The antimalarial activity of a series of synthetic 1,2,4-trioxanes is correlated with molecular structure by using a pharmacophore search method (CATALYST). The technique is shown to have predictive accuracy and confirms that docking between an active trioxane and the receptor, heme, is the crucial step for drug action.

Animals↗

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Correlating the molecular electrostatic potentials of some organic peroxides with their antimalarial activities.

The molecular electrostatic potentials (MEPs) of artemisinin (also known as qinghaosu), yingzhaosu A, and some synthetic analogues have been calculated and studied as a means of distinguishing between high and low antimalarial activity. To facilitate comparison, the dimensionality of the MEP was reduced by Kohonen Neural Network transforms. The reduction revealed that peroxides exhibiting high antimalarial activity are characterized by a continuous strip of negative electric potential surrounding the molecule, whereas peroxides of lesser activity show a broken strip.

Animals↗

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A "normal" individual with a positive direct antiglobulin test: case complicated by pregnancy and unusual autoantibody specificity.

A "normal" individual with a positive, direct antiglobulin test is described. In common with many other "normal" persons in whom a similar finding has been made, there was no evidence of an increased rate of in vivo red blood cell destruction in this patient. The patient successfully completed a pregnancy during the time that detailed serologic studies on her autoantibodies were being performed. Although the maternal autoantibodies were demonstrable in both an eluate made from the red blood cells of her newborn infant, and in the cord serum, there was no reason to believe that the antibodies caused red blood cell destruction in the infant. The case was of further interest because of the specificities of some of the autoantibodies. Although the mother and child were both C-negative, eluates from their red blood cells contained what ostensibly appeared to be anti-C. Studies that showed that the antibody could be totally adsorbed with C-negative, as well as C-positive red blood cells, proved that this was another example of an autoantibody mimicking an alloantibody. Although this autoantibody appeared initially to have anti-C specificity it was eventually shown to be more closely related to anti-Hr or anti-Rh34, than to anti-C.

Adult↗

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Allo-anti-C in a patient who had previously made an autoantibody mimicking anti-C.

A patient, previously studied by us, who had produced a benign autoantibody with a specificity that mimicked anti-C, has now produced allo-anti-C that is not of the mimicking type. She is no longer producing any serologically demonstrable autoantibody. It is highly probable that conversion from auto to alloantibody production in this patient was prompted by the introduction of additional foreign immunogen on fetal red blood cells during her third pregnancy.

Autoantibodies↗

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[Paleopathology of the lumbar spine in the early medieval period].

AIM: The lumbar spine of people from ancient civilizations can provide a large amount of information about these individuals and their physical condition through paleopathological investigation. METHOD: This study was conducted on a sample of 185 lumbar spines from southwestern Germany dating back in the early medieval period. The skeletons came from the row graves from Nusplingen, Schretzheim, Neresheim, and Pleidelsheim. RESULTS: Examples of congenital malformations, degenerative processes, infections and traumatic diseases were discovered. The most common pathological findings were degenerative changes of the lumbar spine in 24 %. Congenital anomalies and spondylolysis were relatively common in this population. Examples of traumatic injuries and infections of the spine were rare. Metastatic lesions on the vertebral bodies were identified in no case. CONCLUSION: Most diseases of the lumbar column in the ancient inhabitants of southwestern Germany were similar to those that affect the present-day population of that area.

Adult↗

PubMedDate not supplied

[Degenerative changes of the cervical facet joints in the medial and lateral atlantoaxial joint - a paleopathological study].

AIM: This article describes the prevalence of degenerative changes of the upper cervical spine (C1-C2) and cervical facet joints found during investigations of spinal column remains. MATERIALS AND METHODS: This study was conducted on a sample of 196 cervical spines from southwestern Germany which derive from the 6th to 8th centuries AD. The degenerative lesions were classified into grades 1 (marginal osteophytes), 2 (uneven joint surfaces), or 3 (osseous ankylosis). RESULTS: Of the skeletons examined, 19.4 % (n = 38) showed degenerative changes of the cervical facet joints and/or upper cervical spine (mean age at death was 44 years). The medial (6.1 %) and lateral (0.6 %) atlanto-axial joints were rarely involved in degenerative changes. The facet joints from C3-C4 to C6-C7 showed degenerative changes in 8.0-11.7 % of cases (usually grade 1 and 2). The C2-C3 facet joints were significantly involved in degenerative changes in 19.7 % of cases, one fourth of which were osseous ankylosis (grade 3). CONCLUSION: The C2-C3 facet joints showed a high rate of degenerative changes.

