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Biomedical subjects

S Morse

Publications and source records attributed to S Morse.

At least 19 recordsLinked to original sources
PubMed1999

Newly available and future laboratory tests for sexually transmitted diseases (STDs) other than HIV.

BACKGROUND AND OBJECTIVES: The development and introduction of nucleic acid amplification (NAA) tests by commercial sources has improved our ability to diagnose chlamydial infections and other sexually transmitted diseases (STDs). A review of approaches to diagnosing STDs can provide a clearer picture of the present needs. GOALS: To review the advantage and disadvantages of current and future diagnostic approaches. STUDY DESIGN: Survey the literature and define current and future needs in developed and developing country settings. RESULTS: The increase in analytical sensitivity afforded by NAA has enabled the use of noninvasive specimens, such as first-void urine (FVU) and self-obtained vaginal swabs, for diagnostic testing and screening asymptomatic low-prevalence populations and hard-to-access populations. This technology allows multiplexing in which targets from multiple agents responsible for a particular syndrome can be amplified and detected. Although NAA tests have been designed to minimize contamination, there is some reluctance to replace less sensitive tests with this new technology. The concerns involve potential false positive and false negative results caused by the presence of inhibitors, even though the rates of false results are low. Other concerns are cost, through-put, hands-on time, and time necessary for results. CONCLUSIONS: Nucleic acid amplification tests are a great improvement and additional tests are needed for the diagnosis of STDs at the point of first encounter, with minimal delay between diagnosis and treatment. Affordable tests, which are rapid, sensitive, and specific are needed for use in resource-limited settings where most STDs are seen; this has been a major undertaking for the Sexually Transmitted Diseases Diagnostics Initiative.

Clinical Laboratory Techniques↗
PubMed1997

Aetiology of yam (Dioscorea rotundata) tuber rots held in traditional stores in Nigeria: importance of Fusarium spp. and yam beetle.

The extent and causes of yam (Dioscorea rotundata) tuber rots were investigated in Igalaland, Nigeria. Rots were found to be associated with prior physical damage in almost all cases. Numerous fungal species were isolated from the infected lesions of which Fusarium spp. predominated, not Botrydiplodia theobromae as previously reported in other studies. None of the fungi was able to infect undamaged yams in laboratory experiments. The damage was caused by both biotic and abiotic factors of which the yam beetle (Heteroligus meles) was the largest single cause. There were significant differences in the frequency with which different varieties of yam were attacked by H. meles and found to be infected with Fusarium spp. In an independent survey of farmers' experience of yam rots, varieties that scored well correlated with apparent resistance to the beetle and Fusarium spp. These studies highlight the importance of yam beetle infestation and the need to have independent methods for varietal authentication.

Animals↗
PubMed1997

Pelvic inflammatory disease isolates of Neisseria gonorrhoeae are distinguished by C1q-dependent virulence for newborn rats and by the sac-4 region.

The virulence mechanism of Neisseria gonorrhoeae in pelvic inflammatory disease (PID) is not well understood, and an objective diagnostic method to identify patients with PID is lacking. We investigated the hypothesis that development of PID was associated with a C1q-dependent virulence property of gonococcal strains. Recent development of a C1q-dependent experimental model of gonococcal infection (S. Nowicki, M. Martens, and B. Nowicki, Infect. Immun. 63:4790-4794, 1995) created an opportunity to evaluate this hypothesis in vivo. Therefore, the virulence of 32 clinical isolates (18 PID isolates and 14 local infection [LI] isolates) was evaluated in experimental rat pups. A serum bactericidal assay was used to characterize a gonococcal serum-resistant (ser(r)) phenotype. PCR primers designed to amplify a suitable-size gonococcal sac-4 DNA fragment (unique for serum-resistant donor JC1) were used to evaluate the association of serum-resistant genotype sac-4 with two phenotypes: C1q-dependent virulence expressed in vivo and resistance to bactericidal activity of human serum expressed in vitro. Strains were also characterized by auxotyping and serotyping. Of 32 gonococcal strains, 15 (46.7%) caused C1q-dependent bacteremia in rat pups and were sac-4 positive and ser(r). However, of the 15 isolates, 13 (87%) represented strains associated with human PID and 2 (13%) were associated with LI. None of the strains that were completely serum-sensitive (ser(s)) and sac-4 negative produced C1q-dependent bacteremia in rat pups, suggesting that both ser(r) and sac-4 were required for infection. The serum-resistant recombinant recipient of sac-4 produced C1q-dependent bacteremia in the rat model similarly to the serum-resistant donor of sac-4; the serum-sensitive parent strain did not produce bacteremia. These data suggest that sac-4-mediated serum resistance conferred C1q-dependent virulence and is a unique characteristic associated with PID. These newly identified features may contribute to the understanding of the pathogenic mechanism of PID-associated strains and open perspectives for establishing novel diagnostic methods.

