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Biomedical subjects

R P Oates

Publications and source records attributed to R P Oates.

At least 19 recordsLinked to original sources
PubMed1993

Effects of PEG-electrolyte (Colyte) lavage on serum acetaminophen concentrations. A model for treatment of acetaminophen overdose.

The purpose of this study was to evaluate whole gut lavage with polyethylene glycol electrolyte solution (Colyte), as a potentially adjunctive measure in lowering serum acetaminophen levels. The effect of bowel lavage was evaluated on serial serum acetaminophen concentrations after 2-g and 4-g doses in 7 and 12 male patients, respectively. Mean peak level of serum acetaminophen after 2 g (60 min after intake) was not significantly lowered by bowel lavage. After 4 g, peak acetaminophen serum levels were significantly lower after bowel lavage (65.4% of controls, P < 0.001). Urinary concentrations of the mercapturic acid conjugate of the toxic metabolite were also significantly reduced by lavage (55% after 2 g and 45% after 4 g, P < 0.01). Activated charcoal given orally after administration of 4 g of acetaminophen had no significant effect on peak serum levels and had no additive effect on lavage. These studies suggest that rapid, complete bowel lavage with a polyethylene glycol electrolyte solution may be beneficial as an adjunct to the treatment of the acetaminophen intoxication.

Acetaminophen↗
PubMed1992

Hyperamylasemia in patients with the acquired immunodeficiency syndrome.

Marked elevations of serum amylase, unexplained despite extensive evaluation in patients with acquired immunodeficiency syndrome (AIDS), prompted this retrospective review of 85 patients to determine the prevalence of hyperamylasemia and identify any associated demographic and etiologic factors. Of 39 patients who had amylase determinations, 54% had hyperamylasemia (2/3 pancreatic, 1/3 salivary) and 31% had pancreatitis. Biliary tract disease, alcohol intake, and opportunistic infections were similar in hyperamylasemic and normoamylasemic subjects. Non-Caucasian race, intravenous drug abuse, renal dysfunction, alkaline phosphatase elevation, and pentamidine use were more prevalent in patients with hyperamylasemia (p less than 0.001, p less than 0.001, p less than 0.01, p less than 0.05, and p less than 0.05, respectively). However, by stepwise deletion multiple regression analysis, only non-Caucasian race, pentamidine use, and Mycobacterium avium-intracellulare infection were significant, independent predictors of hyperamylasemia (R2 = 0.65). Followed over time, in a historical prospective manner, case fatality rates (66.6% and 61.1%) and median survival times (101 and 84 days) were similar in the hyperamylasemic and normoamylasemic groups. We conclude that, although pancreatitis occurs frequently in AIDS, hyperamylasemia is often of salivary origin and clinical outcome is unaffected. Certain demographic factors are strongly associated with hyperamylasemia in AIDS patients, but multiple, concurrent, etiologic factors are probably operative in these patients.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Creatine kinase isoenzymes in the diagnosis of intestinal infarction.

Total creatine kinase and its isoenzymes CK-MB and CK-BB were measured in the serum of patients admitted with acute abdominal pain or signs suggestive of an intraabdominal catastrophe. Total creatine kinase was measured by automated spectrophotometry, CK-MB by chemiluminescent assay, and CK-BB by radioimmunoassay. Patients were grouped according to their final diagnosis: intestinal infarction (N = 8); all other diagnoses (N = 22); controls (N = 20). CK-BB in the infarction group (22.3 +/- 5.3 ng/ml, mean +/- SE) was significantly greater (P less than 0.01) than in the noninfarction or the control groups (11.0 +/- 0.8 ng/ml and 5.8 +/- 0.7 ng/ml, respectively). There were no differences in total creatine kinase and CK-MB in the three groups. Stepwise deletion multiple regression analysis of 26 independent regressors showed that among a cluster of six significant variables (R2 = 0.92, P less than 0.005), CK-BB greater than 20 ng/ml was the best predictor of intestinal infarction. Results of this study indicate that CK-BB isoenzyme measurement may be useful in the diagnosis of intestinal infarction in man.

Adult↗
PubMed1991

Susceptibility and resistance to poliovirus-induced paralysis of inbred mouse strains.

Susceptibility to human poliovirus-induced disease in different inbred mouse strains was analyzed after intracerebral inoculation of two mouse-adapted type 2 polioviruses, the attenuated W-2 strain and the virulent Lansing strain. In contrast to inoculation with the Lansing strain, which was invariably lethal, inoculation with the W-2 strain defined three groups of mice with high, intermediate, or low disease incidence. Those in the high-disease-incidence group, the DBA/1J and DBA/2J mice, exhibited a high level of virus replication in the spinal cord by day 2 postinfection, with no detectable neutralizing-antibody response. Mice in the intermediate- and low-incidence groups had lower levels of virus replication in the spinal cord and/or produced neutralizing antibodies. No correlation was observed between H-2 haplotype and the extent of virus replication, production of neutralizing or enzyme-linked immunosorbent assay-detectable antibodies, or T-cell-proliferative response. However, mice of the H-2k haplotype manifested a low incidence of disease.

