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Biomedical subjects

W Andrews

Publications and source records attributed to W Andrews.

At least 19 recordsLinked to original sources
PubMed1992

New-generation RIBA hepatitis C strip immunoblot assays.

Second-generation hepatitis C virus (HCV) ELISAs are currently in use in Europe and have been submitted for approval in the United States. These new assays contain additional antigens from the putative nucleocapsid and NS-3 regions of the HCV genome in addition to the c100-3 antigen present in first-generation ELISAs. A supplementary test, the second-generation RIBA HCV strip immunoblot assay (2-RIBA HCV SIA) has also been developed. The strip immunoblot assay uses four recombinant HCV antigens [5-1-1 (NS-4), c100-3 (NS-4), c33c (NS-3), and c22-3 (NS-3) (nucleocapsid)] slot blotted on nitrocellulose. Screening of random volunteer blood donors with the Ortho second-generation HCV ELISA (ORTHO HCV 2.0 ELISA) indicates that a substantial change in the repeat reactive donor population is observed with the new test. Two notable features of this change are: (1) A large number of samples reactive in the 2-RIBA HCV SIA for the second-generation antigens, c33c and c22-3, are detected by the ORTHO HCV 2.0 ELISA; (2) the percentage of ORTHO HCV 2.0 ELISA reactive specimens found indeterminate (reactive for only one HCV antigen) by the 2-RIBA HCV SIA is higher than in first-generation HCV ELISAs (approximately 25 vs. 5%). In addition, ORTHO HCV 2.0 ELISA repeat reactive, 2-RIBA HCV SIA indeterminate samples are dominated by reactivity to c22-3 instead of c100-3, which is the case for first-generation HCV ELISA repeat reactive samples. Resolution of 2-RIBA HCV SIA indeterminate samples as either containing anti-HCV antibodies or not, is important in both diagnostic and blood screening environments, especially where donor notification is required. Our approach to resolution of these troublesome samples evolved from initial work with HCV peptides. Early studies with an experimental strip immunoblot assay containing 5 peptides from the nucleocapsid, E2 (NS-1), NS-4, and NS-5 regions of the viral genome indicated that peptides from the nucleocapsid and NS-4 regions of the genome could provide additional evidence for the presence of anti-HCV antibodies with good specificity, but other peptides suffered from poor specificity. In addition, no immunoreactive peptide from the NS-3 (c33c) region of the virus is available, presumably because the major epitope(s) of this key second-generation antigen is a conformational determinant.(ABSTRACT TRUNCATED AT 400 WORDS)

Blood Transfusion↗
PubMed1992

Expectant management of preterm ruptured membranes: effects of antimicrobial therapy.

OBJECTIVE: To determine whether the addition of broad-spectrum antimicrobial therapy to traditional expectant management improves pregnancy outcome in patients with premature rupture of membranes (PROM) remote from term. METHODS: Patients with preterm PROM before 34 weeks' gestation who were not in labor and had no signs of infection or fetal distress were randomized to one of two study groups: 1) expectant management alone and 2) expectant management plus antimicrobial therapy. Women in the latter group received intravenous ampicillin, gentamicin, and clindamycin for 24 hours, followed by amoxicillin plus clavulanic acid orally for 7 days. Other than antibiotic use, management of the two groups was identical. RESULTS: Significantly more women (P < .01) treated with antibiotics (20 of 48, 42%) remained undelivered 7 days after admission compared with those managed expectantly without antibiotics (seven of 46, 15%). In addition, more neonates in the group managed with antibiotics were admitted to the routine nursery (nine of 48 versus two of 45; P = .03). However, there was no difference between the groups in the frequency of serious maternal or neonatal morbidity. CONCLUSIONS: The addition of broad-spectrum antimicrobial therapy to traditional expectant management of pregnancy complicated by preterm PROM may increase the number of gestations undelivered 7 days after admission. It may also decrease the proportion of infants admitted to special care nurseries. Whether these effects result in significant short- or long-term maternal or neonatal benefit remains to be determined.

Anti-Bacterial Agents↗
PubMed1992

New generation RIBA hepatitis C strip immunoblot assays.