Animals↗
PubMed1995

Hepatitis B virus infection in high-risk inner-city neighborhoods in San Francisco.

To examine the extent of hepatitis B virus infection (HBV) in an inner-city community, we determined the prevalence, incidence, and correlates of HBV seroreactivity in a representative sample of unmarried whites, African-Americans, and Hispanics living in San Francisco during 1988 to 1989 and again 1 year later in 1989 to 1990. Unmarried men and women aged 20 to 44 years were surveyed in a random household sample drawn from three neighborhoods of varying geographic and cultural characteristics. Hepatitis B infection was determined by testing specimens for antibody to hepatitis B core antigen (anti-HBc). Of blood samples available from 1,108 participants from the initial survey, 159 (14%) were anti-HBc positive. There was a strong positive association between anti-HBc positivity and positive serological tests for human immunodeficiency virus, herpes virus type 2, and syphilis. In women and heterosexual men, after controlling for other variables, anti-HBc positivity was significantly associated with older age (P < .001), nonwhite ethnicity (P < .01), less education (P < .05), injection drug use (P < .001), being paid for sex (P < .05), and lifetime number of sexual partners (P < .05). Among homosexually active men, after controlling for other variables, anti-HBc positivity was significantly associated with nonwhite ethnicity (P < .001), injection drug use in a sexual partner (P < .05), and number of lifetime sexual partners (P < .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Genetic diversity of the iron-binding protein (Fbp) gene of the pathogenic and commensal Neisseria.

The pathogenic Neisseria and most commensal Neisseria species produce an iron-binding protein (Fbp) when grown under iron-limited conditions. In the current study, we confirmed the presence of Fbp, as well as DNA sequences homologous to the gonococcal fbp, in strains of N. gonorrhoeae, N. meningitidis, N. cinerea, N. lactamica, N. subflava, N. kochii and N. polysaccharea. The fbp genes from these strains were amplified by the polymerase chain reaction, digested with StuI or RsaI, and the restriction patterns examined. The patterns for the gonococcal and meningococcal fbp were virtually identical; however, variations were observed in the fbp sequences of the commensal Neisseria species. N. flavescens, N. mucosa, N. sicca, N. ovis and Branhamella catarrhalis, did not produce Fbp as detected by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and reactivity with an Fbp specific monoclonal antibody, nor did they hybridize to an fbp-specific DNA probe.

Amino Acid Sequence↗
PubMed1994

Prevalence, incidence, and correlates of syphilis seroreactivity in multiethnic San Francisco neighborhoods.

