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Biomedical subjects

G Anderson

Publications and source records attributed to G Anderson.

At least 19 recordsLinked to original sources
PubMed1992

Invasive Haemophilus influenzae infections in men with HIV infection.

OBJECTIVE: To determine the incidence of invasive Haemophilus influenzae disease in men with the acquired immunodeficiency syndrome (AIDS) or human immunodeficiency virus (HIV) infection and the proportion of disease due to serotype b. DESIGN: Population-based, active surveillance. SETTING: San Francisco (Calif) Department of Health. PARTICIPANTS: All men 20 to 49 years of age with invasive H influenzae disease. RESULTS: The cumulative incidences of invasive H influenzae disease in men 20 to 49 years of age with AIDS and in HIV-infected men 20 to 49 years of age without AIDS were 79.2 and 14.6 per 100,000, respectively, but only 33% of cases were due to serotype b. The corresponding rates for invasive H influenzae b disease were 11.3 and 7.6 per 100,000. CONCLUSIONS: Men with AIDS or HIV infection are at increased risk of invasive H influenzae infections, including H influenzae b, but such infections are still infrequent in this population.

AIDS-Related Opportunistic Infections↗
PubMed1992

The use of the major anoxic stress response protein P34, the K isozyme of lactate dehydrogenase, and carcinoembryonic antigen in the follow-up of patients with colorectal adenocarcinoma.

BACKGROUND: This prospective study evaluated the use of the K isozyme of lactate dehydrogenase (LDH-K) as a complementary tumor marker to carcinoembryonic antigen (CEA) in patients with colorectal adenocarcinoma. METHODS: In this series, 355 patients underwent potentially curative surgery for primary colorectal adenocarcinoma. A close surveillance program of follow-up revealed 108 patients (30%) who had a serum elevation in CEA and/or LDH-K. RESULTS: The patients were divided into three groups. Group 1 consisted of 43 patients with elevations in CEA alone. Twenty-seven of 43 patients (63%) had tumor at exploratory laparotomy; and 16 patients (37%) had no evidence of disease after a median follow-up of 74 months. Group 2 consisted of 33 patients with a serum elevation of LDH-K alone. In this group, 5 of 33 patients (15%) had recurrent disease with true elevations of LDH-K. In 28 patients (85%), there were falsely elevated levels of LDH-K with no evidence of disease. Group 3 consisted of 32 patients with elevations of both serum LDH-K and CEA. In this group, 17 of 32 patients (53%) had true elevations of CEA and LDH-K with tumor recurrence, and 15 patients (47%) had false elevations with no evidence of disease. CONCLUSION: LDH-K did not complement CEA as a tumor marker for detecting recurrence in this group of patients with colorectal cancer.

Adenocarcinoma↗
PubMed1992

Studies on T cell maturation on defined thymic stromal cell populations in vitro.

We describe an in vitro system in which positive selection of developing T cells takes place on defined stromal cell preparations, which include major histocompatibility complex class II+ epithelial cells but exclude cells of bone marrow origin. In this system, maturation of double-positive T cell receptor negative (TCR-), CD4+8+ thymocytes into single-positive TCR+, CD4+ and CD8+ cells takes place together with the development of functional competence. As in vivo, this maturation is associated with the upregulation of TCR levels as cells progress from double-positive to single-positive status. We also show that class II+ epithelial cells in these cultures are less efficient than dendritic cells in mediating the deletion (negative selection) of V beta 8+ cells by the superantigen staphylococcal enterotoxin B. For the first time, this approach provides a model in which the cellular interactions involved in both positive and negative selection can be studied under controlled in vitro conditions.

Animals↗
PubMed1992

Tubal sterilization and risk of subsequent hospital admission for menstrual disorders.

OBJECTIVE: Our objective was to investigate tubal sterilization and subsequent hospitalization for menstrual disorders. STUDY DESIGN: Automated discharge data were used in a population-based cohort study of 7253 women aged 20 to 49 years with tubal sterilization (1968 through 1983) at Group Health Cooperative of Puget Sound. Comparisons were with an age-matched cohort of 25,448 nonsterilized women and a nonmatched cohort of 5283 spouses of men with vasectomies. RESULTS: In the sterilization cohort, 282 had hospitalization for menstrual disorders (curettage, n = 191; hysterectomy, n = 66; nonsurgical, n = 25). Risk of hospitalization for menstrual disorders was 2.4 times greater after tubal sterilization (95% confidence interval 2.0 to 2.9). This risk was 6.1 times greater for sterilized women aged 20 to 24 years (95% confidence interval 0.72 to 3.2). Compared with the risk for nonsterilized women whose spouses had a vasectomy, the risk was 1.6 times greater (95% confidence interval 1.3 to 2.1). Hospitalization for menstrual disorders was not more common after unipolar sterilization than after other methods, as might have been expected if the menstrual disorder was related to impaired uteroovarian circulation. CONCLUSIONS: Tubal sterilization is associated with a greater risk of hospitalization for menstrual disorders. A biologic association is not supported by these results.

