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Biomedical subjects

W Greaves

Publications and source records attributed to W Greaves.

9 recordsLinked to original sources
PubMed2000

A multicenter, randomized, double-blind, placebo-controlled trial of recombinant human interleukin-10 in HIV-infected subjects.

OBJECTIVE: To determine the effect of multiple subcutaneous doses of recombinant human interleukin (rhuIL)-10 on plasma HIV RNA levels and CD4 T-cell counts, and to evaluate its safety and tolerability in HIV-infected subjects. DESIGN: Prospective, randomized, double-blind, placebo-controlled, multicenter trial. SUBJECTS: Thirty-nine HIV-infected subjects with CD4 T-cell counts > 200 x 10(6)/l, plasma HIV RNA concentrations > or = 3.18 log10 copies/ml and on stable antiretroviral therapy were recruited from six centers. INTERVENTION: Subjects received (subcutaneously) rhuIL-10 1 microg/kg daily, 4 microg/kg daily, 8 microg/kg three times per week, placebo daily or placebo three times per week for 4 weeks. MAIN OUTCOME MEASURES: Prospectively defined outcomes included safety and tolerability, plasma HIV RNA levels and CD4 T-cell counts. Outcomes were assessed at baseline, weeks 1, 2, 3 and 4 during treatment and weeks 2 and 4 following completion of therapy. RESULTS: Baseline characteristics were similar in all groups. Compared to baseline, no significant change in plasma HIV RNA concentrations or CD4 T-cell counts was observed in any of the groups. RhuIL-10 was generally well tolerated. Two patients receiving rhuIL-10 4 microg/kg required discontinuation due to thrombocytopenia. One patient receiving rhuIL-10 4 microg/kg who had chronic hepatitis B and C infections discontinued drug because of elevated liver function tests. One patient receiving placebo discontinued study drug because of depression. CONCLUSION: The lack of a demonstrable virological benefit, as assessed by plasma viral load, with 4 weeks of rhuIL-10 does not support the development of this immune-based therapy for treatment of HIV infection.

Adult↗
PubMed1999

A multicenter, randomized, controlled trial of three preparations of low-dose oral alpha-interferon in HIV-infected patients with CD4+ counts between 50 and 350 cells/mm(3). Division of AIDS Treatment Research Initiative (DATRI) 022 Study Group.

To evaluate the effectiveness of low-dose oral alpha-interferon (alpha-IFN), 247 HIV-infected study subjects received placebo, Alferon LDO, Veldona, or Ferimmune in a randomized, double-blind trial. Subjects had CD4+ counts between 50 and 350 cells/mm3 and HIV-related symptoms at entry. Study subjects rated the severity of eight symptoms using a symptom burden index (SBI). Study endpoints included changes in SBI, weight, CD4+ count, and Karnofsky score between baseline and the 24-week visit. The SBI outcome and weight were measured in 99 and 106 study subjects, respectively, at both the baseline and 24-week visits. Baseline SBI scores ranged from 5.4 to 7.9 in the four arms. No clinically important or statistically significant differences were found among the four arms with regard to SBI or weight change over the 24-week period. There were also no significant differences among the arms for CD4+ cell count and Karnofsky score. Few adverse reactions were noted in any arm, and there were no significant differences between arms. Although the trial was designed to enroll 560 study subjects and was prematurely terminated because of slow accrual and discontinuations of participants, the small differences among the arms in the primary and secondary endpoints do not support claims of efficacy for the measures studied.

Administration, Oral↗
PubMed1992

Autopsy findings in HIV-infected inner-city patients.

To assess the importance of the autopsy in HIV-1 infection, we retrospectively reviewed the autopsy reports of 70 HIV-1-seropositive patients at Howard University Hospital. Of the 58 patients with AIDS, the diagnosis of AIDS was made after autopsy in 24 (41%) cases. The lung was the most common site of AIDS-diagnostic diseases, and was affected in 90% of patients. Pneumocystis carinii infection was the most common AIDS-diagnostic disease, and was present in 50% of the AIDS patients. Thirty-eight percent of AIDS diagnostic diseases were diagnosed antemortem, including 15 of the 29 Pneumocystis carinii infections. Most of the AIDS-diagnostic diseases were disseminated at autopsy and two or more diseases were found in some organs. Overall, Pneumocystis carinii pneumonia was the most common cause of death, accounting for a mortality of 43% among AIDS patients. Bacterial infections were common and contributed to the mortality and morbidity of both AIDS and non-AIDS patients. Bacterial infection was the cause of death in 15 AIDS and 9 non-AIDS patients. The clinical cause of death concurred with the pathological cause in 53% of our cases.

