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Biomedical subjects

P A Green

Publications and source records attributed to P A Green.

At least 19 recordsLinked to original sources
PubMed1999

Evaluation of the association between medial patellar luxation and hip dysplasia in cats.

OBJECTIVE: To investigate the association between hip dysplasia (HD) and medial patellar luxation (MPL) in cats. DESIGN: Cross-sectional prevalence study. ANIMALS: 78 cats. PROCEDURE: A complete history was obtained. Cats were examined to detect MPL and HD. Radiographs of the stifle and hip joints were obtained. Hip joints were evaluated by use of Norberg angle, distraction index, and scoring consistent with that established by the Orthopedic Foundation for Animals. RESULTS: There were 43 male and 35 female cats mean age, 2.5 years). Eleven cats had clinical signs of disease in the pelvic limbs. Medial subluxation of the patella (subgrade 1) was seen in 31 of 33 cats with otherwise normal stifle joints. Medial patellar luxation was found in 45 of 78 (58%) cats, and 35 of 45 (78%) had grade-1 MPL. Bilateral MPL was seen in 32 of 45 (71%) cats. A weak association existed between MPL and HD, because cats were 3 times more likely to have HD and patellar luxation than to have either condition alone. Concurrent MPL and HD were detected in 19 of 78 (24%) cats, and HD was diagnosed radiographically in 25 of 78 (32%) cats (19 mild, 4 moderate, 2 severe). Eighteen of the 25 cats with HD had bilateral HD. CONCLUSIONS AND CLINICAL RELEVANCE: Clinically normal cats may have a certain degree of laxity in the stifle joint, evident as medial patellar subluxation (< grade 1). There is a weak association between MPL and HD, and both conditions may develop, alone or in combination, more frequently than has been reported.

Animals↗
PubMed1999

Acute renal insufficiency due to oral acyclovir in a man with sickle cell trait.

Several published reports have suggested that oral acyclovir can cause renal insufficiency, but baseline renal function was either abnormal or unclear in those reports. We describe a patient with oral acyclovir-induced acute renal failure and a normal serum creatinine level documented just before exposure to the drug. Conceivably, competition with a cephalosporin for renal tubular elimination predisposed our patient to nephrotoxic serum levels of acyclovir. In addition, the patient had sickle cell trait, which might have contributed to a disproportionate degree of hyperkalemia and acidosis seen early in the patient's clinical course.

Acidosis, Renal Tubular↗
PubMed1998

Antiretroviral therapy, 1998.

In summary, during 1996 and 1997 important improvements occurred in HIV therapy. The introduction of new drugs benefited patients with access to these medications. The use of antiretrovirals remains complex and is rapidly evolving. This is an inspiring challenge for physicians and health workers caring for HIV-infected patients.

Anti-HIV Agents↗
PubMed1997

Reduction of serum matrix metalloproteinase 1 and matrix metalloproteinase 3 in rheumatoid arthritis patients following anti-tumour necrosis factor-alpha (cA2) therapy.

Matrix metalloproteinase (MMP)-1 and MMP-3 levels were measured in serum samples from rheumatoid arthritis (RA) patients undergoing a double-blinded placebo-controlled trial with the chimaeric anti-tumour necrosis factor (TNF)-alpha antibody cA2. Both MMP-1 (P < 0.015), but to a larger extent MMP-3 (P < 0.001) levels were elevated in all RA patients prior to the commencement of the trial compared with normal control sera. Following cA2 therapy, MMP-1 and MMP-3 levels were assessed in the placebo, and 1 and 10 mg/kg cA2-treated groups at 7, 14, 21 and 28 days. In both the 1 and the 10 mg/kg cA2-treated groups, a significant decrease in serum MMP-3 levels at all time points was observed, reducing maximally to 41% of pre-infusion values at day 7. MMP-1 levels were also reduced, but less dramatically than MMP-3, to 85% of pre-infusion values after 14 days in the 10 mg/kg cA2 treated group. In a separate non-placebo-controlled study, we also evaluated the tissue inhibitor of metalloproteinase (TIMP)-1 levels in plasma following cA2 infusion. Pre-infusion TIMP-1 levels were above the normal control range, but were significantly reduced (P < 0.035) 14 days after infusion to 72% of pre-infusion values. This study confirms previous reports that MMP-3 levels are elevated and correlate with measures of inflammation in RA, and furthermore demonstrate that serum MMP-3 and MMP-1 levels are downmodulated following anti-TNF-alpha antibody therapy. Whilst serum MMP-3 levels correlated with C-reactive protein (CRP) both prior to and following anti-TNF-alpha antibody therapy, it remains to be demonstrated that serum MMP-3 and/or MMP-1 levels reflect the cartilage and bone resorptive processes which are evident in this disease.

