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Biomedical subjects

C Davis

Publications and source records attributed to C Davis.

At least 145 records · Page 8Linked to original sources

Neutropenia in allogeneic marrow transplant recipients receiving ganciclovir for prevention of cytomegalovirus disease: risk factors and outcome.

To determine risk factors, frequency, time patterns, and outcome of ganciclovir-related neutropenia in allogeneic marrow transplant recipients, 278 consecutive patients receiving ganciclovir from engraftment until day 100 were studied. In this cohort, 159 patients (57%) had absolute neutrophil counts (ANC) less than 1,500/microL, 112 (41%) had an ANC less than 1,000/microL, 87 (31%) less than 750/microL, and 56 (21%) less than 500/microL for at least 2 consecutive days. Statistically significant risk factors for neutropenia in a Cox model were low marrow cellularity between day 21 and 28 (relative risk [RR] 2.4, P = .0002), hyperbilirubinemia > or =6 mg/dL during the first 20 days (RR 2.5, P = .0001), and elevation of serum creatinine > or =2 mg/dL after day 21 after transplant (RR 2.1, P = .001). Restriction to factors present at engraftment resulted in a similar model with low marrow cellularity, hyperbilirubinemia > or =6 mg/dL, and elevated serum creatinine as significant risk factors. Patients with no risk factor had an incidence of neutropenia of 21%, an incidence of 31% for one risk factor, and of 57% for two or more risk factors (RR 3.8, P = .001). Neutropenia was a negative predictor of overall (RR 2.0, P = .0001) and event-free survival (RR 2.1, P < .0001), and a predictor of relapse (RR 1.7, P = .03) and nonrelapse mortality (RR 2.1, P = .003). Thus, early liver dysfunction, elevated serum creatinine, and low marrow cellularity are risk factors for ganciclovir-related neutropenia. Neutropenia in ganciclovir recipients after marrow transplantation is an independent risk factor for mortality.

Adolescent↗

A randomized trial of a consultation service to reduce falls in nursing homes.

CONTEXT: Falls are a major health problem in nursing homes, but no interventions have been shown to prevent falls in nursing home residents. OBJECTIVE: To evaluate an intervention program designed to prevent falls and associated injuries in high-risk nursing home residents. DESIGN: Randomized controlled trial. SETTING AND PARTICIPANTS: Seven pairs of middle Tennessee nursing homes with 1 facility in each pair randomly assigned to the intervention. Facilities had 482 (261 control, 221 intervention) residents who qualified for the study because they had high risk of falls and a potential safety problem that could be addressed by the intervention. INTERVENTION: Comprehensive structured individual assessment with specific safety recommendations that targeted suboptimal practices for environmental and personal safety, wheelchair use, psychotropic drug use, and transferring and ambulation. Facility staff were encouraged to implement the individual recommendations and to improve overall facility safety. MAIN OUTCOME MEASURES: The mean proportion of recurrent fallers and incidence rate of injurious falls in the facility in the year following the intervention. RESULTS: The mean proportion of recurrent fallers in intervention facilities (43.8%) was 19.1% (95% confidence interval, 2.4%-35.8%) lower than that in control facilities (54.1%, P=.03). Intervention facilities had a nonsignificant trend toward a lower mean rate of injurious falls (13.7 vs 19.9 per 100 person-years, reduction of 31.2%, P=.22). Subgroup analyses suggested greatest benefits for residents for whom the recommended interventions were carried out or who had 3 or more falls in the preceding year. CONCLUSION: The high rate of falls and related injuries in nursing homes should not be viewed as inevitable, but as outcomes that can be substantially improved through structured safety programs.

Accident Prevention↗

Human submandibular saliva specifically inhibits HIV type 1.

