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Biomedical subjects

L L Sanders

Publications and source records attributed to L L Sanders.

12 recordsLinked to original sources
PubMed1987

Chancroid in the United States. Reestablishment of an old disease.

For 30 years, chancroid has been an uncommon and geographically localized disease in the United States; a mean of 878 cases were reported annually between 1971 and 1980. Since 1981, however, numerous outbreaks have established chancroid as an endemic disease in many additional areas and, in 1986, 3418 cases, the largest number since 1952, were reported. Cases are occurring preponderantly among men who patronize prostitutes, and infected individuals who have traveled from outbreak areas or from outside the United States are suspected of having contributed to the spread of disease. Efforts to eradicate disease in outbreak areas have been only occasionally effective and have been hampered by difficulty in locating potentially infected individuals and by travel by infected individuals. The failure to eradicate outbreaks leaves residual sources for new disease transmission into yet additional areas.

Black or African American↗
PubMed1987

Chlamydia trachomatis infections in the United States. What are they costing us?

Chlamydia trachomatis has emerged as the most common sexually transmitted bacterial pathogen in the United States and is now recognized to cause substantial morbidity. To determine the economic consequences of chlamydial infections in the United States, we analyzed data from local, state, and national sources. We estimate that C trachomatis infections cost Americans over $1.4 billion per year in direct and indirect costs. Chlamydial infections in women account for 79% of this cost, although men and infants are also affected. Three fourths of the total cost is due to sequelae of untreated, uncomplicated infections. If the current rate of chlamydial infection persists, the projected annual costs will exceed $2.18 billion by 1990. Reducing the incidence of personal suffering and heavy economic burden imposed by C trachomatis infections requires establishment and maintenance of effective prevention/control programs.

Chlamydia Infections↗
PubMed1987

Inhibitor of calmodulin and cAMP phosphodiesterase activity in BB rats.

Diabetes mellitus in humans is associated with increased plasma and tissue levels of cAMP and decreased cAMP phosphodiesterase (PDE) activity. Calmodulin (CM) is a low-molecular-weight protein essential for activation of cAMP PDE. The inhibitor (INH) is a low-molecular-weight substance that inhibits the activity of CM in multiple systems, including PDE. Spontaneously diabetic BB rats (SDR) and their nondiabetic littermates (NDR) were used in this study. Holtzman rats were rendered diabetic by streptozocin (STZ). STZ-induced diabetic rats (STZ-DR) and BB rats were studied with and without the benefit of insulin therapy. Calmodulin was assayed both by bioassay and by specific radioimmunoassay. The inhibitor was bioassayed by its ability to inhibit CM-activated PDE. Results showed that both spontaneous and STZ-induced diabetes are associated with a decrease in activity of the low-Michaelis constant (Km) cAMP PDE in the liver (39%, SDR; 70% STZ-DR). Calmodulin activity was also decreased in the livers of both animals (13%, SDR; 68%, STZ-DR). Similar data were obtained for NDRs. The inhibitor, on the other hand, was increased in the livers of untreated SDRs and STZ-DRs (155%, SDR; 125%, STZ-DR). No change was noted for NDRs. All these changes were restored toward normal after treatment with insulin. These data suggest that in diabetes the defect in the cAMP PDE-CM-INH system is demonstrated in both an environmental model, as illustrated by STZ-DRs, and a genetic model, as shown by SDRs and NDRs. The inhibitor activity, however, is not changed significantly in NDRs. We speculate that the inhibitor activity plays a role in dictating whether the genetic NDR will or will not become clinically diabetic.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed1987

False elevation of hemoglobin A1 by hereditary persistence of fetal hemoglobin.