Second generation hepatitis C virus (HCV) Elisas are currently in use in Europe and have been submitted for approval in the United States. These new assays contain additional antigens from the putative nucleocapsid and NS-3 regions of the HCV genome in addition to the c100-3 antigen present in first generation Elisas. A supplementary test, the second generation RIBA (Chiron Co trademark) HCV strip immunoblot assay (2-RIBA HCV SIA) has also been developed. The strip immuno-blot assay uses four recombinant HCV antigens (5-1-1 [NS-4], c100-3 [NS-4], c33c [NS-3], and c22-3 [NS-3 [nucleocapsid]) slot blotted on nitrocellulose. Screening of random volunteer blood donors with the Ortho (Ortho Diagnostic Systems trademark) second generation HCV Elisa (2-Ortho HCV Elisa) indicates that a substantial change in the repeat reactive donor population is observed with the new test. Two notable features of this change are: i) a large number of samples reactive in the 2-RIBA HCV SIA for the second generation antigens, c33c and c22-3, are detected by the 2-Ortho HCV Elisa; ii) the percentage of 2-Ortho HCV Elisa reactive specimens found indeterminate (reactive for only one HCV antigen) by the 2-RIBA HCV SIA is higher than in first generation HCV Elisas (approximately 25 versus 5%). In addition, 2-ortho HCV Elisa repeat reactive, 2-RIBA HCV SIA indeterminate samples are dominated by reactivity to c22-3 instead of c100-3 which is the case for first generation HCV Elisa repeat reactive samples.(ABSTRACT TRUNCATED AT 250 WORDS)

Enzyme-Linked Immunosorbent Assay↗
PubMed1991

Schistosoma mansoni tropomyosin: production and purification of the recombinant protein and studies on its immunodiagnostic potential.

A cDNA that encodes Schistosoma mansoni tropomyosin, except for 10 amino acids at the amino terminus, has been cloned into a pOTSNCO plasmid vector. Induced expression resulted in a constant level of recombinant protein production. The recombinant S. mansoni tropomyosin was purified from preparative SDS-PAGE gel and by a combination of 20% ammonium sulfate fractionation and fast protein liquid chromatography-ion-exchange chromatography. The purified recombinant S. mansoni tropomyosin was tested as an immunodiagnostic reagent in Western blot and enzyme-linked immunosorbent assays. Sera from individual patients with chronic S. mansoni infection, but not S. haematobium, S. japonicum, parasitic infections other than schistosomiasis, and without infection reacted with the recombinant tropomyosin. The species specificity of S. mansoni tropomyosin suggests that further study of its potential as an immunodiagnostic reagent is warranted.

Animals↗
PubMed1990

Renal stone formation following medical treatment of renal candidiasis.

Two very low birth weight infants who developed renal candidiasis with pelvicalyceal fungal concretions were treated medically with Amphotericin B and 5 Fluorocytosine. Two months following cessation of therapy, the fungal concretions decreased in size, became sterile and developed calcification in residual debris. The calcifications was still present at demise in one patient and at 18 months follow up in the other. These calcifications occurred in the absence of simultaneous furosemide therapy.

Amphotericin B↗
PubMed1990

Chlamydia trachomatis pneumonitis: a case study and literature review.

Chlamydia trachomatis was cultured from the lung and eye of an 11-day-old infant who had rapidly deteriorating respiratory symptoms. Chlamydia trachomatis inclusion bodies were identified on thick Epon sections and by electron microscopy. We discuss the unusual presentation and review the published histopathological lung findings.

Chlamydia Infections↗
PubMed1985

Towards ICD 10: the attitudes of Australian and New Zealand psychiatrists.

About 15% of practising psychiatrists in Australia and New Zealand responded to a brief postal questionnaire. This sample appears reasonably representative of the various groups within the profession and of the geographical distribution of the clinicians. Ninety-one per cent of the respondents thought it was important to have a reliable classification; 83% thought that ICD 10 should incorporate specific diagnostic criteria; and 78% were of the view that ICD 10 should have a multiaxial system. Overall, DSM-III is used twice as often as ICD 9, and only 12% of psychiatrists do not use DSM-III at all. A very small minority (6%) use some other classification system. The results of this survey are discussed against the background of the intended introduction of ICD 10 in about 1990. Preliminary preparations for it are already in progress.

Attitude of Health Personnel↗
PubMed1984

Influence of DR matching in cadaveric renal transplants performed with cyclosporine. A retrospective analysis of one center.

