Biomedical subjects

Elizabeth Taylor

Publications and source records attributed to Elizabeth Taylor.

7 recordsLinked to original sources

PubMed2006

A metabolic study of patients with lung cancer and hyponatremia of malignancy.

PURPOSE: One-third of patients with lung cancer and hyponatremia have no evidence of ectopic arginine vasopressin (AVP) production and the cause of their hyponatremia is not conclusively established. We sought to distinguish patients with hyponatremia caused by elevated AVP versus those with ectopic atrial natriuretic peptide (ANP) via this detailed metabolic study. EXPERIMENTAL DESIGN: We enrolled 24 patients recently diagnosed with lung cancer in a metabolic study in which patients were placed on sodium and fluid restriction for 4 days. Serum electrolytes, osmolality, urine electrolytes and osmolality, plasma AVP, ANP, aldosterone, urinary cyclic AMP and cyclic guanosine 3',5'-monophosphate were measured daily and tumor tissue was obtained to measure ectopic hormone production. We attempted to characterize the pathophysiology of hyponatremia caused by ectopic ANP production in patients with small cell lung cancer (SCLC) and to determine its effect on the aldosterone axis. RESULTS: Seven of the nine patients with SCLC presented with hyponatremia and three had elevated ANP levels at presentation without elevation of AVP. All three patients who presented with hyponatremia and elevated ANP showed a decline in serum sodium following fluid restriction, whereas two patients with SCLC and elevated AVP had normalized serum sodium levels. The combination of hyponatremia and elevated ANP was associated with a persistent natriuresis and inappropriately low aldosterone levels despite sodium restriction, suggesting ANP suppression of the aldosterone axis. CONCLUSIONS: Management of patients with hyponatremia and SCLC should be guided by the knowledge that some patients with SCLC have ectopic production of ANP as the cause of their hyponatremia.

Adult↗

PubMed2005

Shared alterations in NK cell frequency, phenotype, and function in chronic human immunodeficiency virus and hepatitis C virus infections.

Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) cause clinically important persistent infections. The effects of virus persistence on innate immunity, including NK cell responses, and the underlying mechanisms are not fully understood. We examined the frequency, phenotype, and function of peripheral blood CD3- CD56+ NK subsets in HIV+ and HCV+ patients and identified significantly reduced numbers of total NK cells and a striking shift in NK subsets, with a marked decrease in the CD56(dim) cell fraction compared to CD56(bright) cells, in both infections. This shift influenced the phenotype and functional capacity (gamma interferon production, killing) of the total NK pool. In addition, abnormalities in the functional capacity of the CD56(dim) NK subset were observed in HIV+ patients. The shared NK alterations were found to be associated with a significant reduction in serum levels of the innate cytokine interleukin 15 (IL-15). In vitro stimulation with IL-15 rescued NK cells of HIV+ and HCV+ patients from apoptosis and enhanced proliferation and functional activity. We hypothesize that the reduced levels of IL-15 present in the serum during HIV and HCV infections might impact NK cell homeostasis, contributing to the common alterations of the NK pool observed in these unrelated infections.

CD3 Complex↗

PubMed2004

The largest outbreak of measles in the United States during 1999: imported measles and pockets of susceptibility.

The largest measles outbreak in the United States during 1999 was traced to a 34-year-old minister with an undocumented history of vaccination, infected while traveling outside the United States. Local health departments in the Central Virginia Health District performed an epidemiological and laboratory investigation that identified 14 additional confirmed cases of measles, including 2 in health care providers and 5 in congregation members. Eight cases (53%) occurred among adults aged 30-35 years and 7 (47%) among children aged 13 months to 8 years. Although no religious exemptions were cited, only 2 case patients had documented proof of vaccination. This outbreak demonstrates the potential for limited indigenous spread of measles that occurs when imported cases expose susceptible groups. Almost half of the imported measles cases in the United States occur in US residents returning from foreign travel. Vaccination is highly recommended for all overseas travelers who are without documented proof of adequate immunization or measles immunity.

Adult↗

PubMed2004

Clinical evaluation of a continuous minimally invasive glucose flux sensor placed over ultrasonically permeated skin.

