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Biomedical subjects

C B Hughes

Publications and source records attributed to C B Hughes.

At least 19 recordsLinked to original sources

Cycloviolins A-D, anti-HIV macrocyclic peptides from Leonia cymosa.

Four novel anti-HIV macrocyclic peptides containing 28-31 amino acid residues, named cycloviolins A-D, have been isolated from the hitherto unstudied tropical plant Leonia cymosa. Their primary structure, including amino acid composition and sequence, was determined by a combination of MALDI-TOF and FAB MS and by enzymatic digestion of reduced derivatives, followed by Edman degradation and mass analyses. All of the cycloviolins contain six cysteines, which are present as three intramolecular disulfide bridges. Intriguingly, cycloviolins A-D showed high degrees of sequence homology to the known cyclopsychotride A and circulins A and B from the Rubiaceae family but much less homology to the varv peptides from Viola, a member of the same family (Violaceae).

Amino Acid Sequence↗

Boosting social support in caregivers of children with HIV/AIDS.

Providing care for a child that is infected with human immunodeficiency virus (HIV) is challenging for the child's caregiver and affects the entire family system. Research has demonstrated that social support has the potential to buffer caregiver stress and facilitate caregiver coping. A two-group experimental study was implemented to test the effect of a social support boosting intervention on caregiver stress, coping and social support among caregivers of children with HIV/acquired immune deficiency syndrome (AIDS). The subjects in the study were caregivers of children with HIV/AIDS. The sample strata included seropositive caregivers (biological parents) and seronegative caregivers (foster parents and extended family members). The measures for the study included the Derogatis Stress Profile, The Family Crisis Oriented Personal Evaluation Scale, and the Tilden Interpersonal Relationship Inventory. These data were then analyzed descriptively and then with a repeated measure MANOVA. Initially, there were no statistically significant differences found between the control and intervention groups. However, when subject HIV status was included in the analysis, the combined dependent variables of stress, coping, and social support were significantly related to the interactions of group by HIV status over time. F values were then computed and no statistically significant differences were found for stress or coping. There were, however, significant differences in measures of social support between groups when adjusting for HIV status of caregivers. In this study, social support levels over time for seronegative caregivers were significantly different from those of seronegative caregivers in the control group. Three case studies are presented that illustrate differences between seronegative and seropositive caregivers. The case studies describe the problems identified by caregivers and the effectiveness of problem solving using the social support boosting intervention. Finally, the mobilization of social support is discussed. Contrasts between the problems of caregivers are made relative to their HIV status. The potential for the effectiveness of the social support boosting intervention is discussed within the context of the caregiver's HIV status.

Adaptation, Psychological↗

Anti-TNFalpha therapy improves survival and ameliorates the pathophysiologic sequelae in acute pancreatitis in the rat.

BACKGROUND: Elevated levels of tumor necrosis factor-alpha (TNFalpha) have been measured in a lethal model acute pancreatitis (AP) and may contribute to the pathophysiologic sequelae of the disease. METHODS: To determine the significance of anti-TNFalpha therapy on survival and disease manifestations in a clinically relevant model of AP, a rat model was developed using a retrograde pancreatic ductal infusion of bile. Animals were randomized to no treatment (n = 30) or treatment with anti-TNFalpha antibody 15 minutes prior to induction of AP (n = 30). Five treated and 5 untreated rats were killed at various time periods up to 72 hours to provide temporal characterization of TNFalpha activity in AP. RESULTS: A burst Of TNFalpha activity in the serum of untreated pancreatitis animals between 1 and 3 hours after induction of the disease is prevented by pretreatment with anti-TNFalpha antibody. CONCLUSIONS: These findings provide a plausible mechanism for the improvement in biochemical and histologic parameters as well as in overall survival in an experimental model of acute pancreatitis in the rat.

Acute Disease↗

Effects of social support, stress, and level of illness on caregiving of children with AIDS.

The purpose of this descriptive correlational study was to explore the relationship between social support, stressors, level of illness, and perceived caregiver burden in caregivers of children with HIV/AIDS. Instruments used were: (1) the Classification System for Human Immunodeficiency Virus (HIV) Infection in Children Under 13 Years of Age (1987), (2) the Daily Hassles Scale, (3) the Tilden Interpersonal Relationship Inventory (IPRI), (4) the Derogatis Stress Profile (DSP), and (5) the Caregiver Appraisal Scale. The sample was drawn from two medical centers in New Jersey. The 49 caregivers of children with perinatally acquired HIV were predominantly HIV-positive biological mothers of African American descent whose education ranged from 8th grade through college. One-half of the children were classified at the CDC P2 level. Descriptive statistics and stepwise multiple regression were used to analyze the data. The results of the DSP indicated subjects were slightly below the 70th percentile for anxiety, depression, hostility, and work stressors and that subjects' social support levels were in the upper end of the low support category. Stepwise regression indicated that depression and anxiety predicted 40% of the variance in caregiver burden (R2 = .399; F = 14,985; p = .000). Hostility and level of social support predicted 37% of the variance in caregiving impact (R2 = .37; F = 13.254; p = .000). Finally, social support predicted 17.5% of the variability in the caregivers' sense of caregiving competency (R2 = .175; F = 9.788; p = .003). The child's level of illness and HIV status of caregiver did not significantly predict variance in caregiving appraisal.

