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Biomedical subjects

J Main

Publications and source records attributed to J Main.

53 records · Page 3Linked to original sources
PubMed1988

Management of non A, non B hepatitis: the problem and its treatment.

Non A, non B (NANB) hepatitis is caused by at least three, as yet unidentified, viruses and can occur as a result of blood transfusions, the use of blood products, covert or overt percutaneous exposure and epidemic waterborne outbreaks of infection. The three types of viruses are characterised by their incubation times; a short time of 2-4 weeks, a longer time of 6-12 weeks and a intermediate period for the waterborne NANB hepatitis virus. Acute NANB hepatitis is milder than HBV hepatitis with lower peak transaminase levels. However, some develop into fulminant hepatitis with a lower survival rate of 0.13%. Ten to 100% of acute patients progress to chronic NANB hepatitis. It was found that alpha-lymphoblastoid interferon at levels of 3-5 megaunits (MU) thrice weekly returned transaminase levels to normal within 6-8 weeks. Approximately 80% had normal levels by the eighth week of treatment and this was maintained on 2.5-3 MU thrice weekly; a well tolerated dose. Long term, low-dose therapy is needed to maintain remission.

Acute Disease↗
PubMed1986

Vindesine and mitomycin C in inoperable non-small cell lung cancer.

Twenty-nine patients with inoperable non-small cell lung cancer were treated as out-patients with vindesine and mitomycin C. Eight patients had a complete response, and nine a partial response. Response was generally associated with either stable or improving ECOG and symptom scores. The incidence of serious side-effects was low--only two patients' white cell count fell below 3000 cells/mm2, only one patient's platelet count fell below 100,000 cells/mm2, and two patients developed vomiting associated with treatment. The combination of vindesine and mitomycin C appears to be effective in the treatment of inoperable non-small cell lung cancer. Side effects were generally well tolerated and allowed out-patient treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

The effect of the dihydroxylated metabolites of vitamin D and dietary phosphate restriction on bone disease in uraemic rats.

Uraemic rats maintained on either a high or a low phosphate diet for 12 weeks were allocated to one of the following oral vitamin D treatment groups and received: 1,25-dihydroxycholecalciferol [1, 25-(OH)2D3], 24,25-dihydroxycholecalciferol [24,25-(OH)2D3], both 1,25-(OH)2D3 and 24,25-(OH)2D3, or no vitamin D supplements. Mean serum creatinine concentrations were elevated to a similar extent in all groups. Mean serum concentrations of calcium, phosphate and alkaline phosphatase were not significantly different from normal in any of the groups. In the group receiving the high phosphate diet and no vitamin D supplements, calcified bone area measured by quantitative computerized histomorphometry was significantly lower than in the group receiving the low phosphate diet and no vitamin D supplements (0.01 greater than P greater than 0.001), and in the groups receiving high phosphate diet and either 1,25-(OH)2D3 (0.01 greater than P greater than 0.001) or 24,25-(OH)2D3 (0.01 greater than P greater than 0.001). We conclude that uraemic rats maintained on a high phosphate diet for 12 weeks develop skeletal demineralization, this process does not occur in rats on a low phosphate diet, and a decrease in calcified bone area may be prevented by treatment with either 1,25-(OH)2D3 or 24,25-(OH)2D3.

24,25-Dihydroxyvitamin D 3↗
PubMed1986

An open study of Timentin for the initial treatment of serious infections.

Fifty patients were treated for suspected serious bacterial infection with Timentin 3.2 g 6-8-hourly. Three patients did not complete a minimum of 48 h treatment. Pathogens were isolated from 28 of the remaining 47 patients; 13 were resistant to ticarcillin but fully sensitive to Timentin; six of these isolates were Staphylococcus aureus. Five of the patients with Timentin-sensitive organisms or no significant growth failed to respond or relapsed after Timentin but also failed on subsequent therapy. An additional patient relapsed because of inadequate duration of treatment and one patient, with salmonella enteritis, became an asymptomatic carrier. The Timentin-resistant organisms were a Pseudomonas aeruginosa which responded to ceftazidime, a Klebsiella pneumoniae which was of doubtful clinical significance and an Escherichia coli which caused a relapse of pyelonephritis 16 days after apparently successful treatment with Timentin. No serious adverse reactions were seen. Timentin was effective against ticarcillin-resistant organisms but its final role will depend on the prevalence and significance of in-vitro resistance to the combination amongst Enterobacteriaceae and pseudomonads.

