Bilateral simultaneous rupture of the quadriceps tendon.
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Biomedical subjects
Publications and source records attributed to A Mansingh.
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Patients with sickle cell disease are more susceptible to acute anaerobic osteomyelitis due to focal gut mucosal ischaemia, translocation of bacteria, and seeding in infarcted bone marrow. Modulation of the immune system is also present. The isolation of anaerobic organisms requires a high index of suspicion, correct specimen collection procedures and meticulous specimen handling. Bacteroides is the predominant organism isolated. Intra-osseous gas in the bone may be seen within four days and radiographs are therefore useful earlier than with aerobic osteomyelitis. Surgical débridement and intravenous antibiotics are the mainstay of treatment with the erythrocyte sedimentation rate being relied on heavily to guide conversion to oral antibiotics. Coexistence of septic arthritis is more common with anaerobic osteomyelitis.
The 2-week no observed effect (NOEC) and lowest observed effect (LOEC) concentrations of dieldrin were determined for Macrobrachium faustinum de Sassure in fresh and brackish waters. LOEC1,10,50,95 values in fresh water were 0.001, 0.003, 0.011 and 0.058 microg l(-1), respectively, and in brackish water, 0.00006, 0.00027, 0.00165, and 0.0172 microg l(-1), respectively. The 96-hr LC10, LC50 and LC95 values were 0.029, 0.123 and 0.771 microg l(-1), respectively. It is proposed that NOEC and LOEC be redefined to take into account the percentage of individuals affected, the severity of symptoms and the recovery of poisoned individuals. Two new terms are proposed--Median Observable Effect Concentration (MOEC) for pronounced toxic symptoms in most individuals but mortality in <50%, and Pronounced Observed Effect Concentration (POEC), which inflicts mortality in >50% individuals. Bioaccumulation of dieldrin by M. faustinum from surrounding fresh and brackish waters were rapid and fairly uniform for the first 48 h when the bioconcentration equilibrium (14.4 +/- 0.42 ng g(-1) at 0.001 microg l(-1) and 42.5 +/- 1.72 ng g(-1) at 0.01 phi g l(-1)) was achieved. Relative partitioning of residues (ng g(-1) wet wt.), after 24h exposure to 0.001 microg l(-1) of dieldrin in fresh water, in the different tissues was hepatopancreas > gonads > gills > large claws > muscle and exoskeleton. Shrimp which had accumulated 10.5 +/- 0.52 ng g(-1) dieldrin in fresh and brackish water, eliminated only about 52% of the residues after eight days in uncontaminated water.
Persistence of Dursban 2E formulation of chlorpyrifos was studied in aerated and unaerated tap, river and brackish water, under laboratory conditions. Adsorption of residues onto a glass surface over 12-24 h was 12%. The half-lives of the residues in aerated and unaerated (data in parenthesis) tap, river and brackish waters were 23 and (403) h, 3.2 and (60) h, and 5.8 and 232 h, respectively. The kinetics of dissipation of residues from aerated and unaerated tap, river and brackish waters suggested a linear relationship for most of the data sets, and could not be ascribed to distinct first- or second-order models.
Bioaccumulation, degradation, elimination and tissue partitioning of chlorpyrifos (Dursban 25E) was studied under static conditions for 3-4 days, in fresh (FW) and brackish (BW) waters by two methods: in the renewal method, fish were transferred every 24 h to FW or BW aquaria containing 0.05 mg l(-1) of the insecticide; in the spiking method, the original concentration of 0.005 mg l(-1) was spiked every 8 h. Samples of fish and water were collected at regular intervals and residues determined gas chromatographically. In the renewal experiments with 0.05 mg l(-1), bioconcentration reached its peak within 8 h of exposure in FW (1.25 mg l(-1)) and within 1 h in BW (0.95 mg g(-1)); in spiking experiments with 0.005 mg l(-1), these peaks were attained in 48 h in FW (3.8 mg g(-1)) and 8-24 h in BW (1.67 mg g(-1)). Thereafter, the concentrations declined. The concentrations of an unidentified metabolite were generally but not always correlated with that of the parent compound. Upon exposure of contaminated fish to uncontaminated waters, 72% was eliminated within the first 12 h and 4% later in 60 h in FW, and only 23% in 1 h and another 21% in the following 60 h in BW. Concentration of the metabolite was very high during the elimination. In the renewal experiment with 0.05 mg l(-1) of chlorpyrifos, tissue distribution was much higher in FW than in BW, while the reverse was true in spiking experiments with 0.005 mg l(-1) of the chemical. Testis, heart and brain had the highest levels of residues, followed by ovaries and other tissues.
Empirical antibiotic treatment for hand infections is changing to single antibiotic therapy against Staphylococcus aureus in immunocompetent patients. Fifty-one patients treated surgically for hand infections were reviewed to assess the nature of infection in terms of site, organism, mechanism of injury, and antibiotic sensitivity of the organisms. Twenty-three per cent of patients had diabetes mellitus and were noted to be older than non-diabetics. Eighty-four per cent of non-diabetic patients had single organism infections, 59% involving S aureus. Fifty per cent of diabetic patients had multi-organism infection caused by gram positive and gram negative organisms. Patients stuck with a piece of wood also had multi-organism infections. Double antibiotic therapy is therefore advocated for patients with diabetes mellitus and all patients who had hand infections as a result of being stuck with a piece of wood. All others should have single antibiotic therapy with amoxycillin and clavulanic acid.
