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Biomedical subjects

D Purcell

Publications and source records attributed to D Purcell.

15 recordsLinked to original sources

Childhood sexual abuse and sexual transmission risk behaviour among HIV-positive men who have sex with men.

Previous studies have indicated an association between childhood sexual abuse (CSA) and adult sexual risk behaviour among women and among men who have sex with men (MSM). However, no studies to date have tested the hypothesis that a history of CSA predicts sexual behaviour carrying risk of transmission of HIV to others, i.e. in a known HIV-positive cohort. The present study tested this hypothesis among a sample of 456 HIV-positive MSM recruited from community venues in New York and San Francisco. CSA history was found to be significantly associated with past (in the last 90 days) unprotected anal sex acts, both insertive (33% versus 20%, p < 0.05) and receptive (43% versus 27%, p < 0.02), with partners of HIV-negative or unknown serostatus. Further, several potential mediators of this effect were tested, and three found to be predicted by CSA history. Each of these potential mediators was associated with sexual risk behaviour, but differentially: anxiety and hostility were significantly associated with insertive acts, while anxiety, hostility and suicidality were associated with receptive acts. Mediation analyses supported the hypothesis that these factors significantly (albeit partially) accounted for the association of CSA with receptive anal intercourse. Nonsignificant mediation effects were found for insertive sex, suggesting the operation of unmeasured mediating variables. These results highlight the importance of mental health services for individuals who have been sexually abused, both for personal and for public health benefit, and also indicate a need for further research into mediators of CSA effects on transmission-related behaviour.

Adult↗

nef-deleted HIV-1 inhibits phagocytosis by monocyte-derived macrophages in vitro but not by peripheral blood monocytes in vivo.

OBJECTIVE: HIV-1 infection impairs a number of macrophage effector functions, but the mechanism is unknown. We studied the role of HIV-1 Nef in modulating phagocytosis by human monocytes and monocyte-derived macrophages (MDM). DESIGN AND METHODS: Using a flow cytometric assay, phagocytosis of Mycobacterium avium complex (MAC) by monocytes in whole blood of Sydney Blood Bank Cohort (SBBC) members infected with a nef-deleted (Delta nef) strain of HIV-1 was compared with that of monocytes from uninfected or wild-type (WT) HIV-infected subjects. The specific impact of Nef on phagocytosis by MDM was determined by either infecting cells in vitro with Delta nef strains of HIV-1 or electroporating Nef into uninfected MDM. RESULTS: MAC phagocytic capacity of monocytes from SBBC members was equivalent to that of cells from uninfected individuals (P = 0.81); it was greater than that of cells from individuals infected with WT HIV-1 (P < 0.0001), irrespective of CD4 counts and HIV viral load. In contrast, in vitro infection of MDM with either Delta nef or WT strains of HIV-1 resulted in similar levels of HIV replication and equivalent impairment of phagocytosis via Fc gamma and complement receptors. Electroporation of Nef into MDM did not alter phagocytic capacity. CONCLUSIONS: This study provides evidence demonstrating the complex indirect effect of Nef on phagocytosis by peripheral blood monocytes (infrequently infected with HIV-1) in vivo. Conversely, the fact that MDM infected with either Delta nef or WT HIV-1 in vitro (high multiplicity of infection) show comparably impaired phagocytosis, indicates that HIV-1 infection of macrophages can directly impair function, independent of Nef.

CD4 Lymphocyte Count↗

Suicide among the elderly in Honolulu County: a multiethnic comparative study (1987-1992).

Suicide rates for the elderly continue to be the highest for any age group. Although these rates are known to be significant, little study has been given to the ethnic variability associated with this phenomenon. This retrospective study was undertaken to explore this issue and involved a review of the coroner's reports for completed elder suicides (65 years of age or older) for Honolulu County from 1987 through 1992 inclusive. The results showed a mean age of 75 years, with the highest incidence of completion in the 80+ age group. The predominant method of suicide completion in this study group was found to be hanging, followed by jumping, firearms, and poisoning. There were significant gender and ethnic differences in the method of suicide completion. Almost half of the sample saw a healthcare provider within the 6 months before their death. Comparisons with other elder suicide studies are presented.

Age Distribution↗

Objective calibration of bone conductors using otoacoustic emissions.

