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Biomedical subjects

L Sharma

Publications and source records attributed to L Sharma.

At least 37 records · Page 2Linked to original sources
PubMed1996

Human T-cell lymphotropic virus type 1-associated myelopathy, Sjögren syndrome, and lymphocytic pneumonitis.

OBJECTIVE: To describe the first case of human T-cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy, Sjögren syndrome, and lymphocytic pneumonitis in a nonendemic area. BACKGROUND: Retroviruses are implicated in the pathogenesis of autoimmune diseases, including Sjögren syndrome. Asymptomatic lymphocytic pneumonitis is prevalent in HTLV-1-associated myelopathy. There are 7 case reports with the combination of HTLV-1-associated myelopathy, Sjögren syndrome, and lymphocytic pneumonitis, all of them in endemic areas for HTLV-1. DESIGN: Case report and literature review. RESULTS: A 40-year-old Creole woman from New Orleans, La, presented with progressive spastic paraparesis and exertional dyspnea. Review of systems revealed chronic complaints consistent with sicca syndrome. She was found to have HTLV-1-associated myelopathy by polymerase chain reaction in the cerebrospinal fluid. Increased levels of SSA, positive results on a Schirmer test, and the findings of biopsy of the minor salivary gland were consistent with Sjögren syndrome. A lung biopsy specimen showed marked lymphocytic infiltration. CONCLUSIONS: The present case raises questions about the role of HTLV-1 in the development of autoimmunity. It also happens to be a unique occurrence in a nonendemic area.

Adult↗
PubMed1996

The effects of cortical lesions on recognition of object context in a visuomotor task in the Mongolian gerbil.

Two experiments were carried out in order to determine the effects of either parietal or temporal lesions on performance in a depth vision task in which gerbils normally use retinal image size (RIS) as a cue to distance. In the first experiment, gerbils were trained to jump to two training targets that differed in size and which were always presented with distinctive local features and in a particular spatial location. After lesions, gerbils were presented with further training trials and sets of probe trials in which they were presented with targets that differed in width from the training targets, and sets of local features and distal cues that either matched or mismatched those presented during training. Shams and temporal animals made predictable over- or underjumps when local feature and distal information matched, and stopped using retinal image size when they did not match. Parietal animals did not use retinal image size either during the match or the mismatch conditions. In a second experiment, gerbils with parietal lesions were shown capable of using retinal image size in a simpler task that did not contain distinguishing local features or distal cues. Taken together, these results suggest that parietal lesions in gerbils disrupt object recognition, when the purpose of the recognition process is to complete a distance estimate for a visuomotor act.

Animals↗
PubMed1996

Prognostic factors for functional outcome of total knee replacement: a prospective study.

BACKGROUND: The objective was to investigate whether baseline physical functioning, medical, psychosocial, or demographic variables predict functional outcome in patients undergoing total knee replacement. METHODS: A prospective cohort study was performed between December 1991 and August 1993. Consecutive, unilateral tricompartmental total knee replacement patients aged > or = 55 yr with osteoarthritis, who met criteria, were enrolled and evaluated one month before and 3 months after total knee replacement. The primary outcome measure was the Medical Outcome Study 36 Item Short Form Health Survey (known as the SF36) Physical Functioning Scale score. The outcome evaluator was not involved in patient care. RESULTS: A hierarchical multiple regression analysis was performed to calculate the contribution of baseline variables to TKR outcome. Of the 27% of outcome variance explained by the model, demographic variables accounted for 4%, psychosocial variables (motivation, role functioning-emotional, and social functioning) for 19% (p = .013), medical variables (previous reconstruction, comorbidity, body mass index, bodily pain) for 2%, and baseline physical function for 2%. CONCLUSIONS: Psychosocial variables are significantly related to total knee replacement functional outcome. Assessment of baseline psychological and social functioning may identify a subset of patients at risk for worse outcome. Specific interventions for these patients should be developed and evaluated as components of patient management prior to and after the procedure.

Activities of Daily Living↗
PubMed1996

Decline of plasma growth hormone binding protein in old age.

Aging is associated with a progressive decline in GH secretion and serum insulin-like growth factor (IGF)-I levels. This change in the GH-IGF axis is thought to contribute to the changes in body composition associated with aging, such as a loss in lean body mass and an increase in adipose tissue mass. Although the decrease in GH secretion starts in the third decade of life, marked changes in muscle mass and strength become apparent only much later. To assess whether a component of GH resistance supervenes in senescence, we studied plasma GH binding protein (GHBP) levels in 50 normal subjects between the ages of 61 and 98 yr. The GHBP is a soluble, circulating ectodomain of the GH receptor (GHR); its plasma level is thought to reflect GHR levels in tissues and, hence, GH responsivity. GHBP activity in plasma declined progressively between age 60 and 98 yr. The GHBP levels in nonagenarians was about half that of persons aged 60-65. This contrasts with younger adults, where GHBP levels remain relatively stable between the ages of 20 and 60. We conclude that in advanced age. GHBP and, by inference, GHR levels, decrease, which may add an element of GH resistance to the already compromised GH secretion status, thereby further contributing to the changes in body composition and frailty in the elderly.

Aged↗
PubMed1995

Clinical significance of anti-At(a).

