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Biomedical subjects

E R Rhoades

Publications and source records attributed to E R Rhoades.

At least 37 records · Page 2Linked to original sources
PubMed1995

The role of interleukin-12 in acquired immunity to Mycobacterium tuberculosis infection.

The early phase of acquired cellular immunity to Mycobacterium tuberculosis infection is mediated by the emergence of protective CD4 T lymphocytes that secrete cytokines including interferon-gamma (IFN-gamma), a molecule which is pivotal in the expression of resistance to tuberculosis. Recent evidence demonstrates that infection with M. tuberculosis induces peripheral blood mononuclear cells to release the cytokine interleukin-12 (IL-12), a molecule that promotes the emergence of T-helper type-1 (Th1), IFN-gamma-producing T cells. We demonstrate here that IL-12 mRNA expression was induced by M. tuberculosis infection both in vivo and in vitro and that exogenous administration of IL-12 to mice transiently resulted in increased resistance to the infection. IL-12 also increased the production of IFN-gamma by both splenocytes derived from infected animals treated in vivo and by antigen-stimulated CD4 cells from untreated infected animals, with maximal effects at times associated with the expansion of antigen-specific CD4 T cells in vivo. In the absence of a T-cell response, as seen in SCID mice or nude mice, IL-12 only slightly augmented the moderate bacteriostatic capacity of these immunocompromised mice. Neutralization of IL-12 by specific monoclonal antibodies resulted in a reduction in granuloma integrity and slowing of the capacity of the animal to control bacterial growth.

Animals↗
PubMed1995

The University of Oklahoma College of Medicine Rural Health Educational Program.

Training of physicians to meet the health care needs of rural residents has long been a priority of the University of Oklahoma College of Medicine. With establishment of the much imitated Rural Preceptorship Program in 1948, the college launched an ongoing series of efforts all directed toward increasing the number of graduates choosing to practice in rural locations. In addition to the required senior Preceptorship Program, a series of educational programs is available in each year of medical school, actually beginning prior to freshman enrollment. As a result, the college now offers a comprehensive series of educational experiences involving not only four years of medical school, but graduate training in the primary care specialties as well. This report summarizes the various activities of the college that now make up the rural emphasis program, all of which are designed to help ensure an adequate supply of physicians for rural Oklahoma.

Curriculum↗
PubMed1992

Mortality of American Indian and Alaska native infants.

Accurate determination of infant mortality rates among Indians in seriously hampered by variations in the identification of Indian persons and use of different subsets of the Indian population for various purposes. Lack of consistency in the reporting of racial origin on birth and death records is a source of substantial error. Because of these factors, more than the usual care must attend comparisons and inferences drawn from data in which these differences are present. At present, it would seem prudent to regard all data about American Indians as provisional. Even though Indian infant mortality remains higher than that for US all races, regardless of techniques used for estimates, the decline of Indian infant mortality by more than 80% since the establishment of the IHS is a truly remarkable achievement. This success has been ascribed to a combination of activities, including the provision of safe drinking water, especially as an integral part of the IHS program; the nearly universal immunization of Indian children; and emphasis upon comprehensive, community-oriented programs focused on maternal and child care. These successes have contributed to changes in the distribution of the leading causes of Indian infant mortality, so that the most prominent causes now are SIDS, congenital anomalies, injuries, and various infections. Because of these changes and advances in knowledge, the IHS has recently revised its five-year plan for dealing with infant mortality to provide greater attention to injuries and infections and has embarked upon a series of discussions with the American Academy of Pediatrics to address postneonatal deaths and the difficult problem of SIDS. Low socioeconomic conditions, so important in influencing mortality rates (7, 14, 29), have thus far proved to be intractable. In the meantime, success will depend upon ensuring optimal prenatal care, reducing those risk factors amenable to correction, and solving the problem of SIDS.

Alaska↗
PubMed1992

The University of Oklahoma College of Public Health and the American Indian.

This article illustrates how the relationship between the University of Oklahoma College of Public Health, the American Indians, and the Indian Health Service is especially appropriate to the state of Oklahoma. It reviews the development of the College of Public Health as an important component of the university and the state of Oklahoma. Included are observations about the special contributions made by American Indians to both the nation and to the state, as well as reflections upon the development of public health in the young nation and in the newly forming state of Oklahoma.

History, 18th Century↗
PubMed1990

The major respiratory diseases of American Indians.

