Consumer-run mental health services: results from five demonstration projects.
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Community Mental Health Services↗
Biomedical subjects
C Reed
Publications and source records attributed to C Reed.
Isolation and partial characterisation of a 26 kilodalton antigen from Plasmodium falciparum recognised by an inhibitory monoclonal antibody.
A 26 kDa protein, present in trophozoites and schizonts of Plasmodium falciparum, has been identified as the target of a monoclonal antibody that weakly inhibits parasite growth in vitro. The antigen has been purified to homogeneity by immuno-affinity chromatography and electrophoresis. The sequence of 19 amino acids at the N-terminus of the protein has been determined.
Amino Acid Sequence↗
Is antibiotic prophylaxis necessary for routine urodynamic investigations? A controlled study in 100 patients.
The value of a prophylactic antibiotic before a routine cystometrogram has been assessed in a controlled trial of 100 patients. The infection rate was low and not statistically different in both groups. Subsequent symptoms of dysuria and haematuria had a mechanical aetiology.
Female↗
Non-cytocidal natural variants of human immunodeficiency virus isolated from AIDS patients with neurological disorders.
To understand the mechanism of HIV-mediated neuropathology five viral isolates were obtained from four AIDS cases with central nervous system manifestations as the primary involvement. The isolates were identified as HIVs by antigenic cross-reactivity and nucleic acid hybridizations to HIV-specific antibodies and DNA probes. The replication and cytopathic properties of these isolates were studied and compared with lymphadenopathy-associated virus (HIVLAV). All isolates had replication competence equivalent to LAV, but four isolates did not kill T4 (CD-4) cells. This isolation of non-cytocidal natural variants of HIV raises the possibility that in some AIDS cases the neurological disorders might be due to HIV variants that are non-cytocidal to T4 cells. The results also indicate that virus replication and cytotoxicity are not always concordant functions in HIV.
Acquired Immunodeficiency Syndrome↗
3 fast steps to better patient care plans.
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Heart Failure↗
Activated K-ras and N-ras oncogenes in primary renal mesenchymal tumors induced in F344 rats by methyl(methoxymethyl)nitrosamine.
Administration of methyl(methoxymethyl)nitrosamine to newborn Fischer 344 rats results in the preferential induction of renal tumors arising from the mesenchymal component of the kidney. DNA from a significant proportion of these tumors was capable of transforming NIH/3T3 cells. This report describes the renal tumor model, the detection of two different ras transforming genes in the kidney tumors (the N-ras oncogene in 1 and K-ras oncogene in 10 kidney tumors) and the characterization of DNA sequences specifying the transformed phenotype.
Animals↗
Intrinsic laryngeal muscle activity in a spastic dysphonia patient.
EMG activity from four intrinsic laryngeal muscles (thyroarytenoid, posterior cricoarytenoid, interarytenoid, and cricothyroid) was obtained from one female spastic dysphonia patient while she performed a variety of speech and nonspeech tasks. These tasks were performed before and during a period of temporary unilateral laryngeal muscle paralysis. In the nonparalyzed condition, adductory muscle activity showed intermittent sudden increases that coincided with momentary voice arrests. These muscle patterns and accompanying voice interruptions were not present either when speech was produced in falsetto register or at anytime during the paralysis condition. The data suggest that individuals with this type of spastic dysphonia have normal morphology of recurrent laryngeal nerves and intrinsic laryngeal muscles, which means that the triggering mechanism(s) for spastic dysphonia symptoms must be located at some point neurologically upstream from the larynx.
Combined Modality Therapy↗
A comparison of intranasal and oral flunisolide in the therapy of allergic rhinitis. Evidence for a topical effect.
Intranasal flunisolide is an effective treatment for allergic rhinitis. Flunisolide has high bioavailability when administered to normal subjects (50% of an intranasal dose reaches the systemic circulation) with minimal systemic effects. Bioavailability in patients with active rhinitis averages 62.4 +/- 15.7%. The oral dose bioequivalent to 100 micrograms intranasally is 500 micrograms. To define the comparative trial and systemic effects of intranasal flunisolide in patients with active allergic rhinitis, a multicenter, randomized, double-blind, placebo-controlled study was conducted during the 1983 ragweed hayfever season. Ninety-nine patients with ragweed hayfever for greater than or equal to 2 years and positive prick skin tests to ragweed were randomly allocated to one of three treatment groups: 0 = oral flunisolide 500 micrograms b.i.d. and intranasal placebo b.i.d.; N = intranasal flunisolide 50 micrograms per nostril b.i.d. and oral placebo b.i.d.; P = intranasal and oral placebo b.i.d. Treatment continued for 4 weeks. Patients kept daily symptom scores. Patients were evaluated by a blinded observer every 2 weeks and were globally evaluated at the study's end. Data were analyzed for each center and pooled. There were no significant differences in symptom severity of sneezing, nasal congestion, and throat itch in the 0 (oral flunisolide) and P (placebo) groups. N (nasal flunisolide) was significantly more effective than O or P (P less than or equal to 0.005) for each symptom for at least one 2-week period. Global evaluation demonstrated control of overall hayfever severity for N (nasal flunisolide) but not for O (oral flunisolide). We conclude that the therapeutic efficacy of flunisolide is achieved by topical and not by systemic action.
