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Biomedical subjects

A Diwan

Publications and source records attributed to A Diwan.

At least 19 recordsLinked to original sources

Temperature trends in total hip arthroplasty: a retrospective study.

The purpose of this study was to define the temporal trend in body temperature of patients during the first 5 days after total hip arthroplasty (THA). The medical records of 98 consecutive THAs were reviewed, 88 clinically uncomplicated cases were included. The average maximum temperature reached during the study period was 38.08 degrees C, a 3.7% (P< or =.01) increase from the preoperative base line of 36.64 degrees C. In this study, 62.5% of patients reached a temperature > or =38.0 degrees C; 19.3% > or = 38.5 degrees C; and 3.4% > or = 39.0 degrees C. No patients had a preoperative temperature of > or =38 degrees C recorded. On the first postoperative day, 39 patients had a temperature > or =38 degrees C. The number of febrile patients progressively decreased until by the fifth postoperative day, only 5 patients had a temperature > or =38 degrees C recorded.

Arthroplasty, Replacement, Hip↗

Incidence of femoral and popliteal artery aneurysms in patients with abdominal aortic aneurysms.

OBJECTIVE: The purpose of this study was to determine the incidence of femoral and popliteal aneurysms in men and women who have abdominal aortic aneurysms (AAAs) and to assess potential etiologic differences in patients with and without these lower extremity aneurysms. METHODS: We studied 313 consecutive patients with AAAs encountered from 1995 to 1998 who underwent prospective ultrasound scanning to detect the presence or absence of femoral and popliteal aneurysms. Patients with and without these extremity aneurysms were compared for differences in potential etiologic risk factors with each other and with a statewide population of patients with AAAs. RESULTS: A total of 51 femoral and popliteal aneurysms were encountered, all occurring in male patients. Among the 251 men with AAAs, the incidence of femoral or popliteal aneurysms was 14%, compared with 0% among the 62 women with AAAs (P <.01). A family history of aneurysmal disease was present in only one (3%) of the 36 men with these extremity arterial aneurysms, a significant finding (P <.01) when compared with the family history that was positive for aneurysmal disease in 14 women (23%). Peripheral arterial occlusive disease affected 14 (39%) of the 36 men with peripheral arterial aneurysms versus 20 (9%) of the 215 men without these aneurysms (P <.01). Most other etiologic variables studied proved not to be different among the various groups of patients examined. CONCLUSION: The incidence of femoral and popliteal aneurysms in persons with AAAs appears higher than that noted previously. Femoral and popliteal aneurysmal disease preferentially affects men; however, the basis for this sex difference is unknown. Few common etiologic factors differed between men with and without these extremity aneurysms. Most femoral and popliteal artery aneurysms in this study were undetectable on physical examination, suggesting that ultrasound scanning is appropriate in the recognition of peripheral aneurysms among men with AAAs.

Aged↗

Nitric oxide regulates alkaline phosphatase activity in rat fracture callus explant cultures.

Nitric oxide (NO) is synthesised by a group of enzymes called nitric oxide synthases (NOS) and oxidizes to its stable end-products nitrite (NO2-) and nitrate (NO3-) We have previously reported in an in vivo rat model that NO is an important regulator for rat bone fracture healing. This study examines the effects of NO on alkaline phosphatase (ALP) activity in a rat fracture callus explant culture system. Explants of rat femoral fracture callus from days 4, 7, 14 and 28 post fracture induced NO2 release and ALP activity in a biphasic temporal manner, with the highest activity on day 7 and the lowest activity on day 14. Inhibition of NOS by co-incubation with an NOS inhibitor, S-(2-aminoethyl) isothiouronium bromide hydrobromide (AETU), inhibited ALP activity by an average of 50% at each time point (P <0.01). Supplementation with NO donor 3-morpholinosydnonomine hydrochloride (SIN-1) at low doses (25 and 0.025 microM) increased ALP activity by 20% (P < 0.01). ALP mRNA and histochemical ALP activity were localised to osteoblast-like and chondrocyte-like cells within fracture callus. The current study provides evidence that NO plays a regulatory role in ALP activity during rat fracture healing.

