PubMed Health⌕ Search

Biomedical subjects

D Lam

Publications and source records attributed to D Lam.

At least 55 records · Page 3Linked to original sources

Microbial adhesion and biofilm formation on ureteral stents in vitro and in vivo.

Thirty ureteral stents, inserted for 5 to 128 days following extracorporeal shock wave lithotripsy, were examined for the presence of bacterial biofilms. Of these, 90% had adherent pathogens (44% mixed organisms) on the stents, 45% of which were present in low numbers (10(1)-10(2) per 1 cm3 section) and 55% were in small and large microcolony biofilms (> 2 x 10(2)-10(7)). The organisms were recovered from the stents even though urine culture was only positive in 27% of patients. Of the organisms isolated, 77% were Gram positive cocci, 15% Gram negative rods and 8% Candida. No blockage of the stents occurred. All of the patients had received antimicrobial therapy post-insertion, and in 15 cases biofilms were found while on treatment. None of the patients received therapy for urinary tract infections while the stent remained in place. In vitro experiments demonstrated the ability of Escherichia coli, Proteus mirabilis, Staphylococcus epidermidis and Enterococcus faecalis uropathogens to adhere and form biofilms on ureteral stents within 24 hours. Clearly, bacterial biofilms do occur on ureteral stents and urinary culture may not detect their presence. The high recovery rate of Gram positive organisms may indicate a preferential adhesion to the biomaterial surface. The findings also indicate that unlike biofilm formation on many other prosthetic implants, colonization with Gram positive organisms on ureteral stents does not necessarily coincide with the development symptomatic infection.

Adolescent↗

Bacterial biofilm formation in the urinary bladder of spinal cord injured patients.

Ten spinal cord injured patients aged 8 to 55 years (mean 32) were followed for up to 2 months after admission to a rehabilitation setting from an acute care hospital. Urinary fluid and bladder epithelial cells were collected weekly by intermittent catheterization and examined for bacterial colonization. Six patients had no history of urinary tract infection upon admission, likely due to the antimicrobial coverage given during acute care. All the patients subsequently became colonized with uropathogens at some time during the study period. Bacterial biofilms were found in 73% of the samples (73% Gram negative organisms, 27% Gram positive), with mean pathogenic adhesion counts of 29 organisms per bladder cell. In 16% of cases, bladder biofilms were found when urine culture was negative. Bacterial biofilms were also evident during antimicrobial therapy in 10 of 12 samples tested and urine cultures showed breakthrough infections in 50% of cases. Two asymptomatic patients were colonized with Klebsiella pneumoniae and Pseudomonas aeruginosa and were dismissed without requiring therapy. Clearly, bacterial biofilms can exist on bladder epithelia, without being detected in urine samples and without giving rise to symptoms. The extent to which they occur and damage the host remains to be determined, as does the answer to the question, should these patients be treated?

Adult↗

Neuromuscular impairment: a major cause of non-syncopal falls in elderly Chinese.

A survey was conducted on 138 residents in Old Age Hostels and 217 subjects living at home. Twenty-five percent of women and 12% of men reported one or more non-syncopal falls in the previous year. Neuromuscular impairment, which included knee pain, a positive Romberg sign, an abnormal gait and use of walking aids, was the main risk factor for falls in this population. Screening and preventive programmes may be based on these findings.

Accidental Falls↗

Graded stress radiography of injured anterior cruciate ligaments.

Fifty-five patients with clinical suspicion of injury to their anterior cruciate ligament (ACL) were examined by graded stress radiography before arthroscopic verification in an effort to determine the loss of ACL function as a result of ligament tearing. Using a commercially available stress device capable of applying varying pressures to the mid-calf, anterior drawers were measured from lateral radiographs at 0-, 7-, 14-, and 21-kiloPascal pressures and used to calculate the equivalent elastic modulus of the remaining ACL fibers. According to viscoelastic theory, this modulus is proportional to the number of elastically active fibers in the ligament. To verify the validity of this concept, the stress-strain relationship of a freshly excised ACL ligament was examined in a tensile testing machine, and the procedure was repeated after the ligament had been partially transsected with a scalpel. Comparison with the elastic modulus of the (intact) ACL of the opposite knee permits an estimate of the percentage of rupture in cases of partial tears. Overstretched ligaments show essentially normal viscoelastic properties once the slack in the ligament has been taken up. Complete tears, on the other hand, show a complete breakdown in the viscoelastic properties of the ACL. The results show that partial tears can be diagnosed by graded stress radiography with a sensitivity of 20% and specificity of 90%. Diagnosis of overstretched ligaments had sensitivity of 50% and specificity of 94%. Complete tears were detected with sensitivity of 88% and specificity of 75% as diagnosed against all other ACL lesions and including normals.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Age, experience, educational status, and differences in income: the United States and Brazil].

"This paper analyses age and experience profiles of earnings inequality for American and Brazilian males. Decomposition of the inequality profiles using a human capital framework clarifies the determinants of cross-section inequality profiles and demonstrates a number of important differences in the shape of the two countries' profiles and in their underlying components. Changes in the distribution of schooling across cohorts are shown to play a central role in explaining cross-section inequality profiles within each country and in explaining differences in earnings inequality in the United States and Brazil." (SUMMARY IN ENG)

Age Factors↗

Hepatic iron and iron absorption in hemochromatosis.

