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J Sheppard

Publications and source records attributed to J Sheppard.

At least 19 recordsLinked to original sources
PubMed1992

The clinical task.

Explore the source record for details and available documents.

Community Health Services↗
PubMed1991

Latrine ownership as a protective factor in inflammatory trachoma in Egypt.

We investigated the association between inflammatory trachoma in children aged 1-5 and environmental and sociodemographic risk factors in a rural Nile Delta hamlet. Inflammatory trachoma clustered in households, emphasising the child-to-child nature of transmission in the hamlet. Multiple logistic regression analysis revealed three factors predicting inflammatory trachoma in children: the absence of a latrine in the household, school-age siblings with inflammatory trachoma, and additional same-age siblings (with or without disease) in the household. In the Egyptian setting the presence of pit latrines in all houses, even when full and unscreened, might result in a reduction in trachoma prevalence in this population from the current 49% to 35%. The construction of pit latrines may offer the simplest and most acceptable environmental method for reducing trachoma in this trachoma endemic area.

Child, Preschool↗
PubMed1989

Trachoma and blindness in the Nile Delta: current patterns and projections for the future in the rural Egyptian population.

A population based survey of trachoma and blindness was conducted in a rural Nile Delta hamlet. Trachoma remains hyperendemic in this region. Active trachoma was common among preschool children; over half had moderate to severe disease. Of residents 25 years old 90% had substantial conjunctival scarring. Severe conjunctival scarring was commoner among women (84%) than men (58%), and three-quarters of older women had trichiasis/entropion compared with 57% of older men. Males and females had equivalent age specific rates of inflammatory disease. Blindness was associated with old age; 17% of residents aged 50 and over were blind. Estimates of blindness based on this survey and other surveys in Egypt indicate that blindness is still a serious public health problem in rural Egypt. The number of blind persons in Egypt will increase from an estimated 420,000 in 1980 to 868,000 by the year 2020. The current crude blindness rate of 1.8% is expected to increase to 2.3% in the year 2000 and to 3.2% in 2020.

Adolescent↗
PubMed1988

Nonculture methods for diagnosing chlamydial infection in patients with trachoma: a clue to the pathogenesis of the disease?

We studied five different tests for diagnosing conjunctival Chlamydia trachomatis infection in specimens obtained from 100 children with moderate-to-severe trachoma. The tests were Giemsa stain, isolation in cell culture, direct fluorescein-conjugated monoclonal antibody, enzyme immunoassay, and a DNA probe. The Giemsa stain was least sensitive at 29%. The other tests gave essentially equivalent performances: sensitivity ranged from 73% to 84% and specificity from 93% to 100%. Seven of the 45 positive specimens were only positive in cell culture, whereas 11 of the 45 were negative in culture but positive in at least two nonculture tests. We speculate that these discordant results actually reflect the biologic status of the chlamydial infection. There appears to be a stage in the infection where chlamydial antigens and nucleic acids can be detected in the absence of infectivity. This stage of infection may contribute to the pathogenesis of trachoma by providing a source of sensitizing antigen.

Azure Stains↗
PubMed1988

Closed complex dorsal dislocation of the middle finger metacarpophalangeal joint: anatomic considerations and treatment.

A rare complex isolated metacarpophalangeal joint dislocation of the middle finger is described, and the pathology is reviewed. The dorsal longitudinal incision used in this case provided excellent exposure for the reduction and helped avoid injury to the digital nerves on the palmar side of the injury. Early mobilization with extension blocking is advocated to maximize joint range of motion postoperatively.

Aged↗
PubMed1987

Reconstitution of the Gs protein from B16 melanoma clones of high and low experimental metastatic potential into S49 cyc-membranes.

The ability of a series of B16 melanoma clones to form experimental lung metastases in syngeneic mice has been shown to correlate positively with adenylate cyclase activity. (Sheppard et al, Int. J. Cancer 37 (1986) 713-722). To begin to identify the components of the adenylate cyclase complex that account for enhanced enzyme activity in highly metastatic tumor populations, cholate extracts containing the GTP-binding protein GS from B16 melanoma clones of different metastatic capacities were reconstituted with membranes prepared from S49 cyc-, a variant lymphoma cell line that lacks GS function. The results revealed that extracts from a highly metastatic B16 clone (F10-C23) reconstituted significantly greater adenylate cyclase activities in S49 cyc- membranes than parallel preparations from a B16 clone (F1-C29) of low metastatic capacity. The data suggest that aberrations in GS function may contribute to the heightened responsiveness of adenylate cyclase observed in B16 melanoma clones of increased metastatic potential.

Adenylyl Cyclases↗
PubMed1987

Aminocaproic acid reduces the risk of secondary hemorrhage in patients with traumatic hyphema.

In a prospective, randomized, double-masked study, 34 patients (34 eyes) with nonperforating ocular injury and traumatic hyphema were treated with either aminocaproic acid (Amicar), 100 mg/kg every four hours, up to a maximum of 30 g/d, or placebo for five days. None of 21 patients who were treated with aminocaproic acid rebled, while three (23%) of 13 patients who were treated with placebo rebled. This difference was statistically significant. Of the three patients who rebled, two required surgical intervention, with one patient requiring four surgical procedures. Although complications following aminocaproic acid therapy included light-headedness, nausea and vomiting, and systemic hypotension, only one patient was withdrawn from the study because of drug-related adverse reactions. This study strongly confirms that aminocaproic acid therapy significantly reduces the incidence of secondary hemorrhage following traumatic hyphema.

Aminocaproates↗
PubMed1987

2'-nor-cGMP, a new cyclic derivative of 2'NDG, inhibits HSV-1 replication in vitro and in the mouse keratitis model.

The present study examined the antiherpetic effect of 2'-nor-cGMP, a new cyclic phosphate derivative of 2'NDG, in vitro and in the mouse keratitis model. The 50% inhibitory dose (ID50) was determined with HSV-1 RE strain in Vero cell monolayers for 2'-nor-cGMP (6.9 mcg./ml), 2'NDG (.06 mcg/ml), and trifluridine (F3T) (.72 mcg/ml). Balb C mice underwent bilateral ocular inoculation with HSV-1 RE strain, and then were treated with different therapeutic regimens. The antiviral efficacy of each drug was evaluated by ocular virus titers, clinical grading of epithelial keratitis, and histological evaluation of stromal keratitis. 2'-nor-cGMP was the most effective drug (P = .0001) in reducing ocular viral titers. Both 2'-nor-cGMP and 2'NDG were significantly more effective (P = .0001) than F3T in reducing epithelial keratitis, and as effective as F3T in reducing stromal keratitis.

Acyclovir↗