OBJECTIVE: To demonstrate a technique for objectively calibrating bone conductors on an individual basis using distortion product otoacoustic emissions (DPOAEs). DESIGN: Individual calibrations were obtained using DPOAEs recorded from a single ear of 21 normally hearing adults. Validity and robustness of the technique were investigated through subjective phase cancellation measurements and sensitivity analysis. RESULTS: Calibrations obtained using the DPOAE method were well supported by phase cancellation results. Intersession repeatability was good, and manipulation of the DPOAE data showed that the calculated calibration is relatively insensitive to small variations of emission magnitude. Bilateral stimulation through bone conduction did not display an apparent effect on emission magnitude in a single individual. CONCLUSION: Bone conductors can be accurately calibrated on an individual basis with good repeatability using DPOAEs. The technique is robust and offers an objective, noninvasive calibration method for research and specialized clinical applications. No training and only passive cooperation are required, making the procedure ideal for special groups such as children. A number of limitations will reduce the clinical utility of this technique. Important audiometric frequencies below 1 kHz cannot be tested because of noise, because individuals with significant hearing loss are unlikely to produce sufficient DPOAEs, and because commercial bone conductors typically have poor high-frequency response above 4 kHz.

Acoustic Stimulation↗

Distortion product otoacoustic emissions stimulated through bone conduction.

OBJECTIVE: To demonstrate the viability of bone conduction as a novel method for stimulation of distortion product otoacoustic emissions (DPOAEs). DESIGN: DPOAEs were recorded from a single ear of 23 normally hearing adults using bone and air conduction for the delivery of stimulus tones. Exploration of the input-output function was performed by varying stimulus frequency and magnitude. RESULTS: Bone-stimulated emissions demonstrated similar characteristics to those obtained through standard air transmission techniques. Characteristic nonlinear DPOAE growth was found as the magnitude of the higher frequency stimulus tone, L2, was increased monotonically with other parameters fixed. Bilateral stimulation due to using bone conduction did not saturate the mechanisms of emission suppression. Emission magnitude was not altered substantially by occlusion of the ear canal. CONCLUSION: Bone conduction can be used successfully to elicit DPOAEs. Absolute comparison of air- and bone-stimulated DPOAEs was difficult because of imprecise calibration of the bone conductors for each individual and particular placement. Properties unique to bone conduction, such as simultaneous bilateral stimulation and reduction of stimulus magnitude in the ear canal, may make bone conduction attractive for clinical measurement of DPOAEs.

Acoustic Stimulation↗

Restricted HIV-1 infection of human astrocytes: potential role of nef in the regulation of virus replication.

A small percentage of astrocytes are consistently infected in vivo by HIV-1 and may contribute to neuropathogenesis despite a non-productive infection. Overexpression of the nef gene product has been associated with their infection both in vivo and in vitro. We examined the role of the nef gene during HIV replication in astrocytes (U251MG cells) following transfection with pNL4-3 proviral plasmid or isogenic strains containing a deletion or point mutation in the nef gene (pNL4-3deltaNef; pNL4-3-nef-stop). We were able to initiate virus replication which peaked at 5 days post-transfection and became non-productive after 21 days. Nef protein expression by wild type pNL4-3 was observed at low levels compared to control HeLa cells at peak virus replication. At later time points after development of a non-productive infection, viral antigen and Nef protein was not detectable however virus was readily recovered by co-culture with CD4+T-cells. Interestingly, virus production was significantly enhanced by a 222 base pair deletion in the nef reading frame. This was not observed with a frame shifting point mutation in nef, indicating a suppressive effect of nef on virus production in astrocytes. The enhanced virus production from nef-deleted pNL4-3 in U251MG cells was not reversed by co-expression of Nef from a second Nef-expressing plasmid, and in fact Nef expression in trans had a further positive effect on virus production. This suggested opposing effects of the Nef protein and elements contained within the nef sequence on virus production in astrocytes. Despite the low expression of Nef by U251MG astrocytes, relatively high amounts of multiply spliced 2 kb mRNA were present compared to HeLa cells. These data demonstrate that an acute low-level infection of astrocytes rapidly becomes a non-productive infection and this process is assisted by sequences in nef. The low level Nef protein expression, despite high levels of mRNA, suggests a block in translation of multiply spliced HIV mRNA in astrocytes, or a translational control mechanism not yet characterised.

AIDS Dementia Complex↗

Myopathy and spontaneous Pasteurella pneumotropica-induced abscess formation in an HIV-1 transgenic mouse model.

