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Biomedical subjects

S Connolly

Publications and source records attributed to S Connolly.

At least 55 records · Page 3Linked to original sources
PubMed1994

Serial MRI of the brain in asymptomatic patients infected with HIV: results from the UCMSM/Medical Research Council neurology cohort.

Seventy-six homosexual or bisexual men underwent two cranial MRI studies at a mean interval of 13 months; 23 were HIV seronegative, 41 seropositive but asymptomatic (Center for Disease Control (CDC) groups II/III), and 12 had AIDS related complex (ARC)/AIDS (CDC group IV). Agreement between two neuroradiologists was rated as very good for assessment of enlargement of ventricles and good for widening of cerebral sulci and the presence of focal lesions. For assessment of serial studies, the agreement was moderate. The prevalence of cerebral atrophy and focal white matter lesions was no higher in the asymptomatic patients (CDC group II/III) than in appropriate seronegative controls. Some patients with ARC/AIDS showed evidence of developing cerebral atrophy during the study period when serial scans were compared. The imaging evidence supports the other data obtained from this cohort, which suggest that no significant CNS involvement occurs in HIV infection before the development of ARC/AIDS.

Adult↗
PubMed1993

Chronic fatigue: electromyographic and neuropathological evaluation.

Single fibre electromyography of extensor digitorum communis muscle (EDC) was performed on 35 patients with chronic fatigue, the majority of whom also had creatine kinase estimation and biopsy of EDC. The subjects were categorised as having an acute-onset post-viral fatigue syndrome, a non-specific chronic fatigue or possible muscle disease in view of pronounced myalgia. Of 11 subjects who had myalgia as a significant symptom, abnormalities in fibre density were found in 6, and 5 of these had some non-specific abnormalities on muscle biopsy, with creatine kinase levels being normal in all cases. Fibre density estimation may be a useful way of identifying a subgroup of chronic fatigue sufferers with a possible primary muscle disorder.

Adolescent↗
PubMed1993

Muscle disease, HIV and zidovudine: the spectrum of muscle disease in HIV-infected individuals treated with zidovudine.

Eleven patients with AIDS or AIDS-related complex who developed muscle-related symptoms whilst taking zidovudine were investigated. The clinical details of a further ten patients who did not undergo muscle biopsy are also outlined. The clinical features, quantitative muscle strength testing, electromyographic findings, serial creatine kinase levels, muscle biopsy appearance on light microscopy and the effects of zidovudine withdrawal and rechallenge are described. The spectrum of muscle disease encountered included four cases of frank myopathy diagnosed using clinical, electrophysiological and histological criteria, four patients with mild weakness and myalgia in whom muscle biopsies were normal, three patients with myalgia only and a mild increase in the interstitial cell infiltrate shown by biopsy. The patients presenting with myopathy showed no improvement on withdrawal of zidovudine but responded to immunosuppressive therapy with steroids and, in one case, thalidomide prescribed incidentally. At present, it is not yet possible to clinically define a specific zidovudine-induced myopathy that is distinct from the other effects of HIV infection on muscle structure and function. Our experience suggests that zidovudine may be implicated as a myotoxin in some patients, particularly those with myalgia and mild weakness. In those patients with severe weakness, and with biopsy findings of necrosis and inflammation, the drug effects may be difficult to separate from the primary effects of HIV.

AIDS-Related Complex↗
PubMed1993

Mupirocin resistance in coagulase-negative staphylococci.

High-level mupirocin resistance in coagulase-negative staphylococci isolated from patients undergoing peritoneal dialysis was investigated by transfer of the resistance determinants, usually in the form of a plasmid, to Staphylococcus aureus strains, cleavage of the plasmid by restriction endonuclease and hybridisation with a probe comprising a 4.05 kb EcoRI fragment of a plasmid from a S. aureus strain. In most instances the mupirocin-resistant staphylococci isolated from each patient were different according to the species, antibiogram and plasmid profile data. The mupirocin resistance determinant was carried on various plasmids as judged by EcoRI restriction fragment length polymorphisms. All hybridised at about 4 kb with the S. aureus probe.

Animals↗
PubMed1993

Mood and psychiatric disturbance in HIV and AIDS: changes over time.

A sample of 26 HIV seronegative, 59 HIV seropositive asymptomatic and 7 HIV seropositive symptomatic homosexual and bisexual men were assessed over two visits, a mean of 11 months apart, using the BDI, STAI, and CIS. Significant differences emerged between the symptomatic group and the other two groups. Past psychiatric history and the somatic items in the assessments accounted for some of these differences. The seropositive asymptomatic and the seronegative groups did not differ on any of the mood or psychiatric assessments, suggesting minimal effect on psychological well-being of seroconversion in the absence of symptoms.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Design and synthesis of some substrate analogue inhibitors of phospholipase A2 and investigations by NMR and molecular modeling into the binding interactions in the enzyme-inhibitor complex.

