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Biomedical subjects

W Lim

Publications and source records attributed to W Lim.

At least 73 records · Page 4Linked to original sources
PubMed1995

HIV infection in pregnancy. A review of current developments.

It appears that pregnancy itself is not adversely affected by HIV infection, but the course of HIV infection in the mother may be accelerated by pregnancy. The results of the 076 trial have changed our approach to AIDS in pregnancy. Heretofore AZT was only given for maternal indications such as severe immunodeficiency (CD4 count less than 200). We now recommend that AZT be given to all women with HIV infection and to infants postpartum. As to mode of delivery, Cesarean section may be beneficial, but we await further studies. We strongly encourage all pregnant women to have HIV testing regardless of risk factors. The HIV epidemic is here, in North Carolina. It is our responsibility as doctors to help pregnant women as best we can with their disease.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Histoplasma capsulatum infection associated with continuous ambulatory peritoneal dialysis.

Fungal infection has become increasingly more important in patients undergoing continuous ambulatory peritoneal dialysis. We report here a case of Histoplasma capsulatum infection in such a Hong Kong Chinese patient who presented with fever and peritonitis. Histoplasma capsulatum was isolated from the dialysis fluid and histoplasma antibody was detected in the serum. The patient responded to the combined treatment of fluconazole, 5-flurocytosine and amphotericin B. This is the first reported case of histoplasmosis in Hong Kong.

Amphotericin B↗
PubMed1991

An investigation of maternal morbidity with identification of life-threatening 'near miss' episodes.

This study was designed to investigate the pattern of obstetric morbidity and to determine the frequency of serious life-threatening episodes as a basis for clinical audit. The records of over 2,000 maternities from a National Health Service Consultant Unit during a six-month period were analysed. Morbidity was noted in almost a quarter of the cases, and life-threatening episodes, termed 'near miss' morbidity, were identified. As the maternal death rate has fallen in this country, maternal morbidity has come to represent a more useful indicator of obstetric care than mortality. The results of this study identify the need for an agreed set of definitions for 'near miss' morbidity, and suggest that not only should it be included for discussion in unit perinatal meetings, but that Regional obstetric morbidity enquiries would provide valuable denominator data on morbidity.

Female↗
PubMed1989

In vitro synthesis of human immunodeficiency virus-specific antibodies in peripheral blood lymphocytes of infants.

An assay system was developed for the analysis of antibodies secreted in vitro against human immunodeficiency virus (HIV) by cultured peripheral blood lymphocytes of HIV-infected individuals. Cultures of peripheral blood lymphocytes were established with medium alone or with medium containing Epstein-Barr virus (EBV) or pokeweed mitogen. HIV antibodies were determined by an ELISA performed with commercial kits in which a whole virus extract served as antigen. Optimal antibody secretion was detected in 7-day peripheral blood lymphocyte cultures to which EBV had been added to provide polyclonal B-cell activation. Pokeweed mitogen-induced antibody secretion and spontaneous antibody secretion were less consistent. With EBV as a stimulus, the sensitivity and specificity of this assay for determining HIV infection status were each 100% in adults. When the assay was applied to infants and children, 23 of 24 symptomatic HIV-seropositive children (class P-2) and 11 of 33 asymptomatic seropositive infants aged less than or equal to 15 months (class P-0) tested positive for EBV-induced antibody secretion. Six of the 11 P-0 patients who tested positive have progressed to develop symptomatic disease, while the remainder are still seropositive at ages 2-15 months. Of the infants who were negative in this assay, all have remained asymptomatic. Treatment with 3'-azido-3'-deoxythymidine in infected adults and children has resulted in transient suppression of the in vitro antibody response in some instances. Thus EBV-induced synthesis of HIV-specific antibodies in vitro is a sensitive and specific indicator of HIV infection and is of help in determining infection status of asymptomatic seropositive infants who are classified as having "indeterminate" infection.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Continuous varicella-zoster infection associated with acyclovir resistance in a child with AIDS.