Antibodies, Monoclonal↗
PubMed1997

Carbohydrate intake and recovery of intermittent running capacity.

The purpose of the present study was to examine the influence of an increased carbohydrate intake on the recovery of endurance running capacity after exhaustive intermittent running. Six male subjects were randomly assigned to two dietary recovery conditions, each involving two running tests separated by 22 hr. The protocol comprised a prolonged, intermittent, high-intensity shuttle run test (I-HI). One week later subjects repeated the I-HI on consecutive days under different dietary conditions. During the 22-hr recovery, either the carbohydrate intake of the subjects was increased (CHO) or they ate an isocaloric diet by supplementing their normal diet with extra protein and fat (CON). Intermittent running capacity was improved when subjects increased their carbohydrate intake to 10 g.kg-1 bm during the 22-hr recovery between trials, but an isocaloric diet without additional carbohydrate did not bring about the same improvements.

Adult↗
PubMed1997

The impact of socioeconomic status on cardiovascular risk factors in African-Americans at high risk for type II diabetes. Implications for syndrome X.

OBJECTIVE: The rate of type II diabetes in African-Americans is reaching epidemic proportions. African-Americans with type II diabetes suffer from more cardiovascular diseases (CVDs) associated with diabetes than the general population. Lower socioeconomic status (SES) and family history are often cited as contributory factors to the premature development of diabetes and CVDs in the general population. However, we are not aware of any study that has examined the relationships between SES and CVD risk factors (i.e., syndrome X) in a genetically enriched African-American population at high risk for type II diabetes. RESEARCH DESIGN AND METHODS: We studied 200 healthy first-degree relatives of African-American patients with type II diabetes (age 25-65 years, mean 42.5 +/- 8.4 years; 42 men, 158 women). Standard oral glucose tolerance test, metabolic, and anthropometric parameters, as well as questionnaires on SES, demographic characteristics, and physical activity, were obtained for each subject. SES was divided into quartiles based on annual income. To assess the impact of insulin on CVD risk, we examined clinical characteristics and metabolic parameters according to quartiles of fasting insulin concentrations. RESULTS: Clinical characteristics, including mean age, BMI, waist-to-hip ratio (WHR), percentage body fat and lean body mass, and blood pressure were not statistically different among SES quartiles. There were no significant differences in any of the metabolic, blood pressure, lipid and lipoprotein, or anthropometric parameters among SES quartiles. When examined by insulin quartile, BMI, WHR, and body fat content tended to be greatest in the fourth quartile. Similarly, fasting and postprandial serum C-peptide and glucose levels were significantly higher in the fourth quartile. We observed greater levels of very low density lipoprotein (VLDL) cholesterol and triglycerides and lower levels of HDL cholesterol in the fourth compared with the first through third insulin quartiles. Serum cholesterol and LDL cholesterol were not associated with increasing insulin concentration assessed by quartiles. We found similar systolic and diastolic blood pressure, irrespective of insulin quartiles. We found relationships between fasting insulin and systolic blood pressure (r = 0.181, P < 0.05) and triglycerides (r = 0.247, P < 0.01), VLDL cholesterol (r = 0.237, P < 0.01), WHR (r = 0.268, P < 0.005), BMI (r = 0.308, P < 0.001), and percentage of body fat (r = 0.237, P < 0.01). CONCLUSIONS: The present study demonstrates no SES/income effect on CVD risk factors or syndrome X in African-Americans at high risk for type II diabetes. Clustering of several components of syndrome X was seen in individuals in the highest quartiles compared with the lowest quartiles of insulin in our high-risk African-American population. We conclude that the well-established conventional risk factors for CVD in genetically enriched African-Americans are found only in individuals with the highest insulin levels, independent of SES.

