Prolactin-dependent rat mammary cancer: a model for man?
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Adenocarcinoma↗
Biomedical subjects
T Butler
Publications and source records attributed to T Butler.
The black death past and present. 1. Plague in the 1980s.
This paper considers firstly the epidemiology of plague in the 1980s. The largest number of cases occurred in Tanzania. Most cases were in children and young adults; in the USA the male:female ratio was about 2:1. Plague had a seasonal distribution. Almost all cases arose from bites of infected rodent fleas, and Rattus spp. were the most important reservoir hosts. Virulence is linked with the presence of a 45 MDa plasmid. The predominant clinical form of plague is bubonic, followed by septicaemic, meningitic and pneumonic. For treatment, streptomycin is the antibiotic of choice, with tetracycline and chloramphenicol as alternatives. Treatment given on the first 1-2 d of illness is highly effective, and resistance is not a problem. Rodent control, insecticide application, and avoidance of contact with rodents and their fleas remain the prime means of control. Plague vaccine is not in general use.
Animals↗
Depletion of hepatic glycogen in the hypoglycaemia of fatal childhood diarrhoeal illnesses.
To determine whether depletion of liver glycogen or accumulation of liver fat (steatosis) was associated with the development of hypoglycaemia in children with fatal diarrhoeal illnesses, a case-control study was carried out comparing 17 children who had blood sugars less than or equal to 30 mg/dl with 17 age matched control children who had blood sugars greater than or equal to 59 mg/dl. The most common causes of diarrhoea in the hypoglycaemic children were Shigella sp. and Vibrio cholerae. The mean duration of diarrhoea before admission for the hypoglycaemic children, 7.8 d, was shorter than the 20.7 d for the controls (P less than 0.01). Most children in both groups showed signs of malnutrition, metabolic acidosis, and pneumonia. Liver specimens were obtained at post-mortem examination and stained with haematoxylin and eosin for general assessment and with periodic acid-Schiff stain for glycogen. Glycogen depletion was detected in 9 hypoglycaemic children and in only 3 control children (P less than 0.05). Hepatic steatosis, on the other hand, occurred with equal frequency in both groups but was associated with severe malnutrition in the hypoglycaemic patients (P less than 0.05). This result suggested that hypoglycaemia develops during acute diarrhoeal illnesses because gluconeogenesis fails to maintain the blood sugar concentration after depletion of liver glycogen. Frequent feeding of children with diarrhoea might help to prevent this complication.
Acidosis↗
Concomitant intestinal adenovirus infection and pulmonary cytomegalovirus infection in children causing fatal enteritis and pneumonia.
Three children in Bangladesh who presented with diarrhoea, cough, dyspnoea, fever, and signs of malnutrition and died in the hospital were shown at post-mortem examination to have both adenovirus infection of the intestine (by immunofluorescence) and cytomegalovirus infection of the lung (by immunoperoxidase staining). This finding of dual viral infections of the intestine and lung in patients with concomitant enteritis and pneumonia provides a basis for symptoms emanating simultaneously from these two organ systems.
Adenovirus Infections, Human↗
Reduction of fluid-loss in cholera by nicotinic acid: a randomised controlled trial.
A randomised controlled clinical trial was conducted to investigate the ability of nicotinic acid to reduce intestinal secretion in patients with severe cholera. Of the 62 adults investigated, 29 received either 1 or 2 g of nicotinic acid given orally in divided doses and 33 served as controls. Patients who received the 2 g dose had less fluid loss than did their controls during the first (p less than 0.01) and second (p less than 0.05) 8 h post-treatment periods. During the third and fourth 8 h periods, the rates were lower in the treatment groups, but not significantly so. The drug-specific stool reduction was 31%-47% during the first 16 h. Patients receiving 1 g consistently had lower rates of purging than had their controls during each 8 h observation period, but the differences were not significant. The effect of the 2 g dose was significantly better than that with the 1 g dose. The peak inhibition occurred 8-16 h after start of therapy. The drug was well tolerated, the only side-effect being transient flushing of the body in 1 patient.
Adult↗
Acute lower respiratory tract infections in hospitalized patients with diarrhea in Dhaka, Bangladesh.
This study focused on 401 children less than 5 years old who were hospitalized with acute lower respiratory tract infection (ALRI) and diarrhea in Dhaka, Bangladesh, and who were investigated for the presence of both bacterial and viral respiratory tract pathogens as well as for selected diarrheal pathogens. The most common manifestations of ALRI were pneumonia (374 cases), bronchiolitis (12 cases), and tracheobronchitis (11 cases). The majority (77%) of the illnesses were in children less than 2 years of age, and 88% of the children were malnourished. A respiratory tract pathogen was identified in 30% of the patients, and a diarrheal pathogen was identified in 34%. The overall case-fatality rate in children with ALRI and diarrhea was 8%. The case-fatality rate was 14% in children with bacterial pneumonia and diarrhea, 3% in those with viral pneumonia and diarrhea, and 14% in malnourished children with shigellosis and ALRI. The most common respiratory tract pathogens were respiratory syncytial virus, Streptococcus pneumoniae, influenza viruses, and Haemophilus influenzae type b.
