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Biomedical subjects

D J Kelly

Publications and source records attributed to D J Kelly.

123 records · Page 7Linked to original sources
PubMed1982

Fatal aplastic anemia following topical administration of ophthalmic chloramphenicol.

A 73-year-old woman died of aplastic anemia less than two months after undergoing cataract extraction and beginning topical therapy with chloramphenicol. The first signs of pancytopenia began within one month of the surgery. The pattern of the aplastic anemia was associated with an idiosyncratic response to chloramphenicol. This was the second report of fatal aplastic anemia after topical treatment with chloramphenicol for ocular conditions, although two cases of reversible bone marrow hypoplasia have also been reported. Any other suspected cases of ocular toxicity associated with topically applied chloramphenicol should be reported to the National Registry of Drug-Induced Ocular Side Effects, Oregon Health Sciences University, Portland, OR 97201.

Aged↗
PubMed1982

Rocky Mountain spotted fever in areas of high and low prevalence: survey for canine antibodies to spotted fever rickettsiae.

Antibodies to Rickettsia rickettsii were detected by indirect immunofluorescence in sera from 149 of 467 dogs (32%) examined from 4 military installations located in Kentucky, North Carolina, Pennsylvania, and Virginia. The prevalence at individual installations ranged from 4.3% at Fort Knox, Ky, to 63.4% at Fort Bragg, NC. Most of the seropositive dogs were in the working and sporting groups of dogs. The difference in antibody prevalence between sexes was not significant. Serologic responses were related to R rickettsii infection, although antibodies to R montana also were detected in a few of the sera. Comparison of serodiagnostic methods indicated that the indirect fluorescent antibody test was more sensitive than was the indirect hemagglutination test for obtaining survey data on the prevalence of Rocky Mountain spotted fever in the area.

Animals↗
PubMedDate not supplied

A cluster of tick-borne infections: association with military training and asymptomatic infections due to Rickettsia rickettsii.

During the spring of 1989, 86 members of a military unit from the state of Maryland, USA, participated in two-week-long training manoeuvres in the states of Arkansas (location FC) and Virginia (location FAPH). Acute febrile illnesses due to infections with two tick-borne pathogens, Rickettsia rickettsii and Ehrlichia sp., were confirmed serologically in 2 initial cases who were admitted to the hospital. A seroepidemiological investigation among unit members found an additional 17 of 109 individuals (16%) with elevated post-exposure indirect immunofluorescent antibody (IFA) titres to R. rickettsii (16 cases) and/or E. canis (2 cases). The seropositivity rate of personnel who trained at FC was 38% (15 of 40), compared to only 13% (4 of 31) and 8% (3 of 38) of personnel who trained at FAPH or who did not train in the field, respectively (P < 0.001). Seropositivity was associated with symptoms suggestive of a tick-borne illness. Only 4 (22%) and 6 (33%) of the 18 personnel seropositive for R. rickettsii reported an erythematous or petechial type of rash or a febrile illness, respectively, within 4 weeks of exposure; 5 of 18 (28%) personnel infected with R. rickettsii reported no symptoms and only 8 of 18 (44%) received medical treatment. Mild infections with R. rickettsii, or a closely related spotted fever group agent, may have accounted for the high infection rate experienced by this group.

Antibodies, Bacterial↗
PubMedDate not supplied

Rapid, simple serodiagnosis of murine typhus.

The dot-blot enzyme-linked immunosorbent assay (dot-ELISA) was compared to latex agglutination (LA) and the Weil-Felix OX-19 test for the diagnosis of murine typhus using the indirect immunofluorescent antibody (IFA) test as the 'gold standard'. With a panel of 74 positive and 47 negative sera, the dot-ELISA was 98% specific and 74% sensitive at a cut-off value of the second dot. With acute sera, latex agglutination was 100% specific and 74% sensitive at a cut-off titre of > or = 1:64. Both tests were more sensitive than the OX-19 test, which was 98% specific and 56% sensitive at a titre of > or = 1:320. Both dot-ELISA and latex agglutination were comparable and the results were available within one hour of testing. The rapidity, ease in performance and minimal requirement for electrical instruments made these 2 tests suitable for the diagnosis of murine typhus in countries where sophisticated laboratory facilities are lacking.

Acute Disease↗
PubMedDate not supplied

Tranilast reduces mesenteric vascular collagen deposition and chymase-positive mast cells in experimental diabetes.

The mast cell has a central role in the pathogenesis of fibrosis a common feature of diabetic microvascular complications. Increased mast cell numbers have been demonstrated in diabetic nephropathy in association with renal fibrosis, and diabetes acutely increases mast cell infiltration in the mesentery. Antimast cell agents such as tranilast may ameliorate the acute vascular changes in diabetes due to stabilisation of mast cells and/or reduction in mast cell numbers. After 3 weeks of streptozotocin diabetes, light microscopy techniques were used to estimate mesenteric vessel fibrosis and mast cell infiltration. Mast cells were identified by toluidine blue staining and tryptase, chymase and TGF-beta immunohistochemistry in three study groups of rats: control, diabetic and plus tranilast. Diabetes was associated with an increase in both mesenteric vessel fibrosis and mast cell numbers. Administration of tranilast to diabetic rats reduced mesenteric vessel fibrosis and this was associated with a reduction in chymase-positive mast cells. These changes were independent of mast cell TGF-beta and were not associated with a reduction in tryptase-positive mast cells. The amelioration of diabetes-induced vessel fibrosis may be due to a reduction in the liberation of angiotensin II by inhibiting mast cell chymase.

Animals↗
PubMedDate not supplied

Comparative evaluation of four serodiagnostic tests for scrub typhus in Thailand.

The commercial dot-blot enzyme-linked immunosorbent assay Dip-S-Ticks dipstick test was compared with the indirect immunoperoxidase (IIP) and Weil-Felix (WF) tests for the diagnosis of scrub typhus, using the indirect immunofluorescent antibody test (IFA) as the reference standard. With a panel of 117 positive and 75 negative sera, the dipstick test was 94% sensitive and 98.7% specific at a cut-off value of one or more positive dots. The IIP was 90.6% sensitive and 100% specific at a cut-off titre of 1:400, and was more sensitive than the IFA with acute sera (79.6% vs. 68.5% at a titre > or = 1:400). All 3 were superior to the WF, which lacked sensitivity. The dipstick assay was easy to perform and did not require sophisticated electrical equipment, and the results were available within one hour. It is therefore suitable for use in rural Thailand, where scrub typhus is common.

Agglutination Tests↗
PubMedDate not supplied

The interaction between the renin-angiotensin system and vascular endothelial growth factor in the pathogenesis of retinal neovascularization in diabetes.

Despite the use of laser photocoagulation and knowledge of the beneficial effects of good glycaemic control, visual loss due to diabetic retinopathy remains the commonest cause of blindness in the working population. This visual loss is principally the result of proliferative diabetic retinopathy and macular oedema. The processes by which diabetes mellitus results in retinopathy are incompletely understood, but recent evidence has suggested a pathogenetic role for the renin-angiotensin system (RAS) and vascular endothelial growth factor (VEGF) in the eye in response to chronic hyperglycaemia. This review will explore evidence of a local RAS in the eye, the involvement of VEGF in diabetic retinopathy and the interaction between the RAS and VEGF in the pathogenesis of retinal neovascularization.

Animals↗