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Biomedical subjects

R Miller

Publications and source records attributed to R Miller.

At least 415 records · Page 23Linked to original sources
PubMed1994

Transient erythroblastopenia of childhood in infants < 6 months of age.

PURPOSE: During a 6-year period, we identified six infants < 6 months of age with transient erythroblastopenia of childhood (TEC). PATIENTS AND METHODS: All patients presented with moderate to severe anemia, reticulocytopenia, and age-appropriate mean corpuscular volume and fetal hemoglobin level. RESULTS: Severe aregenerative anemia in an infant < 6 months of age often raises the diagnostic possibility of Diamond Blackfan anemia (DBA). Given prognostic and therapeutic implications, distinction between DBA and TEC is of crucial importance. CONCLUSIONS: We suggest that TEC may occur more commonly in infants < 6 months of age than has heretofore been recognized and that it has a clinical and hematologic picture similar to that seen in older children. Recognition of the occurrence of TEC in very young infants may help avoid an inappropriate diagnosis of DBA.

Age Factors↗
PubMed1994

Antimalarial activity of WR 243251, a Dihydroacridinedione.

WR 243251 is a dihydroacridinedione that was evaluated for antimalarial blood schizonticidal activity in vitro and in vivo. The in vitro doses calculated to kill 50% of organisms were 11 nM for a chloroquine-susceptible, mefloquine-resistant standard strain and 25 nM for a chloroquine- and pyrimethamine-resistant standard strain. The total dose needed to cure 100% of mice infected with a drug-susceptible strain of Plasmodium berghei was 12 to 20 mg/kg of body weight for both oral and subcutaneous administration. The regimen needed to cure 100% of Aotus monkeys infected with Plasmodium falciparum was 8 mg/kg/day for 3 days (chloroquine-susceptible strain) and 16 mg/kg/day for 3 days (chloroquine-resistant strain). The 100% curative doses for Aotus monkeys did not increase for parasites previously exposed to subcurative doses. The absolute value of the curative doses of WR 243251 was comparable to or lower than the values for clinical antimalarial agents. The high absolute activity, comparability of activities against susceptible and resistant parasites, and inability to induce resistance by exposure to subcurative doses suggest that WR 243251 has strong potential as a blood schizonticidal agent.

Acridines↗
PubMed1994

Cryptosporidium antigen detection in human feces by reverse passive hemagglutination assay.

A reverse passive hemagglutination (RPH) assay was developed for Cryptosporidium oocyst antigen with an antioocyst monoclonal antibody (MAb; MAb-C1) coupled to stabilized sheep erythrocytes. RPH was compared with microscopy of auramine-phenol-stained smears of 56 oocyst-positive fecal samples, each of which was tested blindly by RPH with two oocyst-negative samples received on the same day (a total of 112 controls). Thirty-nine additional fecal samples from human immunodeficiency virus type 1 antibody-positive patients with diarrhea (10 of which were positive in auramine-phenol-stained smears) were stored at -20 degrees C before testing. Thirty specimens with a variety of other fecal pathogens (all negative for oocysts) were also tested. Of the 237 samples tested, 69 were positive by one or both methods: 65 by RPH and 66 by microscopy. The kappa coefficient of agreement between the methods was very high at 0.926. The sensitivity of RPH was 93.9%, the specificity was 98.2%, the positive predictive value was 95.4%, and the negative predictive value was 97.7%. Visible oocyst numbers and RPH titers were measured after storage of fecal samples and oocyst concentrates for 8 days at 4 degrees C. Oocyst morphology was generally poor in specimens from the human immunodeficiency virus type 1 antibody-positive group, and it degenerated during the 8-day storage experiments. MAb-C1-reactive antigen eluted from oocysts to give progressively higher reciprocal titers during storage, and it was partially removed from the oocysts by concentration. RPH is a promising technique for the detection of Cryptosporidium antigen in human feces and may be useful when specimens are stored before testing. Studies of the sensitivity of Cryptosporidium immunoassays should take into account the possible release of antigen from oocysts.

Adolescent↗
PubMed1994

Cognitive impairment and medication adherence.

1. The findings of this study are congruent with previous work that found that subjects' knowledge about medication is not necessarily correlated with adherence to medication regimens. 2. The nature and experience of forgetting medications merits further investigation. Asking patients about forgetting medication is easy to do, and many methods of compensating for forgetfulness are available. 3. Cognitive impairment was not associated with medication adherence. Cognitively impaired elders were likely to have caregivers assisting in the administration of their medication in the period immediately after discharge from acute care facilities.

Aged↗
PubMed1994

At what price?

The Clinton Administration has proposed a capped entitlement program to expand home- and community-based services for the disabled. This program's impact on nursing facilities is yet to be interpreted.

Community Health Services↗
PubMed1994

The reduction clamp: a simple device for closed reduction during intramedullary nailing.

Reduction of femoral shaft fractures prior to passing the guide pin during intramedullary fixation may be a challenging problem, especially in delayed reductions or obese patients. We describe a simple and useful instrument for obtaining and maintaining reduction for closed intramedullary fixation. It provides a three-point fixation that may be locked into position to maintain the reduction. The surgeon is not required to hold the device in position while passing the guide pin, the reamer, or the nail. It frees the surgeon's hands, minimizes the need for an assistant, and reduces harmful x-ray exposure to the hands.

Femoral Fractures↗
PubMed1994

Epidemiological study of metritis in Michigan dairy cattle.

A prospective study using the Michigan National Animal Health Monitoring System was conducted to determine factors that affect the incidence of metritis in Michigan dairy herds. Data on herd management, disease, and environmental risk factors were collected from a stratified random sample of 97 herds with 7,835 cows for 12 months. Linear and logistic regression models were developed to assess the association between metritis and factors at the herd and cow level. Significant factors included retained placenta, dystocia, routine post partum examinations, herd size, and parity. Implications on the interpretation and use of results from herd- and cow-based analyses are discussed.

Animals↗
PubMed1993

Loss of striatal cholinergic neurons as a basis for tardive and L-dopa-induced dyskinesias, neuroleptic-induced supersensitivity psychosis and refractory schizophrenia.

In the first section of this paper several aspects of tardive dyskinesia (TD) (clinical, epidemiological, pharmacological) are reviewed. We propose that this syndrome is not the consequence of dopamine receptor proliferation, but results from damage or degeneration of striatal cholinergic interneurons. We suggest that this cellular damage is caused by prolonged overactivation of these neurons, which occurs when they are released from dopaminergic inhibition following neuroleptic administration. Overactivity of central cholinergic systems during akinetic and motor retarded depression could be a contributory cause. The predisposition to L-DOPA-induced peak-dose dyskinesia in Parkinson's disease may depend on the same type of striatal neuronal loss. In the second part of the paper, the subject of supersensitivity psychosis and drug-resistant schizophrenia is reviewed. These two syndromes, are commonly associated with TD, have similar predisposing factors and pharmacology to TD, and are potentially persistent. We suggest that these conditions also result from degeneration of cholinergic striatal interneurons following chronic neuroleptic administration. The efficacy of clozapine for such treatment-refractory psychoses is explained in terms of its blockade of D-1 dopamine receptors. Other drugs effective against refractory psychoses (e.g. risperidone) are predicted to reduce activation at D-1 receptors.

Antipsychotic Agents↗