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Biomedical subjects

R Marsella

Publications and source records attributed to R Marsella.

6 recordsLinked to original sources

Genital papillomavirus infection and cervical dysplasia--opportunistic complications of HIV infection.

Certain human genital papillomaviruses (HPV) are strongly associated with cervical dysplasia and cancer. Evidence is accumulating that HPV infection and ano-genital cancers are more common in patients with the acquired immunodeficiency syndrome. The objective of our study was to evaluate the extent to which HPV infection and associated cervical disease constitute opportunistic complications of human immunodeficiency virus (HIV) infection in a population of sexually promiscuous, HIV-infected women in Kinshasa, Zaire. In 1989 we obtained Pap smears and cervicovaginal lavage specimens for HPV DNA testing from 47 HIV-seropositive and 48 HIV-seronegative prostitutes who were part of a cohort under observation since 1988. Thirty-eight percent of the HIV-seropositive and 8% of the seronegative women (odds ratio = 6.8; p = 0.001) had HPV DNA detected by either ViraType, a dot-blot assay which detects specific genital HPV types, or low-stringency Southern blot, which detects all HPV types. Eighty-two women (86%) had an interpretable Pap smear; 11 of 41 (27%) HIV-seropositive women and one of 41 (3%) seronegative women had cervical intra-epithelial neoplasia (CIN) (odds ratio = 14.7; p = 0.002). HIV seropositivity, HPV infection and CIN were highly associated. Eight (73%) of 11 seropositive women with CIN had HPV detected. Both HPV infection and cervical cancer may emerge as opportunistic complications of HIV infection in populations in which HIV, HPV and cervical cancer are common.

DNA, Viral

A new pacemaker algorithm for continuous capture verification and automatic threshold determination: elimination of pacemaker afterpotential utilizing a triphasic charge balancing system.

A new pacemaker algorithm designed to automatically verify pacemaker capture and determine pacing threshold by detection of a stimulus evoked potential was studied in 20 patients undergoing permanent pacemaker implantation. To eliminate pacing stimulus afterpotential and detect an evoked response, a hardware feedback circuit and a software template matching algorithm were used to produce a triphasic charge-balanced pacing pulse. After charge balancing the pacing lead, a residual artifact is measured. A capture window is defined as the area integral of the first 24 msec of the evoked depolarization, and a capture threshold as one third the amplitude of the capture window. The maximum allowable residual artifact is one eighth the amplitude of the capture window. Once the stimulus afterpotential is eliminated and the evoked response detected, capture threshold is automatically and continuously determined and the algorithm adds a 0.8-V safety margin to the pacemaker output. This algorithm was run automatically and after simulated loss of capture, produced by manually decreasing pacer output below threshold, in the bipolar (13 patients) and unipolar (20 patients) pacing modes. In each patient loss of capture was immediately detected. The data were consistent (P = NS) between algorithm runs. During unipolar pacing the area integral of the first 24 msec of the evoked response was 412 +/- 137 versus 413 +/- 144 and the residual artifact 5.8 +/- 4.8 versus 8.1 +/- 7.5. The resulting ratio (signal/noise) of the two parameters was 150 +/- 141 versus 145 +/- 181. Automatically determined threshold was 0.69 +/- 0.43 V versus 0.69 +/- 0.42.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged

A pilot study of paramedic-administered, prehospital thrombolysis for acute myocardial infarction.

We have implemented a pilot program of supervised paramedic administration of thrombolysis in the field. This program was begun on a small scale by training and equipping one paramedic service of one hospital. Four patients with acute myocardial infarction were rapidly and appropriately treated in the field. We compared these 4 patients with 21 patients who were brought to hospital by ambulance, but treated with thrombolysis conventionally in the emergency department. The patients in the field were treated an average of 86 minutes sooner than the patients treated in the emergency department.

Allied Health Personnel

Isolation of keratomycetes from the soil of wild animal cages and enclosures in the zoo of the Parco Nazionale d'Abruzzo, Italy.

The keratinophilic fungi present in the soil of wild animal cages and enclosures in the zoo of the "Parco Nazionale d'Abruzzo", at Pescasseroli, Italy were studied. The goal of the investigation was to determine what species of such fungi existed in wild animal habitats in that area and what variation there may be in their frequency in connection with the seasons. The most prevalent fungus was Trichophyton ajelloi, followed in decreasing order by the Chrysosporium species (C. keratinophilum, C. tropicum, C. state of Ctenomyces serratus). The Microsporums were relatively rare. The perfect forms Arthroderma uncinatum, A. quadrifidum, Nannizzia cajetani and Ctenomyces serratus were isolated from plates containing their corresponding imperfect forms. The recurrence of the species present in the soil of each cage and enclosure in April and in July was remarkable.

Animals