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Biomedical subjects

R Nugent

Publications and source records attributed to R Nugent.

24 records · Page 2Linked to original sources

The classification and management of acute orbital pseudotumors.

The clinical presentation, investigative findings, classification, and management of 17 acute pseudotumors based on patterns of orbital involvement is presented. Acute pseudotumors developed over days to weeks and were dominated by pain, neuropraxia, and inflammatory clinical features. Five patterns of acute inflammatory pseudotumor were seen. Anterior and diffuse acute pseudotumors were characterized by manifestations of inflammation of the globe and orbit including pain, lid swelling, ptosis, diplopia, uveitis, papillitis, optic neuropathy, and exudative retinal detachment. Anterior or diffuse orbital infiltration was noted on computerized tomography (CT) and ultrasound. Lacrimal involvement was characterized by local pain, tenderness, lid swelling and inflammation, with CT and ultrasound confirming an anterior inflammatory mass. Posterior or apical involvement led to an early optic neuropathy, and myositic lesions were characterized by features of muscle infiltration. Management with steroids was effective and could be followed by serial CT studies.

Acute Disease↗

Effect of increasing the plasma oxygen diffusivity on experimental cryogenic edema.

Mongrel cats with experimental cryogenic brain lesions were treated with the carotenoid compound crocetin. It has been shown that crocetin increases the diffusion speed of oxygen through plasma, and should provide a net increase in available oxygen to the capillary endothelial cell. The treated group of animals showed a significant reduction in edema as compared to a comparable control group. It is suggested that oxygen availability is an important factor in vasogenic edema.

Animals↗

Prophylactic intravenous immunoglobulin in HIV-infected children with CD4+ counts of 0.20 x 10(9)/L or more. Effect on viral, opportunistic, and bacterial infections. The National Institute of Child Health and Human Development Intravenous Immunoglobulin Clinical Trial Study Group.

OBJECTIVE: To evaluate the efficacy of intravenous immunoglobulin (IVIG) for prevention of viral, opportunistic, and minor bacterial infections in children infected with human immunodeficiency virus (HIV). DESIGN: Randomized, double-blind, placebo-controlled, outpatient clinical trial comparing subjects treated with 400 mg of IVIG per kilogram of body weight every 28 days with those given albumin placebo. SETTING: Twenty-eight clinical centers in mainland United States and Puerto Rico. PATIENTS: Three hundred seventy-six children infected with human immunodeficiency virus with clinical or immunologic evidence of HIV disease, 313 of whom had entry CD4+ counts of at least 0.20 x 10(9)/L (greater than or equal to 200/mm3). MAIN OUTCOME MEASURES: The incidence of laboratory-proven and clinically diagnosed viral, opportunistic, and bacterial infections. MAIN RESULTS: Viral infections and minor bacterial infections contributed more frequently to morbidity in children with entry CD4+ counts of at least 0.20 x 10(9)/L (together over five times as frequent) than did serious bacterial infection, the primary outcome measure of the trial. Opportunistic infections occurred at a similar rate as laboratory-proven serious bacterial infections. In this group of children, IVIG was significantly associated with a decrease in the rate of viral infections and minor bacterial infections per 100 patient-years (36.0 vs 54.0 episodes of viral infection per 100 patient-years, IVIG vs placebo, P = .01; and 115.1 vs 159.7 episodes of minor bacterial infection per 100 patient-years, IVIG vs placebo, P = .02), as well as a decrease in the rate of serious bacterial infections per 100 patient-years (26.4 vs 48.2 episodes per 100 patient-years; P = .002). There was no apparent difference in the rate of opportunistic infections between treatment arms. CONCLUSIONS: Beneficial effect of IVIG was seen across multiple infectious outcome measures, with reductions in serious and minor viral and bacterial infections observed in children with entry CD4+ counts of at least 0.20 x 10(9)/L.

Bacterial Infections↗

Homosexuality: Protestant, Catholic, and Jewish issues; a fishbone tale.

Homosexuality is compared to a fishbone caught in the church's throat that the church can neither eject nor swallow entirely. Authors in all denominations are questioning traditional church stances influenced by the model of clinical pastoral education. Most major denominations have made policy statements on homosexuality. Four such stances discussed here highlight some of the common issues denominations face in their reexamination of the subject. Homosexuals struggling for full acceptance in the church must confront the classical understanding of the human being and human sexual differentiation as these concepts have traditionally influenced the churches.

Catholicism↗