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Biomedical subjects

T McGinn

Publications and source records attributed to T McGinn.

At least 19 recordsLinked to original sources
PubMed1999

Coinfection of macaques with simian immunodeficiency virus and simian T cell leukemia virus type I: effects on virus burdens and disease progression.

To test the hypothesis that coinfection with human immunodeficiency virus (HIV) and human T cell leukemia/lymphoma virus types I or II (HTLV-I or -II) accelerates progression to AIDS, pig-tailed macaques were inoculated with the simian counterparts, SIV and STLV-I. During 2 years of follow-up of singly and dually infected macaques, no differences in SIV burdens, onset of disease, or survival were detected. However, in the first coinfected macaque that died of AIDS (1 year after infection), >50% of CD4+ and CD8+ lymphocytes expressed CD25. On the basis of the low incidence of HTLV-I- and STLV-I-associated disease during natural infections, this early evidence of neoplastic disease was unexpected. While these results demonstrate that coinfection with SIV and STLV-I has no influence on the development of immunodeficiency disease, they do establish a reliable macaque model of persistent STLV-I infection.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Emergency contraception among refugees and the displaced.

In 1994, the international relief community began to recognize and address the reproductive health needs of refugees and displaced populations. A minimum initial service package of reproductive health services for refugees and the displaced, which includes emergency contraception (EC), was developed and recommended for use in refugee settings. This paper describes the experience of one international relief organization, the International Rescue Committee (IRC), in introducing EC into its worldwide reproductive health program. A recent IRC survey found that EC is available in 4 out of 14 settings where it provides reproductive health services. A case study from Tanzania demonstrates the modes of delivery, the demand for EC by women who have experienced sexual violence, and the community responses to this method of contraception. More information, education, and communication directed at refugee communities; more donor support for supplies; and institutional commitment to train staff are needed to expand refugee access to EC.

Contraceptives, Postcoital↗
PubMed1997

Monitoring and evaluation of PMM efforts: what have we learned?

One element of the operations research carried out by the Prevention of Maternal Mortality (PMM) teams in West Africa was a test of the indicators they used to monitor and evaluate their efforts. A small number of process indicators directly related to the PMM interventions in the health facilities and in the communities was selected and monitored. An examination of the teams' experiences in gathering and using these indicators shows: (i) that they are extremely useful for project design and management; (ii) that the necessary data are obtainable; (iii) that staff need training to gather, interpret and use the data; (iv) that monitoring and evaluation systems must be designed so that managers will use the information; and (v) that data on the costs of interventions can be tracked and are useful for evaluation and replication.

Africa, Western↗
PubMed1996

Genetic counseling in an extended attenauted familial adenomatous polyposis kindred.

OBJECTIVES: To provide DNA-based genetic counseling to family members in the direct genetic lineage of a family fulfilling phenotypical criteria for the autosomal, dominantly inherited, attenuated familial adenomatous polyp (AFAP) syndrome. This enabled highly targeted cancer risk estimation based on cancer phenotype in concert with the presence or absence of the adenomatous polyposis coli (APC) germline mutation. Management recommendations could then be fully responsive to this syndrome's natural history. METHODS: Detailed family history with pathology verification of colonic polyps and cancer was performed on an extended AFAP kindred. Endoscopic gastrointestinal examinations enabled detailed knowledge of the syndrome's upper and lower gastrointestinal tract phenotype. Molecular genetic evaluation of DNA led to the identification of the APC germline mutation which co-segregated with the phenotype. RESULTS: Forty-two members of this extended AFAP family underwent DNA testing, wherein 27 were found to harbor the APC germline mutation,thereby enabling precision in their genetic counseling. Anecdotal examples of this counseling experience, with particular attention to psychological reactions, as well as concerns about such issues as insurance and employer discrimination, have been described. CONCLUSIONS: When DNA-based testing is offered to AFAP family members, genetic counselors must compassionately consider patients' psychological concerns when providing detailed risk status and available surveillance and management programs.

Adenomatous Polyposis Coli↗
PubMed1996

Perihepatic abscess formation in diabetes: a complication of silent gallstones.

Perforation of the gallbladder is a serious complication of acute cholecystitis, with significant morbidity and mortality rates. We present the case of a diabetic adult in whom the usual signs and symptoms of acute cholecystitis were obscured. A high index of suspicion at the time of admission prompted emergent evaluation. Computerized axial tomography revealed a large perihepatic abscess extending from a perforated gallbladder. Fourteen hundred milliliters of malodorous brown fluid were drained by ultrasound-guided percutaneous aspiration from the collection. Early clinical suspicion combined with conservative surgical management may prevent serious morbidity and/or mortality in diabetic patients with complicated cholecystitis.

Cholecystitis↗
PubMed1995

Attenuated familial adenomatous polyposis (AFAP). A phenotypically and genotypically distinctive variant of FAP.

