AIDS and heterosexuals.
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Acquired Immunodeficiency Syndrome↗
Biomedical subjects
R Mills
Publications and source records attributed to R Mills.
Distribution of galanin-immunoreactive cells within sexually dimorphic components of the medial preoptic area of the male and female rat.
A high percentage of galanin-immunoreactive (GAL-I) cells within sexually dimorphic components of the medial preoptic area (MPOA) of the rat also concentrate estrogen and GAL microinjected within the medial preoptic nucleus (MPN) facilitates masculine sexual behavior after testosterone priming. Thus, we determined the distribution of GAL-I cells within the MPOA and their response to gonadal steroids. We report significantly greater numbers of GAL-I cells within the central division of the medial preoptic nucleus (MPNc) and fewer within the anteroventral periventricular nucleus (AVPv), of the gonadectomized male than the gonadectomized female; that GAL-I cell numbers and densities within the AVPv are increased significantly in the intact, testosterone- or estrogen-treated male compared to the gonadectomized male and that GAL-I cell numbers and densities within the MPNc and GAL-I cell densities within the medial division of the MPN (MPNm), are increased significantly by gonadal steroids in rats of both sexes. The results suggest an involvement of galaninergic cells within the MPOA in the regulation of sexually dimorphic, gonadal steroid-sensitive functions.
Animals↗
The safety of ranitidine in elderly versus non-elderly patients.
The authors conducted a retrospective review of 21 United States trials of ranitidine in acid peptic diseases and compared the adverse events in elderly (> or = 65 years) and nonelderly (< 65 years) patients. Ranitidine dosages ranged from 150 mg/day to 300 mg twice daily for treatment periods of 4 to 52 weeks. Of the 4041 patients included in this review, 402 elderly and 2188 nonelderly patients received ranitidine and 245 elderly and 1206 nonelderly patients received placebo; 29%, 29%, 32%, and 26% of these patients, respectively, reported some type of adverse event. When only drug-related adverse events (as judged by the investigators under blinded conditions) were evaluated, these percentages dropped to 2%, 2%, and 1% and 2%, respectively. Gastrointestinal adverse events (e.g., nausea and diarrhea) and central nervous system adverse events (e.g., headache and dizziness) were the most common (0.7% and 0.8%, respectively), with comparable incidence rates in the elderly and nonelderly patients. The authors conclude that ranitidine is as safe in elderly patients as it is in nonelderly patients. No difference in the incidence of adverse events was found between older and younger patients who received ranitidine or placebo.
Adult↗
Successful treatment of the idiopathic restless legs syndrome in a randomized double-blind trial of oxycodone versus placebo.
In a double-blind randomized crossover trial, oxycodone or placebo was given in divided night-time doses to 11 patients with idiopathic restless legs syndrome (RLS) for 2 weeks prior to appropriate polysomnographic studies. Under double-blinded conditions, patients were asked to do daily ratings of their leg sensations, motor restlessness and daytime alertness on a 1-4 scale for the 2 weeks prior to the polysomnographic studies and for the nights of the polysomnographic studies as well. Leg sensations (p < 0.009), motor restlessness (p < 0.006) and daytime alertness (p < 0.03) were significantly improved on oxycodone as compared to baseline or placebo. Patients were studied polysomnographically under double-blinded conditions for 2 nights in each phase of the protocol. On an average dose of 15.9 mg oxycodone (equivalent to approximately three 5-mg tablets of commercial preparation), there was a statistically significant reduction in the number of periodic limb movements in sleep [(PLMS)/hour sleep (p < 0.004)] and in the number of arousals/hour sleep (p < 0.009) on drugs as compared to baseline or placebo. A statistically significant improvement was also noted in sleep efficiency (p < 0.006) and 10 of the 11 patients preferred oxycodone over placebo. We conclude that oxycodone is an effective treatment for RLS and PLMS.
Adult↗
What kind of recognition do staff nurses want?
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Awards and Prizes↗
Chronic neurodegenerative disease associated with HTLV-II infection.
Although human T-cell leukemia virus (HTLV) type I is known to cause a number of diseases, there has been no convincing evidence of pathological changes after infection with the related virus, HTLV-II. We have found an endemic focus of HTLV-II infection among members of an American Indian population in New Mexico, USA. We set out to determine the pathological consequences of HTLV-II infection in this population and identified two sisters (aged 59 and 46 years) with a disease superficially resembling the myeloneuropathy induced by HTLV-I. These women had a syndrome similar to the olivopontocerebellar atrophy variant of multiple system atrophy, and HTLV-II infection was confirmed by western blot and the polymerase chain reaction. Thus, HTLV-II may, like HTLV-I, cause a progressive neurodegenerative disease.
