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Biomedical subjects

M J Martin

Publications and source records attributed to M J Martin.

176 records · Page 10Linked to original sources
PubMedDate not supplied

Mycotic keratitis: susceptibility to antiseptic agents.

Oculomycosis is a severe problem in most developing countries. Specific antifungal agents are often unavailable, and are expensive. The use of antiseptic agents was therefore explored. Fungal isolates from patients in India and Ghana were tested against chlorhexidine, povidone iodine, propamidine, and polyhexamethylenebiguanide, and compared with econazole by placing the drugs in wells made in Sabouraud's agar plates seeded with the test organism. Fungal sensitivity testing is a contentious area but this method is simple and cheap. Chlorhexidine showed a good dose related response, povidone iodine showed a good response at all concentrations and econazole was the most effective in vitro. A small pilot study was conducted in India to assess clinical efficacy for fungal corneal ulcers. Both chlorhexidine and econazole proved effective but povidone iodine was ineffective. We suggest that chlorhexidine may be a useful first line agent for fungal keratitis when other antifungals are not available.

Anti-Infective Agents, Local↗
PubMedDate not supplied

13C-urea breath test for the diagnosis of Helicobacter pylori infection before treatment: is citric acid necessary?

AIM: 13C-urea breath test is one of the best methods for the diagnosis of Helicobacter pylori infection. Although a citric acid solution is generally used prior to urea intake, the superiority of this strategy has not been sufficiently demonstrated. Thus, our aim was to compare 13C-urea breath test with and without citric acid solution, to evaluate whether 13C-urea breath test can also achieve favourable results when the test meal is omitted. METHODS: 13C-urea breath test with and without citric acid were compared prospectively in 53 subjects without prior Helicobacter pylori eradication therapy prescription. Basal samples and at 15', 30', and 45' after taking 100 mg of 13C-urea were obtained. The gold standard for Helicobacter pylori diagnosis was the 13C-urea breath test result with citric acid at 30', and "Delta Over Baseline" values >5 at that time were considered positive. RESULTS: The prevalence of Helicobacter pylori infection was 68%. Mean Delta Over Baseline values with citric acid at 15', 30' and 45' were: 29.6+/-39, 30.8+/-37 and 24.6+/-27; whereas respective values without citric acid were lower: 14.9+/-22, 12.2+/-17 and 10D+/-13 (p<O. 001 for all comparisons, Wilcoxon test for paired data). Thus, the area under the curve (constructed with Delta Over Baseline values at different times) with citric acid was 85+/- 102, and 37+/-50 without citric acid [p<0.001). Correlation coefficient between Delta Over Baseline values with and without citric acid at 30' was 0.73 (p<0.0001). The percentage of subjects achieving the highest Delta Over Baseline value at 15', 30' and 45' with citric acid was 51%, 30% and 19%, whereas without citric acid it was 51%, 26% and 23% (non-significant differences). The area under receiver operating characteristic curve for 13C-urea breath test without citric acid was: 0.98 at 15', 1 at 30' and 0.97 at 45'. The best cut-off point for 13C-urea breath test without citric acid at 30' was anywhere between 3. 3 and 3.9 (that is, a lower value than that usually considered with citric acid), with 100% (95% confidence interval, 90-100%) sensitivity and 100% [82-100%) specificity CONCLUSIONS: 13C-urea breath test values with citric acid are higher than those obtained without citric acid, although this difference does not imply a diagnostic superiority in untreated patients when considering 13C-urea breath test without citric acid at 30'. Therefore, for the diagnosis of Helicobacter pylori infection in untreated patients, citric acid solution in 13C-urea breath test protocol can be omitted.

Adult↗
PubMedDate not supplied

Comparison of one first-generation and three second-generation methods for the determination of CA 125.

The monoclonal antibody OC125 (Centocor, Inc, Malvern, PA) was the basis for the first generation of one-step immunoradiometric assays (IRMA), used to detect the glycoprotein CA 125. Recently two-step IRMAs were developed: the CA 125 second-generation assays. In these new assays the CA 125 capture antibody is the M11 monoclonal antibody coated on a solid phase and the OC125 monoclonal antibody is used as tracer. We compared one first-generation radioassay and three second-generation assays (two radioassays and one ELISA) both analytically and clinically. The ELISA method showed the best within-assay precision and the best curve fitting characteristics. In the clinical comparison, none of the correlations between the first-generation and second-generation methods were really satisfactory; however, the cutoff level of 35 U/ml was confirmed. The four CA 125 assays do not yield equal results. As a consequence, the evolution of CA 125 serum concentrations during disease monitoring is not reliable when different determination methods are used consecutively.

Analysis of Variance↗
PubMedDate not supplied

[Continuous enteral nutrition in the treatment of infants with "travelers' diarrhea" and severe malnutrition].

A prospective study of children aged 2-22 mos with traveller's diarrhea and severe malnutrition (weight loss greater than or equal to 10%; mean 17.8%) treated with a standardized progressive semi-elemental drip feeding (Alfaré and Dextrine-maltose) after rehydration was undertaken. In 18 children, this therapy was successful and duration of the hospital stay was 15.7 days. In 6 other children, relapse was treated with the same protocol with success and duration of the hospital stay was 29 days. Total parenteral nutrition was unnecessary. Evolution of serum prealbumin and anthropometric parameters was good.

Anthropometry↗
PubMedDate not supplied

Home dialysis.

Explore the source record for details and available documents.

Home Nursing↗
PubMedDate not supplied

Activating patients to practice skin cancer prevention: response to mailed materials from physicians versus HMOs.

OBJECTIVES: We investigated whether the source and emphasis of mailed messages about skin cancer would differentially activate patients to initiate skin cancer prevention by calling a toll-free number. METHODS: We mailed a questionnaire to 981 randomly selected patients of a large medical group to assess their concern about and risk for skin cancer: 48 were returned undeliverable (n = 933). The booklet was accompanied by a letter inviting patients to call a toll-free number. Patients received the letter from one of three sources: (1) their physician, (2) their HMO, or (3) a fictitious junk mail organization. Patients received one of three different messages emphasizing the effects of ultraviolet (UV) rays on (1) the risk of skin cancer, (2) aging and wrinkling of the skin, or (3) aging and wrinkling accompanied by a book further emphasizing these harmful effects of the sun. RESULTS: The overall activation rate was low (7%); nevertheless, the source of the preventive message significantly affected whether patients called in. Messages from physicians and HMOs were more activating than messages from the junk mail organization (odds ratio [OR] = 3.40, confidence intervals [CI] = 1.66, 6.97), but messages from physicians were not more activating than messages from HMOs (OR = 1.56, CI = .90, 2.72). The emphasis of the message did not significantly affect call-in rates. Risk for skin cancer was positively associated with patient activation, but attitudes and beliefs about skin cancer prevention were unrelated to activation. CONCLUSIONS: These results should encourage HMOs and physicians to continue their preventive health outreach as one aspect of multicomponent prevention efforts. The results also suggest that HMOs and physicians can activate patients most at risk for skin cancer by emphasizing both risks of cancer and aging and wrinkling when they deliver a skin cancer preventive message.

Adult↗