Cohort Studies↗
PubMed1992

Dissociative experiences among psychiatric inpatients.

The Dissociative Experiences Scale was administered to 299 inpatients on an acute care general adult psychiatric ward over a 2-year period. The average score was 14.6, which is significantly higher than the mean for the general population. About one in six inpatients reported very high scores above 50 on the seven most common items in the scale, indicating a high level of dissociative psychopathology. Based on the responses to four items which form a scale factor called Activities of Dissociated States, an estimate is made that 6%-8% of general adult inpatients may have multiple personality disorder. Dissociative psychopathology is common on inpatient units.

Adult↗
PubMed1992

Laryngeal candidiasis: a cause of airway obstruction in the immunocompromised child.

Laryngeal involvement with candida is usually secondary to pulmonary candidiasis and is seen in patients with impaired immunity. We report a case of isolated laryngeal candidiasis involving the vestibular folds and presenting with stridor in a one-year-old child with Down's syndrome and hypogammaglobulinaemia. Vestibular fold reduction and fluconazole achieved resolution of the disease. Candidiasis should be considered in any potentially immunodeficient child presenting with symptoms of laryngeal disease.

Airway Obstruction↗
PubMed1992

Beyond empathy: expanding expressions of caring.

In this paper, a model describing nurses' responses to patients who are suffering is presented. The nurse's level of engagement with the patient is affected by whether the caregiver is focused on him-/herself or on the sufferer (i.e. embodied with the patient) and whether the caregiver is responding reflexively or with a learned response. Four types of communication patterns are identified: engaged responses (first-level) are used in a connected relationship; when the nurse responses reflexively and is focused on him-/herself, the response is reflected; when the caregiver is patient-focused, a learned response is labelled a professional response; and a self-focused, learned response is labelled detached. Examples of each type of response are provided.

Communication↗
PubMed1992

Exploring empathy: a conceptual fit for nursing practice?

After three decades, the efficacy of empathy in the clinical setting remains undocumented. Recently, concerns have been raised that the concept may be inappropriate and even harmful to the nurse-patient relationship. An analysis of the concept indicates that empathy consists of moral, emotive, cognitive and behavioral components. By tracing the integration of this concept into nursing, we suggest that empathy was uncritically adopted from psychology and is actually a poor fit for the clinical reality of nursing practice. Other communication strategies presently devalued, such as sympathy, pity, consolation, compassion and commiseration, need to be reexamined and may be more appropriate than empathy during certain phases of the illness experience. Directions for future research are suggested.

Behavior↗
PubMed1992

Comparison of three different methods for automated classification of cervical cells.

Over 4600 exfoliated squamous cervical cells taken from appropriate Papanicolaou samples were classified as normal, mildly dysplastic, moderately dysplastic and severely dysplastic by an experienced cytopathologist. The slides were de-stained and subsequently re-stained with Feulgen Thionin-SO2 stain. Images of the nuclei were then captured, recorded and processed employing an image cytometry device. Automated classification of the cells was carried out using three different methods--discriminant function analysis, a decision tree classifier and a neutral network classifier. The discriminant function analysis method, which combined all dysplastic cells into an abnormal group, achieved a combined error rate of less than 0.4% for moderate and severe dysplastic cells, and less than 40% for mildly dysplastic cells. All three methods yielded comparable results, which approached those of human performance.

Cell Nucleus↗
PubMed1992

Pericapillary collagen in the human thymus: implications for the concept of the 'blood-thymus' barrier.

The deposition of collagen in the walls of capillary-size blood vessels was studied in 95 human thymuses with respect to the site of deposition, extent of the change and relation to age and degree of involution. When examined by electron microscopy the collagen was found to be situated between the 2 basement membranes of the so-called 'double-layered' capillaries characteristic of the thymus of many species. This results in the formation of substantial 'collars' of collagen around a proportion of the blood vessels examined. Few such collars are seen before birth, but their number and thickness increase markedly during the 1st year of life. The relationship of these changes to the degree of involution is less apparent. The significance of these changes to thymic structure and function is discussed in relation to cell traffic through the thymus and the postulated 'blood-thymus barrier', the existence of which is seen to be in some doubt.

