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Biomedical subjects

B Curtis

Publications and source records attributed to B Curtis.

At least 19 recordsLinked to original sources
PubMed2004

Quality of primary care for sexually transmitted diseases in Durban, South Africa: influences of patient, nurse, organizational and socioeconomic characteristics.

Quality of sexually transmitted disease (STD) primary care in South Africa varies widely but reasons for this are poorly understood. We investigated 37 randomly sampled clinics providing STD care, with simulated patients, and staff interviews and record review. Census data provided local socioeconomic indicators. Multiple regression identified independent predictors of quality. Of 271 simulated patient visits, 79% were correctly treated and 39% were correctly managed. Women received worse care, and care tended to be poorer in mainly African and mainly coloured (mixed race) areas. African and Indian nurses were more likely to provide correct treatment. Previous STD training was marginally associated with correct treatment. Quality assessments using simulated patients were not generally associated with assessments using staff interviews and record review. There were frequent missed opportunities for STD prevention and treatment, and evidence of racial but not socioeconomic inequalities.

Adult↗
PubMed2001

Use of generalized linear mixed models in the spatial analysis of small-area malaria incidence rates in Kwazulu Natal, South Africa.

Spatial statistical analysis of 1994-1995 small-area malaria incidence rates in the population of the northernmost districts of KwaZulu Natal, South Africa, was undertaken to identify factors that might explain very strong heterogeneity in the rates. In this paper, the authors describe a method of adjusting the regression analysis results for strong spatial correlation in the rates by using generalized linear mixed models and variograms. The results of the spatially adjusted, multiple regression analysis showed that malaria incidence was significantly positively associated with higher winter rainfall and a higher average maximum temperature and was significantly negatively associated with increasing distance from water bodies. The statistical model was used to produce a map of predicted malaria incidence in the area, taking into account local variation from the model prediction if this variation was supported by the data. The predictor variables showed that even small differences in climate can have very marked effects on the intensity of malaria transmission, even in areas subject to malaria control for many years. The results of this study have important implications for malaria control programs in the area.

Climate↗
PubMed2001

Identifying and slowing progressive chronic renal failure.

OBJECTIVE: To help inform primary care physicians about how to identify and slow progressive chronic renal failure. QUALITY OF EVIDENCE: The National Library of Medicine (1996 to 2000) was searched using PubMed with search terms pertinent to studies on identification, course, and management of chronic renal failure. References in retrieved papers and older literature known to the authors supplemented the searches. In general, sufficient high-quality studies, systematic reviews, or guidelines based on such evidence were available to support our main points. MAIN MESSAGE: End-stage renal disease (ESRD) poses a large and growing morbidity, mortality, and financial burden. Almost all patients reach ESRD as a result of chronic progressive conditions, particularly diabetic nephropathy, hypertensive-vascular renal disease, and glomerular disorders. Patients at risk merit regular renal assessment with serum creatinine tests and urinalysis. Persistent high blood pressure and heavy proteinuria are the strongest predictors of progression of chronic renal failure. Patients with renal disease should be examined and treated for vascular disease and vice versa. Blood pressure lowering, ACE inhibition, and avoidance of further renal insults (such as use of nephrotoxins) can slow the decline of renal function. Restricting dietary protein has a weak effect on slowing renal failure and is not easy to apply in primary care. Timely involvement of specialized nephrology teams is important. CONCLUSION: Family physicians play an important role in recognizing patients with potential for renal failure, in demonstrating progressive chronic renal failure, and in initiating therapy early to improve outcomes.

Antihypertensive Agents↗
PubMed2000

Gene content and organization of a 281-kbp contig from the genome of the extremely thermophilic archaeon, Sulfolobus solfataricus P2.

The sequence of a 281-kbp contig from the crenarchaeote Sulfolobus solfataricus P2 was determined and analysed. Notable features in this region include 29 ribosomal protein genes, 12 tRNA genes (four of which contain archaeal-type introns), operons encoding enzymes of histidine biosynthesis, pyrimidine biosynthesis, and arginine biosynthesis, an ATPase operon, numerous genes for enzymes of lipopolysaccharide biosynthesis, and six insertion sequences. The content and organization of this contig are compared with sequences from crenarchaeotes, euryarchaeotes, bacteria, and eukaryotes.

Amino Acid Sequence↗
PubMed2000

Spinal hyperostosis--a rare skeletal manifestation of psoriasis vulgaris.

A 28-year-old woman with uncomplicated psoriasis vulgaris presented with spinal hyperostosis and osteitis. The absence of peripheral arthritis, sacroiliitis, and diffuse idiopathic skeletal hyperostosis (DISH) raised the possibility that the spinal lesion was an extracutaneous manifestation of psoriasis. We review the association between uncomplicated psoriasis vulgaris and skeletal involvement.

Adult↗
PubMed1999

Effects of sound-field frequency modulation amplification on reducing teachers' sound pressure level in the classroom.

Voice problems are a frequent difficulty that teachers experience. Common complaints by teachers include vocal fatigue and hoarseness. One possible explanation for these symptoms is prolonged elevations in vocal loudness within the classroom. This investigation examined the effectiveness of sound-field frequency modulation (FM) amplification on reducing the sound pressure level (SPL) of the teacher's voice during classroom instruction. Specifically, SPL was examined during speech produced in a classroom lecture by 10 teachers with and without the use of sound-field amplification. Results indicated a significant 2.42-dB decrease in SPL with the use of sound-field FM amplification. These data support the use of sound-field amplification in the vocal hygiene regimen recommended to teachers by speech-language pathologists.

