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Biomedical subjects

P Martin

Publications and source records attributed to P Martin.

At least 595 records · Page 33Linked to original sources

Indicators of active and passive coping in myocardial infarction victims.

This retrospective study attempted to explore life events, personality factors, subjective perceptions, and coping reactions in myocardial infarction (MI) patients. Seventy-seven MI survivors participated in the study. The PERI Life Events Scale, the 16 PF personality inventory, and a questionnaire covering self-ratings of subjective perception and coping reactions were used to assess event-related influences. The following results were obtained: Multiple regression analyses yielded strong relationships between insecurity predicting perceived changeability, challenge, and threat. The number of prior events was a good predictor for problem solving and self-reflection, while self-attribution for the occurrence of the MI predicted self-blame and denial. A structural equation model indicated that anxiety and experience with stressful events were salient predictors for appraisal, whereas experience with prior events best predicted active coping, and socioeconomic status negatively predicted passive coping.

Adaptation, Psychological↗

Mathematical models of wound healing in embryonic and adult epidermis.

Epidermal wound healing occurs by quite different mechanisms in embryos and adults. In the latter case, it has long been known that cells crawl inwards via lamellipodia to close the defect. In the embryonic system, recent evidence suggests that healing may be caused by a quite different mechanism, namely the contraction of a cable of filamentous actin at the wound edge. The authors use mathematical modelling to investigate both systems. A mechanical model for the initial formation of the actin cable in embryonic epidermal wounds is presented, which incorporates the important phenomenon of stress-induced microfilament alignment. Also discussed is a reaction-diffusion model for the healing of adult wounds subject to autoregulation of cell division. In both cases, the results suggest possible biological mechanisms for key aspects of the healing process.

Actins↗

Diarrhea among African children born to human immunodeficiency virus 1-infected mothers: clinical, microbiologic and epidemiologic features.

Diarrhea and weight loss are common features of pediatric and adult human immunodeficiency type 1 (HIV-1) infection, particularly in developing countries. We studied prospectively episodes of diarrhea in 559 children, ages 10 to 15 months, participating in a longitudinal study of perinatal HIV-1 infection in Kinshasa, Zaire. Children with HIV-1 infection had more frequent episodes of diarrhea and were more likely to present with fever or moderate or severe dehydration and to have persistent or fatal diarrhea. Of 9 HIV-1-positive infants with diarrhea, 3 had enteroadherence factor-positive Escherichia coli, compared with 5 of 74 HIV-1-negative children with diarrhea (P = 0.04); no other pathogen was associated with HIV-1 infection. In a logistic regression model diarrhea was significantly associated with HIV-1 infection in the child, moderate or severe malnutrition and symptoms of acquired immunodeficiency syndrome in the mother. Diarrhea among children with perinatal HIV infection in Zaire is more severe than among uninfected children and is associated with malnutrition and advanced disease in the mother.

Cohort Studies↗

A pilot study of low-dose cyclosporin for graft-versus-host prophylaxis in marrow transplantation.

Nineteen patients with leukaemia, preleukaemia, and aplastic anaemia were treated by marrow transplantation from HLA-identical siblings. All were given postgrafting immunosuppression with a combination of methotrexate (days 1, 3, 6 and 11) and cyclosporin (days--1 to 180). In an attempt at reducing cyclosporin-associated toxicity, we explored whether the cyclosporin dose during the first 2 weeks could be decreased by 50% (from 3.0 to 1.5 mg/kg/d intravenously) without adversely affecting the incidence, onset, and severity of acute graft-versus-host disease (GVHD) and overall survival. Results from this pilot study were compared to those of a matched cohort of 38 patients given a standard dose of 3.0 mg cyclosporin/kg/d starting on day--1. The cumulative incidence of grade II and III acute GVHD in the 'low dose' cyclosporin group was 42% compared to 51% in the 'standard dose' group (P = 0.60). Three-year survival was 63% and 54% respectively (P = 0.59). Patients receiving the reduced cyclosporin dose during the first 14 d appeared to have less hepatotoxicity, and the methotrexate and cyclosporin doses administered were closer to the doses intended per protocol. We suggest that 'low dose' cyclosporin from day--1 to day 15 postgrafting might be as effective as 'standard dose' cyclosporin during that time period for the prevention of acute GVHD.

Acute Disease↗

Recurrence of hepatitis B and delta hepatitis after orthotopic liver transplantation.