A series of substrate analogue inhibitors of pancreatic phospholipase A2 has been designed and synthesized. The compounds were tested in a novel dual-screening system based on parallel assays with monomeric and micellar substrates. Intermolecular nuclear Overhauser effects between vinylic protons on one inhibitor and identified active site residues on the bovine pancreatic enzyme have been observed in solution NMR studies of the enzyme-inhibitor complex. It can be deduced from both the biochemical results and the NMR data that the mode of interaction between this type of inhibitor and the active site of phospholipase A2 is essentially the same, irrespective of the presence or absence of an aggregated phospholipid surface. A model of the binding between the enzyme and inhibitor which incorporates the two-dimensional NMR data has been developed. The model can account for the activity of modified inhibitor structures and can be extrapolated to an assessment of the mode of binding of the natural substrate itself.

Animals↗
PubMed1992

Neurological and neuropsychological performance in HIV seropositive men without symptoms.

Ninety five HIV seropositive and 32 seronegative homosexual men were recruited to a prospective study of the early features and natural history of the neurological manifestations of HIV infection. There was no evidence from the initial neurological examination, a neuropsychological test battery, nerve conduction studies, somatosensory evoked potentials from the legs, P300 event related auditory evoked potentials, magnetic stimulation of the motor cortex, or MRI scans that HIV infected men without symptoms in CDC groups II/III differed significantly from a well matched seronegative comparison group. Only the subgroup in CDC IV showed evidence of impairment, and this was restricted to their performance on some of the cognitive tests. The results imply that, despite early invasion of the CNS by HIV, major disturbances of function manifest themselves only when the patient becomes immunosuppressed. The importance of an appropriate comparison group and awareness of the potentially confounding influences such as age, education, exposure to alcohol and drugs, and mood and anxiety in such studies is stressed. The essentially negative findings are important in the understanding of the pathogenesis of neurological effect in HIV infection and in the design and interpretation of therapeutic trials.

AIDS Dementia Complex↗
PubMed1992

Bilateral paramedian thalamic infarction: a distinct but poorly recognized stroke syndrome.

Six patients with bilateral paramedian thalamic infarction were seen in a general hospital over a 4 year period. This distinct stroke syndrome was recognized by the features of disturbed vigilance, often episodic, with vertical gaze disorder. Other signs included an amnesic syndrome, convergence difficulty, third nerve palsies, eyelid retraction, dysarthria, ataxia and involuntary limb movements. Diagnosis was confirmed by CT brain scan or magnetic resonance imaging. A variety of risk factors for stroke were present. All patients improved but two had significant residual disabilities.

Adult↗
PubMed1990

Diversity of staphylococci exhibiting high-level resistance to mupirocin.

Plasmids mediating high-level resistance to mupirocin (MIC greater than 1000 mg/L) in staphylococci from various sources were studied by restriction endonuclease cleavage. Several patterns were obtained but six plasmids isolated from various Staphylococcus aureus and S. epidermidis strains were indistinguishable. The diversity and spread of these plasmids is illustrated.

Coagulase↗
PubMed1987

Surgical control of Hailey-Hailey disease.

Hailey-Hailey disease is a benign, chronic genodermatosis manifested by recurrent lesions with a predilection for the intertriginous areas. The malodorous, weeping sores are a source of great discomfort to the patient. Medical therapy controls most lesions adequately; however, some are refractory. Experience with excision of skin involved with Hailey-Hailey disease is reported. The best results were obtained in those patients whose wounds were resurfaced with split skin grafts. Primary suture was associated with recurrent disease and residual morbidity. The findings of other isolated reports in the literature are also summarised. The results show that surgical control of Hailey-Hailey disease is indicated in recalcitrant cases.

Chronic Disease↗
PubMed1984

Cyclical variation of the heart rate in sleep apnoea syndrome. Mechanisms, and usefulness of 24 h electrocardiography as a screening technique.

400 sleep-apnoeic patients with an intact autonomic nervous system underwent twenty-four-hour electrocardiography with simultaneous polygraphy recording at night. At onset of sleep apnoea all showed progressive bradycardia, followed by abrupt tachycardia on resumption of breathing. The electrocardiographic pattern, which is identifiable by computer analysis, can be used as a screening tool for sleep apnoea; it was not seen in controls without sleep apnoea syndrome. A subgroup of patients with sleep apnoea and impairment of autonomic nervous control of the heart (heart transplants, autonomic neuropathy, Shy-Drager syndrome) did not show the cyclical heart rate pattern. In obstructive sleep apnoeic patients with normal autonomic nervous function, atropine sulphate blocked the pattern by eliminating the bradycardia component, while 100% oxygen, even at high rates of administration, caused only moderate blunting of the heart rate variation. The electrocardiographic changes observed in sleep apnoea syndrome are therefore mediated by the autonomic nervous system; hypoxia is not the only factor involved.

Activity Cycles↗
PubMed1984

Propafenone disposition kinetics in cardiac arrhythmia.

Propafenone disposition kinetics were studied after intravenous and oral doses in patients with ventricular arrhythmias. Plasma concentration-time data were fit to a two-compartment model for all but one patient, whose data required fitting to a three-compartment model. The model-independent calculated values of clearance, steady-state volume of distribution, and terminal t1/2 were 11.2 +/- 4.8 ml/min/kg, 3.6 +/- 2.1 l/kg, and 5.0 +/- 3.6 hr. After 5 days on oral propafenone, elimination t1/2 was 6.2 +/- 3.3 hr. The longer t1/2s and the estimates of steady-state bioavailability above 100% suggests that clearance decreases during chronic oral dosing. Considerable intersubject variability was noted in all disposition parameters.

Adult↗