Biomedical subjects
Publications and source records attributed to J Kendall.
[figure: see text] A series of 1-arylcyclohexenes have been deconjugated to the corresponding 3-arylcyclohexenes via a photosensitized electron-transfer reaction. The introduction of substituents on the aryl group has provided insight into the underlying mechanism and has defined the scope and limitations of the reaction.
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A vaccine trial was conducted with rhoptry-associated proteins 1 and 2 (RAP1 and RAP2) of Plasmodium falciparum in Saimiri boliviensis monkeys to compare the ability of parasite-derived (PfRAP1 and 2) and recombinant proteins (rRAP1 and 2) to induce protective immune responses and to find adjuvants suitable for use in humans. Eight groups of 6 monkeys each were immunized with parasite-derived or recombinant RAP1 and 2 with Freund's complete adjuvant (FCA) followed by Freund's incomplete adjuvant (FIA), Montanide ISA720 adjuvant, or CRL1005 adjuvant. Recombinant RAP1 and RAP2 were also administered separately, with Montanide ISA720. After 3 immunizations, monkeys were challenged by iv inoculation of 50,000 parasites of the Uganda Palo Alto strain of P. falciparum. Of the animals vaccinated using FCA/FIA, 1 of 6 control monkeys, 3 of 6 immunized with PfRAP1 and 2, and 2 of 6 with rRAP1 and 2 did not require drug treatment. Of the monkeys vaccinated with Montanide ISA720 adjuvant, 0 of the 6 control monkeys, 2 of 6 immunized with RAP1 and 2, 1 of 6 immunized with rRAP1, and 4 of 6 immunized with RAP2 did not require drug treatment. Two of 6 monkeys immunized with PfRAP1 and 2 with CRL1005 did not require treatment. All groups receiving RAP1, RAP2, or both had a significant decrease in initial parasite multiplication rates and there was a significant negative correlation between anti-RAP2 antibody and multiplication rates. Animals were rechallenged with the homologous parasite 126 days after the first challenge. Of the monkeys that did not require drug treatment after the first challenge, none developed detectable parasitemia following rechallenge.
The spread of chloroquine-resistant Plasmodium vivax from Papua New Guinea and Indonesia poses a serious health threat to areas of Southeast Asia where this species of malaria parasite is endemic. A strain of P. vivax from Indonesia was adapted to develop in splenectomized Aotus lemurinus griseimembra, Aotus vociferans, Aotus nancymai, and Saimiri boliviensis monkeys. Transmission to splenectomized Saimiri monkeys was obtained via sporozoites. Chemotherapeutic studies indicated that the strain was resistant to chloroquine and amodiaquine while sensitive to mefloquine. Infections of chloroquine-resistant P.vivax in New World monkeys should be useful for the development of alternative treatments.
Molecular genetics was used to devise the first reliable diagnostic tool for differentiating morphologically indistinguishable dorsal-spined, first-stage larvae (L1's) and other stages of the nematode protostrongylid subfamily Elaphostrongylinae. A polymerase chain reaction (PCR) assay employing specifically designed primers was developed to selectively amplify DNA of the ITS-2 region of the ribosomal gene. Amplification of the entire ITS-2 region differentiated between larvae of the genera Elaphostrongylus and Parelaphostrongylus, based on the lengths of fragments produced. Three sets of primers were designed and used successfully to distinguish larvae at the species level. Although it was demonstrated that one primer set in a single PCR assay was capable of distinguishing each of the three Parelaphostrongylus spp., a second primer set would be required for confirmation in routine diagnostic use. Two of the three primer sets were capable of amplifying DNA from all six elaphostrongyline species and of identifying Elaphostrongylus alces and Parelaphostrongylus odocoilei. Although two separate fragments were produced from each Elaphostrongylus cervi and Elaphostrongylus rangiferi, it was not possible to distinguish these two parasites from each other based on the fragment size. The use of various nematodes, hosts, and fecal controls demonstrated the reliability of the primers for all developmental stages including L1's, third-stage larvae, and adult worms. These primers also have potential for identifying other lungworms as was shown by the amplification of Umingmakstrongylus pallikuukensis, the muskox protostrongylid, and Dictyocaulus sp. from white-tailed deer. Although this assay may benefit from further refinement, its present design provides researchers, wildlife managers, clinicians, and animal health regulators with a practical tool for the control, management, and study of meningeal and tissue worms and their close relatives.
