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Biomedical subjects

C Mitchell

Publications and source records attributed to C Mitchell.

At least 37 records · Page 2Linked to original sources
PubMed1990

Reduced risk of NSAID gastropathy (GI mucosal toxicity) with nonacetylated salicylate (salsalate): an endoscopic study.

This randomized, investigator-blinded, parallel group endoscopic study evaluated the effects of salsalate and naproxen on the gastroduodenal mucosa over a 3-month period in patients with RA. Using therapeutic doses of the drugs, 8 of 21 patients (38%) in the naproxen group had endoscopically shown active ulcers (seven patients) or diffuse erosions (one patient), whereas none of the 18 patients treated with salsalate (0%) had such lesions (P = .003). Five of the eight naproxen-treated patients with evidence of GI damage were asymptomatic at the time of endoscopic verification of their lesions. The most significant disadvantage of salsalate was its higher incidence of otologic problems accounting for six of the nine discontinuations with salsalate. However, the findings of this study suggest that patients receiving salsalate are at lower risk for developing significant gastropathy than those treated with naproxen. The relative benefit-to-risk ratio of salsalate indicates that this drug should be considered as a significant alternative NSAID therapy.

Adolescent↗
PubMed1990

Ethical dilemmas.

Dilemma is the name we reserve for some of the hardest cases and issues in ethics. Ethical dilemmas arise from fundamental conflicts among ethical beliefs, duties, principles, and theories. This article discusses some of the morally disturbing dilemmas in nursing practice.

Attitude of Health Personnel↗
PubMed1989

Renal disease in children with the acquired immunodeficiency syndrome.

Of 155 children with the acquired immunodeficiency syndrome (AIDS) whom we evaluated during a 6 1/2-year period, 12 were found to have proteinuria. Histologic studies of tissue from these 12 patients revealed a wide spectrum of renal disease: focal glomerulosclerosis in 5, mesangial hyperplasia in 5, segmental necrotizing glomerulonephritis in 1, and minimal change disease in 1. In addition, 6 had tubulointerstitial infiltrates, and 10 had glomerular dense deposits. All 10 renal specimens studied by electron microscopy contained endothelial tubuloreticular inclusions. The mean age (+/- SD) of the five patients with focal glomerulosclerosis when this condition was identified was 27 +/- 19 months. All five had severe renal failure within a year and died of other causes during the following year. The mean age of the five patients with mesangial hyperplasia was 38 +/- 31 months. Although none of them went on to have renal failure, four died within 8 +/- 7 months. Ten of the 12 patients with proteinuria died during the study period. Of the two surviving, one had mesangial hyperplasia and the other had minimal change disease. We conclude that children who acquire human immunodeficiency virus (HIV) infection during the perinatal period may have renal disease, most often focal glomerulosclerosis, as is the case in adults, or mesangial hyperplasia. Although 5 of the 12 children we studied had renal failure during the study period, none died of it. Further studies are needed to determine the correlations between clinical and pathological features and the pathophysiology of AIDS nephropathy in children.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Variables affecting the auditory brainstem response: audiogram, age, gender and head size.

Correlations between the ABR (auditory brainstem response) and the variables of hearing loss, gender, head size and age were determined in simple and multiple regression analyses in 334 ears. The stepwise multiple regression analyses for waves I, III and V of the ABR was used to determine the relative importance of the variables. Regression equations were calculated for the latency of each wave. Wave I latency for all subjects is best predicted by hearing threshold at 8 kHz, gender and age, in that order. Wave III latency depends upon hearing threshold at 4 kHz, age and gender. The latency of wave V is best predicted by gender, age and head diameter with threshold at 4 kHz being of minor importance. The I-V interval depends upon head diameter and threshold at 8 and 4 kHz with age of minor importance. Hearing loss at 8 kHz would shorten the I-V interval, while a loss at 4 kHz would be expected to lengthen the interval. Correlations of these variables with the amplitude of I, III and V are also described. Latency and amplitude are correlated with different subject variables suggesting differences in their generation.

Acoustic Stimulation↗
PubMed1989

Somatic emotional disorders in childhood and adolescence.

We conducted a short-term follow-up study of severe somatic emotional disorders in 93 children and adolescents. Our aim was to investigate whether the type of physical presentation influenced the outcome in terms of symptoms and subsequent use of medical services. Three groups of patients were identified. Two groups presented with neurological symptoms and were divided into a pseudo-epilepsy group (n = 23) and other hysterias (n = 30); and a third presented with non-neurological symptoms which we termed 'other somatic presentations' (n = 40). Cases in the hysteria groups were significantly more likely to be female and post-pubertal. Polysymptomatic presentations accounted for 85% of all cases and were as common in boys as in girls at all ages. The greatest number of symptoms was found in the pseudo-epilepsy group. None of the hysterias met DSM III-R criteria for somatization disorder. Outcome in terms of residual physical symptoms and subsequent use of medical services was poorest for the pseudo-epilepsy group, and nearly 40% of these patients were judged by their general practitioner to be unchanged since discharge. By comparison, 85% of all other somatic cases were judged improved since discharge from hospital out-patients. Neither polysymtomatic presentations nor persistent physical symptoms at discharge predicted a poor outcome in any group. The general practitioners considered the psychiatric treatment to have been helpful in the majority of cases, even when the somatic outcome was rated as unchanged.

