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Biomedical subjects

E Gollub

Publications and source records attributed to E Gollub.

12 recordsLinked to original sources

The co-occurrence of AIDS and homelessness: results from the integration of administrative databases for AIDS surveillance and public shelter utilisation in Philadelphia.

STUDY OBJECTIVE: Administrative databases from the City of Philadelphia that track public shelter utilisation (n=44 337) and AIDS case reporting (n=7749) were merged to identify rates and risk factors for co-occurring homelessness and AIDS. DESIGN: Multiple decrement life tables analyses were conducted, and logistic regression analyses used to identify risk factors associated with AIDS among the homeless, and homelessness among people with AIDS. SETTING: City of Philadelphia, Pennsylvania, USA. MAIN RESULTS: People admitted to public shelters had a three year rate of subsequent AIDS diagnosis of 1.8 per 100 person years; nine times the rate for the general population of Philadelphia. Logistic regression results show that substance abuse history (OR = 3.14), male gender (OR = 2.05), and a history of serious mental disorder (OR = 1.62) were significantly related to the risk for AIDS diagnosis among shelter users. Among people with AIDS, results show a three year rate of subsequent shelter admission of 6.9 per 100 person years, and a three year rate of prior shelter admission of 9%, three times the three year rate of shelter admission for the general population. Logistic regression results show that intravenous drug user history (OR = 3.14); no private insurance (OR = 2.93); black race (OR = 2.82); pulmonary or extra-pulmonary TB (OR = 1.43); and pneumocystis pneumonia (OR = 0.56) were all related to the risk for shelter admission. CONCLUSIONS: Homelessness prevention programmes should target people with HIV risk factors, and HIV prevention programmes should be targeted to homeless persons, as these populations have significant intersection. Reasons and implications for this intersection are discussed.

Acquired Immunodeficiency Syndrome↗

High-risk adolescents and female condoms: knowledge, attitudes, and use patterns.

PURPOSE: To explore data on high-risk male and female adolescents' attitudes towards female condoms, compared with male condoms. METHODS: Exploratory survey research was utilized with a convenience sample of 65 high-risk adolescents at an emergency homeless shelter. A peer-led intervention was conducted and pre-test and post-test interviews explored barriers to female condom use. The intervention consisted of 15- to 30-minute small group sessions, discussing female condoms' construction; purpose of the rings; efficacy preventing pregnancy and sexually transmitted infection (STIs); and how to lubricate, insert, and use. Content and Chi-square analyses were utilized. RESULTS: Sixty-three percent used male condoms as their primary contraceptive method; almost half (48%) said they always used male condoms, but 44% reported having sex without a male condom at least once in the 2 weeks prior to pre-test. Ninety-five percent had heard of the female condom, half 'good' and 24% 'bad' things, but only 15% had ever used one. At post-test all respondents gave reasons they might use female condoms in the future, and 77% gave reasons why they might not. Most (73%) adolescents said they would still prefer the male to the female condom. The major potential barriers to adolescents' female condom use were not having female condoms available and/or females feeling uncomfortable inserting them. CONCLUSIONS: Female condoms should be offered to adolescents as an additional choice rather than as replacements for male condoms. Further research is needed to assure access, availability, and comfort with female condoms and male participation in their use.

Adolescent↗

Male-condom and female-condom use among women after counseling in a risk-reduction hierarchy for STD prevention.

BACKGROUND: A concern with hierarchy messages, which promote male condoms and female-controlled barrier methods along a prevention continuum, is that they may discourage condom use. GOAL: To measure male-condom and female-condom use among women who received hierarchy counseling and compare this with women counseled about condoms only. STUDY DESIGN: Three observational cohorts that correspond to prevention message received were assembled, and consisted of female sexually transmitted disease clinic patients who were counseled about male condoms, female condoms, or a hierarchy message. The hierarchy message promoted male and female condoms, the diaphragm and cervical cap, spermicides, and withdrawal, in descending order of effectiveness against sexually transmitted diseases. After counseling, women were interviewed and returned for follow-up visits at 2 weeks, 4 months, and 6 months. The outcome was the mean proportion of male condom- or female condom-protected coital acts at each follow-up visit in the hierarchy cohort. The outcome was dichotomized as high (> or = 70% of coital acts protected) or low (< 70%), and generalized estimating equations were used to compare observed follow-up condom use with baseline within the hierarchy cohort and observed follow-up condom use between cohorts. It was assumed that condom use in persons not present at 6 months was equal to baseline levels, and condom use estimates were calculated for each full cohort that was initially enrolled.

