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Biomedical subjects

M A Lewis

Publications and source records attributed to M A Lewis.

At least 127 records · Page 7Linked to original sources
PubMed1995

Identification of Candida species by PCR and restriction fragment length polymorphism analysis of intergenic spacer regions of ribosomal DNA.

The PCR was used to amplify a targeted region of the ribosomal DNA from 84 Candida isolates. Unique product sizes were obtained for Candida guilliermondii, Candida (Torulopsis) glabrata, and Candida pseudotropicalis. Isolates of Candida albicans, Candida tropicalis, Candida stellatoidea, Candida parapsilosis, and Candida krusei could be identified following restriction digestion of the PCR products.

Base Sequence↗
PubMed1995

Recruiting patients to clinical trials: lessons from studies of growth hormone treatment in renal failure.

Issues raised by the recruitment of children to trials of growth hormone treatment for short stature in chronic renal failure are reported. Information needs of parents and children are discussed, the latter should take account of the children's developmental level and anticipated involvement in decision making. When the incidence of certain side effects is low and probably unquantifiable there are particular problems; failure to include these in information sheets may compromise informed consent but inclusion will, at least for some families, make an already difficult decision even more complicated. A process of recruitment is described which attempts to protect against bias and which balances the requirement to impart neutral information with appropriate clinical involvement in the decision to enter the study. Other functions of the recruitment process are identified. Analysis of understanding and decision making demonstrates that good understanding is neither necessary nor sufficient for ease of decision making. The recruitment process was time consuming and needs planning and funding in future studies. Many of these issues are of general importance for trials of treatment in children.

Adolescent↗
PubMed1995

Drugs, poverty, pregnancy, and foster care in Los Angeles, California, 1989 to 1991.

To determine the characteristics and childbearing histories of women whose infants entered foster care in Los Angeles County, we examined the cases of 1,155 drug-using women whose infants were removed from them at birth and 236 non-drug-using women whose infants were also removed at birth by court order (July 1989 through March 1991). All of the women were indigent, and less than half had graduated from high school. The drug-using women frequently had criminal records, and more than a quarter were homeless. Many comparison women had mental health problems, and some (16.7%) were teenagers under court custody. Overall, 80% of all the children born to both groups of women were under court jurisdiction. Data obtained after study infants' births on 926 drug-using women observed for 18 months revealed that 22% had borne another infant who was placed in foster care; half of these infants had a positive drug immunoassay. Of the 185 non-drug-using women with 18-month follow-ups, 7.6% had borne another child who was in foster care. The magnitude of the repeated childbearing recorded among both groups of women in this study shows that preventive programs including family planning, mental health services, and drug prevention or rehabilitation programs have not reached this population.

Adolescent↗
PubMed1994

The termination of a randomized clinical trial for poor Hispanic children.

OBJECTIVE: To conduct a randomized clinical trial of the Spanish version of an educational program designed to be an adjuvant to adequate medical care of children with asthma. DESIGN: Randomized, clinical trial. SETTING: Los Angeles County, Calif. PARTICIPANTS: One hundred thirty-eight Hispanic children, ages 7 to 12 years, from disadvantaged families. All had used emergency facilities of major local hospitals in the previous year. MEASUREMENT/MAIN RESULTS: As the study proceeded, it became apparent that subjects were receiving inadequate medical and nursing care and had numerous barriers to applying knowledge and self-care skills gained from the program. Realizing this, we considered it unethical to allow the control children to suffer for the duration of the trial (1 year). Therefore, all children received "adequate" care from the research staff, and the randomized clinical trial, as originally designed, was ended. The emergency department/hospital use by both groups was significantly reduced compared with previous experience. CONCLUSION: Those researchers conducting randomized trials involving poor children should be aware of the potential ethical problems inherent in such ventures.

Asthma↗
PubMed1994

Orofacial artefactual disease.

Self-induced lesions of the face and mouth may occasionally be encountered in dental practice. In general the deliberate creation of orofacial lesions is an indication of underlying psychiatric disease of various types that usually involve a personal gain by the patient from having such lesions. We present three cases of deliberately self-induced lesions and discuss the problem of diagnosis and management of these cases.

Adult↗
PubMed1994

When are dysphoric individuals distressing to others and vice versa? Effects of friendship, similarity, and interaction task.

Interpersonal relationships present difficulties for dysphoric individuals, but the specific contexts in which these difficulties arise remain poorly understood. The authors examined several factors hypothesized to affect how dysphoric and nondysphoric individuals react to each other. Female college students interacted with either a friend or stranger who had a similar or dissimilar dysphoria status in three tasks: a causal conversation, disclosure of a personal problem to the partner, and response to the partner's disclosure of a personal problem. Ss' moods, evaluations of their partners, and verbal behaviors were assessed. Dysphoric Ss exhibited characteristic negative mood and verbal content but did not elicit negative reactions from their partners. Negative reactions were most evident in dysphoric Ss' responses to dissimilar (nondysphoric) strangers, underscoring the need for greater attention to dysphoric individuals' perspective on their social interactions.

