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Biomedical subjects

P De

Publications and source records attributed to P De.

At least 19 recordsLinked to original sources
PubMed2004

Sexual network analysis of a gonorrhoea outbreak.

OBJECTIVES: Sexual partnerships can be viewed as networks in order to study disease transmission. We examined the transmission of Neisseria gonorrhoeae in a localised outbreak in Alberta, Canada, using measures of network centrality to determine the association between risk of infection of network members and their position within the sexual network. We also compared risk in smaller disconnected components with a large network centred on a social venue. METHODS: During the investigation of the outbreak, epidemiological data were collected on gonorrhoea cases and their sexual contacts from STI surveillance records. In addition to traditional contact tracing information, subjects were interviewed about social venues they attended in the past year where casual sexual partnering may have occurred. Sexual networks were constructed by linking together named partners. Univariate comparisons of individual network member characteristics and algebraic measures of network centrality were completed. RESULTS: The sexual networks consisted of 182 individuals, of whom 107 were index cases with laboratory confirmed gonorrhoea and 75 partners of index cases. People who had significantly higher information centrality within each of their local networks were found to have patronised a popular motel bar in the main town in the region (p = 0.05). When the social interaction through the bar was considered, a large network of 89 individuals was constructed that joined all eight of the largest local networks. Moreover, several networks from different communities were linked by individuals who served as bridge populations as a result of their sexual partnering. CONCLUSION: Asking clients about particular social venues emphasised the importance of location in disease transmission. Network measures of centrality, particularly information centrality, allowed the identification of key individuals through whom infection could be channelled into local networks. Such individuals would be ideal targets for increased interventions.

Adolescent↗
PubMed2004

The effect of oral folic acid on glutathione, glycaemia and lipids in Type 2 diabetes.

Plasma homocysteine is an established risk factor for vascular disease and precursor of the anti-oxidant glutathione. This study was designed to investigate the relationship of changes in homocysteine (Hcy) induced by oral folate to glutathione and measures of glycaemia and lipid metabolism in Type 2 diabetes (T2DM). Twenty-seven patients (26 male, 1 female, aged 48-68 years) with T2DM and microalbuminuria were treated with folic acid 10 mg daily for 3 months. During the study, diastolic blood pressure (p=0.04), HbA1c (p=0.04), serum triglycerides (p=0.04) and serum total/HDL-cholesterol ratio (p=0.004) all increased and serum HDL-cholesterol fell (p=0.006). The increased red cell folate correlated with a reduction in microalbuminuria (p=0.001). Overall, plasma glutathione increased (p=0.016) despite reduction in its precursor Hcy (p<0.001). Change in glutathione correlated inversely with change in HbA1c (p<0.02), total cholesterol (p=0.003) and triglycerides (p<0.02) and positively with HDL-cholesterol (p=0.033). Increase in glutathione correlated with levels of vitamin B6 (p<0.05). Metformin treatment protected against the rise in blood pressure (BP) (p=0.02), independently of changes in plasma glutathione. In summary, oral folic acid supplementation in T2DM reduced plasma Hcy and increased glutathione levels. HbA1c, triglycerides and HDL-cholesterol deteriorated during the trial: their levels correlated inversely with changes in glutathione. The increase in glutathione may depend on an adequate supply of B6, as changes in glutathione correlated with vitamin B6 levels. Reduced Hcy and increased glutathione may both mediate improvement in vascular function and outcome. Some aspects of the response to folate may be different in patients on metformin.

Adult↗
PubMed2003

"Osler's phenomenon": misdiagnosing Cushing's syndrome.

