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Biomedical subjects

K M O'Neil

Publications and source records attributed to K M O'Neil.

At least 19 recordsLinked to original sources

Urinary findings in asymptomatic subjects with spina bifida treated with intermittent catheterization.

The urines from 43 asymptomatic children with spina bifida were examined. Eighty-one percent were abnormal because of bacteriuria and pyuria (51%), bacteriuria alone (26%) or pyuria alone (5%). Interleukin-8 was elevated in 54% of the abnormal urines. The presence of pyuria and interleukin 8 suggests that the asymptomatic bacteriuria reflects low grade infection rather than colonization.

Adolescent↗

Methodological variables in Web-based research that may affect results: sample type, monetary incentives, and personal information.

There are many methodological differences between Web-based studies, differences that could substantially affect the results. The present study investigated whether sample type, offering payment through a lottery, and requiring participants to enter personal information would affect dropout rates and/or the substantive results in a study of jury decision making in capital cases. Asking participants to enter their e-mail addresses increased dropout rates, and offering payment through a lottery tended to do so as well. Participants offered payment tended to be less likely to give death sentences, and sample type moderated the influence of attitudes toward the death penalty on verdicts.

Data Collection↗

Prevention of tuberculosis. Vigilance and infection control strategies are mainstays of efforts.

Until a vaccine is available, efforts to control the spread of TB will continue to rely on the effective use of our currently available tools and the diligence of primary care physicians. Rapid diagnosis, directly observed therapy, public health and infection control measures, and appropriate preventive therapy remain the mainstays of TB control. Physicians in the primary care setting, particularly those serving long-term-care institutions or other high-risk populations, need to be keenly aware of the possibility of TB in their patient population and of the methods available in their community for preventing its spread.

BCG Vaccine↗

Effect of influenza vaccine on bronchoprovocation testing in normal subjects.

A study of 55 nonasthmatic patients was undertaken to determine if recent influenza vaccination is a justifiable exclusionary criteria for bronchoprovocation testing. Healthy subjects without history of asthma and with negative methacholine challenge tests were given an intramuscular injection of killed influenza vaccine. Methacholine challenge testing was repeated 24 h later. While a statistically significant decline in FEV1 at 188 methacholine dose units was demonstrated (p < 0.018), this was not clinically significant; none of the 55 subjects converted a negative test to positive. We conclude that recent influenza vaccination is not a sufficient exclusionary criterion for methacholine challenge testing. Positive results in a patient recently vaccinated would still indicate asthma in the correct clinical setting.

Adult↗

Cheerios in the chest.

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Adenocarcinoma, Bronchiolo-Alveolar↗

Wegener's granulomatosis masquerading as pancreatic carcinoma.

A 62-year-old male presented with painless jaundice and solitary pulmonary and pancreatic masses. An extensive evaluation revealed Wegener's granulomatosis as the etiology. His pancreatic mass and jaundice responded to temporary stenting and therapy with cyclophosphamide and prednisone. While pancreatic vasculitis in Wegener's granulomatosis has been noted previously in autopsy studies, symptomatic involvement has been reported only once previously and never as a presenting feature of the disease. The antineutrophil cytoplasmic antibody (ANCA) assay proved useful in establishing the diagnosis. Necrotizing vasculidities can mimic pancreatic carcinoma and should be considered in the differential diagnosis of atypical cases.

Antibodies, Antineutrophil Cytoplasmic↗

Hemoptysis. Indications for bronchoscopy.

Indications for bronchoscopy in patients with hemoptysis and a normal or nonlocalizing chest roentgenogram continue to be controversial. We reviewed the records for 119 bronchoscopies performed for hemoptysis in patients with a normal (n = 75) or nonlocalizing (n = 44) chest roentgenogram. Bronchogenic carcinoma was identified in 2.5% of the bronchoscopies. Additional neoplasms were found in another 2.5%. The presence of nonlocalizing abnormalities was not associated with an increase in either the rate of bronchogenic carcinoma or in the diagnostic yield (specific anatomic diagnosis or bleeding site identified) at bronchoscopy when compared with patients with normal chest roentgenograms. The factors of male sex, age more than 40 years, and a more than 40 pack-year smoking history appear useful in identifying patients in whom the yield of bronchoscopy is likely to be high.

Adolescent↗

Natural history and serologic diagnosis of infants born to human immunodeficiency virus-infected women.

Perinatal transmission of human immunodeficiency virus is thought to occur in 25% to 50% of the offspring of infected women. Standard diagnostic methods do not permit identification of the infected newborns. To assess diagnostic methods and document the natural history of perinatal human immunodeficiency virus infection, 20 children born to human immunodeficiency virus-infected women were followed prospectively for 18 months by measuring antibody titer, Western blot profiles, and antigenemia, and the results were compared with clinical outcome. Endogenous synthesis of anti-human immunodeficiency virus IgG was demonstrated in 6 of the 8 infected children. Four children synthesized IgM against human immunodeficiency virus. Five had demonstrable p24 antigenemia. No significant differences between infected and noninfected children were noted at birth except drug withdrawal, which occurred more frequently in noninfected infants. The incidence of adenopathy, hepatomegaly, and neurologic and immunologic abnormalities in the infected children were compared with noninfected children. The distinguishing illnesses were the opportunistic infections, lobar pneumonia, and failure to thrive. Seven of the 8 infected children had human immunodeficiency virus-mediated disease by 1 year of age (Centers for Disease Control [Atlanta, Ga] P2 classification), and four had acquired immunodeficiency syndrome (Centers for Disease Control P2D). These studies offer an approach to diagnosis of human immunodeficiency virus infection in infants and document the natural history and possible outcomes of infected children.

AIDS Serodiagnosis↗

Role of C3 in humoral immunity. Defective antibody production in C3-deficient dogs.

Previous studies have shown that animals pharmacologically depleted of C3 have impaired antibody responses. However, such C depletion is neither complete nor sustained, and the C3 cleavage products generated by C3 depletion can both enhance and inhibit the immune response. To clarify the role of C3 in humoral immunity, the antibody response of dogs with genetically determined total deficiency of C3 (C3D) was examined. Serum IgG levels of the C3D animals were within the normal range, but were significantly lower than levels seen in normal controls or C3D heterozygotes. Specific antibody production was defective: the antibody titers of C3D dogs in response to primary intravenous immunization with two different T cell-dependent Ag (sheep E and bacteriophage phi X-174) were markedly reduced when compared to either normal controls or C3D heterozygotes. After secondary immunization with T-dependent Ag, the total antibody titers were normal, but the C3D dogs made proportionately more IgM and less IgG antibody than did either control group. After i.v. immunization with a T cell-independent Ag (DNP-Ficoll), the C3D dogs had reduced levels of IgM and IgG antibody after primary and secondary immunization. Neither i.m. immunization nor the use of a 20-fold increase in Ag dose i.v. could correct the defect seen in the antibody response of C3D dogs. The results herein demonstrate that C3 plays a critical role in the generation of a normal humoral immune response.

Agammaglobulinemia↗