Acute Disease↗
Acute lower respiratory tract infection due to virus among hospitalized children in Dhaka, Bangladesh.
The nature of acute lower respiratory tract infection (ALRI) in hospitalized children and of the associated viral agents was assessed in a study of 601 children less than 5 years old over a 24-month period. Of these children, 80% were less than 24 months of age and the ratio of boys to girls was 1.7:1. Pneumonia (86.5% of cases) was the most frequently observed clinical manifestation. Shedding of virus was detected in 21.1% of the children; the highest rate occurred in infants 0-5 months old (27%) as compared with a rate of only 12.5% in children 25-60 months old. Virus was detected in 33.3%, 32.8%, 21.2%, and 20% of the cases of tracheobronchitis, bronchiolitis, pneumonia, and croup, respectively. Among the viruses detected, 78% were respiratory syncytial virus (RSV) (91% of infections with this virus occurred in children less than 2 years old) and 14.4% were influenza virus types A and B. Of the RSV infections, 61% occurred in infants less than 1 year old. The case-fatality rate was 6.8% overall and was 4.8% in virus-associated cases. No consistent pattern of seasonal occurrence of viral infections was discerned. RSV was detected throughout the year, with increased prevalence from January to April.
Acute Disease↗
Patterns of morbidity and mortality in typhoid fever dependent on age and gender: review of 552 hospitalized patients with diarrhea.
Features of typhoid fever were correlated with age and gender through a review of the charts of 552 hospitalized culture-positive patients with diarrhea in Bangladesh. Seizures occurred more frequently in children from birth through 10 years of age (5%-11%) and pneumonia more frequently in children from birth through 5 years of age (8%-15%) than in older age groups (P less than .05), whereas intestinal perforation occurred more frequently in patients greater than or equal to 11 years of age (5%-25%) than in younger age groups (P less than .005). Compared with older age groups, children from birth through 10 years of age were more anemic, those from birth through 5 years of age had a higher mean white blood cell count, and those from birth through 1 year of age had a lower mean blood carbon dioxide content (all P less than .05). Female patients were more severely anemic than male patients (P less than .05). The case-fatality rate was 4.3% overall, with the highest rates for children from birth through 1 year of age (11%) and adults greater than or equal to 31 years of age (10%). Female patients had a higher case-fatality rate (6%) than male patients (3%), although the difference was not significant (P greater than .05). Death was independently associated with seizures, intestinal perforation, pneumonia, and delirium or coma. These results indicated that the patients with typhoid fever who were at highest risk of complications and death were children from birth through 1 year of age and adults greater than or equal to 31 years of age.
Adolescent↗
Response of typhoid fever caused by chloramphenicol-susceptible and chloramphenicol-resistant strains of Salmonella typhi to treatment with trimethoprim-sulfamethoxazole.
Chloramphenicol remains the drug of choice for the treatment of typhoid fever in most areas despite the risks of relapses and toxicity. In a comparison of the efficacy of trimethoprim-sulfamethoxazole (TMP-SMZ) and chloramphenicol against typhoid fever, 60 patients in Indonesia were randomly assigned to receive either TMP-SMZ (320 mg of TMP and 1,600 mg of SMZ daily) or chloramphenicol (2 g daily) for 14 days. TMP-SMZ was significantly more effective in sterilizing the blood, but the two drugs were equally effective with regard to relapse rate, frequency of prolonged fever, and mortality. Use of TMP-SMZ in Vietnam for the treatment of typhoid fever caused by chloramphenicol-resistant Salmonella typhi showed that TMP-SMZ is as effective as ampicillin. Likewise, a review of other published reports suggests that TMP-SMZ has an overall record in the treatment of typhoid fever that is equal to or better than the records of other available drugs. TMP-SMZ has emerged as a satisfactory alternative to chloramphenicol for the treatment of typhoid fever and should be especially useful in areas where chloramphenicol-resistant S. typhi has been isolated.
Adolescent↗
Typhoid fever complicated by intestinal perforation: a persisting fatal disease requiring surgical management.