The clinical manifestations of Cushing's syndrome can be quite variable and are frequently mistaken, with consequent delayed diagnosis and significant morbidity and mortality. Harvey Cushing described the typical signs and symptoms of Cushing's syndrome but unfortunately attributed the features to myxoedema. The first typical description of a patient with Cushing's syndrome was probably made by Sir William Osler in 1898. Thus delay or misdiagnosis with consequent high morbidity and mortality exemplifies the history of Cushing's syndrome. Four cases of Cushing's syndrome are described that were associated with deteriorating morbidity because of the considerable delay from first presentation to a secondary care physician to eventual diagnosis. The clinical diagnosis was delayed in all the four patients, although they had symptoms and signs that were missed by a number of primary and secondary care physicians. Trans-sphenoidal surgery resulted in biochemical cure as well as improvement in the accompanying co-morbidity. Although still rare, the prevalence of Cushing's syndrome is increasing. Increasing clinical awareness and the use of appropriate screening tests should facilitate earlier diagnosis with reduced morbidity and mortality. Although the syndrome is named after Harvey Cushing, Sir William Osler was probably the first to describe it. Therefore, in deference to Osler's contribution to Cushing's syndrome and the work of Harvey Cushing, it is suggested that to the list of the other eponymous conditions of Osler-Weber-Rendu and Osler's nodes, should be added the delay or misdiagnosis of Cushing's syndrome-"Osler's phenomenon".

Cushing Syndrome↗
PubMed2003

Transsphenoidal surgery for acromegaly in wales: results based on stringent criteria of remission.

We retrospectively analyzed 90 patients who underwent transsphenoidal surgery (performed by three surgeons) in our center as initial therapy for acromegaly. We used a combination of modern, evidence-based remission criteria including mean day curve GH less than 2.5 micro g/liter (5 mU/liter), a nadir GH less than 1.0 micro g/liter (2 mU/liter) after an oral glucose tolerance test, and normal age-related IGF-I levels (where available). Fifty-seven of 90 (63%) patients remained in remission after surgery. Seventy-nine percent of patients with microadenomas but only 56% of patients with macroadenomas achieved remission (P < 0.001). Eighty-six percent of patients with preoperative GH levels below 10 micro g/liter (day profile or after oral glucose tolerance test) went into remission, compared with 51% of patients with GH levels above 25 micro g/liter at diagnosis (P < 0.002). The remission rate was also related to the period of surgery that was significantly higher in 1998-2001 (76%; P < 0.05) compared with 1990-1997 (54%) and 1980-1989 (63%). There were no recurrences or perioperative deaths. Meningitis occurred in 3% of patients, cerebrospinal fluid rhinorrhea in 7%, and permanent diabetes insipidus in 15%. The proportion of patients who developed new anterior pituitary hormone deficiencies and panhypopituitarism was significantly less in the period 1998-2001 (P < 0.001) when compared with the periods from 1990-1997 and 1980-1989. Transsphenoidal surgery is a safe and effective treatment for acromegaly, and our results compare favorably with those from published series. The presence of an intrasellar lesion and low preoperative GH levels is a good predictor of remission in the long term, but historically in our center this can only be achieved in a significant proportion of patients at the expense of some degree of hypopituitarism. However, surgical outcome in our center, including a reduced frequency of hypopituitarism, has improved significantly over time, coincident with the arrival of a dedicated pituitary neurosurgeon and the use of selective adenomectomy as the preferred surgical approach wherever possible.

Acromegaly↗
PubMed1999

Hannahpep: A novel fibrinolytic peptide from the Indian King Cobra (Ophiophagus hannah) venom.

A novel fibrinolytic peptide (Hannahpep) was isolated and purified from the venom of the Indian King Cobra (Ophiophagus hannah) by thin-layer chromatography followed by reverse-phase high-performance liquid chromatography. The MW of the peptide was found to be 610 Da and the amino acid sequence of Hannahpep was determined to be Arg, His, Ala, Arg, His, Asp. Hannahpep produced defibrinogenating activity in male albino mice. It exhibited significant fibrinolytic and fibrinogenolytic activity in vitro. Hannahpep showed plasma-anticlotting activity. However, it lacked hemolytic, hemorrhagic, or phospholipase activity. This peptide may have possible therapeutic application in the management of thrombosis or occlusion of a blood vessel.

Animals↗
PubMed1995

Pasteurella multocida--an uncommon cause of obstetric and gynaecological sepsis.

Pasteurella multocida is a common cause of wound infection following animal-inflicted wounds, but is a rare cause of female genito-urinary sepsis. We present a case of vulval sepsis and a case of intrapartum septicaemia with this bacterium. These two cases indicate that Pasteurella multocida can occasionally colonise the female lower genital tract and this bacterium should be considered in the differential diagnosis of serious infection related to this site.

Adult↗
PubMed1994

Luteal phase ovarian oestrogen is not essential for implantation and maintenance of pregnancy from surrogate embryo transfer in the rhesus monkey.

