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Biomedical subjects

R Pollard

Publications and source records attributed to R Pollard.

At least 37 records · Page 2Linked to original sources
PubMed1994

Medical liability claims and lawsuits filed against the University of Texas System involving adult psychiatric patients.

A survey was conducted to investigate medical liability claims filed against the University of Texas System (the U.T. System), physicians, and/or institutions concerning care of adult psychiatric patients. There were 34 such claims filed between 1978 and 1991 that had closed by December 1991. In many of these cases, medical record documentation was determined to be inadequate. Of the 34 claims filed, only seven were settled on behalf of U.T. personnel or U.T. institutions. Of these seven settlements, the mean monetary amount paid per case on behalf of U.T. System and non-U.T. System parties was $98,678.57. The two categories with the largest number of claims were 1) cases involving suicides, and 2) cases involving adverse reactions to medication. The largest award was $350,000, paid on behalf of U.T. physicians, a private physician, and non-U.T. institutions for alleged negligent failure to diagnose Cushing's disease. Of this amount, only $150,000 was paid on behalf of U.T. physicians. Risk management strategies should be implemented to address areas of liability in psychiatry residency programs.

Adult↗
PubMed1993

Malpractice litigation against child and adolescent psychiatry residency programs, 1981-1991.

A national survey was conducted to investigate malpractice litigation at United States child and adolescent psychiatry residency programs between 1981 and 1991. Fourteen percent of the directors of child and adolescent psychiatry reported at least one malpractice claim during this period. The highest percentage of lawsuits reported was in the northeast. Suicide and sexual abuse of latency age patients by other patients accounted for the most litigation. The mean monetary award was $167,000, and the largest award was $500,000 for discharge of a patient who killed his mother. There has been an increase in malpractice litigation during the past 10 years. Risk management strategies should be implemented to address areas of liability in child and adolescent psychiatry training programs.

Adolescent↗
PubMed1992

X-irradiation enhances in vitro human immunodeficiency virus replication correlation with cellular levels of cAMP.

Total body x-irradiation has been utilized in the treatment of several human diseases, including leukemia, where it is followed by bone marrow transplantation, and in some autoimmune disorders. Recently, it was reported that total body irradiation appeared useful in the treatment of Friend leukemia virus infection in mice. In this report, the effect of x-irradiation on the replication of human immunodeficiency virus (HIV) in vitro in CD4+ cells was examined. MT-4 cells and HIV strain human T cell lymphotropic virus Type IIIB were used to conduct this study. Infected MT-4 cells were irradiated at the time of infection or following infection with x-ray doses of 25-300 cGy. Doses of 50, 150, and 300 cGy enhanced HIV replication by 1.6-, 2-, and 4.8-fold, respectively. Irradiating the cells prior to infection also resulted in similar enhancement of HIV replication. This phenomenon was also observed with wild-type HIV isolates grown in peripheral blood mononuclear and in HIV chronically infected cells. In addition, the enhancement was associated with a radiation-induced increase in intracellular levels of cAMP. The use of the cAMP-dependent protein kinase A inhibitor, H-8, inhibited HIV replication by 65%. These data suggest that in vitro exposure to low doses of x-ray enhances HIV replication partially via a cAMP-dependent pathway.

CD4-Positive T-Lymphocytes↗
PubMed1991

Human immunodeficiency virus infection: association with altered intracellular levels of cAMP and cGMP in MT-4 cells.