To examine the extent of infection with syphilis in an inner-city community, we determined the prevalence, incidence, and correlates of syphilis seroreactivity in a representative sample of unmarried whites, African Americans, and Hispanics living in San Francisco during 1988 to 1989 and again 1 year later in 1989 to 1990. One thousand seven hundred seventy single men and women aged 20 to 44 were surveyed in a random household sample drawn from three neighborhoods of varying geographic and cultural characteristics. Syphilitic infection was determined by testing specimens with the microhemagglutination assay for antibodies to Treponema pallidum (MHA-TP). Of blood samples available from 1262 participants from the initial survey, 32 (2.5%) were MHA-TP reactive. After adjustment for age, a reactive syphilis serology was significantly predicted (P < 0.05) by African American race, homosexual activity (men), and less education. In homosexually active men, lifetime number of male sex partners and the presence of antibody to the human immunodeficiency virus (HIV) significantly predicted syphilis seroreactivity (P < 0.01). One year later, of 841 specimens available for testing, an additional 13 (1.5%) had become MHA-TP reactive. Eleven (85%) of the new cases were in heterosexual men and women. Although San Francisco citywide incidence data indicate that syphilis may be decreasing for the city as a whole, incidence data on a community level suggests that syphilitic infection is increasing in high-risk heterosexual communities. Thus, syphilis prevention programs should rely on serologic testing at the community level to plan effective intervention strategies.

Adult↗
PubMed1992

Acquired immunodeficiency without evidence of infection with human immunodeficiency virus types 1 and 2.

There have been three published cases of acquired immunodeficiency in which no evidence for infection with human immunodeficiency virus (HIV) types 1 and 2 was found. We have identified five other individuals, from the New York City area (four who have known risk factors for HIV infection), with profound CD4 depletion and clinical syndromes consistent with definitions of the acquired immunodeficiency syndrome (AIDS) or AIDS-related complex. None had evidence of HIV-1, 2 infection, as judged by multiple serologies over several years, standard viral co-cultures for HIV p24 Gag antigen, and proviral DNA amplification by polymerase chain reaction.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Primary treatment of pelvic osteosarcoma. Report of five cases.

Five patients, ages 12 to 20 years, with nonresectable primary (Patients 2, 3, and 5) and metastatic (Patients 1 and 4) pelvic osteosarcomas were treated with intraarterial cisplatin and concurrent radiation therapy from 1983 to 1987. Long-term local tumor control was achieved in all five patients. Patients 1 and 3 are alive with no evidence of local recurrence or metastatic disease at 77 and 56 months of follow-up, respectively, since diagnosis of the pelvic tumor. Patients 2, 4, and 5 died of metastatic lung disease at 25, 39, and 12 months, respectively, after diagnosis of the pelvic tumor. Patient 4 had no clinical or radiologic evidence of local recurrence. Control of tumor growth in patients with pelvic osteosarcomas can be achieved with regional chemotherapy and concurrent radiation therapy. These patients also should receive adjuvant intensive systemic chemotherapy to increase the probability of eliminating potential subclinical metastatic disease.

Adolescent↗
PubMed1991

Giant colonic mucocele following palliative surgery for recurrent squamous cell carcinoma of the cervix.

We report an unusual complication following palliative surgery in a patient with carcinomatosis peritonei from recurrent squamous cell carcinoma of the cervix. At surgery the ascending colon was bypassed and isolated. Eight months later the patient presented with a giant mucocele. We believe this to be the first reported case in the gynecologic literature. This complication could have been prevented by adhering to the standard surgical management of fashioning a mucous fistula.

Aged↗
PubMed1990

Fluoxetine ingestion: a one year retrospective study.

Fluoxetine (PROZAC) is a recently marketed straight chain antidepressant unrelated to the cyclic anti-depressants. There is only limited information on fluoxetine and a single case report on overdose (benign outcome) in the literature. In response to this we performed a 1y retrospective chart review at 2 AAPCC certified poison centers. Forty-four exposures to fluoxetine were reviewed from 1988; 31 cases were treated in a HCF, 2 cases were followed at home by phone and 11 cases were lost to follow up. Thirteen cases with follow up (FU) reported no coingestants; 3 cases reported increased anxiety without cardiovascular (CV) changes, 2 cases presented confused with out CV changes, and 8 cases were asymptomatic. Eight cases with FU had ETOH and/or benzodiazepines as a coingestant and experienced only a decreased level of consciousness that could be explained by the coingestant. Five cases remained asymptomatic with reported coingestants of APAP #3, lorazepam, haloperidol, molindone, alprazolam, propranolol, phenobarbital (level 18.2). Four cases were excluded from the evaluation due to the coingestants involved. No seizures were recorded in this series. Three possible drug reactions occurred; 2 cases had reactions with tranylcypromine (PARNATE), and 1 case with a diagnosis of septicemia had a severe hyperthermic reaction with therapeutic coingestants of mephytoin, verapamil, digoxin and indocin. We believe overdose with fluoxetine present minimal risk of serious cardiovascular or neurological complications.

