Biomedical subjects

K A Easley

Publications and source records attributed to K A Easley.

58 records · Page 4Linked to original sources

PubMedDate not supplied

Electrocardiography and 24-hour electrocardiographic ambulatory recording (Holter monitor) studies in children infected with human immunodeficiency virus type 1. The Pediatric Pulmonary and Cardiac Complications of Vertically Transmitted HIV-1 Infection Study Group.

Limited data are available on the electrocardiogram and ambulatory electrocardiogram recording (Holter) in children infected with the human immunodeficiency virus type 1 (HIV-1). The purpose of this study was to estimate the prevalence and cumulative incidence of rhythm and conduction abnormalities in HIV-1-infected children. Electrocardiograms and Holter monitoring studies were performed annually on 205 HIV-1-infected children enrolled after 28 days of life (group I), 93 HIV-1-infected infants enrolled during pregnancy or during the first 28 days of life (group IIa), and 463 HIV-1-uninfected infants enrolled during pregnancy or during the first 28 days of life (group IIb). The 5-year cumulative incidence in the group I children of second-degree atrioventricular block or supraventricular or ventricular tachycardia was 13.4%, and the 5-year incidence was higher for the older infected group I children (16.8% for children > or =4 years old at first study and 11.4% for children <4 years, p = 0.04). The mean corrected QT interval was also longer for the older infected group I children (p = 0.002) and prolonged in the HIV-1-infected compared to the HIV-1-uninfected group II children (p = 0.02). None of the children had atrial fibrillation or flutter. Arrhythmias are uncommon in children infected with HIV-1 and in children of HIV-1-infected mothers and the arrhythmias identified tend to be benign. Therefore, routine Holter monitoring does not appear to be indicated in asymptomatic children.

Arrhythmias, Cardiac↗

PubMedDate not supplied

Cardiac, aortic, and pulmonary arteriopathy in HIV-infected children: the Prospective P2C2 HIV Multicenter Study.

Arteriopathy in human immunodeficiency virus (HIV)-infected patients is being increasingly recognized, especially in children. However, few studies have histologically evaluated the coronary arteries in HIV-infected children, and none have systematically assessed the aorta and pulmonary arteries. The coronary arteries, thoracic aorta, and the main and branch pulmonary arteries from the postmortem hearts of 14 HIV-infected children were systematically reviewed for vasculopathic lesions and compared with 14 age-matched controls. Findings from the HIV-infected children were compared with clinical, laboratory, and other postmortem findings. Coronary arteriopathy, seen in seven (50%) of the HIV-infected children, was primarily calcific, and it was associated with decreased CD3 and CD4 peripheral blood counts. Large vessel arteriopathy, seen in 9 (64%) of the 14 HIV-infected children, was primarily centered on the vasa vasorum and consisted mainly of medial hypertrophy and chronic inflammation. Large vessel lesions were associated with increased left ventricular mass z-scores (P = 0.02), and 78% of patients with large vessel arteriopathy had postmortem cardiomegaly. Coronary and large vessel arteriopathies are common in pediatric HIV-infection and have different clinicopathologic features suggesting different pathogenesis.

Aorta↗

PubMedDate not supplied

Serum beta 2-microglobulin and interferon in homosexual males: relationship to clinical findings and serologic status to the human T lymphotropic virus (HTLV-III).

The identification of the human T cell lymphotropic virus (HTLV-III) as the presumed etiologic agent for AIDS has stimulated a re-examination and allowed better understanding of many of the immunologic abnormalities described in high risk individuals with and without clinical disease. Currently needed are useful predictors of clinical progression which will allow better counselling, earlier diagnosis and effective treatment of high risk individuals. We have examined the principles of test selection including sensitivity, specificity, predictive value and overall test efficiency for serum beta 2 microglobulin (beta 2M), serum interferon (IFN) and antibody to HTLV-III (HTLV-III Ab) in a group of 113 homosexual men and 62 controls. The presence of HTLV-III Ab and elevated serum beta 2M appear to be the most sensitive markers of immune dysregulation in the study group but also proved to be the least specific. Rising levels of serum beta 2M correlated with clinical severity where HTLV-III Ab positivity did not. The detection of elevated levels of acid labile serum IFN alpha was most specific for full-blown AIDS and was overall the most efficient test when compared with HTLV-III Ab, serum beta 2M and lymphocyte subpopulations. We believe that further examinations of the principles of test selection for immunologic abnormalities in AIDS may lead to potential applications for these tests in patient management.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Quality of life assessment by patients with inflammatory bowel disease.

Using a direct-interview technique, 164 ambulatory patients with inflammatory bowel disease were evaluated for quality of life. The sample comprised 94 patients with ulcerative colitis and 70 with Crohn's disease, and included both surgical and nonsurgical patients. The interview questionnaire consisted of 47 items in four categories: functional/economic, social/recreational, affect/life in general, and medical/symptoms. Patients with ulcerative colitis had better quality of life than those with Crohn's disease, and patients without surgery had better quality of life than those with surgery. These results are of value in assessing the results of medical and surgical therapy. Quality of life assessment by patients with inflammatory bowel disease gives information not usually obtained by physicians and has implications for quality assurance and outcome measurement.

Adult↗