The clinical course of 10 liver transplant recipients who had hepatitis B virus (HBV) and five recipients with HBV and D (delta) infection before transplantation is described. Six patients who underwent eight transplants died. The estimated one and two year survival rates in patients with HBV only before transplantation were 74% and 67% respectively. The estimated one and two year survival in patients with HBV and HDV infection beforehand was 100%. Graft infection by HBV occurred in 8 of 10 patients infected with HBV only; and in 4 of 5 patients with previous HBV and HDV infection. There was a widely variable time from transplantation to the appearance of HBV markers in liver or serum, ranging from 6-331 days. Hepatitis D antigen (HDAg) appeared in three grafts very rapidly after transplantation at 4, 8, and 37 days respectively. Graft infection by HBV was accompanied by significant liver injury in six allografts in five recipients. In particular, there was a striking morphological appearance in five infected livers in which the hepatocytes became progressively enlarged and distorted as they accumulated huge amounts of hepatitis B surface and core antigens (HBsAg, HBcAg). These features were accompanied by pericellular fibrosis and cholestasis but little associated inflammation. This syndrome carried a poor prognosis. A gradual progression to cirrhosis occurred in one additional liver. Finally, recurrent HBV infection was a principal or a contributing factor in all deaths. The presence of HBcAg and inflammation in he native liver increased the risk of HBV induced tissue damaged in the graft whereas HDV infection in the host liver seemed to reduce the risk of significant HBV induced tissue damage in the allograft. These data suggest that post transplant HBV infection is accompanied by a variety of changes in the liver allograft, some of which are unique to the transplanted liver and may result in impaired allograft function.

Adolescent↗

Glomerular and tubular proteinuria in type 1 (insulin-dependent) diabetic patients with and without retinopathy.

We compared the urinary excretion of albumin, transferrin, N-acetyl-beta-D-glucosaminidase and alpha-1-microglobulin in 78 Type 1 (insulin-dependent) diabetic patients: 39 with retinopathy and 39 without. The two groups were matched for age, sex and duration of diabetes. The patients with retinopathy had increased excretion (median and range) of albumin [1.7(0.3-399.1) versus 1.0(0.3-116.6) mg/mmol creatinine, P less than 0.05], transferrin [114.2 (4.1-37126.2) versus 33.4 (1.0-4176.7) micrograms/mmol creatinine, P less than 0.01] and N-acetyl-beta-D-glucosaminidase [23.8 (1.1-119.1) versus 15.0 (0.1-65.1) mumol/h/mmol creatinine, P less than 0.05] but not alpha-1-microglobulin. Transferrin excretion correlated with albumin excretion. The prevalence of increased transferrin excretion (transferrinuria) was greater than that of microalbuminuria in patients both with and without retinopathy (P less than 0.01 in both cases). Urinary transferrin seems likely to be predominantly of glomerular origin and merits prospective longitudinal evaluation as a potential index of the microangiopathic process.

Acetylglucosaminidase↗

Effects of pimobendan (UDCG 115) on renal function in healthy volunteers.

A phase I, double-blind, single-dose, randomized, two-period crossover study was conducted to investigate the effects of pimobendan on renal function to assess whether renal events were a contra-indication to its administration. Results in eight healthy volunteers indicated no significant adverse events on renal plasma flow, glomerular filtration rate, or laboratory safety screens; side-effects were also found to be minimal. Further studies are indicated to assess whether, in the proposed treatment group, i.e. patients with heart failure (in whom compromised renal function is common), pimobendan similarly elicits no serious adverse renal effects.

Adult↗

Personality, life events and coping in the oldest-old.

This paper compares older adults in their sixties, eighties, and 100s on personality, experience of life events, and coping. A secondary goal was to test a structural model of adaptation. Participants (165) filled out a personality inventory, life-event lists, and coping and mental health measures. Results revealed differences in personality: centenarians scored higher on dominance, suspiciousness, and imagination. While centenarians scored lower on active behavioral coping than other age groups, they used cognitive strategies when coping with health and family events. Results from the structural equation model indicated that extraversion and anxiety predicted morale and mental health.

Adaptation, Psychological↗

Nutritional patterns of centenarians.

This study compares the dietary patterns of centenarians (n = 24) with elderly adults in their sixties (n = 54) and eighties (n = 47). Compared to the younger cohorts, centenarians consumed breakfast more regularly, avoided weight loss diets and large fluctuations in body weight, consumed slightly more vegetables, and relied on their doctor and family more than on the news media for nutrition information. On the other hand, centenarians were less likely to consume diets low in fat and to comply with nutritional guidelines designed to reduce the risk of chronic disease. Elderly black men consumed diets higher in sweets and fat compared to black women and white men and women. Nearly three times as many blacks expressed the desire to eat more nutritiously. High nutrition risks, particularly in blacks, were associated with lower physical and mental health and impaired activities of daily living.

Activities of Daily Living↗

Religiosity and adaptation in the oldest-old.

