols to document pharmacists' impact on clinical, economic, and humanistic outcomes of therapy; (3) develop and implement a data collection process and methodology for outcomes research; (4) evaluate the effectiveness of the multicenter outcomes research process; and (5) prepare clinical pharmacy preceptors and residents to conduct outcomes research. DESIGN AND SETTING: Two research protocols were developed, each a randomized, parallel, open-label evaluation of patients at 10 Department of Veterans Affairs and 1 university medical center. One protocol focused on patients with chronic obstructive pulmonary disease (COPD) and the other on patients with hypertension. The study evaluated pharmacists' management of these two patient groups. PATIENTS AND OTHER PARTICIPANTS: 133 patients with hypertension and 98 patients with COPD; 33 pharmacy directors and preceptors; 45 pharmacy residents. MAIN OUTCOME MEASURES: Clinical, economic, and humanistic outcomes of pharmacists' interventions. The processes of developing a multicenter outcomes study were evaluated, including the data collection process. RESULTS: The two study protocols and an educational program for study participants were developed. A data collection process was developed and implemented, with the paper process being successful and the computer data collection process not implemented due to time constraints. Overall, the multicenter outcomes research process was successful. CONCLUSION: The study provides a framework of processes and sites for the future development of other outcomes research studies. Clinical, economic, and humanistic outcomes are reported in Parts 2 and 3.
The probability of gonorrhea in men attending the DeKalb County, Georgia, clinic for sexually transmitted diseases with the chief complaint of urethral discharge and/or dysuria and whose urethral smears contain intracellular gram-negative diplococci is 94.8%. Absence of intracellular gram-negative diplococci from smears of the same men in associated with a 92.6% probability that they have nongonococcal urethritis rather than gonorrhea. There is a 97.3% probability of gonorrhea in our female patients at high risk of being infected and whose cervical smears contain intracellular gram-negative diplococci. Absence of intracellular gram-negative diplococci is associated with a probability of only 51.2% that these women do not have gonorrhea. The probability of gonorrhea in our male patients, whose smears contain intracellular gram-negative diplococci, drops from 94.8% to 34.9% when specimens are obtained from sexually active men without urethritis and to 53.9% when an inexperienced technician interprets smears from patients with urethritis. Vancomycin . HCl, which is included in Neisseria gonorrhoeae--selective media for suppression of microbial contaminants, also inhibited 2.4% of our gonococcal isolates and resulted in a falsely negative test. Awareness of these and other limitations of tests for gonorrhea, and of the magnitude and means of control of these limitations is essential to determining the presence or absence of gonococcal disease.
The effects of branched chain amino acid (BCAA)-enriched diets (fed for 7 days) on encephalopathy, plasma amino acid concentrations, aromatic amino acid turnover, and protein synthesis rates were determined in eight patients with alcoholic liver failure. Four patients were given the diet intravenously (iv group) (total amino acids, 60-80 g/day, BCAA content 51%, energy 2000 kcal/day) and four patients (NG group) were given a semi-elemental formulation via constant nasogastric (NG) infusion (amino acids 58 g, BCAA 43%, oligopeptides 19.5 g, energy 2000 kcal/day). The enteral diet was given at one-half strength for the first 3 days. A 10-hr constant infusion of [U-14C]phenylalanine tracer was used in four patients to measure aromatic amino acid (AA) turnover and rates of incorporation into various body proteins. Seven of the eight patients made a good clinical recovery, with reversal of encephalopathy within 3 days of dietary intervention. One became septicemic and deteriorated. While plasma bilirubin concentrations dropped, liver enzymes remained elevated. Mean nitrogen balance was negative at the beginning and positive at the end of the study, in both groups. Initial amino acid profiles demonstrated low plasma BCAA content and BCAA:AA ratios. Significant improvements occurred in the iv group by day 2 and in both groups by day 7. Isotope studies showed that, whereas aromatic amino acid oxidation remained unchanged, greater quantities were incorporated in whole body protein, albumin, transferrin, fibrinogen, and immunoglobulins.
Recent studies have shown an elemental diet to be as effective as bowel rest plus steroids in the management of acute Crohn's disease. In order to investigate the metabolic and immunological effects of these two therapies, six patients with an acute inflammatory attack of ileal Crohn's disease were randomly assigned to receive steroids or elemental diet for 7 days. Immunological and protein metabolic studies were performed before and after therapy, protein kinetic rates being measured by the method of constant intravenous infusion of 14C-labeled leucine tracer. Clinical and symptomatic improvement was noted in all six patients with significant falls in sedimentation rate and platelet counts and increases in albumin concentrations. Both forms of treatment increased plasma amino acid flux and oxidation rates, whole body protein turnover and rates of incorporation of amino acid into albumin. However, the increased rates of protein metabolism in the patients given steroids were at the expense of body protein stores with a net (average) loss of 58 g of nitrogen over 7 days. While both forms of therapy were associated with suppression of lymphocyte subsets, complement and circulating immune complexes only the steroid regimen was associated with suppression of in vivo IgG synthesis rates. The results indicated that both forms of therapy were associated with clinical improvement, increases in protein turnover and evidence of reduced inflammatory activity. However, the beneficial effects of steroid regimen must be balanced against the deleterious effects on body protein stores; steroids and bowel rest without nutritional support should be avoided in malnourished patients.
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Conventional radiography with a 35-year-old, portable radiographic unit, a Polaroid processing system, and various speed intensity screens was used to survey an adipocere cadaver. Since the specimen could not be moved, positional strategies that might be used for an immobile emergency room trauma victim were employed to assess skeletal components, and organ and artifact locations.