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The goal of this research was to generate a description of how siblings in families with attention deficit hyperactivity disorder (ADHD) children experienced and lived with this chronic behavioral disorder. Interview and diary data from 11 families (N = 43) were analyzed using the constant comparative method. Data analysis revealed that siblings felt victimized by their ADHD sibling and that their experience of victimization was often minimized or overlooked in the family. Findings suggest that there is a need for increased social and mental health services for all members of the family over the course of the disorder, and that the effects on siblings, in particular, can be potentially quite deleterious to their health and well-being.
The i-STAT point-of-care testing analyser, which utilizes single-use multisensor cartridges, was evaluated. Two cartridges were assessed: the 6+ and the G3+, which provide results for urea, glucose, sodium, potassium, chloride, haematocrit, pH, PCO2, PO2 and various calculated parameters. The results for all analytes agreed well with the analysers in routine use in the laboratory. The reproducibility was comparable even when analysis was carried out by a nurse with only 5 min training. The system was found to be reliable, easy to use and required no maintenance (only a 2-min daily check of the electronics). These features, together with portability and the storage capacity for results, make the i-STAT suitable for point-of-care use, particularly in critical care units.
Serological diagnosis of Parelaphostrongylus tenuis infection should offer many advantages over the currently used method of fecal analysis that relies on a patent infection. Toward this end, we investigated the presence of P. tenuis-specific antibodies in experimentally infected white-tailed deer (WTD) and of unique P. tenuis antigens that may be exploited for serodiagnosis. WTD infected with 6, 20 or 100-150 P. tenuis third-stage larvae (L3) had anti-parasite antibodies from as early as 21 days postinoculation (dpi) until the end of the experiment (147 dpi). Peak anti-P. tenuis enzyme-linked immunosorbent assay (ELISA) titers in individual animals ranged from 1:70 to 1:5,700. Serum from infected WTD reacted with 5 distinct P. tenuis L3 antigens (105, 45, 37, 32, and 19 kDa) as detected by the immunoblotting technique. Serum from caribou infected with Parelaphostrongylus andersoni or Elaphostrongylus rangiferi reacted with all antigens except the 37-kDa antigen of L3, indicating that it may be unique to P. tenuis and can serve as a serodiagnostic antigen. The 37-kDa antigen appears to be present in the adult P. tenuis but not adult E. rangiferi or E. cervi. The development of an ELISA utilizing the unique antigen of P. tenuis should lead to a reliable diagnostic assay for P. tenuis infection in WTD.
A chloroquine-resistant strain of Plasmodium vivax (AMRU-1) from Papua New Guinea has been adapted to grow in 4 species of Aotus monkeys (Aotus lemurinus griseimembra, Aotus vaciferans, Aotus nancymai, and Aotus azarae boliviensis), hybrid Aotus monkeys, and Saimiri boliviensis monkeys. Whereas it was possible to infect Saimiri monkeys with this parasite by inoculation of parasitized erythrocytes, only 42% of Saimiri monkeys became infected, compared to 92% of Aotus monkeys attempted. Comparative mosquito feedings showed that only A. vociferans, A. l. griseimembra, and Saimiri boliviensis monkeys produced infections in mosquitoes. Oocysts were observed on the guts of the 4 species of mosquitoes used (Anopheles gambiae, Anopheles stephensi, Anopheles freeborni, and Anopheles dirus), but sporozoite transmission was effected only with the intravenous inoculation of sporozoites from An. dirus into an A. l. griseimembra monkey.
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OBJECTIVES: To describe the proportion of patients attending an accident and emergency department for whom blood analysis at the point of care brought about a change in management; to measure the extent to which point of care testing resulted in differences in clinical outcome for these patients when compared with patients whose samples were tested by the hospital laboratory. DESIGN: Open, single centre, randomised controlled trial. Blood samples were randomly allocated to point of care testing or testing by the hospital's central laboratory. SETTING: The accident and emergency department of the Bristol Royal Infirmary, a large teaching hospital which cares for an inner city population. SUBJECTS: Representative sample of patients who attended the department between April 1996 and April 1997 and who required blood tests. Data collection was structured in 8 hour blocks so that all hours of the day and all days of the week were equally represented. MAIN OUTCOME MEASURES: The proportion of patients for whom point of care testing brought about a change in treatment in which timing was considered to be critical to clinical outcome. Mortality, the length of stay in hospital, admission rate, the amount of time spent waiting for results of blood tests, the amount of time taken to decide on management plans, and the amount of time patients spent in the department were compared between patients whose samples were tested at the point of care and those whose samples were sent to the laboratory. RESULTS: Samples were obtained from 1728 patients. Changes in management in which timing was considered to be critical occurred in 59 out of 859 (6.9%, 95% confidence interval 5.3% to 8.8%) patients in the point of care arm of the trial. Decisions were made 74 minutes earlier (68 min to 80 min, P < 0.0001) when point of care testing was used for haematological tests as compared to central laboratory testing, 86 minutes earlier (80 min to 92 min, P < 0.0001) for biochemical tests, and 21 minutes earlier (-3 min to 44 min, P = 0.09) for analyses of arterial blood gases. There were no differences between the groups in the amount of time spent in the department, length of stay in hospital, admission rates, or mortality. CONCLUSION: Point of care testing reduced the time taken to make decisions on patient management that were dependent on the results of blood tests. It also brought about faster changes in treatment for which timing was considered to be critical in about 7% of patients. These changes did not affect clinical outcome or the amount of time patients spent in the department.
