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Biomedical subjects

M J Gill

Publications and source records attributed to M J Gill.

At least 91 records · Page 5Linked to original sources
PubMed1991

Occurrence of Pneumocystis carinii organisms in a peritoneal effusion from a patient with the acquired immunodeficiency syndrome.

We describe a unique case of Pneumocystis carinii organisms within a peritoneal effusion of a patient with acquired immunodeficiency syndrome (AIDS). The patient, a 28-yr-old homosexual male with profound immunosuppression, presented with splenomegaly and ascites. A peritoneal tap was performed for diagnostic purposes. Cytologic examination of the cytospin specimen showed reactive mesothelial cells along with aggregates of debris reminiscent of the foamy exudates seen in the alveoli of lungs infected with the Pneumocystis carinii organism. A modified methanamine silver stain was performed and revealed the presence of scattered Pneumocystis carinii in the specimen. Extrapulmonary Pneumocystis carinii infection is occasionally seen in AIDS, but we could find no other reports of its detection in peritoneal fluid.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Hardiness and social support as predictors of psychological discomfort in mothers of children with autism.

Mothers of 60 children with autism participated in this study to measure the effects of social support and hardiness on the women's responses to the stressful demands of raising a child with a disability. MANOVA analysis indicated a significant main effect for hardiness, Wilks' lambda = .859, approx. F(2, 55) = 4.494, p less than .02. There were no main effects for social support, or for the interaction of social support and hardiness. In regression analyses, the best combination of predictors of depressive symptoms were the Commitment dimension on the Hardiness Questionnaire and the total score on the Interpersonal Support Evaluation List social support inventory, mult. R = .783, p less than .001. The best predictor of somatic complaints was total Hardiness score, mult. R = .698, p less than .01. There was a significant correlation between hardiness and perceived social support, r(57) = -.67, p less than .001. Results are discussed in terms of the relationship between perceived social support and hardiness and the potential buffering effect of these dimensions.

Adaptation, Psychological↗
PubMed1991

Does punishment hurt? The impact of aversives on the clinician.

This paper explored the extent to which the use of mild versus strong aversives in programs for clients with autism affected the degree of job stress reported by direct care staff on the Maslach Burnout Inventory. The subjects included 56 staff from programs using only mild aversives and 60 staff from programs using strong aversives. Subjects anonymously completed the inventory and mailed it directly back to the researchers. The most significant finding was that direct care staff in facilities which permitted the use of strong aversives reported more intense feelings of personal accomplishment on the inventory than did subjects whose programs were limited to the use of mild aversives. Furthermore, there was a significant relationship among the personal use of strong aversives, number of years in the field, and the intensity of Personal Accomplishment. These findings suggest that allowing staff to use a wide range of interventions including strong aversives may diminish job stress and enhance one's sense of personal efficacy.

Adolescent↗
PubMed1991

Randomized, double-blind, placebo-controlled, clinic-initiated, Canadian multicenter trial of topical edoxudine 3.0% cream in the treatment of recurrent genital herpes. Canadian Cooperative Study Group.

Treatment for recurrent genital herpes using edoxudine 3% cream for 5 days was evaluated in 200 patients in a randomized, multicenter, double-blind, placebo-controlled, clinic-initiated trial. Lesion tenderness was predictive of and more sensitive and longer-lasting than the symptom of pain. Among patients receiving placebo, times to crusting (P = .043), cessation of investigator-observed signs (P = .005), lesion-associated signs (P = .02), and groin signs (P = .05) were longer in women. Edoxudine reduced viral shedding in men (mean 2.7 vs. 3.4 days, P = .009) and women (2.0 days vs. 3.5 days, P = .0001). Loss of investigator-observed signs (4.4 vs. 6.2 days, P = .002), investigator-observed lesion tenderness (P = .01), lesion signs (P = .02), groin adenopathy (P = .01), and tenderness (P = .01) occurred earlier in women taking edoxudine. Edoxudine was well-tolerated and reduced several signs of herpes in women. Its clinical role in recurrent genital herpes remains to be fully determined.

Administration, Topical↗
PubMed1991

Oral acyclovir therapy of recurrent herpes simplex virus type 2 infection of the hand.

