Tuberculosis due to atypical mycobacteria: review of the literature and report of a case.
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Child, Preschool↗
Biomedical subjects
J Powell
Publications and source records attributed to J Powell.
Can opiate addicts tell us about their relapse risk? Subjective predictors of clinical prognosis.
Given the high relapse rate of opiate addicts following detoxification, it is pertinent to identify whether any subjective variables mediate outcome, since these may then be targets of treatment. The present study assessed personality, cue-elicited craving, outcome expectancies for drug use, and self-efficacy for resisting drug use, in 43 opiate addicts receiving inpatient detoxification in either a specialist drug-dependence unit or a behavioral/general psychiatric ward, within the context of a randomised, controlled-treatment trial. Subjects were followed-up at between 1 and 3 months and again at 6 months after discharge. Frequency of drug use was not predicted by any of the subjective variables at the first follow-up; but at 6 months, subjects with lower self-efficacy and higher positive outcome expectancies were found to be using less often. Latency to first lapse was greater in subjects with higher anxiety and neuroticism scores. Precipitants to the first lapse were identified, but none of the predicted relationships between subjective variables and circumstances of lapse emerged. It is suggested that greater awareness of personal vulnerability may promote effective coping strategies.
Adult↗
Self-sustaining Mars colonies utilizing the North Polar Cap and the Martian atmosphere.
A revolutionary new concept for the early establishment of robust, self-sustaining Martian colonies is described. The colonies would be located on the North Polar Cap of Mars and utilize readily available water ice and the CO2 Martian atmosphere as raw materials to produce all of the propellants, fuel, air, water, plastics, food, and other supplies needed by the colony. The colonists would live in thermally insulated large, comfortable habitats under the ice surface, fully shielded from cosmic rays. The habitats and supplies would be produced by a compact, lightweight (~4 metric tons) nuclear powered robotic unit termed ALPH (Atomic Liberation of Propellant and Habitat), which would land 2 years before the colonists arrived. Using a compact, lightweight 5 MW (th) nuclear reactor/steam turbine (1 MW(e)) power source and small process units (e.g., H2O electrolyzer, H2 and O2 liquefiers, methanator, plastic polymerizer, food producer, etc.) ALPH would stockpile many hundreds of tons of supplies in melt cavities under the ice, plus insulated habitats, to be in place and ready for use when the colonists landed. With the stockpiled supplies, the colonists would construct and operate rovers and flyers to explore the surface of Mars. ALPH greatly reduces the amount of Earth supplied material needed and enables large permanent colonies on Mars. It also greatly reduces human and mission risks and vastly increases the capability not only for exploration of the surrounding Martian surface, but also the ice cap itself. The North Polar Cap is at the center of the vast ancient ocean that covered much of the Martian Northern Hemisphere. Small, nuclear heated robotic probes would travel deep (1 km or more) inside the ice cap, collecting data on its internal structure, the composition and properties of the ancient Martian atmosphere, and possible evidence of ancient life forms (microfossils, traces of DNA, etc.) that were deposited either by wind or as remnants of the ancient ocean. Details of the ALPH system, which is based on existing technology, are presented. ALPH units could be developed and demonstrated on Earth ice sheets within a few years. An Earth-Mars space transport architecture is described, in which Mars produced propellant and supplies for return journeys to Earth would be lifted with relatively low DeltaV to Mars orbit, and from there transported back to Earth orbit, enabling faster and lower cost trips from Earth to Mars. The exploration capability and quality of life in a mature Martian colony of 500 persons located on the North Polar Cap is outlined.
Carbon Dioxide↗
Childhood vulval lichen sclerosus in a patient with ectodermal dysplasia and uncombable hair.
An 11-year-old girl was diagnosed as having ectodermal dysplasia, with abnormalities of her nails, teeth, and hair noted from infancy. Her hair was unruly and investigations confirmed the changes seen in "cheveux incoiffables"-the uncombable hair syndrome. She also had atopy requiring treatment to control asthma and eczema. When she was 8 years old she developed vulval lichen sclerosus, which was controlled easily with early treatment. The coexistence of these conditions is discussed.
Asthma↗
Selective impairments of object knowledge in a case of acquired cortical blindness.