Alkaline Phosphatase↗

Production of atypical measles in rhesus macaques: evidence for disease mediated by immune complex formation and eosinophils in the presence of fusion-inhibiting antibody.

The severe disease atypical measles occurred when individuals immunized with a poorly protective inactivated vaccine contracted measles, and was postulated to be due to a lack of fusion-inhibiting antibodies. Here, rhesus macaques immunized with formalin-inactivated measles vaccine developed transient neutralizing and fusion-inhibiting antibodies, but no cytotoxic T-cell response. Subsequent infection with measles virus caused an atypical rash and pneumonitis, accompanied by immune complex deposition and an increase in eosinophils. Fusion-inhibiting antibody appeared earlier in these monkeys than in non-immunized monkeys. These data indicate that atypical measles results from previous priming for a nonprotective type 2 CD4 T-cell response rather than from lack of functional antibody against the fusion protein.

Animals↗

Evidence for widespread infection of wild rats with hepatitis E virus in the United States.

Hepatitis E is an important medical pathogen in many developing countries but is rarely reported from the United States, although antibody to hepatitis E virus (anti-HEV) is found in > 1% of U.S. citizens. Zoonotic spread of the virus is suspected. Sera obtained from 239 wild rats trapped in widely separated regions of the United States were tested for anti-HEV. Seventy-seven percent of rats from Maryland, 90% from Hawaii, and 44% from Louisiana were seropositive for anti-HEV. Rats from urban as well as rural areas were seropositive and the prevalence of anti-HEV IgG increased in parallel with the estimated age of the rats, leading to speculation that they might be involved in the puzzling high prevalence of anti-HEV among some U.S. city dwellers. The discovery of a in rats in the United States and the recently reported discovery that HEV is endemic in U.S. swine raise many questions about transmission, reservoirs, and strains of HEV in developed countries.

Animals↗

Differential prevalence of cigarette smoking in patients with schizophrenic vs mood disorders.

Rates of substance-use disorders among psychiatric patients are consistently higher than in the general population, yet there is no clear specificity to the relationship between types of substance use and psychiatric diagnoses. Cigarette smoking may represent a substance-use behavior which has greater specificity for major psychiatric diagnoses. We examined the self-reported history of cigarette smoking vs marijuana, alcohol and cocaine use among 83 male veteran psychiatric patients with primary mood (major depression or bipolar disorder; n = 20) or schizophrenic (schizophrenia or schizoaffective; n = 63) disorders. Those in the SCZ group compared to those in the AFF group were more likely to be ever-smokers (OR 8.5, 95% CI [2.2, 32.3]), and current smokers (OR 12.0%, 95% CI [3.6, 40]), independent of age differences between the groups. There were no significant differences in marijuana, alcohol or cocaine use between the two groups when age differences were controlled. Generalizability of the findings is limited by small number of subjects, male gender and veteran status; however, the significantly higher prevalence of smoking among individuals with schizophrenic disorders may support the growing evidence of linkages between the effects of nicotine and the neurobiology of schizophrenia.

Adult↗

Familial slipped capital femoral epiphysis: a report and considerations in management.

BACKGROUND: Familial inheritance of slipped capital femoral epiphysis (SCFE) is known. It has not been described in non-identical twins. A family where the mother and three of five siblings developed SCFE were investigated and managed. METHODS: Anthropometric measurement consisted of height-weight ratios. Serum sex hormone levels and bone Gla Protein was measured. Bone mineral densities were evaluated. RESULTS: The affected siblings had higher bodyweight percentiles. Other investigations were within normal limits. CONCLUSION: The unfavourable height-to-weight ratio was one of the mainstays in developing a management protocol for all siblings. The management protocol developed for the family is discussed.