Studies from a number of laboratories have shown the presence of factor(s) in whole, parotid, and submandibular human saliva capable of inhibiting HIV-1 infectivity in vitro. Data from our laboratory suggested that the level of anti-HIV-1 activity is higher in submandibular than parotid or whole saliva. Previous results obtained with pooled submandibular saliva from seronegative individuals included a filtration step following saliva-virus interaction. In this article, we present data on the HIV-1 inhibitory activity of individual submandibular saliva samples collected from 15 donors. We show that although anti-HIV activity is quantitatively similar in most individuals (9 of 15), some (4 of 15) are much less active than others and some (2 of 15) lack inhibitory activity. We also show that for most individuals the level of anti-HIV inhibitor is similar with or without a filtration step. However, 2 of the 15 samples demonstrated activity only after filtration. The quantitative and qualitative anti-HIV activity of individual saliva samples appeared to reflect differences in the individual donors. We further show that the anti-HIV activity of submandibular saliva is demonstrated not only against laboratory strains of HIV-1 but is similarly active against three clinical HIV-1 isolates. In contrast, submandibular saliva had little effect on the infectivity of HIV-2 or SIV.

Antiviral Agents↗

Normal and neurotic perfectionism in eating disorders: an interactive model.

OBJECTIVE: Previous nonclinical research found that both normal (or adaptive) and neurotic (or maladaptive) perfectionism were related, in the positive direction, to attitudes and behaviors associated with eating disorders. However, based on a related body of research, it was hypothesized that these two aspects of perfectionism would relate to body esteem in an interactive rather than an additive fashion. METHOD: Anorexic and bulimic patients (n = 123) were assessed on multidimensional aspects of perfectionism, neuroticism, and body esteem. RESULTS: Predictions were confirmed. Normal perfectionism was positively associated with body esteem, but only when levels of neurotic perfectionism were low. Conversely, body-image disparagement was most pronounced when normal and neurotic perfectionism were both elevated. DISCUSSION: These findings demonstrate that the interpretation of simple relationships among personality variables--at least in the area of body image and eating disorder research--may provide a misleading picture.

Adult↗

A qualitative study of breast cancer self-help groups.

This study reports on the experience of women in four community breast cancer self-help groups in Ontario, Canada. Semi-structured interviews were conducted with 24 women, asking them about benefits and limitations of their group involvement, and about their perspectives on group processes and structures. Overall, participants reported their group involvement to be extremely helpful for navigating the short and long-term impact of breast cancer. Emotional support benefits included connecting with other breast cancer survivors, feeling understood and sharing experiences, providing hope, and sharing healing laughter. Informational and practical support benefits included sharing of important information and learning how to get what you want. Even where there were concerns about limitations or tensions of group experience, these occurred against a backdrop of appreciation and commitment. From the discussion of group processes and structures, a number of issues were identified as problematic. Most notable were how to deal with deaths of group members and how to balance the group's primary purpose of providing mutual support with secondary goals of dealing with group business and engaging in meaningful advocacy.

Adaptation, Psychological↗

Microwave fixation of rabies specimens for fluorescent antibody testing.

An adaptation of the conventional procedure for fixation of brain impressions prior to rabies testing was developed using a microwave oven to fix slides in less than 1 min. A total of 2394 routine specimens were examined to evaluate the efficacy of microwave fixation of brain impressions as an aid to shortening the turnaround time for reporting. Slides were fixed for 55-60 s in a standard household microwave oven at 50%, power using phosphate buffered saline supplemented with 3% Tween 20 as a fixative medium. They were then stained using the standard rabies immunofluorescent staining procedure with minor modifications. This process potentially could allow results to be reported to submitters within 1.5 h after specimens arrive in the laboratory. Microwave fixation was in complete agreement with conventional acetone fixation for detection of positive rabies specimens.

Animals↗

Use of the QSR.NUD.IST computer program to identify how clinical midwife mentors view their work.

