Hyperosmolar dehydration in infancy due to faulty feeding.
Explore the source record for details and available documents.
Dehydration↗
Biomedical subjects
R B Jones
Publications and source records attributed to R B Jones.
Galactic and Extragalactic Studies: X. Note on Latitude Effect and Radial Gradients in the Northern Galactic Hemisphere.
Explore the source record for details and available documents.
Journal Article↗
Galactic and Extragalactic Studies: IX. A Photometric Survey of 22,000 Galaxies in the Zone from delta = +41 degrees to delta = +46 degrees.
Explore the source record for details and available documents.
Journal Article↗
Determination of body composition in conscious adult female Wistar utilising total body electrical conductivity.
Total body electrical conductivity (TOBEC) is a noninvasive method for estimating fat free mass (FFM) in live animals. In this study, we have evaluated the use of the Em-Scan SA-3000, which is claimed by the manufacturers to perform better than earlier analysers. Previous studies in rats using these earlier versions of the TOBEC analyser have always used anaesthesia to minimise movement artefacts. As repeated anaesthesia also has the potential to induce artefacts by disrupting food intake, for example, we have also attempted to determine if this TOBEC analyser can be used to predict body composition in conscious adult weight-stable female Wistar rats. A simplified cafeteria diet was used to produce large variations in body composition (40-350 g fat/carcass) and a full chemical body composition analysis was performed to generate a TOBEC calibration equation. The TOBEC parameter was more strongly correlated to FFM (r(2)=.785) than it was to body weight (r(2)=.669) or other body composition parameters. Using the TOBEC calibration equation to predict fat mass on these data, there was an excellent correlation with the value obtained by chemical analyses (r(2)=.952, slope=0.958). To determine if the TOBEC calibration equation derived from this calibration study would then be useful for the routine estimation of body composition an additional, validation study was performed. This validation study was performed 6 months later, used an independent group of obese female Wistar rats and was undertaken by different TOBEC operators. This validation study, again, showed a good correlation between the TOBEC- and chemical-derived fat mass (r(2)=.918, slope=1.003) indicating stability of the calibration equation with time and independence from operator. We therefore conclude that it is possible to meaningfully estimate body fat changes in conscious rats using this TOBEC analysis system.
Adipose Tissue↗
Peripheral blood stem cell transplantation in breast cancer.
Over the past decade, peripheral blood progenitor cells (PBPCs) have replaced bone marrow as the major source of haematopoietic support. This transition from marrow to PBPCs is due to the fact that, for many clinical studies, a significantly faster rate of engraftment, particularly for platelets, has been demonstrated for patients who receive PBPC support when compared to similarly treated patients who are transplanted with bone marrow. The leukapheresis procedure itself, quality of PBPC graft, methods of PBPC mobilization, purging, and ex vivo expansion will be discussed in detail.
Breast Neoplasms↗
In vitro activity of rifamycins alone and in combination with other antibiotics against Chlamydia trachomatis.
Rifamycins are highly active against Chlamydia trachomatis, but the possible development of resistance has been of concern. The ability of rifampin, rifamide, and DL473 to induce resistance in chlamydiae and the effect of combinations of antibiotics on chlamydiae were evaluated in tissue culture. When chlamydiae were exposed to stepwise increases in the concentration of rifampin or rifamide, resistance rapidly emerged. Stepwise resistance did not emerge after exposure to DL473, although organisms resistant to one rifamycin were resistant to all three. Single-step emergence of resistance to rifampin or DL473 was also demonstrated. However, these resistant organisms were difficult to maintain in tissue culture. Combinations of ampicillin, erythromycin, or a tetracycline with rifampin or DL473 were neither synergistic nor antagonistic against chlamydiae. However, subinhibitory amounts of erythromycin or oxytetracycline prevented the emergence of resistance to rifampin. Such combinations may prove useful in therapy for chlamydial infections.
Chlamydia trachomatis↗
Cefoxitin in the treatment of gonorrhea.