Adult↗
PubMed1999

Kynurenic acid in brain and cerebrospinal fluid of fetal, newborn, and adult sheep and effects of placental embolization.

Concentrations of the endogenous glutamate receptor antagonist kynurenic acid (KA) were measured in various brain regions and in cisternal cerebrospinal fluid of fetal, newborn, and adult sheep. KA concentrations were significantly higher in the fetal brain and cerebrospinal fluid at 90 and 140 d gestation compared with postnatal ages. In fetuses of 132-139 d gestation, KA concentrations in cerebrospinal fluid collected by drainage from an indwelling cisternal catheter increased significantly after infusion of the organic acid transport inhibitor probenecid (100 or 200 mg/kg, i.v.) indicating active transport of KA out of the fetal brain. In fetuses in which the umbilical circulation had been chronically restricted from 120 to 140 d gestation by partial embolization of the placenta, plasma concentrations of the KA precursor kynurenine were significantly lower than in control fetuses, and KA concentrations in the hypothalamus and hippocampus were significantly reduced; other brain regions were not affected. These results indicate that the production of KA is higher in the fetal brain compared with the newborn and adult brain. Because KA diminishes the risk of excitotoxic neuronal damage under hypoxic-ischemic conditions, the high levels of KA in the brain before birth may have a neuroprotective function. The decrease of KA concentrations in the hypothalamus and hippocampus after umbilical embolization suggests that, after chronic hypoxia in utero, these regions of the brain may become more vulnerable to subsequent episodes of acute hypoxia or ischemia encountered in late gestation or during parturition.

Animals↗
PubMed1999

[The moral lessons of miasma: the "Memorandum on cholera" of Joseph-Charles Taché].

In the spring of 1866, the Canadian government feared that a cholera epidemic was imminent. A conference of medical experts was held at Ottawa to determine the nature of the disease on the basis of "authentic facts" but the participants were unable to agree among themselves. Faced with the necessity of advising Canadians on how to live in time of plague, and yet unable to define clearly the nature of cholera, in his Memorandum on Cholera the deputy-minister of Agriculture, J.-C. Taché, translated medical preoccupations into matters of the government of oneself and others, in terms heavily accented by his fundamentalist Catholic religious beliefs.

Canada↗
PubMed1998

Completing the sequence of the Sulfolobus solfataricus P2 genome.

The Sulfolobus solfataricus P2 genome collaborators are poised to sequence the entire 3-Mbp genome of this crenarchaeote archaeon. About 80% of the genome has been sequenced to date, with the rest of the sequence being assembled fast. In this publication we introduce the genomic sequencing and automated analysis strategy and present intial data derived from the sequence analysis. After an overview of the general sequence features, metabolic pathway studies are explained, using sugar metabolism as an example. The paper closes with an overview of repetitive elements in S. solfataricus.

Base Sequence↗
PubMed1995

A modern translation and interpretation of the treatise on burns of Fabricius Hildanus (1560-1634).

At the beginning of the seventeenth century, some surgeons were as interested in the classification, prognosis and treatment of burns as their successors are at the close of the twentieth century. We present extracts from our translation of the visionary treatise on Burns by Fabricius Hildanus (Wilhelm Fabry), the "Father of German surgery", and show how some of the present day approaches to burns have their origins almost 400 years ago.

Burns↗
PubMed1985

Canine Rocky Mountain spotted fever: a kennel epizootic.

Within a period of 5 consecutive days after the initial observation of illness was made, 7 of 12 Siberian Husky dogs developed clinical signs of Rickettsia rickettsii infection. One dog died and was necropsied. Clinical signs of infection consisted of lethargy, anorexia, ocular and nasal discharges, and neurologic disorder (incoordination and rolling). Scleral blood vessel injection, fever, lymphadenomegaly, splenomegaly, and increased bronchovesicular lung sounds were prominent findings. Clinical laboratory test results identified decreased platelet numbers, variable neutrophil counts, increased serum alkaline phosphatase activity, hyponatremia, hypokalemia, and bilirubinuria. Diagnosis of Rocky Mountain spotted fever was confirmed by serologic evaluation of acute and convalescent sera, using the micro-immunofluorescence technique, and R rickettsii antigen was determined by demonstration of intracellular rickettsial organisms in vascular endothelial cells of brain and lung (stained with carbol-basic fuchsin and aqueous malachite green) and by demonstration of spotted fever-group rickettsiae in tissues by direct fluorescent antibody technique. Near-simultaneous naturally occurring tick-borne infection of 7 dogs with R rickettsii documents an unreported occurrence.

Animals↗
PubMed1982

Do we need thyroid follow-up registers? A cost-effective study.

Patients who had received radioiodine treatment for hyperthyroidism were followed up by two different methods. 576 patients (group 1) were followed up conventionally by their general practitioners and as hospital outpatients. 609 similarly treated patients (group 2) were followed up by a computer-assisted system, the Scottish Automated Follow-up Register (S.A.F.U.R.). Follow-up in the two groups were compared on the basis of cost-effectiveness. On average, patients were seen for follow-up about once every 8 months if in group 1 and every 14 1/2 months in group 2. The overall cost of follow-up and treatment for group 2 patients was less than 60% of that for group 1 patients. A central follow-up register is reliable and cost-effective, particularly so when patients are dispersed over a wide area.

Cost-Benefit Analysis↗