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M Edwardes

Publications and source records attributed to M Edwardes.

10 recordsLinked to original sources
PubMed2003

Changes in immunological and virological parameters in HIV-1 infected subjects following leukapheresis.

In order to assess immune responses during HIV-1 therapeutic immunization, a large number of blood mononuclear cells (PBMC) are needed. Clinical tolerance and safety, as well as changes in immunological and virological parameters, were assessed, following leukapheresis in HIV-1 infected subjects with CD4(+) cell count >200 x 10(6)/l. PBMC were collected using a Fenwal CS3000 cell separator in 29 subjects with mean CD4(+) cell counts of 503 x 10(6)/l (range 172-1,119) and viral load of 2.5 log(10) copies/ml (range <1.7-5.4). Twenty-four (83%) subjects were on antiretroviral therapy while 5 (17%) were untreated. The blood volume processed was 7 L over a period of 3 hours. A mean value (+/- standard error) of 82 +/- 26 x 10(9)/l lymphocytes was collected by a single apheresis in a mean volume of 200 +/- 1.8 ml, containing 9.0 +/- 1.3 x 10(9)/l CD4(+) and 10.2 +/- 1.3 x 10(9)/l CD8(+) cells. The leukapheresis procedures were well tolerated and no immediate or delayed side effects were observed within 90 days of follow-up. No changes from blood pre-leukapheresis values were detected for white blood cells, lymphocytes, monocytes, CD8(+), CD34(+), naive and memory CD4(+) cell counts immediately after, 1 h, 7 days, or within 90 days after leukapheresis. However, absolute CD4(+) cell counts and percentage significantly increased from pre-leukapheresis values after 1 h (530 +/- 43 vs. 700 +/- 75 cell x 10(6)/l; 32.6 +/- 1.6 vs. 36.9 +/- 1.9%; P < 0.001 for both paired t-tests) before returning to pre-leukapheresis levels on day 7. No significant changes in viral load from pre-leukapheresis levels in treated or untreated subjects were detected at any time points. We conclude that leukapheresis in HIV-1 infected subjects with CD4(+) cell counts >200 x 10(6)/l is safe and induces a transient increase in the absolute and percentage of CD4(+) cell count without enhancing viral replication.

Adult↗
PubMed2001

Bcl-2 is a useful prognostic marker in Dukes' B colon cancer.

BACKGROUND: Currently, the use of adjuvant therapy specifically in Dukes' B colon cancers is controversial, emphasizing the importance of identifying prognostic markers to select patients for such therapy. Bcl-2 plays an important role in apoptosis regulation of solid tumors, such as colon and breast cancer, and is normally expressed in the base of the colonic crypts. The purpose of this study is to determine whether or not bcl-2 expression can be used to predict survival in Dukes' B colon cancer patients. METHODS: Charts of 76 patients operated on at the Royal Victoria Hospital from 1986 to 1992 were reviewed. Bcl-2 staining was done with the avidin-biotin-peroxidase complex method using commercially available monoclonal bcl-2 antibodies. Two pathologists graded the intensity of bcl-2 staining on a scale of 0-3 and estimated the percentage of tumor cells staining positively (T-percent). Univariate and multiple regression of factors on overall survival (OS) and disease-free survival (DFS) was done with a Cox proportional hazards model and Kaplan-Meier survival curves. RESULTS: The mean age was 71.2 years, with 41 female and 35 male patients. Mean tumor size was 5.4 cm with tumor grades of 19 well, 52 moderate, and 5 poorly differentiated. Tumors expressing bcl-2 had a similar DFS (P = .14) but a significantly improved OS (P = .04) compared with the bcl-2 negative tumors. The risk ratio for DFS was 0.49 (95% CI, 0.19-1.26) and for OS was 0.35 (95% CI, 0.13-0.94). CONCLUSIONS: These data indicate that enhanced bcl-2 expression, specifically in Dukes' B colon carcinomas, is associated with improved survival. Thus, patients whose tumors do not express bcl-2 should be considered for adjuvant therapy.

Adult↗
PubMed1998

Metabolic changes during recovery in normothermic versus hypothermic patients undergoing surgery and receiving general anesthesia and epidural local anesthetic agents.

BACKGROUND: Mild hypothermia is accompanied by metabolic changes. Epidural local anesthetic agents attenuate the surgical stress response, but it is not known whether they modulate thermal stress. METHODS: Thirty patients undergoing colorectal surgery, performed by one surgical team, received epidural 0.5% bupivacaine to achieve T3-S5 sensory block. They were then assigned randomly to two groups of 15 patients each. The control or unwarmed group was left to cool during surgery, whereas active warming was used in the warmed group. General anesthesia was induced by thiopentone, vecuronium, fentanyl, nitrous oxide in oxygen, and enflurane. At the end of surgery, both groups received epidural 0.25% bupivacaine to maintain a T5-L3 sensory block. Aural canal (core) and skin surface (15 sites) temperatures; oxygen consumption; pain visual analogue score; and concentrations of epinephrine, norepinephrine, glucose, cortisol, lactate, and free fatty acids in plasma were measured before epidural blockade, 30 min after epidural blockade, at the end of surgery, and for 4 h after surgery. Patients and those measuring the outcomes were unaware of group allocation. RESULTS: Core and mean skin temperatures decreased significantly in the control group (P < 0.001) but not in the warmed group. Catecholamine concentrations in plasma decreased significantly after epidural block, and although concentration of epinephrine in plasma increased from baseline sharply in the control group at the end of surgery (P = 0.004), it decreased in the warmed group (P = 0.007). During recovery, there was no difference between the two groups for norepinephrine concentrations in plasma, body weight-adjusted oxygen consumption, pain visual analogue score, and metabolites. CONCLUSIONS: The postoperative metabolic changes obtained with epidural block were similar except for an attenuated concentration of epinephrine in normothermic patients compared with those who were mildly hypothermic.

