Bupropion for smokers. New products for smoking cessation maintain profile of smoking cessation services.
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Bupropion↗
Biomedical subjects
W Richardson
Publications and source records attributed to W Richardson.
Smoking cessation. Pulling out the stops.
The launch of smoking-cessation drug Zyban in June last year greatly increased demand on a local smoking-cessation service. It is important to use local media to increase awareness of local services. Health authorities and pharmaceutical companies should work with the media when new drugs may put extra strain on local services.
Bupropion↗
A new device for microincremental automatic distraction osteogenesis.
We have invented a distraction device that can be placed intraorally and provides autodistraction. The device consists of two units: an implantable component that is applied directly on the bone, and an external component that is distant from the surgical site. The external component is mounted on a standard, battery-driven portable syringe driver or infusion pump. A fine flexible non-compressible tube connects the two. The compression of the bellows in the external component causes fluid to be forced through the connecting tube into the distraction component. The combination of the sealed system and incompressible fluid guarantees expansion of the bellows of the distraction component and gradually separates the bone segments.
Electric Power Supplies↗
Segmental mandibular reconstruction by microincremental automatic distraction osteogenesis: an animal study.
We investigated the reconstruction of a surgically created critical size mandibular defect in sheep using a newly developed automatic distraction device. The device has an implantable component, which is fixed to the mandible to allow the transfer of the transport disc across the created defect, and an external component which is mounted on the activation pump and secured away from the site of bone distraction. Compression of the bellows in the external component causes fluid to be forced through the connecting tube into the distraction component. Distraction at a rate of 1 mm over 24 h was achieved in six sheep. New bone generated at the site of the created defects both anterior (compression side) and posterior (tension side) to the transport disc and had similar radiodensity to the adjacent mandibular bone eight weeks after the completion of distraction.
Angiography↗
Attribution of responsibility for injury and long-term outcome of patients with paralytic spinal cord trauma.
STUDY DESIGN: Survey. OBJECTIVE: To assess the association between patients' perceptions of responsibility for the injury and long term outcomes. SETTING: Duke University Medical Center Spinal Injury Service. METHODS: One hundred and forty patients, who suffered spinal cord injuries between 1985 and 1990, were selected to participate in the study, and 26 (19%), including eight with quadriplegia, completed a telephone interview. The mean age at interview was 39+/-12 years and 12% were women. The mean time from injury to completion of the study was 8.7+/-1.5 years. Attribution of cause of injury, the Craig Handicap Assessment Reporting Technique, and the SF36 mental health depression/vitality surveyed instruments attribution of responsibility for the injury, functional capacity, mental health depression, and vitality. RESULTS: The majority (18/26) of patients either totally blamed themselves or others for their injuries. Overall, there was no statistically significant association between attribution of injury and long-term outcomes. Outcomes were similar in patients who either totally blamed themselves or others for their predicament. CONCLUSION: In this study, long-term outcomes were not influenced by whether patients perceived themselves as being responsible for their injuries.
Activities of Daily Living↗
Use of retinal biopsy to diagnose Bartonella (formerly Rochalimaea) henselae retinitis in an HIV-infected patient.
A patient with the acquired immunodeficiency syndrome developed bilateral retinitis due to a Bartonella (formerly Rochalimaea) henselae infection. A retinal biopsy was performed when severe and progressive retinal infection failed to respond to empirical treatment for cytomegalovirus and Toxoplasma gondii. The biopsy specimen was stained with routine histopathological stains and the Steiner silver stain. Ribosomal DNA was extracted from formalinfixed, paraffin-embedded retinal tissue and amplified with the polymerase chain reaction assay, using Bartonella-specific primers. The amplified DNA fragment was cloned and sequenced. Staining with hematoxylin-eosin revealed tufts of proliferating vascular endothelium with numerous fusiformappearing cells, consistent with a diagnosis of bacillary angiomatosis. A Steiner silver stain revealed numerous small bacilli in the biopsy specimen. Amplification of DNA extracted from the tissue produced a fragment of 16S ribosomal DNA of the expected size; sequencing of the DNA fragment revealed that the infection was caused by B henselae. The retinal infection was treated with minocycline, doxycycline, and ciprofloxacin with improvement in visual acuity in the ensuing 12 weeks. To our knowledge, this is the first human immunodeficiency virus-infected patient with retinitis due to B henselae who was diagnosed by the identification of silver-staining bacilli and amplification and sequencing of B henselae with a polymerase chain reaction assay using a biopsy specimen of retinal tissue. Retinal biopsy is indicated, despite its potential for serious complications, in patients with acquired immunodeficiency syndrome who have a progressive, sight-threatening retinitis that is undiagnosed and unresponsive to therapy.
AIDS-Related Opportunistic Infections↗
Seasonal changes in the Plasmodium falciparum population in individuals and their relationship to clinical malaria: a longitudinal study in a Sudanese village.
