PubMed Health⌕ Search

Biomedical subjects

A Fanning

Publications and source records attributed to A Fanning.

28 records · Page 2Linked to original sources
PubMed1993

DNA fragment length polymorphism analysis of Mycobacterium tuberculosis isolates by arbitrarily primed polymerase chain reaction.

Strain identification of Mycobacterium tuberculosis would prove whether transmission had occurred between individuals. A method to characterize strains of M. tuberculosis has been developed utilizing polymerase chain reaction (PCR). Purified chromosomal DNA of cultured clinical samples of M. tuberculosis were subjected to PCR using short (10-12 nucleotide) oligonucleotide primers. PCR products visualized after agarose gel electrophoresis and ethidium bromide staining demonstrated that different strains of M. tuberculosis give different banding patterns. This technique was used to confirm the relationship between cases of tuberculosis in several clusters, prove the lack of relationship between 2 isolates with the same antibiotic-resistance pattern, confirm a suspected mislabeling event, and suggest the source of infection in a case of tuberculous meningitis. This method is rapid and simple and does not require radioactive probes.

Amino Acid Sequence↗
PubMed1992

Atypical tuberculosis in the pediatric patient: implications for the pediatric surgeon.

Atypical species of mycobacteria (AMB) are now the most common cause of granulomatous lymphadenopathy. It is important for pediatric surgeons to be aware of this disease, because excision is the mainstay of therapy. We have reviewed the experience with this disease in Alberta by reviewing the records of the Provincial Laboratory of Public Health from 1979 to 1990. This facility reviews all tuberculosis cultures for the province. A total of 74 cases of infection caused by AMB were identified in patients under the age of 15. Complete records were available for 53 of these cases. These infections were characterized by a short history (11.2 weeks) of remarkably nontender regional lymphadenopathy (usually cervicofacial, 45/50) in young (average age, 13.6 months), caucasian (48/53) children. Attempts to treat these lesions by incision and drainage or drug therapy were unsuccessful (12/12 failed), whereas primary excision was successful in 33 of 37 cases. Secondary excisions were also successful in 16 of 16 cases where required. The annual rate of AMB over the study period was 1.21 cases per 100,000 children; the rate of M tuberculosis lymphadenopathy was 0.3 per 100,000. In the absence of specific risk factors for human tuberculosis (family history, native Indian or Asian ethnic origin) AMB is the most likely cause of prolonged painless lymphadenopathy and should be treated early by complete excision.

Adolescent↗
PubMed1991

Mycobacterium bovis infection in human beings in contact with elk (Cervus elaphus) in Alberta, Canada.

Human infection with Mycobacterium bovis is rare in developed countries because of milk pasteurisation and the slaughter of infected cattle. An epizootic of M bovis infection in domesticated elk (Cervus elaphus) in Alberta, Canada, which started in April, 1990, prompted us to seek human contacts of elk herds. There were 446 identified contacts, in 394 of whom tuberculin skin tests were done. Of 81 contacts who were skin-test positive, 50 had been in contact with culture-positive animals. 6 of 106 subjects tested a second time became tuberculin positive. 1 case of active M bovis infection was diagnosed by sputum culture. The mode of transmission of M bovis from these farm animals to man is likely to be aerosolisation of infected particles. Because of the apparent susceptibility of farmed Cervidae (deer) to M bovis infection, and the evidence of spread to man, control measures to prevent human infection should be developed.

Adult↗
PubMed1991

Mycobacterium bovis infection in humans exposed to elk in Alberta.

The evidence of zoonotic transmission of M. bovis infection in the 1 veterinarian is confirmed by growth of the organism from his sputum 6 months after animal contact. The high rate of initial tuberculin reactivity and the skin test conversions of 6 persons in contact with culture-positive animals strongly suggest that further human infection has taken place. However, the lack of baseline testing on 48/81 test-positive individuals and the relatively high proportion of immigrants in some occupational groups makes it impossible to determine the extent of reactivity and infection that can be attributed to handling diseased elk. The method of spread is likely by aerosolization of infected particles produced from the cough of live animals, or by the housing of infected material in the rendering plant or postmortem laboratory. Although isoniazid prophylaxis has not been demonstrated to be protective against M. bovis reactivation disease, it seems reasonable to offer the drug to those contacts who are newly infected. Follow-up of human contacts of animal tuberculosis must be carried out.

Adult↗
PubMed1991

The first 24 hours after surgery. A study of complications after 2153 consecutive operations.