BACKGROUND: The usual manifestation of familial adenomatous polyposis (FAP) is hundreds or thousands of colonic adenomas. The authors previously described a colon cancer-prone syndrome characterized by fewer adenomas (1-100), most located in the proximal colon, and upper gastrointestinal lesions, particularly fundic gland polyps and duodenal adenomas. The colonic adenomas are often flat rather than polypoid, a feature emphasized in earlier reports with the term "hereditary flat adenoma syndrome." The syndrome has an autosomal dominant pattern of inheritance and is linked to the adenomatous polyposis coli (APC) locus at 5q. METHODS: This is a descriptive study based on one family that was followed for more than a decade. Total cell RNA was isolated from cultured lymphoblasts, and an in vitro protein synthesis assay was used to detect APC mutations. Sixteen individuals whose APC mutation status was known had sequential endoscopic evaluations. Five patients were given one or more courses of sulindac. RESULTS: There was perfect concordance between clinical affected status and an APC mutation. All affected members generated a 16-kDa polypeptide from the mutant allele, consistent with a 2-base pair deletion at the extreme 5' end of the APC gene. Sixteen mutation-positive individuals underwent upper gastrointestinal endoscopy and colonoscopy; 13 had colonic adenomas, with the number visualized at any one examination ranging from 1 to greater than 50. Upper gastrointestinal examination revealed fundic gland polyps in 15, gastric or duodenal adenomas in 4, and periampullary carcinoma in 1. CONCLUSION: AFAP is a phenotypically distinctive syndrome, differing from classic FAP by having fewer colonic adenomas that tend to be proximally distributed and flat rather than polypoid. The position of the APC germline mutation appears to allow for the molecular differentiation between FAP and the attenuated variant in that the extreme 5' APC mutations are associated with the latter.

Adenomatous Polyposis Coli↗
PubMed1995

Reflux esophagitis in humans is mediated by oxygen-derived free radicals.

BACKGROUND: Oxidative stress in reflux esophagitis was investigated before and after antireflux surgery. PATIENTS AND METHODS: Oxidative stress was studied in the distal and proximal esophagus of control patients (without esophagitis, but with other gastrointestinal disorders), of patients with various grades of esophagitis (including Barrett's esophagus), and in patients who had a Nissen fundoplication. Oxidative stress was assessed by chemiluminescence, lipid peroxidation (LP), and by measuring superoxide dismutase (SOD). RESULTS: Chemiluminescence and LP increased with the degree of esophagitis and was highest in patients with Barrett's esophagus; SOD decreased with damage, except in cases of Barrett's esophagus associated with mild esophagitis. Chemiluminescence and LP in reflux patients were higher in the distal than in the proximal esophagus, and SOD was lower, whereas no such difference was found in controls. Findings after Nissen fundoplication were similar to those of controls. CONCLUSIONS: Reflux esophagitis is mediated by free radicals depleting SOD. Barrett's esophagus is a severe form of oxidative damage; in some patients, high SOD levels may prevent severe esophagitis. Antireflux surgery prevents oxidative damage.

Barrett Esophagus↗
PubMed1990

Distribution of equine infectious anemia in equids in southeastern United States.

State veterinarians in 11 southeastern states completed a questionnaire designed to determine the proportion of equids in the region that were seropositive for equine infectious anemia (EIA). Cases of EIA were diagnosed in each of the states surveyed. Distinct geographic clusters of cases were apparent in Tennessee and Kentucky adjacent to the Mississippi River, in the Piedmont of North Carolina at the Virginia border, in north central Georgia, and throughout the Florida peninsula. It is suggested that the national EIA program could be improved by standardization and wider application of uniform active surveillance measures, and improved documentation of EIA status of horses on acquisition and transfer records.

Animals↗
PubMed1990

Private midwives: a new approach to family planning service delivery in Ghana.

Data on 134 private sector midwives who were educated and trained in family planning service delivery by the Ghana Registered Midwives' Association (GRMA) showed that, for most, the course was the first they had received since qualifying as a midwife. Four out of five of the new family planning clients served by these midwives were first time contraceptive users. Approximately 9% of the clients were men, most of whom requested condoms. While delivering women is still the main function of the maternity homes, it is clear that family planning services have come to represent an important element of the health care the midwives provide. A follow-up study of family planning acceptors found extremely encouraging continuation rates. In addition, a survey of the women that the midwives had delivered showed that the contraceptive prevalence rate among these women was higher than the national rate. Providing family planning services through private sector midwives has been shown to be a very successful approach in Ghana, and one that has the potential to become a pillar of the nation's overall family planning delivery programme. As several other countries in Africa also have active private sector health networks, this approach holds promise far beyond its initial success in Ghana.

Adolescent↗
PubMed1990

Survey of trichinosis in breeding and cull swine, using an enzyme-linked immunosorbent assay.