Algorithms↗

Serological cross-reactivities between the retroviruses HIV and HTLV-1 and the malaria parasite Plasmodium falciparum.

Serum samples from three populations of Papua New Guinea, where Plasmodium falciparum malaria and human T-lymphotropic virus type 1 (HTLV-1) are coendemic at high prevalence rates, showed statistically significant ELISA co-seropositivity and co-seronegativity. Cross-reactivity was further indicated by the presence of 10 bands ranging from 134 kDa to 18 kDa on immunoblots of electrophoresed whole lysate P. falciparum antigen against serum of HTLV-1 seropositive patients from an area where malaria is not present. Similarly, sera from patients positive for human immunodeficiency virus (HIV) from a non-malarious region produced immunoblot bands ranging from 134 kDa to 33 kDa to the P. falciparum antigen. The HTLV-1 and HIV serum samples yielded a number of immunoblot bands when reacted to an electrophoresed human O type red cell membrane antigen, but those bands had no identity to the cross-reactive bands on the P. falciparum antigen immunoblots. Malaria-positive sera from Papua New Guinean subjects presumed to be uninfected with HIV produced a variety of bands, some of intense prominence, to HIV antigen on diagnostic Western blots.

Adolescent↗

Unusual cause of third-body wear in total hip arthroplasty.

A case of severe osteolysis caused by third-body wear using a Harris-Galante II cup (Zimmer, Warsaw, IN) is reported. The prosthesis was inserted in a 23-year-old man 4.5 years ago. At revision, 3 triangular tynes of the acetabular shell rim were found embedded in the polyethylene liner.

Adult↗

Hepatitis B virus infection in Honolulu students.

OBJECTIVES: To determine hepatitis B virus (HBV) carrier and infection rates and HBV epidemiology in Honolulu students. DESIGN: Cross-sectional survey. SETTING: Honolulu public elementary, intermediate, and high schools. PATIENTS: A volunteer sample of 4936 students from 43 Honolulu schools. MAIN OUTCOME MEASURES: HBV carrier rate (presence of hepatitis B surface antigen) and infection rate (presence of either hepatitis B surface antigen, antibody to hepatitis B surface antigen, antibody to hepatitis B core antigen, or any combinations of these) by school grade, ethnicity, and place of birth. RESULTS: Eighty-three (1.68%) students were identified as HBV carriers, and a total of 353 (7.15%) students had serologic evidence of infection. Infection rates increased from elementary school age to high school age, more so in Asian/Pacific Island-born students. The prevalence of infection was higher in Asian/Pacific Island-born students than in those born in the United States. The majority of infected Hawaiian-born students were first-generation Asian/Pacific Island Americans. CONCLUSIONS: Horizontal transmission of HBV occurs in Honolulu school-age children. HBV immunization of all infants in Hawaii, not just those born to carrier mothers, is necessary to reduce HBV transmission in Hawaii.

Adolescent↗

Rotavirus diarrhoea in children in the highlands of Papua New Guinea.

Children from the highlands of Papua New Guinea, hospitalized for severe diarrhoea, were examined for clinical signs and the presence of rotaviruses. Rotavirus was detected in faecal samples from 68% (23/38) of patients examined. In contrast to other studies, an excess of respiratory symptoms was not observed and the infection rate of disease due to rotavirus was relatively high in children under 6 months of age. In an environment where pigs and humans share close contact a rotavirus strain infecting piglets was also demonstrated.

Animals↗

HTLV-I antibody studies in villagers in East Sepik Province, Papua New Guinea.

