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Biomedical subjects

M E Ellis

Publications and source records attributed to M E Ellis.

At least 73 records · Page 4Linked to original sources

Hyperglycemic complications associated with adjuvant chemotherapy of breast cancer. A cancer and leukemia group B (CALGB) study.

Many adjuvant chemotherapy regimens used for breast cancer include prednisone, which has the potential to cause hyperglycemia. We reviewed the results of three CALGB studies employing prednisone as part of adjuvant therapy to determine the incidence and severity of hyperglycemic complications. All treatment regimens included cyclophosphamide, methotrexate or doxorubicin, 5-fluorouracil, and vincristine in addition to prednisone. Among 1,237 evaluable patients receiving a five-drug regimen including prednisone, there were 98 patients (7.9%) who experienced any degree of hyperglycemia. Thirty patients (2.4% overall; 30.6% of those having any hyperglycemia) had severe or life-threatening degrees of hyperglycemia, including two patients whose hyperglycemia contributed directly to death. We conclude that prednisone administration as part of adjuvant chemotherapy regimens in breast cancer produces an appreciable incidence of hyperglycemia. Serum glucose levels should be monitored during therapy to help prevent the occasional severe or life-threatening episode of hyperglycemia in these patients.

Antineoplastic Combined Chemotherapy Protocols↗

Evaluation of adenosine deaminase activity and antibody to Mycobacterium tuberculosis antigen 5 in cerebrospinal fluid and the radioactive bromide partition test for the early diagnosis of tuberculosis meningitis.

A number of different biochemical and serological tests have been described recently for the early and accurate diagnosis of tuberculous meningitis. None of these tests has yet gained widespread acceptance in clinical medicine or in microbiology laboratories. To investigate this problem we evaluated adenosine deaminase activity (ADA), an enzyme linked immunosorbent assay (ELISA) that detects antibody to antigen 5 of Mycobacterium tuberculosis, and the radioactive bromide partition test (BPT) in the cerebrospinal fluid (CSF). Cerebrospinal fluid specimens from children with tuberculous, pyogenic, and viral meningitis as well as from patients with pulmonary tuberculosis without meningitis and from controls with normal CSFs were included inn the study. In addition, we estimated ADAs in serum samples from selected children in these groups. The sensitivity and specificity of the three tests evaluated in the CSF were: ADA assay 73% and 71%; BPT 92% and 92%; and ELISA for antibody to antigen 5, 53% and 90%, 40% and 94%, and 27% and 100%, respectively, at tires of more than or equal to 1:20, 1:40, and 1:80. The serum ADA was lower (11.0 +/- 6.15 IU/l) in children with tuberculous meningitis when compared with those with pulmonary tuberculosis alone (25.8 +/- 20.9 IU/l). The BPT was found to be the most reliable test in the early differentiation of tuberculous from other causes of meningitis and remained abnormal for a period of up to five months after the beginning of treatment. Accordingly, we believe that the BPT should be used in conjunction with bacterial and fungal antigen detection systems for the initial differentiation of clinically suspicious tuberculous meningitis from Gram or culture negative cases, or both, of bacterial and fungal meningitis.

Adenosine Deaminase↗

Amygdala norepinephrine involved in two separate long-term memory retrieval processes.

Noradrenergic manipulation of the rodent amygdala results in time-dependent disruption of long-term memory for a one-trial aversive experience. Findings using both state-dependent and consolidation experimental procedures suggest that the norepinephrine system of the amygdala underlies not only consolidation-like mechanisms. There appear to be specific noradrenergic substrates for two or more memory retrieval processes which may be physiologically similar to either acquisition or later memory development involving aversive information.

Amygdala↗

Nephrotoxicity of lomustine. A case report and literature review.

A patient is presented who developed nephrotoxicity after therapy with lomustine (CCNU) for astrocytoma of the brain. Only three other cases of lomustine nephrotoxicity have been reported, and all cases have been associated with cumulative drug doses of greater than 1,500 mg/m2. The clinical and pathologic features of lomustine nephrotoxicity are reviewed. It is recommended that cumulative doses of more than 1,200-1,4000 mg/m2 lomustine be avoided because of the risk of nephrotoxicity.

Adult↗

How well do asthma clinic patients understand their asthma?

Fifty asthmatic patients attending a hospital asthma clinic were interviewed to determine their understanding of their asthma and its treatment. Serious defects were found in their ability to judge the severity of their asthma, in their knowledge of medication, and in the correct action to take when deterioration in control occurred. Several risk factors previously identified in studies of asthma deaths were also present in this living population--in particular, delay in seeking medical help until critically ill, and lack of awareness of danger signs. There was evidence of poor patient-doctor contact and unsuccessful patient education.

Adrenal Cortex Hormones↗

An analysis of 12 months admissions to a regional infection unit with an open door admission policy.

All admissions to the Aberdeen Infection Unit over a period of 12 months have been analysed. Forty per cent of the patients proved to have non-infectious conditions although most were referred as having an infectious disease. Those patients with infectious diseases were younger and had a shorter stay in hospital. Also there was seasonal variation in the time of their admission as well as a low mortality rate when compared with older patients with non-infectious disease admitted over the same period. Cross infection did not arise in spite of patients sharing accommodation.

Cross Infection↗

Response of early disseminated Herpes simplex to acycloguanosine: a case report.

Acycloguanosine, an anti-viral agent with few side effects and good activity in vitro against Herpes simplex, has not produced a consistently high cure rate in clinical practice (1). This may in part be related to delayed initiation of therapy (2). We describe a case of disseminated Herpes simplex (DHS) in an immunocompromised child (which is normally associated with a fatal outcome) who responded rapidly and completely to treatment with acycloguanosine.

