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Biomedical subjects

A Brownlee

Publications and source records attributed to A Brownlee.

14 recordsLinked to original sources
PubMed2003

Heterozygosity for ABCA1 gene mutations: effects on enzymes, apolipoproteins and lipoprotein particle size.

A cohort of 13 female and 14 male heterozygotes for ATP binding cassette A1 (ABCA1) gene defects was directly compared with 13 and 14 unaffected female and male family members of almost exact same age. The activities of three proteins that play key roles in HDL metabolism were measured in addition to extensive lipid and (apo) lipoprotein subfraction analysis. Compared to controls, LCAT activity was reduced by 15% in affected subjects (P < 0.001) while PLTP activity was unaffected. Interestingly, CETP activity was elevated by 50% in the heterozygote siblings of one kindred but was unaffected in heterozygotes of the three other families. With respect to lipids, the heterozygotes had normal total cholesterol (TC), and LDL-cholesterol concentrations but presented with a trend towards increased triglyceride levels (13%; P = 0.08). HDL metabolism, by contrast, was severely affected as illustrated by 40% reductions in HDL-cholesterol (P < 0.001) with concomitant reductions in apoAI (25%; P < 0.001) levels and in lipoprotein subfraction LpAI (28%; P < 0.001), LpAI:AII (24%; P=0.014), and LpCIII:nonB (34%; P < 0.001) concentrations. We furthermore observed reduced average HDL particle size (5%; P = 0.004; 16% in female and 3.6% in male) and reduced plasma apoCIII concentration (15%; P = 0.006) while apoAII, apoAIV, apoE and apoB levels were unchanged. In conclusion, heterozygosity for ABCA1 defects was associated with reduced LCAT activity in absence of effects on PLTP activity. Of special interest was our finding that the effects of compromised ABCA1 function on HDL were more pronounced in women than in men.

ATP Binding Cassette Transporter 1↗
PubMed2003

A taxonomy of obstacles to breast examinations in African American women.

The purpose of this study was to describe and classify the barriers to breast self-examinations (BSE) and mammography in African American women. A total of 125 African American women were recruited from historically black colleges, churches and community organizations in Nashville, Tennessee. Their responses to a comprehensive open- and closed-ended questionnaire about barriers to BSE and mammography were coded using a hierarchical coding system and analyzed according to participants' stage of behavior change assignment. On the average, each woman reported 3.1 barriers to BSE (2.5 psychological and 0.6 environmental) and 2.5 barriers to mammography (1.5 psychological and 1.0 environmental). Barriers cited included fear of finding cancer, forgetting, lack of time, lack of knowledge, competing demands, costs, pain, emotional consequences, cultural attitudes towards medicine, uncertainty about benefits and laziness. For BSE, the number of psychological barriers exceeded environmental barriers, while for mammography, the number of psychological and environmental barriers was similar. For BSE, but not mammography, psychological barriers appeared most important for women in the precontemplation, contemplation and preparation stages of behavior change. Overcoming barriers to BSE and mammography could increase early detection rates in African American women. Interventions based on stage of change theory may be especially applicable.

Black or African American↗
PubMed2000

IgA myeloma presenting as Henoch-Schönlein purpura with nephritis.

IgA nephropathy (IgAN) and Henoch-Schönlein purpura (HSP) are both characterized by IgA-mediated tissue injury, including mesangial proliferative glomerulonephritis. Abnormalities of IgA1 glycosylation are described in IgA nephropathy and HSP nephritis. IgA-antineutrophil cytoplasmic antibodies (ANCA) have been inconsistently described in the serum of patients with HSP. In IgA myeloma, the paraprotein-mediated renal lesion is typically cast nephropathy; IgAN or HSP have only rarely been reported in myeloma even when an IgA paraprotein is circulating in large concentrations. We report the case of a 50-year-old man with IgA myeloma who presented with HSP including nephritis and rapidly progressive renal failure. His IgA1 had altered O-glycosylation in the pattern seen in IgAN and also contained an IgA-ANCA. This case adds further weight to the evidence that IgA1 O-glycosylation abnormalities predispose to mesangial IgA deposition and also that IgA-ANCA may have a pathogenic role in the development of HSP.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed1997

Antineutrophil cytoplasm autoantibodies against bactericidal/permeability-increasing protein in inflammatory bowel disease.

