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Biomedical subjects

L Hubbard

Publications and source records attributed to L Hubbard.

18 recordsLinked to original sources
PubMed1998

Cytomegalovirus retinitis and viral resistance: 3. Culture results. CMV Retinitis and Viral Resistance Study Group.

PURPOSE: To evaluate the relationship between blood and urine cultures for cytomegalovirus and clinical outcomes in patients with cytomegalovirus retinitis. METHODS: Prospective epidemiologic study of 108 patients with newly diagnosed cytomegalovirus retinitis. Blood and urine were cultured for cytomegalovirus at diagnosis of retinitis, at 1 month and 3 months after diagnosis, and every 3 months thereafter. RESULTS: Of the patients, 80.6% were found to have either a positive blood culture or urine culture for cytomegalovirus at the time of diagnosis of retinitis, and a positive blood culture at diagnosis was associated with an increased mortality (odds ratio = 1.91, P = .012). Follow-up cultures were positive in approximately 20% of patients, and the rate was constant over time. The development of a positive blood or urine culture during follow-up correlated with the occurrence of cytomegalovirus retinitis in the contralateral eye in those patients with unilateral disease at diagnosis (odds ratio = 5.74, P = .001). CONCLUSIONS: Patients with cytomegalovirus retinitis and positive blood cultures for cytomegalovirus have a poorer prognosis.

AIDS-Related Opportunistic Infections↗
PubMed1997

The evolution of apical dominance in maize.

The domestication of crop plants has often involved an increase in apical dominance (the concentration of resources in the main stem of the plant and a corresponding suppression of axillary branches). A striking example of this phenomenon is seen in maize (Zea mays spp. mays), which exhibits a profound increase in apical dominance compared with its probable wild ancestor, teosinte (Zea mays ssp. parviglumis). Previous research has identified the teosinte branched1 (tb1) gene as a major contributor to this evolutionary change in maize. We have cloned tb1 by transposon tagging and show here that it encodes a protein with homology to the cycloidea gene of snapdragon. The pattern of tb1 expression and the morphology of tb1 mutant plants suggest that tb1 acts both to repress the growth of axillary organs and to enable the formation of female inflorescences. The maize allele of tb1 is expressed at twice the level of the teosinte allele, suggesting that gene regulatory changes underlie the evolutionary divergence of maize from teosinte.

Alleles↗
PubMed1995

Oral ganciclovir as maintenance treatment for cytomegalovirus retinitis in patients with AIDS. Syntex Cooperative Oral Ganciclovir Study Group.

BACKGROUND: Cytomegalovirus retinitis, a sight-threatening infection associated with the acquired immunodeficiency syndrome (AIDS), currently requires lifelong intravenous treatment. An effective oral treatment would be an important advance. METHODS: We compared oral with intravenous ganciclovir in an open-label, randomized study in patients with AIDS and newly diagnosed, stable cytomegalovirus retinitis (the disease was stabilized by three weeks of treatment with intravenous ganciclovir). Sixty subjects were randomly assigned to maintenance therapy with intravenous ganciclovir at a dose of 5 mg per kilogram of body weight daily, and 63 to maintenance therapy with oral ganciclovir at a dose of 3000 mg daily. The subjects were followed for up to 20 weeks, with photography of the fundi conducted every other week. The photographs were evaluated at the completion of the study by an experienced grader who was unaware of the subjects' treatment assignments. RESULTS: Efficacy could be evaluated in 117 subjects; photographs were ungradable for 2 of the 117. On the basis of the masked assessment of photographs from 115 subjects, the mean time to the progression of retinitis was 62 days in those given intravenous ganciclovir and 57 days in those given oral ganciclovir (P = 0.63; relative risk [oral vs. intravenous], 1.08; 95 percent confidence interval for the difference in means, -22 to +12 days). On the basis of funduscopy by ophthalmologists who were aware of the subjects' treatment assignments, the mean time to progression was 96 days in subjects given intravenous ganciclovir and 68 days in subjects given oral ganciclovir (P = 0.03; relative risk [oral vs. intravenous], 1.68; 95 percent confidence interval for the difference in means, -45 to -11 days). Survival, changes in visual acuity, the incidence of viral shedding, and the incidence of adverse gastrointestinal events were similar in the two groups. Neutropenia, anemia, intravenous-catheter-related adverse events, and sepsis were more common in the group given intravenous ganciclovir. CONCLUSIONS: Oral ganciclovir is safe and effective as maintenance therapy for cytomegalovirus retinitis and is more convenient for patients to take than intravenous ganciclovir.

AIDS-Related Opportunistic Infections↗
PubMed1995

The risk of infection associated with epidural analgesia.

Four infections were identified among 4,832 patients receiving epidural analgesia (an attack rate of 0.08%). The infections involved cesarean-section patients and occurred within a 9-month period. Findings suggest that the risk of infection is decreased by maintaining a closed system for the duration of the analgesia course.

Analgesia, Epidural↗
PubMed1991

Cloning, nucleotide sequence, and expression of the nitroreductase gene from Enterobacter cloacae.

The "classical" nitroreductases of enteric bacteria are flavoproteins which catalyze the reduction of a variety of nitroaromatic compounds to metabolites which are highly toxic, mutagenic, or carcinogenic. The gene for the nitroreductase Enterobacter cloacae has now been cloned using an antibody specific to this protein. The nucleotide sequence of the structural gene and flanking regions are reported. Sequence analysis indicates that this gene belongs to a gene family of flavoproteins which have not been previously described. Analysis of the 5'-untranslated region reveals the presence of putative regulatory elements which may be involved in the modulation of the expression of this enzyme. The cloned gene was placed under the control of a T7 promoter for overexpression of the protein in Escherichia coli. The expressed recombinant protein was purified to homogeneity and exhibited physical, spectral, and catalytic properties identical to the protein isolated from E. cloacae.