T-cells from human immunodeficiency virus (HIV)-infected patients are characterized by a number of qualitative deficiencies including defective T-cell activation. The latter has previously been shown to be normally regulated by cAMP. In this study the patterns of cAMP and cGMP induction in MT-4 cells following HIV infection were investigated. The MT-4 cells were infected with HIV (strain IIIb) and at selected times postinfection (p.i.), culture supernatants were tested for HIV replication by reverse transcriptase activity or HIV P24 Ag. The cells were also examined for their intracellular levels of cAMP and cGMP by radioimmunoassay. HIV infection was associated with an increase in intracellular levels of cAMP and cGMP. The cAMP was increased 40-fold by Day 8 and cGMP 4-fold by Day 4 Pl. The increase in intracellular levels of the cyclic nucleotides (CN) were virus specific, dependent on virus dosage, genetically conserved among the two fresh patient isolates tested, and were abolished by uv inactivation. An increase in cAMP and cGMP was also observed in other cell lines infected with HIV. The sustained elevation in CN level observed could certainly influence cell activation and HIV replication and may potentially have clinical relevance.

Cell Line↗
PubMed1991

In vivo administration of tumor necrosis factor-alpha is associated with antiviral activity in human peripheral mononuclear cells.

Tumor necrosis factor-alpha (TNF-alpha) has a spectrum of biologic effects and has been shown to exert antiviral effects in fibroblasts in vitro. The in vivo administration of TNF-alpha (40-160 micrograms/m2 intravenously over 2 hr) and its effects on vesicular stomatitis virus (VSV) replication in peripheral blood mononuclear cells (PBMC) from patients with malignancy was investigated. Blood was obtained before, during, and after infusion. The PBMC were separated and infected with VSV at a multiplicity of infection of 0.005 plaque-forming units/cell and virus yields were determined 72 h later. The TNF-alpha inhibited VSV yields by as much as 99% in a dose-dependent manner with the inhibition initially observed during the first hour of infusion. Despite a rapid reduction in TNF-alpha serum levels, the higher doses still produced antiviral effects 4 hr after the infusion. Sera obtained at identical times had no interferon activity. Human gamma-interferon (25 micrograms/ml) added in vitro augmented the TNF-alpha-induced inhibitory activity in both magnitude and duration. Percentages of lymphocytes and monocytes in peripheral blood were reduced at 4 hr after TNF-alpha administration and the monocyte to lymphocyte ratio was diminished and temporally coincided with the loss of TNF-induced antiviral state. These data suggest that the in vivo administration of TNF has a direct inhibitory activity on VSV replication in human peripheral blood mononuclear cells that was enhanceable by gamma-interferon and possibly monocyte mediated.

Cells, Cultured↗
PubMed1987

Recombinant alfa interferon in renal cell carcinoma: a randomized trial of two routes of administration.

Ninety-seven patients with recurrent or metastatic renal cell carcinoma were randomized to receive recombinant interferon (IFN) alfa-2b (Intron A; Schering-Plough, Kenilworth, NJ) by either the subcutaneous (SC) or intravenous (IV) route. The SC dosage was 2 X 10(6) IU/m2 three times weekly, and the IV dose 30 X 10(6) IU/m2 for five consecutive days every 3 weeks. Dose escalation to a maximum of 10 X 10(6) IU/m2 SC and 50 X 10(6) IU/m2 IV was allowed for patients with minimal or absent toxicity. Five of 51 of the SC-treated patients (10%) and three of 46 of the IV-treated patients (7%) had a partial response (PR) or complete response (CR). Patients with prior nephrectomy, no prior treatment, and lack of bone metastases were most likely to respond, and a retrospective analysis of this subgroup revealed a 23% response rate. Achievement of response took from 3 weeks to 11 months, while response duration lasted from 3 to 31+ months. All responders had prior nephrectomy; six of eight had no prior chemotherapy or hormonal therapy; five had lung metastases, and none had bone metastases. Regardless of route, almost all patients developed a flu-like syndrome; however, grade 3 or greater toxicity was much more common for IV-treated patients. This trial demonstrates modest, but definite antitumor activity for recombinant interferon in advanced renal cell carcinoma. SC administration with lower dose and toxicity is as effective as treatment administered IV.

Adult↗
PubMed1986

Home advantage in soccer: a retrospective analysis.