A retrospective analysis of 300 consecutive cadaveric renal allografts performed at our institution between August 1, 1981, and December 1, 1983, was performed to evaluate the influence of DR typing on graft and patient survival. All patients were treated with low-dose steroids and cyclosporine as the only means of immunosuppression. The group included 246 primary graft recipients and 54 retransplants. DR information was available on the donor and the recipient in 225 of these patients, and it was unavailable on the donor and/or recipient in 75 patients. In 49% of the cases in which information was available, 2 alleles were identified in the donor and in the recipient; in the remainder only 1 allele was identified in either the donor or recipient. The results were analyzed according to HLA/DR match and mismatch. Twelve-month graft survival for the 2-DR-match recipients was 67%, versus 78% for the 1-DR match and 76% for the O-DR match. These differences were not significant. For the O-DR mismatch, the one-year actuarial graft survival was 74%, for the 1-DR mismatch 78%, and for the 2-DR mismatch 79%. Again, there was no significant difference. There was no impact of DR matching on patient or graft survival up to 18 months. Additionally, no difference was found in any of the groups regarding the number of treated rejection episodes per patient or the amount of steroid received per patient at the end of a year. These results suggest that cyclosporine negates the effect of DR matching in cadaveric renal transplantation.

Cyclosporins↗
PubMed1983

Reduction of neonatal heat loss by an insulated head cover.

When exposed to a cool environment, the newborn infant responds by nonshivering thermogenesis. The increased heat production is at the expense of body fuel and energy stores. A significant quantity of heat is lost from the head because of its large surface area and the high metabolic activity of the neonatal brain. The purpose of this study was to determine whether dry cranial heat loss could be significantly reduced by covering the head with highly insulated material, and to determine whether plastic lined hats decreased evaporative heat loss. A total of 46 fullterm and premature infants were studied. Hats insulated with material made of olefin and polyester reduced cranial dry heat loss by 73% and 63%. Plastic lined hats reduced evaporative heat loss by 68%. The insulated and lined hats proved to be a simple and safe method of effectively reducing dry and evaporative heat loss.

Alkenes↗
PubMed1981

Thyroid cancer: some basic considerations.

From these data and data from the literature, our recommended treatment for well-differentiated cancer is as follows: For papillary cancer, resection should be adequate to encompass the entire tumor, which in most cases would be complete lobectomy and possibly isthmusectomy. Prophylactic neck dissection is of no value; therapeutic modified neck dissection should be done for stage II disease. Follicular cancer can be treated by lobectomy (for small lesions) or subtotal thyroidectomy. Although total or near-total thyroidectomy may be required in selected patients with large primary cancers or in those with extensive capsular invasion or extrathyroid extension, the number of cases indicating this is small. There were only a few such patients with large primaries requiring total thyroidectomy in this study. Total thyroidectomy is best avoided in most cases. considering the price of hypoparathyroidism and the lack of a significant improvement in survival compared with lesser ablative techniques. Postoperative ablation with iodine-131 did not improve survival in staged patients with papillary cancer (the number of patients with follicular cancer was too small for analysis). Postoperative thyroid suppression by exogenous thyroid hormone postoperatively appeared to improve survival. Although the data were not adequate for evaluation in follicular cancer, there seems to be no reason not to use this postoperatively in high risk patients with either papillary or follicular cancer.

Adenocarcinoma↗
PubMed1976

Respiratory load compensation in infants.

We have studied the respiratory compensation for elastic loads in 15 term and preterm infants. Elastic loads, approximately equal to the infant's effective elastance, were applied to the airway for five breaths while tidal volume and mask pressure were monitored. Motion of the rib cage and abdomen were monitored simultaneously with magnetometers. The studies were done both in active or REM sleep and in quiet or non-REM sleep. During quiet sleep the load immediately reduced the tidal volume by about 50% but a progressive increase in tidal volume occurred over the next four loaded breaths. During active sleep load compensation was disorganized with respect to both tidal volume and frequency, and compensation was significantly less. Active sleep was also characterized by marked rib cage distortion. We suggest that during active sleep there is tonic inhibition of the intercostal muscles, allowing the diaphragm to distort the rib cage. This distortion impairs load compensation by a direct mechanical effect and indirectly by initiating an intercostal-phrenic reflex.

Abdomen↗