Cefoxitin is active in vitro against beta-lactamase-producing strains of Neisseria gonorrhoeae; therefore, its efficacy in the treatment of uncomplicated genital gonorrhea was evaluated in a study of ten men and 15 women. Cefoxitin was administered in two intramuscular doses given 5 hr apart, patients alternately receiving either 1 g or 2 g of cefoxitin in each injection. Probenecid (1 g) was administered orally with both injections to five women, and with the first injection only in the remaining patients. All cases of gonococcal cervicitis or urethritis were cured, and all rectal carriage was eliminated. Four of seven patients had persistent oropharyngeal carriage after treatment. There was no discernible difference between the efficacies of the 1-g and 2-g regimens. It was concluded that the cefoxitin regimens used are effective for therapy of uncomplicated genital or anorectal gonorrhea, but not for eradication of oropharyngeal carriage of N. gonorrhoeae.
Adolescent↗
Moxalactam treatment of uncomplicated gonorrhea in women.
The efficacy of a 1-g dose of moxalactam was evaluated in the treatment of uncomplicated gonorrhea in women. Of 100 infected women, 96 had negative cultures after treatment. Two of the four who were not cured may have been reinfected, while therapy appeared to have failed in the other two. The MICs of moxalactam and penicillin were less than 1 microgram/ml for 100% and less than 0.06 micrograms/ml for 90% of the 115 pre- and post-treatment isolates tested. Moxalactam appears to be safe and effective in the treatment of uncomplicated gonorrhea in women. All of four white women and one of seven black women with pharyngeal gonorrhea gave a history of fellatio. Among those without pharyngeal gonorrhea, 20 of 35 white women and 15 of 111 black women gave such a history. Thus, a history of fellatio may not adequately predict which patients are at risk of pharyngeal gonorrhea, especially for black women.
Adolescent↗
Effect of prior sexually transmitted disease on the isolation of Chlamydia trachomatis.
In developed nations, Chlamydia trachomatis is the most common sexually transmitted pathogen. To determine whether prior disease affects the probability of subsequent chlamydial infection, we took culture specimens from 2,546 men and 1,998 women attending a sexually transmitted diseases clinic. The men had nongonococcal urethritis and the women were contacts of men who had a positive chlamydial culture or nongonococcal urethritis. Significantly lower isolation rates for those with a history of sexually transmitted diseases were found for both men (29% vs. 38%; P less than 0.0001) and women (27% vs. 36%; P less than 0.0001). In addition, both men and women with previously documented chlamydial infections had a lower isolation rate at the index visit, if the previous infection occurred less than, as opposed to more than, six months earlier (men: 20% vs. 41%; P = 0.0006; women: 14% vs. 35%; P = 0.003). These relationships were found to be independent of age. However, the effect of partial immunity due to prior infection could not be distinguished from that of prior antibiotic therapy, and if such immunity does confer protection against reinfection, that protection appears to be both partial and of relatively short duration.
Chlamydia Infections↗
Efficiency and cost-effectiveness of field follow-up for patients with Chlamydia trachomatis infection in a sexually transmitted diseases clinic.
Unlike contact-tracing procedures for syphilis and gonorrhea, field follow-up to locate and treat patients with Chlamydia trachomatis infections has not been extensively applied in the United States. We implemented two studies to assess the efficiency and cost-effectiveness of using field follow-up for contact of two groups: patients with chlamydial infection detected as part of a screening program and women who were sexual partners of men with nongonococcal urethritis (NGU). Of the 142 patients with chlamydial infection who had not been treated empirically, 112 (79%) returned for treatment when a reminder system was used, as compared with a return rate of 97% (259/266) achieved by field follow-up (P less than 0.0001). Among the 678 men with NGU enrolled in a randomized trial of field follow-up vs. two self-referral methods, field follow-up yielded over three times as many partners returning to the clinic for treatment as did either of the other two methods (P less than 0.001). Analyses using the estimated costs of the intervention strategies and the medical costs associated with an untreated chlamydial infection showed that field follow-up by trained investigators proved to be not only the most efficient method for locating patients with chlamydial infection and/or patients who were at risk for it, but also the most cost-effective in terms of total health-care dollars spent.
Chlamydia Infections↗
Proportional payment for pelvic inflammatory disease: who should pay for chlamydial screening?