BACKGROUND: Bactericidal/permeability-increasing protein (BPI), a constituent of primary neutrophil granules, is a potent natural antibiotic and an antineutrophil cytoplasm antibody (ANCA) antigen in cases of vasculitis in which the target antigen is neither myeloperoxidase (MPO) nor proteinase-3 (PR3). AIM: To investigate BPI as a possible target antigen for ANCAs in inflammatory bowel disease. METHODS: ANCAs were detected by routine immunofluorescence (IIF) and solid phase enzyme linked immunosorbent assay (ELISA) performed for antibodies to the purified neutrophil granule proteins; MPO, PR3, cathepsin-G, lactoferrin, and BPI in serum samples from 88 patients with inflammatory bowel disease (36 with Crohn's disease, 52 with ulcerative colitis). Thirty patients with bacterial enteritis acted as controls. RESULTS: Significantly more patients with ulcerative colitis were ANCA positive by IIF (60%) than patients with Crohn's disease (28%) or infectious enteritis (23%) (p < 0.001). IgG anti-BPI antibodies were present in 29% of patients with ulcerative colitis, 14% of patients with Crohn's disease, and 23% of patients with infectious enteritis, occurring in 44% of those patients with inflammatory bowel disease who were ANCA positive by IIF. Antibodies to other ANCA antigens were rare. The presence of ANCAs was not related to either disease activity or extent; presence of anti-BPI antibodies was significantly related to both a lower serum albumin concentration (p = 0.001) and a higher erythrocyte sedimentation rate (p = 0.02) in patients with ulcerative colitis, and to colonic involvement in patients with Crohn's disease (p = 0.01). CONCLUSION: BPI is a significant minority target antigen for ANCAs in inflammatory bowel disease that seems related to colonic Crohn's disease and disease activity in ulcerative colitis. Anti-BPI antibodies occur in infectious enteritis.

Adult↗
PubMed1993

Prospective study of the aetiology of adult community acquired bacterial pneumonia needing hospitalisation in Singapore.

A prospective survey of 96 consecutive adult patients with community acquired pneumonia requiring hospitalisation was carried out at National University Hospital, Singapore. Causative pathogens were identified in 58% of patients. Mycobacterium tuberculosis was the most common pathogen (21%), followed by Streptococcus pneumoniae (12%), Haemophilus influenzae (5.2%), Mycoplasma pneumoniae (5.2%) and Staphylococcus aureus (4.2%). Gram-negative organisms (apart from Haemophilus influenzae) were found in 10% of pneumonia patients. More than half of the patients had pre-existing illness, the most common was diabetes mellitus (21%).

Adolescent↗
PubMed1990

The specificity of anti-neutrophil cytoplasm autoantibodies in systemic vasculitides.

Autoantibodies to neutrophil cytoplasmic antigens are found in patients with small or medium-size vessel systemic vasculitis such as Wegener's granulomatosis and microscopic polyarteritis. We studied the specificity of anti-neutrophil cytoplasm autoantibodies (ANCA) by examining the binding of sera from patients with different forms of systemic vasculitis, to neutrophil extract size-fractionated by gel filtration for high performance liquid chromatography. Sequential fractions were collected for solid-phase radioimmunoassay. Patients with Wegener's granulomatosis showed two peaks of activity over fractions of 12 and 2 kD. Patients with microscopic polyarteritis had two different peaks of activity over fractions of 100 and 25 kD. Patients with Takayasu's arteritis and dermal lymphocytic vasculitis were studied as controls (all were ANCA negative by indirect immunofluorescence studies and solid-phase radioimmunoassay). However, the patient with lymphocytic vasculitis showed a distinct peak of activity over 22 kD and patients with Takayasu's arteritis had a single peak of activity over 200 kD. These results suggest the binding pattern of sera to fractionated neutrophil extract could be useful in differentiating between different diseases within the spectrum of systemic vasculitis. Cryptic antigen recognition in certain vasculitides may only be revealed by this procedure. We conclude that the association of ANCA and systemic vasculitis may not be limited to diseases of small or medium-size vessels, but could also include large vessel disease such as Takayasu's arteritis.

Antibody Specificity↗
PubMed1985

Natriuretic and smooth muscle responses to human urinary natriuretic hormone in rats: relation to blood pressure and kallikrein excretion in patients.

Human urine contains a small molecular weight natriuretic substance and similar material isolated from the kidney inhibits Na/K ATPase. Such action on smooth muscle in blood vessels would cause contraction. Human urinary natriuretic material caused contraction of the smooth muscle in the rat anococcygeus muscle and this activity correlated with its natriuretic activity. Known vasoactive substances could not explain the activity of the natriuretic factor when tested on the anococcygeus muscle. The best correlation with blood pressure of the patient was with the log of the ratio of natriuretic activity divided by the kallikrein excretion. A normotensive woman with severe renal failure had very high kallikrein excretion as well as increased natriuretic activity and her data fitted the same correlation as the hypertensives' data.

Animals↗
PubMed1978

The family and health care: explorations in cross-cultural settings.

This article discusses what a social worker or health practitioner should know about the family and its influence on health care among various ethnic groups, focusing first on basic information on family organization and interrelationships and then on the family's role during health care. The material is presented in a format designed to be useful to the practitioner in the field, discussing what important aspects of various topics the worker might investigate, why the information is important, and how to gather it.

Attitude to Health↗