In an effort to augment human immunodeficiency virus type 1 (HIV-1) gene expression in transgenic mice, an infectious proviral DNA clone was modified by deleting the two NF kappa B binding sites and some adjacent upstream LTR sequences and replacing them with the core enhancer of Moloney murine leukemia virus (MLV). Two independent lines of MLV/HIV transgenic mice were established that expressed HIV-1-specific RNA in lymphoid tissue, striated skeletal muscle, and the eye lens. Heterozygous animals from each transgenic line spontaneously developed an inflammatory disease of the eye associated with the production of copious amounts of purulent lacrimal secretions beginning at 2 weeks of age. Periorbital abscess formation became grossly apparent by 2 months of age and Pasteurella pneumotropica was cultured from the harderian glands and conjunctival surfaces of many of the MLV/HIV animals but not their nontransgenic, cohabiting littermates. This gram-negative commensal bacterium has been previously associated with a similar disease phenotype in immunocompromised (e.g., nude mice) rodent colonies. MLV/HIV mice developed normally until 15 weeks of age, when weight loss and wasting occurred, culminating in premature death (as earlier as 6 months of age). The cachexia was associated with an initially focal and subsequently progressive myopathy, coinciding with age-related increases of HIV gene expression in muscle.

Abscess↗

Effect of poultry waste feeding on intake, body weight and milk yield of Holstein cows.

Forty lactating Holstein cows were fed 0, 5.9, 11.7, or 17.4% processed poultry excreta in total mixed rations. The effect of treatment was evaluated on feed intake, BW, milk yield, and composition. Processes poultry excreta appeared to be well accepted by cows even when included in rations at 17.4% of total DM. Mean DM intake averaged 19.3, 19.7, 19.5, and 19.7 kg/d for cows fed 0, 5.9, 11.7, and 17.4% processed poultry excreta, respectively. Body weight change averaged 2.0, 1.7, -1.7, and 1.4 kg/wk from 90 to 180 d of lactation for cows fed from 0 to 17.4% processed poultry excreta, respectively. Fat-corrected milk (4%) yield was similar among treatment groups, averaging 24.2, 26.1, 24.6, and 25.1 kg/d for cows fed 0, 5.9, 11.7, and 17.4% processed poultry excreta. No differences were found for milk and fat yields of percentage fat among treatment means. No off flavors in milk could be attributed to processed poultry excreta added to feed. Processed poultry excreta fed up to 17.4% of total mixed rations supported both adequate feed intake and high milk yields of mid-lactation cows.

Animal Feed↗

Routine intraoperative angioscopy in lower extremity revascularization.

The inability to see through blood remains the main obstacle to the widespread and routine use of angioscopy. Local irrigation with a balanced salt solution is presently the most widely used method to clear the blood. By applying basic principles of irrigation and using a unique, dedicated, irrigation pump, we found that routine angioscopy during lower extremity revascularization that yields consistent high-quality studies is feasible, clinically useful, and safe. Between May 1, 1987, and July 31, 1988, 136 intraoperative angioscopies were performed during 112 peripheral bypass procedures, 15 thrombectomies, 2 embolectomies, and 7 miscellaneous revascularization procedures. Mean total irrigation fluid used in the peripheral bypasses was 398 mL (range, 0 to 1400 mL). Good visual quality was obtained in more than 80% of angioscopies and the failure rate was only 1.8%. On the basis of the findings in 71 of the 136 angioscopies, 78 clinical or surgical decisions were made. No complications were directly attributable to the insertion of the angioscope or use of the pump.

Angiography↗

Does integration produce masking or protect from it?

To examine the role of integration in pattern masking, possible disruptive effects of integration were minimized by using a mask that overlaid completely all targets. Exposure durations were 10 ms, so under energy summation the target area was much darker than the rest. In another condition the mask was red and targets were blue, so under energy summation the target area could also be distinguished by hue. Masking magnitude increased with delay of mask onset, and it was established by four independent criteria that integration was negligible in the condition which produced most masking. It is deduced that integration is not necessary for masking; furthermore it is suggested that integration never produces masking, but rather may or may not protect from a disruptive effect of interruption. The argument is that were the visual system to have better visual resolution, it would suffer more given the same masking parameters. It is argued that type B masking functions arise from a combination of the facilitatory effect of integration and the detrimental effect of interruption.

Color Perception↗