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Biomedical subjects

D A Hicks

Publications and source records attributed to D A Hicks.

At least 19 recordsLinked to original sources
PubMed1992

Randomized trial of granulocyte transfusions versus intravenous immune globulin therapy for neonatal neutropenia and sepsis.

We prospectively studied newborn infants with sepsis and neutropenia who were randomly selected to receive standard supportive care and either adjuvant granulocyte transfusions or intravenous immune globulin (IVIG) infusions; 21 infants received granulocyte transfusions and 14 received IVIG infusions. Half of the patients were premature (gestational age less than or equal to 32 weeks); the average postnatal age was 5 days (range 3 to 8 days). All infants had neutropenia by the criteria of Manroe et al., and the mean average bone marrow neutrophil storage pool ranged between 35% and 37%. There were no significant differences with respect to serum IgG, IgA, IgM, and total hemolytic complement values between treatment groups or between survivors and nonsurvivors. Clinical severity as defined by hypoxia, acidosis, and hypotension was similar between treatment groups. Group B streptococcus was the most common organism identified and accounted for almost 33% of all bacterial isolates. There was a significantly different survival rate in the group receiving polymorphonuclear leukocyte transfusions (100%, 21/21) compared with the group receiving IVIG infusions (64%, 9/14; p = less than 0.03). There were no significant complications in either treatment group with respect to fluid overload, secondary infection, blood group sensitization, pulmonary complications, or graft-versus-host disease. This pilot study suggests a possible benefit of granulocyte transfusions compared with 'IVIG therapy in the adjuvant treatment of neonatal neutropenia and overwhelming bacterial sepsis.

Bacterial Infections↗
PubMed1992

Primary cutaneous zygomycosis due to Absidia corymbifera in a patient with AIDS.

A case of primary cutaneous zygomycosis due to Absidia corymbifera in a patient with AIDS is described. The lesions, which were located on the forehead, jaw and chest, were intradermal, extending into the subcutaneous fat and did not appear to be associated with any trauma. No deep-seated infection was evident suggesting that the superficial lesions were exogenous in origin. The possible aetiology of this infection is discussed.

AIDS-Related Opportunistic Infections↗
PubMed1990

Implications of inflammatory changes on cervical cytology.

OBJECTIVE: To assess premenopausal women with inflammatory changes on cervical cytology for genital infections and cervical abnormalities. DESIGN: Prospective study of women attending general practice and family planning clinics who had a recent cervical cytology result with inflammatory changes. SETTING: Department of genitourinary medicine. PATIENTS: 102 Premenopausal women with recent cytology result showing inflammatory changes and with no history of antibiotic or antifungal treatment since their smear. INVESTIGATIONS: Genital examination and microbiological screening for genital infections; colposcopic examination about six weeks later. MAIN OUTCOME MEASURES: Detection of genital infections, particularly those sexually acquired, and abnormalities on colposcopy. RESULTS: Genital infections were isolated in 77 patients, and one or more sexually acquired infections were found in 22. Prevalence of sexually acquired infections was significantly correlated with younger age (particularly being under 25), being single, separated, or divorced; using non-barrier contraception; and recent change of sexual partner. An abnormality on colposcopy was found in 36 women. There was a strong correlation of a sexually acquired infection with an abnormality at colposcopy; hence younger women were more likely to have a colposcopic abnormality. CONCLUSIONS: Inflammatory changes on cytology are often associated with the presence of a sexually acquired infection and premalignant disease of the cervix, particularly in younger, single women using non-barrier contraception.

Adolescent↗
PubMed1990

Incidence of Chlamydia antibody in patient groups, as measured by the ELISA technique.

An ELISA technique has been used to study the incidence of antibody against Chlamydiae: the results obtained with a panel of control sera were compared with those for the complement fixation (CF) and whole inclusion immunofluorescence (WIF) tests. The results indicate that the ELISA results correlate well with the WIF test but poorly with the CF test; and the correlation allows ELISA results to be directly related to WIF antibody titres. Using the ELISA test, the incidence of antibody to Chlamydiae by age was determined in sera collected in Great Britain and Iraq; and in sera collections made at three periods during the last 30 years in Great Britain: the results indicate the higher incidence of antibody in this country compared to Iraq, but do not suggest an increased incidence of antibody in Great Britain during the last 30 years. Studies on sera collected from patients with non-gonococcal urethritis and pelvic inflammatory disease indicate significantly higher titres and incidence of antibody compared to controls, which suggest a contiguous spread of infection for the primary genital lesion to involve more distant tissues and organs. A higher incidence of antibody was also seen in patients with cervical intraepithelial neoplasia (CIN) which may be interpreted as either indicating a causal relationship between Chlamydiae and CIN or indicating the importance of a venereal infection in this condition.

Adolescent↗
PubMed1988

Pulmonary hypertension in infants with bronchopulmonary dysplasia.

Seventeen children with oxygen-dependent bronchopulmonary dysplasia, right ventricular hypertrophy, and Doppler echocardiographic evidence of pulmonary hypertension were studied by cardiac catheterization. Fifteen of these patients had pulmonary hypertension when placed in room air; six of these 15 patients were shown to have large systemic-to-pulmonary collateral vessels. The hemodynamic responses to oxygen and hydralazine were evaluated. Five patients developed normal pulmonary artery pressure while receiving supplemental oxygen and were not studied further. Of the remaining ten patients, the six patients with large, hemodynamically significant collateral vessels all had deleterious reactions to hydralazine. Two of the four patients without collateral pulmonary circulation responded to hydralazine with further reductions in mean pulmonary artery pressure. Five of the ten patients who had persistent pulmonary hypertension while receiving oxygen have died. Cardiac catheterization and angiography may provide important diagnostic, therapeutic, and prognostic information in patients with pulmonary hypertension complicating bronchopulmonary dysplasia.

Bronchopulmonary Dysplasia↗
PubMed1988

Value of colposcopy in genitourinary departments.

During 18 months 237 colposcopies were performed on 227 patients in the department of genitourinary medicine, Sheffield. Histological evidence of cervical intraepithelial neoplasia was found in 118 patients (52%), of whom 104 (88%) were aged under 35, 93 (79%) under 30, and 64 (54%) under 25. Most were treated with local destructive treatment, only five (4%) requiring cone biopsy. Colposcopy in a genitourinary department has an important part to play in detecting cervical intraepithelial neoplasia, particularly in younger women. Early diagnosis may often facilitate using local destructive treatment, thereby reducing the numbers of patients needing cone biopsy.

Adolescent↗
PubMed1988

Immunotherapy of genital warts with inosine pranobex and conventional treatment: double blind placebo controlled study.

In a multicentre, prospective, randomised, placebo controlled study of 55 patients with histories of genital warts for at least one year, a four week course of inosine pranobex 3 g a day improved the clinical response to conventional treatment (primarily podophyllin or trichloroacetic (now called trichlorethanoic) acid). Although more patients given inosine pranobex improved than those given placebo, the difference in general response between the two groups was not significant. When other variables (numbers of warts and extent of lesions) were considered, however, the patients given inosine pranobex fared significantly better. These results suggest that inosine pranobex may be worth considering as adjunct to treatment of patients with refractory genital warts.

Adult↗