Aging↗
PubMed1992

Basic epidemiologic and statistical methods in clinical research.

Various study designs and approaches to statistical analysis in clinical research have their own underlying rationales and limitations for interpretation. This information is presented in an intuitive and accessible manner, relying minimally on basic algebra. Epidemiologic concepts of study design and interpretation, bias and confounding, hypothesis testing, and sample size and power are explained. Statistical tests and their appropriate applications are discussed for mean comparisons (t tests and ANOVA), percentages (chi-square), survival analysis, and correlation and regression. Applicable nonparametric tests are also introduced.

Carcinoma, Transitional Cell↗
PubMed1992

Wegener's granuloma. A series of 265 British cases seen between 1975 and 1985. A report by a sub-committee of the British Thoracic Society Research Committee.

In order to describe the British experience of Wegener's granulomatosis Hospital Activity Analysis was used to collect cases diagnosed in England, Wales and Scotland between 1975 and 1985. Where possible clinical details, histological material and chest radiographs were obtained. Two hundred and sixty five patients were considered to have Wegener's granulomatosis. In 109 a single pathologist confirmed the diagnosis by finding both granulomas and vasculitis in biopsy material. The diagnosis was made on clinical grounds or clinical grounds together with histological diagnosis in the local hospital in 156 patients. Wegener's granulomatosis was confined to the lung or upper respiratory tract in 22 per cent of patients and renal disease occurred in 58 per cent. Laboratory tests showed a pattern of mild anaemia, polymorph leucocytosis, eosinophilia and an elevated ESR and hypergammaglobulinaemia, with no specific pattern of changes. Histological confirmation was most frequently obtained by examination of nasal biopsy specimens, but multiple biopsies were often required. Renal biopsies showed focal proliferative glomerulonephritis but granulomatous glomerulonephritis was uncommon. Of available chest radiographs 61 per cent were abnormal, large opacities being most common. Small irregular opacities were found less often and other abnormalities were uncommon. Treatment varied widely and 10 per cent of patients received no drug therapy. This large series illustrates that even without specific treatment, patients with Wegener's granulomatosis can survive for several years and with modern treatment survival for more than a decade is possible. Conclusions about the effectiveness of the various therapies cannot be drawn from this retrospective study. Renal failure and disseminated vasculitis were the commonest causes of death; death was considered to result from complications of treatment with cytotoxic drugs or prednisolone in 6 per cent of patients.

Adolescent↗
PubMed1991

Atrial natriuretic peptide response to cardioversion of atrial flutter and fibrillation and role of associated heart failure.

Plasma atrial natriuretic peptide (ANP) concentrations were measured before and 1 hour after cardioversion in 40 patients (27 with atrial flutter and 13 with atrial fibrillation) admitted for elective cardioversion. Fourteen (11 with atrial flutter and 3 with atrial fibrillation) had clinical evidence of congestive heart failure (CHF). Conversion to sinus rhythm was successful in 39 patients. The mean ANP concentration in the entire group decreased after cardioversion from 38 +/- 4 to 17 +/- 2 pmol/liter (p less than 0.001). In the subgroup with CHF, the ANP level, which was not significantly higher than that in the group without CHF, decreased from 47 +/- 8 to 19 +/- 3 pmol/liter (p less than 0.01). Neither mode of cardioversion (spontaneous 1, pharmacologic 2 and direct-current countershock 36) nor associated CHF influenced ANP response to cardioversion. One patient with atrial flutter and "failed cardioversion" had unchanged ANP level. The decrease after cardioversion in ANP concentration correlated with its control level (r = 0.88, p less than 0.001) but not with the decrease in heart rate. The ANP level in patients with atrial fibrillation was 45 +/- 9 vs 38 +/- 5 pmol/liter in those with atrial flutter (difference not significant). Arrhythmia duration, left atrial size, and ventricular rate or arterial blood pressure did not correlate with ANP concentration in any subgroup. It is concluded that (1) the ANP level is elevated comparably in patients with both atrial flutter and fibrillation regardless of the presence or absence of CHF; and (2) the level decreases, independent of the mode of cardioversion or presence of CHF, promptly after successful cardioversion.

Aged↗