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Biomedical subjects

E Benson

Publications and source records attributed to E Benson.

At least 19 recordsLinked to original sources

Practice parameter: immunotherapy for Guillain-Barré syndrome: report of the Quality Standards Subcommittee of the American Academy of Neurology.

OBJECTIVE: To provide an evidence-based statement to guide physicians in the management of Guillain-Barré syndrome (GBS). METHODS: Literature search and derivation of evidence-based statements concerning the use of immunotherapy were performed. RESULTS: Treatment with plasma exchange (PE) or IV immunoglobulin (IVIg) hastens recovery from GBS. Combining the two treatments is not beneficial. Steroid treatment given alone is not beneficial. RECOMMENDATIONS: 1) PE is recommended for nonambulant adult patients with GBS who seek treatment within 4 weeks of the onset of neuropathic symptoms. PE should also be considered for ambulant patients examined within 2 weeks of the onset of neuropathic symptoms; 2) IVIg is recommended for nonambulant adult patients with GBS within 2 or possibly 4 weeks of the onset of neuropathic symptoms. The effects of PE and IVIg are equivalent; 3) Corticosteroids are not recommended for the management of GBS; 4) Sequential treatment with PE followed by IVIg, or immunoabsorption followed by IVIg is not recommended for patients with GBS; and 5) PE and IVIg are treatment options for children with severe GBS.

Adrenal Cortex Hormones↗

Inhibition of bacterial IF2 binding to fMet-tRNA((fMet)) by aminoglycosides.

Screening for inhibitors of bacterial protein synthesis Initiation Factor 2 (IF2) binding to N-formyl-Methionyl-transfer RNA (fMet-tRNA((fMet))) identified a series of aminoglycosides, that included amikacin and kanamycin A1, as inhibitors of this interaction. Subsequent testing revealed that aminoglycosides displayed a wide range of inhibitory activity. However, the failure of these compounds to completely inhibit binding of IF2 to fMet-tRNA((fMet)), the known ability of aminoglycosides to bind RNA, and the ability of the aminoglycosides to displace PicoGreen bound to fMet-tRNA((fMet)) suggest these compounds act by binding fMet-tRNA((fMet)). This hypothesis is further supported by isothermal denaturation experiments that failed to show any interaction between the IF2 protein and the aminoglycosides.

Amikacin↗

Rivers as urban landscapes: renaissance of the waterfront.

The Lake Ontario Waterfront Trail, currently stretching 350 kilometres along the shore of Lake Ontario, Canada, links 26 communities, 184 natural areas, 161 parks and promenades, 84 marinas and yacht clubs, hundreds of historic places, fairs, museums, art galleries and festivals. The Waterfront Trail is a catalyst for a new attitude and way of thinking towards the Lake Ontario waterfront and its watersheds - one that integrates ecological health, economic vitality and a sense of community. Since it was launched in 1995, the Trail has accompanied the protection of the most valued elements of the waterfront, and the transformation of under-utilized and environmentally degraded lands to vibrant places with businesses and jobs, parks and recreational facilities, green spaces, natural habitats and cultural venues and attractions. It is through the Trail that people have been mobilized to improve the waterfront as they have rediscovered the shoreline and understood the interconnections, both natural and cultural, that are so vital to its health and vitality. The Waterfront Regeneration Trust is the not-for-profit charitable organization that has been leading this large-scale greenway initiative over the past 10 years. While much has been accomplished, there remains much to do to enhance and expand the greenway. This presentation will focus on the lessons we have learned over the past decade in our involvement with more than 100 projects and what those lessons mean for the next decade of waterfront regeneration.

Cities↗

A genome-wide scan for linkage to human exceptional longevity identifies a locus on chromosome 4.

