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Biomedical subjects

D Haley

Publications and source records attributed to D Haley.

12 recordsLinked to original sources
PubMed2004

Manipulating the host response to autologous tumour vaccines.

From our way of thinking the problem facing vaccine strategies for cancer is not that we do not have "enough" tumour antigens. The problem is we cannot induce an immune response that is sufficient to mediate tumour regression. The normal "checks and balances" found in the body prevent the sustained expansion and subsequent persistence of immune killer cells. If vaccine strategies are going to become effective treatments for cancer patients, they will need to overcome this substantial roadblock. Recent developments in immunology have provided insights into the mechanisms that regulate the expansion and persistence of T cells. This has allowed investigators to reinterpret decades-old observations suggesting that chemotherapy administered before vaccination often led to a stronger immune response. This manuscript will review experiments that offer an explanation for these observations and present pre-clinical data from our laboratory that describes an innovative new approach to combining chemotherapy and vaccination. This approach is readily translatable to the clinic and is broadly applicable to any vaccine strategy for advanced cancer.

Antigens, Neoplasm↗
PubMed1997

Proteolytic enzymes in the blood-feeding parasitic copepod, Phrixocephalus cincinnatus.

To understand digestive and invasive mechanisms employed by blood-feeding parasitic copepods, extracts of Phrixocephalus cincinnatus were assayed for specific proteolytic enzyme activity. Intact parasites were dissected into the 3 major body regions, cephalothorax (CT), genital segment (GS), and eggstrings (ES), and homogenized in ice-cold 1% Triton X-100 (v/v) in water. Protease activity in each body region was assayed using several synthetic fluorogenic peptide substrates. The greatest activity was detected when samples were incubated with carbobenzoxy-phenylalanyl-arginyl-7-amido-4-methylcoumarin (CBZ-phe-arg-NHMec) in the presence of cysteine or reducing agents. Substrate specificity, pH profile, and inhibitor sensitivity indicated that the proteolytic enzyme(s) belonged to the cysteine class of endopeptidases and were most similar to mammalian cathepsins L, B, and H, respectively. Intense protease activity was also detected with carbobenzoxy-glycyl-L-prolyl-L-arginine-7-amido-4-methylcoumarin (CBZ-gly-pro-arg-NHMec), a substrate for the serine proteases, plasmin and thrombin. Substrate gel electrophoresis revealed intense gelatinolytic activity in all body regions; however, the ES extract presented a pattern different from that of the adult body, suggesting that distinct proteolytic enzymes are expressed during development. Gelatinolytic activity was inhibited at low pH and in the presence of serine protease inhibitors but not cysteine protease inhibitors. Collectively, the results indicate the presence of 2 major classes of proteolytic enzymes, cysteine and serine proteases. Differential expression of these proteases may be important for the successful completion of the parasite's life cycle, as well as survival of the adult.

Animals↗
PubMed1996

The use of household surveys in community-oriented primary care health needs assessments.

OBJECTIVE: This study demonstrates the use of a community household survey and how it can provide information beyond that obtained with secondary epidemiologic data alone. METHODS: Adults in 215 randomly selected households in an inner-city neighborhood in Bronx, NY, were assessed by in-person interviews in homes of neighborhood residents. The survey collected data on self-reported health status, source and quality of medical care, possible barriers to obtaining medical care, and perceptions of the community. Demographic information was also obtained. Mortality rates, birth outcomes, and census data were obtained from secondary data sources. RESULTS: The overall health of the community members surveyed was poor, and rates of self-reported health status, mortality rates, and poor birth outcomes were all generally higher than city-wide rates. More than half the respondents were using hospital-based outpatient clinics or emergency room care as their primary source of medical care. Nearly half the respondents had no personal health provider, and most respondents could not obtain medical advice over the phone or be seen within a week. A number of barriers to obtaining medical care were found to be associated with either gender or ethnic group. These findings are being used as the basis for a number of community-oriented primary care (COPC) outreach efforts. CONCLUSIONS: Although household surveys are expensive to conduct, the information garnered from this survey could not be obtained from secondary data sources and was important in determining the direction of outreach and intervention programs being carried out in the community by the COPC clinic.

Adult↗
PubMed1995

Diagnostic criteria for screening headache patients for temporomandibular disorders.

Patients with temporomandibular disorders frequently suffer from headache. The purpose of this study was to develop a simple screening exam which would allow the physician to identify headache patients with coexisting temporomandibular disorders. Twenty-eight migraine and 27 tension headache patients were identified by a board certified neurologist and then were examined by a dentist for signs of temporomandibular disorders. These patients were then compared to 63 patients with temporomandibular internal derangements and 62 patients with myofascial pain dysfunction. Comparisons of the clinical signs showed that the temporomandibular internal derangement and myofascial pain dysfunction patients differed significantly from the headache patients in regards to specific signs of jaw dysfunction. The presence of reciprocal clicking of the temporomandibular joint or pain with maximum jaw opening and pain upon palpation of the temporomandibular joint distinguished temporomandibular internal derangement patients from headache patients. These criteria have a sensitivity of 92% and specificity of 91%. Pain on palpation over the temporomandibular joint, or pain with maximum jaw opening using passive stretch, and pain with lateral movement of the jaw, distinguished myofascial pain dysfunction patients from headache patients. These criteria have a sensitivity of 77% and specificity of 85%. By using these screening tests, the physician can identify the concurrent existence of temporomandibular disorders in headache patients and triage the patient to a clinician knowledgeable in the diagnosis and treatment of temporomandibular disorders for further evaluation.