A patient (N.B.) is described, who displays distinct deficits of object knowledge related to knowledge type (Functional/Associative vs Visual) and also to knowledge category (Animate vs Inanimate). The patient was first given an orally presented forced-choice test devised to assess orthogonal combinations of knowledge type and knowledge category. In the production of this test it was found that normals took longer to respond to Visual questions than to Functional/Associative questions; therefore, sets of questions were compiled that were matched for both accuracy and latency. There were two main findings concerning N.B.'s semantic memory. First, with careful matching of difficulty level, the patient showed selective preservation of Functional/Associative knowledge of Animate objects compared with Visual knowledge of Animate objects and also compared with Functional/Associative knowledge of Inanimate objects. Second, there was a qualitative difference in patterns of knowledge retrieval for Visual compared with Functional/Associative knowledge. Retrieval of Visual knowledge, both Animate and Inanimate, was inconsistent and, in a word-pair recall test, a high degree of connection of a Visual property to an object did not promote paired-associate learning. In contrast, retrieval of Functional/Associative knowledge (both Animate and Inanimate) was consistent and paired-associate learning was influenced by connection strength. This study provides strong evidence to support the validity of both "knowledge type" and "category" based accounts of the organisation of semantic memory.
Adult↗
Late luteal rescue in the baboon (Papio cynocephalus).
Numerous studies have used human chorionic gonadotrophin (HCG) administration to study the response of the primate ovary to gonadotrophin stimulation. These studies are generally performed in the luteal phase with very few studies of the follicular phase. We have studied the effect of both HCG and gonadotrophin releasing hormone (GnRH) agonist administered at the early follicular phase in normally cycling baboons (Papio cynocephalus). Five baboons were treated with increasing doses of HCG for 5 consecutive days starting on day 1 of the cycle and three untreated baboons served as controls. Follicular and luteal phase lengths were determined and serum samples were assayed for progesterone, oestradiol and 17alpha-OH progesterone. In a separate study, six baboons were treated with GnRH agonist (WY-40972) on days 2-6 of the cycle and saline-treated baboons served as controls (n = 5). Mean peak progesterone concentrations (+/- SE) during the treatment interval were 3.88+/-0.56 ng/ml in HCG-treated baboons compared to 0.19+/-0.07 ng/ml in controls (P < 0.001). A similar significant increase (P < 0.001) in serum 17alpha-OH progesterone concentrations was also observed (6.13+/-1.12 ng/ml versus 1.13+/-0.49 ng/ml). In association with the increase in luteal steroids there was also a significant prolongation of menstrual cycle length from 32.7+/-1.2 days in controls to 46.8+/-4.9 days in HCG-treated baboons (P < 0.05), which involved prolongation of the follicular phase (16.7+/-1.2 days to 29.0+/-4.6 days; P < 0.05) with no difference in luteal phase length or progesterone concentrations. In GnRH agonist-treated baboons, mean (+/- SE) cycle length was prolonged to 46.3+/-1.6 days and in saline-treated controls was 32.8+/-0.8 days (P < 0.001), again this was completely represented by the change in follicular phase length, from 13.4+/-0.7 days in controls to 27.2+/-2.1 days in agonist-treated baboons (P < 0.001). In contrast, there was no significant difference in luteal phase length between these two groups (19.4+/-0.7 versus 19.2+/-1.0 days). The prolongation of the follicular phase was accompanied by significant increases in both progesterone (P < 0.01) and oestradiol (P < 0.01) during GnRH agonist treatment above control concentrations. Luteal phase concentrations of these hormones were not different from controls. These results demonstrate the previously unreported finding that gonadotropin stimulation will rescue the corpus luteum in the next follicular phase.
Animals↗
Mitochondrial DNA variability in Grauer's gorillas of Kahuzi-Biega National Park.
Eastern lowland gorillas (Gorilla gorilla graueri) are the least studied of the three gorilla subspecies; particularly at the molecular level. We sequenced an internal region of the mitochondrial DNA cytochrome oxidase subunit II (COII) region and a hypervariable portion of the mitochondrial DNA control region (D-loop) from wild gorillas in both the montane and lowland habitats of Kahuzl-Blega National Park, Democratic Republic of Congo. All individuals (n = 38) were identical at the COII region; this sequence indicates that diagnostic sites previously suggested for gorilla subspecies may be valid. Low variability was found within the D-loop region from a subset of the individuals (n = 15) sequenced for COII. Haplotype frequencies differed between the two habitats, suggesting a level of population subdivision that may have demographic consequences. These results also support the distinction of two distinct clades of gorillas comprised of western populations (G. g. gorilla) and eastern populations (G. g. graueri and G. g. beringei). Future management of Kahuzi-Biega National Park should ensure that sufficient habitat remains to prevent further genetic isolation of gorillas in the montane section of the park.
