Search PubMed⌕ Search

Biomedical subjects

L Hall

Publications and source records attributed to L Hall.

230 records · Page 13Linked to original sources
PubMedDate not supplied

False-positive HIV-1 test results in a low-risk screening setting of voluntary blood donation. Retrovirus Epidemiology Donor Study.

CONTEXT: Persons at risk of human immunodeficiency virus 1 (HIV-1) infection, have been classified incorrectly as HIV infected because of Western blot results, but the frequency of false-positive Western blot results is unknown. OBJECTIVES: To determine the frequency of false-positive HIV-1 Western blot results in US blood donors and to make projections to other screened populations. Secondarily, to validate an algorithm for evaluating possible false-positive cases. DESIGN: A retrospective cohort study of HIV-1 enzyme immunoassay (EIA) and Western blot results from large blood donor screening programs in which donors with suspected false-positive Western blot results underwent HIV-1 RNA polymerase chain reaction (PCR) testing and follow-up HIV-1 serology. SETTING: Five US blood centers participating in the Retrovirus Epidemiology Donor Study. PARTICIPANTS: More than 5 million allogeneic and autologous blood donors who successfully donated blood at 1 of the 5 participating centers from 1991 through 1995. MAIN OUTCOME MEASURES: Rate of false positivity by Western blot and true HIV-1 infection status as determined by HIV-1 RNA PCR and by serologic follow-up of blood donors more than 5 weeks after donation. RESULTS: Of 421 donors who were positive for HIV-1 by Western blot, 39 (9.3%) met the criteria of possible false positivity because they lacked reactivity to p31. Of these, 20 (51.3%) were proven by PCR not to be infected with HIV-1. The false-positive prevalence was 4.8% of Western blot-positive donors and 0.0004% (1 in 251000) of all donors (95% confidence interval, 1 in 173000 to 1 in 379000 donors). CONCLUSIONS: A false diagnosis of HIV-1 infection can result from the combination of EIA and Western blot testing in blood donor and other HIV-1 screening programs. Individuals with a positive Western blot result lacking the p31 band should be counseled that, although they may be HIV infected, there is uncertainty about this conclusion. These individuals should be further evaluated by RNA PCR testing (if feasible) and HIV serologic analysis on a follow-up sample.

AIDS Serodiagnosis↗
PubMedDate not supplied

Percutaneous hepaticoneojejunostomy and choledochocholedochal reanastomosis using metallic stents: technical note.

A new, nonsurgical approach to biliary duct reconstruction in two high-operative risk patients is presented. The first patient with an obstructed hepaticojejunostomy underwent such reconstruction by placement of Wallstent, which remained patent 9 months until death from recurrent tumor. The second patient with an inadvertently ligated common bile duct underwent a combined percutaneous transhepatic-retrograde endoscopic reconstruction with placement of a Gianturco-Rösch (GR) stent. Because of occlusion by granulation tissue 5 months later, a new GR stent covered with a silicone membrane was placed within the initial stent. Nine months after the second GR stent placement there is no evidence of obstruction.

Adult↗
PubMedDate not supplied

Comprehensive health promotion for the pregnant woman who is disabled. The role of the midwife.

Increasing numbers of women with physical or sensory disabilities are choosing to bear children. Research and experience seem to indicate serious shortcomings in assisting disabled primiparas toward confident, healthy, and safe childbearing and childcaring. Guidelines are suggested for appropriate referral or direct provision of education and counselling services for such clients during prepregnancy, pregnancy, labor and delivery, and the postpartum period. Useful resources are identified to assist the nurse-midwife in her role.

Activities of Daily Living↗
PubMedDate not supplied

Studies on 1,2,3,6-tetrahydropyridine derivatives as potential monoamine oxidase inactivators.

The Parkinsonian-inducing neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and close structural analogs are the only known cyclic tertiary amines with good monoamine oxidase substrate properties. In addition to its excellent substrate properties, MPTP is a mechanism-based inactivator of monoamine oxidase B (MAO-B). In an attempt to exploit the special interactions between this cyclic tertiary allylamine and MAO-B, we have initiated studies to evaluate the enzymatic and biological properties of MPTP analogs bearing functional groups which are known to mediate the metabolism-dependent inactivation of this enzyme. This paper describes the synthesis, enzyme substrate/inhibitor properties, and neurotoxic/neuroprotective properties of 1-cyclopropyl-4-phenyl-1,2,3,6-tetrahydropyridine, the corresponding acyclic secondary amine (E)-4-cyclopropyl-2-phenyl-2-butene, and 4-cyclopropyl-1-methyl-1,2,3,6-tetrahydropyridine.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗
PubMedDate not supplied

Use of exposure databases for status and trends analysis.

