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Biomedical subjects

M Bartlett

Publications and source records attributed to M Bartlett.

At least 37 records · Page 2Linked to original sources
PubMed1992

Diagnosis of histoplasmosis in patients with the acquired immunodeficiency syndrome by detection of Histoplasma capsulatum polysaccharide antigen in bronchoalveolar lavage fluid.

Diagnosis of histoplasmosis in patients with Acquired Immunodeficiency Syndrome (AIDS) may be established by detection of the organism in lung tissue or bronchoalveolar lavage fluid. In this report we have evaluated the utility of Histoplasma capsulatum polysaccharide antigen (HPA) detection in bronchoalveolar lavage fluid for diagnosis of histoplasmosis. HPA was detected in bronchoalveolar lavage fluid of 19 of 27 cases (70.3%). Of 122 controls with a variety of underlying diseases, HPA was detected in none. Eight of the negative specimens from patients with histoplasmosis were retested after fivefold concentration, and HPA was detected in five. Fivefold concentration of 10 control samples had no effect on HPA level. H. capsulatum was seen by methenamine silver or Giemsa stain in 19 of the 27 (70.3%) and isolated by culture in 24 of 27 (88.9%) cases. Twenty-four of 26 (92.3%) cases had positive cultures from extrapulmonary sites as well. HPA was detected in the urine of 25 (92.6%) and the serum of 23 (88.5%) of the 26 cases. We conclude that HPA detection offers a rapid method for identification of pulmonary histoplasmosis in patients with AIDS and could be a helpful addition to the battery of tests performed on bronchoalveolar lavage fluids in areas where histoplasmosis is endemic.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Correlation of Histoplasma capsulatum polysaccharide antigen with the severity of infection in murine histoplasmosis.

We sought to determine if Histoplasma capsulatum polysaccharide antigen (HPA) levels correlate with the extent of infection in murine of histoplasmosis. Separate groups of mice were inoculated intratracheally with varying numbers of H. capsulatum yeast cells. After 1 week, HPA levels and fungal burden (quantitative culture of lung and spleen and histopathologic stain of lung) were determined in lung and spleen, and HPA levels in serum. HPA levels, cultures and histopathological stain results of lung and spleen tissue showed a direct correlation with increasing inoculum size. HPA levels in serum also correlated with the size of inoculum. H. capsulatum antigen in lung correlated with silver stain scores of lung tissue, (R = 0.948, P less than 0.001) and with quantitative culture scores of lung, (R = 0.929, P less than 0.001). HPA levels in spleen tissue also correlated with spleen culture scores, (R = 0.724, P less than 0.001). These results indicate that determination of HPA level in serum and tissue may be a useful test in evaluating the severity of diseases as well as efficacy of antifungal therapy in histoplasmosis.

Animals↗
PubMed1990

1991 forecast: the year of restructuring.

How is the foodservice industry faring under the clouds of three big uncertainties--oil prices, recession and war? All things considered, its doing quite well. This annual status report of commercial and institutional business shows fast food, catering, nursing homes and employee feeding with growth percentages on the good, left side of the decimal point. Our forecast includes business trends to watch, food trends to guide menu planning and pricing, and interior- and kitchen-design trends that can be a blueprint for a successful new year.

Commerce↗
PubMed1990

Resource needs of an occupational health service to accommodate a hepatitis B vaccination programme.