Amino Acid Sequence↗
PubMed1991

Development of an acute pain service monitoring and evaluation system.

In 1990, Schumpert Medical Center, Shreveport, Louisiana--a 625-bed acute care hospital--established an acute pain service (APS) department and implemented the ten-step monitoring and evaluation process as recommended by the Joint Commission to facilitate the quality assurance program for pain management therapy. The program, which entails the cooperative effort of anesthesiologists and registered nurses, is intended to provide individualized pain management therapy to qualified APS patients on a 24-hour, seven-day-a-week basis. Through continuous, systematic monitoring and evaluation of six aspects of care and their indicators and thresholds, the quality of APS patient care can be determined and improved.

Academic Medical Centers↗
PubMed1991

The Wisconsin age-related maculopathy grading system.

A new system for grading age-related maculopathy is described and measures of reliability are reported. A number of characteristics of age-related maculopathy are graded in a semiquantitative fashion from stereoscopic 30 degrees color fundus photographs, using a grid to define subfields, standard circles printed on plastic to assess size and area, and a specially designed lightbox to allow better discrimination of subtle drusen. The degree of exact agreement achieved between two trained graders across a variety of lesions ranged from 67.1% for drusen size to 99.6% for geographic atrophy. Kappa scores ranged from 0.55 (for drusen confluence) to 0.95 for geographic atrophy. This system will be useful in epidemiologic studies and clinical trials.

Aging↗
PubMed1989

Detection of diabetic macular edema. Ophthalmoscopy versus photography--Early Treatment Diabetic Retinopathy Study Report Number 5. The ETDRS Research Group.

Clinical and photographic methods were used to assess retinopathy during the examinations of diabetic patients enrolled in the Early Treatment Diabetic Retinopathy Study (ETDRS). In analyzing available data from eyes randomly selected for deferral of treatment, the authors compare the clinical detection (including contact lens biomicroscopy) with photographic detection (30 degrees stereoscopic color fundus photographs) of diabetic macular edema. Based on clinical detection, 53% (1778 patients) had hard exudates within 1 disc diameter (DD) of the center of macula, 56% (1868 patients) had retinal thickening within this region, and 31% (1027 patients) had thickening at the center of macula. These analyses show agreements of 83, 78, and 83% between retinal specialists and photographic graders when assessing these three characteristics, respectively. Agreement was 81% in the detection of macular edema for which treatment is indicated (clinically significant macular edema). Each method has its advantages but in general there was close agreement between these methods, particularly for clinically significant macular edema, which supports the reliability of each method.

Diabetic Retinopathy↗
PubMed1987

Urinary and hematologic indexes of hypohydration.

As part of a large-scale field feeding system test we were able to collect and study hundreds of aliquots of overnight urine samples obtained immediately prior to a fasting blood sample on days 1, 20, and 44 of the field test. The large number of experimental samples (greater than 650) and concomitant collection of blood and urine aliquots along with data on body weights gave us the opportunity to assess and quantitate the sensitivity of commonly used criteria of hypohydration. Urine aliquots for all test days were initially categorized by specific gravity (SG) greater than or equal to 1.03 (n = 124) or less than 1.03 (n = 540). Creatinine levels were elevated (P less than 0.001) in the concentrated urine samples, but a decreased trend in sodium-to-potassium ratios in these samples failed to achieve statistical significance (P greater than 0.05). However, when individuals with high SG urine were subclassified by a criterion of weight loss greater than 3% from original body weight, then creatinine concentrations were elevated (P = 0.05), whereas sodium-to-potassium ratios were decreased (P = 0.05) when subjects also with high SG but weight loss less than 3% were compared. Because of the moderate altitude (2,000 m) of the field site and the time of sojourn (44 days), there occurred a slight, but significant (P less than 0.001), erythropoietic response. Hematocrit and serum osmolality were not significantly different when examined by the criteria of high or low SG urine and weight loss greater than or less than 3% original body weight.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Urea Nitrogen↗
PubMed1971

Men at the top.

Explore the source record for details and available documents.

Nurses, Male↗
PubMedDate not supplied

Evaluation of the safety and efficacy of ketorolac versus morphine by patient-controlled analgesia for postoperative pain.

STUDY OBJECTIVE: To compare ketorolac tromethamine with morphine for pain management after major abdominal surgery. DESIGN: Double-blind, randomized study. SETTING: Hospital recovery room and postoperative surgical unit. PATIENTS: One hundred ninety-one patients with at least moderate pain after major abdominal surgery. INTERVENTIONS: Patients received ketorolac by patient-controlled analgesia (PCA) bolus alone (Ket B), ketorolac by bolus plus infusion (Ket I), or morphine by PCA bolus (morphine), with injectable morphine available for supplementation. MEASUREMENTS AND MAIN RESULTS: Levels of sedation, pain intensity, pain relief, and adverse events were recorded at baseline, at 2, 4, and 6 hours, and at termination. Supplemental morphine was required by 71% of Ket B patients, 67% of Ket I patients, and 38% of morphine patients (p < or = 0.001 for Ket B vs morphine). Although patients receiving ketorolac required more supplemental morphine than the morphine group (6.0 mg Ket I, 6.2 mg Ket B, 4.0 mg morphine), there was a large morphine-sparing effect in both ketorolac groups (total morphine 6.0 mg Ket I, 6.2 mg Ket B, 33.3 mg morphine). Overall pain relief scores were similar for morphine and Ket I groups, and were lower for Ket B than for morphine (p = 0.002). There were no differences among groups in numbers of patients with adverse events. CONCLUSION: Ketorolac may be effective when administered by PCA device, and has a clear morphine-sparing effect.

Abdomen↗