The existence of home advantage has been established for all major professional team sports in England and North America. The advantage was found to be greatest in soccer, with the home team currently obtaining about 64% of all points gained in the English Football League. Home advantage has changed very little since the formation of the League in 1888 and there are only small variations between the four Divisions of the League. The advantage is less marked in local derbies, in the FA Cup and in nonprofessional competitions. It is greater in the European Cup and increases as the stages of the competition progress. The allocation of three points, instead of two, for a win in the Football League has not changed home advantage, but its effect has been greatly reduced in the GM Vauxhall Conference where an away win gains more points than a home win. The statistical evidence suggests that crowd support and travel fatigue contribute less to home advantage in soccer than do the less easily quantifiable benefits of familiarity with conditions when playing at home. Further possible explanations for the advantage are discussed in the light of findings in other sports.

Competitive Behavior↗
PubMed1986

Human cytomegalovirus: development and progression of nuclear inclusions by primary clinical isolates and laboratory-adapted strains.

The morphogenesis of cytomegalovirus (CMV) nuclear inclusions (NIs) was investigated using unadapted clinical isolates and adapted laboratory strains. Both adapted and unadapted strains of CMVs induced NIs whose morphologic appearance was similar in human fibroblastic cells. Early NIs appeared as ring-like structures composed of dense granular and fibrillar material, while late NIs appeared to consist of multiple electron-lucent areas containing coarse granules and bounded by electron-dense fibrillar material (cellulae). Capsids and nucleocapsids were associated primarily with the electron-dense fibrillar material; however, developing nucleocapsids were most often observed at the interface of the electron-dense and -lucent areas. Although there was some variation in the rate of development and maturation of the NIs with the intensity of infection, all CMVs examined produced late NIs with similar organizational patterns consisting of cellulae. Substitution of human fibroblastic cells derived from various tissues as cellular substrate did not appreciably affect the results. Thus, the unique organization of the CMV late NI, consisting of multiple cellulae, appears to be an intrinsic feature of CMV replication since it seems to be independent of the extent of laboratory adaptation, the virus strain, the intensity of infection, or the cell type.

Cell Nucleus↗
PubMed1985

Twinning rates in Fiji.

The incidence of twins in Fiji has been investigated using birth registrations for the years 1976-81. The twinning rate for the indigenous Fijians is found to be 9.4 per 1000 live maternities, (based on 407 sets of twins), and for Indians, descendants of immigrants who began to arrive in Fiji in 1879, 6.2 per 1000 (based on 350 twins). After standardizing for maternal age, the difference between the two ethnic groups decreases slightly, but the Fijian rate remains almost 40% above that of the Indians. This difference is consistent over the 6 years of the study, is found for mothers of all age groups under 40 and at all levels of parity. An analysis of hospital records in Fiji produces higher twinning rates for both Fijians and Indians, but a similar difference is found between the two ethnic groups. Although the twinning rate for Fijians is lower than that reported for other Melanesian people, it is well above reliable rates found for Mongoloid races from whom the Fijian is descended. The sparse information on twinning rates among Polynesians suggests rates not dissimilar from Melanesians, so that no support for the hypothesis of low twinning rates in the Pacific is evident. The twinning rate for Indians in Fiji is lower than rates reported from the Indian subcontinent.

Adult↗
PubMed1984

Nutritional status, body size and severity of diarrhoea associated with rotavirus or enterotoxigenic Escherichia coli.

Children with severe malnutrition have an increased risk of death from diarrhoea. To determine if the clinical manifestations of specific types of diarrhoea differed according to the nutritional status or size (weight and length) of the patient, we studied children with acute diarrhoea associated with rotavirus or enterotoxigenic Escherichia coli. In this study we found that a child's body size, which was determined by his age and nutritional status, was a significant predictor of his rate of stool output per kilogram of body weight. Thus, children who are small because of young age and/or malnutrition appear to lose a greater proportion of their total fluid volume during diarrhoea and might be expected to have a higher frequency of severe dehydration and death, if untreated.