The administrative, organizational and clinical commitment of an occupational health department to implement the DHSS recommendation for a hepatitis B vaccination programme for the health care workers in a District General Hospital was reviewed to evaluate the resource implications needed to accommodate the additional workload. The deficiencies observed in the existing DHSS guidance in implementing the plan are described. It is suggested that the Department of Health, while making future recommendations for vaccination, should be more precise in identifying those at risk, in describing the desired titre to be achieved after vaccination, and in describing the follow-up plan for those who accept the vaccination, those who refuse and those who do not seroconvert. The recommendation should describe the commitment of the Health Authorities and must include recommendations for appropriate and adequate resources to support such a programme. Vaccination for 1000 employees at risk required 4000 additional consultations necessitating 16 additional hours of occupational health commitment per week. Eighteen months after initiating the vaccination programme, 677 employees had accepted the vaccine. After receiving 3 vaccines 508 (75 per cent) recipients had protective seroconversion (anti-Hbs greater than 100 I.U.) and a further 61 (9 per cent) converted after the 4th injection, thereby offering protective immunity to 84 per cent of the recipients. During the period 84 (12.4 per cent) were lost to follow-up. Recommendations have been made to accommodate the additional commitment through the vaccination programme to standardize our care and prevent disruption of the existing service.

Health Plan Implementation↗
PubMed1990

Toxoplasmosis of the conus medullaris in a patient with hemophilia A-associated AIDS. Case report.

Toxoplasma gondii has been reported to be the most common cause of focal brain lesions in patients with acquired immunodeficiency syndrome (AIDS). A case of intramedullary toxoplasmosis of the conus medullaris is reported in a patient with hemophilia A-associated AIDS. The diagnosis is discussed, with particular emphasis on the magnetic resonance imaging appearance.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Tricyclic 2,4-diaminopyrimidines with broad antifolate activity and the ability to inhibit Pneumocystis carinii growth in cultured human lung fibroblasts in the presence of leucovorin.

A selected number of 1,3-diaminobenzo[f]quinazolines and 1,3-diamino-5,6-dihydrobenzo[f]quinazolines, which may be viewed as tricyclic analogues of the lipid-soluble antifolates pyrimethamine (PM), metoprine (DDMP), and etoprine (DDEP), were tested as inhibitors of purified dihydrofolate reductase (DHFR) from WI-L2 lymphoblasts, and as inhibitors of the growth of Streptococcus faecium ATCC 8043 and L1210 murine leukemia cells in culture. In addition, these tricyclic compounds were tested for antimalarial activity against Plasmodium berghei in mice, and for the ability to inhibit the growth of Pneumocystis carinii trophozoites in WI-38 human lung fibroblast cultures in the presence of leucovorin (LV). The most potent analogues were those with chlorine substitution in the ring distal to the 2,4-diaminopyrimidine moiety. Fully aromatic compounds tended to be more active than those in which the 5,6-bond was reduced, suggesting that planarity favors binding to the DHFR active site and may be favorable for cellular uptake. Several of the 2,4-diaminopyrimidine analogues showed greater potency than PM, DDMP or DDEP, and were more nearly comparable to the bicyclic 2,4-diaminopyrimidine antifolates trimetrexate (TMQ) or piritrexim (BW301U), which are known to be selectively toxic to P. carinii in the presence of LV. Two of the tricyclic compounds, 1,3-diamino-8-chlorobenzo[f]quinazoline and 1,3-diamino-9-chlorobenzo[f]quinazoline, proved to have activity similar to TMQ and BW301U in this system.

Animals↗
PubMed1984

Opportunistic Scopulariopsis pneumonia in an immunocompromised host.

We have described a patient with fatal Scopulariopsis pneumonia, a previously unreported infection, complicating immunosuppressive therapy for acute myeloblastic leukemia. This Scopulariopsis isolate was highly resistant to available antifungal agents, in part accounting for our patient's death.

Adult↗
PubMed1984

Complete recovery after profound acidosis (pH 6.49).

We describe an infant with profound acidosis caused by chronic therapeutic salicylate poisoning. The confirmed arterial blood pH of 6.49 must be close to the limit of tolerable acidity and is the lowest such value in our experience. Full recovery was made.

Acidosis↗
PubMed1984

D- and L-glucose transport across the pulmonary epithelium.

