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Biomedical subjects

J Fahey

Publications and source records attributed to J Fahey.

At least 19 recordsLinked to original sources

Effects of diets fed to dairy cows before and after calving on their plasma progesterone profiles after calving.

Four weeks before their predicted mean second lactation calving date, 60 spring-calving Holstein-Friesian cows were blocked into groups of six on the basis of their predicted calving date and body condition score, and allocated at random to one of six dietary treatments in a factorial design: ad libitum grass silage, ad libitum grass silage plus barley straw or ad libitum grass silage plus 3 kg of concentrates, was offered for four weeks before the expected calving date, and after calving they were offered either 4 kg or 8 kg of concentrates plus ad libitum grass silage for eight weeks. On average, the first luteal activity occurred in all the groups at 29 days after calving. Seventeen of the cows had an atypical first plasma progesterone profile; 12 were anovulatory, three had prolonged luteal phases and two became anovulatory after having been cyclic. The cows offered grass silage only before calving had a significantly shorter mean (se) interval between calving and second luteal activity (44.9 [2.1] days), than the cows offered grass silage and straw (53.5 [1.9] days) or grass silage and concentrates (51.5 [3.2] days) (P<0.05). After calving none of the 28 cows offered grass silage and 4 kg of concentrates started cycling before day 21, whereas five of the 30 cows offered grass silage and 8 kg of concentrates cycled before day 21 (P<0.05).

Animal Feed↗

The effect of feeding and management practices on calving rate in dairy herds.

The objective of this study was to examine the effects of nutrition and management practices on reproductive performance in 31 Irish dairy herds participating in the Moorepark Dairy Management Information System (DairyMIS) during the period 1991-1998. Fifty variables relating to herd reproductive indices, calving events, stocking rate, disease, concentrate feeding, fertiliser usage, milk production and economic performance were studied using factor analysis. A factor analysis, followed by varimax rotation, identified 13 factors, which accounted for 83% of the total variance of the original variables. A regression model was used to predict calving rate from the orthogonal factor scores identified by factor analysis. Calving rate was defined as the proportion of services, for which an outcome was known, which resulted in a subsequent calving. Year, farm code and factor 3 (labelled herd size) together accounted for 40% of the observed variation in calving rate. The factor scores for factor 3 (herd size) were plotted against calving rate and because the plot was not linear, it was decided that dividing the factor scores into quartiles would produce a better fitting model. The factor scores for herd size were sorted and assigned to four equal categories (n = 47 per category), from lowest to highest. The ranges in herd size according to category were as follows: category 1 (34-96), category 2 (47-103), category 3 (66-152) and category 4 (108-359). The calving rate (%), (+/-S.E.) was 67.0 +/- 2.5 for category 1, 61.8 +/- 1.8 for category 2, 56.9 +/- 1.5 for category 3 and 53.2 +/- 2.85 for category 4. Using pair-wise comparisons, calving rates differed significantly (P < 0.05) between all categories except between categories 3 and 4 (P > 0.05). Herd-level milk production was not associated with calving rate indicating that good management may overcome any adverse effects of high milk production on reproductive performance. Larger herds, in combination with other associated herd characteristics, are likely to have poorer calving rates than medium or small herds.

Animal Husbandry↗

Effects of calcium salts of fatty acids and calcium salt of methionine hydroxy analogue on plasma prostaglandin F2alpha metabolite and milk fatty acid profiles in late lactation Holstein-Friesian cows.