Adult↗
PubMed1994

Chronic low back pain: The relationship between patient satisfaction and pain, impairment, and disability outcomes.

STUDY DESIGN: Treatment outcomes for low back pain have been measured by varying standards of pain, impairment, and disability. This study examines the relationship between these three outcomes and treatment satisfaction in patients with chronic low back pain (CLBP). METHODS: Ninety CLBP patients underwent initial pain (VAS), impairment (PIS), and disability (OPQ) evaluations. RESULTS: Correlation coefficients between initial VAS, PIS, and OPQ were all less than 0.50. At 5-year follow-up, pain and disability scores were closely matched, more with lower mean scores among workers (P = 0.04 and 0.001). For 65 rehabilitation participants, 5-year patients satisfaction scores did not relate closely with VAS, PIS, and OPQ improvements during treatment (r = 0.15, 0.01, and 0.14). Five-year satisfaction correlated weekly with current pain and disability (r = 0.32, -0.36). Satisfaction levels were higher for workers after 1 year (P = 0.01), and after 5 years (P = 0.34. CONCLUSIONS: This study suggests that CLBP patients and their health care practitioners mutually set distinct pretreatment pain, impairment, and disability goals and judge outcomes accordingly.

Adult↗
PubMed1994

Recurrent group B streptococcal infections in infants: clinical and microbiologic aspects.

OBJECTIVE: To describe the potential for recurrence of group B streptococcal (GBS) infection in infants, using pulsed-field gel electrophoresis as an epidemiologic tool. DESIGN: Retrospective review of cases identified by laboratory records and review of the literature. SETTING: Neonatal nurseries of a county hospital system. METHODS: Retrospective review of infants with second episodes of GBS bacteremia or meningitis. Digestion of chromosomal DNA with the restriction enzyme Sma I and separation of fragments by use of contour-clamped homogeneous electric field. RESULTS: Nine cases of recurrent GBS infection were identified during a 14-year period. Eight of the nine infants were born at 25 to 36 weeks of gestation, and one was born at term. The first episode of invasive GBS infection occurred at a mean age of 10.4 days (median, 3 days; range, 1 to 27 days). Parenteral antibiotic therapy was administered for a mean of 13.9 days (median, 14 days; range, 10 to 21 days). Recurrence occurred at a mean age of 42.3 days (median, 48 days; range, 23 to 68 days). One patient died during the second episode; eight infants survived to discharge home. Of seven sets of isolates analyzed from first and second GBS episodes, five were confirmed to be the same genotypically. CONCLUSION: Recurrence of GBS disease in infants may be associated with the original infecting strain or a second acquired strain.

Anti-Bacterial Agents↗
PubMed1994

Dual skin testing with Mycobacterium avium sensitin and purified protein derivative: an open study of patients with M. avium complex infection or tuberculosis.

The sensitivity and specificity of dual mycobacterial skin testing were assessed in an unblinded study of 22 patients with culture-confirmed Mycobacterium avium complex (MAC) infection and 20 patients with culture-confirmed Mycobacterium tuberculosis infection. Intradermal skin tests were performed with 0.1 mL of M. avium sensitin, 0.1 mL of PPD (purified protein derivative), and two control antigens (mumps and Candida). All patients with M. tuberculosis infection reacted to the skin tests; the mean reaction size was 19.7 +/- 1.4 mm when PPD was administered and 10.3 +/- 1.5 mm when M. avium sensitin was administered. Four patients with MAC were anergic; for the remaining 18, mean reactions of 15.2 +/- 1.4 mm to M. avium sensitin and 4.3 +/- 1.3 to PPD were noted. A skin test was defined as M. avium-dominant or PPD (M. tuberculosis)-dominant if there was a minimum reaction size of > or = 5 mm to the given species, and the reaction to the given species was > or = 3 mm greater than the reaction to the heterologous species. Dominant skin test reactions were present in 18 (90%) of 20 patients with M. tuberculosis and 15 (83%) of 18 nonanergic patients with MAC. The specificity of dominant skin tests was 100% for infection with M. tuberculosis and 100% for infection with MAC. M. avium-dominant skin tests identify subjects with prior MAC infection and distinguish them from patients with M. tuberculosis infection.