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In pigs, induction of embryonic degeneration, by exogenous oestrogens given early in gestation, has been long recognised. However, the underlying mechanisms responsible for this degeneration remain unclear. The present study was conducted to determine whether oestrogen-induced early porcine embryonic mortality was associated with changes in the levels of tumour necrosis factor-alpha (TNF-alpha) messenger RNA in the uterine endometrium. Prepubertal gilts were induced into oestrus with PG600 and artificially inseminated at their second natural oestrus and again 24 h later. After insemination, gilts were randomly assigned to treatment and given 0.5 ml intramuscular injections of either oestradiol valerate (10 mg ml-1) or corn oil on day 9 and 10 of gestation. The gilts were slaughtered on day 12, 15 or 18 of gestation. The reproductive tract was removed from each gilt and the uterine horns were flushed to check for the presence and integrity of embryos. Samples of uterine endometrial tissues were collected, snap-frozen in liquid nitrogen and stored at -80 degrees C. Total cellular RNA was isolated from frozen tissues using a guanidine isothiocyanate-cesium chloride method. The abundance of TNF-alpha messenger RNA was determined by Northern blot hybridisation analysis. Treatment of pregnant gilts with oestrogen resulted in severe fragmentation of embryos on days 15 (2/3) and 18 (2/2), confirming the embryocidal effect of exogenous oestrogen. Uterine TNF-alpha messenger RNA level was elevated in oestrogen-treated gilts compared with controls (P < 0.05). This observation of an association between increased levels of TNF-alpha mRNA in the uterus and embryonic degeneration in oestrogen-treated gilts suggests that TNF-alpha may be involved in mediating oestrogen-induced early embryonic mortality in the pig.
Approximately 20% of all new AIDS cases in Thailand are women of childbearing age. Women are particularly vulnerable to HIV infection because of the social and sexual practices of men frequenting prostitutes, even after marriage, and the inability of women to exert control on decisions regarding sexual health. Women's oppression in Thailand is discussed and a position made of the moral imperative to use counterhegemonic methodologies in the study of HIV risk and prevention in Thai women. Interpretive and critical research methodologies are reviewed, and a case is made for using critical hermeneutics as an approach for investigating women's oppression in Thailand and their vulnerability to HIV infection.
OBJECTIVE: To assess the ability of nurse practitioners in accident and emergency (A&E) to interpret distal limb radiographs, by comparison with senior house officers. DESIGN: Nurse practitioners and senior house officers in 13 A&E departments or minor injury units were shown 20 radiographs of distal limbs, with brief history and examination findings, and asked to record their interpretation. OUTCOME MEASURE: A total score for each subject was calculated by comparing answers against agreed correct responses. RESULTS: Nurse practitioners in general compared favourably with senior house officers. Those nurse practitioners who interpret radiographs as part of their role in minor injury units performed as well as the experienced senior house officer group. CONCLUSIONS: Nurse practitioners in A&E are able to interpret radiographs to a standard equal to senior house officers with three to five months' experience. Those nurse practitioners actively interpreting radiographs as part of their role in minor injury units are able to interpret radiographs to the same standard as senior house officers with more than five months' experience.
The goal of the research described in this article was to generate a grounded theory of how parents of children with attention deficit hyperactivity disorder (ADHD) coped with this chronic behavioral disorder. Interview data from 15 families with ADHD children (N = 59) were analyzed using the grounded theory method. Data analysis revealed that parents outlasted the disruption of ADHD through three subprocesses of "reinvesting": making sense, recasting biography, and relinquishing the "good ending." Findings suggest that there is a developmental trajectory of how parents adjust to the disorder over time and that there is a need for increased social and mental health services for all members of the family over the course of the disorder.