Ata is a high-frequency red blood cell (RBC) antigen. Anti-At(a) has been reported in rare At(a-) black subjects. We report two cases of anti-At(a). A clinically significant anti-At(a) was found in a 26-year-old black woman with systemic lupus erythematosus. The patient had a transfusion reaction with chills and nausea during a RBC survival study, and 95% of the radiolabeled At(a+) RBCs were destroyed within 3 h. A concurrently performed monocyte monolayer assay was strongly reactive. Anti-At(a) thus can cause rapid hemolysis of transfused RBCs, but At(a-) donor units are extremely scarce in rare donor registries. A second patient at our hospital had anti-At(a) which did not affect her newborn. She also had autoimmune disease, insulin-dependent diabetes mellitus.

Adult↗
PubMed1992

Antiphospholipid antibodies and arterial thrombosis. Case reports and a review of the literature.

Antiphospholipid antibodies are a relatively heterogeneous mix of immunoglobulins with binding specificities for negatively charged or neutral phospholipids. Currently, the most commonly detected antiphospholipid antibodies include the anticardiolipin antibody, the lupus anticoagulant, and an antibody implicated in false-positive VDRL testing. Recently, a clinical syndrome of vaso-occlusive disorders associated with antiphospholipid antibodies has been identified and may result from immune-mediated disruption of endothelial function. This clinical syndrome encompasses arterial and venous thrombosis, recurrent fetal loss, neurologic dysfunction (eg, migraine, chorea, and encephalopathy), systemic and pulmonary arterial hypertension, and endocardial disease. Although most commonly associated with systemic lupus erythematosus, the antiphospholipid antibody syndrome also has been identified in patients with vaso-occlusive disease without systemic lupus erythematosus. Recently, identification of antiphospholipid antibodies has been facilitated by the development of a more sensitive assay for anticardiolipin antibody. In this article, case histories of three patients with arterial thrombosis and associated anticardiolipin antibodies, including the first associated case of terminal aortic thrombosis, are reviewed and the subject of the antiphospholipid antibody syndrome is discussed.

Adult↗
PubMed1992

Macronodular adrenal hyperplasia causing Cushing's syndrome: report of two cases and an overview.

Of the various entities producing adrenal hyperfunction, nodular adrenal hyperplasia is rarely described, however, recent reports have established it as a distinct cause of Cushing's syndrome. Although the etiology of this disease remains uncertain, two distinct forms are recognised, namely: macronodular hyperplasia and micronodular dysplasia. Establishing the diagnosis preoperatively is difficult but essential to ensure the correct treatment is performed. Two cases of macronodular hyperplasia are reported herein followed by a review of the available literature on this subject.

Adrenal Glands↗
PubMed1991

Generalized peritonitis in India--the tropical spectrum.

Generalized peritonitis is a common surgical emergency in India, the 'Tropical Spectrum' of generalized peritonitis being different from the western spectrum. A total 155 cases of generalized peritonitis were surgically treated at the All India Institute of Medical Sciences between 1981 and 1987, all patients undergoing peritoneal toilet with drainage after the cause of their peritonitis had been treated. The most common cause of peritonitis was peptic ulcer perforation, with simple closure being associated with a 2 per cent mortality, while typhoid perforation was the second most common cause. The diagnosis was clinical, supported by the operative findings of a terminal ileal perforation while bacteriological, serological and histopathological confirmation was retrospective. Appendicular perforations were less common than in the west but the clinical picture was the same. Tubercular perforations were not uncommon with a previous history of subacute intestinal obstruction and evidence of tuberculosis on chest X-ray suggesting the diagnosis. Ruptured amebic liver abscess was the most common hepatobiliary cause of generalized peritonitis with drainage of the abscess producing good results. The average hospital stay was 15 days with an overall mortality of 8 per cent.

Adult↗
PubMed1990

Pilonidal disease of the umbilicus--a report of two cases.

Two cases of umbilical pilonidal sinus are reported herein. Both patients were young adult males aged 21 and 27 years, respectively. The predisposing factors are briefly discussed, however, the exact etiology of this disease remains unknown. Umbilectomy is the most commonly offered treatment and although it is rare, this entity probably goes undiagnosed in the majority of cases.

Adult↗
PubMed1987

Glucose tolerance studies in lichen planus.

A study of glucose tolerance and insulin response to oral glucose was carried out in 56 consecutive histologically confirmed cases of lichen planus. 30.3% patients showed abnormal glucose tolerance. The pattern of insulin response was similar to that seen in type II diabetes. Insulin/glucose ratio showed the same relationship as seen in type II diabetes. These results reinforce the possibility of glucose intolerance in lichen planus patients. However, no correlation between glucose tolerance abnormalities and duration and distribution of lesions was observed.

Adult↗
PubMed1982

Hemodialysis therapy for psoriasis.

Twenty-five patients with extensive plaque psoriasis resistant to conventional treatment were evaluated for study of the effects of dialytic therapy on the skin lesions. Twenty patients were dialyzed twice a week for six hours each time with a 1.0 m2 Cuprophan membrane dialyzer. Eighteen patients responded to this therapy with regression of skin lesions. Twelve of them have not developed recurrence of lesions during a followup period extending from 6 to 27 months. A few new lesions were observed after two to six months in four patients, but the lesions were not severe enough to justify reinstitution of dialysis. Two patients developed relapse within two months after cessation of dialytic therapy. One of them was started on dialysis a second time and this was followed by remission of lesions. Five patients were taken as controls and were treated with other modes of therapy including sham dialysis, ultrafiltration without dialysis, or systemic heparinization before they were taken on the dialysis program. Whereas sham dialysis and systemic heparinization had no effect on the skin lesions which responded later to dialytic therapy, the ultrafiltration procedure was followed by partial regression of psoriasis. Dialysis appears to have a definite role in the treatment of psoriasis.

Adolescent↗