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Biomedical subjects

L Gilbert

Publications and source records attributed to L Gilbert.

At least 73 records · Page 4Linked to original sources
PubMed1992

Cell surface characteristics and virulence in mice of Pasteurella multocida.

The virulence of three avian strains of Pasteurella multocida was evaluated in mice. Strains P-1059I (serotype A:3) and its uncapsulated variant P-1059B and strain 2723 (serotype A:16) were compared. Capsular material thickness after polycationic ferritin labelling of dextrose starch agar (DSA)-grown P. multocida was shown to vary with the strain and was not always related to virulence. Addition of alpha,alpha' bipyridyl (BIP) (160 microM) to the culture medium did not affect capsule production but increased virulence of strains P-1059B and 2723. None of the strains tested showed dermonecrotic activity. Using sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE), outer membrane protein (OMP) profiles indicated for strains P-1059I and P-1059B three proteins of 30, 35, and 38 KDa with the 30 KDa protein being the major one. Strain 2723 showed the same OMP profile but the 38 KDa protein was the major one. DSA + BIP-grown strains showed the same OMP profiles. Whole cell profiles were similar for all strains tested. However, addition of BIP to the culture media increased the virulence of strains P-1059B and 2723 and for all strains a 39 KDa protein was induced by the iron chelator. The results indicate that encapsulation may be important for virulence, but other surface components such as OMPs may be required as well.

Animals↗
PubMed1992

Drug use and AIDS risks in a soup kitchen population.

Untreated substance users remain beyond the reach of most acquired immune deficiency syndrome (AIDS) prevention efforts. In an effort to describe the risk behavior and attitudes of this population, the authors conducted interviews with 148 drug users in an urban soup kitchen. The study focused on subjects' risk-taking and risk-reduction behavior related to injection drug use, perceived changes in risk behavior, perceived risk for contracting AIDS, and socioeconomic and attitudinal correlates of injecting and sharing needles. Study findings underscore the need for community-based AIDS prevention strategies to intervene with high-risk populations beyond the reach of drug treatment and AIDS prevention programs.

AIDS Serodiagnosis↗
PubMed1991

An objective, noninvasive method for the diagnosis of temporomandibular joint disorders.

An objective, noninvasive method for the diagnosis and monitoring of pathology referable to the temporomandibular joint is presented. A computerized temporomandibular joint analyzer was developed to obtain data from the patient's temporomandibular joint area to provide an objective record of clinical symptoms and signs. This data, used in conjunction with a complete history and physical examination, aids in the diagnosis and decision-making process for therapy. Fifty patients with temporomandibular complaints were evaluated. Diagnoses made using the temporomandibular joint analyzer in conjunction with complete histories and physical examinations were confirmed in 81% of the patients by further examinations with x-ray studies, computed tomography scans, magnetic resonance imaging, and arthroscopy. Patients' progress during treatment was monitored using the temporomandibular joint analyzer. Results of the temporomandibular joint analyzer were compatible with patient's progress as reported subjectively and with clinical evaluation in 97% of the cases. The temporomandibular joint analyzer can be used to reduce time and expense as well as to minimize the discomfort involved in the evaluation of temporomandibular joint disorders.

Adolescent↗
PubMed1990

Endoscopic localization of the squamocolumnar junction before cervical cone biopsy in 284 patients.

A preoperative examination of the endocervical canal was performed in 284 patients scheduled for excisional cone biopsy because of abnormal cervical cytology and unsatisfactory colposcopy. The information obtained regarding the depth of the new squamocolumnar junction (SCJ) was used to tailor the length of the cone specimen in an attempt to remove the entire transformation zone (TZ), and was associated with a low rate of incomplete disease excision. An analysis of the data generated by this study indicates that the position of the new SCJ is influenced by age, menopausal status, and the use of estrogen-containing medication.

Adult↗
PubMed1990

Unsatisfactory colposcopy and the response to orally administered oestrogen: a randomized double blind placebo controlled trial.

Thirty-six women with dyskaryotic cervical smears and unsatisfactory colposcopy were randomly allocated to receive either 30 micrograms ethinyl oestradiol or placebo daily by mouth for 10 days. Thirty-four women were available for review (17 women in each of the two groups), full colposcopic inspection of the transformation zone was possible in a significantly greater proportion of the oestrogen treated group (70% versus 23%, P less than 0.01). As most diagnostic conizations are currently performed on the basis of unsatisfactory colposcopy, the use of oestrogen medication followed by colposcopic reassessment should permit a reduction in the number of patients subject to operation.

Adult↗
PubMed1990

Suitability of teachers as oral health educators.