Aged↗
PubMed1996

Control of pest blackflies (Diptera:Simuliidae) along the Orange River, South Africa: 1990-1995.

The efficacy of Bacillus thuringiensis var. israelensis (B.t.i.) and temephos in controlling the pest blackfly Simulium chutteri Lewis along the middle Orange River between 1990 and 1995, was assessed. Larvicides were applied by helicopter to rapids and riffles between Hopetown and Onseepkans, a river distance of 807 km. Larvicidal efficacy was based on the change in larval abundance at selected sites before and after each treatment. The success of the control programme was assessed independently by local farmers, who ranked adult blackfly annoyance on a 4-point scale. Before treatment, blackfly annoyance showed consistent peaks in spring, and sometimes in autumn, and levels were unacceptably high for between 17 and 36 weeks of the year. After treatment started, blackfly annoyance levels were reduced significantly. The number of annual treatments necessary to reduce blackfly annoyance to acceptable levels was highly variable (3-13), and depended on river conditions, as well as the efficacy and timing of each treatment. During low-flow conditions (< 50 m3/s), applications became increasingly difficult in braided sections of the river, and dosage calculations were inaccurate because of local abstraction and return flows. Both larvicides worked well in winter (water temperature 11-13 degrees C). Control of the spring outbreak can be planned well in advance, with the first treatment starting in mid July. A flexible protocol is required to control outbreaks at other times of the year. We recommended the use of B.t.i. for most applications, with increased dosages during algal blooms (> 1500 cells/ml). The use of temphos in the Orange River should be considered only during algal blooms or when flows exceed 300 m3/s. We conclude that helicopter application of larvicides is an effective method or controlling blackflies, along the middle Orange River.

Animals↗
PubMed1996

Culicoides (Diptera:Ceratopogonidae) associated with livestock in the Onderstepoort area, Gauteng, South Africa as determined by light-trap collections.

In 54 light-trap collections made at 28 sites in the Onderstepoort area a total of 178,941 Culicoides midges of 35 species was collected in March 1988; the survey was repeated at 26 sites in September and yielded 19,518 Culicoides of 24 species. The number of Culicoides species collected totalled 38. C,imicola was the most abundant species at 27 of the 28 sites sampled, and accounted for 88% and 67% of all midges collected in the two months respectively. This study not only confirms that C. imicola is widespread and abundant in the greater Onderstepoort area, but also that its numbers correlate positively with the historical prevalence of African horse sickness (AHS) and bluetongue (BT) locally. The high numbers of C. imicola make Onderstepoort the ideal site for the study of its laboratory vector capacity. The relatively low numbers of Culicoides spp. other than C. imicola in the Onderstepoort area, will severely limit studies on their roles in the transmission of arboviruses. The origin of the blood-meals of 1338 engorged Culicoides belonging to 13 species was determined by means of cross-over electrophoresis precipitin test; C. imicola fed on cattle, horses, sheep of pigs, Four other Culicoides species showed a similarly wide host range.

Animals↗
PubMed1991

A randomized trial to evaluate the risk of gastrointestinal disease due to consumption of drinking water meeting current microbiological standards.

BACKGROUND: This project directly and empirically measured the level of gastrointestinal (GI) illness related to the consumption of tapwater prepared from sewage-contaminated surface waters and meeting current water quality criteria. METHODS: A randomized intervention trial was carried out; 299 eligible households were supplied with domestic water filters (reverse-osmosis) that eliminate microbial and chemical contaminants from their water, and 307 households were left with their usual tapwater without a filter. The GI symptomatology was evaluated by means of a family health diary maintained prospectively by all study families over a 15-month period. RESULTS: The estimated annual incidence of GI illness was 0.76 among tapwater drinkers compared with 0.50 among filtered water drinkers (p less than 0.01). These findings were consistently observed in all population subgroups. CONCLUSION: It is estimated that 35% of the reported GI illnesses among the tapwater drinkers were water-related and preventable. Our results raise questions about the adequacy of current standards of drinking water quality to prevent water-borne endemic gastrointestinal illness.

Adolescent↗
PubMed1988

Culicoides species associated with livestock in the Stellenbosch area of the Western Cape Province, Republic of South Africa (Diptera: Ceratopogonidae).

A total of 33,564 Culicoides midges was collected in 44 light trap collections made at 22 sites in the Stellenbosch area during November 1986. Of the 23 species present in these collections 8 were frequently encountered namely, C. magnus, C. imicola, Culicoides sp. 49, C. zuluensis, C. gulbenkiani, C. pycnostictus, C. distinctipennis and C. nivosus. Although C. magnus was abundant at all trap sites, the prevalence of the other species appeared to be affected by the proximity of the light trap to different host animals and/or larval habitats. Plain-wing species and members of the C. schultzei group were rarely collected. The larval habitats of most of the above species were located by the use of tent-type emergence traps. All these habitats were found on irrigated pastures or where drainage water had accumulated. The difference in the requirements of the various species was associated with certain factors, such as degree of moisture, the type and amount of organic matter present and the particle size of the underlying soil. The identity of the blood-meals of 69 individual Culicoides belonging to 7 species was determined. The 5 commonest species had all fed on cattle and 4 of these on sheep. Two species, C. pycnostictus and C. distinctipennis were positive for bird blood.

Animals↗