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Biomedical subjects

M Thomas

Publications and source records attributed to M Thomas.

At least 667 records · Page 37Linked to original sources

Efficacy of oral poliovirus vaccine in rural communities of North Arcot District, India.

The protective efficacy of three doses of oral poliovirus vaccine (OPV) was measured in children under five in the rural blocks of North Arcot District. In 1988, a sample survey of 7% of the total population of the district (population five million) was conducted to determine the immunization coverage with OPV and the incidence of paralytic poliomyelitis in under-fives in the previous 12 months, (n = 42,045). For every case of poliomyelitis, all children matched for exact age in months resident within the same block were taken as controls. Some 67 children had poliomyelitis (prevalence of lameness 1.59/1000, estimated annual incidence 2.57/1000 under-fives). Among cases and controls 24 and 42%, respectively, had received three doses of OPV, while 44 and 33% had received none. In a case-control analysis, the vaccine efficacy (VE) was 62% for all under-fives; for the 12-23 months age group it was 71.4%. For a vaccine with the potential of near 100% VE, this is disappointingly low. Obviously, not only the immunization coverage level, but also the VE should be enhanced if poliomyelitis is to be controlled in India. This may be achieved by a five-dose OPV schedule, annual OPV immunization campaigns in addition to the routine three-dose schedule or by using inactivated poliovirus vaccine of enhanced potency.

Case-Control Studies↗

A comparative study of Canadian nonclinical and British pain clinic subjects.

Forty-six pain clinic patients (British) were compared with 143 nonclinical subjects (Canadian) on a variety of demographic and illness variables. A subset of 43 nonclinical subjects was further compared with the 46 pain clinic patients for depression and illness behaviour. Both groups were well matched for age, sex, and marital status. The nonclinical group was better educated and had higher incomes. The nonclinical group was significantly more socially active. Low back pain, joint pain, and head and chest pain were commonly reported by both groups. Nearly 75% of subjects in both groups were aware of the diagnosis for their pain condition. On Beck Depression Inventory both groups scored in the nondepressed range. On the Illness Behaviour Questionnaire the pain clinic group scored significantly higher on disease conviction, somatization, and denial than did the nonclinical sample.

Age Factors↗

Pancerebellar syndrome in hyperpyrexia.

Two cases of pancerebellar syndrome following hyperpyrexia are described and the relevant literature reviewed. Cranial computed tomography demonstrated morphologic evidence of cerebellar degeneration while the patients were showing satisfactory clinical progress.

Adult↗

Long-term double masked trial of early treatment with L-dopa plus bromocriptine versus L-dopa alone in Parkinson's disease. Interim results.

The quality and duration of control in two groups of parkinsonian patients under treatment with an L-dopa-based drug alone or L-dopa-based drug which has been partially substituted with bromocriptine are being compared over a 5-year period using a double-blind placebo-controlled study design. The aim is to establish whether early addition of bromocriptine will minimise late L-dopa complications. Results are presented after 1 year. Of 31 patients randomised, 13 were treated with combined L-dopa/bromocriptine and 14 with L-dopa/placebo. 4 patients were withdrawn for various reasons. In both groups any dose adjustments were aimed at maintaining the pre-entry clinical condition. In the group receiving bromocriptine combination therapy, progressive reduction of L-dopa was possible without deterioration of the patients' condition. In patients receiving L-dopa alone, the dose of L-dopa at 12 months was almost similar to that recorded on entry to the study. The total number of patients reporting adverse events in the L-dopa/bromocriptine combination and L-dopa alone groups were 8 and 7, respectively. At the present interim stage of the study it is not possible to compare the incidence of L-dopa long-term complications in either group.

Bromocriptine↗

Are estrogen assays essential for monitoring gonadotropin stimulant therapy?

Ovarian responses to human menopausal gonadotropin (hMG) are conventionally monitored by urinary estrogen or serum estradiol (E2) concentration. E2 can also be measured in saliva but this is rarely used. With ultrasound (USS) however, follicular development is assessed directly and we have previously shown that USS is superior to urinary estrogens for monitoring. We have now compared salivary and serum E2 with USS during hMG therapy in 48 women over 101 cycles. Salivary and serum E2 correlated significantly with each other and with the number of mature follicles. The manufacturers of hMG state that hCG should be given only when E2 is between 100 and 3000 pmol/l. However, there were no mature follicles in 40% of the cycles where E2 lay within this range. USS is the most accurate method of monitoring responses to hMG and, where this is available, estrogen assay provides no additional useful information.

Estradiol↗

Waldenstrom's macroglobulinaemia.

Waldenstrom's macroglobulinaemia is a rare form of monoclonal plasma cell dyscrasia in which there is excess production of immunoglobulin M. Clinically the patient has features of hyperviscosity syndrome and the effects of bone marrow replacement by lympho-plasmacytoid cells. We report here two such cases seen within a period of two months.

Female↗

Preliminary assessment of a novel thromboxane A2 receptor-blocking drug, GR32191, in healthy subjects.