This paper looks at the use of a computer program (QSR.NUD.IST) to analyse qualitative data. The data are derived from interviews with clinical midwife mentors as part of an evaluation of a midwifery educational programme. An account is given of the content analysis of the data with reference to the literature, and then the way the programme was used to analyse the data a second time. A description is given of the way this programme in particular functions using the textual data as an example. The use of computers in general for analysing qualitative data is discussed in terms of their advantages and disadvantages. The results of the study are described briefly showing how the mentors view their role and responsibilities.

Data Interpretation, Statistical↗

Comparison of the morphological transforming activities of dibenzo[a,l]pyrene and benzo[a]pyrene in C3H10T1/2CL8 cells and characterization of the dibenzo[a,l]pyrene-DNA adducts.

C3H10T1/2CL8 (C3H10T1/2) mouse embryo fibroblasts were used to study the in vitro carcinogenic activities of dibenzo[a,l]pyrene (DB[a,l]P) and benzo[a]pyrene (B[a]P). The morphological transforming activities of these rodent carcinogens were compared using replicate concentration-response studies. In concentration ranges where both polycyclic aromatic hydrocarbons (PAHs) were active, DB[a,l]P proved to be four to 12 times as potent as B[a]P based on concentration. At lower concentrations DB[a,l]P was active at 0.10 and 0.20 microM, concentrations where B[a]P was inactive. This makes DB[a,l]P the most potent non-methylated PAH evaluated to date in C3H10T1/2 cells. DNA adducts of DB[a,l]P in C3H10T1/2 cells were analyzed by both TLC and TLC/HPLC 32P-postlabeling methods using mononucleotide 3'-phosphate adduct standards derived from the reactions of anti-DB[a,l]P-11,12-diol-13,14-epoxide (anti-DB[a,l]PDE) and syn-DB[a,l]P-11,12-diol-13,14-epoxide (syn-DB[a,l]PDE) with deoxyadenosine 3'-monophosphate and deoxyguanosine 3'-monophosphate. All of the DNA adducts observed in C3H10T1/2 cells treated with DB[a,l]P were identified as being derived from the metabolism of DB[a,l]P to its fjord region diol epoxides through DB[a,l]P-11,12-diol. The predominant adduct was identified as an anti-DB[a,l]PDE-deoxyadenosine adduct. Other major adducts were anti-DB[a,l]PDE-deoxyguanosine and syn-DB[a,l]PDE-deoxyadenosine adducts with minor amounts of syn-DB[a,l]PDE-deoxyguanosine adducts. These DNA adduct data are consistent with similar findings of DB[a,l]PDE-deoxyadenosine adducts in mouse skin studies and human mammary cells in culture.

Animals↗

Inhibition of HIV infectivity by human saliva.

OBJECTIVE: Human saliva is known to decrease HIV infectivity in vitro. The purpose of this study was to extend these findings and to focus on the mechanism of action of these salivary factor(s). DESIGN: A number of viruses and several assay systems have been utilized to determine if the effect of submandibular saliva is directly on the virus, on the host cell, or on the virus-cell interaction. MATERIALS AND METHODS: Submandibular saliva from seronegative donors was incubated with HIV-1, other retroviruses, or unrelated viruses. Viral infectivity was monitored either by determining p24 antigen levels in peripheral blood mononuclear cells or Sup T1 cells, or using HeLa cells expressing CD4 and an HIV derived long terminal repeat linked to the beta-galactosidase gene. RESULTS: The inhibition of viral infectivity by submandibular saliva is specific for HIV-1. While inhibition increases with time of incubation of saliva with virus, pretreatment of cells with saliva does not inhibit HIV production, and saliva has only modest inhibitory effects when added to HIV-infected cells. CONCLUSIONS: It appears that the effect of submandibular saliva on decreasing the infectivity of HIV-1 is directly on the virus, rather than on the host cell.

Antiviral Agents↗

Nightmares, dreams, and schizotypy.

