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Biomedical subjects

M A Simpson

Publications and source records attributed to M A Simpson.

At least 55 records · Page 3Linked to original sources
PubMed1989

Sequential determinations of urinary cytology and plasma and urinary lymphokines in the management of renal allograft recipients.

Urine cytology, plasma (P), and urinary (U) interleukin-2 (IL-2)* and IL-2 receptor (IL-2R) levels were evaluated as immunological monitoring techniques in 65 renal allograft recipients. Normal individuals showed normal urine cytology, IL-2(U) = 0, IL-2(P) = 0.4 +/- 0.1 ng/ml (mean +/- SEM) and IL-2R(P) = 318 +/- 26 U/ml. Stable transplants also showed normal urine cytology, no IL-2(U), IL-2(P) = 0.8 +/- 0.2 ng/ml, and IL-2R(P) = 326 +/- 29 U/ml. Rejection episodes (n = 21) were accompanied by cytologic changes, including lymphocyturia, exfoliation of immature tubular cells, platelet aggregates, and fibrin deposits. The corresponding lymphokine changes were IL-2(U) = 39.6 +/- 1.4 ng/ml, IL-2(P) = 79 +/- 21 ng/ml, and IL-2R = 1884 +/- 202 U/ml, all markedly increased. Successful treatment was associated with return of all parameters to normal; treatment failure was associated with continued abnormalities. Fourteen rejections unresponsive to Solumedrol (500 mg x 5 days) required OKT3 rescue (5 mg x 14 days). In the 11 that were reversed, onset of OKT3 therapy was characterized by markedly increased exfoliation of necrotic cellular debris, lymphocytes, and collecting duct cells. Interestingly, serum creatinine increases of 57.2 +/- 18.9% (range 25-90%) over pre-OKT3 levels were noted. Maximal changes occurred 48-72 hr after the first dose, followed by gradual return to normal. Rejections unresponsive to OKT3 (n = 3) showed no cytologic changes from the pretreatment mean creatinine increase of 13.2 +/- 2.7% (range 9-15%), and maximum change occurred 24 hr after the first dose. Rejections responsive to Solumedrol only (n = 4) showed gradual improvement of all parameters. Rejections treated with Solumedrol following failed OKT3 prophylaxis (n = 3) did not reverse and continued to show rejection associated cytologic changes and abnormal creatinines. Patients experiencing CsA toxicity (n = 12) showed mild creatinine elevations, normal or negative IL-2(P) and IL-2R(P) levels, and no IL-2(U). They showed distinctive cytologic changes consisting of swollen convoluted tubular cells with nuclear pyknosis and cytoplasmic vacuoles. Pretransplant IL-2(P) levels of patients who subsequently rejected were elevated, with 19/21 patients with preoperative IL-2 levels greater than 15 ng/ml having subsequent rejections. In contrast, pretransplant creatinine, urine cytology, and IL-2(U) levels showed no correlation to subsequent clinical course.(ABSTRACT TRUNCATED AT 400 WORDS)

Antibodies, Monoclonal↗
PubMed1988

Clinical, hematologic, and immunologic cross-sectional evaluation of individuals exposed to human immunodeficiency virus type-2 (HIV-2).

We studied the clinical status and certain hematologic and immunologic parameters in healthy prostitutes from Dakar, Senegal who were seropositive for antibodies to human immunodeficiency virus type-2 (HIV-2). Generalized lymphadenopathy and clinical signs or symptoms similar to those which are seen with human immunodeficiency virus type-1 (HIV-1) infection were not present. Comparison to seronegative prostitutes and minor surgery control patients were made and significant elevations were seen in T8 lymphocytes (p = .03), IgG (p = .0001), and beta 2-microglobulin (p = .03). The mean T4 lymphocyte count in seropositive prostitutes was lower than in seronegative prostitutes (757 vs. 1179, p = .15), but this difference was not statistically significant and appeared to be correlated with age. No significant differences were noted between the seronegative and seropositive prostitutes in lymphocyte stimulation studies to certain mitogens. Antilymphocyte antibodies above background were not present in either population. We conclude that HIV-2 is a sexually transmitted agent that produces immunologic alterations consistent with a persistent viral infection. HIV-2 seropositive prostitutes studied to date do not show clinical signs of immune suppression, as has been described with HIV-1 infection. The pathogenic potential of HIV-2 appears to differ from that of HIV-1, the etiologic agent of the AIDS pandemic.

Adult↗
PubMed1988

Prevalence of bovine venereal disease in the Victoria River District of the Northern Territory: likely economic effects and practicable control measures.

Area prevalences of bovine Campylobacteriosis and Trichomoniasis in the Victoria River District (VRD) of the Northern Territory were determined by a survey of bulls. Eighty-seven percent of herds were infected with Campylobacteriosis and 65.6 percent were infected with Trichomoniasis. The levels of infection recorded are likely to be causing significant reductions in reproductive rates. Control of Campylobacteriosis is unlikely to be practicable on a district basis, but in some herds it may be possible to implement control measures in select groups subject to good stock control. Trichomoniasis control measures are generally not implementable in the VRD management situation. Computer modelling suggests that control measures are unlikely to be profitable in commercial herds. There is a need for field investigations to confirm this.

Animals↗
PubMed1987

Referral patterns for psychiatric consultation in a large general hospital.

Referrals for psychiatric consultation from all inpatient and outpatient departments in a large general hospital were analysed. There were 597 referrals--the combined inpatient and outpatient referral rate was approximately 0.78% and the inpatient rate 1.8%. The most common reasons for referral were parasuicide, depression/symptoms of depression, abnormal behaviour and alcohol abuse. Depressive disorders, drug dependence and neuroses were the most common diagnoses made. Medication was prescribed in 38% of cases and psychotherapy was offered in 18%. In 21% of cases the patient was either managed in his original ward or transferred back to the ward with advice regarding management. In 79% of cases management was within the Department of Psychiatry; many of these patients required concurrent treatment from the referring doctor for a physical disorder. The value of improving the quality and availability of consultation-liaison psychiatry services is discussed.

Hospitals, General↗
PubMed1987

Medical psychology--its growth and development in South African medical schools.

New training models and programmes in the teaching of clinical psychology associated with medically applied psychology at medical schools are developing in South Africa. However, a recent survey showed that a minimum number of full-time clinical psychologists is employed by medical schools in South Africa. How the few who are so employed fare away from their 'home base' is also explored as well as what their contributions are in such settings and in providing medical psychological services in general hospitals. These findings are discussed with reference to a developing country such as South Africa. Methods are proposed to further enhance the development of medical psychology and the effective contribution of clinical psychology to medical and related education, and its functioning as a bridge across the body-mind dichotomy within promotive and preventive healing systems.

Psychology, Clinical↗
PubMed1987

Iatrogenesis and suicide in South African Indians.

Psychological profiles were obtained by careful, structured interviewing of those who had been close to 47 consecutive South African Indian suicide victims who had died within the greater Durban area between 1982 and 1984, and whose deaths had been designated as 'suicide' by the magistrate conducting the inquest. Almost 50% of the subjects had been suffering from significant physical illnesses, and 65% were taking medication with the potential to potentiate depression. All were retrospectively diagnosed as having been depressed, as they had shown clear signs and symptoms of this illness, yet none was being treated for depression at the time of his or her death. Warnings that they were considering suicide were given by 68%, but little notice was taken. The implications for medical practice and training are discussed.

Depression↗