Adult↗

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[Anterior lumbar interbody fusion (ALIF) using a cage with stabilization].

AIM: The authors have conducted a prospective observational study to evaluate the clinical and radiological outcome and complications associated with anterior lumbar interbody fusion (ALIF) using a cage with stabilization. MATERIALS AND METHODS: Eighteen patients ranged in age from 36 to 77 years (mean 53 years) who had undergone ALIF were prospectively evaluated. Clinical outcome was graded using a modified Prolo scale (economic, pain, medication) and radiological outcome was recorded (X-rays). RESULTS: Based on Prolo scale scores, excellent or good outcomes were achieved in 61 % of these patients (75 % mono-segmental degenerative disc disease: n = 8; and 50 % after failed-back surgery syndrome: n = 10). The mean follow-up was 14 months (from 12 to 18 months) after surgery. Postoperative X-rays demonstrated solid arthrodesis for 12 (66 %) of the 18 patients. Complications requiring repeated surgery included one case of postoperative peritonitis without infection of the cage. We found one deep-vein thrombosis. There were four cases with postoperative meralgia paresthetica. On routine follow-up radiography one cage was found to be dislocated (2 mm) and in one case we found two broken screws. CONCLUSION: The ALIF cage with stabilization is one possible therapy option for treatment of mono-segmental degenerative disc disease and failed-back surgery after unsuccessful conservative therapy. However, the clinical results should be interpreted with caution.

Adult↗

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Pulmonary disease due to Mycobacterium xenopi in a renal allograft recipient: report of a case and review.

A 39-year-old man with pulmonary disease due to Mycobacterium xenopi is described. He had received prednisone and azathioprine for 5 years and prednisone in combination with cyclosporin A for 1 year in an effort to prevent rejection of his renal transplant. Shortly after the renal allograft was removed because of chronic rejection, the patient developed dyspnea and a decrease in vitality. He had no history of preexisting lung disease. A chest roentgenogram showed multiple nodular infiltrates in both lungs. M. xenopi was cultured from three sputum samples. The organism was susceptible to isoniazid, streptomycin, ethambutol, rifampin, pyrazinamide, and ethionamide. The patient was treated successfully with isoniazid, ethambutol, and rifampin for 3 months and with isoniazid in combination with rifampin for an additional 9 months, while he was maintained on continuous ambulatory peritoneal dialysis (CAPD). The literature on mycobacterial disease, especially in renal transplant recipients and patients on CAPD, is reviewed.

Adult↗

PubMedDate not supplied

Phase I trial of intravenous peptide-pulsed dendritic cells in patients with metastatic melanoma.

Sixteen patients with metastatic stage IV melanoma were treated with use of intravenous infusions of dendritic cells (DC) derived by incubation of plastic-adherent peripheral blood mononuclear cells (PBMC) with IL-4 and GM-CSF for 8 days in serumless AIM-V medium, followed by overnight pulsing with peptides. The tyrosinase368-376 (370D) and gp100(209-217 (210M)) peptides restricted to HLA class I A*0201 each differed from wild type by one amino acid modified to increase HLA binding. Median age was 49, with nine men and seven women. All patients, except one, had visceral disease. Patients received escalating doses of peptide-pulsed DCs at 10e7, 3 x 10e7, and 10e8 cells/dose twice at 2 weeks apart, with toxicity and clinical and immune responses as the principal endpoints. The first infusion of DCs was fresh, and frozen DCs were given for the second infusion of each cycle. Mean DC purity by flow cytometry was 49%, with a mean HLA-DR level of 57%, CD86 of 41%, CD58 of 46%, and mean CD14 cells of 0.9%. Toxicity was minimal, with two patients having transient grade III DC-related toxicity. Ten patients received one cycle of treatment and six patients received two cycles of treatment. One patient had a complete remission (CR) of lung and pleural disease after two cycles of DC therapy. Two additional patients had stable disease and two patients had mixed responses. Overall immunity was assessed by recall skin testing with peptides, gamma interferon ELISA assays of peptide specific cytolytic T cell (CTL) stimulated twice with peptide, IL-2, and IL-7 over 24 days, and peptide-specific tetramer assays performed before and after vaccination. Five of 16 patients had an immune response to gp100 or tyrosinase by gamma interferon ELISA assay; four of five were clinically stable or had tumor regression. These data suggest that melanoma antigen peptide-pulsed DC given intravenously are not toxic, and regression or stability of tumor appeared to correlate with the detection of a peptide-specific immune response in the peripheral blood.

Adult↗

PubMedDate not supplied

Surveillance of burn wound infections: a proposal for definitions.