Ataxia↗
Acromegaly and its treatment in the McCune-Albright syndrome.
The McCune-Albright syndrome, comprising polyostotic fibrous dysplasia, cutaneous pigmentation and endocrine hyperfunction, is occasionally complicated by acromegaly due to a pituitary adenoma. We report a patient with the McCune-Albright syndrome and acromegaly, who developed secondary hypothyroidism and hypoadrenalism, in whom surgical removal of the pituitary tumour was technically difficult. A combination of a long-acting somatostatin analogue ('Sandostatin') and external irradiation were therefore used as treatment.
Acromegaly↗
A prospective study of otitis media with effusion in adults and children.
A prospective study of otitis media with effusion (OME) in both adults and children has been carried out. 75 new adult patients were seen during a 4-year period. Of these, 13 had associated diseases which could reasonably be considered to have been a cause of their effusion. Over a 2-year period, 192 new children with OME were seen. There was a significantly higher incidence of previous otalgia and/or aural discharge in the children as compared to the adults (P less than or equal to 0.001). The adults had significantly more serous effusions than the children (P less than or equal to 0.001), but both mucoid and serous effusions occurred in both groups. Similar rates of spontaneous resolution were observed in the 2 groups. Within the adult group, patients with a history of upper respiratory infection at the onset of hearing loss were significantly more likely to have spontaneous resolution of their effusion (P less than or equal to 0.02).
Adolescent↗
Pseudallescheria boydii keratitis.
We treated a case of post-traumatic keratitis caused by the soil saprophyte, Pseudallescheria boydii. The injury was caused by a wood splinter which produced a perforating corneal laceration that was primarily repaired. Signs of corneal infection were not evident until the fourth postoperative week. The organism was eradicated by topical miconazole and natamycin. Subsequent penetrating keratoplasty combined with cataract extraction and intraocular lens implantation has achieved a good visual outcome.
Adult↗
Putative neurotoxicity of SKF 38393 and other D1 dopaminergic drugs investigated in rat striatum.
The recently alleged neurotoxicity of the D1 receptor agonist, SKF 38393, was investigated in rat striatum by measuring the enzymes acetylcholinesterase (AChE) and glutamate decarboxylase (GAD). First, unilateral intrastriatal microinjection of the excitotoxin kainic acid (2 micrograms in 1 microliter) was shown to evoke vigorous contraversive circling, followed 1 or 2 weeks later by profound decreases in striatal AChE (24 and 54%), GAD (51 and 75%), and protein (36 and 47%), as well as loss of GAD (45% at 2 weeks) in the ipsilateral substantia nigra. Similar striatal treatments with SKF 38393 (30 micrograms in 0.5-1 microliter), the related benzazepines SKF 82526 (D1 agonist, 30 micrograms in 1 microliter) and SCH 23390 (D1 antagonist, 5 micrograms in 1 microliter), or the phenanthridine D1 agonist CY 208-243 (5 micrograms in 1 microliter) failed to affect the rats' behaviour or their striatal levels of AChE, GAD, and protein. Intrastriatal SKF 38393 (30 micrograms in 0.5 microliter) also had no influence on these enzymes in the substantia nigra. It is concluded that none of the D1 dopaminergic compounds examined here was neurotoxic toward the many different cell groups that contain AChE and/or GAD in the striatum.
2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-ben↗
Primary isolation of human T-cell leukemia-lymphoma virus types I and II: use for confirming infection in seroindeterminate blood donors.
We describe the use of an immunofluorescence assay and coculture to confirm human T-cell leukemia-lymphoma virus (HTLV) infection. Peripheral blood mononuclear cells from 32 of 32 seropositive donors were positive in the immunofluorescence assay, and 63% of their cocultures produced p24 antigen. Specific antibodies distinguished HTLV type I (HTLV-I) from HTLV-II. HTLV-I or HTLV-II was isolated from donors with indeterminate serologic test results.
Antibodies, Monoclonal↗
Mössbauer studies of iron hydride at high pressure.
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Journal Article↗
Serologic distinction between human T-lymphotropic virus (HTLV) type I and HTLV type II.
