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Biomedical subjects

Elizabeth J Corwin

Publications and source records attributed to Elizabeth J Corwin.

14 recordsLinked to original sources
PubMed2006

Disruption in Th1/Th2 immune response in young adult smokers.

Interferon (IFN)-gamma and IL-10 cytokines, measures of Th1 and Th2 immunity, were examined in 20 healthy nonsmokers (12 males, 8 females) and 19 smokers (11 males, 8 females), aged 19-41 years (23.46+/-0.82 years). Nonsmokers came to the laboratory once; smokers came to the laboratory after ad lib smoking and following 24-h smoking abstinence. Salivary cotinine and expired CO confirmed smoking status. Plasma was collected at the end of each lab session and assayed for peripheral IFN-gamma and IL-10 levels. Among smokers, peripheral IFN-gamma, IL-10, or IFN-gamma/IL-10 ratio levels did not change in response to 24-h smoking abstinence. IFN-gamma levels and IFN-gamma/IL-10 ratios were higher among female smokers while smoking and following 24-h abstinence compared to male smokers in both conditions and compared to male and female nonsmokers. There was no sex or smoking status difference in IL-10 levels. Results suggest that cigarette smoking may have at least short-term damaging effects on the body's normal immune balance, particularly for women.

Adult↗
PubMed2004

Leptin, hunger, and body weight: Influence of gender, tobacco smoking, and smoking abstinence.

Leptin is a hormone involved in body weight and hunger regulation, and may contribute to the inverse relationship between cigarette smoking and body weight. Leptin levels, body mass indices (BMIs), and hunger ratings were determined in 22 nonsmokers (12 male, 10 female) and 19 cigarette smokers (11 male, 8 female). Smokers were tested after ad lib smoking and following a 24-h smoking abstinence period; nonsmokers came to the laboratory once. Leptin levels were not different among the groups. Hunger ratings, however, were higher after smoking abstinence compared to after ad lib smoking and nonsmokers (Ps<.05); levels of hunger did not differ between ad lib smokers and nonsmokers. Men reported higher hunger levels than did women, but women had higher serum leptin levels than did men, regardless of smoking condition (P<.05). Leptin levels were correlated with BMI (P<.05) among smokers only. This first study on leptin responses in female smokers suggests that leptin levels do not change following a 24-h smoking abstinence period and that leptin may not contribute to increased hunger following smoking abstinence.

Adolescent↗
PubMed2004

Down syndrome with an unusual etiology: case report and review.

PURPOSE: To present the genetic etiology of an unusual case of Down syndrome, arising from translocation of chromosome 21 to chromosome 9; to discuss advanced genetic diagnostic techniques, focusing on how pinpointing a specific genetic mistake can influence treatment and outcome; and to review the role of the nurse practitioner (NP) in caring for families of children with Down syndrome. DATA SOURCES: Case report, literature review, and advanced genetic techniques. CONCLUSIONS: NPs often answer patient questions regarding genetic abnormalities and risk factors for transmission of genetic errors to offspring. Advanced genetic analysis allows for the diagnosis of unusual causes of common genetic disorders. The ability to identify a specific genetic mistake and to predict the scope of its effect on an individual offers health care providers the opportunity to develop a case-by-case plan of care. IMPLICATIONS FOR PRACTICE: NPs have a responsibility to be informed about the processes involved in the transmission of genetic errors and about the subtleties of various expressions of a genetic disorder. The availability of new genetic-testing techniques allows NPs to individualize patient care and family teaching.

Child, Preschool↗
PubMed2003

C-reactive protein and depressed mood in a sub-group of smokers during nicotine abstinence.

Cigarette smokers frequently fail multiple attempts to quit smoking, often because of the unpleasant symptoms that accompany quitting. Similar unpleasant symptoms accompany inflammatory responses during infection and autoimmune disease. The hypothesis that smoking abstinence induces inflammation was tested. Eighteen smokers (n = 18) were evaluated while smoking freely and after 24 h of nicotine abstinence. Immune, cardiovascular and psychological measures were collected. Hunger, nervousness, anxiety, restlessness and irritability increased during abstinence (p < 0.05); systolic blood pressure and heart rate levels decreased (p < 0.05). Analysis demonstrated a split among smokers in response to abstinence compared with smoking freely; some smokers (n = 10) displayed increased C-reactive protein (CRP, p < 0.05) whereas others (n = 8) responded with decreased CRP (p < 0.05). An increase in symptoms of depressed mood and a fall in heart rate occurred only in those who displayed increased CRP with nicotine abstinence ( p < 0.05), while systolic blood pressure fell only in those whose CRP levels decreased with abstinence ( p < 0.05). Interleukin-1 and interleukin-6 did not change with abstinence. The results suggest that 24 h nicotine abstinence does not stimulate inflammation among all smokers, but that a sub-group of smokers do demonstrate an inflammatory response with significant negative psychological and physiological symptomatology.

Adolescent↗
PubMed2003

Low hemoglobin level is a risk factor for postpartum depression.