Frequent monitoring and tight metabolic control of blood glucose levels can reduce microvascular complications and subsequent co-morbidities in patients with diabetes. Self-monitoring with finger sticks provides intermittent data at best, and results in poor compliance. We report on a minimally invasive system that continually measures glucose flux through ultrasonically permeated skin. Ten patients with diabetes were enrolled in a clinical study to determine correlation between data collected by glucose biosensors placed over ultrasonically treated skin sites (two per patient), and blood glucose readings were taken every 20 min over an 8-h period. Glucose flux biosensors measured amperometric current proportional to hydrogen peroxide level, generated from catalytic conversion of glucose by glucose oxidase; the sensor was coupled to the skin by a thin hydrogel containing an osmotic extraction buffer, creating a gradient for glucose transport through the skin. The biosensors were attached to small portable meters that recorded time, current, and temperature readings every 5 s. At the conclusion of the study period, meter recordings were downloaded for data processing. Skin sites were examined for irritation due to biosensor contact. Data from glucose biosensors with completed data sets had a correlation coefficient of 0.84, and 95% of the data pairs (n = 241) were in the A + B region of a Clarke error grid. Ultrasonic pretreatment lasting about 10 s resulted in improved conductance in all patients. No patients complained of pain or irritation at any time during the study. Continuous monitoring of glucose flux through ultrasonically permeable skin is safe and feasible.

Adult↗

PubMed2004

Multicomponent psychosocial support for newly diagnosed cancer patients: participants' views.

The diagnosis and treatment of cancer carries a heavy psychological burden, particularly in the first year after diagnosis. The purpose of this study was to investigate and report qualitatively on patients who had completed a 10-session programme consisting of education, social interaction, psychological support, exercise and complementary therapies for newly diagnosed cancer patients. A thematic analysis of data obtained from purposefully selected focus groups revealed that peer support was the most highly valued aspect of the service and that a variety of needs were being met. The relaxed atmosphere, sensitivity of staff and complementary therapies were particularly appreciated. The findings also indicated that patients would like the option of diversional activities and a period of structured group therapy in addition to the services offered and that the revision of information-giving procedures would enhance psychological support. Opportunities for staff development are identified.

Adaptation, Psychological↗

PubMed2003

Genome-wide mapping of human loci for essential hypertension.

BACKGROUND: Blood pressure may contribute to 50% of the global cardiovascular disease epidemic. By understanding the genes predisposing to common disorders such as human essential hypertension we may gain insights into novel pathophysiological mechanisms and potential therapeutic targets. In the Medical Research Council BRItish Genetics of HyperTension (BRIGHT) study, we aim to identify these genetic factors by scanning the human genome for susceptibility genes for essential hypertension. We describe the results of a genome scan for hypertension in a large white European population. METHODS: We phenotyped 2010 affected sibling pairs drawn from 1599 severely hypertensive families, and completed a 10 centimorgan genome-wide scan. After rigorous quality control, we analysed the genotypic data by non-parametric linkage, which tests whether genes are shared in excess among the affected sibling pairs. Lod scores, calculated at regular points along each chromosome, were used to assess the support for linkage. FINDINGS: Linkage analysis identified a principle locus on chromosome 6q, with a lod score of 3.21 that attained genome-wide significance (p=0.042). The inclusion of three further loci with lod scores higher than 1.57 (2q, 5q, and 9q) also show genome-wide significance (p=0.017) when assessed under a locus-counting analysis. INTERPRETATION: These findings imply that human essential hypertension has an oligogenic element (a few genes may be involved in determination of the trait) possibly superimposed on more minor genetic effects, and that several genes may be tractable to a positional cloning strategy.

Chromosome Mapping↗

PubMed2002

A multi-professional short-term group intervention for informal caregivers of patients using a home palliative care service.

Informal carers of home palliative care patients have high unmet needs. However, interventions for carers are few. This research-based short-term group intervention addresses the information and support needs of carers. Multiprofessional informal teaching is combined with peer support. The intervention was designed by integrating the findings from a qualitative study and the evidence on needs and interventions, in order to address the key issues of feasibility, acceptability, and accessibility. Qualitative data from attendees showed that identifying with other carers and validating feelings, asking questions of professionals, and providing each other with support and encouragement were valuable outcomes from the group.

Adaptation, Psychological↗