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J L Fitzpatrick

Publications and source records attributed to J L Fitzpatrick.

51 records · Page 3Linked to original sources
PubMed1999

The duty to recontact: attitudes of genetics service providers.

The term "duty to recontact" refers to the possible ethical and/or legal obligation of genetics service providers (GSPs) to recontact former patients about advances in research that might be relevant to them. Although currently this practice is not part of standard care, some argue that such an obligation may be established in the future. Little information is available, however, on the implications of this requirement, from the point of view of GSPs. To explore the opinions of genetics professionals on this issue, we sent a self-administered questionnaire to 1,000 randomly selected U.S. and Canadian members of the American Society of Human Genetics. We received 252 completed questionnaires. The major categories of respondents were physician geneticist (41%), Ph.D. geneticist (30%), and genetic counselor (18%); 72% of the total stated that they see patients. Respondents indicated that responsibility for staying in contact should be shared between health professionals and patients. Respondents were divided about whether recontacting patients should be the standard of care: 46% answered yes, 43% answered no, and 11% did not know. Those answering yes included 44% of physician geneticists, 53% of Ph.D. geneticists, and 31% of genetic counselors; answers were statistically independent of position or country of practice but were dependent on whether the respondent sees patients (43% answered yes) or not (54% answered yes). There also was a lack of consensus about the possible benefits and burdens of recontacting patients and about various alternative methods of informing patients about research advances. Analysis of qualitative data suggested that most respondents consider recontacting patients an ethically desirable, but not feasible, goal. Points to consider in the future development of guidelines for practice are presented.

Data Collection↗
PubMed1998

The effects of four mycotoxins on the mitogen stimulated proliferation of bovine peripheral blood mononuclear cells in vitro.

The effects of four mycotoxins, T-2 toxin, deoxynivalenol (DON), ochratoxin A (OTA) and fumonisin B1 (FB1) on the response of bovine peripheral blood mononuclear cells (PBM) in vitro to the mitogens concanavalin A (Con A), phytohaemagglutinin A (PHA) and pokeweed mitogen (PWM) were assayed after 4 days' incubation using 3H-thymidine uptake and the MTT bioassay. The concentrations of mycotoxin required to reduce the proliferative response of PBM by 50% for Con A, PHA and PWM as measured by 3H-thymidine incorporation was for T-2 toxin 0.30, 0.40 and 0.18 ng ml-1; for DON 0.07, 0.09 and 0.04 microgram ml-1; for OTA 0.10, 0.20 and 0.15 microgram ml-1, and for FB1 35, 18 and 11 micrograms ml-1 respectively. The concentrations of mycotoxin required to reduce the proliferative response of PBM by 50% for Con A, PHA and PWM as measured by the MTT bioassay were for T-2 toxin 2.0, 2.0 and 1.0 mg ml-1; for DON 0.70, 0.50 and 0.50 microgram ml-1; OTA 1.5, 1.5 and 1.5 micrograms ml-1; and FB1 > 50, > 50 and 20 micrograms ml-1 respectively. Further cytotoxicity assays including the LDH bioassay and Trypan blue exclusion were performed only on Con A-stimulated PBM cells after 72 h incubation. With the LDH-bioassay the 50% inhibition levels were T-2 toxin 0.3 ng ml-1, DON 0.4 microgram ml-1, OTA 1.4 micrograms ml-1 and FB1 3.5 micrograms ml-1; for Trypan blue uptake the 50% inhibition levels were T-2 toxin 5 ng ml-1, DON 2.3 micrograms ml-1 and OTA 4 micrograms ml-1 respectively.

Animals↗
PubMed1996

Pharmacokinetics of dacarbazine in the regional perfusion of extremities with melanoma.

BACKGROUND: The pharmacokinetics of dacarbazine (DTIC), which has been shown to be an effective therapeutic agent against metastatic melanoma, has not been extensively studied. However, to improve the clinical use of the drug, more information on the kinetics is required. METHODS: A pharmacokinetic study was undertaken in six patients with melanoma of an extremity who were undergoing hyperthermic isolation perfusion with DTIC in order to understand better its clinical pharmacokinetics. Plasma was sampled from the arterial and venous lines of an extracorporeal pump during the perfusion with the systemic vein and urine sampled postperfusion. Samples were analyzed for DTIC. 2-azahypoxanthine (2-AZA), and aminoimidazole carboxamide (AIC). 99(m)Tc (Technetium) human serum albumin (HSA) was used in the perfusion circuit to monitor the crossover of the perfusate into the systemic circulation during the procedure. The data were analyzed using a compartmental model of sampled body compartments incorporating the isolated extremity. RESULTS: High tissue DTIC levels were maintained throughout the perfusion, whereas in the systemic circulation, plasma DTIC concentrations, when observed, were 40-100-fold less than those in the perfusate. Almost 70% of the DTIC administered was not recovered in the perfusate after the washout of the extremity. CONCLUSIONS: High levels of DTIC can be maintained in an extremity (i.e., arm or leg) during perfusion.

