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Biomedical subjects

A Vernon

Publications and source records attributed to A Vernon.

8 recordsLinked to original sources
PubMed1991

Split-mixed insulin regimen with human ultralente before supper and NPH (isophane) before breakfast in children and adolescents with IDDM.

OBJECTIVE: Fasting hyperglycemia is common in patients with insulin-dependent diabetes mellitus (IDDM) treated with twice-daily subcutaneous insulin regimens. We postulated that substituting human ultralente insulin for the presupper dose of intermediate-acting insulin would improve overnight glycemic control in children and adolescents with IDDM. RESEARCH DESIGN AND METHODS: This 6-mo double-blind crossover study compared a conventional insulin regimen, a mixture of human NPH and regular given before both breakfast and supper (NPH), with a novel twice-daily regimen in which human ultralente replaced NPH before the evening meal (ultralente). This study was comprised of 20 children and adolescents (mean age and duration of IDDM 11.3 +/- 2.9 and 2.4 +/- 1.3 yr, respectively) from the Youth Clinic of the Joslin Diabetes Center, all of whom regularly performed self-monitoring of blood glucose (SMBG) and had been treated exclusively with human insulin (mean daily dose 0.75 +/- 0.22 U/kg). Subjects performed SMBG on a prescribed schedule with a glucose meter with an electronic memory, and recorded results of blood glucose measurements, insulin dosages, and episodes of hypoglycemia. Monthly measurements were obtained for height, weight, and HbA1, and mean daily insulin dosages and average blood glucose level before breakfast, lunch, supper, bedtime snack, and between 0200 and 0300 were calculated. Nonfasting serum lipids were measured at entry, crossover, and the end of the study. RESULTS: After 3 mo, mean HbA, did not differ significantly (9.1 +/- 1.7 vs. 9.5 +/- 1.4%, NPH and ultralente, respectively). Mean fasting blood glucose was significantly lower on ultralente (9.6 +/- 1.9 vs. 10.3 +/- 2.2 mM, P less than 0.05, and blood glucose showed a similar trend (0.05 less than P less than 0.1) before lunch (8.9 +/- 1.7 vs. 9.8 +/- 2.6 mM. Mean blood glucose before bedtime snack was significantly lower (P less than 0.01) on NPH (8.4 +/- 1.9 vs. 10.0 +/- 2.1 mM) but did not differ significantly before supper or between 0200 and 0300. On the two regimens, growth and serum lipids were normal and similar, and no differences were observed in the incidence or severity of hypoglycemia. CONCLUSIONS: Compared with a mixed dose of regular and NPH, a similar dose of a mixture of regular and human ultralente insulin before supper caused a modest reduction in fasting blood glucose levels but was associated with higher blood glucose levels before the bedtime snack. Overall glycemic control, reflected in HbA1 values, was not significantly improved.

Child↗
PubMed1990

Acute gastrointestinal illness and child care arrangements.

This study uses data from the 1981 National Health Interview and the 1981 Child Health Supplement to assess the extent to which family day care homes and child care centers pose a risk of acute gastrointestinal illness among preschool children. The study uses a nationally representative sample of children 0-5 years of age (n = 4,845). Acute gastrointestinal illness was identified from parental reports of acute illness in a 2-week period. Information on type and duration of child care, as well as a variety of sociodemographic and environmental factors (e.g., crowding, seasonality), were obtained. The authors hypothesize that risk of acute gastrointestinal illness would vary by group size. Center attendees were thought to have the greatest exposure to infectious agents, followed by children in day care homes, and lastly by those receiving care in their own homes. Risk models were estimated separately for children less than 3 years of age and for children aged 3-5 years. Our results show that an elevated risk of acute gastrointestinal illness associated with child care is confined to children less than 3 years of age who regularly attend centers/nursery schools (odds ratio = 3.49, 95% confidence interval 0.99-4.77), controlling for other confounding variables. For children aged 3-5 years, low socioeconomic status, poverty, and seasonality are stronger predictors of acute gastrointestinal illness than is center care. Family day care appears to be unrelated to the risk of illness for both age groups.

Acute Disease↗
PubMed1988

Prevalence of enteric pathogens in homosexual men with and without acquired immunodeficiency syndrome.

We studied 388 homosexual or bisexual men from the Baltimore-Washington area to define the spectrum of enteric pathogen carriage in a population at high risk for "gay bowel syndrome" in association with human immunodeficiency virus infection. Seventy-seven patients with acquired immunodeficiency syndrome, 68 gay men with symptoms of acute diarrhea or proctitis, and 243 gay men without gastrointestinal symptoms and participating in a natural history study of human immunodeficiency virus infection were selected for study. Approximately 12% of the asymptomatic men harbored at least one enteric pathogen; the most frequently recovered were Chlamydia trachomatis, herpes simplex virus, and Giardia lamblia. Men carrying a pathogen were more likely to be human immunodeficiency virus seropositive (48%) than men without a pathogen (25%) (p = 0.018), more likely to have fewer T helper cells (p = 0.015), and more likely to have a mucopurulent exudate (p = 0.014). We recovered an agent of enteric disease from 68% of gay men presenting with diarrhea or proctitis. Campylobacter species, herpes simplex virus, Neisseria gonorrhoeae, C. trachomatis, G. lamblia, and Shigella species were identified most frequently. The most common pathogen associated with diarrhea in acquired immunodeficiency syndrome was Cryptosporidium (16% of 49 cases). Other agents identified were Clostridium difficile, Vibrio parahemolyticus, Campylobacter species, G. lamblia, Isospora, and cytomegalovirus. Approximately half of the identifiable etiologic agents of diarrhea in acquired immunodeficiency syndrome patients were treatable with antibiotics, but these agents required special culture procedures for detection.

Acquired Immunodeficiency Syndrome↗
PubMed1987

AIDS wrongly diagnosed.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1975

Renal excretion of fluoride in renal failure and after renal transplantation.

We have compared the renal excretion of fluoride in a variety of patients with chronic renal failure maintained with and without protein restriction before and during regular dialysis treatment and after transplantation. The patients tended to continue to excrete normal dietary loads of fluoride quite well until renal function was seriously reduced. From a regression of function on excretion the mean level of creatinine clearance when a normal dietary load of fluoride 0.0526 plus or minus 0.019 mmol/2 h (1.0 plus or minus 0.36 mg/24h) has a 90% chance of being excreted lies around 16 ml/min, a level when most patients with renal failure will be symptomatic. Acute loading of such patients with additional fluoride in the form of sodium fluoride from 40 mg to 60 mg/day showed a twofold to threefold increase of serum fluoride concentrations, slight increases in urinary fluoride excretion, and heavy tissue absorption, suggesting that prior fluoride loading of the skeleton had not taken place. These effects contrasted with those in one patient with normal renal function and with those in one patient with skeletal saturation due to prolonged loading. After renal transplantation fluoride excretion increased but reached normal levels within three months of satisfactory function, suggesting that fluoride loading in renal failure and during regular dialysis therapy had not been excessive.

Calcium↗
PubMed1975

Testicular scanning: a new modality for the preoperative diagnosis of testicular torsion.

A simple, safe and rapid scanning procedure using 99-m technetium is described for the diagnosis of torsion of testicles. The procedure is especially useful in the adult with an enlarged scrotum of recent origin in whom the surgeon cannot clinically differentiate torsion of the testicle from epididmitis. It is not suggested that this procedure replace immediate scrotal exploration in the acutely illpatient.

Adolescent↗