Effects of a dietary lipid supplement containing calcium salts of fatty acids and methionine hydroxy analogue on plasma prostaglandin F2alpha (PGF2alpha) metabolite (PGFM) and milk fatty acid profiles were examined in 40 late lactation, nonpregnant, Holstein-Friesian cows for a period of 70 days. Effects on milk production, milk composition, and blood metabolites were also examined. Cows were paired on the basis of lactation number (first lactation, n = 8; second lactation, n = 32) and randomly assigned from within pairs to one of two dietary treatments: unsupplemented control (C) or 400 g per cow per day of the lipid supplement (S). Cows receiving the supplement had higher (P < 0.05) total milk production, total fat production (kg), and total lactose production (kg). Plasma cholesterol was significantly higher (P < 0.01) after 30 days of treatment in cows receiving the supplement. Cows receiving the supplement had lower (P < 0.01) concentrations of short chain milk fatty acids (C4:0 to C14:1) and higher concentrations of long chain fatty acids (C18:1 and C18:2; P < 0.01) than control animals. Oxytocin-induced prostaglandin release on Day 16 postovulation was increased (P < 0.01) in cows receiving the supplement. In conclusion, supplementation with calcium salts of fatty acids and methionine hydroxy analogue significantly increased milk yield and plasma PGFM.

Animals↗

Relative preservation of natural killer cell cytotoxicity and number in healthy AIDS patients with low CD4 cell counts.

OBJECTIVE: This study examines whether there may be an immune component that protects a relatively rare group of HIV-infected people with very low CD4 cell counts (< or = 50 x 10(6)/l) who have prolonged asymptomatic periods. DESIGN/METHODS: Three groups were recruited in Miami: (i) healthy low CD4 cell count patients (HLC; n = 30) who, for 9 months had < 50 x 10(6) CD4 cells/l, were asymptomatic and were not on protease inhibitors during that time; (ii) HIV comparison group (Comp; n = 60) who had CD4 cell counts predominantly 150 x 10(6) to 400 x 10(6)/l and never had AIDS Category C symptoms; this group was also followed for CD4 cell count and viral load change over 6 months; and (iii) healthy community controls (n = 33). The study was replicated at the University of California at Los Angeles (UCLA) with HLC (n = 31) versus HIV-negative laboratory controls (n = 28). RESULTS: The HLC patients were significantly higher than the Comp group on natural killer cell cytotoxicity (NKCC) and natural killer cell number (NK#) despite their lower CD4 cell numbers and higher viral loads. In fact, there was no difference between the HLC group and the healthy community control group in NK# or NKCC. The NK findings were replicated at UCLA. A retrospective analysis showing that higher NKCC was related to fewer prior symptoms in the HLC group, and prospective analysis in the Comp group showing that NK# predicted a lower increase in viral load over 6 months further supported the importance of NK# and NKCC. CONCLUSIONS: Non-specific cellular immunity may be a factor protecting the health of HIV sero-positive individuals with very low CD4 cell counts.

Acquired Immunodeficiency Syndrome↗

Test-retest reliability for self-reports of sexual behavior among Thai and Korean respondents.

The purpose of this study was to examine the test-retest reliability for reports of sexual behavior from the National Institutes of Mental Health Multisite HIV Prevention Trial survey for two Asian samples. Thai (N = 37) and Korean (N = 46) respondents aged 19-37 years (M = 29, SD = 4.61) completed face-to-face interviews to assess their sexual risk in their ethnic language 3-7 days apart. Test-retest coefficients ranged from .65 to 1.00 demonstrating acceptable reliability of the survey among Thai and Korean adults. The discussion focuses on the development of HIV risk assessments that take into consideration ethnic diversity found within the Asian and Pacific Islander community.

Adult↗

Depression in caregivers of demented patients is associated with altered immunity: impaired proliferative capacity, increased CD8+, and a decline in lymphocytes with surface signal transduction molecules (CD38+) and a cytotoxicity marker (CD56+ CD8+).

Changes in relevant immune parameters, including function, were found to be associated with depression in elderly caregiver wives of demented patients. We studied the relationship between immune cell phenotype and T cell proliferative capacity of such caregivers to levels of stress and depression over the course of a support group intervention. The data indicate the strongest association between depression (of all stress parameters) and impaired T cell proliferative capacity. Depression was also most strongly (of stress parameters) associated with a shift in T cell populations with an increase in CD8+ T cells, and a reduced percentage of CD38+ cells in both CD8+ and CD4+ T cell populations. Since CD38 is a signal transduction factor, it was interesting that a decreased percentage of CD38+ cells correlated with impaired T cell function (proliferation). Another significant difference was the reduction in natural killer (NK) cells as well as the percentage of the CD56+ component of the CD8+ population. This latter subset is important in MHC-unrestricted cytotoxicity, and has been found expanded in healthy centenarians. This study shows that both chronic stress, and depression in particular, and age have deleterious effects on T cells, and together could significantly contribute to the higher risk of disease and mortality associated with being a caregiver of a demented individual.