Administration, Intranasal↗
Assessment of tachyphylaxis following prolonged therapy of asthma with inhaled albuterol aerosol.
Controversy exists concerning possible tachyphylaxis of the acute bronchodilating effect of albuterol, especially with regard to the duration of its acute bronchodilating action. We evaluated 140 patients with bronchial asthma in a prospective double-blind controlled study of possible tachyphylaxis to albuterol aerosol as compared to isoproterenol aerosol. We demonstrated statistically significant tachyphylaxis with regard to duration of acute bronchodilating effect. We believe that this tachyphylaxis is not clinically significant because there was no tachyphylaxis with regard to peak bronchodilating effect and because the duration of bronchodilating effect remains significantly greater, both quantitatively and statistically, when compared to isoproterenol aerosol. Moreover, it appeared that most of the tachyphylaxis was present at four weeks of therapy. There was a small increment of tachyphylaxis after eight weeks of therapy, but no further increase in tachyphylaxis was demonstrated after 13 weeks of inhaled albuterol therapy. We therefore feel that clinically significant tachyphylaxis to inhaled albuterol aerosol must be quite unusual and that chronic therapy with inhaled albuterol aerosol is probably both safe and efficacious for bronchospastic disorders.
Adolescent↗
Reintroduction of dengue fever into the continental United States. I. Dengue surveillance in Texas, 1980.
Two surveillance systems were initiated in Texas in 1980 to detect cases of dengue fever. Physicians throughout the state were requested to report cases of dengue (passive surveillance), and 27 out-patient facilities serving geographically and ethnically high risk populations were asked to report cases of dengue-like illness weekly (active surveillance). Additionally, two clinics participating in active surveillance submitted acute-phase blood specimens weekly for dengue virus isolation. Sixty-three cases of illness due to dengue type 1 infection (dates of onset 2 August-10 November) were documented by virus isolation or serologic testing; 52 of them (83%) occurred n countries adjacent to the Texas-Mexico border. Fifty-six patients (89%) were Hispanic; 46 (73%) were females. Twenty-seven patients (43%) had not traveled outside the U.S. before becoming ill. Since no clinically apparent outbreak of dengue was ever recognized by public health officials in Texas in 1980, the active surveillance system in other Gulf Coast states should be considered when the risk of introduction of dengue is considered high.
Adolescent↗
A large outbreak of infections caused by a strain of Staphylococcus aureus resistant of oxacillin and aminoglycosides.
An extensive outbreak of nosocomial infections caused by oxacillin- and aminoglycoside-resistant Staphylococcus aureus (OARSA) occurred over a 16 month period. A total of 349 isolates of OARSA were obtained from 174 patients. Colonization with OARSA was found in 92 patients. There was 120 infections in 82 patients; 50 were surgical wound infections, 13 were nonsurgical wound infections, six were pneumonias, 15 were urinary tract infections, 12 were intravenous site infections, and there were 19 episodes of bacteremia (seven transient, 12 persistent). In patients with persistent bacteremia, the mortality rate was 33 percent. In patients treated for persistent bacteremia with vancomycin, the survival rate was 80 percent. Infections were highly associated with the surgical intensive care unit, and 90 percent of the isolates of OARSA tested had the same phage-type. Elderly patients with significant underlying disease, a history of previous surgery or of prior antimicrobial therapy appeared to be at increased risk for OARSA infections. OARSA were resistant to multiple antibiotics besides oxacillin, but all isolates were sensitive to vancomycin and rifampin. Three surgical intensive care unit nurses were found to be nasal carriers of OARSA, and one nurse had dermatitis of both hands colonized with OARSA. Following the removal of these nurses from the surgical intensive care unit and the institution of strict infection control measures, the number of OARSA infections and colonizations decreased to less than one per month. OARSA produces serious nosocomial disease, and epidemiologic intervention was effective in controlling this outbreak.
Adult↗
Biliary enteric fistula.
