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Biomedical subjects

D Buchanan

Publications and source records attributed to D Buchanan.

16 recordsLinked to original sources
PubMed1991

Seroprevalence and demographic characteristics of injection drugs users among individuals at risk for HIV infection in Winnipeg, Manitoba, Canada.

From June 1986 to March 1990, a prospective seroprevalence survey and questionnaire of individuals at risk for HIV infection was conducted with volunteers in Winnipeg. Of 610 individuals enrolled, 146 were injected drug users (IDU). Fifteen IDU were in a methadone treatment program and all were seronegative. Three of 131 remaining IDU were HIV-1 seropositive (2.3%), a rate similar to 2.2% positive (20+ of 927) in diagnostic specimens from IDU tested in the province. Demographics and behaviour of 131 IDU were compared with 335 individuals, of whom 112 were gay/bisexual [24 of whom also had sexually transmitted diseases (STD)] and 223 heterosexuals who had STD. Males enrolled were significantly older than females. Multivariate analysis showed that factors independently associated with IDU were: a younger age, less education, mental health counselling, unemployment, and a history of jaundice or hepatitis. Drugs most commonly used were Ritalin/Talwin, cocaine, and heroin. Over 90% of individuals admitted to sharing needles. In spite of the low seroprevalence of HIV-1 infections, these individuals are important for the potential spread of HIV because of multiple means of acquiring and transmitting HIV and a high rate of needle sharing.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Mycobacterial infection in patients infected with the human immunodeficiency virus.

Of 207 homosexual or bisexual patients with the acquired immune deficiency syndrome (AIDS), 24 with the AIDS related complex, and 39 with asymptomatic HIV infection, 32 patients were found to have mycobacterial infection. Mycobacterium tuberculosis was found in 13 patients with AIDS and in two with the AIDS related complex. M avium-intracellulare was found in 15 patients with AIDS and was disseminated in 12. One patient was infected with M kansasii and one with M ulcerans. Invasive procedures were frequently required to obtain positive bacteriological results. Subclinical carriage of M avium-intracellulare and other mycobacteria thought to be nonpathogenic was common in patients seronegative for the human immunodeficiency virus and at all stages of human immunodeficiency virus infection. All but one isolate of M tuberculosis were fully sensitive to standard antimycobacterial antibiotics. Response to treatment was usually rapid. M avium-intracellulare isolates were all resistant to first line agents in vitro, and antibiotics such as ansamycin and amikacin were required to obtain a clinical response.

AIDS-Related Complex↗
PubMed1989

The effect of aminophylline on gastrointestinal blood flow and oxygen metabolism in the conscious newborn lamb.

Aminophylline, widely used in the neonatal period, has been reported to be associated with necrotizing enterocolitis. We hypothesized that aminophylline might alter gastrointestinal blood flow and oxygen delivery. The effects of this drug on gastrointestinal (GI) blood flow and oxygen delivery, consumption, and extraction were examined using the radioactive microsphere method in ten chronically catheterized, unanesthetized lambs aged 5-12 days. While cardiac output and systemic oxygen consumption did not change, we found statistically significant increases (p less than 0.05) in small intestinal blood flow as a function of lamb weight and as a percentage of cardiac output. Splanchnic oxygen consumption also increased significantly. The oxygen reserve available to the GI tract can be compromised by aminophylline at levels similar to those used in the human neonate for treatment of apnea.

Aminophylline↗
PubMed1989

Fetal distress associated with the anticardiolipin antibody and a history of intrauterine fetal demise. A case report.

A woman with a history of fetal demise, an elevated anticardiolipin antibody titer, lupus anticoagulant but no evidence of systemic lupus erythematosus received anticoagulation with heparin in adjusted subcutaneous doses. Daily fetal monitoring demonstrated reactive nonstress tests and normal biophysical profiles initially. At 30 weeks' gestation, however, repeated spontaneous decelerations developed, and fetal bradycardia necessitated delivery. The combination of a poor obstetric history and the presence of high cardiolipin antibody titers requires close fetal surveillance. The benefits of anticoagulation in this setting deserve further study.