Measurement of glycosylated hemoglobin (HgA1) is frequently helpful in the management of patients with diabetes mellitus as it provides an index of average glucose control over the previous two to three months. The present case of a diabetic patient with a markedly increased hemoglobin A1 to 42% (normal 5.2-9.2%) with good glucose control prompted an investigation into the etiology of the increased hemoglobin A1 levels. Hemoglobin electrophoresis revealed that the patient had hereditary persistence of fetal hemoglobin. Hemoglobin F was quantitated and found to be responsible for 73% of the hemoglobin A1 determination. Hemoglobin F co-migrates with hemoglobin A1 on column chromatography and, when present in increased quantities, can falsely elevate the measured hemoglobin A1. Thus, if one utilizes the hemoglobin A1 assay to help guide management of patients with diabetes mellitus, it is important to remember that hemoglobin F can cause falsely elevated hemoglobin A1 levels.

Adult↗
PubMed1986

Treatment of sexually transmitted chlamydial infections.

Tetracycline hydrochloride, 500 mg orally four times a day for seven days, remains the treatment of choice for C trachomatis infections in men and nonpregnant women. Either erythromycin, 500 mg orally four times daily for seven days, or an equivalent dosage of another erythromycin product is an alternative treatment for patients who cannot tolerate tetracycline and for pregnant women. These two treatment regimens can be generalized to include nongonococcal urethritis and mucopurulent cervicitis. However, other treatment regimens that are effective against C trachomatis may not be effective for treating nongonococcal urethritis or mucopurulent cervicitis not caused by C trachomatis. The optimal treatment for pregnant women with C trachomatis infections and women with acute PID has not been established. Additional treatment trials with both groups of patients are needed to determine the effectiveness of antimicrobial agents in addition to those currently used, to establish the appropriate dose of each antimicrobial agent, and to clarify the appropriate duration of treatment. All individuals who are sexual partners of patients with nongonococcal urethritis, mucopurulent cervicitis, and acute PID (within the 30 days prior to onset of their symptoms or time of positive clinical evaluation findings) should be examined for sexually transmitted disease and treated promptly with a regimen effective against uncomplicated gonorrhea and chlamydial infections. Prompt treatment of sexual partners reduces the rate of treatment failure due to reinfection, reduces the transmission of infection, and reduces the frequency of occurrence of adverse sequelae of infection.

Acute Disease↗
PubMed1986

Use of dot-immunobinding and immunofluorescence assays to investigate clinically suspected cases of chancroid.

In 1984 and 1985, outbreaks of genital ulcers occurred in Florida and New York. Initial investigations for syphilis, herpes simplex, Chlamydia trachomatis, and Haemophilus ducreyi did not implicate any of these organisms as etiologic agents. From the results of dot-immunobinding assays, we found that sera from the patients had higher levels of IgM (30 [47.6%] of 63 patients) and IgG (22 [34.9%] of 63 patients) reactivities with an outer-membrane preparation from H. ducreyi strain CIP542 than with outer-membrane preparations from Haemophilus influenzae ATCC 10211 or Haemophilus parainfluenzae ATCC 7901. In contrast, sera from 35 patients in the control group did not react with any of the outer-membrane preparations (P less than .01 for both IgM and and IgG reactivity), nor did sera from eight individuals with disease caused by H. influenzae (P = .051 for IgM reactivity, P = .02 for IgG reactivity). Indirect immunofluorescence assay using a monoclonal antibody reactive with outer-membrane preparations from H. ducreyi strain CIP542 stained organisms in smears of lesion material from genital ulcers from three of six patients. These results suggested that the cause of both outbreaks of genital ulcers was H. ducreyi which was subsequently isolated in both geographic areas.

Antibodies, Bacterial↗
PubMed1976

Gastric emptying of hypertonic glucose in diabetes mellitus and duodenal ulcer.

Gastric emptying of hypertonic glucose liquid meals was studied in diabetes, duodenal ulcer, and hospitalized controls by means of the 10% glucose 30-minute test meal, with phenol red as nonabsorbable marker. Acid secreted into the meal was measured. Results revealed no significant difference in gastric emptying between controls and patients with duodenal ulcer and diabetes mellitus. Among diabetics, some individuals empty this meal more rapidly than normal. The results show that alterations of gastric emptying cannot account for the late peaks observed on oral glucose tolerance tests in diabetics, nor for any tendency toward reactive hypoglycemia in duodenal ulcer. They suggest that autovagotomy may occur in some diabetics.

Diabetes Mellitus↗