In Bangladesh, clinical records of 323 patients with typhoid fever were reviewed to study the incidence, fatality, and optimal therapy of the complication of intestinal perforation. Fifteen patients (4.6%) developed intestinal perforation. Case-fatality rates were six of nine patients treated medically and one of four patients treated surgically for whom the postoperative courses were known. A literature review of 57,864 cases of typhoid fever in developing countries in the antibiotic era revealed that perforation developed in 2.5% of patients, a percentage that was similar to the incidence of 2.8% reported in the preantibiotic era. The median of case-fatality rates in these reports was 43% and the proportion of all reported typhoid deaths attributable to perforation was 25%. The case-fatality rates for patients with perforation were 70% for 410 patients managed medically and 26% for 1,835 patients managed surgically. Although some reports were biased toward placing patients at lower risk into surgical treatment, the large number of patients treated successfully by surgery suggests real improvement in surgical techniques in countries with endemic typhoid fever. These results indicate that intestinal perforation persists as a major cause of death in cases of typhoid fever in developing countries in the antibiotic era and that surgical treatment with use of antibiotic therapy is optimal for this complication.
Adolescent↗
Colonic perforation in Shigella dysenteriae 1 infection.
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Colonic Diseases↗
Job sculpting: the art of retaining your best people.
Hiring good people is tough, but keeping them can be even tougher. The professionals streaming out of today's MBA programs are so well educated and achievement oriented that they could do well in virtually any job. But will they stay? According to noted career experts Timothy Butler and James Waldroop, only if their jobs fit their deeply embedded life interests--that is, their long-held, emotionally driven passions. Butler and Waldroop identify the eight different life interests of people drawn to business careers and introduce the concept of job sculpting, the art of matching people to jobs that resonate with the activities that make them truly happy. Managers don't need special training to job sculpt, but they do need to listen more carefully when employees describe what they like and dislike about their jobs. Once managers and employees have discussed deeply embedded life interests--ideally, during employee performance reviews--they can work together to customize future work assignments. In some cases, that may mean simply adding another assignment to existing responsibilities. In other cases, it may require moving that employee to a new position altogether. Skills can be stretched in many directions, but if they are not going in the right direction--one that is congruent with deeply embedded life interests--employees are at risk of becoming dissatisfied and uncommitted. And in an economy where a company's most important asset is the knowledge, energy, and loyalty of its people, that's a large risk to take.
Career Mobility↗
Managing away bad habits.
We've all worked with highly competent people who are held back by a seemingly fatal personality flaw. One person takes on too much work; another sees the downside in every proposed change; a third pushes people out of the way. At best, people with these "bad habits" create their own glass ceilings, which limit their success and their contributions to the company. At worst, they destroy their own careers. Although the psychological flaws of such individuals run deep, their managers are not helpless. In this article, James Waldroop and Timothy Butler--both psychologists--examine the root causes of these flaws and suggest concrete tactics they have used to help people recognize and correct the following six behavior patterns: The hero, who always pushes himself--and subordinates--too hard to do too much for too long. The meritocrat, who believes that the best ideas can and will be determined objectively and ignores the politics inherent in most situations. The bulldozer, who runs roughshod over others in a quest for power. The pessimist, who always worries about what could go wrong. The rebel, who automatically fights against authority and convention. And the home run hitter, who tries to do too much too soon--he swings for the fences before he's learned to hit singles. Helping people break through their self-created glass ceilings is the ultimate win-win scenario: both the individual and the organization are rewarded. Using the tactics introduced in this article, managers can help their brilliantly flawed performers become spectacular achievers.
Career Mobility↗
Efficacy and tolerability of imipenem-cilastatin versus ceftazidime plus tobramycin as empiric therapy of presumed bacterial infection in neutropenic cancer patients.
The efficacy and tolerability of monotherapy with imipenem-cilastatin (I-C) were compared with that of ceftazidime plus full-course therapy with an aminoglycoside (tobramycin) (C&T) in the treatment of presumed bacterial infection in neutropenic cancer patients. A total of 106 adult patients diagnosed with presumed bacterial infection and an underlying malignancy with an absolute neutrophil count (ANC) < 500/mm3 were enrolled in this open-label study. A total of 131 febrile episodes occurred. Forty-five patients in the I-C group and 41 in the C&T group, who were well matched on demographic and baseline characteristics, were evaluable for efficacy and safety. Seventy-two hours after the start of therapy, no significant between-group differences in treatment outcomes, including withdrawals or deaths, were seen. Thirty-five (78%) of 45 patients in the I-C group and 29 (71%) of the 41 in the C&T group had successful outcomes at the final evaluation. Superinfection occurred in 8 (18%) I-C patients and 3 (7%) C&T patients. Within the subgroup of patients with an initial ANC < 100/mm3, the final evaluation showed no significant differences in treatment outcome between groups. Of the 131 in the safety population 30 (46%) I-C patients and 28 (42%) C&T patients had one or more adverse experiences; drug-related adverse events occurred in 25 (38%) patients in the I-C group and 11 (17%) patients in the C&T group. The data suggest that imipenem-cilastatin should be considered for initial empiric therapy of presumed bacterial infection in neutropenic cancer patients.
Adult↗