Accidents↗
PubMed1989

Complement activity and selected hematologic variables in newborn foals fed bovine colostrum.

Serum complement activity and selected hematologic variables were evaluated in 5 newborn foals fed bovine colostrum (principal group) and 6 foals allowed to nurse their dam (control group). Also, bovine colostrum was evaluated for anti-equine antibodies. Precolostral serum hemolytic and conglutinating complement activities were low and increased similarly in foals of both groups to reach adult values between 1 and 3 weeks after birth. Bovine colostrum strongly agglutinated, but did not hemolyse principal foals' RBC and blood containing all known equine blood group alloantigens. Hemolysis was not detected after administration of bovine colostrum. Physiologic anemia developed in foals of principal and control groups during the first week of life. Erythrocyte osmotic fragility in foals of the principal group prior to and after the ingestion of colostrum remained unchanged. However, at 36 hours after birth, there was a significant decrease in erythrocyte osmotic fragility in foals fed homologous colostrum.

Animals↗
PubMed1987

Hemodynamic evaluation of isosorbide dinitrate in alcoholic cirrhosis. Pharmacokinetic-hemodynamic interactions.

Isosorbide dinitrate, a long-acting organic nitrate, has been shown to decrease portal pressure in the experimental animal and humans. We conducted a double-blind randomized hemodynamic evaluation of the effects of placebo and 10 mg and 20 mg isosorbide dinitrate in stable individuals with alcoholic cirrhosis. Baseline values for all three groups were similar. Isosorbide dinitrate resulted in a peak reduction of the hepatic venous gradient of 24.7% +/- 3.0%, with significantly decreased values 4 h after the administration of the 20-mg dose. A reduction of arterial pressure and cardiac index (peak decrease of 25.7% +/- 1.5%) was well tolerated by 13 of 15 patients. Changes in mean arterial pressure were not predictive of modifications in the hepatic vein wedge pressure. There was no relation between the area under the plasma isosorbide dinitrate concentration curve and hemodynamic changes. Levels of isosorbide-5-mononitrate, a vasoactive metabolite, were detectable for an 8-h period. Isosorbide dinitrate significantly reduced portal pressure in stable cirrhotics, in association with systemic hemodynamic changes. Thus, titration of isosorbide dinitrate is required to maximize hemodynamic benefits in individual patients. As the decrease in portal pressure is more predictable than the effect of previously tested pharmacologic agents, isosorbide dinitrate should be evaluated for its efficacy in the management of portal hypertension.

Blood Pressure↗
PubMed1987

Acute dissection originating in the abdominal aorta.

A primary abdominal aortic dissection was encountered in a 53-year-old hypertensive man who was admitted with a 2-week history of back pain. Treatment with an infrarenal aortic bifurcation graft complemented by reconstruction of the proximal aortic cuff was curative.

Aortic Dissection↗
PubMed1986

Hepatic artery pseudoaneurysm: diagnosis with real-time and pulsed Doppler US.

Duplex ultrasonography (US), consisting of real-time and pulsed Doppler US, was used to identify a pseudoaneurysm in a patient with recurrent bleeding and chronic pancreatitis. The authors present a case that illustrates the limitations of real-time US in evaluating sonolucent masses in pancreatitis and the need for using pulsed Doppler technique.

Aneurysm↗