Adult↗
PubMed1992

Suspected botulism in three intensively managed Australian cattle herds.

Serious outbreaks of a paralytic disease in cattle occurring in the spring and summer of 1988 were investigated on three farms in south eastern Queensland, Australia. On one farm 237 (31 per cent) of 770 cattle died, on the second 109 (40 per cent) of 271 cattle died and on the third 30 (8 per cent) of 380 cows died. Botulism was suspected on the basis of the clinical signs, the lack of significant pathology, a failure to incriminate other agents and a positive feeding trial in one sheep. Laboratory tests for the presence of botulinum toxin failed to confirm this diagnosis, and further feeding trials using ingredients of two rations were also negative.

Animal Feed↗
PubMed1991

Colorectal neoplasia in juvenile polyposis or juvenile polyps.

Juvenile (retention) polyps are usually solitary lesions in the colorectum but may be multiple in juvenile polyposis. The association between juvenile polyps and colorectal neoplasia is controversial. We present three patients with juvenile polyposis who had colorectal adenomas or adenomatous epithelium in juvenile polyps at ages 3, 4, and 7 years. In a retrospective study of 57 additional patients with one or more juvenile polyps, 10 patients (18%) had colorectal neoplasia including three with adenocarcinoma, two with tubular adenoma, and six with adenomatous epithelium in a juvenile polyp (one had both adenomatous epithelium and an adenocarcinoma). Nine of these 10 patients had juvenile polyposis defined by the presence of at least three juvenile polyps; and eight of the nine had a family history of juvenile polyps. Colorectal neoplasia occurred at young age (mean (SEM) 37 (5) years). Our findings suggest that patients with juvenile polyps who have three or more juvenile polyps or a family history of juvenile polyps should undergo surveillance for colorectal neoplasia.

Adenocarcinoma↗
PubMed1990

Phonological processing skills and deficits in adult dyslexics.

This article presents 4 experiments aimed at defining the primary underlying phonological processing deficit(s) in adult dyslexia. 5 phonological processes, all involving spoken language, were studied: phoneme perception, phoneme awareness, lexical retrieval of phonology, articulatory speed, and phonetic coding in verbal short-term memory. 2 differently ascertained adult dyslexic groups, familial dyslexics (n = 15) and clinic dyslexics (n = 15), were the subjects in each experiment. These dyslexic groups were chosen because deficits that persist until adulthood and that are found in differently ascertained dyslexic groups are more likely to be primary. Each dyslexic group was compared to 2 control groups, chronological age (CA) controls who were similar in age and sex, and younger reading age (RA) controls who were similar in reading age and sex. The main finding was a clear deficit in phoneme awareness in both dyslexic groups, with each dyslexic group performing significantly worse than both CA and RA controls. Moreover, performance on the 2 phoneme awareness tasks together uniquely accounted for substantial variance in nonword reading. The clinic but not the familial dyslexics appeared to have an additional deficit in verbal short-term memory. No clear deficits were found in either dyslexic group in phoneme perception, lexical retrieval, or articulatory speed.

Adult↗
PubMed1987

Left-handedness and immune disorders in familial dyslexics.

We examined the frequency of left-handedness, various immune disorders, and comparison disorders in 87 dyslexics and 86 nondyslexics from 14 extended dyslexic families. These families were participants in our genetic linkage studies of dyslexia, which found linkage to chromosome 15 in some families but not others. In the present study, we found a significant elevation of both autoimmune and allergic disorders in the dyslexics only, but no elevation in mixed- or left-handedness in either group. Moreover, the frequency of immune disorders was not higher in the mixed- or left-handed subjects. There was also no elevation in the comparison disorders, which argues against an overreporting bias. The elevation of immune disorders did not vary with linkage status, arguing against a common cause for dyslexia and immune disorders. These findings are discussed in light of Geschwind's hypothesis of a testosterone-mediated association within families between left-handedness, immune disorders, and dyslexia.

Autoimmune Diseases↗