Animals↗
Manipulation under anaesthetic of children's fractures: use of the image intensifier reduces radiation exposure to patients and theatre personnel.
During simulated manipulation of children's forearm fractures, levels of scattered radiation from both plain radiographs and an image intensifier in different modes were measured at various sites on the surgeon, anaesthetist, radiographer, and patient both with and without recommended shielding. By using fluoroscopy in the pulsed screening mode but allowing only single pulses to occur, radiation levels could be substantially reduced to the eye, thyroid, and gonads of all those exposed. The radiographer and the anaesthetist were so far from the source and guarded by various pieces of equipment that levels were almost unrecordable. Effective dose equivalent for the surgeon using pulsed mode, based on circa six pulses per manipulation, during 100 manipulations per year, would equate to 1 microSv even in the unshielded state (< 0.1 microSv shielded), which is approximately 1/1,000 of background radiation at sea level. Because the current dose limit is 50 mSv (50,000 microSv) per year for employees, we are many orders of magnitude in the safety zone.
Anesthesia↗
The effect of acipimox in patients with type 2 diabetes and persistent hyperlipidaemia.
A placebo-controlled, double-blind study was performed to assess the effect of 12 weeks treatment with acipimox (250 mg three times per day) on lipoproteins and glycaemic control in patients with Type 2 diabetes. All patients studied had persistent hyperlipidaemia despite acceptable glycaemic control on treatment with diet alone or diet and oral hypoglycaemic agents, achieving glycosylated haemoglobin (HbA1) of less than 10.5% but with fasting total triglycerides greater than 2.5 mmol l-1 or total cholesterol greater than 6.5 mmol l-1. Forty-eight patients were randomized to treatment, 21 to acipimox and 27 to placebo; 43 completed the trial. All patients had been diabetic for at least 1 year. Total cholesterol fell by 6% and total triglycerides by 19% following 12 weeks of acipimox, compared to rises in the placebo group of 1% and 16%, respectively (p less than 0.05). There were no significant differences between acipimox and placebo in the change in low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, apolipoproteins AI, AII, or B, or in glycaemic control during the treatment period. Acipimox is effective in reducing fasting total cholesterol and total triglycerides in patients with Type 2 diabetes with acceptable blood glucose control but persistent hyperlipidaemia. Acipimox does not adversely affect glucose tolerance.
Apolipoproteins↗
Alpha-1-antitrypsin deficiency in aneurysmal disease.
alpha 1-Antitrypsin (alpha 1-AT) deficiency may play a role in arterial aneurysmal disease by allowing increased proteolysis of arterial structural proteins. Alpha 1-AT levels are influenced by variation at the PI (protease inhibitor) locus. PI phenotypes were determined in 173 patients with abdominal aortic aneurysms (77 from Pittsburgh, 96 from London) and in 72 patients with intracranial aneurysms (26 from Pittsburgh, 46 from London). No excess of PI deficiency alleles was observed in either of the aortic aneurysm data sets or in the Pittsburgh intracranial aneurysm data. The PI*Z deficiency allele frequency in the London intracranial aneurysm data was 8-fold higher than in controls; however, this was not significant after correcting for multiple comparisons. PI phenotype had no effect on aneurysm age-at-diagnosis within any of the data sets. Smoking history had an effect on aneurysm age-at-diagnosis only within the Pittsburgh intracranial-aneurysm data.
Aged↗
Adverse effects of tricyclic antidepressants during nasal surgery.
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Adult↗
Lumbar transverse process fractures in professional football players.
In the general population, fractures of the transverse processes of lumbar vertebrae occur in cases of high-energy blunt trauma, often in motor vehicle accidents. Football players may incur the same fractures, but the circumstances and outcomes are different in this specific subgroup. A review of 29 cases among National Football League players reveals that associated visceral injuries are rare, and the time lost from sports is only an average of 3.5 weeks.