Acquired Immunodeficiency Syndrome↗

Calcium channel blockade inhibits release of TNF alpha and improves survival in a rat model of acute pancreatitis.

Tumor necrosis factor-alpha (TNF alpha) has been implicated as one of the numerous likely mediators of the systemic complications of acute pancreatitis. Recent suggestions that calcium (Ca2+) acts as a signal not only for TNF alpha release but also for TNF alpha action at distant sites led us to hypothesize that the calcium channel blocker diltiazem could inhibit TNF alpha release in acute pancreatitis, ameliorating the severity of the disease and improving overall survival. A rat model of acute pancreatitis induced by retrograde ductal infusion of bile was used for two experiments (n = 120). Experiment 1 was designed to determine the effects of calcium channel blockade using diltiazem on the severity of pancreatitis as measured by changes in biochemistry, pathology, and serum TNF alpha levels. In experiment 2, effects of calcium channel blockade on animal survival were measured over 72 h. Calcium channel blockade was associated with a significant reduction in serum TNF alpha levels as well as amelioration of pancreatitis by biochemical and pathological criteria. Overall survival from bile-induced pancreatitis was dramatically improved in rats pretreated with diltiazem (80%) compared to untreated animals (40%). Our data suggest that calcium channel blockade is associated with TNF alpha inhibition and improved outcome in a rat model of acute pancreatitis.

Acute Disease↗

Inhibition of TNF alpha improves survival in an experimental model of acute pancreatitis.

The development of systemic complications in acute pancreatitis is largely responsible for the mortality associated with this disease. The systemic sequelae encountered in acute pancreatitis are similar to those occurring in patients with septic shock, a syndrome of multiple organ failure thought to be related to overproduction of inflammatory cytokines. As with sepsis, data is mounting that cytokines, particularly TNF alpha, may play a central role in acute pancreatitis and mediate the systemic sequelae of the disease. We have previously shown elevated levels of TNF alpha in the serum of animals with experimental acute pancreatitis. In this study, we use a bile-infusion model of pancreatitis in the rat to show amelioration of disease severity as well as a distinct survival advantage by TNF alpha blockade using anti-TNF alpha polyclonal antibody. These data provide strong evidence that TNF alpha is a major contributor to the morbidity and mortality from acute pancreatitis.

Acute Disease↗

Up-regulation of TNF alpha mRNA in the rat spleen following induction of acute pancreatitis.

Tumor necrosis factor-alpha (TNF alpha) is postulated to be a mediator of the systemic complications associated with acute pancreatitis. Neutralization of TNF alpha with monoclonal antibody ameliorates the morbidity and mortality associated with acute pancreatitis in a rat model. Although high levels of TNF alpha are measurable in peripheral blood in acute pancreatitis, specific sites of TNF alpha production in this disease have not been described. In this study we show that induction of pancreatitis causes up-regulation of TNF alpha messenger RNA (mRNA) at a distant organ site, the spleen. Hemisplenectomies were performed in male Sprague-Dawley rats prior to induction of pancreatitis by pancreatic duct infusion of artificial bile. Completion hemisplenectomies were then performed at 30 min, 1 hr, and 2 hr after pancreatitis induction. Quantitation of TNF alpha mRNA in the hemispleens before and after pancreatitis using a semiquantitative reverse transcriptase-polymerase chain reaction method revealed an 80-fold increase in amount of TNF alpha mRNA by 2 hr after induction of pancreatitis. By contrast, control rats receiving a sham operation showed no significant increase in TNF alpha mRNA expression after infusion of the pancreatic duct with saline. The increase in TNF alpha mRNA production was associated with increased serum TNF alpha product levels and was independent of endotoxin. We conclude that severe acute pancreatitis in the rat model is associated with significant up-regulation of TNF alpha mRNA in splenic mononuclear cells. These data provide evidence that the local events of acute pancreatitis can induce up-regulation of TNF alpha mRNA at a distant site and suggest a possible mechanism of pathogenesis of the systemic manifestations of this disease.

Acute Disease↗

Induction of acute pancreatitis in germ-free rats: evidence of a primary role for tumor necrosis factor-alpha.

