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Biomedical subjects

M Pike

Publications and source records attributed to M Pike.

At least 37 records · Page 2Linked to original sources
PubMed1995

Sydenham's chorea: a case showing reversible striatal abnormalities on CT and MRI.

Sydenham's chorea has not previously been associated with abnormal findings on CT scan, but there have been reports of abnormal MRI in affected patients. The authors describe a case of Sydenham's chorea in which striatal abnormalities were found on both CT and MRI. Repeat MRI when the patient's illness had resolved was virtually normal. This suggests that abnormal imaging is entirely compatible with a diagnosis of Sydenham's chorea in a patient with an appropriate clinical history. Resolution of such abnormalities on repeat scanning provides further support for the diagnosis.

Child, Preschool↗
PubMed1995

Neurological disease associated with Mycoplasma pneumoniae infection. PCR evidence against a direct invasive mechanism.

Aims-To investigate the pathology in patients presenting with sudden onset neurological illnesses associated with Mycoplasma pneumoniae infection.Methods-M pneumoniae infection was diagnosed by a highly rigorous interpretation of serological markers initially using complement fixation, agglutination and IgM antibodies. Confirmation of the serological diagnosis was achieved using indirect immunofluorescence for IgM, IgA, and IgG. Serum and cerebrospinal fluid (CSF) samples from these patients were examined using the polymerase chain reaction to look for evidence of M pneumoniae DNA.Results-No M pneumoniae DNA was found in any serum or CSF samples. Diagnosis of M pneumoniae infection by agglutination and complement fixation antibodies was not always confirmed by indirect immunofluorescence.Conclusion-The neurological lesions in these patients do not appear to be caused by the direct invasion of M pneumoniae into the nervous system. The lesions may be an immune response to infection. Serological diagnosis of M pneumoniae continues to be a laboratory problem.

Journal Article↗
PubMed1994

Optimization of transurethral hyperthermia: number of treatments.

OBJECTIVE: The optimal number of transurethral microwave hyperthermia (TUHT) treatments in patients with moderate to severe symptoms of benign prostatic hyperplasia (BPH) is not known. This study was designed to compare TUHT efficacy with the use of three versus six treatments. METHODS: In a Phase II prospective trial during a three-month period, 28 poor surgical risk patients with moderate to severe prostatism were randomized to receive three or six TUHT sessions. TUHT treatments were given on an outpatient basis without sedation or anesthesia for sixty minutes at 915 MHz with the temperature controlled on the urethral surface at 45 degrees C. RESULTS: Subjective improvement was obtained in 7 (50%) patients receiving three TUHT treatments and in 12 (86%) patients receiving six treatments. A greater degree of improvement in total symptom score (P = 0.01) and obstructive (P = 0.01) and irritative (P = 0.04) symptoms was also recorded in the 14 patients receiving six treatments compared to those treated with three TUHT sessions (P = 0.01). A posttreatment improvement in objective study parameters was recorded for both treatment groups. The 14 patients treated with six TUHT sessions, however, showed a better improvement in peak flow rates (51% vs. 8.4%, P = 0.003) and postvoiding residual volume compared to the 14 patients treated with three TUHT sessions (P = 0.10). Treatments were very well tolerated and no clinically significant toxicity was recorded. Of the 9 study patients who failed to respond to treatment, 1 patient was successfully retreated with TURP while 8 patients required an indwelling catheter. CONCLUSIONS: In TUHT in poor surgical risk patients with BPH with the temperature controlled at 45 degrees C, six treatments were superior to three treatments, based on a higher incidence of subjective and objective improvement.

Aged↗
PubMed1994

Kleine-Levin syndrome: a cause of diagnostic confusion.

The case is described of a boy with the Kleine-Levin syndrome in whom prominent behavioural disturbances and the initial absence of a clear cyclical pattern obscured the diagnosis. Treatment with lithium was effective.

