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Biomedical subjects

G A Dinkins

Publications and source records attributed to G A Dinkins.

2 recordsLinked to original sources
PubMed2001

The effects of retained lead bullets on body lead burden.

BACKGROUND: Numerous case reports have demonstrated that lead poisoning with potentially fatal consequences can result from retained lead projectiles after firearm injuries. To assess the impact of retained projectiles on subsequent lead exposure in the population, one cannot rely on self-selected cases presenting with symptoms of lead intoxication. This preliminary study seeks to identify increased lead burden and identify risk factors of elevated blood lead levels for individuals with retained lead bullets. METHODS: Forty-eight patients were originally recruited from gunshot victims presenting for care at the King/Drew Medical Center in Los Angeles, California. An initial blood level was measured for all recruited patients and repeated for the 28 participants available for follow-up, 1 week to 8 months later. Medical history, including a history of prior firearm injuries and other retained projectiles, was taken, along with a screening and risk factor questionnaire to determine other sources of lead (occupational/recreational) to which the patient might have been, or is at present, exposed. The participants also had K-shell x-ray fluorescence determinations of bone lead in the tibia and calcaneus in order to determine past lead exposures not revealed by medical history and risk factor questionnaire. Multivariate models of blood level were made using risk factor and bone lead concentration data. RESULTS: We demonstrated that blood lead tends to increase with time after injury in patients with projectile retention, and that the increase in significant part depended on the presence of a bone fracture caused by the gunshot. CONCLUSION: We encountered evidence suggesting that the amount of blood lead increase in time after injury is also dependent on the tibia lead concentration. There were too few cases in the study to fully test the effects of bullet location, or the interaction of bullet location with bone fracture or bullet fragmentation.

Adolescent↗
PubMed1990

Interferon production in sickle cell disease.

There is limited data on cytokine production in sickle cell disease (SCD). In this study, both alpha (Poly IC-induced) and gamma (PHA-induced) interferon (IFN) were measured in 62 SCD steady state patients, and 21 in the crisis state associated with infections. Comparable normal controls (30 healthy and 14 with infections) were assessed in a similar manner. Gamma IFN production in both SCD groups, steady state (35 +/- 6 U/ml) and crisis state (24 +/- 11 U/ml) was significantly diminished when compared to the normal healthy controls (65 +/- 14 U/ml) with P less than .005. Both SCD groups were also less than normals with infections (56 +/- 23 U/ml) with P less than .005. On closer analysis of individual titers, 15/62 (24%) in the steady state, 11/21 (52%) of SCD patients with infection and 2/14 (14%) of normals with infection, showed impaired gamma IFN when compared to normals without infection (range 27-2187 U/ml). Alpha IFN production in the SCD groups; steady state (512 +/- 113 U/ml) and SCD crisis with infection (559 +/- 110 U/ml) was virtually equivalent to normals (524 +/- 170 U/ml) and normals with infection (509 +/- 116 U/ml). Analysis of individual titers, in contrast to gamma IFN, also showed no significant differences. These results indicate that a significant percentage of SCD patients in both the steady state and infectious state associated with crisis, have impaired gamma IFN production. In view of the known immunomodulatory functions of gamma IFN, this apparent defect may be another factor to explain the increased frequency and severity of infections in SCD.

Adolescent↗