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Biomedical subjects

F Trimboli

Publications and source records attributed to F Trimboli.

11 recordsLinked to original sources
PubMed2001

HLA-DRB1 DNA sequencing based typing: an approach suitable for high throughput typing including unrelated bone marrow registry donors.

The HLA-DRB1 sequencing based typing strategies reported to date require separate amplifications of each sample with a series of group-specific primers followed by sequencing of any resulting polymerase chain reaction (PCR) products. Whilst this results in high resolution typing in the majority of cases, a number of unnecessary amplifications are performed. We report here a novel approach where amplification of the second exon of HLA-DRB1 is performed in a single tube for all alleles. Retrospective analysis of 642 consecutive Western Australian unrelated bone marrow registry donors has shown that this approach results in unambiguous typings in 71.1% of cases. Ambiguities can be readily resolved if necessary with a single additional sequencing reaction on the original PCR product.

Alleles↗
PubMed2000

Unrelated donors selected prospectively by block-matching have superior bone marrow transplant outcome.

Previous retrospective studies have demonstrated improved outcome in patients whose donors were matched for non-HLA markers in the MHC as well as for HLA genes. Forty patients receiving transplants from unrelated donors were typed prospectively for HLA and non-HLA markers. Non-HLA markers near HLA-B (beta-block markers) and in the DRB1 introns (delta-block markers) were used to assess MHC match between donors and recipient. Patients whose donors were matched at the beta- and delta-blocks had improved event free survival (63%) compared to patients whose donors were mismatched at one or both blocks (25%) (p < 0.05). Patients whose donors were matched at the beta-block had significantly less severe acute graft versus host disease (p < 0.05). In order to investigate the basis for improved outcome block matching was correlated with HLA matching as determined by DNA sequencing. Beta-block matching was highly correlated with matching for exons 2 and 3 of HLA-B but less so for HLA-C. Delta-block matching was highly correlated with matching for exon 2 of HLA DRB1. It is concluded that matching for non-HLA markers in the MHC improves matching for HLA genes. Further studies are required to determine whether matching for non-HLA markers improves outcome to a greater extent than matching for the HLA genes alone.

Adolescent↗
PubMed1999

Matching for TNF microsatellites is strongly associated with matching for other non-HLA MHC sequences in unrelated bone marrow donor-recipient pairs.

The use of unrelated donors for bone marrow transplantation is associated with an increased morbidity and mortality when compared with HLA identical siblings. We have demonstrated previously that matching of unrelated donors and recipients for TNFa microsatellites is correlated with lower CTLp frequencies. Matching of unrelated donors and recipients for other non-HLA sequences in the major histocompatibility complex has been reported to result in less graft-versus-host disease and improved survival. It has been argued that matching for non-HLA sequences in the MHC in addition to the HLA genes themselves results in matching for the entire MHC and is therefore the equivalent of providing an HLA identical sibling donor. In order to test this hypothesis we have examined TNFa microsatellites of unrelated donor recipient pairs in whom matching for HLA loci, non-HLA sequences near HLA B (beta-block markers) and non-HLA sequences near DRB1 (delta-block markers) had been determined. All 17 patients who were matched for HLA and non-HLA markers were also matched for TNF microsatellites. This data supports the idea that matching for HLA genes and non-HLA markers results in matching at all other loci in the MHC.

Bone Marrow Transplantation↗
PubMed1983

A study of repeat visits to a psychiatric emergency room.

The authors examined the records of 3,824 patients making their first visit to a psychiatric emergency room of a teaching hospital. Data on the patients who made repeat visits (17.7 percent) were analyzed to determine variables that may correlate with repeating for follow-up periods of 90 and 360 days. Although no factors present in the initial visit allowed a useful level of prediction of repeat visits, psychiatric history, cognitive difficulties, and a diagnosis of more severe psychopathology were validated as correlates of repeating. Results suggested there were two subgroups of repeaters: those who repeated within 30 days and who were distinguished from nonrepeaters solely by their previous psychiatric contact, and those who repeated after 30 days and who appeared chronically ill and afflicted with profound psychological, social, and economic problems. Implications for the emergency room are discussed.

Emergency Services, Psychiatric↗
PubMed1983

A psychodynamic approach to MMPI Interpretation.

An interpretive approach to the Minnesota Multiphasic Personality Inventory (MMPI), based on a psychodynamic conceptual system, is presented. Scale elevations and configurations on the MMPI are viewed as reflecting the following dimensions of personality: (a) characteristic security and defense operations, (b) capacity to manage or tolerate anxiety, c) characteristic ways of dealing with aggression and hostility, d) stability of reality contact, e) quality of object relations, and f) level of psychopathology. Various MMPI profile configurations, and empirical research findings where applicable, are related to variations in personality functioning and psychopathology within each of these six dimensions. The interpretive approach described is consistent with the authors' belief that psychological assessment should go beyond the level of description and attempt to understand the individual in a more comprehensive and integrated manner.

Aggression↗
PubMed1982

Correlates of successful short-term psychiatric hospitalization.

The increased popularity of short-term psychiatric hospitalization has raised the question of what kinds of patients benefit most from this treatment. The authors examined the records of 612 patients admitted to an urban general hospital's psychiatric inpatient unit over two years; all subjects had been referred by the hospital's psychiatric emergency room. A total of 156 clinical variables and 18 demographic variables recorded on the emergency room's intake form were examined and correlated with treatment outcome in terms of length of inpatient stay and disposition on discharge, as recorded on discharge records. A total of 21 clinical variables were found to be positively or negatively related to patient discharge into the community within 21 days after admission. None of the demographic features studied were unequivocally related to that outcome measure. The authors suggest that less severely ill patients may respond better (and thus have better treatment outcomes) than more debilitated ones, or that patients who recognize and acknowledge their distress may be better candidates for crisis-oriented short-term treatment.

Community Mental Health Services↗