Window on the breast: 19th century English developments in pulmonary diagnosis.
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Auscultation↗
Biomedical subjects
P Warren
Publications and source records attributed to P Warren.
Donor work-up and transport of bone marrow--recommendations and requirements for a standardized practice throughout the world from the Donor Registries and Quality Assurance Working Groups of the World Marrow Donor Association (WMDA).
In October 1995 the World Marrow Donor Association (WMDA) was restructured in order to facilitate its primary function of establishing guidelines in relation to international bone marrow and blood stem cell transplants -- transplants in which the donor is in one country and the patient is in another country. Five new working groups were established -- Donor Registries, Ethics, Quality Assurance, Finances, and Stem Cells. This paper, prepared by members of the Donor Registries Working Group, in consultation with the Quality Assurance Working Group, provides recommendations for the 'donor work-up'. This term covers events that start when the definitive donor has been identified, includes the harvesting (collection) and transportation of the stem cell product and ends when the product reaches the transplant centre. The paper includes examples of the documentation intended to ensure compliance with the recommendations at all key points in the sequence.
Bone Marrow Transplantation↗
Pulmonary illness associated with exposure to Mycobacterium-avium complex in hot tub water. Hypersensitivity pneumonitis or infection?
BACKGROUND: Mycobacterium avium complex is common in water. When aerosolized, it is frequently inhaled but rarely causes illness in healthy people. Hypersensitivity pneumonitis to inhaled aerosols has been described; these aerosols are from several sources of water. The pneumonitis forms are collectively known as humidifier lung; the responsible agent in the water remains uncertain. PURPOSE: To report five cases of respiratory illness in healthy subjects using hot tubs contaminated with M avium complex. DESIGN: Descriptive case reports. SETTING: Consultations in two teaching hospitals. PATIENTS: Five healthy people developed respiratory illnesses characterized by bronchitis, fever, and "flu-like" symptoms after using a hot tub. Acute exacerbations of their illness developed within hours of heavy use of the hot tubs. INVESTIGATIONS: A chest radiograph and sputum culture in all, BAL in one, CT scan and lung biopsy in another were performed. Culture of the water of the two hot tubs also was done. RESULTS: Chest radiographs showed interstitial infiltrates or a miliary nodular pattern. Cultures of all sputum samples, the lung biopsy specimens, lung lavage and water samples were positive for M avium complex. The lung biopsy specimen revealed noncaseating granulomas. All patients recovered with no treatment for M avium complex. CONCLUSION: We conclude that the M avium complex in the water was responsible for the pulmonary illnesses. The symptoms and the results of investigations are more suggestive of a hypersensitivity pneumonitis than of an infection, but no serologic proof of an immunologic reaction to the M avium complex or water was obtained.
Adolescent↗
Measurement of prostate specific antigen as screening test for prostate cancer. False positive results cast doubt on conclusion.
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Aged↗
House dust mite allergen levels in two cities in Canada: effects of season, humidity, city and home characteristics.
The homes of 120 patients with asthma, 57 in Vancouver and 63 in Winnipeg, were studied. The characteristics of the homes were assessed by a questionnaire. Dust samples were collected and the indoor relative humidity was measured four times during the year covering all four seasons in both cities. Mite allergen levels were determined using monoclonal antibodies against Der p I and Der f I by the ELISA method. The mean levels of both mite allergens in mattress and floor samples in the homes in Vancouver and in Winnipeg were relatively low for all seasons. Mite allergen levels were found to be associated with city, season and individual home differences. They were significantly higher in Vancouver than in Winnipeg. Der p I and Der f I in mattress samples in both cities and Der f I in floor samples in Vancouver, varied by season. The indoor relative humidity level in the homes in Vancouver were also significantly higher than those in Winnipeg. There was, however, no significant association between the levels of indoor relative humidity and the levels of mite allergens after adjusting for variations in city, season and individual home. Although individual home differences were highly associated with mite allergen levels, only a few home characteristics were found to be related to mite allergen levels such as the type and the age of the home, the type of heating, the use of feather pillows and the number of occupants in the homes. Whether low levels of mite allergens are partially responsible for the relatively low prevalence of childhood asthma in Canada remains to be investigated.
Allergens↗
The comparative tea staining potential of phenolic, chlorhexidine and anti-adhesive mouthrinses.