The role of maternal anemia in the development of postpartum depression (PPD) is unclear. PPD is a serious disorder that may negatively affect the physical and emotional health of a new mother and her infant. Although psychosocial factors that increase the risk of developing PPD are known, few studies have identified physiologic factors that predispose a woman to PPD. New mothers were visited at home on d 7, 14 and 28 after an uncomplicated labor and delivery. Hemoglobin (Hb) concentration was measured via finger-prick blood at each visit, and the women completed the Center for Epidemiological Studies-Depressive Symptomatology Scale (CES-D) on d 28. There was a negative correlation between Hb concentration on d 7 postpartum and depressive symptoms on d 28 (r = -4.26; P = 0.009). CES-D scores (means +/- SEM) on d 7 of women with normal Hb levels > 120 g/L (12 g/dL) were significantly lower (6.90 +/- 1.04) than those of women with Hb levels < or = 120 g/L (12 g/dL) [16.36 +/- 3.34; t(35) = -3.632, P = 0.001]. Thus, women suffering early postpartum anemia may be at increased risk of developing PPD.

Adult↗
PubMed2003

Interleukin-1beta elevation during the postpartum period.

During the postpartum period, women frequently report increased fatigue, which, if severe, may interfere with maternal-child bonding, delay a new mother's return to her activities of daily living, and contribute to depression. Several studies have sought to determine psychosocial contributions to fatigue during the postpartum period, but few evaluate any physiological changes that may contribute to fatigue during this time. The following study was designed to test whether the potent, pro-inflammatory cytokine interleukin-1beta (IL-1beta), known to be a physiological mediator of fatigue in several clinical and experimental conditions, is elevated in women during the postpartum period and whether it might be related to symptoms of fatigue. Levels of fatigue and the urinary excretion of IL-1beta were measured in 26 women over 4 weeks postpartum. Correlations between fatigue and activation of the inflammatory response were investigated. Results demonstrated a significant elevation in IL-1beta during the postpartum period compared to control participants (p < .05) and a significant, although delayed, correlation between IL-1beta elevation and fatigue (p < .05). These results suggest that activation of the inflammatory response, as reflected by elevation in urinary IL-1beta, occurs in association with postpartum fatigue. Studies to explore further this association and to identify specific mechanisms of action are needed.

Adult↗
PubMed2003

Smoking abstinence impairs time estimation accuracy in cigarette smokers.

Time estimation is used as an index of attention processes and may be sensitive to self-administration and withdrawal of psychoactive drugs such as nicotine, the primary addictive ingredient in tobacco. To test this hypothesis, 22 nonsmokers (12 male, 10 female) and 20 daily cigarette smokers (12 male, 8 female) were asked to estimate the duration of a 45-second period of time in a laboratory setting. Smokers participated in two sessions: once after smoking ad-lib and once after objectively confirmed 24-hour smoking abstinence. In smokers, time estimation accuracy was impaired after smoking abstinence compared to accuracy after ad-lib smoking (P<.01). Relative to nonsmokers, smokers' time estimation accuracy differed significantly after the abstinence period only (P=.05). Smokers reported feeling more stressed and unable to focus after abstinence relative to nonsmokers (P<.05). No gender differences were observed on any outcome measures. These results suggest that, in a controlled laboratory setting, smoking abstinence has a negative impact on time perception, which may contribute to the performance decrements and discomfort that smokers report during an attempt to quit.

Adolescent↗
PubMed2002

Seeing the unexpected: how sex differences in stress responses may provide a new perspective on the manifestation of psychiatric disorders.

In this report, the authors propose that underlying sex differences in the biobehavioral response to stress may contribute to the variance in prevalence of some psychiatric disorders based on sex. The authors begin with a discussion of stress physiology and review a new theory on sex differences in stress responses (ie, the "tend-and-befriend" response), which may provide a recent framework for considering sex differences in the manifestation of some psychiatric illnesses. The authors then move to a discussion of major depression and attention deficit hyperactivity disorder as examples of how sex differences in stress responses may influence the behavioral symptoms of psychiatric disorders that are more often diagnosed in one sex compared with another. The authors conclude with a brief discussion of the implications of this new perspective on treatment approaches and encourage further inquiry into the importance of sex-based differences in the behavioral manifestation of some psychiatric illnesses.

Adrenocorticotropic Hormone↗
PubMed2002

Predictors of fatigue in healthy young adults: moderating effects of cigarette smoking and gender.

Fatigue is a common complaint of patients seen in primary care. Factors that contribute to fatigue in a patient population include poor health status, psychological stress, poor nutrition, and pregnancy. Less well understood are factors that contribute to fatigue among healthy, nonpregnant individuals. Within the framework of the theory of unpleasant symptoms, 40 healthy young smoking and nonsmoking adults between the ages of 18 and 35 were evaluated to determine self-report level of fatigue and contributing physiological, psychological, and situational factors. Results indicate that while self-report of fatigue did not vary in this population based on gender, subjects who were moderate to heavy cigarette smokers were significantly more fatigued than were nonsmokers (F = 10.24, df = 1, 38, P < 0.01), with the effect being specific to male smokers. Self-report of fatigue did not correlate with body mass index, baseline inflammatory or immune status, or blood pressure. Positive psychological and situational predictors of fatigue included depression (r = 0.556, P < 0.001), state anxiety (r = 0.569, P < 0.001), sleep quality (r = -0.399, P < 0.05), and sleep quantity (r = -0.411, P < 0.05). These results suggest that psychological and situational factors are key contributors to fatigue in young adults and that smoking is a risk factor for fatigue in men.

