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Biomedical subjects

C Howard

Publications and source records attributed to C Howard.

At least 37 records · Page 2Linked to original sources
PubMed1998

Detection of fetal messenger ribonucleic acid in maternal blood to determine fetal RhD status as a strategy for noninvasive prenatal diagnosis.

OBJECTIVES: Our purpose was to test the hypothesis that reverse transcriptase-polymerase chain reaction for fetal messenger ribonucleic acid in maternal blood is more sensitive than polymerase chain reaction from genomic deoxyribonucleic acid in prenatal determination of fetal RhD blood type. STUDY DESIGN: Fetal nucleated erythrocytes in peripheral blood from 35 RhD-negative women were enriched by triple-density gradient centrifugation, anti-CD71 magnetic sorted, and deoxyribonucleic acid and ribonucleic acid extracted. Sensitivities of reverse transcriptase-polymerase chain reaction and polymerase chain reaction were compared to predict definitive fetal RhD blood type determined in fetal tissues. RESULTS: Reverse transcriptase-polymerase chain reaction was significantly more accurate (P = .03) than genomic-polymerase chain reaction in predicting fetal RhD blood type, both overall (28 of 35 vs 22 of 35) and when the fetus was RhD-positive (12 of 19 vs 6 of 19). CONCLUSIONS: Reverse transcriptase-polymerase chain reaction is more sensitive than genomic-polymerase chain reaction in detection of fetal RhD sequences in maternal blood.

Female↗
PubMed1998

Ketoacidosis occurring in newly diagnosed and established diabetic children.

A 6-y retrospective case note review was performed to determine the causes of ketoacidosis. 135 patients and 463 diabetic years were involved. Fifty-two ketoacidosis episodes occurred: 19 episodes in new patients and 33 episodes in 19 patients with established diabetes. 27% of newly diagnosed patients presented in ketoacidosis. They were similar in terms of age, sex and proportion living in single parent families to those presenting without ketoacidosis. The 33 ketoacidosis episodes occurring in established patients included 12 episodes in 3 children who were transferred to our care because of uncontrolled diabetes. Insulin omission was the cause of ketoacidosis in 9/19 (47%) patients, and was suspected in a further 5/19 (26%). Family and school problems were common and 14/19 patients came from single parent families. Established patients aged > or = 11 y were predominantly female (10F, 2M), whereas patients aged < or = 10 y were predominantly male (6M, 1F). 7 patients with multiple ketoacidosis episodes were all > or = 11 y and 6 were female. Families with > or = 2 diabetic children appeared vulnerable, 4 cases coming from 3/7 such families.

Adolescent↗
PubMed1998

Volatilization of chemicals from drinking water to indoor air: the role of residential washing machines.

Previous research has indicated that residential washing machines are potential sources of pollution due to the associated use of chemicals found in consumer products, for example, ethanol in laundry detergent and chlorine in bleach. Washing machines may also emit hazardous air pollutants found in contaminated drinking water. To better understand the extent and impact of chemical emissions from tap water, 26 experiments were completed using a residential washing machine and a cocktail of chemical tracers representing a wide range of physicochemical properties. Variable operating conditions for these experiments included water temperature, amount of clothes present in the machine, water volume, and level of washwater agitation. Chemical stripping efficiencies and mass transfer coefficients were determined during each cycle (fill, wash, and rinse) of a normal washing machine event. Headspace ventilation rates were determined using an isobutylene tracer gas. Mass transfer rates were significantly influenced by operating parameters as exhibited by a wide range of chemical stripping efficiencies. Stripping efficiencies ranged from 0.74 to 36% for acetone, 8.2 to 99% for toluene, 10 to 99% for ethylbenzene, and 6.9 to 100% for cyclohexane.

Air Pollution, Indoor↗
PubMed1998

'Epiphyseal dysgenesis' in Laurence-Moon-Biedl-Bardet syndrome.

Ten patients with Laurence-Moon-Biedl-Bardet syndrome were investigated. They all belonged to one large family within which several intermarriages had taken place. We found that, apart from the already described abnormalities, these patients suffered from dysgenesis of the following epiphyses: vertebrae, proximal femur, proximal tibia, capitellum, tarsal navicular, and the distal epiphysis of the first metatarsal. The degree of polydactyly, a prominent feature of this syndrome, varied from patient to patient, ranging from a wide fifth metatarsal or metacarpal to a complete sixth digit. As in other epiphyseal dysgenesis, a pseudoepiphysis of the distal first metacarpal was present. One patient (the eldest) was tetraparetic due to severe spinal stenosis.