Acyclovir was evaluated as treatment of recurrent herpes simplex virus type 2 infection of the hand in a double-blind, placebo-controlled crossover study. In nine fully evaluable patients, oral acyclovir (2 g/day in three doses for 10 days) initiated during the earliest phase of a recurrence reduced the mean durations (+/- standard deviation) of clinical symptoms from 10.1 (+/- 3.6) to 3.7 (+/- 3.0) days (P = 0.008), signs from 11.1 (+/- 3.7) to 6.2 (+/- 3.3) days (P = 0.024), and viral positivity from 5.3 (+/- 3.8) to 0.6 (+/- 1.1) days (P = 0.011).

Acyclovir↗
PubMed1991

Rhodococcus equi--an easily missed opportunistic pathogen.

Over the last 10 years Rhodococcus equi has been identified as an important, albeit very rare, opportunistic pathogen. As the number of patients immunocompromised from HIV infection grows, this microorganism will likely become of increasing clinical importance. Infection with R. equi is usually insidious, causing progressive pulmonary disease that is typically pleural based at the time of microbiological diagnosis. As in the case we present, the clinical and microbiological diagnoses may be significantly delayed, either by the common pitfalls encountered in the laboratory identification of R. equi, or by the failure to recognize the pathogenic potential of the isolate. R. equi infection should be suspected in immunocompromised patients with pneumonia, when a pure or predominant growth of aerobic, non-sporeforming gram-positive bacilli is found on cultures of bronchoalveolar lavage fluid and other pulmonary pathogens have been excluded.

Actinomycetales Infections↗
PubMed1990

Gastrointestinal function and structure in HIV-positive patients.

We examined 19 patients (17 men) with human immunodeficiency virus (HIV) infection and gastrointestinal symptoms to determine whether those symptoms were due to either a gastrointestinal tract infection or a defect in mucosal absorption because of an enteropathy. The erythrocyte folate and serum vitamin B12 levels were within normal limits in all of the patients. The serum ferritin level was elevated in 12. The xylose absorption test results were abnormal in 8 of the 13 patients able to complete the study. None of the duodenal aspirates yielded a pathogen. Light microscopy revealed nonspecific lymphocytic inflammation without infection in the stomach (in seven patients), the esophagus (in five), the duodenum (in two) and the rectum (in two). However, biopsy specimens were positive for Candida albicans in the esophagus (four patients), cytomegalovirus in the esophagus (one) and the rectum (two), Helicobacter pylori in the antrum (two), Treponema infection in the rectum (two) and Mycobacterium avium-intracellulare in the small intestine (one). Only three patients had a normal series of biopsy specimens. All of the patients had similar ultrastructural changes at the epithelial-stromal junction of the antral glands and in the intestinal crypts. We conclude that abnormal biochemical and endoscopic findings are common in HIV-positive patients with gastrointestinal symptoms. Defects in carbohydrate absorption and ultrastructural changes may be responsible for some aspects of HIV enteropathy.

Bacterial Infections↗
PubMed1990

Intraperitoneal administration of acyclovir in patients receiving continuous ambulatory peritoneal dialysis.

In subjects with normal renal function, acyclovir is rapidly removed from the body via the kidneys. In subjects with end-stage renal disease, the half-life is significantly prolonged. The half-life in subjects receiving hemodialysis and continuous ambulatory peritoneal dialysis (CAPD) is similarly prolonged (10.0 +/- 2.2 and 13.2 +/- 4.7 hours, respectively). After intravenous dosage, peritoneal clearance was 3.4 +/- 0.2 mL/min. Intraperitoneal dosing in subjects receiving CAPD resulted in a bioavailability of 61 +/- 10% and drug levels sufficient to inhibit herpes simplex virus (HSV) and varicella zoster virus (VZV). Intraperitoneal administration is an alternative route of administration in patients with poor vascular access.

Acyclovir↗
PubMed1990

Herpes simplex virus infection of the hand.

The first episode of herpes simplex virus (HSV) infection of the hand can occur in association with infection at another site, such as primary HSV-1 gingivostomatitis. Autoinoculation is the likely route of transmission. The attacks are usually solitary and last about 14 days. A first episode that results from exogenous inoculation may be severely inflammatory and may last up to 28 days. The majority of cases are recurrent infections and most often occur in adults with HSV-2 infection.

Adult↗
PubMed1990

Transfer of beta-lactamase plasmids by conjugation in Neisseria gonorrhoeae.