Previous research has yielded mixed results with respect to the relationship between religiosity and adaptation in older adults. Most studies show that religiosity is stable over the life span, but that religiosity may or may not be related to such factors as physical and mental health, life satisfaction, and coping. This study adds to earlier investigations by including centenarians among the sample. The preliminary results of this research project support earlier findings that religiosity does not change significantly as one ages, although there is a trend in the results that suggests otherwise. The results also indicate a significant relationship between religiosity and physical health but no significant relationship between religiosity and mental health and life satisfaction. Religiosity and coping are strongly related, and there is the suggestion that religious coping mechanisms might be more important in the oldest-old.

Adaptation, Psychological↗

The influences of cognitive resources on adaptation and old age.

In the Georgia Centenarian Study, cognitive resources were estimated by fluid and crystallized intelligence, acquisition and retrieval of new information, retrieval of familiar information, and problem-solving ability in community-dwelling and nondemented adults ranging from sixty to one hundred plus years of age. Five clusters of results were found: 1) cognitive performances were lower for the older cohorts; 2) when cognitive activities were dependent on everyday experiences, no age-related problem-solving decline was found; 3) physical health and mental health can significantly influence cognitive performances; 4) cognitive and personality factors can combine to account for a larger amount of adaptation variance than can be accounted for by either of the factors alone; and 5) individuals with a high level of intelligence and affect sustain their instrumental activities of daily living. Cognitive resources were an important contributor to successful adaptation for the oldest-old.

Activities of Daily Living↗

Circadian variation of the phagocytic activity of polymorphonuclear leukocytes and of various other parameters in 13 healthy male adults.

Twenty-four different laboratory parameters including the phagocytic activity (phagocytic index) of polymorphonuclear leukocytes (PMNs) and various hematologic variables were investigated in 13 young healthy men during Spring 1988 in Munich, Germany. Venous blood of these volunteers was obtained under standardized conditions at 4-h intervals over a 24-h span. All parameters were analyzed by the single cosinor method and by a Kruskal-Wallis analysis of variance (ANOVA). Statistically significant circadian rhythms were found for the number of circulating lymphocytes and leukocytes (WBCs), potassium, systolic blood pressure, phagocytic index, Quick test, heart rate, and rectal body temperature (p less than 0.05; single cosinor). For all of these parameters except WBCs, rectal body temperature, and Quick test, a temporal variation was confirmed by the ANOVA (p less than 0.05; phagocytic index: p = 0.05). The circadian acrophases of WBC, number of circulating lymphocytes, and phagocytic index were all found at about 01:00 h. This temporal coincidence of the acrophases of the phagocytic index and the number of circulating lymphocytes may reflect the modulation of phagocytosis by T lymphocytes that release cytokines known to stimulate the phagocytic activity of PMNs.

Adult↗

[Resurgence of yaws in Central African Republic. Role of the Pygmy population as a reservoir of the virus].

The authors present the results of a clinical (framboesia) and serological (TPHA and VDRL) investigation aimed at defining the reservoir of virus of yaws in the Lobaye area (southwest of CAR) out of which the disease spreads in spite of previous mass treatment campaigns. The Lobaye focus is still active because we found among the pediatric population under the age of 15 years, 5.6% contagious skin lesion and 19.6% VDRL+. In this area with contact between nomadic Pygmies and sedentary ethnic groups, the observed level of clinical and serological attacks suggested that the pygmie population, as previously described, makes up the principal focus of yaws. For every 1 case found through clinical examination, 3.5 cases VDRL+ and 4.8 cases TPHA+ are found through serological examination. This proportion indicates that clinical screening alone is not sufficient to evaluate the endemic yaws level in a population.

Adolescent↗

[Comparison of polyurethane and polyethylene for central venous catheter in intensive care units].

Polyurethane (PU) and polyethylene (PE) central venous catheters were compared for their respective responsabilities in catheter related sepsis (CRS). From may 1988 to may 1989, 300 central venous catheters were inserted. Insertion sites were freely chosen by physicians. The polymer type was randomized. Catheters were removed after 10 days in place. Microbial loads were assessed on insertion sites, catheter hubs and tips, and blood drawn through the catheters lumen. One hundred eighty three catheters were available for complete evaluation (101 PE, 82 PE). Eleven were responsible for CRS, 4 were colonized (BB3 according to Brun-Buisson's classification), 19 were contaminated (BB2), and 149 were sterile (BB1). When comparing the "infected" group (CRS+BB3) and the "noninfected" (BB2 + BB1), no difference appeared between the tested polymers. CRS were significantly associated with insertion into the internal jugular vein. It seems useless to exclude from clinical practice any of the biomaterials tested.

Biocompatible Materials↗