Adult↗
PubMed1990

Pneumococcal sepsis and meningitis in adults with sickle cell disease.

Patients with sickle cell disease are predisposed to infection caused by Streptococcus pneumoniae. However, there has been only one published case of bacteremic pneumococcal meningitis in an adult with sickle cell anemia. We report here the cases of six adults with sickle cell disease, pneumococcal sepsis, and meningitis. Five patients were male and one was female. Their ages ranged from 18 to 34 years (mean, 25.7 years). Five patients had the SS and one had the SC hemoglobin phenotype. Only one patient had received pneumococcal vaccine (14 valent). This vaccine did not protect against the pneumococcal serotype causing his infection. All patients had high fever (mean, 39.8 degrees C [103.7 degrees F]) on admission; five had generalized weakness and four had neck stiffness. Leukocyte counts were greater than 30,000/mm3 in all patients. Streptococcus pneumoniae was isolated from the blood and the cerebrospinal fluid in all patients. The cerebrospinal fluid showed pleocytosis in six patients, an elevated protein level in five, and hypoglycorrhachia in two. Complications included renal failure in four patients, disseminated intravascular coagulation in one, and seizures in another. Two patients died. Pneumococcal sepsis and meningitis are uncommon in adults with sickle cell disease, but they carry a high morbidity and mortality. Wider use of the new 23-valent polysaccharide vaccine in these patients is recommended.

Adult↗
PubMed1983

A study of dermatitis in trona miners and millers.

Trona (sodium sesquicarbonate) is mined from an underground deposit in Wyoming and processed for use in the manufacture of glass, paper, and detergents, and in chemical applications. Trona dust is alkaline (pH 10.5) and may have an irritant effect on the respiratory airways, mucous membranes, and the skin. One hundred forty-two underground miners and 88 surface workers from one trona facility participated voluntarily in an epidemiologic and clinical study. Their mean age was 37.6 and their mean working period, 10.0 years. One half of the study participants complained of skin symptoms; dermatologic symptoms increased from twofold to fifteenfold after the subjects began trona mining. Trona dermatitis consists of pruritic, erythematous, raised, dry, and fissured lesions commonly affecting the hands, arms, and legs. A dose-response relationship was observed among underground workers. Patch testing with 10% aqueous trona and sodium carbonate was negative, suggesting that the dermatitis was primarily irritant in nature.

Adult↗
PubMedDate not supplied

An epidemiologic study of the respiratory effects of trona dust.

Trona (sodium sesquicarbonate) is mined from an underground deposit in Wyoming and processed for use in glass, paper, detergent, and chemical applications. Trona dust is alkaline (pH 10.5) and can have an irritant effect on respiratory airways, mucous membranes, and the skin. A study population of 142 underground miners and 88 surface workers from one facility volunteered for an epidemiologic study. Their mean age was 37.6 yr and mean duration of employment was 10.0 yr. The percentage with chronic cough and phlegm was 23%; both symptoms were more common among smokers than nonsmokers. Thirty-three percent of the workers complained of dyspnea when hurrying on level ground or walking up a slight hill. Half of the workers complained of upper respiratory tract symptoms and eye irritation. Both smokers and exsmokers had significant declines of forced expiratory volume in 1 sec (FEV1.0) with age; exsmokers also had declines with work-years when compared to a nonsmoking comparison population. Nonsmokers with personal dust measurements had a significant decline of FEV1.0 related to respirable dust exposure. A shift study of 104 workers revealed a significant fall in FEV1.0 among nonsmokers and surface workers. Significance was approached in the high dust exposure group. An increase in the mean percent predicted forced vital capacity and FEV1.0 was shown for the 125 workers who had a 5-yr follow-up of pulmonary function. There was no correlation between the shift study decrements and the longitudinal 5-yr follow-up. Industrial hygiene dust sampling found elevated levels of total dust but lower respirable dust, with no detectable free silica.

Bicarbonates↗