Residents of Daraweesh village in Sudan were monitored for Plasmodium falciparum infection and malaria morbidity in 3 malaria seasons from 1993 to 1996. Malaria parasites were detected microscopically and by polymerase chain reaction (PCR) in a series of cross-sectional surveys. PCR revealed submicroscopical infections during the dry season, particularly among individuals who had recovered from a malaria episode following successful drug treatment. Clinical and subclinical infections were contrasted by assaying for allelic polymorphism at 2 gene loci, MSP-1 and GLURP and 2 hypotheses examined with reference to these data: that clinical malaria is associated with infection with novel parasite genotypes not previously detected in that host, or alternatively, that clinical malaria episodes are associated with an increased number of clones in an infection. We detected more mixed infections among clinical isolates, but people carrying parasites during the dry season were not found to have an increased risk of disease in the following malaria season. There was a clear association of disease with the appearance of novel parasite genotypes.
Adolescent↗
Leukemia cutis with prominent giant cell reaction.
We present a case of leukemia cutis associated with a prominent giant cell component. This lesion was initially diagnosed as chronic granulomatous inflammation 1 year before the definitive diagnosis of leukemia cutis was made. Skin biopsy specimens showed numerous Langhans-type giant cells occurring singly and as poorly formed granulomas. However, the majority of the infiltrate consisted of immature myeloid cells, positive for chloroacetate esterase, lysozyme, and CD 68. Subsequent peripheral blood and bone marrow examinations confirmed the progression of the disease to acute myeloid leukemia.
Aged↗
The effect of intravenous administration of a chimeric anti-IgE antibody on serum IgE levels in atopic subjects: efficacy, safety, and pharmacokinetics.
CGP 51901 is a non-anaphylactogenic mouse/human chimeric anti-human IgE antibody that binds to free IgE and surface IgE of IgE-expressing B cells but not to IgE bound to high affinity IgE receptors (Fc epsilonR1) on mast cells and basophils or low affinity IgE receptors (Fc epsilonR2) on other cells. A phase 1 double-blind, placebo-controlled, single dose study with doses of 3, 10, 30, and 100 mg of CGP 51901 was conducted in 33 pollen-sensitive subjects who had raised levels of serum IgE and received either intravenous CGP 51901 or placebo. The administration of CGP 51901 was well tolerated and resulted in a decrease of serum free IgE levels in a dose-dependent manner, with suppression after 100 mg of CGP 51901 reaching > 96%. Time of recovery to 50% of baseline IgE correlated with the dose of administered antibody and ranged from a mean of 1.3 d for the 3 mg to 39 d for the 100 mg dose. Total IgE, comprised of free and complexed IgE, increased as stored and newly synthesized IgE bound to CGP 51901. Complexed IgE was eliminated at a rate comparable with the terminal half-life of free CGP 51901 (11-13 d at all doses). Only one subject showed a weak antibody response against CGP 51901. We conclude that the use of anti-human IgE antibody is safe and effective in reducing serum IgE levels in atopic individuals and provides a potential therapeutic approach to the treatment of atopic diseases.
Adolescent↗
Protective immune responses to Theileria annulata of relevance to vaccine development.
A series of projects on Theileria annulata funded by the European Union (STD1/STD2/STD3) have provided convincing evidence that macrophage and natural killer (NK) cell-dependent immune mechanisms may directly control the proliferation of different stages of T. annulata in cattle. The evidence for this conclusion and the implications for vaccine development are discussed in the following paper.
Animals↗
Possible mechanisms for the protective action of alpha-tocopherol in vascular hypoxia.
1. The mechanism of the protective action of alpha-tocopherol (vitamin E) in sustaining noradrenaline-induced responses in vascular hypoxia was investigated using pharmacological methods. 2. Four vascular spasmogenic agents, methoxamine, acetylcholine, histamine and potassium, each with a different mode of action were used to produce responses in guinea-pig isolated portal vein. In each case the responses were significantly reduced by hypoxia or hypoxia and a substrate-free environment. 3. Pre-incubation of the vein with alpha-tocopherol protected the noradrenaline-induced responses against hypoxia in the substrate-free environment, However, at the EC50 concentration for protection of noradrenaline, alpha-tocopherol failed to protect the responses of each agent from the inhibitory effects of hypoxia, suggesting a mechanism of protection involving noradrenaline. 4. Drugs known to interfere with the disposition of noradrenaline in sympathetically innervated tissues, cocaine, hydrocortisone and tyramine did not affect the response to alpha-tocopherol. 5. Responses to calcium were unaffected by alpha-tocopherol in normoxia and hypoxia. 6. The protective action of alpha-tocopherol was not mimicked by the chromanol ring of the vitamin structure, Trolox C, suggesting that the vascular protection in hypoxia was not dependent on an antioxidant mechanism. 7. However, the glycolytic enzyme inhibitor, iodoacetic acid, prevented the protective action of the vitamin in hypoxia, suggesting that alpha-tocopherol enhanced noradrenaline-mediated activity in hypoxia through an iodoacetic acid-sensitive pathway.