Animals↗
PubMed1990

Serum factors in the progression of human immunodeficiency virus type 1 infection to AIDS.

We studied the prevalence of four serum factors in individuals at different stages of human immunodeficiency virus-1 (HIV-1) infection. Soluble interleukin-2 receptors (sIL-2R) were elevated in all antibody-positive groups compared with high-risk, antibody-negative controls. Paraproteins, usually of the IgG-kappa isotype, were found in the sera of a significant number of HIV-1-infected individuals as were antibodies to lymphocytes (ALAs). Serum factors that inhibit proliferation of peripheral blood mononuclear cells from healthy donors appear late in the course of infection and were associated with increasing clinical severity. Measurement of these factors may prove to be useful in defining the stages of infection and in predicting the appearance or exacerbation of symptoms. They may also play a role in the development of the HIV-1-induced immune defects that lead to the expression of clinical acquired immunodeficiency syndrome.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Duplex ultrasound evaluation of normal native kidneys and native kidneys with urinary tract obstruction.

The average resistive indices of 15 native kidneys from 8 patients with no known renal dysfunction were determined with the Doppler waveform obtained from the interlobar arteries. The average resistive index for this group was .58; the highest value was .66. The interlobar arteries of four native kidneys with urinary tract obstruction as well as those of the contralateral unobstructed kidneys were evaluated by Duplex ultrasound. Unilateral urinary tract obstruction was due to a congenital ureteropelvic junction obstruction in one patient or an acutely obstructing calculus at the ureterovesical junction in three patients. The average resistive index of the four obstructed kidneys was .75 and the lowest value was .71. The average resistive index of the four contralateral unobstructed kidneys in these patients and the 15 kidneys from patients with no known renal abnormalities was .58, which was significantly different from the value for the obstructed kidneys (p less than .005). The resistive index from the interlobar arteries of normal native kidneys is reproducible as previously reported in renal transplants. Pathologic renal processes, such as urinary tract obstruction, may be characterized by abnormally high resistive indices.

Adolescent↗
PubMed1989

Quantitative evaluation of the skin and accessory appendages in vulvar carcinoma in situ.

Fifty cases of vulvar carcinoma in situ comprising over 1000 histologic sections were studied. Each case was evaluated to determine the thickness of the neoplastic epidermis and the depth of involved skin appendages. Two precise techniques were used to perform the microscopic measurements. The areas most frequently afflicted with neoplasia were: one or both labia (45%), interlabial folds (27%), perineum-fourchette (15%), and perianal skin (10%). Multicentric disease was observed in 68% of the cases. The epidermal thickness ranged between 0.35-1.66 mm. The mean depth (+/- SD) of the epidermis was 0.93 +/- 0.37 mm. Eighteen of the 50 patients demonstrated involvement of the skin appendages to a mean depth of 1.53 +/- 0.77 mm, suggesting that laser vaporization to a depth of 2.5 mm will, with the anticipated additional thermal necrosis, eliminate appendages involved with carcinoma in situ in 95% of instances. The most common sites of skin appendage involvement were the labia majora or minora and the interlabial folds.

Adult↗
PubMed1986

Random versus predictable risks of mortality after thoracotomy for lung cancer.

Over a period of 12 1/2 years, 476 patients underwent thoracotomy for lung cancer at two affiliated hospitals. Hospital mortality for all patients was 5.25% and for those undergoing pulmonary resection, 5.67%. Hospital mortality is more indicative of true risk than is the 30 day mortality figure, which we regard as arbitrary and misleadingly low. Thirty-seven preoperative risk factors were analyzed for their effects on both morbidity and mortality, and 12 classes of postoperative complications were analyzed for their effect on mortality. All preoperative risk factors together accounted only for 12% of the risk of mortality (R2 by multiple regression analysis). Only three of these factors bore a significant association with mortality: patient age 60 years or over (p less than 0.05), need for pneumonectomy (p less than 0.005), and premature ventricular contractions on the admission electrocardiogram (p less than 0.05). All the listed postoperative complications together accounted for only 28% of the risk of mortality. Of these complications, four showed a significant association with postoperative death: infectious complications (pneumonia and empyema) and cardiovascular accidents (pulmonary embolism and myocardial infarction). In both analyses, the remainder of the risk of death must be attributed either to factors not considered or to purely random factors. It follows that much the greater part of the risk of death from surgical treatment of lung cancer could not be predicted from the preoperative status of the patients.

Aged↗
PubMed1985

Cell volumes of lymphoblasts in patients with acute lymphocytic leukaemia.

