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Biomedical subjects

P Miles

Publications and source records attributed to P Miles.

30 records · Page 2Linked to original sources
PubMed1989

Opportunistic Strongyloides stercoralis infection in lymphoma patients. Report of a case and review of the literature.

Strongyloides stercoralis is an intestinal parasite that may cause fatal opportunistic infections in immunocompromised patients. Herein is reported a patient who developed fatal disseminated strongyloidiasis 6 weeks after the initiation of chemotherapy for a large cell lymphoma of the small intestine. After reviewing the clinical and epidemiologic features of 16 other cases of disseminated strongyloidiasis in patients with malignant lymphomas, the currently available laboratory methods for the diagnosis of this parasite are outlined. Because uncomplicated infections are treatable, candidates for chemotherapy or immunosuppression with a relevant geographic history should be screened for S. stercoralis prior to the initiation of the treatment.

Antibodies↗
PubMed1989

Barriers to influenza vaccine acceptance. A survey of physicians and nurses.

The Immunization Practices Advisory Committee (ACIP) recommends that health care providers who contact high-risk patients receive influenza immunization annually. There are few available data on hospital employees' acceptance of these recommendations or their attitudes about influenza immunization. In a hospital where no formal influenza immunization program was in place, a survey of 193 nursing personnel and physicians showed that only 2.1% received the 1986-1987 trivalent influenza vaccine and 3.2% the monovalent A/Taiwan/1/86 vaccine before the 1986-1987 influenza season. An influenza-like illness developed in a total of 35.3% of hospital employees during the influenza season, and 76.6% of them cared for patients while ill. Fear of adverse reactions, avoidance of medications, and the inconvenience of vaccine administration were frequently cited reasons for declining immunization. Hospital employees would be more inclined to receive future influenza immunization if vaccine administration were more accessible and if they were informed that immunization were a national health care policy. During the influenza season, nurses and physicians should be considered a uniformly susceptible reservoir of infection capable of transmitting influenza to patients. Moreover, ACIP guidelines alone probably will not lead to acceptable immunization rates among health care providers; organized institutional efforts to promote immunization of health care providers may be required.

Attitude of Health Personnel↗
PubMed1988

Regulation of glucose turnover during exercise in pancreatectomized, totally insulin-deficient dogs. Effects of beta-adrenergic blockade.

To examine whether glucose metabolic clearance increases and whether catecholamines influence glucose turnover during exercise in total insulin deficiency, 24-h fasted and insulin-deprived pancreatectomized dogs were studied before and during exercise (60 min; 100 m/min; 10% slope) with (n = 8) and without (n = 8) propranolol infusion (PI, 5 micrograms/kg-min). Exercise with or without PI was accompanied by four and fivefold increments in norepinephrine and epinephrine respectively, while glucagon (extrapancreatic) fell slightly. Basal plasma glucose and FFA concentrations and rates of tracer-determined (3[3H]glucose) hepatic glucose production (Ra) and total glucose clearance (including urinary glucose loss) were 459 +/- 24 mg/dl, 1.7 +/- 0.5 mmol/liter, 7.8 +/- 0.9 mg/kg-min and 1.6 +/- 0.1 ml/kg-min, respectively. When corrected for urinary glucose excretion, basal glucose metabolic clearance rate (MCR) was 0.7 +/- 0.1 mg/kg-min and rose twofold (P less than 0.0001) during exercise. Despite lower lactate (3.3 +/- 0.6 vs. 6.6 +/- 1.3 mmol/liter; P less than 0.005) and FFA levels (1.1 +/- 0.2 vs. 2.2 +/- 0.2 mmol/liter; P less than 0.0001) with PI, PI failed to influence MCR during exercise. Ra rose by 3.7 +/- 1.7 mg/kg-min during exercise (P less than 0.02) while with PI the increase was only 1.9 +/- 0.7 mg/kg-min (P less than 0.002). Glucose levels remained unchanged during exercise alone but fell slightly with PI (P less than 0.0001). Therefore, in total insulin deficiency, MCR increases marginally with exercise (13% of normal); the beta adrenergic effects of catecholamines that stimulate both FFA mobilization and muscle glycogenolysis do not regulate muscle glucose uptake. The exercise-induced rise in hepatic glucose production does not require an increase in glucagon levels, but is mediated partially by catecholamines. Present and previous data in normal and alloxan-diabetic dogs, suggest that (a) in total insulin deficiency, control of hepatic glucose production during exercise is shifted from glucagon to catecholamines and that this may involve catecholamine-induced mobilization of peripheral substrates for gluconeogenesis and/or hepatic insensitivity to glucagon, and (b) insulin is not essential for a small exercise-induced increase in muscle glucose uptake, but normal insulin levels are required for the full response. Furthermore, the catecholamines appear to regulate muscle glucose uptake during exercise only when sufficient insulin is available to prevent markedly elevated FFA levels. We speculate that the main role of insulin is not to regulate glucose uptake by the contracting muscle directly, but to restrain lipolysis and thereby also FFA oxidation in the muscle.