The occurrence of acute pelvic inflammatory disease (PID) caused by Chlamydia trachomatis could be reduced if chlamydial screening were more widely instituted, but financial support for such programs remains limited. Logically, the agencies that could most cost-effectively fund screening programs are those that benefit most from reduction in costs incurred by PID. Therefore, the authors retrospectively analyzed charges for 630 women with acute PID presenting to a county hospital over a 2-year period. Sixteen per cent of patients required hospitalization. Of the total charges, 54% were not paid by any agency, 18% were paid by the county, and 22% by the state. A computer model was developed for analysis of screening programs in high-risk women (prevalence, 17%). The savings in charges for acute cases of PID alone did not make it cost-effective for any single agency to fund chlamydial screening. However, the model showed that it would be cost-effective for the county and the state jointly to fund a screening program using a direct antigen test costing under $7 per test.
Chlamydia Infections↗
Diagnosis of mucopurulent cervicitis among women at risk for Chlamydia trachomatis infection.
The present study was undertaken to evaluate the utility of a gram stain of endocervical secretions in the prediction of endocervical infection with Chlamydia trachomatis. Endocervical examinations, Gram stains and chlamydial cultures were performed on 214 women who were attending a sexually transmitted diseases clinic and were at increased risk for chlamydial infection. Almost 24% of the Gram stains were judged inadequate because of the presence of ectocervical material. However, significantly higher isolation rates for C. trachomatis were found for those women with valid smears and 10 or more polymorphonuclear cells on their smear (44% vs 19%, P = .0008). This relationship was independent of the presence of gonococcal infection. Based on the results of this study, endocervical Gram stains appear to be a valuable screening tool for chlamydial infection, particularly among those without mucopurulent discharge.
Adolescent↗
A randomized trial to compare 7- and 21-day tetracycline regimens in the prevention of recurrence of infection with Chlamydia trachomatis.
Standard therapy for Chlamydia trachomatis in the United States consists of a 7-day course of tetracycline administration. Recurrent infections are frequent, however, in circumstances in which reinfection seems unlikely, suggesting that the standard regimen may be insufficient to cure the infection. It may reduce the number of organisms, however, below a detectable level at a test-of-cure visit. To evaluate recurrent infection, the authors studied patients with chlamydia who were treated with standard therapy, and they found a recurrence rate of 29% among 2,983 patients who returned to the clinic during a 2-year follow-up period. Recurrent infection was associated with younger age but was not related to either race or gender. To test the hypothesis that a longer treatment course might be more effective in preventing recurrent infection, the authors conducted a randomized trial that compared 7- and 21-day regimens of tetracycline administration. Of the 918 subjects enrolled in the trial, 220 were infected with C. trachomatis. The overall recurrence rate among patients who were infected and returned was 18.4% (9/49) in the 21-day group and 13.8% (8/58) in the 7-day group (P = .60). Similar results were obtained using survival analysis methods. Given the number of subjects who returned, this study had approximately a 65% statistical power to detect a reduction in recurrence rate, from 20% to 5%. Because of the similarity of the results in the two groups, it was concluded that 21 days of tetracycline administration is no more effective in preventing recurrence than 7 days of administration.
Adult↗
Multicenter, comparative study of cefotaxime and ceftriaxone for treatment of uncomplicated gonorrhea.
BACKGROUND AND OBJECTIVES: Cefotaxime is a third-generation cephalosporin that has in vitro activity against Neisseria gonorrhoeae, including beta-lactamase-producing strains. A single 1-g intramuscular dose is effective and is recommended by the Centers for Disease Control and Prevention as an alternative treatment for uncomplicated gonorrhea. GOAL OF THIS STUDY: This study was conducted to evaluate the efficacy and safety of a lower 500-mg dose of cefotaxime in the treatment of uncomplicated gonococcal infections. STUDY DESIGN: In a randomized multicenter study, patients who had uncomplicated gonorrhea were treated with 500 mg of cefotaxime or 250 mg of ceftriaxone. Both antibiotics were given intramuscularly. Efficacy and safety were assessed four to seven days following treatment. RESULTS: Six hundred thirteen patients were enrolled. Bacteriologic eradication rates for anogenital infection were 97.7% of the patients (213/218) in the cefotaxime group and 99.1% of the patients (221/223) in the ceftriaxone group (P = 0.243). Adverse events occurred in 4.2% and 7.5% of patients in the two groups, respectively. CONCLUSION: Cefotaxime 500 mg appears to be a safe and cost-effective alternative to ceftriaxone 250 mg for the treatment of uncomplicated gonorrhea.
