Search PubMed⌕ Search

Biomedical subjects

P Davis

Publications and source records attributed to P Davis.

At least 307 records · Page 17Linked to original sources
PubMed1990

Life expectancy free of disability: a composite measure of population health status.

Access to disability data from a nationwide survey of New Zealanders provides the opportunity to estimate Life Expectancy Free of Disability (LEFD) for the non-institutional adult population. This measure of population health status combines mortality and morbidity data into a single index. The analysis is restricted to the 15-64 age range and results on partial life expectancy free of disability are presented for the key sociodemographic groups. The results conform to the international evidence and highlight the potential impact of disability as a component in a composite measure of population health status: although women live longer than men, almost all this apparent advantage in longevity is spent in some state of disablement; Maori are disadvantaged in comparison with non-Maori both in terms of longevity and in the proportion of the life span spent disability-free; and, social class comparisons show a decline in LEFD with declining social class that is steeper than the corresponding mortality gradient. Despite some technical difficulties and the strong requirements of the data, the LEFD measure has many potential applications in public health research and planning. In particular, it has the potential to direct research and policy towards the enhancement of the active years of life rather than just the postponement of mortality.

Adolescent↗
PubMed1990

Rheumatic disorders in Zimbabwe: a prospective analysis of patients attending a rheumatic diseases clinic.

The pattern of rheumatic disease in Africa differs from that in Europe and the United States and these differences may provide clues to its cause or pathogenesis. In a six month prospective analysis of 141 patients (83 female) attending a rheumatic diseases clinic rheumatoid arthritis was the commonest disorder, occurring in 49 patients. Twenty seven of the 49 (55%) were seropositive, 25 (51%) had erosive disease with rheumatoid nodules (13/49, 27%), and extra-articular complications (6/49, 12%), indicating a pattern of disease unlike the early reports from Africa. Systemic lupus erythematosus found in 18/141 (13%), gout in 12 (9%), ankylosing spondylitis in six (4%), and Reiter's syndrome in five (4%), in contrast with their rarity in previous reports from Africa, were not uncommon, whereas tropical polyarthritis was seldom diagnosed. The pattern of rheumatic disease in Harare, a large city, is changing to approximate more closely the pattern seen in developed countries.

Adult↗
PubMed1990

Gold induced marrow suppression: a review of 10 cases.

We have reviewed 10 cases of gold sodium aurothiomalate (GSTM) induced marrow suppression. All had biopsy proven marrow hypoplasia/aplasia. Anemia, neutropenia and thrombocytopenia were observed in 7 of the 10 patients. In 2 patients, hypoplastic marrow was associated with suppression of 2 of the formed elements of the blood, while in one patient, there was isolated neutropenia. Nine of the 10 patients survived. Bone marrow recovery occurred within an average of 5.4 months. A response was seen in 3 with antithymocyte globulin. One patient required an allogeneic bone marrow transplant. A combination of corticosteroids and androgens was associated with recovery in 5. Blood and platelet transfusions and antibiotics were instituted only when clinically indicated. We conclude that the prognosis of GSTM induced marrow suppression is better than previously reported.

Adult↗
PubMed1990

The spondyloarthropathies in Zimbabwe: a clinical and immunogenetic profile.

Spondyloarthropathies are rare in Africa and there is little data regarding HLA association. We prospectively studied 19 patients with spondyloarthropathy, recording clinical details and performing tissue typing (ABC loci). There were 9 patients with ankylosing spondylitis (8 males), all had severe spinal disease but none had ocular or cardiac involvement and HLA-B27 antigen was not found in any of the 7 patients tested; only one patient possessed a B7 crossreacting antigen. The 10 patients with Reiter's syndrome (8 males) had typical clinical features but again the HLA-B27 tissue type was not found. B7-CREG antigen was found in 7 of the 10 patients with Reiter's syndrome.

Adult↗
PubMed1989

Isoflurane for refractory status epilepticus: a clinical series.