Staining of teeth and mucous membranes is a well-known side-effect with chlorhexidine mouthrinses in which dietary chromogens play an important rôle. The purpose of this study was to determine whether a co-polymer anti-adhesive agent would prevent staining by a low concentration chlorhexidine solution. Additionally, the possibility that an essential oil/phenolic rinse product may cause staining was investigated. The rinses studied were the anti-adhesive alone and combined with 0.02% chlorhexidine and the essential oil/phenolic rinse. These were positioned against a positive control rise, 0.2% chlorhexidine, and a negative control rinse, water. The study was a single blind 5-treatment, randomised Latin square cross-over design, incorporating balance for carry-over effects. 15 volunteers participated and on Day 1 of each study period were rendered stain free by scaling and polishing of the teeth. Oral hygiene was suspended and 8 x per day subjects rinsed under supervision, firstly with the allocated formulation and then with 10 ml of warm black tea. On Day 4, tooth and tongue staining was scored by area and intensity (colour). A washout period of at least 3 1/2 days was permitted between treatment periods when oral hygiene was resumed. Before the study and during washouts, volunteers practised tongue brushing. Tooth and tongue staining was significantly increased with 0.2% chlorhexidine compared to the essential oil/phenolic rinse which in turn was significantly increased compared to the other 3 rinses. The antiadhesive/chlorhexidine rinse produced no more staining than the anti-adhesive or water rise. However, the parallel plaque regrowth study suggests this inhibition of staining resulted from the vitiation of the chlorhexidine activity by the antiadhesive. The methodology would appear a simple and quick way of assessing the propensity of mouthrinses to cause extrinsic staining.
Anti-Infective Agents, Local↗
The comparative effects on plaque regrowth of phenolic chlorhexidine and anti-adhesive mouthrinses.
The inhibition of bacterial attachment to the tooth surface is one possible approach to plaque control. This study evaluated in vivo the plaque inhibitory action of a novel copolymer reported to have considerable antiadhesive properties in vitro. The study was a single blind, 5-treatment, randomised Latin square crossover design, incorporating balance for carry-over effects. The rinses were the antiadhesive (1%), the antiadhesive with 0.02% chlorhexidine, a 0.2% chlorhexidine rinse product, an essential oil/phenolic rinse product and water. 15 volunteers participated and on day 1 of each study period were rendered plaque-free, ceased toothcleaning and rinsed 2 x daily, under supervision, with the allocated formulation. On day 5, plaque was scored by index and area. Washout periods were 2 1/2 days. Alone or combined with chlorhexidine, the antiadhesive agent showed no effects greater than water. The chlorhexidine rinse was significantly more effective than the essential oil/phenolic rinse which in turn was significantly more effective than the other rinses.
Anti-Infective Agents, Local↗
Mite and cat allergen levels in homes and severity of asthma.
The relationships between mite and cat allergen levels in the home, skin test reactivity, and severity of asthma were explored in 120 asthmatic subjects, 57 in Vancouver and 63 in Winnipeg. Patients in the two cities were similar in age, gender distribution, and severity of asthma. Skin tests were performed using 13 common allergens, including D. pteronyssinus, D. farinae, and cat dander, as well as control subjects. Patients recorded their asthma symptoms, medication requirement, and twice daily peak expiratory flow rate for 1 yr. Dust samples were collected every 3 mo during each season of 1992 through 1993 in both cities. Mite and cat allergen levels were determined with an ELISA using monoclonal antibodies against Der p I, Der f I, and Fel d I. There was no relationship between skin test reactivity and levels of mite and cat allergens. In children with positive skin tests to either mite allergen, total mite (sum of Der p I and Der f I) allergen level was positively related to the mean daily symptom score and negatively related to the daily mean PEF (% of predicted). There was no such relationship among adult asthmatic patients with positive skin tests to either mite allergen. No relationship was found between cat allergen level and the severity of asthma.
Adult↗
Categorising [s], [integral of] and intermediate electropalatographic patterns: neural networks and other approaches.
We consider two approaches to the interpretation of EPG data, using materials designed for the investigation of [s]-[integral of] assimilations across word boundaries, as in boss Shep. A contact index is based on electrode contact in different row groups, whereas a neural network is used to determine patterns of contact. Both approaches are speaker sensitive, reflecting the wide variation in [s] and [integral of] articulation between speakers. The advantage of the neural net analysis is that the investigator need not make any assumptions about the relative value of specific electrodes or groups of electrodes. We found that the 'hand-selected' index, in general, modelled linguopalatal movement for all degrees of [s]-[integral of] assimilation better than the neural net. However, the neural net very successfully characterised stable /s/ and /integral of/ and has the potential to give an accurate representation of intermediate assimilatory cases, if trained on a more varied input set than the rather limited one used in this experiment.
Electrodiagnosis↗
A twin study of polycystic ovary syndrome.
OBJECTIVE: To examine the role of genetic and environmental factors in polycystic ovary syndrome (PCOS) by using the classic twin model. SETTING: Outpatient clinic of the Royal Hospital for Women, Paddington, Sydney, New South Wales, Australia. PATIENTS: A group of 19 monozygotic (MZ) and 15 dizygotic (DZ) twin pairs identified from the national twin register. INTERVENTIONS: Ultrasound, clinical, and biochemical parameters were used to define PCOS. RESULTS: Eleven pairs of twins (5 MZ, 6 DZ pairs) were scan-discordant (i.e., one twin had scan-PCOS and the co-twin did not). Model-fitting analysis suggested that fasting insulin level, androstanediol glucuronide, and body mass index (BMI) were significantly influenced by genetic factors. CONCLUSION: This study suggests that PCOS is not the result of a single autosomal genetic defect, but rather environmental factors, perhaps both intrauterine and extrauterine, are involved in the pathogenesis of this disorder or that PCOS may be an X-linked disorder or the result of polygenic factors. However, fasting insulin level, androstanediol glucuronide, and BMI did appear to be under significant genetic influence.