Cell volumes of lymphoblasts from 75 cases of acute lymphocytic leukaemia (ALL) and lymphocytes from 33 normal individuals were determined using a Coulter Counter Model H4 Channelyzer. The average mean cell volume (MCV) and the model volume (MV) of lymphoblasts were larger than the MCV and MV of normal lymphocytes (P less than 0.01). In addition, the cell volumes of lymphoblasts from patients with ALL were more heterogeneous than normal lymphocytes. When the volumes of lymphoblasts were compared to the FAB classification, lymphoblasts from cases of L3 were larger than those from L2 and the latter were larger than lymphoblasts from the L1 subtype. When the volumes of lymphoblasts were compared to an immunological classification, lymphoblasts from cases of B cell ALL were larger than those from non-B, non-T and T cell ALL. The volume of lymphoblasts, however, showed no significant predictive value in the determination of complete remission, duration of first remission, or survival.

Adolescent↗
PubMed1984

Dependent rubor as a predictor of limb risk in patients with claudication.

We followed up 133 patients with claudication to determine the prognostic value of dependent rubor. Life tables analysis was used, with a threatened limb as the endpoint. A threatened limb was defined as the development of ischemic rest pain, skin ulceration, or gangrene. At four years, the rubor group had a limb-threat incidence of 25%, compared with only 9% in the nonrubor group. While not indicative of imminent limb loss, the presence of dependent rubor defines patients whose limb risk is greater than in those with claudication alone.

Adult↗
PubMed1983

Prognostic significance of the revised French-American-British classification for acute lymphocytic leukaemia.

The French-American-British (FAB) classification of acute lymphocytic leukaemia (ALL) has recently been modified to improve its reproducibility. We therefore thought it beneficial to test the utility of this modified classification in the prognosis of children with ALL. Eighty-eight patients of less than 18 years of age with ALL were subtyped according to the modified FAB classification by two independent observers. The initial concordance was 86%. Seventy per cent of the patients were subtyped as L1, 27% as L2 and 3% as L3. Patients with L3 subtype were not analysed further. No significant differences were observed between L1 and L2 subtypes when the distribution of other prognostic factors were examined. No differences were observed between L1 and L2 subtypes in the achievement of complete remission. Patients with L1 morphology demonstrated no significant increased duration of first remission or survival when compared to patients with L2 morphology. We conclude that the morphology of lymphoblasts may not be an independent prognostic variable in patients with ALL.

Bone Marrow↗
PubMed1982

Senile macular degeneration: a preliminary study.

Fifty patients with senile macular degeneration and 50 age-sex-matched control patients were studied retrospectively by multiple regression analysis. The patients with senile macular degeneration more often had hyperopia by a 2.4:1 ratio and when receiving treatment for hypertension, in a 6.1:1 ratio. The significance of these findings needs prospective study.

Age Factors↗
PubMed1981

The relation between oral contraceptive use and subsequent development of hyperprolactinemia.

Serum prolactin levels were determined in 123 patients who presented with menstrual irregularities and/or infertility of more than 1 year's duration. Sixty-three patients had hyperprolactinemia with serum prolactin levels of 26 to 843 ng/ml (normal 5 to 22 ng/ml); 44.4% of this group of patients received oral contraceptive for a period of 2 months to 7 years. Sixty patients were normoprolactinemic, with serum prolactin levels of 3 to 22 ng/ml; 33.4% of this group received oral contraceptives for a period of 6 months to 7 years. The age of presentation, onset of symptoms, age at which they started on oral contraceptives, and duration of use were tabulated. The data were analyzed using chi 2 test corrected for continuity. There was no significant difference in age at the time of evaluation between oral contraceptive users and nonusers with hyperprolactinemia. The relative odds developing hyperprolactinemia were 2.64 times greater among women who has used oral contraceptives for more than 1 year and 6.25 times greater if this use started before the age of 25.

Adolescent↗
PubMed1979

Longitudinal study of career choices of a SUNY-Upstate cohort of medical students.

A SUNY-Upstate cohort was observed during the four-year matriculation (1974--1978) of the students for changes in their career choices. Medical school exposure seemed to increase students' interest in all major specialties, with the exception of family practice for which there was an overall 3% decrease. Internship and residency appointments accepted indicated that 75% entered primary care specialties, 8% more than the national average for 1978.

Adult↗
PubMed1978

Retinal detachment in the second eye.

Bilateral retinal detachment (RD) occurred in 13% of 737 patients, with an interval between detachments of up to 30 years. Bilateral RD was more common in male patients and in those having more than 3 diopters of myopia. Detachment in the second eye was caused by retinal breaks in previously observed degeneration in 43% and in unsuspected diseased retina 57%. A significant number of patients with bilateral RD had multiple breaks. Aphakic RD occurred in bilateral RD and in unilateral RD patients at a comparable frequency; 28% of bilateral (mean duration, four years) and 35% of unilateral aphakic RDs occurred within one year of cataract surgery. Symptoms from retinal breaks were not reliable prognostic factors; only 39% of patients had warning before RD. Patients with bilateral RD had more reoperations with fewer successes, factors suggesting greater severity than unilateral RD.

Adolescent↗