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Biomedical subjects

D Neville

Publications and source records attributed to D Neville.

14 recordsLinked to original sources
PubMed1998

Analysis of primate renal allografts after T-cell depletion with anti-CD3-CRM9.

BACKGROUND: FN18-CRM9 is a CD3-specific immunotoxin that is capable of depleting CD3+ T cells. Pretreatment of rhesus monkeys with this agent before transplantation can induce donor-specific tolerance and "split tolerance" to renal allografts. METHODS: Heterotopic renal transplants were performed on monkeys that received posttransplant FN18-CRM9. Histological and immunohistological staining, as well as analysis of the intragraft cytokine profile by reverse transcriptase polymerase chain reaction, was performed on percutaneous allograft biopsies. RESULTS: Experimental monkeys had significant prolongation of allograft survival. Although an interstitial, mononuclear cell infiltrate was seen in all of the renal transplants, there was minimal evidence of acute cellular rejection. Histological evidence of alloantibody-mediated damage was detected 3 to 5 months after transplantation in the monkeys treated with FN18-CRM9. Immunohistology demonstrated the reappearance of CD3+ and CD4+ T cells, as well as CD20+ B cells, in the grafts. Cytokine analysis demonstrated expression of interferon-gamma. An intact anti-donor IgG response was seen. CONCLUSION: Treatment of monkeys with FN18-CRM9 immediately after transplantation significantly prolongs renal allograft survival. Allograft biopsies demonstrate a lack of acute cellular rejection; however, alloantibody-mediated graft damage and rejection occur, with an intact anti-donor IgG response. The intragraft expression of the interferon-gamma may reflect this ongoing humoral rejection. These data suggest that even a brief period of T-cell allosensitization may lead to humorally mediated allograft damage. Efforts to achieve tolerance with posttransplant FN18-CRM9 will require modification of the protocol to deplete T cells before allosensitization exposure or to supplement the posttransplant immunomodification strategy.

Animals↗
PubMed1996

Hospitalization and case-fatality rates for stroke in Canada from 1982 through 1991. The Canadian Collaborative Study Group of Stroke Hospitalizations.

BACKGROUND AND PURPOSE: The purpose of this study was to estimate rates of hospitalization and in-hospital case-fatality for cerebral infarction and intracerebral hemorrhage in Canada and to describe variation in rates by age, sex, and calendar period. METHODS: Data were obtained from hospitalization databases for each of Canada's 10 provinces for the 10 fiscal years of 1982 through 1991. All hospitalizations of persons 15 years of age or older with a primary diagnosis at discharge coded 431, 434, or 436 according to the International Classification of Disease, 9th Revision, were included. Rates per 100,000 population were calculated for intracerebral hemorrhage and cerebral infarction, for men and women, and for five age groups. Annual age- and sex-specific, 30-day, in-hospital case-fatality rates were also calculated. RESULTS: A total of 335,283 discharges for stroke were enumerated over the 10-year period (309,631 cerebral infarctions and 25 652 intracerebral hemorrhages). A significant decline of approximately 1% per year was observed for the rate of cerebral infarctions. For hemorrhages, the reverse was seen. For men there was a 44% increase over the 10-year period, and for women there was a 34% increase. In-hospital case-fatality rates for cerebral infarctions increased with age but did not differ by sex when age was considered. For the five age groups of 15 to 54, 55 to 64, 65 to 74, 75 to 84 and > or = 85 years, rates were 6%, 8%, 12%, 18% and 27%, respectively. For intracerebral hemorrhage, the in-hospital case-fatality rates declined significantly over time from approximately 36% to 29%, 55% to 37%, 49% to 41%, 66% to 45%, and 72% to 59% for the five age groups, respectively. CONCLUSIONS: The possibility that these changes are artifactual could not be ruled out, but because there is no obvious risk in assuming that they are not, it would be prudent to investigate their causes further.

Adolescent↗
PubMed1992

Body dysmorphic disorder. Diagnostic issues and related disorders.

This article reviews diagnostic issues about body dysmorphic disorder and discusses its relationship to other disorders. Diagnostic and symptomatic overlap with obsessive-compulsive disorder is explored; associated features, course of illness, presumed etiology, and treatment outcome are compared; and similarities and differences are reviewed. Other illnesses with similar features, such as anorexia nervosa, social phobia, and the disorders associated with cosmetic surgery are mentioned. These findings are discussed in light of the development of DSM-IV diagnostic criteria.

Adolescent↗
PubMed1992

Chronology of a hospital-wide measles outbreak: lessons learned and shared from an extraordinary week in late March 1989.

In March 1989, Mount Sinai Hospital, a community hospital in Hartford, Connecticut, faced a potential hospital-wide outbreak of measles when eight cases of measles occurred among medical personnel during several days. This article describes the chronology of events, from the initial discovery of the outbreak to the evolution of the hospital-wide containment program designed to protect patients and staff members. Measles IgG immune status was determined for 1249 employees during a 9-day period. Measles vaccine and immune serum globulin were administered to patients and employees. We offer advice from our experience for infection control practitioners who may face outbreak situations in their institutions.

Adult↗
PubMed1991

General deterrence of drunk driving: evaluation of recent American policies.

A testable hypothesis of deterrence theory is that efforts to increase the expected cost of criminal activity by increasing the threat of punishment should, other things being equal, reduce the crime rate. In this paper, we examine whether the incidence of drinking and driving is responsive to escalation of the punitive threat. The recent national campaign against drunk driving provides a natural experiment in which to test the predictions of deterrence theory. Using state level data over the 1975-1986 period, we report no conclusive evidence that any specific form of punitive legislation is having a measurable effect on motor vehicle fatalities. We report suggestive evidence that multiple laws designed to increase the certainty of punishment (e.g., sobriety checkpoints and preliminary breath tests) have a synergistic deterrent effect. The most striking finding is that mandatory seat belt use laws and beer taxes may be more effective at reducing drunk driving fatalities than policies aimed at general deterrence.

Accidents, Traffic↗
PubMedDate not supplied

Uncomplicated and comorbid obsessive-compulsive disorder in an epidemiologic sample.

This study investigated lifetime prevalence rates, demographic characteristics, childhood conduct disorder and adult antisocial features, suicide attempts, and cognitive impairment in individuals with obsessive-compulsive disorder (OCD) uncomplicated by or comorbid with any other psychiatric disorder. The data are from the NIMH Epidemiologic Catchment Area (ECA) study, and the current analyses compared subjects with uncomplicated OCD (no history of any other lifetime psychiatric disorder), comorbid OCD (with any other lifetime disorder), other lifetime psychiatric disorders, and no lifetime psychiatric disorders across these variables. OCD in its uncomplicated and comorbid form had significantly higher rates of childhood conduct symptoms, adult antisocial personality disorder problems, and of suicide attempts than did no or other disorders. Comorbid OCD subjects had higher rates of mild cognitive impairment on the Mini-Mental Status Exam than did subjects with other disorders. These findings suggest that a subgroup of OCD patients may have impulsive features, including childhood conduct disorder symptoms and an increased rate of suicide attempts; wider clinical attention to these outcomes is needed.

Adolescent↗
PubMedDate not supplied

Home comforts.

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Community Health Nursing↗