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Biomedical subjects

J D Frame

Publications and source records attributed to J D Frame.

72 records · Page 4Linked to original sources
PubMed1984

Endemic Lassa fever in Liberia. VI. Village serological surveys for evidence of Lassa virus activity in Lofa County, Liberia.

Six villages in Lofa County, north-west Liberia, and one near the coast were surveyed for the presence of indirect fluorescent antibodies (IFA) to Lassa virus (LV). Prevalences were similar among males and females, and among various age groups. The prevalence of IFA positive sera, 6.4%, in two roadside villages was significantly higher than in two matched villages "in the bush", 1.9%. It was also higher in Gbanwei, a roadside village which did not maintain traditional sanitary measures, than in Zuwulo, similarly located but with maintenance of clean-swept areas without shrubbery or rubble between the houses. In another pair of villages, the one adjacent to a Mission Clinic with a very high prevalence of IFA positive staff members had significantly higher prevalence, 14.1%, than did the other, a roadside village with 5.1% seropositives. LV antibodies were also found in 4.3% of the inhabitants of a small coastal village near Robertsfield International Airport. Though LV infections are more common in villages in which traditional practices have been modified, they are present even in villages which are relatively unchanged. In the former they appear to be continuous while sporadic in the latter. The prevalences of IFA in the villages with the highest rates are about one third of what is found in personnel of hospitals near them, suggesting that hospital staff members acquire infections from patients as well as from the communities in which they live.

Adolescent↗
PubMed1984

Endemic Lassa fever in Liberia. I. Clinical and epidemiological aspects at Curran Lutheran Hospital, Zorzor, Liberia.

In a study to assess the epidemiological and clinical aspects of endemic Lassa fever (LF) in Liberia at Curran Lutheran Hospital (CLH), 44 cases were diagnosed by virological and serological techniques over a 22-month period. During one calendar month, testing of febrile patients admitted to the medical-surgical ward revealed six cases of LF, 13% of all febrile cases and 17% of those who were tested. As the study progressed the diagnostic skills of the hospital staff improved. The most common mistake was the diagnosis of a case of LF as pneumonia; the most potentially serious diagnostic problem was differentiating LF from typhoid fever, a readily treatable infection. LF may also mimic other diseases such as aseptic meningitis, pelvic inflammatory disease, gastroenteritis or arbovirus infection. We found a previously unreported symptom of LF, rib tenderness typical of costochondritis. The mortality rate in the medical-surgical ward was 5.4%; the over-all case-fatality rate was 13.6%. Women outnumbered men by nearly three to one, and had a higher mortality particularly noted in the pregnant. LF is common at CLH, and as many as 100 cases may occur annually at this hospital.

Adolescent↗
PubMed1984

The use of Lassa fever convalescent plasma in Nigeria.

Lassa fever convalescent plasma (LFCP) has been administered to 27 patients in hospitals at Jos and Vom, Nigeria. Among serologically or virologically confirmed cases of Lassa fever (LF) given plasma on or before the 10th day, all eight survived, as did two of three possible LF cases. Of eight patients given LFCP after the 10th day, five died, as did all three possible LF cases. LFCP was also administered to five patients subsequently shown not to have LF, and to a suspected case contact; all survived without complications of therapy. There were 15 cases of LF during this time who did not receive plasma; 11 survived. Most cases of LF who received plasma and survived showed a rapid response to therapy, in contrast with the gradual recovery in those who did not receive LFCP.

Adolescent↗
PubMed1984

Endemic Lassa fever in Liberia. II. Serological and virological findings in hospital patients.

Patients admitted with fever to four Liberian hospitals were tested for Lassa fever (LF) by means of the indirect fluorescent antibody technique and by virus isolation. The incidence of LF and presumptive LF among consecutive febrile adult patients was 14% and 17% in two hospitals located in the interior; no cases of LF were found among 24 consecutive patients in a hospital near the coast. In the three inland hospitals the incidence of confirmed or presumptive LF among the patients in whom the diagnosis was seriously considered varied from 13% to 36%. Lassa virus was isolated from 17 patients out of the 59 cases found in this survey. LF is a common cause of fever in northern Liberia. The diagnosis depends upon the readiness of the staff to consider the diagnosis, the collection of blood specimens at appropriate times, and the preservation of sera at sub-freezing temperatures to permit survival of active virus and its subsequent recovery in an appropriate laboratory.