Substantial evidence supports the familial aggregation of exceptional longevity. The existence of rare families demonstrating clustering for this phenotype suggests that a genetic etiology may be an important component. Previous attempts at localizing loci predisposing for exceptional longevity have been limited to association studies of candidate gene polymorphisms. In this study, a genome-wide scan for such predisposing loci was conducted by using 308 individuals belonging to 137 sibships demonstrating exceptional longevity. By using nonparametric analysis, significant evidence for linkage was noted for chromosome 4 at D4S1564 with a MLS of 3.65 (P = 0.044). The analysis was corroborated by a parametric analysis (P = 0.052). These linkage results indicate the likelihood that there exists a gene, or genes, that exerts a substantial influence on the ability to achieve exceptional old age. Identification of the genes in humans that allow certain individuals to live to extreme old age should lead to insights on cellular pathways that are important to the aging process.

Aged↗

The application of a PCR technique for the detection of immunoglobulin heavy chain gene rearrangements in fresh or paraffin-embedded skin tissue.

Although detection of a clonal sequence of the heavy chain gene of immunoglobulin by the polymerase chain reaction (PCR) is frequently used to assess lymphoid infiltrates in skin biopsy specimens, there are no data on the sensitivity and specificity of this test in detecting clonal B cell populations. Having refined a PCR technique for the detection of immunoglobulin heavy chain (IgH) gene rearrangement in both fresh and formalin-fixed, paraffin-embedded skin samples, we undertook to define the role of this assay in the diagnostic setting. Thirty-one cases of cutaneous B cell lymphoma (CBCL), 19 cases of B cell pseudolymphoma (lymphocytoma cutis), 34 cases of benign lymphocytic infiltrates of the skin and one case of cutaneous T cell lymphoma (CTCL) were studied using the polymerase chain reaction assay. All biopsies were formalin-fixed, paraffin-embedded skin sections apart from 13 of the 31 CBCL specimens which were fresh skin specimens. DNA from the framework region 3 (FR3) sequence of the IgH genes was amplified to ascertain the presence of a clonal IgH gene rearrangement. The findings were correlated with histological and immunophenotyping results on all samples. The assay performed with 73% sensitivity and 100% specificity, comparable to results obtained examining fresh lymphoid tissue specimens from patients with B cell tumours. The results indicate that this technique is a useful tool in the work up of suspected CBCL and in differentiating between CBCL and mixed lymphocytic infiltrates, a clearly important distinction with regards to prognosis and treatment.

Clone Cells↗

Stressful life events and difficulties and onset of breast cancer: case-control study.

OBJECTIVE: To determine the relation between stressful life events and difficulties and the onset of breast cancer. DESIGN: Case-control study. SETTING: 3 NHS breast clinics serving west Leeds. PARTICIPANTS: 399 consecutive women, aged 40-79, attending the breast clinics who were Leeds residents. MAIN OUTCOME MEASURES: Odds ratios of the risk of developing breast cancer after experiencing one or more severe life events, severe difficulties, severe 2 year non-personal health difficulties, or severe 2 year personal health difficulties in the 5 years before clinical presentation. RESULTS: 332 (83%) women participated. Women diagnosed with breast cancer were no more likely to have experienced one or more severe life events (adjusted odds ratio 0.91, 95% confidence interval 0.47 to 1. 81; P=0.79); one or more severe difficulties (0.86, 0.41 to 1.81; P=0.69); a 2 year severe non-personal health difficulty (0.53, 0.12 to 2.31; P=0.4); or a 2 year severe personal health difficulty (2.73, 0.68 to 10.93; P=0.16) than women diagnosed with a benign breast lump. CONCLUSION: These findings do not support the hypothesis that severe life events or difficulties are associated with onset of breast cancer.

Adult↗

International Consensus Statement on Testing and Reporting of Antineutrophil Cytoplasmic Antibodies (ANCA)