Child↗
PubMed1994

Depot leuprolide acetate with estrogen and progestin add-back for long-term treatment of premenstrual syndrome.

OBJECTIVE: To test the effectiveness and safety of long-term depot leuprolide acetate (GnRH-a) plus estrogen and progestin add-back therapy in the treatment of moderate and severe premenstrual syndrome (PMS). DESIGN: A prospective trial with each patient serving as her own control. SETTING: University teaching hospital. PARTICIPANTS: Ten women with regular menstrual cycles complaining of moderate to severe PMS. Premenstrual syndrome was diagnosed when symptoms increased > or = 25% during the luteal phase. TREATMENT: Four-week cycles of IM injections of placebo or GnRH-a with all patients receiving saline (placebo), the first cycle followed by 12 cycles of GnRH-a, 7.5 mg. Conjugated equine estrogen (0.625 mg/d) was started Monday through Saturday within the first cycle and increased as needed. Medroxyprogesterone acetate (MPA), 10 mg/d, was taken orally for 10 days after 4, 8, and 12 cycles of GnRH-a therapy. MAIN OUTCOME MEASURES: Changes in three symptom categories (water retention, pain, and psychological function), serum levels of total cholesterol and HDL, HDL-2, and LDL cholesterol, E2, and estrone. Endometrial biopsy was obtained 1 day after the end of the 12th GnRH-a cycle, and bone density was assessed using quantitative computer tomography at the end of the 12th GnRH-a cycle. RESULTS: During treatment, there was a significant decrease compared with baseline and placebo in all three symptom categories. There were no significant changes in lipids. Endometrial biopsies revealed progestational changes with no evidence of hyperplasia. Quantitative computer tomography bone density dropped 3.7 on average compared with baseline after 12 months of treatment, but this was not statistically significant. CONCLUSION: Gonadotropin-releasing hormone agonist therapy with hormonal add-back therapy is effective in treating PMS symptoms with progressive improvement over a 12-month period. This therapy prevents changes in lipids and adequately protects the endometrium with the addition of MPA every 4th cycle. Quantitative computer tomography bone density dropped at 12 months; further examination of bone changes is necessary.

Adult↗
PubMed1992

Relationship of response to transurethral hyperthermia and prostate volume in BPH patients.

A response to transurethral microwave hyperthermia (TUHT) at 915 MHz and its relationship to prostate volume was examined in 63 poor surgical risk benign prostatic hyperplasia (BPH) patients. All patients had moderate-to-severe obstructive signs and symptoms, and received > or = 5 TUHT one-hour sessions. Treatment temperature was controlled on the urethral surface at 45 degrees C +/- 1 degree C. Follow-up ranged from twelve to forty-four months (mean 18 months). The mean prostate volume was 57 cc (range 10-301 cc). There were 40 patients (63%) with prostate volume < or = 50 cc and 23 (37%) with a volume > 50 cc. Treatment failure was seen in 6 patients (10%). It was 10 percent in 40 patients with smaller glands and 9 percent for those 23 with larger prostates, N.S. at p = 0.49. Subjective treatment response was seen in 58 patients (92%). It was 90 percent for the 40 patients with < or = 50 cc prostates vs. 96 percent for the 23 with > 50 cc prostates, N.S. at p = 0.75. This study suggests that the initial prostate volume is not an important parameter predicting response to TUHT.

Aged↗
PubMed1990

The validity of case-control studies with nonrandom selection of controls.

An unbiased estimate of the rate ratio can be obtained using a case-control design in which each case is matched to one or more controls randomly selected from population members at risk and in the same stratum as the case at the time of disease onset. However, the nonrandom assignment of controls to cases is quite frequent in case-control research. It occurs, for example, in matched case-control studies using either friend controls or neighborhood controls. Many valid random designs, in contrast to most nonrandom designs, require enumeration of a substantial fraction of the study base. Therefore, there may be important cost and logistic advantages to using valid nonrandom designs. In this paper we determine those nonrandom case-control designs that can produce unbiased estimates of the rate ratio and discuss the implications of our findings for the design of case-control studies. We conclude, as did Flanders and Austin, that friend-case-control studies should generally be avoided. On the other hand, in a typical neighborhood-matched, case-control study, any bias attributable to nonrandom control selection is usually too small to affect substantive conclusions.