Adolescent↗
PubMed1979

Lassa virus antibodies in hospital personnel in western Liberia.

The sera of 844 Liberian hospital staff memebers were positive for Lassa Virus (LV) antibodies in a survey using the indirect fluorescent antibody technique (IFAT). In two hospitals in Lofa County near the Sierra Leone border, the prevalence, 15.4%, was significantly higher than the 8.4% in seven others. There were near differences between the prevalence among laboratory workers, 15.3%, and other workers, 7.7%, and between midwifery students, 21.2%, and midwives, 4.2%, suggesting their infection from patients or their blood products. However, the over-all prevalence among those with patient contacts was the same as that among those without direct patient contact; most LV infections were apparently acquired from sources other than patients in hospital. This finding, the lack of evidence of hospital outbreaks and the presence of comparable prevalences in all age groups suggest that LV infections occur on a continuing basis in this population. In one hospital the comparison of the results of IFAT and complement fixation tests revealed some who reacted by one technique and not by the other. In one person the titre by IFAT had dropped from 1:32 to undetectable levels in two years. This finding prompts caution in the interpretation of results.

Adolescent↗
PubMed1977

The international distribution of biomedical publications.

An investigation of the U.S. role in international biomedical publication is reported, based on counts of articles, notes and reviews in 975 biomedical journals covered by the Science Citation Index in 1973. U.S. scientists authored 42% of these biomedical papers, the U.K. 10%, West Germany and France 7% and 6%, and the U.S.S.R. 4%, a sharp change from earlier in this century when Germany and France had much more prominent roles. Overall, 94% of the papers are from OECD and Eastern European countries; only 4% are from underdeveloped regions. U.S. and U.K. papers are far more heavily cited than are papers from other countries; U.S.S.R. papers are particularly under-cited. Biomedical publication rates are shown to be highly correlated (r = 0.9) with both national wealth (GNP) and national affluence (GNP/capita). National publication rates also correlate with Nobel Prize recipients. - Frame, J. D., and F. Narin. The international distribution of biomedical publications.

Economics↗
PubMed1976

NIH funding and biomedical publication output.

An investigation of the relationship between NIH funding and biomedical publication output is reported for 229 major NIH supported institutions. A correlation of 0.95 was found between the amount of NIH funding and the number biomedical publications for 132 U.S. universities. For 52 hospitals a correlation of 0.89 was found. For all 229 institutions it was found that NIH provided 91% of the boimedical research support from major federal agencies, and more than half of the total extramural biomedical research support. There was no indication of either economies or diseconomies of scale in the number of publications produced by the institutions, which ranged from a few publications per year to over 700 per year.

Economics↗
PubMed1975

Surveillance of Lassa fever in missionaries stationed in West Africa.

To determine the distribution of Lassa virus in West Africa, a serological survey was undertaken. A number of mission hospital supplied sera from patients admitted with a history of fever and specimens were also collected in New York from missionaries who had experienced an unusual febrile illness while working in Africa. More cases of Lassa fever were detected among missionaries than among Africans, possibly because many African patients had left hospital before the complement fixation tests had become positive. Although most adults had fairly high fever and some were prostrated, fever was less severe in the children examined. In general the findings confirm that not all Lassa fever patients have the severe syndrome described in the original reports.

Adult↗
PubMedDate not supplied

Pectoralis major ruptures postsuction lipectomy for surgical management of gynecomastia.

Over the last decade, suction-assisted lipoplasty has been shown to be a safe and reliable procedure in the hands of trained individuals. A large number of plastic surgeons employ liposuction as an adjunct to surgery for gynecomastia with excellent results and low morbidity. An unusual problem, traumatic rupture of the pectoralis major muscle, has been observed by us in a patient who had undergone the procedure. The physical deficit arising from the injury may go unnoticed in all but the most physically active people, and surgeons should be wary of the possibility of this previously unreported complication.

Adult↗
PubMedDate not supplied

Clinical features of Lassa fever in Liberia.