The relationship between iron absorption and hepatic iron was studied in 21 patients with hemochromatosis. Iron absorption was studied using 59Fe and total body counting and hepatic iron was measured by atomic absorption spectrophotometry. Iron absorption was inversely related to hepatic iron concentration (r = -0.51, p = 0.009) in this patient population. This observation suggests that iron absorption is regulated by body iron stores even in hemochromatosis, and does not support the hypothesis that the primary metabolic defect in hemochromatosis is a deregulation of iron absorption in relation to iron stores.

Absorption↗

Effect of starvation and insulin in vivo on the activity of the pyruvate dehydrogenase complex in rat skeletal muscles.

The in vivo responses of pyruvate dehydrogenase (PDH) complex to starvation and insulin was assessed in heart, diaphragm and red quadriceps muscle. PDH complex activity was decreased by starvation (3.4-10.2-fold), the magnitude of change depending on muscle type. Insulin increased PDH activity in all muscle types. In fed rats, this effect was relatively small (1.25-1.29-fold). In starved rats there were effects in heart (4.3-fold) and red quadriceps (1.7-fold) but no effect in diaphragm. These results demonstrate that PDH complex in different groups of muscle has different insulin sensitivity (particularly in tissues from starved animals).

Adipose Tissue, Brown↗

Recovering event histories by cubic spline interpolation.

If event data are recorded in discrete intervals of time, errors are introduced when the data are converted from the unit in which they were recorded, such as date, to another unit such as age or duration. The problem is illustrated by the inconsistent age at marriage schedules published by 2 recent US censuses. This paper develops a general method for treating problems of this type using cubic spline interpolation. The method is used to adjust US age at marriage schedules, explaining a substantial part of the discrepancy in the 1960 and 1970 censuses.

Americas↗

Ferritin release by mononuclear cells in hereditary hemochromatosis.

An anomaly of the iron-loading disorder hereditary hemochromatosis is that bone marrow iron stores remain low until later stages of the disease. The possibility that this may be related to a disorder of reticuloendothelial ferritin metabolism was examined by studying ferritin release from mononuclear cells. Ferritin release was measured in peripheral blood mononuclear cells from four patients with hemochromatosis who had not received treatment, from six patients with hemochromatosis who had received treatment, and from 10 age- and gender-matched controls by using a modified hemolytic plaque assay. Ferritin release from the hemochromatotic cells was enhanced when compared with that of controls, and added iron stimulated ferritin release to a comparable degree in both groups. Enhanced ferritin release above matched control values was found both in cells from patients with hemochromatosis with partial phlebotomy who had high serum ferritin values and in cells from patients with hemochromatosis with full phlebotomy who had normal serum ferritin values. The increased ferritin release observed in these studies may signify abnormal reticuloendothelial iron metabolism in hemochromatosis.

Aged↗

Hyperalgesic properties of 15-lipoxygenase products of arachidonic acid.

Induction of hyperalgesia by leukotriene B4 (LTB4), a potent chemotactic factor for polymorphonuclear leukocytes (PMNLs), depends on the generation by cutaneous PMNLs of mediators that are probably derived from the 15-lipoxygenation of arachidonic acid. The capacity of dihydroxyeicosatetraenoic acid (diHETE) products of the 15-lipoxygenation of arachidonic acid in PMNL to elicit hyperalgesia was evaluated by assessing the effects of intradermal injection of synthetic diHETEs on the pressure nociceptive threshold in rats. (8R,15S)-Dihydroxyeicosa-(5E-9,11,13Z)-tetraenoic acid [(8R,15S)-diHETE] produced a dose-dependent hyperalgesia, as measured by decrease in threshold for paw withdrawal. The isomer (8S,15S)-diHETE antagonized in a dose-dependent manner this hyperalgesia due to (8R,15S)-diHETE but did not suppress prostaglandin E2-induced hyperalgesia. (8S,15S)-DiHETE produced a dose-dependent hypoalgesia, as reflected by an increase in nociceptive threshold, suggesting a contribution of endogenous (8R,15S)-diHETE to normal nociceptive threshold. The hypoalgesic effect of (8S,15S)-diHETE was blocked by corticosteroids but not by the cyclooxygenase inhibitor indomethacin. Neither (8R,15S)-dihydroxyeicosa-(5,15E-9,11Z)-tetraenoic acid nor (8R,15S)-dihydroxyeicosa-(5,11E-9,13Z)-tetraenoic acid exhibited any hyperalgesic or hypoalgesic activity. The stereospecificity of the effect of (8R,15S)-diHETE suggests that the induction of hyperalgesia is a receptor-dependent phenomenon and that (8S,15S)-diHETE may be an effective receptor-directed antagonist. The (8R,15S)-diHETE and (8S,15S)-diHETE from PMNL, keratinocytes, and other epithelial cells may modulate normal primary afferent function and contribute to inflammatory hyperalgesia.

Animals↗