Antineoplastic Agents↗
PubMed1995

Presentation of soluble and bacterial antigens by milk-derived cells to unprimed bovine T cells in vitro.

The ability of cells isolated from bovine milk and peripheral blood to present soluble protein and particulate bacterial antigens to peripheral blood T lymphocytes was compared using a culture system which consistently supports antigen-specific, primary, proliferative responses. The present study shows that cells from blood and from milk can present antigen to unprimed T cells. Major histocompatibility complex class II restriction of the responses was demonstrated by abrogation of proliferation by the addition of anti-bovine class II monoclonal antibody to cultures. Although cells derived from blood or milk were shown to be capable of presenting antigen to T cells, differences in optimal culture conditions and kinetics of the resulting response were observed.

Animals↗
PubMed1994

Cytokine-induced major histocompatibility complex class II antigens on cultured bovine mammary gland epithelial cells.

The aim of this work was to establish a simple but reliable method of collecting epithelial cells from tissue lining the gland cistern of the bovine mammary gland and to investigate the ability of cultured epithelial cells to express major histocompatibility complex class II antigens. Bovine mammary gland epithelial cells were isolated and grown as monolayers on five substrates in vitro. The cells were identified as epithelial in origin by immunofluorescent staining with anticytokeratin monoclonal antibodies. Major histocompatibility complex class II antigens were induced on epithelial monolayers by incubation with supernatants from bovine peripheral blood mononuclear cells stimulated with concanavalin A or incubation with recombinant bovine interferon-gamma. These results suggest that, in bovine mammary gland epithelium, recombinant bovine interferon-gamma, acting alone, can induce class II expression. This observation permits future investigation of the putative role of bovine mammary gland epithelial cells as accessory cells in the initiation of local immune responses and their involvement in peptide transport.

Animals↗
PubMed1993

Expression of major histocompatibility complex (MHC) class II antigens in the murine mammary gland.

Major histocompatibility complex (MHC) class II antigens were identified on cells within mammary gland connective tissue of lactating mice using a paraformaldehyde-lysine-periodate-gluteraldehyde fixative and an immunoperoxidase staining method. The distribution of class II expressing cells within interalveolar and interlobular connective tissue was similar both throughout lactation and in successive lactations. Epithelial cells within secretory alveoli and mammary ducts did not express class II antigens.

Animals↗
PubMed1993

Community attitudes toward drug use: the need to assess community norms.

Four neighborhoods at high-risk for alcohol and drug problems were surveyed concerning residents' perceptions of the extent and nature of these problems in their neighborhood. Residents were found to have relatively mild perceptions of the extent of misuse but relatively significant experiences with problems caused by drug abuse. They lacked knowledge of treatment and prevention programs. Significant differences were noted among the neighborhoods. Results are discussed in terms of the role of evaluation in community-based programs and the need to survey community norms to plan such programs.

Adult↗
PubMed1992

MHC class II expression in the bovine mammary gland.

The distribution of major histocompatibility complex (MHC) class II positive cells within the connective tissue and the epithelium of the involuted bovine mammary gland has been determined. The effect of intramammary administration of the antigens ovalbumin and formalin killed Streptococcus uberis on the distribution pattern has also been investigated. Infusion of formalin killed S. uberis increased cellular expression of class II antigens when compared with quarters either infused with ovalbumin, not infused at all, or from which minor pathogens had been isolated. The increased expression occurred particularly in the area of the gland cistern-secretory tissue junction.

Animals↗
PubMed1992

Comparison of antibody and cell-mediated immune responses in horses following feeding of a novel dietary antigen, ovalbumin, and rotavirus.

