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Biomedical subjects

D B Craig

Publications and source records attributed to D B Craig.

At least 19 recordsLinked to original sources
PubMed1992

Correlation of oral disease with the Walter Reed staging scheme for HIV-1-seropositive patients.

This study correlates the prevalent oral disease findings in 390 patients seropositive for human immunodeficiency virus type 1 (HIV-1) with their level of staging (Walter Reed) and depletion of peripheral helper T lymphocytes (CD4+). Chronic lymphadenopathy of the head and neck was a common finding (59.2%) that occurred early in staging progression and did not correlate with depression of helper T-cell levels. Of the three prevalent oral disease findings (oral hairy leukoplakia (OHL), candidiasis, necrotizing ulcerative gingivitis [NUG]) only OHL and NUG were significantly correlated with helper T-cell depletion. The occurrence of visually detectable OHL and NUG corresponds to depletion of peripheral helper T-lymphocyte values in a range of 157 to 299 cells/mm3. This range may represent a more accurate value for biologically significant lymphocyte depletion than the Walter Reed value of 400 cells/mm3. The presence of OHL showed a weak statistical correlation with staging progression, indicating deteriorating immunoregulation. No cases of Kaposi's sarcoma or other HIV-1-associated oral diseases were observed in the sample population, regardless of the patient's staging category or peripheral helper T-lymphocyte count.

Adult↗
PubMed1992

Predictors of HIV-1 disease progression in early- and late-stage patients: the U.S. Army Natural History Cohort. Military Medical Consortium for Applied Retrovirology.

HIV-infected individuals in both early and late stages of HIV disease were evaluated over 2 years to assess temporal trends and determinants of disease progression. The Walter Reed (WR) staging system was used to categorize patients into an early-stage cohort (WR Stages 1 and 2, N = 1183) and a late-stage cohort (WR Stage 5, N = 260) based on the initial clinical evaluation. Progression was defined as the occurrence of Stage 5 disease or beyond for the early cohort and Stage 6 disease or beyond for the late cohort. The cumulative incidence of progression was 15.7% (137 events) for the early-stage cohort, and 53.7% (85 events) for the late-stage cohort. Baseline CD4+ T lymphocyte (T4) count was the most significant marker of progression: 26% of WR Stage 1 or 2 patients with T4 lymphocytes below 500/mm3 progressed, compared with 12% with T4 lymphocytes at or above 500/mm3. In late-stage individuals, 83% with T4 lymphocytes under 200/mm3 progressed, compared with 27% with T4 lymphocytes at or above 200/mm3. Older age was associated with progression in both early- and late-stage groups. Differences in the rates of disease progression were not significant between blacks and whites or between men and women. Two-year rates of progression among the late-stage patients dropped from 78 to 47% between 1986 and 1988. This contrasted with progression rates in the early-stage cohort, which remained stable: 18% for those entering follow-up in 1986 and 17% for those entering follow-up in 1988. These data indicate a significant slowing of HIV disease progression rates and mortality rates among individuals with late-stage disease that is temporally associated with the increased availability and use of therapies. With control of T4 lymphocyte count, age, and calendar time, neither gender nor race was significantly associated with progression in either early- or late-stage patients.

Adolescent↗
PubMed1991

The specificity and Kd at physiological ionic strength of an ATP-binding site on cytochrome c suit it to a regulatory role.

Cytochrome c binds ATP with marked specificity at a site that contains the evolutionarily invariant residue Arg-91. The binding of ATP to this site was studied using equilibrium gel filtration, equilibrium dialysis and affinity chromatography. At physiological ionic strength the affinity is such that the major change in occupancy coincides with the normal cellular ATP concentration range, and the degree of saturation is proportional to the ratio of [ATP]/[ADP]. The specificity of binding at this site is more a function of the degree of phosphorylation of the nucleotide, than of the nature of the nucleoside moiety. Thus under physiological conditions the degree of occupancy of this site is proportional to the energy state of the cell, providing a means for the regulation of the respiratory chain which is sensitive to cytoplasmic ATP levels.

Adenosine Triphosphate↗
PubMed1991

Jehovah's Witness.

Explore the source record for details and available documents.

Advance Directives↗
PubMed1988

Melioidosis: a reminder.

