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Biomedical subjects

R Cunningham

Publications and source records attributed to R Cunningham.

At least 19 recordsLinked to original sources
PubMed1992

Prosthetic hip-joint infection associated with a penicillin-tolerant group B streptococcus.

We report a case of prosthetic hip-joint infection with Streptococcus agalactiae (Lancefield group B streptococcus). The infection recurred after 3 months' treatment with amoxycillin. On further investigation, the isolate was found to be amoxycillin-tolerant. Addition of gentamicin abolished tolerance in vitro and the patient has remained asymptomatic since receiving a 10-day course of amoxycillin and gentamicin followed by amoxycillin alone.

Aged↗
PubMed1992

Comparative activity of glycopeptide antibiotics against coagulase-negative staphylococci embedded in fibrin clots.

The susceptibilities of 16 strains of coagulase-negative staphylococci to vancomycin and teicoplanin were determined by three microdilution methods run in parallel; (i) a reference method in which the medium was Iso-Sensitest broth, (ii) a method in which the organisms were suspended in plasma and (iii) one in which the bacteria were incorporated into a fibrin clot. In comparison with the reference method there was a less than two-fold change in the geometric mean MICs of both antibiotics in plasma, while in clot the increase was 12-fold for vancomycin and 28-fold for teicoplanin. MBCs showed a similar trend although the increase was greater for teicoplanin. These results suggest that protein binding may have a much greater impact on antimicrobial activity when the mobility of the protein is reduced within a clot.

Blood Coagulation↗
PubMed1992

The influence of mental health problems on AIDS-related risk behaviors in young adults.

This paper explores how symptoms of mental health problems influence acquired immune deficiency syndrome-related risk behaviors, and how changes in those symptoms relate to risk behaviors engaged in by young adults. Repeated interviews with 602 youths since 1984 provide a history of change in behaviors. Mental health symptoms during adolescence (alcohol/drug [r = .28]; conduct disorder [r = .27]; depression [r = .16]; suicide [r = .14]; anxiety [r = .16]; and posttraumatic stress [r = .09]) are associated with higher numbers of risk behaviors (specifically, prostitution, use of intravenous drugs, and choice of a high-risk sex partner) during young adulthood. Changes in mental health symptoms between adolescence and young adulthood are related to the number of risk behaviors engaged in by young adulthood (total number of symptoms [B = .10], alcohol/drug abuse or dependence [B = .34], depression [B = .20], suicidality [B = .35], anxiety [B = .13], and posttraumatic stress [B = .14]). Changes in symptoms of mental health problems are associated specifically with those risk behaviors that are initiated primarily in young adulthood: intravenous drug use, prostitution, and choice of risky partners. The findings show that prevention and treatment of mental health problems are important components of preventive interventions for human immunodeficiency virus infection in high-risk teens and young adults.

Acquired Immunodeficiency Syndrome↗
PubMed1992

On the determinants of persistent gambling behaviour. I. High-frequency poker machine players.

Persistent gambling was studied as a function of the reinforcement of arousal and winning during normal poker machine playing sessions. Play rate, heart rate, winnings, subjective excitement and expectations of winning were recorded for five male and five female high-frequency players. Autoregressive regression analysis indicated that wins affect play rate for up to three minutes, while effects of the other variables were inconsistent. Markov chain analysis confirmed that wins smaller than 50 credits tend to elevate play rate, while larger wins cause a breakdown in the otherwise very regular rate of play. Results are discussed in relation to the development of impaired control of gambling behaviour.

Adolescent↗
PubMed1992

Acute gastroenteritis: effect on nutritional status.

Anthropometric measurements were performed on admission and at four weeks post discharge on 25 adults referred to hospital with acute gastroenteritis. There was a significant change in weight (P < 0.001) and mid-arm circumference (P < 0.05), but no change in skinfold thickness, arm muscle area or arm fat area. The results suggest that weight change during acute gastroenteritis is more a consequence of dehydration than of malnutrition.

Acute Disease↗
PubMed1992

Changes in acquired immunodeficiency syndrome-related risk behavior after adolescence: relationships to knowledge and experience concerning human immunodeficiency virus infection.

This paper explores the extent of change in acquired immunodeficiency syndrome (AIDS) risk level and in the numbers of AIDS-related risk behaviors in 602 inner-city adolescents as they enter young adulthood. Youths' risk level for human immunodeficiency virus (HIV) infection during adolescence was categorized as high (engaging in prostitution, male homosexual or bisexual activity, or injectable drug use or having ulcerative sexually transmitted diseases), moderate (having six or more sex partners in a 1-year period or nonulcerative sexually transmitted diseases), or low (none of the above). Although a proportion at high or moderate risk during adolescence did move to lower risk levels by young adulthood, the overall risk level stayed fairly stable: 45% were at high or moderate risk levels during adolescence, and 35% were at those levels by young adulthood. Then change in the total number of risk behaviors engaged in by the youths was examined. Knowledge about AIDS or HIV infection and its prevention was not associated with any change in risk behavior, nor were the number of sources of information about the epidemic, acquaintance with those who are infected, estimates of personal risk, or exposure to HIV-test counseling. In fact, youths whose risk behaviors increased the most were more likely to know someone who had died of AIDS and to estimate their own risk as high. Most youths reported that they did not use condoms regularly, disliked them, and had little confidence in their protective ability. Changes in preventive strategies and further research on the causes of behavior change are needed.

