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Biomedical subjects

C B Hsiao

Publications and source records attributed to C B Hsiao.

5 recordsLinked to original sources

Prevention of disseminated Mycobacterium avium complex infection with reduced dose clarithromycin in patients with advanced HIV disease.

OBJECTIVE: To evaluate the ability of once daily reduced dose clarithromycin to prevent disseminated Mycobacterium avium complex (dMAC) infection in patients with advanced HIV disease. DESIGN: Non-randomized, retrospective study. SETTING: Outpatient clinic of an urban university-affiliated municipal hospital. PATIENTS: A group of 192 HIV-infected patients with a CD4 count < 100 x 10(6) cells/l who were followed for at least 90 days during a 6-year period (1991-1996) before the use of protease inhibitors. INTERVENTIONS: Clarithromycin 500 mg orally once daily (n = 84), rifabutin 300 mg orally once daily (n = 47) or no prophylaxis (n = 61). MAIN OUTCOME MEASURES: Positive blood culture for M. avium complex (MAC), time to development of dMAC, and time to death. RESULTS: When compared with no prophylaxis or rifabutin, the incidence of dMAC and time to development of dMAC were improved among those patients receiving clarithromycin (P < 0.001). Prolonged survival was associated with both clarithromycin and rifabutin use when compared with no prophylaxis (P < 0.002). In patients who failed prophylaxis, resistance to clarithromycin and rifabutin was observed. CONCLUSIONS: In the era prior to protease inhibitor use, once daily clarithromycin at a dose of 500 mg was associated with a reduction in the incidence of dMAC, appeared to be superior to rifabutin, and was associated with prolonged survival in patients with advanced HIV disease.

AIDS-Related Opportunistic Infections↗

Predicting active pulmonary tuberculosis using an artificial neural network.

BACKGROUND: Nosocomial outbreaks of tuberculosis (TB) have been attributed to unrecognized pulmonary TB. Accurate assessment in identifying index cases of active TB is essential in preventing transmission of the disease. OBJECTIVES: To develop an artificial neural network using clinical and radiographic information to predict active pulmonary TB at the time of presentation at a health-care facility that is superior to physicians' opinion. DESIGN: Nonconcurrent prospective study. SETTING: University-affiliated hospital. PARTICIPANTS: A derivation group of 563 isolation episodes and a validation group of 119 isolation episodes. INTERVENTIONS: A general regression neural network (GRNN) was used to develop the predictive model. MEASUREMENTS: Predictive accuracy of the neural network compared with clinicians' assessment. RESULTS: Predictive accuracy was assessed by the c-index, which is equivalent to the area under the receiver operating characteristic curve. The GRNN significantly outperformed the physicians' prediction, with calculated c-indices (+/- SEM) of 0.947 +/- 0.028 and 0.61 +/- 0.045, respectively (p < 0.001). When the GRNN was applied to the validation group, the corresponding c-indices were 0. 923 +/- 0.056 and 0.716 +/- 0.095, respectively. CONCLUSION: An artificial neural network can identify patients with active pulmonary TB more accurately than physicians' clinical assessment.

AIDS-Related Opportunistic Infections↗

Outer membrane protein CD of Branhamella catarrhalis: sequence conservation in strains recovered from the human respiratory tract.

Branhamella catarrhalis causes lower respiratory tract infections in patients with chronic obstructive pulmonary disease. The outer membrane protein CD (OMP-CD) of B. catarrhalis is a major, heat-modifiable OMP. The goals of this study are to characterize the degree of conservation of OMP-CD among strains and to investigate if OMP-CD maintains its homogeneity under the effect of host immune selective pressure. Isolates of B. catarrhalis were collected prospectively from patients with bronchiectasis and chronic bronchitis. We studied the OMP-CD gene by analysis of PCR restriction fragment length polymorphisms (PCR-RFLP) and further determined DNA sequence of the CD gene of eight selected isolates. Five patterns of PCR-RFLP of the OMP-CD gene were observed among all isolates when the gene was digested with Sau3AI. The sequence analysis revealed a high degree of homogeneity in OMP-CD among strains of B. catarrhalis. Three regions of OMP-CD with minimal sequence heterogeneity were identified. The sequences of the OMP-CD gene of isolates collected from patients colonized with the same strain for up to 6 months was identical. These observations establish that the OMP-CD of B. catarrhalis recovered from clinical isolates is highly conserved among strains.

Bacterial Outer Membrane Proteins↗

Isoenzyme biotypes of Candida species.

Isoenzyme profiles were obtained following polyacrylamide gel electrophoresis of crude extracts of Candida albicans and C. tropicalis. The two species were separated by distinct isoenzyme patterns. Within each species, variations were found for several isoenzymes. This allowed the development of a method for biotyping these fungi. Isoenzyme patterns of the sucrose-negative variants "C. stellatoidea" and "C. paratropicalis Baker, Salkin, Pincus, and D'Amato" were obtained and subjected to cluster analysis. This procedure failed to place the variants into clusters that were clearly distinct from the conventional sucrose-positive strains. All sucrose-negative strains were found to have alpha-glucosidase activity. There was an almost complete lack of heterogeneity in the isoenzyme patterns of 11 C. stellatoidea type I strains.

Alkaline Phosphatase↗

Protein and enzyme electrophoresis profiles of selected Candida species.

The cellular protein profiles and malate dehydrogenases, superoxide dismutases, alkaline phosphatases, and esterases from whole cell extracts of Candida spp. were studied with polyacrylamide gel electrophoresis. We investigated isolates that differed in their ability to assimilate sucrose as the sole carbon source. The protein and enzyme patterns of Candida tropicalis and its sucrose-negative variant "Candida paratropicalis Baker, Salkin, Pincus et D'Amato" were indistinguishable. Although the cellular protein and superoxide dismutase patterns of Candida albicans and its sucrose-negative variant "Candida stellatoidea" were quite similar, differences were noted in the profiles of the other enzymes studied. In addition, the C. stellatoidea isolates were found to be separable, on the basis of their enzyme profiles, into the same two types that have been reported by Kwon-Chung et al. (K.J. Kwon-Chung, B.L. Wickes, and W.G. Merz, Infect. Immun. 56:1814-1819, 1988).

Alkaline Phosphatase↗