Adolescent↗
PubMed1998

Methodological approaches to assessing risk perceptions associated with food-related hazards.

The psychometric approach developed by Slovic and his co-workers has been effectively used to assess risk perceptions associated with different food-related hazards. However, further examination (using questionnaire data and partial correlation techniques) has indicated that technological hazards are highly differentiated from lifestyle hazards, in terms of both hazard control and knowledge about the hazard. Optimistic bias was also seen to vary between hazards. Further research has focused on a particular hazard, genetic engineering. Risk perceptions associated with genetic engineering are underpinned by ethical concern and questions relating to perceived need for the technology, as well as perceptions of risk or harm. However, increasing the specificity of hazard stimuli was found to alter the factor structure of underlying risk perceptions. The utility of preference mapping procedures in determining individual differences in trust in risk regulators is also discussed.

Bias↗
PubMed1997

Purification and characterization of bovine dendritic cells from peripheral blood.

Optimal activation of T lymphocytes depends on TCR interaction with peptide/MHC complexes in conjunction with costimulatory signals, which are delivered by specialized cells called antigen-presenting-cells (APC). The population of APC is heterogeneous and includes dendritic cells, B cells and macrophages. The family of dendritic cells (DC) is widely distributed in tissues and plays a major role in the induction of primary T-dependent immune responses. The aim of this paper was to isolate and characterize dendritic cells from cattle. Two methods are described that have been used to isolate dendritic cells from bovine peripheral blood. One method involves sequential depletion of other cells, adherence and isolation of low buoyant density cells on Metrizamide column. The second involves enrichment of cells displaying receptors for plasma fibronectin, followed by adherence and separation on Metrizamide. Both preparations were characterized morphologically by flow cytometry and functionally. Both procedures produced enriched populations that did not express molecules typical of T cells (CD3, CD4, CD8, WC1), B cells (sIg, CD21) and monocytes (CD14, Fc gamma 2R). Procedure 2 yielded cells with a typical veiled DC morphology that were highly effective at stimulating allogeneic T cells. Procedure 1 yielded cells that did not have the veiled morphology and were less effective in the MLR which may represent a more immature stage.

Animals↗
PubMed1997

Renal structural-functional relationships in early diabetes mellitus.

To define the earliest renal morphological changes in patients with type I diabetes, we studied renal function and morphometric analysis of renal biopsies in 59 patients with diabetes for 5-12 years and normal blood pressure, normal creatinine clearance (CCr), and negative dipstick urinary protein. Arteriolar hyalinization and intimal fibrous thickening were noted in 43%. Glomerular basement membrane thickness and fractional mesangial volume were increased in 51% and 56%, respectively. The pre-pubertal and post-pubertal years of diabetes were associated with similar degrees of renal structural changes, but during the pre-pubertal years normal urinary albumin excretion (UAE) was seen. Principal factor analysis of morphometric structural parameters yielded four clusters of variables: "glomerular size" correlated with patient age, CCr, and UAE; "peripheral capillary decrease" correlated with glycosylated hemoglobin, diastolic blood pressure, glomerular filtration rate, and UAE; "mesangial increase" correlated with UAE; and "interstitial scarring" correlated with diastolic blood pressure. This study provides unique documentation of renal structural abnormalities which precede clinically evident renal functional abnormalities and documents that these early structural abnormalities are present in the pre-pubertal years of diabetes as well as postpuberty, and are associated with each other in constellations that correspond to postulated mechanisms in diabetic nephropathy.

Adolescent↗
PubMed1997

The elaboration likelihood model and communication about food risks.

Factors such as hazard type and source credibility have been identified as important in the establishment of effective strategies for risk communication. The elaboration likelihood model was adapted to investigate the potential impact of hazard type, information source, and persuasive content of information on individual engagement in elaborative, or thoughtful, cognitions about risk messages. One hundred sixty respondents were allocated to one of eight experimental groups, and the effects of source credibility, persuasive content of information and hazard type were systematically varied. The impact of the different factors on beliefs about the information and elaborative processing examined. Low credibility was particularly important in reducing risk perceptions, although persuasive content and hazard type were also influential in determining whether elaborative processing occurred.

Adult↗
PubMed1996

Volatilization of chemicals from drinking water to indoor air: role of the kitchen sink.

