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Biomedical subjects

S Munn

Publications and source records attributed to S Munn.

31 records · Page 2Linked to original sources
PubMed1992

Polymerase chain reaction in detection of CMV DNA in renal allograft recipients.

This study investigates the use of polymerase chain reaction (PCR) in comparison with viral culture and serology for monitoring of cytomegalovirus (CMV) infection in 21 consecutive renal allograft recipients treated with a quadruple immunosuppression protocol. In addition, an attempt is made to explore the significance of quantitation of CMV signals obtained from peripheral blood leucocytes. CMV infection developed in 16 patients with seven of these patients having organ involvement. All of these 16 patients had a fourfold rise in antibody titres as well as positive identification of CMV DNA in peripheral blood leucocytes by PCR. Blood viral cultures were negative in two of these patients. All five patients who remained PCR negative also remained culture negative with no antibody change. PCR detected CMV infection on average 15 days and 20 days earlier than viral culture and serology respectively. All except one of the patients with CMV organ involvement had an initial peak of CMV DNA followed by prolonged carriage of detectable CMV. The majority of patients with fever only or asymptomatic CMV infection had a transient peak of CMV DNA. A high incidence of CMV disease with organ involvement occurred in seronegative recipients of kidneys from seropositive donors (3/5) and in seropositive recipients of kidneys from seronegative donors (3/7). OKT3 was associated with a higher incidence of CMV organ involvement compared to Antilymphocytic globulin (3/5 v 4/16) but there was a higher incidence of CMV mismatched patients in the OKT3 treated group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Quadruple immunosuppression in renal allografts--the Auckland experience.

Recipients of live related and first cadaveric renal allografts were retrospectively reviewed before and after institution of a standardized regimen incorporating greater immunosuppression, (by the addition of antilymphocyte preparations). The two review groups were comparable with 11 live related and 27 first cadaver grafts in each. Despite a small advantage in terms of graft survival and diminished rejection, this was at the expense of septic morbidity. The implications of this are discussed.

Antilymphocyte Serum↗
PubMed1991

Hepatic metastasis from a meningeal haemangiopericytoma.

Intracranial tumours rarely metastasize outside the central nervous system (CNS). Meningeal haemangiopericytoma is an exception. We report the case of a 41-year-old female who initially presented in 1984 with what was thought to be a posterior fossa meningioma which was excised, as were two subsequent recurrences in 1987 and 1988. In October 1990 she represented, having discovered a mass in her abdomen. This proved to be a metastatic haemangiopericytoma in the liver which had similar histology to the original intracranial tumour. This metastasis, and another found at operation, have been excised, and at the time of this report, she is alive and well seven months after surgery without any evidence of other metastasis or recurrence. Hemangiopericytomas are unusual in their propensity to metastasize outside the CNS and successful resection of hepatic metastases from this tumour has not been reported before.

Adult↗
PubMed1989

Assessing dermatitis in epidemiologic studies: occupational skin disease among California grape and tomato harvesters.

We conducted a cross-sectional investigation to determine whether table grape harvesters, who have significant cutaneous contact with crop-associated materials that may cause skin disease, are more likely to develop dermatitis than are a control group of tomato workers performing mechanical harvesting with minimal cutaneous contact with crop-associated substances. A secondary aim was to develop methods for studying skin disease in farm workers, including a standard questionnaire and physical examination. California table grape workers (n = 183) and tomato workers (n = 43) completed an interviewer-administered questionnaire and waist-up physical examination at their work site during harvest operations. On physical examination, pustular eruptions such as acne and folliculitis were present in 30% of subjects, and eczematous rashes were noted in 10% of subjects. Irritant or allergic contact dermatitis was diagnosed in 2% of subjects. No significant differences in prevalence for these skin conditions were observed between the two groups of workers. In contrast to the physical examination results, grape workers were more likely than tomato workers to report a rash occurring in the previous 3 months (52% vs. 19%, p less than 0.001). Explanations for this discrepancy are discussed. The sensitivity of the questionnaire for current skin conditions was 31%, and the specificity was 94%. Improved sensitivity was seen for eczematous skin conditions (55%). We conclude that questionnaires provide an efficient means of assessing subject characteristics, but may have limited sensitivity for some dermatologic outcomes.