Cohort Studies↗

In vivo detection of a novel macrophage-derived protein involved in the regulation of nasal mucus-like glycoconjugate secretion.

BACKGROUND: We recently described a novel 68 kd mucus secretagogue (MMS-68) derived from human monocytes, pulmonary macrophages, and a macrophage hybridoma, clone 63. We detected MMS-68 in monocyte culture supernatants from patients with steroid-dependent asthma and in bronchoalveolar lavage fluid from patients with chronic bronchitis by antigen capture ELISA and in normal lung tissue by immunohistochemistry. METHODS: To determine a role for MMS-68 in the regulation of nasal mucus, we labeled human nasal turbinates with tritiated glucosamine and assayed for the ability of the previously purified MMS-68 (stock solution) to induce mucus-like glycoconjugate release (MLGC). We also performed immunohistochemistry stains with an anti-MMS-68 antibody (1-D-10) on frozen sections (n = 5) of nasal turbinates from patients with allergic and nonallergic rhinitis who were undergoing rhinoplasty and measured MMS-68 levels in nasal lavages from patients who were undergoing topical nasal histamine or methacholine challenge. RESULTS: MMS-68 is a potent nasal MLGC secretagogue causing a dose-dependent increase in MLGC release in vitro. Staining revealed a subepithelial distribution for MMS-68. Antigen capture ELISA of nasal lavages demonstrated mean MMS-68 levels from saline control challenge of 0.9 +/- 0.5 micrograms MMS-68 per milligram of protein (n = 5), 8.6 +/- 1.4 micrograms MMS-68 per milligram of protein from histamine challenge and 20.7 +/- 2.3 micrograms MMS-68 per milligram of protein (n = 5) after methacholine challenge. CONCLUSION: Taken together these data suggest that MMS-68 may play a role in the normal regulation of mucus secretion.

Adult↗

Acceptability of a new intravaginal barrier contraceptive device (Femcap).

A comprehensive questionnaire to assess acceptability was sent to 106 participants (and their partners) in a study on the safety and effectiveness of the Femcap. Participants were asked to rate their satisfaction with various aspects of the method, and were also asked about complaints such as vaginal infections, urinary tract infections, or other irritation. Eighty-one percent of the study sample either returned the mailed questionnaires or completed telephone interviews. Results were encouraging in that none of the study subjects or their partners reported any discomfort, trauma, or interference in sexual spontaneity with the cap. Vaginal irritation and infections were infrequently reported. The feature best liked by most participants was the absence of hormones associated with the method; the feature least liked was removal of the device. The Femcap may be an acceptable alternative to currently available barrier contraceptive devices.

Adolescent↗

In vivo detection of a novel macrophage-derived protein involved in the regulation of mucus-like glycoconjugate secretion.

We previously described a novel 68,000 D macrophage-derived protein (MMS-68) that can stimulate mucus-like glycoconjugate (MLGC) secretion from cultured human airways, respiratory epithelial cells, and the ishikawa adenocarcinoma cell line. To better characterize this mucus secretagogue, we generated monoclonal antibodies against MMS-68 by injecting crushed SDS-PAGE gel slices containing this protein into Balb-C mice followed by fusion with SP2/0, a nonsecreting mouse myeloma cell line. A panel of monoclonal antibodies was produced that identified the 68,000 D MMS by immunoblot analysis and immunoprecipitation. The monoclonal antibodies detected MMS-68 in normal peripheral blood monocytes and pulmonary macrophages by cytofluorographic analysis and in human airways as determined by immunohistochemistry. Utilizing the monoclonal antibodies, an antigen-capture ELISA assay was developed. Statistically significant elevations in levels of MMS-68 were detected in bronchoalveolar lavage fluid (BALF) of chronic bronchitic subjects and cigarette smokers and in monocyte culture supernatants from steroid-dependent asthmatic patients compared to normal control subjects. The 68,000 D MMS is a potent secretagogue and may play an important role in the regulation of mucus secretion, especially in chronic bronchitis and steroid-dependent asthma.

Adult↗

Mucus secretagogue production by a human macrophage hybridoma.