ADP-ribosyl Cyclase↗

Long-term survival without clinical AIDS after CD4+ cell counts fall below 200 x 10(6)/l.

OBJECTIVE: Quantify and study cofactors of long-term survival without AIDS in HIV-1-infected individuals with CD4+ cell counts < 200 x 10(6)/l. DESIGN: Comparison of 579 participants who could be longitudinally evaluated for at least 3 years after the earliest date of first reaching a CD4+ cell count < 200 x 10(6)/l or an AIDS-defining illness (1987 Centers for Disease Control and Prevention definition). SETTING: Ongoing 9-year cohort study with data collected at 6-month intervals. PATIENTS: HIV-1-infected homosexual men. MEASUREMENTS AND MAIN RESULTS: Of the men, 20% did not develop an AIDS illness within 3 years following a confirmed CD4+ cell count < 200 x 10(6)/l; 29 and 28% were diagnosed with a first clinical AIDS illness from 1-3 and < 1 years, respectively, beyond their first CD4+ cell count < 200 x 10(6)/l; 23% were diagnosed with a clinical AIDS illness prior to their first CD4+ cell count < 200 x 10(6)/l. Slower decline of CD4+ cell count (P < 0.001) and presence of higher body-mass index during the period prior to the first CD4+ cell count < 200 x 10(6)/l (P < 0.001) predicted longer time to an AIDS illness once this threshold was reached. Most men had rapid loss of CD4+ cells, total T cells, and hemoglobin during the period after CD4+ cells declined below 200 x 10(6)/l. However, those remaining free of AIDS illnesses the longest arrested their decline in CD4+ cell counts and hemoglobin levels and increased total T cells during this period. Although antiretroviral therapy and Pneumocystis carinii prophylaxis extend AIDS-free survival, 45% of the group who were AIDS-free > or = 3 years after CD4+ cells fell below 200 x 10(6)/l had not used these treatments. CONCLUSIONS: Significant numbers of individuals remain free of illnesses and AIDS symptoms > or = 3 years after CD4+ cell counts drop below 200 x 10(6)/l. This occurs even in the absence of treatment. The associations seen here suggest that host and viral factors play important roles. Thus, further studies are needed to determine the biological basis of long-term survival without AIDS illnesses in HIV-1-immunosuppressed patients.

Acquired Immunodeficiency Syndrome↗

A comparative study of intravenous versus intralymphatic interleukin-2, with assessment of effects of interleukin-2 on both peripheral blood and thoracic-duct lymph.

Recombinant human interleukin-2 (IL-2) was administered by the intravenous (i.v.) or intralymphatic (i.l.) route to 14 patients with advanced malignancy. IL-2 was given in doses of 600,000 IU/kg or 1,050,000 IU/kg daily x 5. Thoracic duct (TD) catheters were placed, and both TD lymphocytes (TDL) and peripheral blood lymphocytes (PBL) were studied. Five of eight patients at the 600,000 IU/kg dose experienced grade III toxicity as did five of six patients at the 1,050,000 IU/kg dose. Two episodes of grade IV toxicity were seen at the higher dose. The i.l. and i.v. routes had a similar toxicity profile excepting lymphangitis/pedal infection, seen only with i.l. administration. One partial response was seen in a patient with renal cell carcinoma. Lymphopenia was seen early in therapy, with lymphocytosis by day 6. Lymphoid yield of the TD catheter fell early in therapy, then increased over baseline by the end of treatment. Intralymphatic administration resulted in a prolonged serum t1/2 and lower serum levels than did i.v. administration, but resulted in higher TD levels. Antibodies against IL-2 were ubiquitous but had no clear effects. Lymphocyte trafficking studies suggested that IL-2 affected lymphocyte redistribution to liver, spleen, bone marrow, and lymph nodes. NK activity and phenotype and LAK activity increased in response to IL-2, with no advantage for TDL. Tumor necrosis factor-alpha and gamma-interferon levels increased sporadically with treatment. The i.l. route offered no advantage over the i.v. route, and TDL offered no advantage over PBL.