In view of the vast number of people to whom dental services are not accessible, the WHO has proposed the use of lay persons as health educators. This study investigated the suitability of teachers in Gazankulu to fulfil this role. Two hundred and twenty-two teachers from the district of Letaba provided the study population. Oral health status was measured and a structured questionnaire was administered which probed areas such as knowledge, attitudes, reported behaviour, motivation and interest. The mean DMFT was 4,7 with an M component of 3,6 while 28 per cent of subjects were free from caries. The majority of subjects expressed an adequate knowledge of causes of decay, frequency of brushing, dental visits and fluoride. In terms of oral health status and knowledge the teachers appear to be suitable as oral health educators. With regard to utilisation of services, their self-assessment, attitudes, motivation and interest, several contradictions exist, which raise some doubt about their suitability. This however, can be minimised by adequate training and does not preclude the utilisation of teachers as oral health educators, especially in the context of the social reality in Gazankulu.

Adult↗
PubMed1990

Aerotitis: cause, prevention, and treatment.

Aerotitis, an acute inflammation of the middle ear caused by the difference in air pressure between the airplane cabin and the middle-ear space, is becoming more common in the United States as our society becomes increasingly mobile. We describe a case in which a 33-year-old woman with a resolving upper respiratory tract infection and mildly blocked eustachian tubes flew on a business trip. During ascent, her ears became blocked. This blockage was partially alleviated by a Valsalva's maneuver. On descent, however, her ears became severely blocked, she experienced intense pain, and her tympanic membranes ruptured. She became nauseated and vomited. Her hearing became significantly diminished and she experienced vertigo. On landing, she was taken to a local emergency room and treated with penicillin and antivertiginous medication. Subsequent otologic evaluation revealed severe permanent sensorineural hearing loss. The vestibular symptoms lasted several months. She now requires hearing aids on a permanent basis. Suggestions are presented for prevention and treatment of aerotitis.

Adult↗
PubMed1990

Microcolpohysteroscopic tailoring of cervical conization.

The ideal cone biopsy should have its apex just above the transformation zone to ensure removal of all abnormal squamous and metaplastic epithelium in the endocervix, with only minimal normal glandular tissue included. The microhysteroscope has been shown to be useful in identifying the upper limit of the transformation zone within the canal, and this distance from the external os can be measured. However, this technique has not been evaluated to determine whether it can tailor cone length to this predetermined measurement. We report an observational analysis of 176 consecutive conizations in patients with colposcopically proved extension of abnormal epithelium high into the cervical canal. In 162 cases, the distance of the transformation zone from the external os could be measured with the microhysteroscope and its endocervicometer, permitting an attempt to tailor the cone length to this measurement plus a safety margin of 5 mm. There was good correlation between the intended cone length and the excised cone length, with 85% of the excised cones falling within 5 mm above or below the intended measurement. In 153 instances (94.4%), the excised cones had clear endocervical margins. Thus, tailoring of the cone length to the hysteroscopically determined measurement is feasible, thereby increasing the chances of complete excision while limiting cone size to the required minimum.

Adult↗
PubMed1989

Oxytocin infusion during second stage of labour in primiparous women using epidural analgesia: a randomised double blind placebo controlled trial.

OBJECTIVE: To determine whether the high rate of forceps delivery associated with the use of epidural analgesia could be reduced through giving an intravenous infusion of oxytocin during the second stage of labour. DESIGN: A randomised, double blind, placebo controlled trial. SETTING: Delivery suites in three hospitals. SUBJECTS: 226 Primiparous women with adequate epidural analgesia in whom full dilatation of the cervix had been achieved without prior stimulation with oxytocin. INTERVENTION: An infusion of oxytocin or placebo starting at the diagnosis of full cervical dilatation at an initial dose rate of 2 mU/min increasing to a maximum of 16 mU/min. MAIN OUTCOME MEASURES: The outcome of labour was assessed in terms of the duration of the second stage, mode of delivery, fetal condition at birth, postpartum blood loss, and the incidence of perineal trauma. RESULTS: Treatment with oxytocin was associated with a shorter second stage (p = 0.01), a reduction in the number of non-rotational forceps deliveries (p = 0.03), and less perineal trauma (p = 0.03) but was not associated with any reduction in the number of rotational forceps deliveries performed for malposition of the occiput. No adverse effects on fetal condition at birth or in the early puerperium were seen in association with the use of oxytocin. CONCLUSIONS: The use of an oxytocin infusion may reduce the high rate of operative delivery associated with epidural analgesia provided that the fetal occiput is in an anterior position at the onset of the second stage of labour but within the dose range studied does not seem to correct malposition of the fetal occiput.