Acyclovir↗

Manipulation of the amygdala noradrenergic system impairs extinction of passive avoidance.

In a consolidation paradigm, noradrenergic manipulation of the rat amygdala results in disruption of extinction for passive avoidance. These results are discussed in light of a recent controversy concerning the role of central norepinephrine systems in general extinction behavior. The discussion is cast primarily within the framework of rodent natural life history, the presence of innate behavioral strategies, and the organization of information processing as an integration of experiential attributes.

Amygdala↗

Contemporary gastroenteritis of infancy: clinical features and prehospital management.

In a prospective survey carried out over 12 months 447 children aged under 2 years were admitted to the Manchester Regional Infectious Diseases Unit for treatment of gastroenteritis. Comparison of the children with those in a survey 15 years previously in the same unit showed that the illness was milder than in the earlier series, with no deaths and with lower incidences of hypernatraemia (1%), uraemia (8%), and dehydration (14%). These improved findings occurred despite several deficiencies of care in the prehospital phase of the illness, particularly poor compliance with the widely recommended guidelines for fluid and dietary management in infantile gastroenteritis.

Child, Preschool↗

Clostridium difficile and its cytotoxin in infants admitted to hospital with infectious gastroenteritis.

During a prospective study of infectious gastroenteritis in children under 2 years, 19 out of 390 patients (4.9%) were found to have Clostridium difficile cytotoxin in the faeces. In several there was no history of use of antibiotics. The symptoms of many infants with toxin settled spontaneously, but one child became acutely and severely ill and developed a toxic megacolon and five others required, and responded to, vancomycin. Cl difficile was cultured from the stools in 191 (49%) of the children. The highly significant increased prevalence of past use of antibiotics in 118 control patients was not associated with an increased incidence of either isolation of Cl difficile or presence of faecal cytotoxin. Cl difficile should not be overlooked as a cause of acute diarrhoea and vomiting in children under 2 years.

Anti-Bacterial Agents↗

Double-blind placebo-controlled trial of erythromycin in the treatment of clinical campylobacter infection.

In a double-blind placebo-controlled trial in patients hospitalized with campylobacter infection, erythromycin lessened pain and curtailed the carriage state but otherwise did not alter the natural course of the illness, which proved to be a short-lived, self-limiting one, even in this selected group of hospitalized patients; the majority had become asymptomatic by the time of the bacteriological diagnosis. The rarity of bacteraemia is highlighted by the study.

Adolescent↗

The effect of cimetidine on the relative cardioselectivity of atenolol and metoprolol in asthmatic patients.

The effects of chronic cimetidine therapy on the pharmacodynamic properties of atenolol and metoprolol were assessed in eight asthmatic patients using a placebo-controlled trial. When atenolol and metoprolol were administered at doses which achieved an equivalent degree of beta1-adrenoceptor blockade, metoprolol caused a significantly greater reduction in mean forced expiratory volume in one second (FEV1). This demonstrates the greater cardioselectivity of atenolol. The reductions in mean FEV1 induced by either atenolol or metoprolol were each unaffected by cimetidine. Plasma levels of each of the beta-adrenoceptor blockers were not affected by the addition of cimetidine. The FEV1 in one patient was further reduced when cimetidine was administered with metoprolol, although there was no corresponding change in plasma levels of drug. In this patient there was no such further reduction in FEV1 with atenolol. This study has not provided evidence for a pharmacodynamic interaction between cimetidine and either atenolol or metoprolol, but further studies are indicated.

Asthma↗

Micro-organisms in gastroenteritis.

We present bacteriological and virological findings together with salient clinical features from a prospective study of 447 children aged under 2 years admitted to hospital with infectious gastroenteritis. Putative pathogenic micro-organisms were identified in the stools of 75% of these children. Eight identifiably distinct groups of viruses, found on electron microscopy and tissue culture were present in 67% of patients--rotavirus was detected most frequently. Pathogenic bacteria (salmonellas, shigellas, Escherichia coli, and Campylobacter jejuni--but excluding Clostridium difficile) were found in 16% only. Altogether 4 X 9% of 390 patients had gastroenteritis associated with Cl difficile toxin. The mean duration of diarrhoea was shortest in patients with identifiable virus, with rotavirus having a mean of 5 X 01 days, and was longest in patients with pathogenic bacteria in the stools (11 X 14 days). The finding of more than one type of virus did not seem to be associated with a significantly increased duration of diarrhoea. There are few clinical features which can be associated specifically with any particular micro-organism or groups of these. Multiple organism isolation was common, but the severity of the illness in those patients with at least two types of organism was not greater. Certain viruses, including the norwalk-like virus, known to be associated with outbreaks of gastroenteritis were found as frequently in a group of patients who did not have diarrhoea studied for comparison. Virus was still detectable in the stools of up to 40% of asymptomatic children on the day of discharge.

Adenoviruses, Human↗

Memory consolidation: brain region and neurotransmitter specificity.

Post-trial injections of norepinephrine, but not dopamine, into the amygdala produce a long-term retention deficit (amnesia) for a 1-trial footshock experience in rats. In contrast, post-trial injections of dopamine, but not norepinephrine, into the caudate produce long-term facilitation. The data provide evidence for brain region-neurotransmitter specificity which supports a multiple component hypothesis.

Amygdala↗

Cause of death in patients admitted to hospital for pulmonary tuberculosis.

Study of hospital case-notes and necropsy reports of 60 patients certified as dying from tuberculosis over 7 years identified a group of 16 patients (27%) who died suddenly and unexpectedly and in whom the cause of death was obscure. In 14 of the 16 death followed initiation of antituberculous chemotherapy.

Adrenal Cortex Hormones↗