Adult↗
PubMed1988

Seroprevalence and demographic information of patients at risk for human immunodeficiency virus (HIV) infection in Manitoba, Canada.

Two hundred fifty individuals from high risk categories were enrolled in a seroprevalence survey for human immunodeficiency virus (HIV) infections in Winnipeg. The overall seroprevalence in the Manitoba AIDS Virus Epidemiology Study (MAVES) was 5.2%. Of 2651 diagnostic and screening specimens in the province of Manitoba submitted over a similar period, 103 were positive (3.9%). HIV seropositivity in Manitoba was noted mainly in homosexual/bisexual males (especially those who were also intravenous drug abusers), hemophiliacs, and individuals from endemic regions of the world. Individuals whose only risk factor was intravenous drug abuse, those with sexually transmitted diseases, or those with high risk sex contacts have not demonstrated HIV seropositivity in Manitoba to date. Manitoba is currently a low seroprevalence region for HIV infection. Our study demonstrated that the awareness level of people at risk for HIV infections was low. In our study population, one-on-one counseling was demonstrated to be an effective way to improve short-term knowledge about HIV infections. Appropriate education approaches must be considered for Native/Metis peoples (26.4% of our MAVES study population), who were younger and had a lower educational and employment level compared to Caucasian/other racial groups.

Acquired Immunodeficiency Syndrome↗
PubMed1987

3-Hydroxy-3-methylglutaric aciduria: response to carnitine therapy and fat and leucine restriction.

A female infant, born to first cousin parents, lapsed into coma with severe metabolic acidosis on day three of life. The gas chromatographic/mass spectrometric urinary organic acid profile showed marked elevation of the leucine metabolites 3-hydroxy-3-methylglutaric, 3-methylglutaconic, 3-methylglutaric and 3-hydroxy-isovaleric acids. Less than 5% of the normal activity of the enzyme 3-hydroxy-3-methylglutaryl CoA lyase was detected in cultured skin fibroblasts. The patient's total and free carnitine was initially low but rose to normal levels after placing her on DL-carnitine (100 mg kg-1 d-1). On a diet providing 87 mg kg-1 d-1 of leucine and only 25% of total calories as fat and 2 g kg-1 d-1 protein, the concentration of the urinary organic acids fell markedly. She is now 15 months old with normal growth and development. This regimen appears effective in the early treatment of 3-hydroxy-3-methylglutaric aciduria.

Acidosis↗
PubMed1985

Changing cognitive outcome in preterm infants with hyaline membrane disease.

One hundred seventy-four preterm survivors of hyaline membrane disease, born 1961 through 1971, were followed up for at least six years with serial psychological and neurological evaluations. This relatively mature population had a mean birth weight of 2,133 g and gestational age of 34.6 weeks. All children had consecutive preschool and school age psychological tests. The mean preschool test score was 91 (SD = 13) and the mean school age score was 101 (SD = 16). The ten-point difference between the mean preschool and school age test scores was significant. Perinatal variables and indexes of disease severity did not correlate with test scores. Higher test scores were correlated with higher paternal educational and employment levels. Improving test scores by school age may be due to test instruments that measure different cognitive skills and/or the diminishing effects of prematurity.

Achievement↗
PubMed1979

Indomethacin increases plasma lithium.

The effects of indomethacin on plasma lithium concentrations and renal lithium clearance were investigated in three psychiatric patients and four normal volunteers. After steady-state plasma lithium concentrations had been reached, the subjects received indomethacin placebo for three to seven days, indomethacin (50 mg thrice daily) for seven days, and placebo again for three to seven days. Indomethacin increased plasma lithium concentrations by 59% in the psychiatric patients and 30% in the volunteers. Renal lithium clearance was reduced by indomethacin by 31% in the group as a whole, and prostaglandin synthesis, determined by measuring the major metabolite of PGE2 with mass spectrometry, was reduced by 55%. These results show that indomethacin reduces renal lithium clearance to an extent which may be clinically important. They also suggest that the renal clearance may be affected by a prostaglandin-dependent mechanism, possibly located in the distal tubule.

Drug Interactions↗
PubMed1972

Moving a ward.

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England↗