Exposure databases are useful for monitoring status and trends in environmental health. However, other supporting data are usually needed to infer human exposure or internal dose. Program planning and evaluation, environmental health surveillance, epidemiologic research, and contributions to international efforts are four major purposes for monitoring environmental exposure status and trends. Although databases play an important role in monitoring human exposure, certain methodological problems need to be overcome. The work group developed six criteria for meeting information needs for human exposure assessment. Areas that need attention are (1) specification of location, (2) specification of facility and chemical identifiers, (3) documentation of special populations at risk, (4) provision of early warning of new problems, (5) monitoring changes over time, and (6) enhancement of documentation. We tested these criteria by examining six available databases that might be used for monitoring exposure to contaminants in drinking water. Available data fell short of information needs. We drew four conclusions and offered several recommendations for each. First, available data systems lack adequate measures of human exposure. Second, data for monitoring exposures for many important population subgroups and environmental settings are inadequate. Third, an "early warning" system that monitors human exposures is needed. Fourth, designers of data-collection systems should consider the needs of users who monitor status and trends of human exposure.

Data Collection↗
PubMedDate not supplied

Examining management of pain for infants following cardiothoracic surgery.

Pain management for infants continues to be inadequate despite evidence that infants do experience pain. Some health professionals fear that the risks of administering medication for pain outweigh the benefits. In caring for infants thought to be in pain, nurses often choose to administer a minimal dosage of analgesia; administer a sedative for its calming effects; or try to maximize relief by combining the analgesics and sedatives prescribed. Findings from this study indicate that the administration of analgesics and sedatives to relieve pain or calm an infant may be too conservative.

Humans↗
PubMedDate not supplied

'Learning Diabetes'--a multi-media learning package for patients, carers and professionals to improve chronic disease management.

A multi-media program for those with insulin and non-insulin dependent diabetes, and for their carers, has been produced. It is delivered on CDROM and contains an extensive amount of very high quality generated video of patients using short clips (maximum 2 min) totalling 2.5 h in 240 files using MPEG compression. The video is combined with a wide range of graphic based activities engaging the user in fully interactive processes and allowing them to obtain extensive understanding of the disease and to relate to attitudes and perceptions about it from those with the same condition. The program is robust and appears to meet the educational needs for its extent of interactivity, degree of choice for the user and provision of information based on real patient experience. It is easily used and modified to meet users of different socio-cultural needs and can be translated into different languages. It offers the opportunity not only for increased learning and improved self-management of those with diabetes, but also greater understanding by those who care for them, both professional and non-professional. Using the same framework, programs are being developed for other chronic diseases including asthma and hypertension.

CD-ROM↗
PubMedDate not supplied

Malaria on the move: human population movement and malaria transmission.

Reports of malaria are increasing in many countries and in areas thought free of the disease. One of the factors contributing to the reemergence of malaria is human migration. People move for a number of reasons, including environmental deterioration, economic necessity, conflicts, and natural disasters. These factors are most likely to affect the poor, many of whom live in or near malarious areas. Identifying and understanding the influence of these population movements can improve prevention measures and malaria control programs.

Agriculture↗
PubMedDate not supplied

Gynecomastia as the initial manifestation of hyperthyroidism.

OBJECTIVE: To present two new cases of gynecomastia as the initial manifestation of hyperthyroidism. METHODS: We describe detailed case reports of two men with breast enlargement who were found to have hyperthyroidism, and we review the related literature. RESULTS: Two men sought medical assistance because of unilateral tender gynecomastia. In one of these patients, thyroid, gonadal, and prostate examinations showed normal findings at the time of initial assessment, and symptoms of hyperthyroidism developed later. In our other patient with gynecomastia, other symptoms of hyperthyroidism--for example, nervousness, irritability, palpitations, and fatigue--had been present for a prolonged period but had been considered "normal" by the patient. In both patients, the hyperthyroidism was treated with radioiodine. Breast pain disappeared in both patients, and breast enlargement disappeared in one patient and was decreased in the other patient after euthyroidism was achieved. Review of the literature disclosed only two similar cases. CONCLUSION: Because of the rarity of gynecomastia as the initial symptom of hyperthyroidism, we believe that thyroid function tests are not indicated in the workup of patients whose major complaint is gynecomastia.

Journal Article↗