The effects of GR32191, a novel, specific, thromboxane A2 receptor-blocking drug, on platelet aggregation induced by U-46619 and adenosine diphosphate (ADP) ex vivo, have been examined in healthy male subjects. In two placebo-controlled studies (the first, a single-dose, crossover study, and the second, a group comparative, multiple-dose study), concentration-effect curves for both agonists were constructed in whole blood by counting platelets electronically before and after dosing. Single oral doses of 0.125 and 0.25 mg/kg (four subjects) and 0.5 and 1.0 mg/kg (four subjects) produced dose-related shifts to the right in U-46619 concentration-effect curves. The elimination half-life of GR32191 (up to 8 hours postdrug) was approximately 2 hours. Multiple dosing with GR32191, 17.5 mg (equivalent to 0.25 mg/kg for a 70 kg subject), three times daily (three subjects) or every 12 hours (six subjects), resulted in a cumulative inhibitory effect on U-46619 platelet aggregation in the apparent absence of a build-up of plasma concentrations of GR32191. Primary platelet aggregation induced by ADP was unaffected by GR32191. Multiple dosing had no effect on lancet bleeding time, and no drug-related changes were seen in routine laboratory hematologic and biochemical screens. GR32191 was well tolerated, although a subject with a history of drug-induced rectal bleeding reported the same symptom while taking GR32191.

15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5↗

The lap belt complex: intestinal and lumbar spine injury in children.

The "seatbelt syndrome" describes intestinal and spinal injury caused by lap-style automotive restraints. More than 2,600 children were admitted to Children's National Medical Center with blunt injury in 3 years; 395 were involved in a motor vehicle crash. Ninety-five of the crash occupants (24%) were known to be wearing safety belts. Ten children sustained a "lap belt injury": five with lumbar spine injury, four with combined lumbar spine and intestinal injuries, and one child with intestinal injury. All ten children presented with a characteristic transverse abdominal ecchymosis. The CT scan was unreliable in evaluation of both spinal and intestinal injury. Lateral radiographs were required for definitive diagnosis in eight of nine children with lumbar spinal injury. CT scan was clearly diagnostic in only one of five children with intestinal injury. Children wearing lap belts are at risk of a "lap belt complex." Lateral spine X-rays, peritoneal lavage, and early laparotomy are recommended to establish an accurate diagnosis and to decrease morbidity.

Accidents, Traffic↗

Mutation of the p53 gene in human soft tissue sarcomas: association with abnormalities of the RB1 gene.

Soft tissue sarcomas have been examined for alterations in the p53 gene. In six sarcomas, loss or rearrangement of both alleles of this gene was detected while in a further seven sarcomas, point mutation or absence of transcription of the p53 gene was observed. Abnormalities of the p53 gene were found in several classes of soft tissue sarcoma, including leiomyosarcomas, rhabdomyosarcomas and malignant fibrous histiocytomas. Our studies also show that abnormalities of the RB1 suppressor gene and of the p53 gene frequently occur together. These results are consistent with the idea that the p53 gene is a tumour suppressor gene and indicate that coincident inactivation of more than one tumour suppressor gene may, in some cases, be required for tumour development.

Base Sequence↗

Calcitonin: chronotherapeutic effect on osteopenia in the ovariectomized rat.

This chronotherapeutic study has revealed no clear evidence to support the concept that calcitonin promotes bone formation in intact or OVX'd rats. Rather, the efficacy of CT-impaired bone resorption appeared to be optimal in OVX'd rats treated during the daytime, and least effective during the first half of the environmental dark span. These findings indicate a benefit for calcitonin chronotherapy in this animal model where the cellular kinetics resemble those documented in early development of postmenopausal osteoporosis.

Animals↗

The first attack of acute rheumatic fever in childhood--clinical and laboratory profile.

One hundred consecutive cases of 'first attack' of acute rheumatic fever were studied. There were 52 males and 48 females, constituting 1.12% of total hospital admissions. Nearly 10% of children were below the age of 5 years, stressing the early onset of rheumatic fever in tropics. Only 47% gave a definite history of overcrowding at home. Sore throat was present in 67%, overt arthritis in 66%, carditis in 57%, arthralgia alone in 22% of which 45.45% had carditis. Small joint involvement was noticed in 23% of cases of which 73.91% had carditis. Only 33.33% had congestive cardiac failure. Ten per cent of children had chorea, while subcutaneous nodules were seen in 4% of cases, all of whom had associated carditis. Erythrocyte sedimentation rate (ESR) showed good correlation with clinical profile. Throat cultures were positive for beta hemolytic streptococci only in 12% of cases. Anti-streptolysin 'O' (ASO) titre showed significant titres on 68% of cases, anti-deoxyribonuclease "B" (ADN-B) in 69.32%, antibody to group A carbohydrate (ACHO) in 70.65%. ASO, ADN-B, and ACHO titres together gave 87.5% positivity while estimations in paired sera showed ASO 79.54%, ADN-B 82.27% and ASO, ADN-B together 99.92% significant titres. Study of blood groups showed A group children to be more vulnerable to rheumatic fever (37.5%) and rheumatic carditis (47.37%). Mortality in the present study was nil.

Child↗