Serum samples obtained from 40,927 swine at various locations in North Carolina between Aug 1, 1987 and July 31, 1988, were tested for antibodies to Trichinella spiralis, using an ELISA based on a larval T spiralis excretory-secretory antigen. In the ELISA, samples were considered to have positive results if the optical density (OD) reading was equal to or 5 times greater than the mean OD value of 4 negative-control sera from trichina-free swine. Of the 40,927 serum samples tested, 154 (0.38%) were positive by ELISA; the rate for breeding swine was 0.35% (105/30,162), and the rate for cull swine was 0.45% (49/10,765). Of the 49 seropositive samples from cull swine, 11 were from out of the state, 22 had no identification, and 16 were known to originate from North Carolina. Seropositivity had a bimodally seasonal distribution, with peaks in March and September. There was no difference between the mean age of seropositive and seronegative swine, but males were at greater risk for seropositivity than were females. Pigs from lots with less than 100 sera tested were at increased risk for seropositivity, as were pigs from the central coastal region of North Carolina.

Animals↗
PubMed1987

Disordered spatiotemporal processing in schizophrenics.

Schizophrenics have been observed to process information slower than normal individuals. The present study evaluated spatiotemporal information processing by schizophrenics and normal controls by means of a contrast sensitivity task. Spatial frequency gratings (0.9, 3.8, 15 cycles/degree), temporally modulated at 0.0 stationary, 0.8, 3.25, 6.5, and 26.0 Hz, were presented to evaluate whether or not schizophrenics are deficient in processing patterns or temporal information. While the patterns were increasing linearly from 0% to 30% contrast, the subjects were required to discern when pattern or temporal changes first occurred. A multivariate Analysis of Variance revealed that schizophrenics were poorer at detecting temporal changes between 3.25 and 6.5 Hz, whereas they were able to detect patterns better on the low and poorer on the high spatial frequencies compared to normals. No differences were obtained for the stationary pattern. These results are discussed in terms of abnormal sensory gating occurring during the critical duration of temporal integration.

Adolescent↗
PubMedDate not supplied

Update on the differential diagnosis, surveillance and management of hereditary non-polyposis colorectal cancer.

Hereditary non-polyposis colorectal cancer (HNPCC) is the most common hereditary form of colorectal cancer (CRC), accounting for approximately 10% of the total CRC burden. HNPCC lacks premonitory physical stigmata, thereby making the family history crucial for diagnosis. Advances in molecular genetics during the past 2 years have led to the cloning of four HNPCC genes (MHS2, MLH1, PMS1 and PMS2). It is now possible to provide presymptomatic DNA testing followed by genetic counselling for gene carriers. Some studies have shown that adenomas in HNPCC are larger, more villous, and have more high grade dysplasia than sporadic cases, suggesting an accelerated adenoma-carcinoma sequence. Given the early age of onset and proximal predominance of CRC, we initiate colonoscopy at age 20-25 years and we recommend that it be performed every 1-2 years. The wealth of clinical and molecular genetic knowledge currently available to physicians about HNPCC can be used effectively for cancer control.

Colorectal Neoplasms, Hereditary Nonpolyposis↗
PubMedDate not supplied

The natural history of liver disease in former drug users.

Three hundred and twenty drug-free former narcotic addicts were studied with regard to persistence of abnormalities of liver function and morphology, and their relation to hepatitis B infection. Hepatitis B antibody was present in 52.4 per cent, while HBs antigen was detected in only 6 per cent. Transaminase abnormalities, initially present in 39 per cent, were found in 22 per cent six months after cessation of drug abuse. Abnormalities tended to persist thereafter, although there was some continued return to normal levels. Liver biopsy findings of chronic persistent and aggressive hepatitis correlated with persistence of HBs antigenemia and transaminase elevation. Follow-up liver biopsies in seven subjects showed decreased inflammatory reaction in five. None showed progressive liver disease. We conclude that: (1) 15 to 20 per cent of former narcotics addicts have chronic persistent hepatitis or chronic aggressive hepatitis after cessation of drug absuse for six months or more; (2) serologic evidence of exposure to HBs antigen is frequent, and rapidly develops after the start of needle use; (3) although histologic ad chemical abnormalities usually persist, progression did not occur, and some individuals demonstrated spontaneous improvement.

Acute Disease↗
PubMedDate not supplied

Family planning operations research in Africa: reviewing a decade of experience.

Between 1979 and 1990, Columbia University conducted 26 family planning operations research (OR) projects in 13 sub-Saharan African countries. Most of these projects were implemented in settings where family planning service delivery had not yet been initiated or was new and poorly developed. In keeping with program needs in the early stages of development, the majority of the OR projects were based on demonstration or diagnostic designs. Only four of the 23 projects were comparative or quasi-experimental in design. Projects demonstrated the growing demand for family planning, and the feasibility and acceptability of a range of service delivery models. Sixteen of the projects have been sustained or replicated by national or local governments and institutions following the initial OR phase, replication of two others is planned, and another four resulted in policy formulation or improvements in existing national programs. OR in Africa played an important role in generating political and medical support for contraceptive services, and served to improve project management. OR proved more useful in the implementation and strengthening of individual programs than in generating universal lessons regarding service delivery. In order to maximize OR's utility in Africa, simple research designs and methods should be adopted.

Africa↗