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Biomedical subjects

R Long

Publications and source records attributed to R Long.

At least 73 records · Page 4Linked to original sources
PubMed1991

Major problems with paediatric bed usage statistics?

This study was carried out on the way in which children's beds were used by the specialty of paediatrics in a district general hospital. Five differing ways were found of interpreting the present Department of Health guidelines on health services information (Körner recommendations). These gave bed occupancy figures varying between 73% and 106%; throughput figures varying between 23.8 and 34.7 discharges per bed; and turnover interval varying between -0.17 and 1.1 days for the same group of paediatric admissions. For comparisons of efficiency and costs between hospitals, which are based upon bed utilisation statistics, it is essential that there is standardisation of method of analysis.

Bed Occupancy↗
PubMed1991

Impact of human immunodeficiency virus type 1 on tuberculosis in rural Haiti.

We conducted a case-control study to determine the relative and attributable risk of HIV seropositivity for bacillary-positive (smear and/or culture) pulmonary tuberculosis in Haiti. There were 274 patients with tuberculosis and an equal number of control subjects. Antibodies to HIV were present in 67 (24%) patients and eight (3%) control subjects. Odds ratios suggested that the risk of pulmonary tuberculosis was 15.7 times as great (95% confidence interval, 4.8 to 5.0; p less than 0.05) in patients 20 to 39 yr of age who were HIV-seropositive than in HIV-seronegative patients. In contrast, the relative risk in those 40 to 59 yr of age was elevated (3.0 times), though not significantly (lower 95% confidence interval, 0.8). In the 20- to 39-yr age group, 31% of tuberculosis was attributable to HIV infection (95% confidence interval between 23 and 39%). HIV-seropositive and HIV-seronegative patients did not differ with respect to sputum smear positivity. HIV-seronegative patients were twice as likely to be infected with resistant organisms, though this was not significant. We conclude that HIV infection is a major risk factor for pulmonary tuberculosis in young adult residents of Haiti. This, together with the fact that similar proportions of HIV-seropositive and HIV-seronegative patients were potentially infectious, suggests that without vigorous counteraction tuberculosis will become a greater problem for Haiti.

Acquired Immunodeficiency Syndrome↗
PubMed1991

The chest roentgenogram in pulmonary tuberculosis patients seropositive for human immunodeficiency virus type 1.

To determine the impact that co-infection with HIV has on the radiographic presentation of pulmonary tuberculosis, we examined the chest roentgenograms obtained before treatment in 225 HIV-tested adult Haitians with bacillary (smear or culture or both) positive pulmonary tuberculosis. There were 67 HIV-seropositive and 158 HIV-seronegative patients. Intrathoracic adenopathy alone was more common and parenchymal infiltrates less common in HIV-seropositive patients (p less than 0.05). Although a parenchymal infiltrate was less likely to be cavitating in the HIV-seropositive group (p less than 0.05) when cavitary parenchymal disease was present, HIV seropositivity did not affect the number of cavities (single or multiple) or the size of the largest cavity. Patients with AIDS were significantly more likely to have a chest radiographic pattern consistent with primary tuberculosis (80 percent) than HIV-seropositive patients without AIDS (30 percent), and the latter were significantly more likely to have such a pattern than HIV-seronegative patients (11 percent) (p less than 0.05). The HIV-seropositive patients were equally infectious, regardless of the pattern of disease (primary vs postprimary). Even though pulmonary tuberculosis in an HIV-seropositive adult probably results from reactivation of dormant foci or reinfection, the pattern on the chest roentgenogram often suggests primary disease, especially if the patient has AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1991

The impact of HIV on the usefulness of sputum smears for the diagnosis of tuberculosis.

In a developing country, 289 patients were examined for active pulmonary mycobacterial disease (sputum smear and culture) and HIV infection (serology) to compare the sensitivity and positive predictive value of sputum smears for diagnosing pulmonary tuberculosis in patients with and without antibodies to HIV. Seventy-nine percent of HIV-seronegative vs 66% of HIV-seropositive patients with positive cultures for Mycobacterium tuberculosis were smear positive (P less than .05), and a positive sputum smear predicted the presence of M. tuberculosis in 90% of HIV seronegative vs 80% of HIV seropositive patients (P less than .05). In our opinion, HIV did not significantly compromise the diagnostic utility of the sputum smear.

Adolescent↗
PubMed1991

Subchronic oral toxicity of pyridostigmine bromide in rats.

This study evaluated the oral toxicity of pyridostigmine bromide in Sprague-Dawley rats when administered for 13 weeks by daily gavage. Groups of 10 rats/sex received doses of 0, 5, 15, 30, or 60 mg/kg/day. Toxicity was limited to exaggerated cholinergic stimulation at doses of 15 mg/kg/day or greater. Significant findings included tremors and inhibition of RBC acetylcholinesterase. Thus, 5 mg/kg/day of pyridostigmine bromide appears to be the no observed toxic effect level under the conditions of the present investigation.

