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Biomedical subjects

S Miles

Publications and source records attributed to S Miles.

At least 19 recordsLinked to original sources
PubMed1990

Recombinant human erythropoietin for patients with AIDS treated with zidovudine.

Bone marrow suppression and anemia are frequent side effects of treatment of the acquired immunodeficiency syndrome (AIDS) with zidovudine (formerly azidothymidine [AZT]). We conducted a randomized, double-blind, placebo-controlled clinical trial of recombinant human erythropoietin (100 U per kilogram of body weight thrice weekly by intravenous bolus) in 63 patients with AIDS treated with zidovudine (29 in the erythropoietin group and 34 in the placebo group). Reductions in the number of units of red cells transfused and the number of patients given transfusions per month became apparent in the second and third months of the trial. The reductions were observed in patients with endogenous erythropoietin levels less than or equal to 500 IU per liter at base line, but not in patients whose levels were greater than 500 IU per liter at the beginning of the study. Although the hematocrit and hemoglobin level were not used as the primary criteria of efficacy because the patients received transfusions when their physicians decided that they needed them, a significantly higher rate of increase in the hematocrit was observed in the patients treated with recombinant human erythropoietin whose levels of endogenous erythropoietin were less than or equal to 500 IU per liter (0.00353 points per week) than in the patients given placebo (0.00116 points per week). This effect was not seen in patients with higher levels of endogenous erythropoietin. Serious side effects did not occur more often in the group treated with erythropoietin than in the placebo group. We conclude that recombinant human erythropoietin may be useful in patients with AIDS treated with zidovudine, although the indicators for its use remain to be clarified.

Acquired Immunodeficiency Syndrome↗
PubMed1990

High levels of unintegrated HIV-1 DNA in brain tissue of AIDS dementia patients.

In the host cell, retroviral DNAs exist in three main forms: unintegrated linear, unintegrated circular, and integrated (the provirus). High levels of unintegrated forms of retroviral DNA often correlate with superinfection and accompanying cytopathic effects, as, for example, in the case of feline acquired immunodeficiency. In culture, HIV-1 infection also results in high levels of unintegrated viral DNA although direct correlations with cytopathicity have not been made. The low frequency of HIV-1-infected cells in patients has made it difficult to determine the structure of the viral DNA in fresh tissue samples from AIDS patients by standard methods such as Southern hybridization. The PCR technique however, which allows the detection of viral DNA at levels far below that possible by other hybridization methods is, in its conventional form, of limited use for quantitative analysis. To study the amount and form of HIV-1 DNA in primary tissue of AIDS patients we have therefore modified the PCR method. Our results indicate that each of the three species of viral DNA are detectable in blood and brain of AIDS patients, and that in autopsy samples from patients with HIV encephalitis there is a considerably higher proportion of unintegrated viral DNA.

AIDS Dementia Complex↗
PubMed1990

Anaesthesia of the tympanic membrane: comparison of EMLA cream and iontophoresis.

The authors undertook a study to evaluate the effectiveness of two methods for providing local anaesthesia of the tympanic membrane for the purpose of inserting a grommet. The methods compared were the application of EMLA (Eutectic Mixture of Local Anaesthetics) cream and the use of iontophoresis. Both methods seem to provide a satisfactory level of local anaesthesia. It was felt that where multiple procedures were to be performed in one outpatient session the use of EMLA cream might be a more efficient technique.

Adult↗
PubMed1987

Dual infection of the central nervous system by AIDS viruses with distinct cellular tropisms.

Human immunodeficiency virus (HIV) is the causative agent of the acquired immune deficiency syndrome (AIDS). A large number of AIDS patients show evidence of neurologic involvement, known as AIDS-related subacute encephalopathy, which has been correlated with the presence of HIV in the brain. In this study, two genetically distinct but related viruses were isolated from one patient from two different sources in the central nervous system: brain tissue and cerebrospinal fluid. Both viruses were found to replicate in peripheral blood lymphocytes, but only virus from brain tissue will efficiently infect macrophage/monocytes. The viruses also differ in their ability to infect a brain glioma explant culture. This infection of the brain-derived cells in vitro is generally nonproductive, and appears to be some form of persistent or latent infection. These results indicate that genetic variation of HIV in vivo may result in altered cell tropisms and possibly implicate strains of HIV with glial cell tropism in the pathogenesis of some neurologic disorders of AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1987

A latex agglutination assay for D dimer: evaluation and application to the diagnosis of thrombotic disease.

Although latex agglutination assays have been used for some years to diagnose thrombotic disorders, only recently has it been possible to measure specifically the products of fibrin breakdown in the presence of fibrinogen degradation products, by using monoclonal antibodies. We have evaluated a preparation of latex particles coupled to the monoclonal antibody DD-3B6/22, which is specific for cross-linked fibrin degradation products (XDP) and allows accurate discrimination between normal and pathological conditions. Of samples from 515 apparently healthy volunteers, 97.7% failed to agglutinate the latex; the normal reference interval for XDP determined by enzyme immunoassay was less than 78-320 micrograms/L. The use of different anticoagulants with or without the addition of a protease inhibitor had no significant effects on the results of the latex assay. The latex preparation provides a useful, rapid diagnostic tool for assaying small numbers of samples or as an emergency test.

Antibodies, Monoclonal↗
PubMed1983

Child's play.

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Child Day Care Centers↗
PubMed1979

How not to drown!

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Accident Prevention↗
PubMed1978

Distal splenorenal shunt in children.

The distal splenorenal end-to-side anastomosis (Warren shunt) decompresses esophageal varices while maintaining high portal hypertension and avoiding reduction of portal venous blood inflow to the liver. The Warren shunt was performed in seven consecutive patients with portal hypertension, including post-necrotic cirrhosis, portal thrombosis, and schistosomiasis, all with recurrent esophageal bleeding. Five shunts remained patent and two thrombosed. There was no mortality. If long-term follow-up evaluations indicate its effectiveness in preventing esophageal hemorrhage, the distal selective splenorenal shunt would be the more physiologic and safer procedure in children with portal hypertension.

Child↗
PubMed1977

Doppler ultrasound in the diagnosis of the popliteal artery entrapment syndrome.

Doppler pulse recordings in a patient with asymptomatic popliteal entrapment were compared with those in 25 normal subjects. A drop in pulse amplitude and ankle systolic pressure produced by forcible leg extension and active foot plantar flexion distinguished the patient with the anomaly from the controls, in whom no change was noted during these manoeuvres. This simple, non-invasive test thus diagnosed a potentially limb-threatening congenital abnormality in an asymptomatic patient with equivocal arteriographic findings.

Adolescent↗