Female↗
PubMed1994

Investigative techniques and renal parenchymal damage in children with spina bifida.

The case records of 72 patients attending a multidisciplinary spina bifida clinic were reviewed to discover the prevalence of renal parenchymal damage. 19.4% of the total population had such damage. More detailed analysis of the group according to age showed that the prevalence of parenchymal damage in the over ten year olds (27.3%), was twice that of the under five year olds (13.3%) but the same as the prevalence of "at risk" patients (26.6%) in this group. On the basis that most renal parenchymal damage occurs early we conclude that the current approach to investigation and treatment is reducing the incidence of renal parenchymal damage in this population. Further reduction would require the early identification of the high risk bladder before the onset of hydronephrosis.

Adolescent↗
PubMed1994

An unclassified Eubacterium taxon in acute dento-alveolar abscess.

The microflora of pus samples aspirated from 50 acute dento-alveolar abscesses was examined. A total of 143 bacterial strains was isolated, consisting predominantly of Prevotella spp., alpha-haemolytic Streptococcus spp., Peptostreptococcus spp. and Eubacterium spp. An unclassified asaccharolytic Eubacterium taxon was encountered in 17 (34%) of the abscesses. This taxon was found to have a positive association with Fusobacterium spp. and a negative association with alpha-haemolytic Streptococcus spp.

Acute Disease↗
PubMed1993

A randomised trial of co-amoxiclav (Augmentin) versus penicillin V in the treatment of acute dentoalveolar abscess.

In a randomised, operator-blind, comparative clinical trial, the efficacy of co-amoxiclav (250 mg amoxycillin plus 125 mg clavulanic acid, eight-hourly) was compared to that of penicillin V (250 mg phenoxymethylpenicillin, six-hourly) in the treatment of acute dentoalveolar abscess. In each case surgical drainage was established at the time of initial presentation by incision of any soft tissue swelling, accompanied by either extraction of the tooth or extirpation of the pulp as indicated clinically. Each patient recorded the severity of their pain and swelling at eight-hourly intervals using graduated scales. Clinical review was performed after 1, 2 and 5 days of treatment, at which time sublingual temperature was recorded and the presence of cervical lymphadenopathy determined. A total of 79 patients were clinically assessable on Day 5 (co-amoxiclav, n = 41; penicillin V, n = 38). The two groups were comparable for sex, age, presenting features and microbiology. Penicillin-resistant organisms were isolated from five patients (co-amoxiclav, n = 3; penicillin V, n = 2). Symptoms improved in all patients following the start of treatment, however those receiving co-amoxiclav recorded a significantly greater decrease in pain during the second (P = 0.026) and third days (P = 0.025). Only one patient reported a significant adverse effect associated with drug therapy, and this was in the penicillin group. Co-amoxiclav was as effective as penicillin therapy.

Adolescent↗
PubMed1993

Waves of extinction from sterile insect release.

Employing theoretical models, we show that the sterile insect release method (SIRM) can give rise to traveling waves of fertile insects. The velocity of these waves depends critically upon the density of sterile insects (and thus upon the rate at which sterile individuals are being released into the environment). When the sterile density is sufficiently low, the traveling wave advances, giving rise to an invasion. However, when the sterile density exceeds a critical threshold, the wave reverses direction, thereby retreating and giving rise to local extinction. Both analytical (regular perturbation) methods and numerical methods are used to determine wave velocities and wave profiles. This is the first time traveling wave solutions have been shown for the SIRM.

Animals↗
PubMed1993

Diagnostic and socio-demographic changes in multiple hospital admission in children under two over a five-year period.

Diagnostic and socio-demographic changes for children experiencing multiple hospital admissions (three or more) before the age of two years in two whole-year birth cohorts five years apart-1980 and 1985-are reported. The increase in multiple admissions between 1980 and 1985 was distributed evenly throughout the diagnostic groups. Although a disproportionate increase in admissions per child for asthma was noted, the results suggest that the increase accounts for only a small proportion of the total increase. A marked trend to earlier age of first admission is reported. Low-birthweight infants, infants of young mothers and infants from deprived areas of the city are overrepresented in the multiple admission groups in both cohorts. There was a marked increase in the proportion of low-birthweight infants in the multiple admissions group between 1980 and 1985 compared with a decrease in the percentage of low-birthweight infants in the control group over the same period. The study results are discussed with particular reference to the unexplained increase in early childhood admissions.

Adult↗