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Biomedical subjects

G L Davis

Publications and source records attributed to G L Davis.

At least 217 records · Page 12Linked to original sources
PubMedDate not supplied

Complete resolution of inflammatory activity following corticosteroid treatment of HBsAg-negative chronic active hepatitis.

To assess the frequency and significance of complete resolution of inflammatory activity following corticosteroid therapy, 115 patients with severe HBsAg-negative chronic active hepatitis were followed regularly for 84 +/- 5 months. Of 83 patients eligible to revert to normal liver tissue, 18 did so after 56 +/- 8 months. Five of the 18 relapsed after treatment withdrawal. Only patients who improved spontaneously after cessation of treatment from histologic features of chronic persistent hepatitis to normal invariably sustained the improvement. Of 32 patients with cirrhosis at presentation, 17 reverted to inactive cirrhosis after 48 +/- 10 months, but only 3 remained inactive after discontinuation of treatment. Mortality was similar in patients with and without reversion to normal tissue (0 vs. 14%, p greater than 0.2), but the frequency of relapse was less after complete resolution (28 vs. 76%, p less than 0.001). Reversion to inactive cirrhosis did not improve survival or reduce relapse frequency after remission and treatment withdrawal. Findings prior to therapy did not predict outcome. We conclude that complete resolution of inflammatory activity is possible, but that it occurs slowly, infrequently and unpredictably after therapy. In patients without cirrhosis, reversion to normal liver tissue decreases the likelihood of relapse and the requirement for retreatment. In patients with cirrhosis at presentation, elimination of inflammatory activity is rarely sustained and does not improve prognosis after remission and treatment withdrawal.

Adolescent↗
PubMedDate not supplied

Treatment of chronic hepatitis C: impact of combination therapy.

Interferon as a single agent results in normalization of the serum alanine aminotransferase (ALT) levels, loss of detectable serum hepatitis C virus RNA, and histologic improvement in approximately 40% of patients. However, regardless of the duration of initial therapy, most patients relapse within the first few months after the drug is stopped, and only a small proportion have a sustained response. Ribavirin is a nucleoside analogue that is known to have in vitro activity against a number of both RNA and DNA viruses. As a single agent, oral ribavirin treatment transiently lowers serum ALT values into the normal range in about 40% of cases of chronic hepatitis C, but it does not affect the level of viremia. However, when given in combination with interferon for 6 to 12 months, ribavirin results in a sustained normalization of serum ALT levels and loss of detectable hepatitis C virus RNA in 30% to 40% of previously untreated patients. Retreatment of interferon relapsers with the combination of interferon and oral ribavirin for 6 months results in a sustained viral-negative response in about half of patients. Thus far, there is little evidence that combination therapy is effective in patients in whom ALT fails to normalize and who have lost hepatitis C virus RNA during a previous treatment course (nonresponders). Studies are ongoing in this group.

Antiviral Agents↗
PubMedDate not supplied

A psychometric normative database for pre-liver transplantation evaluations. The Florida cohort 1991-1996.

In this study, the authors describe the psychological characteristics of a large sample (N = 407) of adult patients evaluated for liver transplantation, and provide normative data on commonly used measures of cognitive functioning, affective status, psychosocial adjustment, coping, quality of life, and life satisfaction. The normative data suggest that the study's liver transplant candidates have poorer cognitive functioning and health-related quality of life when compared with available normative comparison groups, yet the former group is more comparable to medically ill peers on measures of anxiety, depression, psychosocial adjustment, and coping. Data also suggest a high rate of affective disturbance in liver transplant candidates. Results indicate the utility of normative data, such as the authors', for providing an appropriate comparison group for liver pretransplant candidates.

Activities of Daily Living↗
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Pathology of otosclerosis: a review.

Otosclerosis is a bone disorder of unknown etiology confined to the otic capsule. Failure of remodeling of newly formed vascular, woven bone (otospongiosis) results in sclerotic bone (otosclerosis) with abnormal osteons. Involvement of the oval window causes conductive hearing loss. Electron microscopic, histochemical, and biochemical studies identify normal cellular and matrix components of otosclerotic bone without providing clues to the abnormal bone formation and resorption. Plastic-embedded, nondecalcified histologic sections with in vivo tetracycline labels permit the study of mineralization rates to separate this disorder from other bone dyscrasias that have similar histopathologic appearances. Characterization of the cells, matrix, and their mediators can yield an understanding of abnormalities that disorder bone.

Animals↗
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In vitro cultivation of the fetal guinea pig inner ear.

Fetal guinea pig inner ears, gestational age from 21 to 54 days, were cultivated in vitro and then observed with light and electron microscopes. Early 21-day gestation otocysts developed cartilaginous capsules from differentiating mesenchyme and discrete neurosensory structures from endolabyrinthine epithelium. Coiling of the cochlea occurred. Older, differentiated inner ears showed progressive increase in size and development of the labyrinth. The 26-day gestation cochlea, maintained for 12 days in vitro, doubled in size with development comparable to the 37-day gestation in vivo control. The large size of the guinea pig inner ear resulted in varying degrees of necrosis. However, the well-defined growth and development of the guinea pig fetal inner ear in vitro indicates the efficacy of the technique and suggests that similar success would be forthcoming with other animals used in audiologic research, such as chinchilla and hamster.

Age Factors↗
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Fibrinolysis inhibitors.

The fibrinolytic system involves a series of enzymatic reactions that results in the conversion of the proenzyme, plasminogen, into the trypsin-like lytic enzyme, plasmin. The major physiologic target of plasmin is fibrin. Free plasmin in plasma is a nonspecific lytic enzyme that will degrade other proteins such as fibrinogen and coagulation factors V and VIII. Plasmin and activators of plasminogen also play a role in ovulation, embryo implantation, tissue remodeling, and inflammation.

Female↗
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Platelet specific alloantigens.

The ability of platelets to aggregate and to form a platelet plug is central to the maintenance of normal hemostasis. When platelets have normal function, the severity of bleeding is related to the degree of thrombocytopenia. In patients with normal platelet production, the most common cause of thrombocytopenia is due to immune mechanisms that results in platelet injury and removal from the circulation. These mechanisms involve the binding of platelet-associated immunoglobulins and are classified as immune. Immune thrombocytopenias can be caused by autoantibodies (autoimmune thrombocytopenia), alloantibodies (isoimmune thrombocytopenia), or drug-induced immune complexes and conditions secondary to autoimmune disorders such as systemic lupus erythematosus. In this paper the focus is on alloimmune thrombocytopenias resulting from the formation of alloantibodies to platelet specific antigens. The clinical importance of the platelet alloantigens is due to their ability to elicit alloantibody production. Alloantigens, also referred to as isoantigens, are substances that induce the production of alloantibodies when they are infused into individuals of the same species who lack the specific alloantigen.

Antigens, Human Platelet↗
PubMedDate not supplied

The narrow lumbar spinal canal or lumbar spinal stenosis.

Narrow lumbar spinal canal or lumbar spinal stenosis is a not uncommon problem. Thirty-two patients with this disorder have been treated surgically at the Ochsner Medical Center between 1963 and 1973. The best method of diagnosis is a careful history and second is roentgenographic evidence, particularly the myelogram. The surgical treatment consists of total laminectomy and foraminotomy to insure complete decompression of the nerve roots. Eighteen patients have been followed from 14 to 44 months. Sixteen of the 18 considered their operations a success.

Adult↗