Antineutrophil cytoplasmic antibody (ANCA) tests are used to diagnose and monitor inflammatory activity in the primary systemic small vessel vasculitides. ANCA is best demonstrated in these diseases by using a combination of indirect immunofluorescence (IIF) of normal peripheral blood neutrophils and enzyme-linked immunosorbent assays (ELISAs) that detect ANCA specific for proteinase 3 (PR3) or myeloperoxidase (MPO). For ANCA testing in "new" patients, IIF must be performed on all serum samples. Serum samples containing ANCA, any other cytoplasmic fluorescence, or an antinuclear antibody (ANA) that results in homogeneous or peripheral nuclear fluorescence then should be tested in ELISAs for PR3-ANCA and MPO-ANCA. Optimally, ELISAs for PR3-ANCA and MPO-ANCA should be performed on all serum samples. Inclusion of the most recent positive sample in the IIF or ELISA may help demonstrate a change in antibody level. Reports should use recommended terms. Any report of positive neutrophil fluorescence issued before the ELISA results are available should indicate that positive fluorescence alone is not specific for the diagnosis of Wegener granulomatosis or microscopic polyangiitis and that decisions about treatment should not be based solely on the ANCA results.

Antibodies, Antineutrophil Cytoplasmic↗

Abnormalities of visual spatial attention in HIV infection and the HIV-associated dementia complex.

Covert orienting of visuospatial attention (COVAT) was examined in 88 homosexual or bisexual men: 12 with mild HIV-associated dementia complex (ADC), 30 neurologically intact with AIDS (NI-AIDS), 23 asymptomatic HIV+ (HIV+ASX), and 23 HIV-negative control subjects. In mild ADC, COVAT was normal for spatial but impaired for nonspatial cues; 17% of NI-AIDS and HIV+ASX subjects had similar COVAT impairment patterns and also showed cognitive deficits. HIV+ subjects with normal COVAT showed normal cognitive performance. Impairment of nonspatial attentional processing in the ADC subjects and subgroups of the neurologically intact HIV+ subjects may reflect early subcortical dysfunction caused by HIV infection. COVAT assessment may be sensitive for detection of early subclinical neurological impairment in HIV infection.

AIDS Dementia Complex↗

Prognostic value of immunophenotyping in acute myeloid leukemia. Australian Leukaemia Study Group.

The diagnostic and prognostic value of immunophenotyping with 18 murine monoclonal antibodies (MoAbs) to a variety of leukocyte differentiation antigens was assessed in 168 adults aged 15 to 60 years with acute myeloid leukemia (AML). Patients were entered on the multicentre Australian Leukaemia Study Group M4 protocol, and were randomized to receive either standard or high-dose Ara-C together with daunorubicin and etoposide as induction chemotherapy, followed by standard consolidation and maintenance therapy. Diagnostic bone marrow aspirate (152 cases) or peripheral blood samples (16) were analyzed by indirect immunofluorescence and flow cytometry. MoAbs used were directed at myeloid (CD11b, CD13, CD14, CD15, CD33, CD41), lymphoid (CD2, CD3, CD7, CD9, CD10, CD19), or stem cell (HLA-DR, CD34, c-kit receptor) antigens, as well as the leukocyte integrins CD18 and CD49e, and the transferrin receptor CD71. Of the myeloid markers, CD13 and CD33 were the most useful diagnostically (71% and 79% of cases positive, respectively), with CD11b, CD14, and CD15 less commonly positive. A minority of cases expressed lymphoid antigens, either T cell (CD2 16%, CD3 7%, CD7 28%) or B cell (CD10 2%, CD19 7%). CD34 was detected on 42% and c-kit receptor on 48%. When patients were analyzed for response to treatment, CD2, CD9, and CD14 were significantly associated with complete remission rate: cases expressing these antigens had a poorer response than negative cases. In univariate analysis, CD11b+ cases had shorter periods of remission (relative risk of relapse, 2.33; P = .003) and shorter survival (relative death rate, 1.91; P = .006). In multivariate analysis, adjusting for other prognostic factors, CD9 and CD11b were significantly predictive of shorter survival. No other marker had a significant predictive effect. We conclude that myeloid MoAbs are useful in confirming the diagnosis of AML, but their prognostic value may be limited to CD11b. Lymphoid antigen expression is a consistent phenomenon in a minority of cases of AML, but appears to have little clinical significance.

Acute Disease↗

Neuropsychological characterization of the AIDS dementia complex and rationalization of a test battery.