Contaminated tap water is one source of potentially hazardous air pollutants in residential indoor air. Contaminants have been observed to volatilize from household tap water sources, including showers, wash basins, bath-tubs, washing machines, dishwashers, and toilets. A background search of these sources led to the conclusion that more attention should be given to wash basins and tubs, the numerous operating conditions of which yield a significant range of chemical stripping efficiencies. In response, nine laboratory experiments were completed to determine chemical stripping efficiencies and mass transfer coefficients for a kitchen wash basin. Chemical stripping efficiencies ranged from 1.1% to 4.9% for acetone, 13% to 26% for toluene, and 18% to 48% for cyclohexane. The product of overall mass transfer coefficient and interfacial area (KLA) ranged from 0.06 L/min to 0.24 L/min for acetone, 0.7 L/min to 1.9 L/min for toluene, and 0.9 L/min to 3.5 L/min for cyclohexane. Results clearly indicate that chemical properties (e.g., Henry's law coefficient) and system operating conditions (e.g., liquid flow rate and nozzle type) have a significant effect on contaminant stripping efficiency. Furthermore, significant gasphase resistance can occur, even for relatively volatile contaminants, during some operating conditions. The latter observation has important implications with respect to conventional protocols used to extrapolate radon data to other volatile contaminants in drinking water.

Air Pollution, Indoor↗
PubMed1996

Randomized, placebo-controlled, double blinded trial of dexamethasone in African children with sepsis.

OBJECTIVE: To determine the effect of moderate dose dexamethasone administered before antibiotics on the outcome of African children with sepsis. METHODS: The design was a randomized, double blinded, placebo-controlled trial of dexamethasone (0.2 mg/kg) vs. placebo given intravenously before antibiotic therapy. Patients were recruited from the patient populations at two missionary hospitals. Primary outcome variables were determined before analysis of data. RESULTS: Seventy-two children with sepsis were enrolled in the study. Treatment with dexamethasone was not associated with improved outcome for any of six outcome variables: survival to discharge (83%, dexamethasone group; 89%, placebo group); hemodynamic stability at 48 h (33%, dexamethasone group; 49%, placebo group); median length of hospital stay (11 days, dexamethasone group; 11 days, placebo group); normal at discharge (90%, dexamethasone group; 75%, placebo group); normal at follow-up (90%, dexamethasone group; 72%, placebo group); and afebrile at 48 to 72 h (61%, dexamethasone group; 44%, placebo group). CONCLUSIONS: These data indicate that a moderate dose of dexamethasone given before antibiotic therapy did not improve outcome in the pediatric patients with sepsis whom we studied.

Adolescent↗
PubMed1996

What determines trust in information about food-related risks? Underlying psychological constructs.

Trust in risk information about food related-hazards may be an important determinant of public reactions to risk information. One of the central questions addressed by the risk communication literature is why some individuals and organizations are trusted as sources of risk information and others are not. Industry and government often lack public trust, whereas other sources (for example, consumer organizations, the quality media, medical doctors) are highly trusted. Problematically, previous surveys and questionnaire studies have utilized questions generated by the investigators themselves to assess public perceptions of trust in different sources. Furthermore, no account of the hazard domain was made. In the first study reported here, semistructured interviewing was used to elicit underpinning constructs determining trust and distrust in different sources providing food-related risk information (n = 35). In the second study, the repertory grid method was used to elicit the terminology that respondents use to distinguish between different potential food-related information sources (n = 35), the data being submitted to generalised Procrustes analysis. The results of the two studies were combined and validated in survey research (n = 888) where factor analysis indicated that knowledge in itself does not lead to trust, but that trusted sources are seen to be characterised by multiple positive attributes. Contrary to previous research, complete freedom does not lead to trust-rather sources which possess moderate accountability are seen to be the most trusted.

Adult↗
PubMed1996

Diagnosis and management of asthma: occupational health nurses' awareness and use of national consensus practice guidelines.

A regional sample of members of the American Association of Occupational Health Nurses (AAOHN) from Maryland, Delaware, Virginia, and the District of Columbia was surveyed prior to the publication of the Expert Panel Report on Guidelines for the Diagnosis and Management of Asthma (time 1). The guidelines were disseminated directly to AAOHN members through an article in AAOHN Journal and an annual convention plenary session presentation at which copies of the Report were distributed. They were disseminated indirectly through medical journals and government documents. A follow up survey of AAOHN members' familiarity with and use of the Expert Panel Report was conducted 1 year later (time 2). Of the total eligible sample of 570 persons, 325 (57.0%) responded at time 1. Of these, 232 (71.4%) responded at time 2. One year after publication, 31 (13.4%) of the nurses participating in the time 2 survey were aware of the Report, 16 (6.9%) reported having an available copy of the Report, 31 (13.4%) were familiar with the recommendations in the Report, 17 (7.3%) referred to the guidelines and 34 (14.7%) based care on the guidelines. Multiple direct dissemination strategies of consensus guidelines to improve practice will be necessary if nurses' awareness and use are to be enhanced.