Recrudescent pulmonary melioidosis developed in two patients 12 and 16 years after their last travels to an endemic area. In one, a clinically silent prostatic abscess may have been the focus; and in both, the diagnosis was difficult to make even when the laboratory was notified of the possibility of infection with Pseudomonas pseudomallei. Recrudescent melioidosis should be considered in febrile patients who have been in endemic areas regardless of the interval from last exposure to the development of disease.

Humans↗
PubMed1988

Comparison of bupivacaine and alkalinized bupivacaine in brachial plexus anesthesia.

To define the effect of alkalinization of bupivacaine 0.5% in subclavian perivascular brachial plexus blockade, the time to onset, time to peak effect, and 6-hour regression of sensory and motor blockade were determined. Sixty physical status ASA I and II patients were randomly allocated to one of two groups and a double-blind design was used: group I (n = 30) received bupivacaine 0.5% (pH, 5.5) 3 mg/kg, while group II (n = 30) received alkalinized bupivacaine 0.5% (pH, 7.05-7.15) 3 mg/kg. Onset and regression of sensory blockade were determined by pinprick in the C4-T2 skin dermatomes, while motor blockade was assessed using a scheme of proximal to distal muscle group paralysis. Time to onset of sensory blockade (group I, 4.0 +/- 1.2 min; group II, 3.6 +/- 0.9 min) and time to peak sensory effect (group I, 17.7 +/- 1.8 min; group II, 16.3 +/- 1.8 min) did not differ significantly between the groups. Similarly, no difference in time to onset of motor blockade (group I, 6.9 +/- 1.7 min; group II, 6.3 +/- 1.5 min) or time to peak motor effect (group I, 18.1 +/- 1.9 min; group II, 15.1 +/- 1.9 min) was observed. Regression of postoperative sensory and motor blockade was similar in both groups. It is concluded that alkalinization of bupivacaine 0.5% solutions does not confer any added clinical advantage in subclavian perivascular brachial plexus blockade when compared with commercially available bupivacaine.

Adolescent↗
PubMed1986

Constant flow ventilation in anesthetized patients: efficacy and safety.

Constant flow ventilation (CFV) maintains normal gas exchange in apneic dogs and has potential clinical application during thoracic surgery or pulmonary edema. We compared CFV and intermittent positive pressure ventilation (IPPV) in five healthy, anesthetized, (fentanyl, diazepam, and nitrous oxide) and paralyzed patients undergoing nonthoracic operations. Constant flow ventilation was delivered at a total flow of 0.9-1.6 L . kg-1 . min-1 (nitrous oxide-oxygen at 1:1) into two tubes of 2.5-3.5 mm inner diameter attached to each side of an 8-9 mm inner diameter orotracheal tube (OTT). Under bronchoscopic guidance, the CFV-OTT was advanced to position each ventilating tube at a mainstem bronchial orifice. Gas exhausted through the OTT lumen. If intrathoracic pressure exceeded a preset limit, a solenoid valve automatically interrupted gas flow to the patient to prevent barotrauma. Compared to IPPV, during CFV for up to 30 min average PaCO2 increased to 69.2 +/- 14.5 from 35.9 +/- 2.9 mm Hg, reflecting a calculated alveolar ventilation (VA) of 46 +/- 22% of the eucapnic level. We suggest that a technique combining CFV at lower flow rates with IPPV may prove clinically useful by allowing decreased tidal volume and inspiratory pressure while maintaining normal VA.

Adult↗
PubMed1980

A post-anaesthetic follow-up program.

Experience with an in-hospital post-anaesthetic follow-up program is reported. Visits are made by a Registered Nurse, a hospital employee working under the direction of the Head of the Department of Anesthesia. Over a three-year period 21,116 of 39,239 patients receiving anaesthetics were visited. Those not visited were mainly outpatients or patients discharged early following minor surgery. Anaesthetic related minor complications were noted in 8.15% of the patients seen in follow-up. Major complications occurred in 0.37% of patients seen.

Adult↗
PubMed1979

Safety modifications to mobile hypothermia units.

Major safety deficiencies of older mobile hypothermia units are described. Problems include absence of high or low temperature output limitation or of visual warning of abnormal operating temperatures. Modifications described provide two high temperature thermostats and one low temperature thermostat, which shut the unit down if the temperature limits are exceeded. Visual and auditory alarms were also added. Operators of mobile thermal units should be aware of the major safety deficiencies of some older models, and should insist on either modification, where appropriate, or replacement.

Anesthesiology↗