Adolescent↗
PubMed1989

Autoimmune disease and cochlear pathology in the C3H/lpr strain mouse.

The C3H/lpr autoimmune strain mouse is a model for spontaneous systemic lupus erythematosus. Inner ear structure and function were examined during systemic autoimmune disease progression to identify correlated auditory system pathology. Onset of the systemic disease occurred at 2-3 months of age and was characterized by elevated serum immune complexes, cryoglobulins, and antinuclear antibodies. Coincident with the onset of autoimmune disease was degeneration of the stria vascularis. Early edema of the stria occurred in the apex and progressed basalward with duration of the disease. By 10 months of age, stria vascularis area was smaller and auditory brainstem response thresholds were elevated. No degeneration of hair cells was seen at any age, suggesting that the stria vascularis may be the primary anatomic site of autoimmune auditory damage in this mouse model.

Age Factors↗
PubMed1989

Proteins that interact with GTP during sporulation of Bacillus subtilis.

During sporulation of Bacillus subtilis, several proteins were shown to interact with GTP in specific ways. UV light was used to cross-link [alpha-32P]GTP to proteins in cell extracts at different stages of growth. After electrophoresis, 11 bands of radioactivity were found in vegetative cells, 4 more appeared during sporulation, and only 9 remained in mature spores. Based on the labeling pattern with or without UV light to cross-link either [alpha-32P]GTP or [gamma-32P]GTP, 11 bands of radioactivity were apparent guanine nucleotide-binding proteins, and 5 bands appeared to be phosphorylated and/or guanylated. Similar results were found with Bacillus megaterium. Assuming that GTP might be a type of signal for sporulation, it could interact with and regulate proteins by at least three mechanisms.

Bacillus subtilis↗
PubMed1989

A placebo-controlled dose-response study of enprofylline in the maintenance therapy of asthma.

We assessed the efficacy and side effects of oral enprofylline in the maintenance therapy of 206 asthmatics 19 to 71 yr of age. After a 1-wk placebo run-in, patients were randomized to receive in double-blind fashion one of three doses of slow-release enprofylline tablets (150 mg, 300 mg, or 450 mg twice daily) or matching placebo for 4 wk. At baseline, mean (SD) peak expiratory flow rate (PEFR) was 62 (19)% of predicted normal values. The mean increase in morning PEFR 12 h after dosing was: for 450 mg, 14(17)%; for 300 mg, 8(23)%; for 150 mg, 2(11)%, for placebo 0(10)%. The increases over baseline for 450 mg and 300 mg compared with 150 mg and placebo were statistically significant. The mean asthma symptoms score (scale zero to 3) exhibited a dose-related reduction. Significantly less beta 2-receptor agonist inhalations were used in the 450-mg group than in the placebo group. There was a statistically significant increase in headache and nausea with the doses 450 mg and 300 mg given twice daily during the first treatment week compared with 150 mg and placebo. Subsequent to the first week, there were no differences between the active treatments and placebo with respect to the incidence of these and other side effects. We conclude that oral enprofylline, in a dosage of 300 to 450 mg twice daily is an effective and well-tolerated drug that may be useful in the maintenance therapy of asthma.

Adult↗
PubMed1988

A simple inexpensive post-operative management regime following surgery for Dupuytren's contracture.

A simple regime has been devised for the post-operative management of patients following surgery for Dupuytren's contracture; this includes splintage of the hand for two weeks and active and passive mobilisation by the patient according to precise instructions. Selective help was provided by minimal occupational therapy in 5 of 50 patients. The results of the method were assessed prospectively by subjective criteria and objective assessment by measuring the deformity of the finger joints, lateral and tip pinch and grasp and shear forces.

Dupuytren Contracture↗
PubMed1988

Comparison of the effects of nebulized terbutaline with intravenous enprofylline in patients with acute asthma.

We compared the bronchodilating effects of intravenously administered enprofylline (2 mg/kg) with nebulized terbutaline (10 mg) in patients presenting to hospital with acute asthma in a multicenter double-blind parallel study. One hundred twenty three patients were randomized into the study, and 69 of these fulfilled the inclusion criteria and a retrospective time to study entry criterion; 34 received enprofylline and 35 received terbutaline. There was no significant difference in maximum increase in forced expired volume in 1 second (FEV1) between the enprofylline group (0.24 +/- 0.33 L) and the terbutaline group (0.25 +/- 0.28 L) (p greater than 0.05), nor for the increase in FEV1 over the 1-hour study period. Tremor was reported more in the group receiving terbutaline, and nausea was reported more in the group receiving enprofylline. Two patients experienced hypotension and one patient had a vasovagal episode with enprofylline treatment. Both agents acted as bronchodilators with similar efficacy in patients with acute asthma in this study.

Acute Disease↗