Adolescent↗
Age and clinical immunity to infections with Chlamydia trachomatis.
BACKGROUND AND OBJECTIVES: The prevalence of chlamydial infection decreases with age possibly in part because of increasing immunity. GOAL OF THIS STUDY: To determine whether increased age is an independent predictor of decreased chlamydial infection and whether chlamydia-specific antibody titer and blastogenesis increase with age. STUDY DESIGN: Data from all patients cultured for Chlamydia trachomatis between January 1984 and August 1989 were examined and multiple logistic regression models were used to identify the independent predictors of culture positivity. Antichlamydial antibody titer and chlamydia-specific blastogenesis were examined for a subset of patients for correlation with age. RESULTS: Young age was found to be predictive of chlamydial infection independent of all factors examined in men and women. Antibody titers had no relation to age (n = 245) whereas the level of blastogenesis correlated only weakly with age (n = 155). CONCLUSIONS: Assays of systemic immunity do not reflect the protection from chlamydial infection associated with age.
Adolescent↗
Declining prevalence of chlamydial infection among adolescent girls.
BACKGROUND AND OBJECTIVES: Chlamydial control programs that identify and treat infected persons have been used as a means of reducing prevalence and morbidity. The overall objective of the current study was to examine the prevalence of chlamydial infection during the course of such a program. GOALS: To determine whether a reduction in isolation rates was evident among adolescent girls during the 8.75 years that the control program has been in place. STUDY DESIGN: The study population consisted of all 4,329 sexually active girls between the ages of 13 and 19 attending the four adolescent health clinics in Indianapolis, Indiana, during the period beginning October 1, 1985, and ending June 30, 1994. All girls were cultured for Chlamydia trachomatis, and behavioral data were collected for those attending the clinics before 1989. The trend in quarterly isolation rates was examined using linear regression analysis. RESULTS: Results showed that there was a significant decrease (P = 0.0001), from 25.9% to 9.7%, in the first-visit chlamydial isolation rate over the study period. Behavioral data showed decreases in the frequency of sexual intercourse and in lifetime years of sexual activity, as well as an increase in condom use. CONCLUSIONS: The quarterly isolation rates showed that there has been a 63% decline in chlamydial infection among adolescent girls attending the clinics for the first time.
Adolescent↗
Prevalence of smoking in a diabetic population: the need for action.
Smoking habits in insulin-treated diabetics in Nottinghamshire (UK) and clinic-attending diabetics in Nottingham have been analysed. Compared with the general population, the prevalence of current cigarette smoking is significantly less (p less than 0.001) in both diabetic men and women older than 50 years. Fewer diabetic men over 60 years have ever smoked than in the general population (p less than 0.001) but this finding does not apply to diabetic women. While intervention probably plays some part in this lower prevalence, the most likely explanation is the multiplicative effect of both smoking and diabetes to produce high mortality risks. Actuarial analysis of insulin-treated clinic attenders diagnosed after 1970 showed that at most 14% (95% confidence interval [Cl] 9-18%) of the 183 who smoked at diagnosis had given up 5 years later while a minimum of 8% (95% Cl, 6-11%) of the 313 who were non-smokers had started smoking. Information about the patterns of smoking in patients with chronic disease is incomplete and it appears that too little is being done in clinical services which provide long-term management for these patients to either discourage smoking or determine why some patients give up smoking but others do not.
Age Factors↗
Natural language generation in health care.
Good communication is vital in health care, both among health care professionals, and between health care professionals and their patients. And well-written documents, describing and/or explaining the information in structured databases may be easier to comprehend, more edifying, and even more convincing than the structured data, even when presented in tabular or graphic form. Documents may be automatically generated from structured data, using techniques from the field of natural language generation. These techniques are concerned with how the content, organization and language used in a document can be dynamically selected, depending on the audience and context. They have been used to generate health education materials, explanations and critiques in decision support systems, and medical reports and progress notes.
Expert Systems↗