Football↗
Lipopolysaccharide from an Escherichia coli htrB msbB mutant induces high levels of MIP-1 alpha and MIP-1 beta secretion without inducing TNF-alpha and IL-1 beta.
OBJECTIVE: To identify a lipopolysaccharide (LPS) that retains the capacity to induce beta-chemokine secretion without the concomitant activation of pyrogenic cytokines. METHODS: LPS was extracted from strain MLK986 (mLPS), an htrB1::Tn10, msbB::ocam mutant of Escherichia coli that is defective for lipid A synthesis, and from wild-type parent E coli strains, W3110 (wtLPS). The capacity of these LPS preparations to induce tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), and macrophage inflammatory proteins 1 alpha (MIP-1 alpha) and MIP-1 beta was assessed using a human peripheral blood mononuclear cell (PBMC) activation assay. RESULTS: Stimulation of PBMCs with mLPS did not induce measurable levels of pyrogenic cytokines TNF-alpha and IL-1 beta, whereas wtLPS induced high levels of these cytokines. Furthermore, mLPS antagonized the induction of TNF-alpha secretion by wtLPS. Nonetheless, mLPS retained a discrete agonist activity that induced MIP-1 alpha and MIP-1 beta secretion by PBMCs. This latter agonist activity appears to be unique to mLPS, since two previously documented LPS antagonists, Rhodobacter sphaeroides diphosphoryl lipid A and synthetic lipid IVA, did not induce MIP-1 alpha and MIP-1 beta secretion. Furthermore, synthetic lipid IVA was an antagonist of MIP-1 alpha and MIP-1 beta induction by mLPS. CONCLUSION: These results show that mLPS exhibits a novel bipartite activity, being an effective antagonist of TNF-alpha induction by wtLPS, while paradoxically being an agonist of MIP-1 alpha and MIP-1 beta secretion.
Chemokine CCL3↗
Reliable standards of care are determined by consensus of those who provide that care.
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Chiropractic↗
Desensitization of both luteal and pituitary function in baboons with nafarelin, a potent LH-RH agonist.
Acute responsiveness in vivo of the baboon corpus luteum to a course of twice daily injections of human chorionic gonadotropin (hCG) has been studied with and without concomitant injections of nafarelin, a potent luteinizing hormone-releasing hormone (LH-RH) agonist. HCG injection alone caused an acute (1 hour) rise in circulating levels of progesterone (P), confirmed to be a direct effect at the luteal level, since no change in circulating levels of endogenous LH was detected. When hCG was coadministered with a low dose of nafarelin (50 micrograms per injection), circulating levels of LH rose, but the rise in serum P levels was blunted. However, when hCG was coadministered with a high dose of nafarelin (250 micrograms per injection), serum LH levels rose only in response to the first injection and serum levels of P were not elevated, suggesting a desensitization of the pituitary to the LH-RH agonist and of the corpus luteum to the hCG. The profile of luteal P during the luteal phase in response to combined treatment with hCG and nafarelin also reflected these effects, being intermediate between vehicle controls and hCG treatment alone. This first demonstration of a luteal desensitization to gonadotropin by an LH-RH agonist in primates may account for previously noted successful interception of pregnancy in baboons treated with these agents.
Administration, Cutaneous↗
Patterns of substance use and abuse in inner-city adolescent medical patients.
Distinct patterns of use and abuse of alcohol and illicit drugs are described in a sample of 2,415 teenage patients using primary health clinics over a two-year period. The sample was obtained in the course of a large-scale study to evaluate the effectiveness of consolidated medical programs directed to predominantly inner-city, minority-group adolescents. Information was obtained in personal interviews using a structured format and professional interviewers. Analysis of data proceeded in two steps. First, the rates of progression from abstention or light use of alcohol and drugs to regular use or abuse, and the reverse of this pattern (i.e., remission) were examined. The second step in the analysis was to examine the degree to which certain psychosocial variables characterized temporal patterns of heavy use. Regular tobacco use had a substantial influence on the progression to substance abuse in male and female patients. The results indicate that about 20 percent of the patients attending these clinics were in some phase of either increasing or decreasing their substance use, and another 20 percent engaged in regular use continuously over the two-year period, while the remaining 60 percent of patients stayed at low risk over this same period. These subgroups were rather easy to differentiate on the basis of concurrent behavioral and lifestyle problems.
Adolescent↗