Previously we observed what appeared to be augmented D-glucose transport across the pulmonary epithelium. To investigate this phenomenon we placed fluid containing L-[3H]glucose and D-[U-14C]glucose in the alveoli of isolated Ringer-perfused lungs from 4-wk-old rabbits. The appearance of radioactivity in recirculating glucose-free perfusate was measured. 3H appearing in the perfusate was associated with L-glucose. 14C, however, was associated with three compounds, with approximate molecular weights of 180 (glucose), 300, and 560. The nonglucose species were not identified. This 14C movement was inhibited by phlorizin, but not phloretin, in the alveolar fluid. A similar pattern of 14C movement occurred when D-[U-14C]glucose was replaced with 2-deoxy-D-[U14C]-glucose, but not with methyl-alpha-D-[U-14C]glucopyranoside. The activation energy of the 14C metabolism-transport process was found to be 34 kcal/mol, and L-glucose transport showed an unusual temperature dependence, with maximum conductance at 15 degrees C. It appears that some D-glucose crosses the pulmonary epithelium as does L-glucose. However, most enters epithelial cells and is incorporated into larger molecules which enter the vascular but not the alveolar space.

Animals↗
PubMed1983

Treatment of Torulopsis glabrata peritonitis with intraperitoneal amphotericin B.

Torulopsis glabrata peritonitis occurred in a patient after surgery for a ruptured abdominal viscus. The infection was successfully treated with intraperitoneal amphotericin B alone. Pharmacokinetic information regarding the distribution and clearance of amphotericin B administered by this route is presented, and the clinical manifestations and treatment modalities for T glabrata and Candida peritonitis are reviewed.

Abdomen↗
PubMed1981

Responses to salmon calcitonin in chronic renal failure: relation to histological and biochemical indices of bone turnover.

Twenty-one patients with chronic renal failure and bone disease or hypercalcaemia were studied before and following single (twenty patients) or repeated (fourteen patients) intravenous injection of synthetic salmon calcitonin. Significant correlations were noted before treatment between bone surfaces occupied by osteoblasts or osteoclasts and plasma levels of immunoreactive parathyroid hormone, alkaline phosphatase and hydroxyproline. Following a single injection of 2--200 i.u. salmon calcitonin, plasma levels of calcium and phosphate fell for 6--8 h, but rose subsequently to pre-injection levels at 24 h. The magnitude and duration of the hypocalcaemic response was not clearly dose-dependent, but correlated with measured indices of bone cell activity. Repeated administration of calcitonin (10--200 i.u. thrice weekly for up to 2 months) lowered plasma calcium in the majority of patients and restored plasma calcium to normal in four previously hypercalcaemic patients. Mean levels of alkaline phosphatase increased but no significant changes in plasma phosphate, immunoreactive parathyroid hormone and calcitonin, or hydroxyproline occurred. Calcium absorption (six studies) did not change during treatment. We conclude that synthetic salmon calcitonin is an effective short-term inhibitor of bone resorption in patients with chronic renal failure. Its use as a possible treatment for hypercalcaemia and hyperparathyroid bone disease in chronic renal failure is discussed.

Adult↗
PubMed1981

Attenuated responses to CO2 and hypoxia in parents of threatened sudden infant death syndrome infants.

Ventilatory and heart rate responses to hypercapnia and hypoxia were measured in the following three groups: group I, controls (n equals 15); group II, parents of threatened sudden infant death syndrome (SIDS) infants (n equals 10); and group III, parents of SIDS infants (n equals 17). We found significantly reduced heart rate responses to carbon dioxide and hypoxia in group II (1.4 plus or minus 1.9 percent and 16.0 plus or minus 4.0 percent; mean plus or minus SEM) compared with controls (7.1 plus or minus 1.4 percent and 26 plus or minus 2.4 percent; P less than .025). Ventilatory responses to hypoxia in groups II and III were not significantly different from controls. Two group II mothers had a greatly reduce ventilatory response to carbon dioxide. Four other parents in group II had abnormally low heart rate responses to hypoxia or carbon dioxide. We concluded that parents of threatened SIDS infants had reduced heart rate responses to carbon dioxide and hypoxia and may have reduced ventilatory responses to carbon dioxide.

Adult↗