Acyclovir has become the treatment of choice for varicella-zoster virus (VZV) infections in immunocompromised individuals. This article describes a 4-year-old girl congenitally infected with human immunodeficiency virus who developed a continuous cutaneous infection with VZV that persisted over a 14-month period until her death. Initial episodes of varicella and zoster were responsive to acyclovir treatment; however, subsequent recurrences necessitated administration of multiple courses of acyclovir. Lesions became markedly hyperkeratotic, slow healing, and persistent despite acyclovir therapy. Numerous attempts to isolate virus from the lesions yielded only one isolate late in the course of therapy. This virus clearly demonstrated acyclovir resistance in vitro. Bizarre manifestations of VZV infection could present both diagnostic and therapeutic dilemmas. Prolonged acyclovir treatment of highly immunocompromised patients with acquired immunodeficiency syndrome and severe VZV may lead to the appearance of resistant virus.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Penicillium marneffei infection: an underdiagnosed disease?

Penicillium marneffei is a rare human pathogen that often causes problems in clinical and histological diagnosis. A patient who presented with autoimmune haemolytic anaemia and hepatosplenomegaly, and was subsequently found to be suffering from disseminated Penicillium marneffei infection, is reported. The liver biopsy showed epithelioid cell granulomas only, and tuberculosis was initially considered the most likely diagnosis. The correct diagnosis became evident in a subsequent colonic biopsy, which showed extensive infiltration by penicillium-laden macrophages.

Bacterial Infections↗
PubMed1986

The problem of home management in the estimation of the incidence of acute myocardial infarction from hospital records.

Past studies of the incidence of acute myocardial infarction (AMI) have found information for patients managed at home difficult and expensive to obtain. This study attempted to find whether the efficiency of gathering this information could be improved, or if this group of patients could be neglected entirely. A random sample of 270 doctors in Perth were asked about their management of cases of suspected AMI at home. Of these doctors, 78% said that they never managed AMI at home; excluding such doctors before seeking voluntary notification of new cases managed at home could make population surveys of AMI more efficient. For patients under 65 it was estimated that about 1% or less of non-fatal cases meeting World Health Organization criteria for definite AMI were managed at home. Thus neglecting this group would probably cause little bias in computing incidence rates for AMI in Perth.

Acute Disease↗
PubMedDate not supplied

Multiple ischemic infarcts in a child with AIDS, varicella zoster infection, and cerebral vasculitis.

A 4 1/2-year-old girl with acquired immunodeficiency syndrome and prolonged varicella zoster virus skin infection developed multiple ischemic strokes and radiologic and histopathologic evidence of central nervous system vasculitis. Typical features of acquired immunodeficiency syndrome encephalitis were not present and there was no evidence of vasculitis outside the nervous system. Central nervous system vasculitis probably resulted from varicella zoster virus infection that persisted because of immunodeficiency. This acquired immunodeficiency syndrome complication has only rarely been described in adults and to our knowledge has not been described in children.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Skin diseases in children with HIV infection and their association with degree of immunosuppression.

Since the recognition of the acquired immunodeficiency syndrome (AIDS) in 1981, several dermatologic manifestations have been associated with the syndrome, including candidiasis, dermatophyte infection, molluscum contagiosum, herpes simplex and zoster, bacterial infection, and malignancy. Skin diseases have been observed in both the adult and the pediatric human immunodeficiency virus (HIV) infection in an academic hospital setting in relationship to the current CDC classification of pediatric HIV infection. The severity of dermatologic manifestations is correlated with the immune status of the patients. The latter was determined by T4 helper cell numbers and lymphoproliferative responses to mitogens and recall antigens. More severe T helper cell depletion was associated with a wider spectrum and increased severity of dermatologic manifestations.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Prevalence of hepatitis C infection in Hong Kong.

A study of a cross-section of the Hong Kong Chinese population was done to investigate the seroprevalence of hepatitis C. Healthy subjects were random visitors of a health exhibition, while clinical subjects were recruited from an outpatient liver disease clinic, sexually transmitted disease clinics, dialysis centres and drug rehabilitation centres. A total of 910 subjects were tested. The assay kits were from Abbott and Ortho laboratories. Of the general population, 0.5% was found to be positive for antibody to hepatitis C (anti-HCV). Suspected chronic non-A non-B patients, parenteral drug abusers and haemophiliacs shared a common high (up to 70%) prevalence of anti-HCV. Sexual partners of index patients, homosexuals and female prostitutes as well as hepatitis B carriers had 0% prevalence. It was concluded that parenteral and blood product exposures were the two main risk factors for hepatitis C.

Adolescent↗