Bias↗
PubMed1990

Gonadotropin hormone releasing hormone agonists [GnRHA] and prevention of familial breast cancer.

The use of GnRHA to induce a "medical" oophorectomy may be a useful method of prevention of breast carcinoma. The addition of ERT and intermittent progestogen to the GnRHA would be expected to prevent the adverse effects of estrogen deprivation, and still provide a significant reduction in breast cancer risk. Evaluation of the regimen in a high risk group such as sisters or daughters of index cases of early onset breast cancer is justifiable.

Adult↗
PubMed1988

Benign ovarian teratomas: a population-based case-control study.

We attempted to identify all cases of benign ovarian teratoma which occurred in two health districts in the UK during a 56 month period. The crude incidence was 8.9 cases/100,000 women. One hundred and twenty cases and 119 age-matched controls were interviewed to identify risk factors for this disease. In addition, 137 mothers completed postal questionnaires. Cases were older at leaving school, had higher social class occupations, were more often unmarried or married late, and had fewer children than controls. Oral contraceptive use was similar for both. Cases reported more exercise at all ages, and more alcohol consumption 1 year before diagnosis. Cases' mothers reported slightly less nausea during pregnancy than controls' mothers, and none of the mothers reported exogenous hormone exposure during the index pregnancy. In this study benign ovarian teratomas strongly resemble testicular cancer in their age distribution in the population. They also resemble testicular cancer in their association with educational status and marital status. There was, however, no similarity regarding prenatal hormone exposure. The increased risks associated with exercise and alcohol use were unexpected; we need further information about how these exposures affect the ovary, and whether they affect the testis.

Adult↗
PubMed1986

Serum testosterone levels in healthy young black and white men.

Blacks in the United States have the highest prostate cancer rate in the world and nearly twice that of whites in the United States. The 2:1 black-to-white ratio in prostate cancer rates is already apparent at age 45 years, the age at which the earliest prostate cancer cases occur. This finding suggests that the factor(s) responsible for the difference in rates occurs, or first occurs, early in life. Testosterone has been hypothesized to play a role in the etiology of prostate cancer, because testosterone and its metabolite, dihydrotestosterone, are the principal trophic hormones that regulate growth and function of epithelial prostate tissue. This report gives the results of assays of circulating steroid hormone levels in white and black college students in Los Angeles, CA. Mean testosterone levels in blacks were 19% higher than in whites, and free testosterone levels were 21% higher. Both these differences were statistically significant. Adjustment by analysis of covariance for time of sampling, age, weight, alcohol use, cigarette smoking, and use of prescription drugs somewhat reduced the differences. After these adjustments were made, blacks had a 15% higher testosterone level and a 13% higher free testosterone level. A 15% difference in circulating testosterone levels could readily explain a twofold difference in prostate cancer risk.

Adolescent↗
PubMed1976

The epidemiology and virology of C-type virus-associated hematological cancers and related diseases in wild mice.

In several different populations of wild mice, observed over a 35-month period in laboratory geriatric colonies, a direct correlation was found between the prevalence and titer of spleen complement-fixing gs (p30) antigen and C-type particles in newly trapped healthy mice and a predilection to lymphoma and a hind leg paralytic disease upon aging. Other studies have established the indigenous C-type virus as the essential etiological determinant of both diseases in wild mice. An increased incidence of breast carcinomas, hepatomas, and pulmonary adenomas associated with C-type virus also occurred in the lymphoma-paralysis-prone colony as compared with the tumor-resistant colonies.

Animals↗