Adult↗
PubMedDate not supplied

Risk indicators of metabolic syndrome in young adults: a preliminary investigation on the influence of tobacco smoke exposure and gender.

BACKGROUND: Metabolic syndrome is characterized by hypertension, dyslipidemia, insulin resistance, and obesity. Limited investigations have studied early indicators of metabolic syndrome in healthy young adults before diagnosis of disease. PURPOSE: The purpose of this investigation is to identify shifts in cardiovascular (CV), metabolic, and immune variables consistent with metabolic syndrome but occurring before development of the disorder, and to determine whether these variables are influenced by gender or cigarette smoking. METHODS: A pilot study of 41 subjects ages 18 to 39 years, with 20 smokers and 21 nonsmokers, was undertaken. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured to evaluate CV status; cholesterol, body mass index, leptin, percent glycated albumin, and homocysteine were measured to evaluate metabolic status; C-reactive protein, interleukin-1beta, and interleukin-10 were measured to evaluate immunologic status. Risk scores were assigned to each indicator, and total risk score was computed. RESULTS: Men had higher SBP (P<.001), DBP (P=.046), and body mass index (P=.01), whereas women had higher leptin (P=.002). Total risk scores in men were greater (P=.02). There was no effect of smoking on risk score, related to the increase in two risks for smokers (SBP, P=.04, DBP; P=.027) reciprocated by a decrease in another (percentage of glycated albumin; P=.02). CONCLUSION: Risk factors contributing to metabolic syndrome are present and highest in young men compared with women, whereas the effects of cigarette smoking on the syndrome are mixed. Early intervention to reduce modifiable risks may prevent full expression of disease.

Adolescent↗
PubMedDate not supplied

Fatigue as a predictor of postpartum depression.

BACKGROUND: The postpartum is a time when women commonly report increased fatigue that may contribute to depression. Studies have not examined fatigue alone as a predictor of postpartum depression. OBJECTIVE: To examine whether and when fatigue in the early postpartum is predictive of postpartum depression. DESIGN: Correlational, longitudinal study. SETTING: Two hospitals and participants' homes in central Pennsylvania. PARTICIPANTS: Convenience sample of 38 healthy women recruited from hospital maternity units within 24 hours after an uncomplicated birth. MAIN OUTCOME MEASURES: Fatigue was measured using the Modified Fatigue Symptom Checklist (MFSC) on Days 0, 7, 14, and 28 after childbirth. Depression was assessed using the Center for Epidemiological Studies-Depressive Symptomatology Scale (CES-D) on Day 28. RESULTS: After adjustments for multiple comparisons, a significant correlation was obtained between fatigue as measured by the MFSC and postpartum depression on Day 7 (r = .46; p < .05), Day 14 (r = .57), and Day 28 (r = .70). Fatigue on Day 0 was correlated with fatigue on Day 7 (r = .45), Day 14 (r= .58), and Day 28 (r = .34). CONCLUSIONS: Fatigue as early as 7 days postpartum is predictive of depression at Day 28 postpartum.

Adult↗
PubMedDate not supplied

The impact of fatigue on the development of postpartum depression.

BACKGROUND: Previous research suggests early postpartum fatigue (PPF) plays a significant role in the development of postpartum depression (PPD). Predicting risk for PPD via early identification of PPF may provide opportunity for intervention. OBJECTIVE: To replicate and extend previous studies concerning the impact of PPF on symptoms of PPD and to describe the relationships among PPF, PPD, and other variables using the theory of unpleasant symptoms. DESIGN: Correlational, longitudinal study. SETTING: Participants' homes. PARTICIPANTS: Convenience sample of 42 community-dwelling women recruited before 36 weeks of pregnancy. MAIN OUTCOME MEASURES: PPF, depressive symptoms, and stress measured during prenatal weeks 36 to 38, and on Days 7, 14, and 28 after childbirth. Salivary cortisol was measured as a physiological marker of stress. RESULTS: Significant correlations were obtained between PPF and symptoms of PPD on Days 7, 14, and 28, with Day 14 PPF levels predicting future development of PPD symptoms in 10 of 11 women. Perceived stress, but not cortisol, was also correlated with symptoms of PPD on Days 7, 14, and 28. Women with a history of depression had elevated depression scores compared to women without, but no variable was as effective at predicting PPD as PPF. CONCLUSIONS: Fatigue by Day 14 postpartum was the most predictive variable for symptoms of PPD on Day 28 in this population.

Adult↗