Adolescent↗
PubMed1986

The effect of hemodialysis, vitamin D metabolites and renal transplantation on the skeletal demineralization associated with renal osteodystrophy: a computerized histomorphometric analysis.

Twenty-three patients with end-stage renal failure treated by hemodialysis or transplantation were followed for up to 10 years. Sequential full thickness iliac crest bone biopsies were obtained to assess the effects on bone disease of hemodialysis, treatment with 1,25-dihydroxycholecalciferol [1,25-(OH)2D3] and 24,25-dihydroxycholecalciferol [24,25-(OH)2D3] and renal transplantation. The biopsies were analyzed by a computerized histomorphometric technique which allowed accurate measurements of calcified bone and osteoid areas. Serum aluminum and parathyroid hormone concentrations were also monitored. Hemodialysis was associated with a loss of calcified bone and an increase in osteoid areas. The progressive bone loss was arrested but not reversed following treatment with either 1,25-(OH)2D3 or 24,25-(OH)2D3. Osteoid area was unchanged or reduced following treatment with 1,25-(OH)2D3 in all but three patients who had serum aluminum concentrations in excess of 5 mumol/l. 24,25-(OH)2D3 was not effective in reducing osteoid area, and combined treatment with 1,25 and 24,25-(OH)2D3 had no effect beyond that expected with 1,25-(OH)2D3 alone. Bone biopsies showed loss of calcified bone and an increase in osteoid areas one year and more after successful renal transplantation in five patients. Nineteen of the 23 patients developed serum aluminum concentrations greater than 3 mumol/l, probably because of the use of oral aluminum hydroxide as a phosphate binding agent. In these patients serum parathyroid hormone concentrations greater than 600 pg/ml appeared to prevent the development of osteopenia.

24,25-Dihydroxyvitamin D 3↗
PubMed1985

Lactic acidosis and beer drinking.

A patient is reported who developed lactic acidosis, hyponatraemia and features of the Wernicke-Korsakoff syndrome following long term excessive ingestion of beer and lager. Intramuscular thiamine caused a rapid correction of the lactic acidosis, and the hyponatraemia was corrected by intravenous therapy. On discharge after six weeks of intramuscular Parentrovite the patient still retained some chronic features of the Wernicke-Korsakoff syndrome.

Acidosis↗
PubMed1984

Influence of socioprofessional conditions on blood pressure levels and hypertension control. Epidemiologic study of 6,665 subjects in the Paris district.

A total of 6,665 subjects (3,896 men and 2,769 women) employed by small and medium-sized companies in the Paris region were examined. Mean systolic blood pressure (SBP) was significantly higher in the lowest than in the highest occupational categories (p less than 0.001), even when results were adjusted for age (p less than 0.001) and body mass index (p less than 0.001). Diastolic blood pressure (DBP) differed among the occupational categories (p less than 0.001); the differences were still significant after adjustment for age but not for body mass index, suggesting that the latter might be partly responsible for the differences in DBP. Prevalence of hypertension was 14.7% and was negatively associated with a high occupational category (p less than 0.001). Multivariate analysis confirmed the influence of occupational category on SBP (p less than 0.001). Exposure to noise at work and assembly line work were associated with high SBP (p less than 0.01 for both). Of the subjects with detected hypertension, 65.6% were aware of their illness, and 35.3% were undergoing treatment. Both the percentage of treated patients and compliance with treatment were positively associated with occupational category (p less than 0.01 in both cases). Among women, SBP of treated hypertensives was higher in the lowest than in the highest occupational categories (p less than 0.05). It is suggested that the differences in blood pressure levels observed among occupational categories are partly due to working conditions, and that poor compliance with treatment among the low occupational categories enhances these differences.