Administration, Oral↗
PubMed1991

Pulmonary tuberculosis, human immunodeficiency virus type-1 and malnutrition.

In rural Haiti we measured and compared the muscle protein and calorie reserves (anthropometrics) as well as the visceral protein reserves (serum albumin, tuberculin sensitivity) in 56 HIV (human immunodeficiency virus type-1) seropositive and 108 HIV seronegative pulmonary tuberculosis patients. Results in patients were also compared to the results of the same measurements made in 160 age, sex and residence matched HIV seronegative controls without tuberculosis. Tuberculosis patients, regardless of HIV status, had significantly reduced muscle protein and calorie reserves compared to controls. The serum albumin was significantly lower in HIV seropositive tuberculosis patients (21.0 g/l) compared to HIV seronegative tuberculosis patients (26.9 g/l) and the serum albumin in both tuberculosis groups was significantly lower than in controls (41.3 g/l). The lower the serum albumin in the tuberculosis patients the greater the likelihood of a negative tuberculin test. HIV seropositive tuberculosis patients were significantly more likely to be tuberculin negative than HIV seronegative tuberculosis patients. Tuberculosis is associated with significant malnutrition. Worse malnutrition in tuberculosis patients co-infected with HIV suggests that the effect of the two pathogens on nutrition is additive or, alternatively, that tuberculosis patients who are particularly malnourished are at increased risk for HIV.

Adult↗
PubMed1990

Antituberculous drug resistance in central Haiti.

To determine the prevalence of antituberculous drug resistance in Haiti, we conducted a 1-yr survey in a central district. From a bacillary positive (smear and/or culture positive) case rate of 80/100,000, there were 282 patients from whom Mycobacterium tuberculosis was cultured. Each isolate was packaged and delivered to Canada where speciation and drug susceptibility testing were performed. Reported resistances are those using the proportions method (Laboratory Center for Disease Control, Ottawa, Canada). Resistance to one or more drugs was found in 22% of isolates. Age was the most important predictor of resistance in Haiti; resistance rates for age groups less than 14, 14 to 29, 30 to 44, greater than or equal to 45 were 8, 19, 22, and 31%, respectively. In patients not known to have received antituberculous drugs in the past, resistances were isoniazid (19%), streptomycin (5%), ethambutol (2%), ethionamide (2%), rifampin (1%). We conclude that antituberculous drug resistance is prevalent in Haiti, especially in older age groups, and that in persons with no known antituberculous drug use in the past, resistance to isoniazid is significant.

Adolescent↗
PubMed1990

[Studies on immunoregulation and hypersensitivity of secretary otitis media].

Sixty patients with secretary otitis media (SOM) and 50 control cases were studied for their cellular immunity and hypersensitivity. Most of patients revealed that total T or T cell subpopulations were below those of the control. Eighty percent of patients had high serum IgE level and 81.2% as Positive in intradermal skin tests on inhalant allergy, but only 51.7% of patients had clinical symptoms of allergy. It was found immunologically that SOM occurred more frequently in allergic patients and most of them had abnormality of immunoregulation, and that there was a subclinical allergy for some of the patients. Allergy might play a significant role in the etiology of this disease. Authors suggest that it is necessary for patients with SOM to have some tests and treatment of immunology.

Adolescent↗
PubMed1989

The relation of flow cytometry to clinical and biologic characteristics in women with node negative primary breast cancer.

Flow cytometry (FC) analysis including DNA index (ploidy status) and cell kinetics (%S and %S + G2/M) was done on frozen tissue of the primary lesions of 101 women with node negative (N-) breast cancer who were studied prospectively. Currently, 19% (19/101) of the patients have recurred. No significant relations have been found between recurrence or survival and age, estrogen/progesterone receptor status, tumor size, and tumor type. The DNA index (ploidy) was not related to any clinical variable, time to recurrence, or survival. Aneuploid tumors did, however, have significantly higher %S phase activity. Patients with %S activity less than or equal to the median value were significantly different from those patients with %S above the median. They were older and had a higher frequency of ER/PR positive and well- or moderately differentiated tumors. Patients with %S + G2/M greater than the median value showed shorter time to recurrence (P = .055) and shorter survival (P = .006), whereas %S alone was significantly associated only with survival. Multivariate analysis showed that neither DNA index nor cell kinetics was significantly associated with time to relapse. DNA index was not significantly associated with survival; %S was of borderline significance whereas %S + %G2/M was a significant independent predictor of survival. Although FC data may provide independent information related to survival in N-women, additional research in a larger number of patients is needed to define its precise role in patient management.

Breast Neoplasms↗
PubMed1989

Chronicity. Adjustment differences of Vietnam combat veterans differing in rates of psychiatric hospitalization.