Adult↗

Neonatal correction of transposition of the great arteries: the Connecticut experience.

The treatment of transposition of the great arteries, a common congenital cardiac defect, has undergone significant development. Prior to 1989 a surgical approach which repaired the transposition at the atrial level (Senning's operation), but did not restore normal anatomy, was the procedure of choice. Since 1989 a surgical approach that restores normal anatomy (Jatene's arterial switch) has been followed. Forty-four patients have been corrected since 1979 (N = 26 Senning's operation, N = 18 arterial switch). The arterial switch patients are corrected at an earlier age, have a longer, more complex operation without a significant increase in operative mortality, intensive care, or duration of hospitalization. The prevalence or frequency of normal ventricular function and normal sinus rhythm is significantly increased over the repair at the atrial level. The frequency of pulmonary stenosis is increased. The duration of follow-up for these patients is significantly shorter than for those with atrial level repair.

Connecticut↗

Achieving quality management through organizational values.

By focusing on its mission values, a hospital can enhance the quality of patient care, improve staff morale, promote cost effectiveness and achieve a competitive advantage in the hospital market place. Since 1986, St Vincent's Private Hospital has implemented strategies and formed task forces to clarify and apply its values to the hospital's overall direction and the everyday work setting. This work has proved that a concentration on the hospital's mission can result in quality management and can benefit both the hospital's basic 'spirit' and its bottom line. Eight guiding principles were found to be essential in achieving quality management through organizational values.

Efficiency, Organizational↗

A seroepidemiologic study of cytomegalovirus infection in a Canadian recruit population.

The prevalence of antibodies to cytomegalovirus (CMV) was investigated in a population of Canadian male and female military recruits entering a basic-training session in Nova Scotia. Of 660 incoming recruits, 119 (18.0%) had IgG and/or IgM antibodies to CMV detectable by a latex agglutination procedure. There was no statistically significant difference between the prevalence of CMV antibodies among male recruits (16.2%) and that among female recruits (21.8%) (p = .085). The prevalence of antibodies to CMV in this recruit population is similar to that in the general Canadian population. During the 8- to 10-week training session, 1.7% of the recruits (.8% of the males and 3.6% of the females) seroconverted to become seropositive for antibodies to CMV. There was some equivocal evidence that the females had a higher CMV seroconversion rate than did the males (p = .030). There was no significant difference between the geometric mean titers of the male and female recruits who seroconverted. This seroconversion rate suggests that CMV transmission was low during the training session even though physical crowding was present.

Adolescent↗

Serum and effector-cell antibody-dependent cellular cytotoxicity (ADCC) activity remains high during human immunodeficiency virus (HIV) disease progression.

The activity of both serum and effector cell antibody-dependent cellular cytotoxicity (ADCC) against human immunodeficiency virus (HIV-1, HIV) was assessed in HIV-infected individuals. The goal was to relate ADCC levels with the stage or progression of HIV disease. Serial serum samples, usually collected at 6-month intervals, from individuals at defined stages of HIV disease (seroconversion, the HIV-seropositive period before AIDS, and around the time of clinical AIDS diagnosis) were tested. HIV-coated CEM tumor cells were used as targets. Effector-cell ADCC activity was evaluated using fresh peripheral blood mononuclear cells (PBMC) from HIV-infected individuals at different stages of HIV disease. Samples were obtained from male homosexual participants in the Multicenter AIDS Cohort Study (MACS). In seroconverters, ADCC-inducing HIV-specific antibodies were detected at the time that the ELISA antibody test was first positive. Within several months, serum ADCC activity stabilized in each individual. In 29 HIV-seroprevalent individuals (HIV seropositive on their first visit), serum ADCC activity remained constant regardless of whether the individual's HIV disease was stable (high stable CD4; n = 9) or rapidly deteriorating (sharply declining CD4, n = 10; AIDS progressors, n = 10). With respect to effector-cell activity, PBMC from HIV-infected individuals with or without AIDS were capable of mediating ADCC with heterologous and usually with autologous sera. Although the level of NK cytotoxic activity and the level of antibody-armed effector cell activity have been reported to decline as disease progresses, our results support previous observations that ADCC effector-cell activity against antibody-coated targets does not decline in HIV infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗

Results of the flow cytometry ACTG quality control program: analysis and findings.