Adolescent↗
Levels of perceptual representation and process in lexical access: words, phonemes, and features.
Three experiments and a simulation study investigate competing featural and phonemic views of the representation of the speech input in access to the mental lexicon. Auditory lexical decision and gating tasks show that the processing consequences of subcategorical mismatches (conflicts between phonetic cues to speech segment identity) depend on the lexical status of the conflicting cues, such that conflicts that only involve nonwords do not disrupt performance. A further study, using a phonetic-decision task with the same stimuli, found the same pattern. A simulation study shows that the interactive activation model TRACE, with top-down feedback to a prelexical phonemic level, does not model these effects successfully. The authors argue instead for a direct access featural model, based on a distributed computational substrate, where featural information is mapped directly onto lexical representations.
Adult↗
World Marrow Donor Association: a progress report.
The World Marrow Donor Association was founded in 1988 with a view to establishing guidelines to promote the use of volunteer bone marrow donors for transplants involving patients and donors in different countries. Members have met approximately twice yearly on one or other side of the Atlantic since 1988. A Special Report summarising recommendations and requirements for a standardized practice throughout the world in relation to bone marrow transplants using volunteer donors was published in 1992.
Adult↗
The 18 to 20 week obstetrical scan. A joint statement from the Australasian Society for Ultrasound in Medicine, the Royal Australian College of Obstetricians and Gynaecologists and the Royal Australasian College of Radiologists.
The Australasian Society for Ultrasound in Medicine, The Royal Australian College of Obstetricians and Gynaecologists and the Royal Australasian College of Radiologists have produced jointly the accompanying document on the 18-20 week obstetrical scan. It is an important document not only for the sonologists and sonographers but also for clinicians who request ultrasound examinations for pregnant women, so that they may have a better idea of what the examination should cover and its limitations.
Female↗
Prenatal diagnosis for hemoglobinopathies--10 years experience using fetal blood sampling.
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Anemia, Sickle Cell↗
Unrelated bone marrow transplantation in Canada, the national experience. Canadian Red Cross Society.
The Canadian Unrelated Bone Marrow Donor Registry (UBMDR) of the Canadian Red Cross Society (CRCS) was officially funded as of April 1, 1989 for an initial three year period with a mandate to recruit 50,000 unrelated bone marrow donors and to conduct the search activities for unrelated bone marrow donors worldwide on behalf of Canadian patients. Since February of 1988, 162 unrelated bone marrow transplants have been carried out in Canada. The registry now stands at an enrollment of 35,705 with approximately 1,200 donors being added monthly. Recruitment of unrelated bone marrow donors is now established in fourteen Canadian cities, and an active ethnic recruitment is now in progress.
Bone Marrow Transplantation↗
Enhanced expression and immunohistochemical distribution of transforming growth factor-beta in idiopathic pulmonary fibrosis.
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Animals↗
The clinical significance of blood transfusion at the time of radical hysterectomy.
A retrospective review was conducted to evaluate the clinical implications of perioperative blood transfusion in the surgical management of stage IB cervical cancer. The investigation focused on 126 patients treated with radical hysterectomy and retroperitoneal lymph node dissection who were found to have clear surgical margins, negative retroperitoneal lymph nodes, and no lymph-vascular space involvement in the hysterectomy specimen, and who had no perioperative radiation therapy, no history of immunosuppression with medication, and at least 18 months of follow-up. The distributions of age, weight, operative time, nodal yields, mean lesion diameters, median depths of invasion, and histologic subtypes were not statistically different between the transfused and untransfused groups. The average estimated blood loss among the transfused patients was 1104 mL, compared with 764 mL among the untransfused patients (P = .015). Among the 68 who received blood perioperatively, there were ten recurrences (14.7%), compared with two (3.4%) among the 58 patients who did not receive blood (P = .035). In this select population of patients, in which perioperative transfusion was isolated as a variable, transfusion adversely affected the outcome of surgical therapy.
Adult↗
Estimation of reference intervals for total protein in cerebrospinal fluid.
Protein in cerebrospinal fluid (CSF) was measured by a modified biuret procedure and in two automated instruments, the Du Pont aca and the Kodak Ektachem. The latter's dry-slide reagent was also evaluated for precision, linearity, and effect of potential interferents. In vitro, ampicillin and vancomycin increase the apparent value for CSF protein as measured with the Ektachem slides. We excluded patients with disorders of the central nervous system, and we estimated the central 95% percentile reference intervals for CSF protein for each of the three methods. We found no age or gender dependence of values. By the biuret procedure, the reference interval is 140 to 620 mg/L.
Adult↗