Serum samples collected in 1984 during a malariometric survey of two villages in the East Sepik Province of Papua New Guinea were tested for antibodies to HTLV-I. None of the villagers showed any symptoms suggestive of retrovirus infection. Eighteen of the 186 (9.5%) sera tested at that time were found to be positive. Blood samples were subsequently obtained from fifteen of the eighteen positives and subjected to analysis by enzyme-linked immunosorbent assay (ELISA), radioimmuno assay (RIA), radioimmunoprecipitation assay (RIPA), and Western blot (WB). Fourteen of the fifteen gave a positive ELISA response, but none were unequivocally positive by p 24 RIA. All sera tested were reactive to gag antigens by WB, but gave "indeterminate" results currently accepted criteria. Notably absent from the WB profiles of all of the study subjects was an antibody response to HTLV-I envelope protein gp 46. It is possible that these antibody responses are directed against a variant of HTLV-I or to a novel retrovirus which possesses core antigens similar to those of HTLV-I but has different envelope antigens. Until a virus is isolated, or the viral genome is identified in infected lymphocytes, the possibility remains that the response may be due to factors unrelated to retrovirus infection.

Adult↗

Human T-lymphotropic virus type I (HTLV-I) and tropical spastic paraparesis or HTLV-I-associated myelopathy in Hawaii.

Tropical spastic paraparesis or human T-lymphotropic virus type I (HTLV-I)-associated myelopathy is a degenerative encephalomyelopathy with pyramidal tract dysfunction affecting the lower extremities. It is associated with HTLV-I infection and found primarily in the Caribbean region and in southwestern Japan. Five cases of tropical spastic paraparesis (or HTLV-I-associated myelopathy) in Hawaii are reported. All five patients were born in Hawaii; four are women. Each of the patients has parents who were from HTLV-I-endemic areas of Japan. Two of these patients had serum antibodies to HTLV-I. Five of six of the spouses and children of the seropositive patients were also seropositive. Viral cultures of lymphocytes from both seropositive patients and two of the three seropositive children were positive for HTLV-I. None of the five patients had a history of antecedent blood transfusion, multiple sexual partners, or intravenous drug use. There is no evidence of adult T-cell leukemia or lymphoma in any of the patients or their families. Given the increasing seroprevalence of HTLV-I in the United States, clinicians need to be alert to new cases of this disorder.

Back Pain↗

Precautions in medical care of, and in handling materials from, patients with transmissible virus dementia (Creutzfeldt-Jakob disease).

We have formulated a series of precautions to be observed in caring for patients with Creutzfeldt-Jakob disease and in handling their tissues. The virus resists inactivation by simple boiling in water. Also ineffective are 10 per cent formalin, 70 per cent alcohol and ionizing and ultraviolet radiation. Autoclaving for one hour at 121 degrees C and 20 psi inactivates the agent completely. Five per cent hypochlorite, 0.03 per cent permanganate, phenolics and iodine solutions are adequate disinfectants inactivating large infective doses of the virus. Special isolation wards for afflicted patients seem unwarranted. Workers exposed to infected saliva, nasopharyngeal secretions, urine or feces need to and should wash thoroughly with ordinary soap. Needles and needle electrodes should be autoclaved or incinerated and discarded. Demented persons should not be used for donations of blood or other tissues. Although precautions are necessary, the epidemiologic evidence does not suggest an unusual risk of Creutzfeldt-Jakob disease for medical workers.

Animals↗

Antibiotic susceptibility of Staphylococcus aureus in Saigon, South Vietnam.

Methicillin resistant staphylococci are unevenly distributed throughout the world; the explanation for this is not known. During a survey of local hospitals for methicillin resistance, a number of strains from South Vietnam became available for study. Tests were performed in microtiter plates using various concentrations of several antibiol. With the larger number of organisms in the inoculum, 17% of strains required 12.5 mug/ml or more of methicillin for inhibition. This is in contrast to a very low percentage of methicillin resistant staphylococci from local sources encountered in our laboratory. An unexpected finding was the occurrence of considerable lincomycin resistance in staphylococci from South Vietnam.

Anti-Bacterial Agents↗