The AIDS Clinical Trial Group's (ACTG) Immunology Committee was charged with initiating a quality control program for all laboratories participating in the ACTG program reporting flow cytometry data. Forty-one laboratories were evaluated. This report defines the goals of this program and the subsequent findings after 19 send-outs were made. Both HIV positive volunteer donors and normal age-matched donors were used. Sample sets included both heparin and EDTA anticoagulated bloods. Laboratories were asked to report hematologic parameters as well as flow cytometry data both in percentages and absolute numbers. Results were evaluated using nonparametric statistical analysis. Robust CVs and interquartile ranges were used to define the performance of individual laboratories for each CD subset analyzed. Intralaboratory reproducibility was analyzed by paired sample sets. All laboratories were found to be able to define normal samples as normal. Seventy-five percent of the laboratories were able to define abnormal samples as abnormal. Twenty-five percent could not identify two abnormal samples as abnormal. Forty percent of the labs were found unable to reproduce paired samples within an absolute of +/- 5%. EDTA was found slightly superior to heparin in bloods evaluated by flow cytometry within 30 hr of collection. The analysis of specific histograms, questionnaires, and data analysis led to a specific set of recommendations for performance of flow cytometry studies.

Acquired Immunodeficiency Syndrome↗

Quantitating the effect of cystic fibrosis on linear growth by mathematical modelling of longitudinal growth curves.

Cystic fibrosis (CF) is a systemic disorder that may compromise linear growth in childhood, but quantitating this effect requires accurate mathematical models for normal growth. Anthropometric measurements on a cohort of 37 CF patients were analyzed using the growth model of Preece and Baines (1978) which reduces longitudinal height data to 6 quantitative parameters. When parameter means for CF females (n = 19) were compared to the reference population in the Harpenden growth study, the overall difference was significant (p less than 0.05). Examination of the derived biological parameters revealed 12-month and 14-month delays in age at take off and peak height velocity, respectively, indicating that the pubertal growth spurt in female patients is delayed. Mean ages at take off and peak height velocity were delayed 9 months in the CF males (n = 18). These results reaffirm the observation that CF females experience greater morbidity in later childhood and adolescence than males, and illustrate a quantitative approach that should facilitate further examination of CF and the efficacy of different treatment modalities on the disease process in both sexes.

Adolescent↗

Persistent left superior vena cava causing subdivided left atrium: diagnosis, embryological implications, and surgical management.

A 3-month-old infant is described in whom a persistent left superior vena cava impinged on the posterior wall of the left atrium, producing a subdivided left atrium with left-to-right shunting and congestive heart failure. To our knowledge, this anomaly has not previously been reported. The preoperative diagnosis, surgical management, and embryological implications are discussed.

Echocardiography↗

Antibody that inhibits human immunodeficiency virus reverse transcriptase and association with inability to isolate virus.

Most individuals infected with human immunodeficiency virus (HIV), the causative agent of acquired immune deficiency syndrome, produce an antibody against the viral reverse transcriptase (RT). Our studies show that 67% of HIV-seropositive individuals (33 of 49) produced an antibody that specifically inhibited viral RT enzyme activity. We were able to isolate HIV from only 18% of these individuals (6 of 33). On the other hand, virus was readily isolated from 63% of HIV-seropositive individuals (10 of 16) who did not demonstrate this antibody. Further examination of this RT-inhibiting antibody and its role during virus infection is needed, as it may prove to be of diagnostic, prognostic, or therapeutic value in this study and treatment of acquired immune deficiency syndrome.

Acquired Immunodeficiency Syndrome↗