BACKGROUND: Tumor necrosis factor-alpha (TNF-alpha) has been implicated as a mediator of the systemic manifestations associated with acute pancreatitis. The purpose of this study was to show that TNF-alpha expression in pancreatitis is a primary response and is not the result of endotoxemia. METHODS: Severe acute pancreatitis was induced in germ-free rats, which have no source of endogenous endotoxin, by ductal infusion of artificial bile. Control animals underwent sham operation and ductal infusion of saline solution. TNF-alpha levels were measured by the WEHI bioassay. Endotoxin was measured by the Limulus assay. RESULTS: TNF-alpha levels remained low in the sham group (mean, 24.6 +/- 8.0 pg/ml) but were significantly elevated in normal rats with pancreatitis (181 +/- 26.8 pg/ml; p < 0.001 versus sham group) and in germ-free rats with pancreatitis (213 +/- 90 pg/ml; p < 0.002 versus sham group). No endotoxin was detected in any of the experimental rats. CONCLUSIONS: Our results indicate that TNF-alpha levels are elevated in acute pancreatitis despite the absence of endotoxin, indicating a primary role of TNF-alpha in this disease.

Acute Disease↗

Solid organ pancreas transplantation: a review of the current status and report of one institution's experience.

Pancreas transplantation is a procedure with numerous potential complications for graft and patient. However, the severity of the complications of diabetes, including nephropathy, retinopathy, neuropathy, etc., makes pancreas transplantation a viable alternative, if not necessity, in the end-stage diabetic. The procedure is being performed more and more frequently worldwide with improvements in graft survival and patient quality of life. Options for graft placement, including systemic-versus-portal venous drainage and enteric-versus-bladder exocrine drainage, are raising questions as to the best method for prevention of complications and for monitoring of graft function. A review of pancreas transplantation as well as the experience with 60 such transplants performed between April 1989 and January 1993 at the University of Tennessee, Memphis, is reported.

Graft Survival↗

A celebration.

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Anniversaries and Special Events↗

Predicting effective contraceptive behavior in college females.

This article reports the results of a preliminary research project that explored the relationship between assertiveness, cognitive development and contraceptive behavior among single young women in their freshman and senior years at college. A total of 60 college women at a university health center volunteered to participate in this pilot study. They filled out three instruments: the Galassi College Self-Expression Scale (SES), the Measure of Intellectual Development (MID) tool and an author-developed sexuality questionnaire. Although there was a significant relationship between cognitive development and assertiveness, no significant relationships were found between cognitive development, assertiveness and use of effective contraception. Interesting descriptive characteristics were identified. Clinical implications are discussed.

Adolescent↗

An eclectic approach to parent group education.

Many factors contribute to a need for parent education today. Parent education has changed over the past centuries as a result of our changing values, our increasing knowledge base, and changes in family structure. The parent education group attempts to meet the parents' need to validate their concerns and offer them process and skills that promote mental health in children. Two popular models of parent education, the reflective model and the behavioral model, stem from two schools of psychologic thought-the phenomenologic school and the behavioral school. Because of the weaknesses and strengths of each model, an eclectic model of parent education is proposed which facilitates an authoritative patern of parenting correlated with self-reliant, explorative, and self-controlled children. This eclectic model of parent education is perceived as being within the role description of the generalist nurse who has access to back-up specialists in the health care system. Many opportunities exist for the nurse to offer this type of health education.

Female↗

Empowerment: a case study of a grandmother caring for her HIV-positive grandchild.

A case study methodology is used to explore the meaning and development of empowerment in a grandmother who is the primary caregiver of a child with HIV infection. Empowerment to this grandmother meant being strong, coming to grips with life's challenges, and then moving on. Empowerment developed over the grandmother's life span as a result of developmental and situational experiences such as motherhood, disclosure of the HIV diagnosis, sharing her positive and negative feelings with others, gaining knowledge about HIV, making management decisions, and her increasing sense of spirituality. This grandmother manifests her empowerment through her public commitment to influence others positively about HIV infections through speaking, writing, and leadership in groups. Clinical implications are discussed.

Adolescent↗

Preliminary experience with a cuffed ePTFE graft for hemodialysis vascular access.

The purpose of this study was to determine graft patency and blood flow rates in recipients of a new cuffed ePTFE graft (Venaflo graft) used for hemodialysis access. A pilot study was conducted with 12 (7 men, 5 women) consecutive patients (age range, 36-76 yr; mean, 65 yr). All patients were recipients of a new cuffed PTFE graft placed for hemodialysis access. Seven were high risk because of a prior history of clotted hemodialysis accesses (1-6; mean, 3.3). Blood flow rates were determined by ultrasound dilution technique at 3 month intervals. One year and 2 year overall graft patency rates were 90.9% and 68.2%, respectively. One graft (high risk, six prior grafts) was lost to thrombosis in the first year; two grafts (one high risk, four prior grafts) were lost to thrombosis in the second year of follow-up. No graft thrombosis resulted from stenosis at the graft-vein anastomosis. Blood flow rates ranged from 550 to 2,110 ml/min (mean, 1,086 ml/min; n = 8) when first measured 3 months after graft placement. Similar flow rates were observed at 12 months (mean, 1,043 ml/min; n = 7) and 24 months (mean, 1,014 ml/min; n = 4) in grafts available for comparison. Dialysis flow rates in excess of 350 ml/min were possible with all patent grafts. A cuffed ePTFE graft provided stable blood flow and satisfactory graft patency during 2 years of follow-up, even in high risk patients with a prior history of vascular access thrombosis.

Adult↗