General anesthesia has been recommended to control convulsive status epilepticus that is refractory to conventional anticonvulsant therapy. Halothane has been the recommended agent, but without experimental justification. Isoflurane, which has no reported organ toxicity and produces electrographic suppression at clinically useful concentrations in normal humans, should be a better volatile anesthetic for this purpose. The efficacy and safety of isoflurane administered to control convulsive status epilepticus were assessed on 11 occasions in nine patients in seven North American hospitals. Isoflurane, administered for 1-55 h, stopped seizures in all patients and was able to be titrated to produce burst-suppression patterns on electroencephalograms. Blood pressure support with iv fluids and/or pressor infusions was required in all of the patients. Seizures resumed upon discontinuation of isoflurane on eight of 11 occasions. Six of the nine patients died. The three survivors sustained cognitive deficits. In one patient urine fluoride concentrations were elevated, although not to nephrotoxic levels. These cases suggest that isoflurane 1) is an effective, rapidly titratable anticonvulsant; 2) does not reverse underlying causes of the refractory seizures; and 3) usually necessitates hemodynamic support with fluids and/or pressors. Isoflurane may be administered for seizures, but only when iv agents in anesthetic doses are ineffective or produce unacceptable side effects.

Adolescent↗
PubMed1989

Serological profiles in the connective tissue diseases in Zimbabwean patients.

The serological profiles of 104 Zimbabwean patients with clinically diagnosed connective tissue diseases were determined. The prevalence of rheumatoid factor was less than would have been expected in other geographical groups, but the prevalence of antinuclear antibodies was similar. Despite considerable racial, socioeconomic, and genetic differences in our patient group compared with other previously published studies the specificity and sensitivity of antinuclear antibodies, notably to DNA and Sm, correlated well with clinical diagnoses. This study validates the use of these serological tests in the investigation of this group of patients.

Adolescent↗
PubMed1989

Acute arthritis in Zimbabwean patients: possible relationship to human immunodeficiency virus infection.

The clinical features of an acute arthritis in 20 Zimbabwean patients, 17 of whom fulfilled criteria for the diagnosis of complete or incomplete Reiter's syndrome, are described. Fourteen of 19 patients tested were positive for human immunodeficiency virus (HIV) antibodies and most had features of the AIDS related complex. None of 14 patients tested possessed the HLA-B27 tissue antigen commonly associated with Reiter's syndrome. The relationship between HIV infection, immunogenetic factors and the arthropathy we have observed remains to be elucidated.

AIDS-Related Complex↗
PubMed1988

Autoantibodies of primary biliary cirrhosis recognize dihydrolipoamide acetyltransferase and inhibit enzyme function.

Autoantibodies against mitochondria occur in the sera of patients with primary biliary cirrhosis (PBC) with characteristic reactivity to an inner membrane protein of approximately 74 kDa. To precisely define these autoantigens, we recently cloned and sequenced a rat liver cDNA (pRMIT) that encodes for all of the epitopes recognized by Ig to the 74-kDa autoantigen. In the present study we have used this recombinant probe as a tool, in addition to purified enzymes, to demonstrate by immunoblotting that the 74-kDa mitochondrial autoantigen is dihydrolipoamide acetyltransferase (EC 2.3.1.12), the core protein of the pyruvate dehydrogenase complex. Furthermore, and of particular interest, inhibition of pyruvate dehydrogenase enzyme activity was demonstrated after incubation with sera from patients with PBC but not from normal volunteers or patients with chronic active hepatitis. Such inhibition was abrogated by absorption of the PBC sera with an expressing subclone of pRMIT, designated pRMIT-603. Identification of dihydrolipoamide acetyltransferase as the target of autoimmunity in PBC provides a reagent that can be used to determine mechanisms by which this molecule is recognized. It will allow study of whether autoimmune reactivity, at the humoral or T cell level, is the basis for the pathogenesis of PBC. Additionally, such data present evidence of functional inhibition of a critical metabolic enzyme. Dihydrolipoamide acetyltransferase is well-known to mitochondrial biochemistry and, similar to identified autoantigens in other autoimmune diseases, is highly conserved in evolution.

Autoantibodies↗