Agricultural Workers' Diseases↗
PubMed1980

Plasma and urine concentrations of acebutolol and its acetyl metabolite in patients with renal functional impairment.

This study was undertaken to examine the elimination of orally administered acebutolol and its major acetyl metabolite in four healthy controls and seven patients with varying degrees of renal functional impairment. Analysis of acebutolol and its metabolites was undertaken using a high performance liquid chromatographic method. Plasma concentrations of acebutolol and the acetyl metabolite were greater in patients with renal functional impairment than in controls. The elimination of acebutolol did not appear to be influenced by impaired renal function. However the elimination of the acetyl metabolite decreased as renal function diminished. Acebutolol has a major non-renal route of elimination, but the acetyl metabolite (also a beta-adrenoreceptor blocking drug) is primarily excreted by the kidney and may accumulate in renal failure.

Acebutolol↗
PubMed1979

Acebutolol in the treatment of patients with hypertension and renal functional impairment.

Eleven patients with hypertension and varying degrees of stable renal functional impairment were treated with the beta adrenoreceptor blocking drug, acebutolol (Sectral). Parameters of renal, cardiovascular and respiratory function were measured immediately prior to treatment and again after four and 12 weeks. In five patients the blood pressure was well controlled throughout the 12-week period on 400mg of acebutolol each morning, in three the blood pressure was satisfactory after four weeks treatment with 400mg each morning but control had been lost by 12 weeks, while in the remaining three patients 800mg each morning was ineffective. There was no significant change in the mean glomerular filtration rate of the 11 patients but in two of these patients with severe, but stable, chronic renal failure the introduction of acebutolol was associated with a decline in renal function and the onset of uraemic symptoms. One of these patients showed an improvement when the acebutolol was discontinued but the other required regular dialysis treatment. Beta adrenoreceptor blockers should be used cautiously in severe renal failure.

Acebutolol↗
PubMedDate not supplied

A comparative study of pesticide exposures in adults and youth migrant field workers.

To study possible differences between pesticide exposures received by youth (subjects less than 16 yr of age) and adults (subjects greater than 16 yr of age), human exposure samples (gloves and urine) were collected during the onion harvesting season of 1982. Environmental samples (soil, foliage, and field air) were also collected during the study period. All samples were analyzed for toxaphene, ethyl parathion, methyl parathion, and malathion. Environmental samples were found to have very low levels of these insecticides. The youth cohort had lower residue values than did the adults, and these differences were statistically significant (P less than 05) for toxaphene residues on gloves on each sampling day, and for ethyl parathion residues on gloves on one sampling day only. Detectable levels of dialkyl phosphates were found in only 2 of 44 urine samples.

Adolescent↗
PubMedDate not supplied

Fluticasone propionate in the treatment of inflammatory dermatoses.

Fluticasone propionate is a new, topically active glucocorticoid which shows high specificity for the glucocorticoid receptor. After topical application systemic absorption is low. The small amount that is absorbed is rapidly and completely inactivated by esterase-catalysed hydrolysis in the liver. Even when applied in large doses under occlusion, there is no evidence of hypothalamic/pituitary/adrenal (HPA) axis suppression. Studies on skin thinning have shown no significant effect on skin thickness after once-daily application of fluticasone propionate 0.05% cream for 8 weeks. This cream has been shown to be highly effective in the treatment of eczema, and once-daily application shows no significant difference in efficacy compared with twice-daily treatment. Limited studies using 0.005% ointment in moderate to severe psoriasis showed similar efficacy to 0.1% betamethasone-17-valerate ointment. Fluticasone propionate 0.05% thus represents a major advance in topical corticosteroids. It has a high safety profile and the cream formulation is effective in a single daily application.

Administration, Topical↗