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Biomedical subjects

P Courtright

Publications and source records attributed to P Courtright.

84 records · Page 5Linked to original sources
PubMed1989

Use of a Chlamydia trachomatis DNA probe for detection of ocular chlamydiae.

We examined the efficacy of a Chlamydia trachomatis DNA probe in detecting ocular chlamydiae by comparing it with tissue culture isolation, direct fluorescent-antibody cytology, and clinical eye exams. In a trachoma-endemic area of Nepal, 430 Nepalese villagers were examined according to the World Health Organization trachoma grading scale. Upper tarsal conjunctival specimens from each subject were obtained for DNA probing, tissue culture, and fluorescent-antibody screening. Moderate to severe intensity of inflammation was found in 85 (21%) of 430 people studied. An additional 25 (7.2%) of 345 people with low or no intensity of inflammation also had microbiologically proven infection, which may reflect asymptomatic carriage. Compared with culture, the DNA probe had a sensitivity of 86.9% and a specificity of 91%. For direct fluorescent antibody versus culture, the values were 47.8 and 96.9%, respectively. Results from this study indicate that the DNA probe for C. trachomatis might be considered a valuable epidemiologic tool in screening trachoma-endemic populations for ocular chlamydiae.

Adolescent↗
PubMed1989

Ocular autonomic dysfunction and intraocular pressure in leprosy.

We examined 241 leprosy patients and 135 age-matched healthy controls in central South Korea, measuring intraocular pressure in the supine and the upright positions and measuring the size of the pupils in darkness as an indication of ocular autonomic dysfunction. The mean intraocular pressure was significantly lower in the patients and the mean size of pupils was significantly smaller in the patients than in the controls. However, there was no correlation between pupil size and intraocular pressure in our patients. Our findings show that leprosy patients have ocular autonomic dysfunction, but do not support previous speculation that this dysfunction is the primary cause for low intraocular pressure in leprosy.

Adult↗
PubMed1989

Trachoma and blindness in the Nile Delta: current patterns and projections for the future in the rural Egyptian population.

A population based survey of trachoma and blindness was conducted in a rural Nile Delta hamlet. Trachoma remains hyperendemic in this region. Active trachoma was common among preschool children; over half had moderate to severe disease. Of residents 25 years old 90% had substantial conjunctival scarring. Severe conjunctival scarring was commoner among women (84%) than men (58%), and three-quarters of older women had trichiasis/entropion compared with 57% of older men. Males and females had equivalent age specific rates of inflammatory disease. Blindness was associated with old age; 17% of residents aged 50 and over were blind. Estimates of blindness based on this survey and other surveys in Egypt indicate that blindness is still a serious public health problem in rural Egypt. The number of blind persons in Egypt will increase from an estimated 420,000 in 1980 to 868,000 by the year 2020. The current crude blindness rate of 1.8% is expected to increase to 2.3% in the year 2000 and to 3.2% in 2020.

Adolescent↗
PubMed1988

Nonculture methods for diagnosing chlamydial infection in patients with trachoma: a clue to the pathogenesis of the disease?

We studied five different tests for diagnosing conjunctival Chlamydia trachomatis infection in specimens obtained from 100 children with moderate-to-severe trachoma. The tests were Giemsa stain, isolation in cell culture, direct fluorescein-conjugated monoclonal antibody, enzyme immunoassay, and a DNA probe. The Giemsa stain was least sensitive at 29%. The other tests gave essentially equivalent performances: sensitivity ranged from 73% to 84% and specificity from 93% to 100%. Seven of the 45 positive specimens were only positive in cell culture, whereas 11 of the 45 were negative in culture but positive in at least two nonculture tests. We speculate that these discordant results actually reflect the biologic status of the chlamydial infection. There appears to be a stage in the infection where chlamydial antigens and nucleic acids can be detected in the absence of infectivity. This stage of infection may contribute to the pathogenesis of trachoma by providing a source of sensitizing antigen.

Azure Stains↗
PubMedDate not supplied

Hydatid disease in the Hamar of Ethiopia: a public health problem for women.

A population-based study of hydatid disease was conducted among the Hamar of Ethiopia. Seven of 990 patients examined with a portable ultrasound scanner proved to have cysts (0.7% prevalence). Cysts were most common (4.7%) among women > or = 40 years of age. Only one male presented with a cyst. These results indicate a sex-specific hydatid public health problem in this tribe.

Adolescent↗
PubMedDate not supplied

A new focus of onchocerciasis in Mwanza District, Malawi.

Anecdotal information suggested that a new focus of onchocerciasis had recently developed in Mwanza in Malawi, a district not contiguous with Thyolo, the only district in Malawi with recognized autochthonous transmission. We carried out a survey of the northern half of Mwanza district, randomly selecting 62 villages for assessment. Two iliac crest skin snips were taken from 2215 residents over the age of 15 years; one-quarter had Onchocerca volvulus microfilariae. Prevalence increased with age and was higher overall among men than women. The age-adjusted prevalence among migrants from Thyolo was 31%. Among residents who had never been outside Mwanza, the gender-specific prevalences and microfilarial loads were similar. The intensity of infection was low. Autochthonous transmission of O. volvulus has thus been demonstrated in Mwanza and illustrates the possibility of the spread of the disease to new foci in Malawi and the surrounding countries, due to significant population shifts.

Adolescent↗
PubMedDate not supplied

Retinal findings predictive of outcome in cerebral malaria.

The pathogenesis of cerebral malaria is poorly understood. Direct and indirect ophthalmoscope examinations of 141 Malawian children with strictly defined cerebral malaria revealed 2 distinct and prognostically significant findings: papilloedema and extramacular retinal oedema. The relative risk of death in patients with papilloedema was 6.7 times that in patients without papilloedema. Extramacular retinal oedema was associated with a 2.9 fold increase in the relative risk of dying. The mortality rate in patients with neither of these signs was only 1.3% compared to an overall mortality rate of 9.2%. The clinical and laboratory features associated with each of these ophthalmological findings were different, suggesting that there may be at least 2 different pathogenetic processes in patients with cerebral malaria.

Blood Glucose↗
PubMedDate not supplied

Creation of priority criteria for corneal transplantation and analysis of factors associated with surgery following implementation.

PURPOSE: We sought to test the effectiveness and application of a system for prioritizing corneal disease patients for corneal transplantation. METHODS: All patients wait-listed for corneal transplantation in British Columbia in April 1995 were followed for 10 months to determine whether they received surgery and to assess the application of recently introduced priority criteria. RESULTS: The factors that determined whether a patient had surgery were as follows: having vision in one eye only, being female, having progressive disease, and experiencing pain. The surgeon involved was also a factor. Overall, the priority system did not adequately predict who had surgery and who did not have surgery. CONCLUSIONS: The priority system needs to be re-structured to reduce the contribution of months waited and to more adequately take into account patient need. Furthermore, its application by individual surgeons needs to be strengthened.

Canada↗