Asthma↗
PubMed1996

In situ distribution of integrin alpha 2 beta 1 and alpha-actinin in melanocytic proliferations.

Integrin alpha 2 beta 1 is a transmembrane protein receptor for collagen and laminin previously reported as a melanoma tumor progression antigen. alpha-Actinin is an actin-binding protein reported to interact with the cytoplasmic domain of the beta 1-integrin chain of alpha 2 beta 1. In vitro, both alpha 2 beta 1 and alpha-actinin play a role in melanoma cell motility. In turn, increased melanoma cell line motility (measured as mean migration rates), correlates with metastasis. To determine the in situ distribution of these proteins, we used monoclonal antibodies directed against the alpha 2-integrin subunit of alpha 2 beta 1 and alpha-actinin on frozen sections of 33 melanocytic proliferations, which included dermal nevi, primary melanomas, and metastatic melanomas. We found that the superficial portion of all of the melanocytic proliferations tested stained for alpha-actinin. In benign nevi and superficial spreading melanoma, there was a notable loss of staining for alpha-actinin in the cells in the deep reticular dermis. In contrast, alpha-actinin was present on almost all of the tumor cells in the nodular melanomas and the melanoma metastases. Tumors stained either uniformly positive or uniformly negative for alpha 2 beta 1; the expression of this protein correlated with the later stages of melanoma progression. Our findings suggest that alpha-actinin protein levels initially decrease and then increase during melanocytic tumor progression, whereas the alpha 2 subunit protein appears in the later stages of melanoma progression. The variable distribution of these proteins is evidence for the differential adhesive and motile properties of subpopulations of cells in melanocytic proliferations.

Actinin↗
PubMed1995

Long-term efficacy of continuing hepatitis B vaccination in infancy in two Gambian villages.

In 1984, all non-immune children under the age of 5 years in the Gambian villages of Keneba and Manduar were vaccinated against hepatitis B virus (HBV). All children born in these villages since 1984 have been vaccinated in infancy. Despite a rapid fall in antibody concentrations, vaccine efficacy against HBV infection and chronic carriage of HBsAg has increased with time. Overall, vaccine efficacies in 1993 against HBV infection and chronic HBsAg carriage were 94.7% (95% Cl 93.0-96.0) and 95.3% (91.0-97.5), respectively. Breakthrough infections in vaccinated children largely originate from chronic HBsAg carriers. Thus, we tested 261 chronic carriers for HBV DNA and e antigen. The prevalence of these markers of infectivity, and the amount of HBV DNA, decreased greatly with age. Detailed studies of breakthrough infections over two 4-year periods revealed that in the second period there were fewer than half the expected numbers of infections. Our findings suggest that in Keneba and Manduar long-term vaccination is progressively decreasing HBV transmission by chronic carriers, since their infectivity diminishes with time.

Adolescent↗
PubMed1995

Laboratory and bedside evaluation of portable glucose meters.

A two-phase, laboratory and bedside, evaluation of blood glucose meters was conducted in this study. Four meters, the AccuData Easy (Boehringer-Mannheim, Indianapolis, IN), HemoCue Glucose (HemoCue, Mission Viejo, CA), LifeScan One Touch II (LifeScan, Milpitas, CA), and Miles Encore QA (Miles, Elkhart, IN) systems, were compared to the Nova Stat Profile 5 (Nova, Waltham, MA) as the laboratory reference. Precision, linearity, correlation to the laboratory method, interference from hematocrit, data management, and operator preference were examined. None of the meters were found to satisfy all of the study's evaluation criteria. Therefore, institutions must weigh which criteria are most important to their individual settings. Although the HemoCue Glucose was found to be technically superior, this meter had no data management capabilities. The Encore QA had greater variance and low bias, whereas the AccuData Easy had bias affected by hematocrit and glucose concentration, and the One Touch II had a negative hematocrit bias and limited linear range when compared to the Nova. Only meters meeting both minimal analytical performance and computerization requirements, the One Touch II and AccuData Easy, were selected for further evaluation. At the bedside, the One Touch II demonstrated performance consistent with the lab evaluation, whereas the AccuData Easy showed greater imprecision in the low glucose range and a correlation that varied with sample type: capillary, venous, or arterial blood. This evaluation indicates that the clinician must interpret near-patient glucose results with respect to meter limitations. FDA approval and marketing statistics, alone, are insufficient to judge the performance of the meters in routine institutional use. Independent method validation, under actual operating conditions, is a better means of predicting future performance of the meters.

Blood Glucose↗