Bangladesh↗
PubMed1983

Combination chemotherapy with mitomycin C, adriamycin, and cyclophosphamide (MAC) in stage III and IV ovarian cancer.

Twenty-nine patients with stages III and IV epithelial carcinomas of the ovary were treated with a combination of mitomycin-C, adriamycin, and cyclophosphamide (MAC). A 62% response rate (CR + PR) was observed in previously untreated patients with a median survival of responding patients of 100+ weeks, compared to 29 weeks for nonresponding patients (p less than 0.001). Toxicity was acceptable with moderate to severe but manageable myelosuppression. Prospective, randomized trials comparing this drug combination to others with demonstrated efficacy are indicated.

Cyclophosphamide↗
PubMed1982

Antibody to cytomegalovirus in Malta.

Antibody to cytomegalovirus (CMV) was sought in sera from Malta using immunofluorescence. Seven per cent of the infants, 36% of the school children, increasing to 100% of the adults aged over 40 years were found to have antibody. Most infection occurred in pre-school children and adults over 25 years of age. This pattern of antibody acquisition appears different from that described for other countries.

Adolescent↗
PubMed1981

A complete response in metastatic malignant thymoma to cis-platinum, doxorubicin and cyclophosphamide: a case report.

Systemic chemotherapy as a mode of therapy in metastatic malignant thymoma has never been systematically evaluated. Chemotherapeutic agents, including doxorubicin, cyclophosphamide, cis-platinum, nitrogen mustard, prednisone or combination of agents like MOPP have produced tumor remission. A case report of complete remission of malignant thymoma in which the combination of cyclophosphamide, doxorubicin and cis-platinum (CAP) was used is reported.

Cisplatin↗
PubMed1980

Vigorous exercise in leisure-time: protection against coronary heart disease.

1138 first clinical episodes of coronary heart disease (CHD) in 17 944 middle-aged male office workers in the Civil Service are reported. Men who engaged in vigorous sports, keep-fit, and the like during an initial survey in 1968-70 had an incidence of CHD in the next 8 1/2 years somewhat less than half that of their colleagues who recorded no vigorous exercise. The CHD rates of men who took such vigorous exercise were lower in both fatal and non-fatal clinical manifestations, though more so in fatal; throughout the age-range studied, though more striking in later middle age and early old age; and in all other sub-groups examined, including men with a family history of CHD, the obese, the short of stature, cigarette smokers, and men with severe hypertension and subclinical angina, as well as in those in favourable situations for CHD or neutral. The generality of the advantage suggests that vigorous exercise is a natural defence of the body, with a protective effect on the ageing heart against ischaemia and its consequences.

Adult↗
PubMed1980

T-cell lymphomas of large cell type. A variety of malignant lymphomas: "histiocytic" and mixed lymphocytic-"histiocytic".

Clinical and morphologic features of seven T-cell lymphomas of the large cell type are described. The tumors were grouped into those with irregular (3 cases) and those with round and regular nuclei (4 cases). In both groups, variation in cell size, numerous histiocytes and vessels, and many mitoses were distinguishing features. In only 1 case in the round and regular nucleus group was there relatively little variation in cell size and a paucity of histiocytes. Abundant polyribosomes, long strands of rough endoplasmic reticulum, and lysosomal granules were prominent electron microscopic features in both groups of tumors. The clinical presentations and courses varied considerably, especially in patients with tumors of the round nucleus type. One patient presented initially with chronic lymphocytic leukemia, 1 with Lennert's lymphoma, another with bone marrow infiltration, and a fourth with subcutaneous tumors. Two patients with the round nucleus type are still alive one and a half and two years after the original diagnosis. Two patients died two years after the onset of symptoms. Each of the 3 patients with tumors of the irregular nucleus type had a rapid clinical course and died within ten months.

Aged↗