A pulmonary macrophage-monocyte-derived mucus secretagogue (MMS) oligopeptide has been previously reported to induce mucus secretion in an in vitro model system with human airway explants and secretory epithelial cells. To understand the possible role of macrophages in the regulation of secretion of mucus, our laboratory has used a series of human macrophage hybridomas that were generated by fusing an hypoxanthine guanine phosphoribosyl transferase-deficient promonocytic line, U937, with macrophages obtaining by maturing monocytes in Teflon bags. The cell lines were proven to be true hybridomas by acquisition of donor class I antigens, additional chromosomes, as well as macrophage specific (maximum velocity) not present on the U937 parent line. One clone, clone 63, produced large amounts of an oligopeptide with an approximate molecular weight of 2000, which was identified from culture supernatants by ultrafiltration, chromatography, isoelectric focusing, and Western blot. Processed clone 63 supernatant had biologic activity causing increased secretion of radiolabeled glycoconjugate in both cultured airways and secretory epithelial cells. Immunoblot analysis with a polyclonal rabbit antisera generated against MMS was positive, and Western blot analysis produced a band at approximately 2000 daltons, consistent with the previously described MMS. MMS secretion could be stimulated by zymosan and lipopolysaccharide and inhibited by both cycloheximide and erythromycin. Dexamethasone had a different effect, appearing to stimulate MMS production intracellularly but inhibiting its release once it was synthesized. The availability of cloned hybridomas allows for study of the regulation of mucus secretagogue production as well as purification of molecular species and provides a valuable tool for the study of mucus secretion.

Cell Line↗

CA 125 levels in menopausal women.

To assess the use of CA 125 as a potential screening test for ovarian cancer, it is necessary to understand how the test performs among cancer-free women, who would constitute the overwhelming majority of those being tested at any time. Two hundred fifty-eight menopausal volunteers who were not seeking gynecologic care had CA 125 measured on two occasions and also underwent transvaginal ultrasonography to measure ovarian volumes. Only one subject had a CA 125 level greater than 35 U/mL. The mean value for CA 125 was 5.6 +/- 3.5 U/mL. Within women, the correlation between two tests was very high (r = 0.82). Among women with apparently normal ovaries, CA 125 values were low, tightly distributed, and reproducible; these findings indicate that the test may prove to be useful and cost-effective in a screening program. The correlation between CA 125 values and ovarian volume determined by sonogram was low (r = 0.11). The independence of these two tests would also be desirable in any screening program. Other studies have found normal women to have higher levels of CA 125 with wider distributions than found here; further evaluation of test performance at these low levels is needed.

Adult↗

Characterization of a unique mucin-like glycoprotein secreted by a human endometrial adenocarcinoma cell line (Ishikawa).

A human endometrial adenocarcinoma cell line (Ishikawa) has been shown to incorporate [3H]glucosamine and to secrete a radiolabeled high molecular weight compound which is excluded from a Sepharose CL-2B column. The excluded material was resistant to hyaluronidase, chondroitinase ABC, and heparinase. These findings rule out the possibility of this material being a proteoglycan. The susceptibility of this material to digestion with pronase, neuraminidase, and alkaline borohydride treatment strongly suggests that the excluded material is an O-glycosidic glycoprotein. The glycoprotein secreted by Ishikawa cells (ICGP) did not react immunologically with antibodies against either lactoferrin or fibronectin, but did react with an antibody made against tracheal mucin. Conversely, immunoblot analysis revealed that an antibody made against ICGP did not recognize hyaluronic acid, chondroitin, heparin, nasal turbinate mucin, bovine submaxillary gland mucin, lactoferrin, or fibronectin, but did recognize tracheal mucin. Analysis of ICGP amino acid and carbohydrate composition showed that it is rich in serine, threonine, glutamic acid, aspartic acid, and N-acetylneuraminic acid. In this respect, ICGP differs from other mucins, even though it is immunologically similar to respiratory mucin; hence we may consider ICGP to be a mucin-like glycoprotein. Secretion of ICGP can be modulated by Ca(2+)-ionophore and other mucus secretagogues, such as platelet activating factor, carbachol, and monocyte/macrophage mucus secretagogue, all mediators of lung inflammation. Ishikawa cells and anti-ICGP antibody may be used in studies on in vitro regulation of mucin-like glycoprotein synthesis and secretion in the respiratory tract as well as in the endometrium.

Adenocarcinoma↗