Conjugation experiments in vitro have been used in an attempt to explain certain epidemiological phenomena seen amongst penicillinase producing Neisseria gonorrhoeae (PPNG) isolated at St Mary's Hospital, London. These include changes in plasmid profiles, a lack of beta-lactamase encoding plasmids in PAOU-requiring strains and a difference in the serological classification of strains of PPNG and non-PPNG isolated from the same clinic. It was shown that acquisition of the conjugative plasmid by beta-lactamase producing transconjugants does vary, but is not related to the auxotype/serovar (A/S) class of, or type of beta-lactamase plasmid carried by the donor. It was not possible to transfer either the 3.2MDa or 4.4MDa plasmids to PAOU-requiring strains of N gonorrhoeae. The conjugation frequency from a single donor to different recipients was shown to be variable, but was not influenced by the serovar of the recipients. It was shown that the transfer and acceptance of beta-lactamase encoding plasmids is variable but it was not possible to identify the factors responsible.

Conjugation, Genetic↗
PubMed1990

Penicillin and cephalosporin resistance in gonococci.

Non-penicillinase producing Neisseria gonorrhoeae isolated at St Mary's Hospital, London were examined for the prevalence of resistance to penicillin and for decreased susceptibility to cefuroxime. Of the 941 non-PPNG tested 100 (10.6%) were resistant to penicillin (minimum inhibitory concentration, MIC, greater than or equal to 1 mg/l) and were considered to be chromosomally-resistant N gonorrhoeae (CMRNG). Decreased susceptibility to cefuroxime (MIC, greater than or equal to 0.5 mg/l) was detected in 79% of the CMRNG. The CMRNG were also more often prototrophic and of serogroup IB than the remaining non-PPNG. The correlation coefficient for resistance to penicillin and cefuroxime was high, 0.79. Transformation experiments with both genetically-defined strains and transformants obtained using DNA from clinical isolates, showed that increased resistance to cephalosporins was acquired in three steps in close association with penicillin. We think this suggests that the loci controlling resistance to the cephalosporins are identical or closely linked to those controlling penicillin resistance.

Cefuroxime↗
PubMed1990

HPV DNA typing of adult-onset respiratory papillomatosis.

Respiratory papillomatosis is a recalcitrant, human papillomavirus-induced disorder of the upper airways. Using in situ hybridization and biotinylated deoxyribonucleic acid (DNA) probes, the type of human papillomavirus (HPV) in nine adults was determined both at presentation and during subsequent recurrences. Fifty-three biopsies obtained from seven men and two women over a 10-year period were examined for HPV 6, 11, 16 and 18. All patients had either type 6 or 11. One dual infection was found. Despite intensive therapy with lasers with or without alpha interferon, no elimination or change in viral type occurred. Despite identical histologies, the amount of HPV DNA present in a given patient's papillomata varied markedly. The results suggest that adult-onset respiratory papillomatosis is due to HPV 6 and/or HPV 11, and that its recurrent nature, despite therapy, is due to persistence of a viral reservoir.

Adult↗
PubMed1990

Human orf. A diagnostic consideration?

We saw four unrelated cases of human orf infection over a 3-month period. Each patient had a clear-cut history of contact with sheep and developed a characteristic painful pustular lesion on the hand. There were no significant systemic symptoms. Examination of an aspirate by electron microscopy confirmed the diagnosis. The lesions resolved spontaneously within 6 weeks. Human orf infection occurs in North America, and although seldom reported, it should be considered in the diagnosis of cutaneous lesions in patients who have exposure to animals associated with it.

Adult↗
PubMed1989

Psychosocial distress and well-being among gay and bisexual men with human immunodeficiency virus infection.

The authors examined levels of psychosocial distress and well-being in 65 gay or bisexual men infected with the human immunodeficiency virus (HIV); 24 of these men had asymptomatic HIV infection, 22 had acquired immune deficiency syndrome (AIDS)-related complex, and 19 had AIDS. All of the men evidenced high levels of psychosocial distress, but those with AIDS-related complex and those with asymptomatic HIV infection were significantly more distressed than those with AIDS. Corresponding differences were not observed in feelings of psychosocial well-being. The authors conclude that specific psychosocial issues and adaptive demands should be identified over the course of HIV illness.

AIDS-Related Complex↗
PubMed1988

Factitious AIDS.

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Acquired Immunodeficiency Syndrome↗