In November 1988, the Food and Drug Administration approved reagents for serologic screening for human T-lymphotropic virus type I (HTLV-I) infection in blood donors and patients suspected of having HTLV-I-related illnesses. These reagents are able to detect HTLV type II (HTLV-II), a close relative of HTLV-I with no known pathologic effect. The distinction between the two forms of HTLV is important to the donor and to any recipient of blood containing HTLV. The application to sera from 38 seropositive blood donors and 2 recipients (37 "confirmed" positive and 3 indeterminate by Western blot) of two methods (Western blot and peptide enzyme immunoassay) for serologic distinction between HTLV-I and -II is described. These results were compared to those from polymerase chain reaction (PCR) analysis of HTLV proviral DNA obtained from donor peripheral blood mononuclear cells. The peptide enzyme immunoassay was found to be less sensitive than the Western blot, but completely concordant with PCR results when differential reactivity could be established. The Western blot pattern showed complete diagnostic concordance with the samples with confirmed-positive serologic tests, but was incorrect in two HTLV-II-infected donors with indeterminate serologic tests. Thirty-three (89%) of the 37 individuals from this predominantly Native American and Hispanic group of blood donors were found to have HTLV-II. These findings confirm and extend previous reports that HTLV-I infection may be less common, and HTLV-II infection more common, than previously believed. The peptide enzyme immunoassay can provide most individuals who have positive results with the HTLV-I/II screening test with serologic distinction between HTLV-I and HTLV-II.
Blood Donors↗
The effect of a glaucoma medication reminder cap on patient compliance and intraocular pressure.
A multi-site, open-labeled clinical trial was conducted to evaluate the ease of use and acceptance of a newly developed medication cap with a memory aid (C Cap Compliance Cap, Allergan, Inc.) and its effect on patient compliance and intraocular pressure. One-hundred-twenty-two patients with glaucoma or ocular hypertension received their prescribed eye drops in bottles with the compliance cap. Overall, 83% of the patients found the compliance cap very easy to use. By the end of the study, significantly more patients (67%) claimed 100% compliance than prior to using the compliance cap (41%). An overall drop in intraocular pressure of 0.8 mm Hg was seen. However, in a subset of patients who reported an increase in compliance, mean intraocular pressure decreased from baseline by 1.7 mm Hg. The results of this study suggest that the compliance cap helps patients with glaucoma or ocular hypertension remember to take their medication as prescribed.
Adolescent↗
Incidence of hairy cell leukemia, mycosis fungoides, and chronic lymphocytic leukemia in first known HTLV-II-endemic population.
Unlike human T cell leukemia-lymphoma virus type I (HTLV-I), HTLV-II has not been convincingly linked to a malignancy. In the first 10 months of serologic screening for HTLV-I/II among blood donors in New Mexico in 1988-1989, HTLV-I/II infection was found in 27 donors. HTLV-I/II infection was present in 1.0%-1.6% of American Indian and 0.16%-0.27% of Hispanic donors compared with 0.009%-0.06% of non-Hispanic white donors. HTLV-II was identified by DNA amplification in 12 of 13 samples from Indian and Hispanic seropositive donors. Despite apparent endemic HTLV-II infection in these populations, New Mexico Tumor Registry data showed that the incidences of hairy cell leukemia, mycosis fungoides, and chronic lymphocytic leukemia were comparable among the three ethnic groups. A population with endemic HTLV-II infection has been identified, and there is no evidence of increased risk for these three malignancies in the endemic groups.
Blood Donors↗
Transmission of HTLV-II via blood transfusion.
Transmission of HTLV-I by transfusion is well documented in Japan, where HTLV-I is endemic. In non endemic regions such as the United States, HTLV-I/II infection has been transmitted by transfusion as well, but no effort to distinguish HTLV-I from HTLV-II infection was made in these studies. There is a growing body of evidence that a substantial proportion of HTLV-I/II seropositivity in the US is due to infection with HTLV-II. We report 2 cases of apparent transfusion-transmitted HTLV-II infection and discuss the importance of distinguishing between the two viruses in blood donors and recipients.
Adult↗
Out-patient examination of the upper airway: a survey of current practice in the UK.
Questionnaires have been sent to all ENT Consultants practising in the UK in an attempt to establish current practice with regard to out-patient examination of the upper aerodigestive tract. Seventy-eight per cent of these were returned completed. The results indicate that mirror examination remains the most widely used method, though the fibreoptic rhinolaryngoscope and/or the Hopkins rod telescope are now used by many specialists. Mirrors are most frequently warmed by a spirit lamp, despite the fact that 125 respondents reported having had a fire in their departments. Other methods of warming mirrors are discussed.
Ambulatory Care↗
Has the increasing use of grommets influenced the frequency of surgery for cholesteatoma?
The number of operations for cholesteatoma, together with the number of cases undergoing insertion of ventilation tubes in the Tayside region of Scotland between 1966 and 1986 have been studied. During this period there has been a sixty fold increase in the use of ventilation tubes, but the incidence of cholesteatoma surgery has only varied between 0.94 and 1.88 operations per 10,000 of population per year. The mean annual incidence of cholesteatoma during this period was 1.32 cases per 10,000 of population. The results indicate that there has been neither a rise nor a fall in the incidence of cholesteatoma in Tayside despite a considerable increase in the use of ventilation tubes.
Child↗