Cross-Sectional Studies↗
PubMed1993

The comparison of patients suffering from temporomandibular disorders and a general headache population.

The purpose of this study was to examine the possible association of signs and symptoms of temporomandibular disorders relative to headache. Fifty-six sequential patients referred to the Headache Institute of Minnesota for evaluation and treatment of migraine and tension headaches were examined for signs and symptoms of temporomandibular disorders. The results of the examination of headache patients were compared to patients suffering from myofascial pain dysfunction and/or TMJ internal derangements from the TMJ and Craniofacial Pain Clinic at the University of Minnesota. Finally the migraine and tension headache patients were compared to each other and an asymptomatic population. Results indicate that patients with temporomandibular disorders exhibit significantly more jaw dysfunction and pericranial muscle tenderness than migraine and tension headache patients. Migraine and tension headache patients were found to have similar amounts of pericranial muscle tenderness. Migraine and tension headache patients exhibited significantly more pericranial and neck muscle tenderness than a general population.

Analysis of Variance↗
PubMed1993

Marketing strategy determinants in rural hospitals.

Rural hospitals confront an inauspicious environment due to changes in patient reimbursement and medical practice. Facing a situation of declining revenues, marketing presents an option for rural hospitals to adapt to the growing constraints. This paper analyzes the determinants of marketing strategy emphasis in rural hospitals. The conceptual model adopted in this study predicts that prior performance and contextual variables explain marketing strategy emphasis. The relationships are examined in a case study of rural New Mexico hospitals. Results suggest that prior performance and several contextual variables explain variations in marketing strategy emphasis. In particular, higher gross patient revenues are associated with more emphasis on television and radio advertising. Furthermore, rural New Mexico hospitals with high numbers of licensed beds and medical staff members, or that are affiliated with a chain organization, place greater emphasis on market research and market planning. The implications for marketing practice in rural hospitals are discussed.

Advertising↗
PubMed1992

Prognostic significance of DNA ploidy in male breast carcinoma. A retrospective analysis of 32 cases.

BACKGROUND: DNA aneuploidy has been prognostically significant in female breast carcinoma of low stage, but its value in male breast carcinoma remains undetermined. METHODS: Flow cytometric DNA analyses were performed retrospectively on paraffin-embedded tissue from 32 men with breast carcinoma (mean follow-up time, 5.97 years [standard deviation +/- 4.63]; range, 1 to 18 years). RESULTS: Multivariate discriminant function analysis showed only tumor size less than 2 cm to be independently predictive of better disease-free survival (P less than 0.05). DNA ploidy (aneuploid, 25 patients; diploid, 7 patients) and lymph node status (positive, 22 patients; negative, 10 patients) were not predictive of survival, regardless of tumor size. CONCLUSIONS: The authors concluded that DNA ploidy may not significantly predict survival in male breast carcinoma.

Adult↗
PubMed1992

The relationship of occlusion, parafunctional habits and recent life events to mandibular dysfunction in a non-patient population.

This study investigated the association between occlusion, oral habits and stress relative to the level of mandibular dysfunction in the total population and in specific diagnostic subgroups (normal, joint disorder, muscle disorder and joint/muscle disorder). A total of 269 nursing students were given a questionnaire and examination. The questionnaire included items to calculate an oral habit index and a social readjustment rating scale. The examination included items to calculate an occlusal index, two craniomandibular indices and a diagnostic criteria for specific subgroups. In the total population there was a positive association between mandibular dysfunction and three postulated risk factors. The total population was then divided into diagnostic subgroups. There was a positive association between the degree of mandibular dysfunction and parafunctional habits for normals, muscle disorders and joint/muscle disorders. There was a positive association between mandibular dysfunction and occlusion for normals only. Finally there was a positive association between mandibular dysfunction and stress for muscle disorders only. The results suggest that associations between postulated aetiologic factors and mandibular dysfunction vary depending on whether the subjects have a muscle and/or joint disorder. Since all associations were weak, other possible risk factors need to be investigated.

Adult↗
PubMed1985

Myofascial pain syndrome of the head and neck: a review of clinical characteristics of 164 patients.

Myofascial pain syndrome (MPS) is a common but misunderstood muscular pain disorder involving pain referred from small, tender trigger points within myofascial structures in or distant from the area of pain. Misdiagnosis or inadequate management of this disorder after onset may lead to development of a complex chronic pain syndrome. A review of the clinical characteristics of 164 patients whose chief complaints led to the diagnosis of MPS revealed that these patients had (1) tenderness at points in firm bands of skeletal muscle that were consistent with past reports, (2) specific patterns of pain referral associated with each trigger point, (3) frequent emotional, postural, and behavioral contributing factors, and (4) frequent associated symptoms and concomitant diagnoses.

Adolescent↗
PubMed1984

Human figure drawing ability and vestibular processing dysfunction in learning-disabled children.

Explored the relationship between vestibular function as measured by duration of postrotary nystagmus and human figure drawing ability in 40 children labeled as learning disabled. Regression analysis revealed that the variable of chronological age shared the most variance with human figure drawing scores. Postrotary nystagmus durations also shared a significant amount of variance with human figure drawing scores, while the variables of IQ and sex were nonsignificant. The results provide additional support for the assertion that some learning-disabled children evidence deficits in vestibular processing ability and that these deficits may affect performance on cognitive-perceptual tasks.

Child↗