Acquired Immunodeficiency Syndrome↗
PubMed1991

On the determinants of persistent gambling. III. Personality, prior mood, and poker machine play.

Sixty-four poker machine players were observed in the ecologically valid setting of their social club while completing a session of play. Subjects were assessed by interview, the Profile of Mood States, and personality measures. Personality scores did not predict level of involvement in gambling, session duration, or persistence when losing. High-frequency players were generally more predictable than other players, with over 70% of the variance of session duration accounted for by predictor variables. Also for this group of players, persistence when losing was significantly accounted for by prior mood and cognitions concerning win size.

Adult↗
PubMed1990

Improved results of vascular reconstruction in pediatric and young adult patients with renovascular hypertension.

From 1955 to 1988, 56 patients 21 years old or younger underwent surgical treatment for renovascular hypertension at our clinic. The cause of renal artery disease was fibrous dysplasia in 53 patients, Takayasu's arteritis in 2 or an arterial aneurysm in 1. Bilateral or branch renal artery disease, and extrarenal arterial disease were present in 16, 23 and 11 patients, respectively. The results of 28 patients treated from 1955 to 1977 (group 1) were compared to those of 28 patients treated from 1978 to 1988 (group 2). Hypertension was cured or improved postoperatively in 83% of the patients from group 1 and in 96% from group 2 (p = 0.07). However, this outcome was achieved through surgical revascularization in only 48% of the patients from group 1 compared to 96% from group 2 (p = 0.0002). A multivariate analysis revealed that the only significant variable related to clinical outcome was the era of treatment, which reflects the improved technical efficacy of revascularization during the last decade. Aortorenal bypass and renal autotransplantation have emerged as the preferred revascularization operations. It currently is possible to achieve amelioration of hypertension and preservation of renal function in most young patients with renal artery disease.

Adolescent↗
PubMed1990

Rubeosis capsulare.

Two patients with diabetes had extracapsular cataract extraction with intraocular lens (IOL) implantation. Both developed rubeosis iridis and neovascularization within the lens capsule supporting the IOL, a condition we have termed rubeosis capsular. Argon laser treatment was ineffective in both patients. One patient was successfully treated by virectomy with endophotocoagulation. The other patient had a vitrectomy which was followed by a fibrinoid reaction, continued inflammation, rubeosis, and phthisis bulbi.

Cryosurgery↗
PubMed1989

Recent results of cadaver kidney retransplantation.

The results of secondary cadaver renal transplantation in 42 patients treated from 1980 to 1986 have been reviewed. The initial graft was from a cadaver donor in all cases. All patients were managed with a maintenance immunosuppressive regimen, including either antilymphoblast globulin and/or cyclosporine. The over-all 1 and 2-year patient survival rates were 97 and 94 per cent, respectively. The over-all 1 and 2-year graft survival rates were 69 and 63 per cent, respectively. Graft success was not influenced by patient age greater than 50 years, diabetes, initial graft removal, interval between initial graft removal and retransplantation, duration of initial graft function, level of presensitization or HLA-Dr antigen matching. Currently, cadaver renal retransplantation can be performed safely and with an improved opportunity for graft success. Patients who return to dialysis after losing an allograft should be encouraged to consider another transplant for the same reasons that prompted initial transplantation.

Adolescent↗
PubMed1989

Secondary renal revascularization for recurrent renal artery stenosis.

Six patients are presented who underwent secondary renal revascularization for recurrent renal artery stenosis. The initial pathologic diagnosis was fibrous dysplasia in three patients and atherosclerosis in three patients. All patients had initially undergone a successful aortorenal bypass operation. Recurrent renal artery stenosis and hypertension developed 11 to 120 months later (mean, 58 months). Secondary revascularization operations included renal autotransplantation (2 patients), hepatorenal bypass (2), iliorenal bypass (1), and aortorenal bypass (1). Hypertension was relieved, and renal function was stabilized or improved in all cases. If hypertension recurs after renal revascularization, a recurrent but correctable lesion should be suspected.

Adult↗
PubMed1987

Immunological characterization of a novel human colon-associated antigen (CAA) by a monoclonal antibody.

We have generated a monoclonal antibody (MAb), designated anti-CAA (colon-associated antigen), using as immunogen a membrane-enriched fraction of a biopsy from a moderately-differentiated human colonic adenocarcinoma. The molecular weight of this reactive antigen was determined by Western blotting to be greater than 200 kDa. When immunohistochemical techniques were used, MAb anti-CAA reacted with epithelium in the majority of normal, dysplastic and malignant colon specimens tested (greater reactivity was observed in normal colon than in benign or malignant lesions). Cell sorter analyses demonstrated a heterogeneous distribution of CAA on the cell surface of the well-differentiated LS-174T cell line. Antigen positive and antigen-negative cells were separated by means of flow cytometric techniques. These two subpopulations were then inoculated into immunosuppressed rats, resulting in xenograft tumors which differed significantly in their degree of histologic differentiation. Antigen-positive cells developed into well-differentiated adenocarcinomas, while antigen-negative cells developed into poorly differentiated adenocarcinomas. These results, along with immunohistochemical studies, indicate that the antigen detected by MAb anti-CAA has characteristics of a colon-associated antigen whose expression correlates with cellular differentiation. Moreover, differences in molecular weight as well as tissue distribution indicate that CAA may be a novel antigen different from those previously described.

Adenocarcinoma↗