The aim of this study was to investigate whether luteal phase ovarian oestrogen is required for blastocyst implantation and pregnancy maintenance in the rhesus monkey. Preimplantation embryos were retrieved from naturally ovulated, mated embryo donor monkeys. In group I, developmentally normal, age- and stage-matched embryos were transferred to recipient monkeys showing naturally synchronized ovulatory cycles. Immediately prior to embryo transfer, recipients were subjected to bilateral ovariectomy, and following transfer they were treated with i.m. injections of either progesterone (group Ia, n = 4), or oestradiol + progesterone (group Ib, n = 2). Recipient monkeys of group Ic (n = 4) were subjected to sham ovariectomy and vehicle injection. In group Ia, progesterone supplementation alone led to three pregnancies and live births. In group Ib, there was one live birth. In the control group Ic, four transfers resulted in two live births and one abortion on cycle day 58. Analysis of serum progesterone and oestradiol profiles showed that oestradiol had declined to undetectable levels within 3-5 days after ovariectomy in group Ia recipients, and the area under the curve of serum oestrogen concentrations during the peri-implantation period (days 10-20 after ovulation) were less (P < 0.001) in group Ia compared with group Ic. There were no changes in the area under the curve among serum progesterone concentrations in all the subgroups. In group II, long-term ovariectomized embryo recipients (n = 4) were primed with oestradiol till cycle day 11 of simulated transfer cycle, and received progesterone treatment from cycle day 10 till the end of the experiment.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Luteal phase contraception with mifepristone (RU 486) in the rhesus monkey.

Mifepristone (RU 486), an antiprogesterone, is a promising luteal phase contraceptive agent for human use. However, at present its use is limited by the practical constraint of determining the day of ovulation for an LH + 2 day administration of the drug as indicated from experimental and clinical studies. The aim of the present study was to identify the effective period of luteal phase (luteal phase window) when a single administration of mifepristone would induce antinidatory activity without disturbing menstrual cyclicity and ovulatory pattern in the rhesus monkey. RU 486 (2 mg/kg body weight in benzyl benzoate/olive oil, 1:3) was given to mated monkeys (n = 9) on cycle day 16 in the first treatment cycle (treatment group T1, n = 9), and in the following cycle on cycle day 20 (treatment group T2, n = 8). A single s.c. injection of this antiprogestin during early to midluteal phase (days 1-10 after ovulation, as determined from retrospective analysis of serum concentrations of estrogen and progesterone) provided a one hundred per cent protection against pregnancy, with no apparent side effects. There were no changes in cycle lengths (F = 3.5; P < 0.3), day of ovulation (F = 1.8; P < 0.7) and duration of menses (F = 3.5; P < 0.3) compared with the pre-treatment and post-treatment cycles. Pooled analyses of serum concentrations of estrogen and progesterone during luteal phases of T1 and T2 cycles also showed no variations with those in pre- and post-treatment cycles.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

Contranidatory activity of early luteal phase administration of mifepristone in the rhesus monkey.

The contranidatory action of mifepristone (RU 486) given as a single application at different dosages to mated rhesus monkeys (Macaca mulatta) on second day after ovulation has been examined in the present study. In group 1, monkeys (n = 3) received only vehicle (benzyl benzoate: olive oil, 1:4, v/v) and were treated as controls. In group 2 monkeys (n = 4), RU 486 was given by gavage at 10 mg/kg in group 4 (n = 5). The patterns of cycles and profiles of serum estrogen and progesterone were monitored for assessing the occurrence of implantation and pregnancy. At a single dose of 10 mg/kg, RU 486 was found to be ineffective in preventing nidation, resulting pregnancy in three females out of four treated monkeys. Similarly, an s.c. administration of 1 mg/kg could provide pregnancy protection in two of the four treated monkeys. In these monkeys, however, the menstrual cycle characteristics were not affected as compared to pretreatment cycles. Interestingly, the administration of 2 mg/kg, s.c., RU 486 could provide a hundred percent pregnancy protection in mated monkeys, and there was no significant changes in the pattern of menstrual cycle characteristics. It appears that an early post-ovulatory administration of RU 486 may be successfully used in human as an effective once-a-month, early luteal phase contranidatory agent.

Animals↗