Blood Pressure↗
PubMed1983

Relation between coffee drinking and blood pressure: analysis of 6,321 subjects in the Paris region.

The possible link between coffee drinking and blood pressure (BP) was studied in a cross-sectional epidemiologic survey of 6,321 adults in the Paris region. Systolic and diastolic BP levels were higher among the 5,430 coffee drinkers than among the 891 nondrinkers (p less than 0.001 and p less than 0.01). BP levels adjusted for age by covariance analysis increased gradually from the non-coffee consumption category (125.6/79.8 +/- 15.0/10.5 mm Hg [mean +/- standard deviation]) to the highest consumption category (greater than or equal to 5 cups/day) (128.1/80.6 +/- 15.6/10.2 mm Hg) (p less than 0.001 for systolic BP and p less than 0.002 for diastolic BP). The positive association between coffee consumption and systolic, but not diastolic, BP remained significant in a multivariate analysis after controlling for age, sex, body mass index, alcohol consumption, tobacco consumption and socioeconomic category (p less than 0.02 for systolic BP and p = 0.16 for diastolic BP). It is concluded that coffee consumption is a significant but not strong contributor to the variation in BP levels.

Adult↗
PubMed1980

Diagnosis and management of long-standing benign oral ulceration.

The authors formed a Mouth Clinic at Sunnybrook Hospital in 1973 since when there have been 3025 patient visits. Those patients with chronic ulceration present a challenge, the diagnosis sometimes being difficult and therapy not rapidly effective. The differential diagnosis includes lichen planus, pemphigus vulgaris, benign mucous membrane pemphigoid, discoid lupus erythematosus, erythema multiforme, aphthous ulcers, Behcets disease, periadenitis mucosa necrotica recurrens, specific infections and iatrogenic causes. It is possible to reach a definite diagnosis in virtually every case by means of a good history and careful clinical examination supplemented by biopsies and in some cases direct and indirect immunofluorescent studies. Treatment emphasizes scrupulous attention to oral hygiene with baking soda mouthwashes and careful teeth cleaning to minimize the accumulation of dental plaque. Specific therapy includes topical steroids in lichen planus, intra muscular gold in benign mucous membrane pemphigoid, a previously unreported treatment which considerably improved seven out of ten patients, and tetracycline mouthwashes in aphthous ulcers.

Behcet Syndrome↗
PubMed1977

Oral manifestations of herpes simplex virus infections.

Most individuals are infected with Herpes Simplex in childhood usually suffering a mild febrile illness of no consequence. Later some individuals suffer recurrent infections which appear as cold sores on the lip while others intermittently shed virus in the oro-pharygeal secretions. Adults uninfected in childhood may be exposed to viruses for example by kissing and develop an acute primary herpes with fever and gingivo-stomatitis occasionally requiring hospital admission. Awareness of this condition is required for diagnosis after which the majority of patients seen in otolaryngological practice need only supportive therapy, explanation and reassurance. Recurrent cold sores are no more that a nuisance in most patients, but occasionally they are severe and in others the cold sore may precipitate oral erythema multiforme. Unfortunately the treatments available for recurrent cold sores are rather unsatisfactory.

Erythema Multiforme↗
PubMedDate not supplied

Tuberculosis in HIV seropositive individuals--a retrospective analysis.

A retrospective analysis of all culture-positive cases of Mycobacterium tuberculosis infection in HIV positive individuals, over a 5 year period, revealed 18 cases, drawn from a population of approximately 1500. The prevalence of culture proven M. tuberculosis over the 5 year period was therefore 1.2% and was strongly associated with either a concomitant, or a subsequent, AIDS diagnosis. Sixty-one per cent had pulmonary tuberculosis, 17% had both extra-pulmonary and pulmonary infection and 22% had extra-pulmonary infection alone. Although a wide range of radiological abnormalities was seen, segmental consolidation was the commonest, occurring in 57% of cases. Only 55% of the specimens were positive on initial stains for M. tuberculosis, with a mean duration of 4 weeks to become culture positive, emphasizing that early diagnosis rests on clinical suspicion.

Adult↗