Animals↗
Characteristics of the protective action of alpha-Tocopherol in vascular hypoxia.
The functioning of the guinea-pig isolated portal vein was monitored by measuring spontaneous mechanical activity, responses to electrical stimulation and administered noradrenaline in normoxic conditions. The effect of hypoxia, induced by bubbling the physiological bathing solution with a 95% N(2)/5% CO(2) gas mixture, on the mechanical performance of the vein was then assessed. Spontaneous activity declined in hypoxia, with mean contraction tension reduced by 55 + or - 8.8%. The responses to electrical field stimulation (2-32 Hz, 0.7 msec. 70 V) were lowered by 14 + or - 4.6% but contractions produced by a range of noradrenaline concentrations (0.01-160 mu M) were unaffected by hypoxia. Substitution of glucose in the bathing solution with sucrose, a substrate unavailable to the cells for energy generation, produced a marked enhancement of the effect of hypoxia. Spontaneous activity was reduced by 76 + or - 8.3%, electrically-induced activity by 80 + or - 14.4% and noradrenaline-induced responses by 85 + or - 6.8%. Although in normoxia the activity and responses of the portal vein were unaffected by the presence of alpha-tocopherol, it significantly protected the functioning of the vein in hypoxic conditions. This effect was concentration-dependent within the range 10-160 mu M and was most marked when glucose was replaced by sucrose in the bathing solution.
Adrenergic alpha-Agonists↗
Marked bone marrow eosinophilia at the time of relapse of acute myeloblastic leukaemia in association with the appearance of translocation t(12;20)(q24;q11).
We report a case of acute myeloblastic leukaemia (AML), FAB type M2, with karyotype t(8;21)(q22;q22), who at the time of relapse showed marked eosinophilia of the bone marrow. Karyotype analysis showed the appearance of an additional clone t(8;21)(q22;q22),t(12;20)(q24;q11). To the best of our knowledge, marked eosinophilia has not been reported in association with this particular chromosomal translocation.
Adult↗
Detection of very low level Plasmodium falciparum infections using the nested polymerase chain reaction and a reassessment of the epidemiology of unstable malaria in Sudan.
We have used the nested polymerase chain reaction (PCR) to assay for low level Plasmodium falciparum infections that were below the threshold of detection of blood film examination. This revealed a substantial group of asymptomatic, submicroscopically patent infections within the population of a Sudanese village present throughout the year although clinical malaria episodes were almost entirely confined to the transmission season. In our September, January, April, and June surveys, the PCR-detected prevalences were 13%, 19%, 24%, and 19%, respectively. These figures reveal a much higher prevalence of dry season infection than previous microscopic surveys have indicated. Furthermore, 20% of a cohort of 79 individuals were healthy throughout the September to November transmission season but were PCR-positive for P. falciparum in a least one of a series of samples taken in the ensuing months. Levels of exposure to P. falciparum infection were therefore higher than was previously believed in this region, highlighting the fact that many individuals were infected but healthy for most of the year. The reservoir parasite population was thus larger and more stable than previously thought, a finding that is consistent with the high levels of genetic variation at polymorphic loci reported from analysis of P. falciparum parasites in this area.
Adolescent↗
A facemask connector.
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Anesthesia, Local↗
The first t-test.
The data with which Student illustrated the application of his famous distribution are examined from a number of aspects. Central to the discussion is the within-patient clinical trial at Kalamazoo whose results were published by Cushny and Peebles and misquoted by Student and Fisher. This trial is discussed from historical, pharmacological and statistical perspectives. Student's and Fisher's analyses and a more modern analysis by Preece are considered as is Cushny's and Peebles's interpretation. Brief biographies of the five physicians involved in running the trial are presented.
Animals↗
Sclerosing peritonitis.
Sclerosing peritonitis (SP) is an uncommon and devastating problem which involves the visceral and parietal peritoneal surfaces of the abdominal cavity. SP has been reported in association with peritoneal dialysis, with medications, and following peritonitis. No clear etiology or preventative treatment exists for this unusual problem. Herein, we report 3 cases with the unusual aspect of apparent progression of this fibrotic and sclerosing process after the termination of the peritoneal dialysis and successful renal transplantation. Each of these cases resulted in a mechanical small bowel obstruction secondary to a densely fibrosing and encasing peel of reactive connective tissue visibly different from the usual postoperative adhesions. Sclerosing peritonitis should be included in the differential diagnosis of a current peritoneal dialysis patient who exhibits signs of partial small bowel obstruction with a continual decrease in peritoneal clearance and/or successfully transplanted patients who had utilized peritoneal dialysis therapy in the past and now exhibit signs and symptoms of a mechanical small bowel obstruction.
Adult↗