OBJECTIVE: To define the neuropsychological deficits present in mild human immunodeficiency virus type 1 (HIV-1) associated with the acquired immunodeficiency syndrome (AIDS) dementia complex (ADC) and to develop a rational neuropsychological test battery for its diagnosis. DESIGN: Survey. SETTING: Subjects were recruited from large metropolitan hospital outpatient clinics and were all living independently in the general community. PATIENTS: Three volunteer samples of homosexual-bisexual men: (1) 15 patients who met clinical and research criteria for mild ADC; (2) 27 HIV-seronegative (HIV-) controls; and (3) 17 patients with AIDS who were neurologically intact (NI-AIDS) who were matched with the ADC subjects by CD4 lymphocyte counts for severity of systemic HIV disease. MAIN OUTCOME MEASURES: Neuropsychological test performance; z score comparisons were made with the HIV-control group using 2.25-SD cutoffs for abnormality. RESULTS: Compared with NI-AIDS subjects, performance of patients with mild ADC was markedly worse in the cognitive areas of executive function, memory, and complex attention but not in affect or the cognitive areas of simple motor function, orientation, language, or visuospatial construction. Within the areas of executive function, memory, and complex attention, all of the HIV-controls and 95% of the NI-AIDS subjects had impaired test performance in a maximum of one area only. In marked contrast, 14 (93%) of the 15 patients with mild ADC had abnormal test performances in all three of these cognitive areas. Using a criterion of abnormal performance in at least two of the cognitive areas of executive function, memory, and complex attention, all patients with mild ADC could be differentiated from HIV-controls with 100% sensitivity and specificity and from NI-AIDS subjects matched for disease severity by CD4 lymphocyte count with 100% sensitivity and 94% specificity, which increased to 100% with the requirement of impairment in all three cognitive areas. CONCLUSIONS: If time constraints or patient compliance limit neuropsychometric testing, examination to detect mild ADC first should be directed to the areas of executive function, memory, and complex attention. This pattern of neuropsychological deficits in patients with mild ADC is suggestive of subcortical dementia.

AIDS Dementia Complex↗

Computer-administered visual analogue mood scales: rapid and valid assessment of mood in HIV positive individuals.

Studies of cognition in patients with the human immunodeficiency virus must take into account the effects of mood. Standardised mood-rating questionnaires are oftentimes consuming and fatiguing for such patients and so may be omitted from experiments. Visual analogue rating scales for affective state are rapidly administered and are quite acceptable to subjects. In 64 HIV seropositive homosexual or bisexual males, measures of anxiety and depression derived from two computer-administered visual analogue scales were compared with anxiety and depression ratings from the Spielberger State-Trait Anxiety Inventory and the Center for Epidemiological Studies-Depression. Analogue ratings of anxiety correlated .80 with STAI State anxiety and .58 with STAI Trait anxiety measures and analogue ratings of depression correlated .78 with CES-Depression measures. Analogue ratings may differentiate situational anxiety and depression more effectively and so are valid tools in assessment of anxiety and depression in HIV seropositive subjects. These may be of particular value when limitations of time or patient illness require a rapid assessment of mood variables in neuropsychiatric research.

AIDS Dementia Complex↗

Expression of B-type Epstein-Barr virus in HIV-infected patients and cardiac transplant recipients.

In the present study, peripheral blood mononuclear cells (PBMCs) were obtained from HIV+ subjects as well as cardiac transplant recipients, and the presence of A- and B-type Epstein-Barr virus (EBV) was determined using the polymerase chain reaction (PCR). Of the HIV+ patients studied, 24% were found to be infected with A-type EBV, 27% with B-type EBV, and 39% with both A and B virus types. Analysis of PBMCs from cardiac transplant recipients revealed that 39% were infected with A-type EBV, 33% with B-type EBV, and 28% with both EBV types. These results demonstrate a higher prevalence of infection with B-type EBV in HIV+ patients, than had been found previously by an analysis of spontaneously generated lymphoblastoid cell lines. The data indicated that it is not HIV per se which is responsible for the high incidence of B-type EBV in HIV+ individuals.

Australia↗