The hydrolytic half lives of ethoprophos in distilled, river, brackish and open sea water were 25, 133, 65 and 81 days, respectively. Under laboratory conditions, volatilisation of the residues after 12 h was 1.4-3.6, 2.3-4.5 and 6.5-20.2% from a sandy loam soil with 1, 10 and 20% moisture levels, respectively. Photolysis in soil was significantly faster (P < 0.05) in direct sunlight (T1/2 of 4.7 days) than in the shade (T1/2 of 12.3 days). The microbial degradation of ethoprophos was more than two-fold faster in unsterile soil (T1/2 of 10.9 days) than in sterile soil (T1/2 of 28.8 days). The runoff of ethoprophos from unweeded plantation soil at 23 degrees slope was significantly (P = 0.015) less than at 38 degrees slope; the amounts lost after 9 weeks and 27.5 mm of rainfall were 89.4 and 91.2%, respectively, of the applied amount from the two respective slopes. In the weeded plots, 93.6 and 92.4% of the applied insecticide were lost from 23 degrees and 38 degrees slopes, respectively. Under laboratory conditions, between 67.0 and 85.1% of ethoprophos leached through the soil columns. Under field conditions, after 9 weeks and 25 mm of rainfall, only 2.8 and 2.0% residues were recovered at a depth of 10-15 cm from unweeded and weeded slopes, respectively at 23 degrees slope, and 2.2 and 1.9% from the two respective plots at 38 degrees slope.
We investigated the pathogenesis of soft-tissue contracture in club foot, using immunohistochemistry to study 41 biopsy specimens and 12 normal deltoid ligaments from cadavers. Five biopsy specimens were studied by electron microscopy (EM) to determine the presence of myofibroblasts. All 41 specimens of club foot stained positively for vimentin as against only one of the 12 control specimens. By contrast, there was no difference in staining for desmin or alpha-smooth muscle actin. EM showed some variability in the appearance of ligamentous cells. Most contained bundles of microfilaments in the cytoplasm and many had abundant pinocytotic vesicles, but no basal lamina or plasmalemmal attachment plaques. Cells of the medial ligamentous tissue in patients with club foot contain vimentin and others have myofibroblastic characteristics. Both features may contribute to recurrence after soft-tissue release.
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A random prospective study of 640 victims (76.6% in the 15-39-year-old age group) of interpersonal violence (IPV) at the Kingston Public Hospital was conducted over three months. About 87.5% of the aggression on males and 74.5% on females was committed by males. However, there was more female/female than female/male violence. Weapons used ranged from guns to a variety of cooking wares, though knives were used most frequently (34.8%) for stabbing 48% of the victims. Head, neck and upper limb were the main sites of injury; only 13.4% of all the injured had complications, and 63% of these required hospitalization. Family members and acquaintances contributed to about 84% of the violence. Instinctive spontaneous aggression aimed at maiming the victim characterizes IPV in Jamaica. The Jamaican taxpayer bears 90-94% of the cost of managing trauma injuries. These costs should be recovered from the assailants, even in the form of blood donations and community service.
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In vitro bioassay of (a) aqueous methanol extracts (AME) of the green leaves of mimosa (Mimosa pudica), love weed (Cuscuta americana), vervine (Stachytarpheta jamaicensis), chicken weed (Salvia serotina) and breadfruit (Artocarpus altilis); (b) methanol-water fraction (MWF) of breadfruit leaves, and (c) commercially available drugs albendazole, thiabendazole and levamisole were assayed for nematode inactivating potential, using filariform larvae of Strongyloides stercoralis. Test larvae were obtained from a 10-day-old charcoal coproculture. Bioassays were conducted in Locke's solution, using 100 larvae in each of three replicates. Inactivation was recorded microscopically at 1, 3, 6 and 12 hours, then every 24 hours up to 5 days' incubation. It50 (time for inactivation of 50% of larvae) values read: levamisole and mimosa extract less than 1 hour; love weed extract, approximately 2 hours; breadfruit (MWF), 9.5 hours; chicken weed, 20 hours; albendazole, 35 hours; breadfruit (AME), 49 hours; thiabendazole, 74 hours and vervine extract, 81.5 hours. It95 values followed a similar, trend, and were approximately double the It50 measures. A potential role for locally available natural products in the treatment of strongyloidiasis is highlighted.
The effect of dieldrin on the heart and ventilatory activity in the shrimps Macrobranchium faustinum and Macrobrachium amazonicum was studied over 4 and 7 day exposure periods, respectively. In M. faustinum, ventilatory rate increased by 43% and heart rate by 14.4%. In M. amazonicum, the ventilatory and heart rates decreased by 21 and 6%, respectively. In M. amazonicum ventilatory reversal frequency, an index of respiratory stress, was 6.7 times higher than the control values. All the changes, except for M. amazonicum heart rate were significant at the 0.01 level of probability.
The effects of dieldrin on the active (VaO2) and resting (VrO2) oxygen consumption rates of the shrimps Macrobrachium faustinum (De Sassure) and Macrobrachium amazonicum (Heller) were studied during exposure for 4 days at 0.01 p.p.b. and 7 days at 0.0002 p.p.b., respectively. The VrO2 of M. faustinum increased significantly (P less than 0.01) by 48% but the VaO2 decreased by 13%. The VrO2 and VaO2 decreased by 43 and 70%, respectively, in M. amazonicum. Thus, in both species the aerobic metabolic scope for activity decreased. The increased resting metabolic rate of the indigenous M. faustinum is ascribed to energy consuming responses which allow compensation for the effects of the stressor. The stressor may be said to have moved this species into a metabolic "zone of compensation". The decreased resting metabolic rate of the pond-cultured M. amazonicum is ascribed to greater susceptibility, more extensive metabolic breakdown and failure of compensatory responses. This species might be said to have been forced by the stressor into a metabolic "zone of collapse".
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