The first 24 hours of the postoperative course of 2153 consecutive patients who had operations at the Nottingham Hospitals were studied in detail. Five per cent of patients had serious complications during this period; 15% of those having major operations, 1.8% having intermediate operations and 1.4% having minor operations. Thus, a significant number of patients were in an unstable condition for many hours after they were discharged from the main theatre recovery areas to the surgical wards. In 17 out of 23 patients who died and six out of six patients who suffered severe disability as a result of their surgery, the final outcome was a direct result of a sequence of events which began with an initial deterioration within 24 hours of surgery. We considered that, for at least 10 of these 29 patients, the outcome might have been different had more sophisticated postoperative facilities been available. In the light of this study we have identified the operations for which high dependency facilities are most likely to be required.

Adolescent↗
PubMed1990

Fish oils in hypertriglyceridemia: a dose-response study.

The effects of three supplemental doses of fish oil on plasma lipids, lipoproteins, and bleeding times were studied in ten hypertriglyceridemic patients. After a 3-wk baseline period each patient was given 15, 25, or 40 mL fish oil/d (containing 4.5, 7.5, and 12 g n-3 fatty acids) for three successive 6-wk periods, each separated by a 4-wk period of no supplementation. Plasma cholesterol concentrations decreased from 7.40 mmol/L to 6.35, 6.55, and 6.40 mmol/L with increasing doses of fish oil (p less than 0.01 vs baseline for each). Plasma triglyceride concentrations decreased from 6.10 mmol/L to 2.90, 2.80, and 2.35 mmol/L (p less than 0.01 vs baseline for each). Low-density-lipoprotein cholesterol concentrations increased significantly (by 23% and 28%) with the two higher doses, respectively. Bleeding times increased only with the largest dose. The lowest dose was the most hypolipidemic per gram n-3 fatty acids.

Adult↗
PubMed1990

The effectiveness of bacillus Calmette-Guérin (BCG) vaccination against tuberculosis. A case-control study in Treaty Indians, Alberta, Canada.

Bacillus Calmette-Guérin (BCG) vaccination against tuberculosis has been used around the world for 60 years, yet its efficacy in large, controlled prospective studies is inconsistent. The factors influencing BCG protection include variation in immunogenic potential, background exposure to environmental mycobacteria, and differences in host response to vaccine. As a means of addressing regional differences in protection, case-control studies provide a relatively inexpensive, rapid means of assessing regional vaccine effects. Treaty Indian cases (n = 160) resident in Alberta, Canada, presenting during a 5-year period (1975-1979) were individually matched for age, sex, and Band with two nontuberculous controls. A 57 percent protection by BCG vaccination was demonstrated. These results support the usefulness of case-control studies and their importance in planning tuberculosis control programs.

Adolescent↗
PubMedDate not supplied

Medical versus surgical treatment of a primary tuberculous pleural peel.

The role and timing of surgical decortication in the management of a primary tuberculous pleural peel remains controversial. The present report describes the case of a young man with an extensive primary tuberculous pleural peel that responded dramatically to medical therapy. A serious attempt at surgical decortication three weeks into antituberculous drug therapy may have removed some compressive aspects of the peel, facilitating lung expansion. However, it had almost no measurable impact on the size of peel and was technically very difficult. Response to treatment was measured anatomically (computed tomography scans) and physiologically (pulmonary function tests).

Adult↗
PubMedDate not supplied

Drug resistance study of Mycobacterium tuberculosis in Canada, February 1, 1993 to January 31, 1994.

OBJECTIVE: To estimate the prevalence of resistance of Mycobacterium tuberculosis to first-line antituberculosis drugs in Canada. METHODS: M. tuberculosis isolates from one third of all culture-positive tuberculosis (TB) cases diagnosed between February 1, 1993 to January 31, 1994 in Canada were collected prospectively. Proportion of drug-resistant isolates and the factors related to drug resistance were measured. RESULTS: Of 458 study cases, 40 (8.7%) had resistance to at least one first-line antituberculosis drug, of which 5.9% had mono-resistance, 0.7% had multidrug-resistance(MDR-TB)--i.e., resistance to at least isoniazid and rifampin--and 2.2% had other patterns. The overall prevalence of resistance among the foreign-born cases was 10.6% with the highest level among those who resided in Canada for less than four years (15.5%). CONCLUSIONS: Canada has a relatively low prevalence of antituberculosis drug resistance and a very low prevalence of MDR-TB. Some new immigrants to Canada may be at higher risk for drug resistance and their initial treatment needs to be tailored accordingly.

Adolescent↗