Two hundred thirteen cases of Lassa fever (LF) were diagnosed by virus isolation and seroconversion at Curran Lutheran Hospital in Zorzor, Liberia, between July 1980 and April 1986. An additional 40 cases of probable and presumptive LF were diagnosed on the basis of single serum samples. Of the 246 assessable patients, 23 (9%) died; no data were available for seven patients. Five (16%) of 32 pregnant women and three (43%) of seven immediately postpartum women died. Four (26%) of 15 children less than 12 years died. Case-fatality rates among 125 nonpregnant women and 67 men were approximately 6%. Among 150 patients studied in detail, the case-fatality rate was also 9%. Seventeen (11%) of these patients had abnormal bleeding; of these, six (35%) died. Most platelet counts were at low normal to mildly depressed levels. However, serial counts in seven patients suggested a decrease on about days 10-12 of illness. The symptoms of LF in Liberia are those of a viral syndrome. Edema, sometimes marked, is noted in seriously ill patients. A great variation in mortality and incidence of abnormal bleeding is recorded in reported series of LF; it appears that hemorrhage is a marker for cases with a high mortality. The incidence and severity of hearing defects in LF outbreaks vary. Elucidation of a number of clinical problems in LF requires more information on how strain differences affect the pattern of illness.

Diagnosis, Differential↗
PubMedDate not supplied

Changing flora in burn and trauma units: experience in the United Kingdom.

Bacterial colonization of burned and devitalized tissue is inevitable. The types of organisms that are isolated from burn wounds depend on such factors as preexisting illness, types of topical antiseptics and antimicrobials used, microbial sampling techniques, and indigenous flora that inhibit the burn unit. Among organisms that are capable of producing disease, Staphylococcus aureus remains the most common isolate in the patient with burns. The decrease in the prevalence of Pseudomonas aeruginosa, which was initiated by the advent of effective topical antiseptics, appears to have continued to the present. Acinetobacter is now a common organism in the burn unit; although the organism has developed resistance to multiple antimicrobial agents, it infrequently causes serious problems. Comparisons between burn units with intensive-care capability that practice an aggressive approach to surgical management and burn units that continue to use a more traditional approach have revealed little difference with regard to incidence of or time to acquisition of potentially pathogenic bacteria. In a recent comparison that involved a unit of each type, marked reductions in the incidence of isolation of P. aeruginosa and Streptococcus group A organisms were observed over the course of 2 years in both of the units. Significant problems with viruses, yeasts, and fungi have not yet been encountered (or identified) in burn units; further study of the potential role of such organisms in infection in the patient with burns is required.

Acinetobacter Infections↗
PubMedDate not supplied

Immunohistochemical analysis of burn depth.

Clinical assessment of burns is accurate for very deep and very shallow burns, but it has been suggested that there is a high degree of inaccuracy in the assessment of dermal burns. Histologic analysis has, by some, been considered too time-consuming for routine diagnosis. It also requires an expert skin histopathologist to categorize the depth. With the use of an in vitro model, we have found the use of cryosections and an immunofluorescent staining method to be quicker and more clear-cut than standard light microscopic techniques. We believe this method plays a role in helping to define burns that would benefit from early excision and grafting. However, further investigation is required to transform the method from an experimental model to standard practice in the clinical setting.

Burns↗
PubMedDate not supplied

Exogenous interleukin-10 increased in vitro rejection of allogeneic keratinocytes.

Interleukin-10 (IL-10) is an anti-inflammatory cytokine that has been shown to alter HLA expression in some hemopoietic cells. In skin, the presenting capacity of Langerhans' cells is reduced by IL-10, but little is known about the effect of IL-10 on keratinocytes. Using in vitro experiments, we have shown that IL-10 augments the HLA-DR expression of keratinocytes in the presence of interferon gamma. The increase in HLA-DR expression increased the stimulation and proliferation of allogeneic peripheral blood mononuclear cells, which in turn increased the in vitro rejection of allogeneic keratinocytes. Therefore exogenous application of IL-10 to cultured keratinocytes augments the rejection by allogeneic peripheral blood mononuclear cells in vitro conditions rather than having the suspected protective effect.

Burns↗