Adolescent↗
PubMed1989

Replication of measles virus in the human plasma cell leukemia-derived LICR-LON-HMy2 cell line.

Measles virus is usually grown in human or monkey fibroblast cells. We now show that LICR-LON-HMy2 (LL2) cells, a human plasma cell leukemia-derived line which grows in suspension culture, will permissively support replication of measles virus to an extent achievable with Vero cells. Sodium dodecyl sulphate-polyacrylamide gel electrophoresis of measles virions produced by LL2 cells showed a polypeptide pattern typical of measles virus. As well, measles virus-infected LL2 cells, like infected Vero cells, were found to secrete large amounts of virus hemagglutinin, but not other virus proteins. We thus conclude that LL2 cells can be effectively used to produce milligram amounts of measles virus and that virus-clarified culture medium from measles virus-infected LL2 cells is a potential source for purifying virus hemagglutinin.

Animals↗
PubMed1989

Racial classification in dental literature: is it always necessary?

The purpose of the present study is to describe and analyse the use of terms (black, coloured, white, indian, african and non-white) that classify people for research purposes along racial lines. All scientific articles published in the Journal of the Dental Association of South Africa, from Jan 1979 to Dec 1988, were reviewed. Of the 493 articles covered, 92 made use of one or more of the terms, and 10 (11 per cent) either explained, defined, referenced and/or justified their use, while 09 per cent of the articles did not do so. Based on these reviews, it may be concluded that the use of these terms is not always necessary or justified and can reinforce thinking in racial rather than in social and behavioural terms. The unjustified usage of racial variables may limit our theoretical perspectives and lead us into questionable research.

Humans↗
PubMed1989

Social characteristics and oral health behaviour of families in Riverlea.

Planning of community health programmes requires a comprehensive "community diagnosis" as its basis, taking into account a complex range of health related factors. The family and particularly the mother play a crucial role in oral health. Thus, the social context, the source and extent of health information, as well as their oral health behaviour, can determine the mothers' function in promoting oral health. This study examined the social characteristics and oral health behaviour of families in Riverlea. One hundred and fifty seven mothers were interviewed in their homes using a structured questionnaire. The results reveal a picture where the percentage of 'broken' or single mother families is high. There is overcrowding in the homes combined with a low level of education and employment in mainly non-skilled, low-paid jobs. The utilisation of existing dental services was poor despite the fact that 43 per cent of the families are members of medical aid schemes. Almost one third of the mothers were edentulous. Although cost and other factors were cited as barriers for not 'going to the dentist', most of the respondents have a symptomatic approach to oral health which might be responsible for poor utilisation. The 'lay referral system' for obtaining information was common and teachers played a role in this process. The study identified various factors that adversely affect the process of development of good oral health and related behaviour in the home environment. Schools and supportive community networks as well as outside organizations could be enlisted to take part in the efforts to overcome the barriers identified and improve the situation.

Dental Health Surveys↗
PubMed1989

Hemostasis and cold knife cone biopsy: a prospective randomized trial comparing a suture versus non-suture technique.

Two methods of obtaining hemostasis after cold knife cone biopsy were compared in a prospective randomized trial involving 200 patients. One method relied primarily on hemostatic sutures, and the other involved the use of a styptic solution (Monsel's solution) and vaginal pack, thus avoiding the use of sutures altogether. The short- and long-term morbidity in these two groups were compared and 12-month follow-up was completed. The use of sutures did not reduce the incidence of primary hemorrhage. Secondary hemorrhage was twice as frequent in the suture group, although this trend did not quite reach statistical significance. During long-term follow-up, significantly more patients in the suture group developed menstrual symptoms, cervical stenosis, and unsatisfactory colposcopy, requiring further operative intervention as a result.

Adult↗
PubMed1988

The management of multiple pregnancy in women with a lower-segment caesarean scar. Is a repeat caesarean section really the 'safe' option?

Multiple pregnancy occurring in a patient who has previously had a lower-segment caesarean section is an unusual sequence of events. Retrospective analysis over an 11-year period in Sheffield from 1975 to 1985, revealed 25 cases, a rate of 1 in 3300 deliveries. The caesarean section rate in this group of women rose from 20% (3/15) in the first six years to 70% (7/10) in the latter years for no obvious reason. This change in management did not produce any improvement in fetal outcome but there was an increase in maternal morbidity. This analysis and a review of available literature suggest that multiple pregnancy is not in itself an indication for elective repeat caesarean section.

Cesarean Section↗