The diagnosis of burn wound infections is a subjective art, with no recent attempts to standardize or validate the definitions of terms used to discuss such infections. The Centers for Disease Control included definitions of types of burn wound infections in its definitions for nosocomial infections in 1988. Although the other Centers for Disease Control criteria for nosocomial infections have epidemiological applications, its criteria for burn wound infections have neither clinical nor epidemiological value to burn centers and their health care providers. With the approval of the Board of Trustees of the American Burn Association, the authors of this article formed a working subcommittee of the Committee on the Organization and Delivery of Burn Care. Definitions of burn wound infections are presented for consideration for application in either of 2 areas: (1) surveillance of burn wound infections in burn centers and (2) standardized criteria for multicenter clinical trials or national registries.

Burn Units↗

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Early burn center transfer shortens the length of hospitalization and reduces complications in children with serious burn injuries.

Prompt transfer of the child with acute burns can be difficult from distant or inaccessible locations, and it is believed that the outcomes of children with serious burns whose transfer to a specialized burn care facility is delayed may be compromised. A 4-year experience with 16 consecutive children with serious burns (> or =20% of the body surface area) whose transfer to a burn care facility was delayed for 5 or more days was reviewed to document the difficulties that can follow such delays. These 16 children had an average age of 8.6+/-1.6 years and an average wound size of 57.6%+/-5.8% of the body surface area, and they arrived a mean of 16.3+/-3.4 days after the injury (range, 5 to 44 days). These children had undergone an average of 1 operation, excluding escharotomies, at referring facilities. Only 4 (25%) of the children had no infectious focus at transfer, and at admission resistant bacteria were recovered from 9 (56%) of the children and fungal organisms were found in 10 (63%). Compared with a concurrently managed matched control group of patients admitted to the burn center within 24 hours of injury, the delayed-transfer group had statistically significantly more bacteremia, renal dysfunction, wound sepsis, and central venous catheter days. It was also more expensive to manage these children; the delayed-transfer group required statistically significantly longer to achieve 95% wound closure, and they had greater total lengths of hospital stay and more rehabilitation days. The early transfer of children with serious burns to a specialized burn center may truncate hospitalization and thereby reduce costs.

Body Surface Area↗

PubMedDate not supplied

Regional relative blood volume MR maps of meningiomas before and after partial embolization.

PURPOSE: Our goal was to evaluate the role of relative blood volume (rBV) measurements in monitoring the embolization effect in meningiomas by using maps of susceptibility-weighted first pass MR data. METHOD: Eighteen examinations of nine patients before and following partial embolization were performed on a 1.5 T scanner. Embolization was achieved by injection of particles (45-150 microns). During dynamic imaging a bolus (0.2 mmol/kg) of gadopentetate dimeglumine was injected. RESULTS: The tumor rBV/gray matter rBV ratio was 3.11 +/- 1.40 for untreated tumors and 0.12 +/- 0.09 for successfully embolized tumors. The regional rBV in embolized meningiomas was significantly lower than that in untreated meningiomas (t test, p < 0.001). Vital tumor tissue showed positive enhancement in T1 and high rBV; nonvital tissue lacked T1 enhancement and bolus effect in the first pass, thus leading to low or missing rBV values. However, we also observed lack of bolus formation despite T1 enhancement (6/9 postembolization regions), possibly due to slow collateral flow. One of the patients treated with embolization bled during surgery. CONCLUSION: Maps of relative regional cerebral BV provide hemodynamic information in meningiomas and monitor the treatment effect of embolization in meningiomas more precisely than T1-weighted contrast-enhanced imaging.

Blood Loss, Surgical↗

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Nursing diagnosis: a curricular model based on the NANDA list.

Explore the source record for details and available documents.

Curriculum↗

PubMedDate not supplied

Prevalence of genital pathogens among female prostitutes in New York City and in Rotterdam.

The authors studied the prevalence of genital microorganisms among 300 female prostitutes in brothels in New York City and 60 female prostitutes attending a sexually transmitted diseases clinic in Rotterdam, The Netherlands. Rates of isolation of Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum in the two cities were 9.3% and 8.3%, 25.3% and 16.6%, 57.3% and 74.9%, and 73% and 79%, respectively. Trichomonas vaginalis was detected in 3.6% of New York prostitutes and in 16.6% of those in Rotterdam. Nonspecific vaginitis was found in 33% of prostitutes examined in New York. In New York, Asian prostitutes were more likely to be infected with C. trachomatis (33 of 102; 32.3%) than were prostitutes of other ethnic backgrounds (44 of 194; 21.5%; P less than .05.

Adult↗