The study focuses on the frequency of inpatient care for patients with Posttraumatic Stress Disorder (PTSD). This factor, termed "chronicity," is, perhaps surprisingly, largely overlooked in many PTSD studies. The significance of chronicity was addressed through administration of Minnesota Multiphasic Personality Inventory (MMPI) to Vietnam Theater and Era veterans in an inpatient psychiatry service. MMPI scores were analyzed for two main effects: combat exposure and chronicity (i.e., number of inpatient psychiatry admissions). The results replicated research showing combat exposure is associated with greater maladjustment (i.e., higher MMPI scores). Moreover, chronicity also emerged as a significantly important variable: of all groups compared, Vietnam combat veterans higher in chronicity scored higher on MMPI clinical scales, particularly on scales Paranoia, Psychasthenia, and Schizophrenia, thereby (a) empirically establishing (a) the methodological point that number of admissions must be controlled and (b) the substantive point that chronicity is important in studies of PTSD.

Adaptation, Psychological↗
PubMed1989

Tuberculous pericarditis: long-term outcome in patients who received medical therapy alone.

A conservative approach to operative intervention in the treatment of active tuberculous pericarditis was adopted and only 4 of 16 consecutive patients underwent pericardiectomy, all within 2 months of diagnosis. One patient died of constrictive pericarditis despite pericardiectomy, and one died of acute bronchopneumonia after 8 months of otherwise successful medical management. All 14 long-term survivors were reevaluated to exclude chronic constrictive pericarditis and other potential sequelae of tuberculous pericarditis. Reevaluation included physical examination, chest radiograph, electrocardiogram, M-mode and two-dimensional echocardiogram, computed tomography (CT) scan, and in patients less than or equal to 75 years of age, incremental cycle exercise to maximum oxygen consumption. None were found to have chronic constrictive pericarditis or convincing evidence of other recognized complications of tuberculous pericarditis. Our results suggest that when pericardiectomy is not required for the relief of cardiac compression during the acute phase of tuberculous pericarditis and patients are treated with medical therapy alone, an excellent long-term outcome may be anticipated.

Adrenal Cortex Hormones↗
PubMed1989

Serotypes of Pseudomonas aeruginosa from human and animal sources.

Forty human isolates and twenty-eight animal isolates of Pseudomonas aeruginosa from Prince Edward Island area (Atlantic Canada) were serotyped using a kit consisting of 4 polyvalent O-group antisera and 17 monovalent O-type (serovar) antisera, in accordance with the International Antigenic Typing Scheme. The results showed a difference between humans/dogs (50%/48% group I) and pigs (71% group IV). Whereas O-serovar 9 and 1 appeared to be most involved in human and canine infections, O-serovar 3 was the predominant type in porcine infections.

Animals↗
PubMed1989

[Research on the etiology of nasal polyps].

One hundred and seventy patients with nasal polyps were studied. According to the history, skin tests with inhalant allergens, determination of serum nasal secretion and polyp fluid IgE, and X-ray films of nasal sinuses, it was suggested that 93.5% of them might have complicated with allergic diseases, 87.7% with sinusitis. A relationship between local IgE production and the eosinophil infiltration of polyps existed. This study suggests that allergic process acting locally on the mucous membrane of the nose is the etiologic factor and bacterial allergy probably contributes to the development of nasal polyps. In order to prevent the recurrence after polypectomy, antiallergic management combined with antibiotics and drainage of infected sinuses may be necessary in most cases.

Adolescent↗
PubMed1988

Anatomical analysis of frontal cortex sites at which carbachol induces motor seizures in the rat.

High amplitude spiking representative of seizures, accompanied by an unusual motor behavior pattern of rearing and forelimbic clonus resembling "boxing," was elicited by microinjection of the cholinergic agonist, carbachol, 4 micrograms, into the medial prefrontal cortex of the rat. A rating scale devised to score the behavior revealed a motor pattern elicited by carbachol from the medial anterior cortex which was similar to that described by Racine for electrical stimulation of the amygdala. Topographical analysis of the areas surrounding the medial anterior cortex region revealed that the motor manifestations of seizures were elicited over a wide region of the anterior cortex, with scores significantly lower at carbachol microinjection sites greater than 1 mm rostral, 2 and 3 mm caudal, and 2 mm lateral to the standard medial prefrontal cortex site. Unilateral microinjection of carbachol yielded motor seizures primarily from the contralateral forepaw, suggesting involvement of a crossed pathway. Retrograde tracing with fast blue dye, combined with immunostaining for choline acetyltransferase and NADPH-diaphorase, found that the cholinergic neurons innervating the standard microinjection site were the dorsolateral tegmental cells, as previously reported, which have been shown to also contain substance P and corticotropin releasing factor. In addition, cholinergic neurons of the nucleus basalis of Meynert region were found to innervate the standard microinjection site. These findings implicate cholinergic innervation of the rostral cortex in classical limbic seizures.

Animals↗