The theory that psychosis and dreaming share some common underlying mechanism finds support in the observation that chronic nightmare sufferers are at increased risk for psychopathology. We examined this connection in a large general population sample, administering a battery of psychosis proneness and other personality scales, together with a nightmare distress scale; participants also answered a single question on pleasurable mood associated with dreaming. In addition, they completed the Bem Sex Role Inventory, to reinvestigate previously observed gender differences in nightmare susceptibility. It was found that, among the psychosis proneness scales, the best predictor of nightmare distress was STA, a mostly cognitive measure of schizotypy; this was true even after allowing for a strong influence in the data of general neuroticism. Other aspects of psychosis proneness--e.g. anhedonia--were unrelated to nightmares. However, sex and sex role differences did make a significant contribution, self-confessed feminine females and masculine males reporting, respectively, the highest and lowest nightmare distress. For schizotypy it was further shown that relationships were not confined to the nightmare experience; high (STA) schizotypes also significantly more often reported enjoyable dreaming. It was concluded that a unifying theme explaining the data is the schizotype's greater imaginativeness, which can have both positive and negative expression in sleep and consciousness.

Adolescent↗

Personality factors related to the prevalence of somatic symptoms and medical complaints in a healthy student population.

Previous research in somatization has identified strong positive relationships between this variable, and both neuroticism, and depression. Many studies, however, are limited by a cross-sectional approach, correlational analyses, and/or the restriction to clinical (psychiatric or medical) populations. The present investigation prospectively compared the relationships between neuroticism, depression, and somatic symptoms in a healthy student sample. As predicted, neuroticism and depression were significantly and positively related to symptom reporting. The results of a multiple regression analysis indicated that depression contributed significantly to the variance in symptom-reporting even after controlling for the effects of neuroticism. This finding suggests the importance of mood state in the experience of somatic symptoms. However, this influence is not independent of the trait neuroticism. The results of this study also indicated that females reported significantly more symptoms than males, and gender-specific relationships are discussed.

Adult↗

Eating disorders and hyperactivity: a psychobiological perspective.

OBJECTIVE: To review the eating disorder research investigating the psychobiological connections between self-starvation and high-level exercising, including both animal experimentation and clinical field studies. In recent years it has been proposed that physical activity plays a central role in the pathogenesis and progression of the eating disorders-in particular, anorexia nervosa. METHOD: A review of research from animal experimentation and from clinical field studies investigating the biological and psychological implications of physical activity and starvation in the pathogenesis of eating disorders. RESULTS: Animal research indicates that physical activity and starvation seem to potentiate one another and that alterations in the serotonergic system may underlie this process. Similar behavioural results have been found in recent clinical studies with eating-disordered patients, which suggests that physical activity plays a more central role in the development and maintenance of the eating disorders than had previously been thought. CONCLUSIONS: The emerging picture is that psychosocial factors seem to provide the most compelling factors in the etiology and onset of the disorder, while biological factors-in most cases induced by severe malnutrition and strenuous overexercising-predominate in the maintenance of the disorder.

Adolescent↗

Lighting test partnership: Southern California/Kaiser Permanente lighting study.

Energy-reduction conservation efforts are in the interest of any well-run health care facility. Energy-efficient lighting and lighting systems can deliver significant energy savings while maintaining optimum lighting levels. This document is a result of a lighting study conducted by Southern California Edison's Customer Solution's Group and Kaiser Permanente to help resolve some issues relating to future lighting projects. In particular, specular reflectors as an issue was addressed.

California↗

Interviews with men with prostate cancer about their self-help group experience.

This study reports on the results of semi-structured interviews with 12 men involved in prostate cancer self-help groups in three Canadian cities. Overall, participants reported their group involvement to be helpful, especially in terms of accessing information. Additional benefits included finding commonality with others, being able to talk about difficult issues, being productive and accomplishing tasks, advocating to make a difference, and engaging with family members around health issues. We conclude that the recent growth of self-help groups speaks to the challenge inherent for men in dealing with prostate cancer and counteracts tendencies to minimize the suffering which they experience.

Adaptation, Psychological↗