From 1932 to 1978, 105 patients with biliary enteric fistulas are reported upon from The New York Hospital-Cornell Medical Center. During this 46 year period, 11,808 patients were operated upon for nonmalignant biliary tract disease, representing an incidence of biliary enteric fistulas of 0.9 per cent. The most common location of the fistula was cholecystoduodenal in 77 per cent and cholecystocolic in 15 per cent. Ninety-eight of the 105 patients underwent 109 surgical procedures for symptoms and complications associated with the fistula. The operative mortality was 6 per cent. The recommended definitive procedure includes cholecystectomy, excision of the fistula, common bile duct exploration and operative cholangiography. Among the 105 patients were 22 who presented with intestinal obstruction or ileus due to gallstones. The operative mortality in this group was 4.5 per cent. The recommended treatment for this condition is operative relief of the obstruction with correction of the biliary enteric fistula at an elective second stage operation.
Adult↗
Toxic epidermal necrolysis in a monkey (Macaca fascicularis).
An adult male Macaca fascicularis monkey developed toxic epidermal necrolysis after ingestion of methylmercury. The clinical picture was characterized by the development of large cutaneous bullae with subsequent full-thickness epidermal exfoliation. Areas of sparse pelage were most affected, with the most severe exfoliation occurring on the palms, soles, face and ears. Erosions also developed within the oral mucosa and conjunctivae.
Animals↗
A card sort method for pain assessment in gynaecology: a multidimensional approach.
This paper considers the problem of measuring the subjective report of pain. In view of the limitations of existing approaches an alternative method of pain assessment is proposed. This approach derives from a multidimensional concept of pain. The test is in the form of pair comparisons and is designed to measure different pain dimensions. Sufficient consensus was found over the meaning and relevance of words describing intrauterine device related pain and primary dysmenorrhoea to allow a standard test to be developed. The reliability of the test was found to be high and its clinical advantages promising. It was not possible to provide an adequate evaluation of the test's validity. In view of these findings a longer-term treatment evaluation study is currently being undertaken in order to establish this.
Analysis of Variance↗
A new guinea pig mutant with abnormal hair production and immunodeficiency.
Hairless guinea pigs were born in a closed colony of Hartley guinea pigs. At birth, hairless guinea pigs were smaller than littermates, had wrinkled skin and stunted vibrissae. The most striking abnormality histologically was distension of the upper portion of the pilary canal with thickening of the epidermis. Hairlessness resulted from production of abnormal hair shafts. Preliminary work indicated that in addition to hairlessness, the guinea pigs were athymic or hypothymic. Initial immunologic studies showed that the guinea pigs also were agammaglobulinemic. Animals that survived the weaning period died of infections that are usually associated with immunodeficiencies, such as systemic cytomegalovirus, systemic balantidiasis and Pneumocystis carinii pneumonia.
Animals↗
Measuring the subjective aspect of pain.
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Humans↗
Conditions required for induction of murine p30 by herpes simplex virus.
Mouse cells (line N cIA cl10) contain 1.2-2.5 ng murine leukaemia virus (MuLV) p30 antigen/mg of protein; this amount of antigen is measurable by competition radioimmunoassay (RIA) but is not detectable by indirect immunofluorescence (IF). Infection of N cIA cl10 cells with herpes simplex virus type 2 (HSV-2) induces expression of MuLV p30. Induction by HSV-2 does not require either cell or virus DNA synthesis and is optimal 8 h post infection when cells at 50-70% confluence are infected at a multiplicity of infection (MOI) of 5-8 PFU/cell. At an MOI of 2.5, 70-80% of the cells express HSV antigens while none of the cells express p30; at an MOI of 5.0, 70-80% of the cells express HSV antigens but 55% of the cells express p30. Using the conditions reported in this paper for preparation of competing antigen, induction of p30 by HSV-2 (strain 333) infection is not measurable by competition RIA.
Animals↗
Relationships between prednisone therapy, disease activity, and the total serum IgE level in allergic bronchopulmonary aspergillosis.
Allergic bronchopulmonary aspergillosis (ABPA) is an unusual syndrome caused by hypersensitivity to Aspergillus spores growing in the bronchii. Previous investigators have suggested that the IgE levels and precipitating antibodies may vary according to disease activity. We have been able to closely follow 12 out of a group of 40 ABPA patients with IgE and serum precipitating antibody measurements. Our results confirm that both the total serum IgE and the precipitin response vary according to ABPA disease activity. In particular the IgE trend appears to mirror the disease activity in that a rising level may portend a flare, while a stable or declining value implies disease remission.
Antibodies, Fungal↗