3-Hydroxybutyric Acid↗
PubMed1978

Determination of iodide in nutritional beverage products using an ion selective electrode.

An ion selective electrode procedure is described for the precise, accurate determination of iodide at the sub-ppm level in a variety of nutritional beverages. The relative standard deviation of the analysis is 1--4%; recoveries range from 90 to 120%. Comparison with results from neutron activation analysis and the traditional Sandell-Kolthoff procedure shows that the ion selective electrode procedure is free of determine error and that dry ashing of samples can lead to low results.

Beverages↗
PubMedDate not supplied

Do hospital employees benefit from the influenza vaccine? A placebo-controlled clinical trial.

Although current guidelines target hospital employees who contact high-risk patients as a high priority for influenza immunization, there are few data to support or refute this recommendation. Therefore, the authors enrolled 179 hospital employees in a randomized double-blind placebo-controlled clinical trial during the 1985-1986 influenza season. Influenza immunization was performed without serious adverse reactions and there was no increase in absenteeism attributable to the vaccination. Among those who developed clinical influenza, there was a trend toward fewer days of illness in the vaccinated group compared with the placebo group (6.0 vs. 8.0, p = 0.07). There were no statistically significant differences between subjects receiving influenza vaccine and those receiving the placebo when comparing incidences of influenza-like illness, severities of illness, and sick absenteeism. Influenza immunization of hospital employees was performed at minimal cost and risk but provided little benefit, most likely because of an unexpected drift of the prevalent influenza strain away from the vaccine type.

Absenteeism↗
PubMedDate not supplied

A national minority transplant program for increasing donation rates.

Since 1982, our group efforts demonstrated statistically significant improvements in minority donation rates which have applicability to all minority populations. As we continue to reach out to the various ethnic communities, we must listen to the needs of the community understanding that all ethnic communities have various beliefs and cultural barriers that will need to be addressed. For instance, the African-American population revealed the previously mentioned five obstacles to donation. The Hispanic population has revealed relatively the same fears to donation as the African-American population. In addition, the tribes within the Native-American population each have their own belief systems which will have to be addressed appropriately. The fears and obstacles toward donation within the Asians and Pacific Islanders and the Alaska Native groups are being defined. However, initial research reveals that all of the minority groups have very similar, if not the same, fears that were identified with the initial focus group in 1978. This simple methodology that has been established can ultimately help achieve the overall desired goal--an increase in minority donation rates.

Black or African American↗
PubMedDate not supplied

Failure of gonadotropin releasing hormone therapy in patients with metastatic ovarian sex cord stromal tumors.

Ovarian sex cord stromal tumors are usually indolent neoplasms that are generally confined to one or both ovaries at the time of diagnosis. The overall prognosis for these women is good though advanced or recurrent tumors occasionally occur. In such instances, if the tumor is localized, surgical or radiation therapy often provides good results; however, diffuse intra-abdominal disease is uncommon and difficult to treat effectively. Recently, synthetic gonadotropin releasing hormone (GnRH) analogue therapy has been advocated as an effective therapy with low toxicity. We report on 2 women whose advanced recurrent ovarian cord stromal tumors failed to respond to repetitive surgical, chemotherapeutic, and GnRH therapies. In these 2 cases, GnRH therapy was not successful in controlling diffuse spread of two separate gonadal stromal tumors. Systemic toxicity was minimal.

Aged↗