The most prominent respiratory diseases of American Indian adults are pneumonia, cancer of the lung, chronic obstructive pulmonary disease (COPD), and tuberculosis. Mortality and hospitalization rates of these diseases were compared with those for the rest of the U.S. population and between Indian groups in the various Indian Health Service Areas. Pneumonia and influenza constitute the sixth leading cause of death among Indians and the fifth leading cause of death among the U.S. All Races population. Chronic obstructive pulmonary disease is the fourth leading cause of death among U.S. All Races, but only the tenth leading cause of death among Indians. Pneumonia and tuberculosis are more significant causes of death and disability for Indians than are COPD and cancer of the lung. The explanation for these differences in mortality rates between Indians and the general population are not known. Respiratory system diseases are responsible for 10.6% of Indian hospitalizations. The most frequent is pneumonia, which accounts for approximately 4% of all Indian hospitalizations. Differences in respiratory diseases between Indian groups are sometimes striking, with a sharp increase in mortality and hospitalization in the Areas across the northern border of the lower 48 states. There is also a much higher prevalence of cigarette smoking in those same Areas.

Asthma↗
PubMed1987

A comprehensive programme to reduce the incidence of hepatitis B virus infection and its sequelae in Alaskan natives.

In 1983, a comprehensive programme was introduced to halt the spread of hepatitis B virus (HBV) infection and to reduce mortality from hepatocellular carcinoma (HCC) in Alaskan Natives, in whom the incidence of HBV infection was high. This programme includes: serological screening of all Alaskan Natives; immunisation of susceptible persons, including all newborn babies, with hepatitis B vaccine; and testing HBsAg-positive carriers twice a year for alpha-fetoprotein (AFP) to detect HCC at an early stage. By October, 1986, over 53,000 Alaskan Natives (84% of the total Native population) had been tested for HBV serological markers and 80% of the identified susceptibles had been or were being vaccinated against HBV. After complete immunisation of 90% of the susceptibles in the area with the highest infection rates in Alaska, the annual incidence of acute symptomatic HBV infection decreased from 215 to 14 cases per 100,000 population. After the introduction of AFP screening, the 1-year-case-fatality rate for HCC fell, from 100%, to 50%.

Alaska↗
PubMed1980

Relative resistance to penicillin in the pneumococcus. A prevalence and case-control study.

Isolates of Streptococcus pneumoniae from 103 patients were submitted for serotyping and determination of the minimum inhibitory concentration (MIC) for penicillin. Isolates from 16 patients were relatively resistant to penicillin (MIC, 0.1 to 0.5 micrograms/mL). In a study to determine if the patients with relatively resistant pneumococci (RRP) differed from patients with normally susceptible pneumococci, 18 patients with RRP showed no significant difference from their matched controls in antibiotic use during the two months prior to isolation of the pneumococcus. Other variables that showed no significant difference between the two groups were (1) antibiotic use in household contacts in the previous six months, (2) presence of chronic infection in the case or control patients, and (3) recurrence of pneumococcal infection following therapy. The high rate of relative resistance to penicillin is heretofore unknown in a general, unconfined population in this country. The case-control study suggests that no strong relationship exists between isolating RRP and prior penicillin administration. More extensive surveys in the United States are needed.

Adolescent↗
PubMed1980

Impact of mental disorders upon elderly American Indians as reflected in visits to ambulatory care facilities.

In order to assess the impact of mental health problems among elderly American Indians, a study was conducted on the utilization patterns of ambulatory care facilities by various age groups of Indians. Since most health care of Indians is rendered by the Indian Health Service (IHS), data obtained from IHS computer centers provided a reasonable index of disease patterns. Because the elderly have constituted such a small fraction of the Indian population, they have not heretofore received significant attention. However, their problems are rapidly increasing. By adjusting the frequency of visits according to population, an estimate of visit "rates" was made. These rates showed one visit for every 10 persons in the 0-44 age group, one for every 5 persons in the 45-54 age group, but only one visit for every 25 persons in the 65+ age group. Most of the visits by older Indians concerned "social" problems rather than "mental" disorders as such. These data provided information that should prove especially helpful in the design of social and health programs for elderly Indians.

Adult↗
PubMed1980

The influence of local factors on the reaction to tuberculin. 1. The effect of injection.

Forty-three patients being evaluated for the presence of clinical tuberculosis received careful simultaneous cutaneous tests with intermediate-strength tuberculin, comparing reactions elicited with intradermal tests to those elicited by subcutaneous tests. In another study, reactions elicited by 0.1 ml of tuberculin were compared to those elicited by 0.05 ml of the same material in the other forearm. Analysis of scattergrams comparing sizes of reactions to each technique show that differences in the sizes of the reactions elicited by intradermal and subcutaneous tests are usually small and insignificant, but subcutaneous tests unexpectedly were found to often produce larger, rather than smaller, reactions. Likewise, differences in cutaneous reactions to 0.05 and 0.1 ml of tuberculin were not impressive. We conclude that the common impression that errors of technique in the application of cutaneous tests are common explanations for false-negative tests is unwarranted.

False Negative Reactions↗