Adult ponies which were fed ovalbumin (OVA) daily for 2 weeks had significantly greater serum anti-OVA IgG (P = 0.001) and antigen specific lymphocyte responses (P = 0.031) after intramuscular injection with OVA given with saponin than control ponies which had not been fed the antigen. This suggests that, despite the lack of evidence of B- or T-cell activation in peripheral blood during the period of OVA feeding, the animals were primed for an active secondary immune response. Adult ponies were challenged with equine rotavirus, strain H-2, but no statistically significant differences were found in serum IgG-associated antibody responses or antigen-specific lymphocyte responses between the rotavirus-challenged group and the control group, either following rotavirus challenge or intramuscular injection of rotavirus antigen given with saponin. Our findings, that feeding the non-replicating protein antigen OVA appeared to prime for an increased immune response rather than inducing oral tolerance, may be of relevance to future studies on the way the equine gastrointestinal tract handles usually harmless antigens.

Animals↗
PubMed1989

A comparison of cognitive-behavioral and hypnotic treatments of chronic pain.

Twenty-seven chronic pain patients were assigned to one of three treatment groups: hypnosis, cognitive-behavioral, and an attention control. Hypnosis and cognitive-behavioral treatments were identical with the exception of the hypnotic induction. Scores on the McGill Pain Questionnaire (MPQ) and the Activity Log (Fordyce, 1976) were collected at pretreatment, posttreatment, and follow-up intervals. Analyses of changes showed significant increases in activity and decreases in pain intensity for the cognitive-behavioral treatment. Changes for the hypnosis treatment were noted only on the MPQ. Changes for both groups were sustained on the 1-month follow-up. Results of ANCOVAs showed that the cognitive-behavioral treatment resulted in significantly lower pain rating scores than those in the control treatment, but no significant differences were observed between the behavior and hypnosis groups. Findings support the superiority of the cognitive-behavioral treatment on behavior measures and equivalence to hypnosis on subjective measures.

Adult↗
PubMed1989

Risk factors before hepatectomy, hepatic function after hepatectomy and computed tomographic changes as indicators of mortality from hepatic failure.

The mortality rate from hepatic failure after extensive resection should be negligible in the presence of normal results from preoperative liver function tests in patients without pre-existing hepatitis and cirrhosis. Despite conventionally acceptable results from preoperative hepatic function tests in 56 patients undergoing extensive hepatic resection for tumours (47 metastatic, six hepatomas and three adenomas), however, five patients died of hepatic failure. Among the many preoperative and intraoperative risk factors studied, the important factors in the group with hepatic failure were very high levels of serum alkaline phosphatase (p less than 0.05) in the presence of normal levels of bilirubin and large tumor, preoperative administration of chemotherapy, the presence of hepatomas rather than metastatic carcinoma (p = 0.083) and intraoperative blood loss of greater than 5,000 milliliters (p = 0.03). The patients receiving preoperative chemotherapy or those with hepatoma showed a minimal rise of alkaline phosphatase (p less than 0.03) and a minimal regeneration of liver on computed tomographic (CT) scan after hepatic resection. In the group with hepatic failure, a consistent postoperative pattern of increasing bilirubin with normal or subnormal alkaline phosphatase levels corresponded with lack of regeneration of liver on repeated CT scans. Conversely, the pattern of decreasing bilirubin with reciprocal increase in alkaline phosphatase corresponded with hepatic regeneration on CT scan in the group of survivors. Thus, we observe that alkaline phosphatase is a good indicator of hepatic regeneration in the absence of jaundice in patients after hepatectomy. To avoid postoperative hepatic failure, we recommend more discriminant tests than conventional hepatic function tests in patients with large tumors associated with high alkaline phosphatase levels, preoperative chemotherapy and hepatoma even without pre-existing cirrhosis or hepatitis.

Adult↗
PubMed1986

Toxicity and complications of vascular isolation and hyperthermic perfusion with imidazole carboxamide (DTIC) in melanoma.

The authors have used imidazole carboxamide (DTIC) in vascular isolation and hyperthermic perfusion for melanoma. The regional and systemic toxicity and complications of this procedure were studied in 40 cases with Stage III (15) and Stage I (25) melanoma. Technetium 99m-labelled serum albumin crossover and pharmacokinetic studies were done simultaneously to see if these correlate with toxicity. Local toxicity on muscles, nerves, skin, and arteries was conspicuously absent despite using dosages of 2 g/m2 (40-45 mg/kg) for the lower extremity and 1.2 g/m2 (24-28 mg/kg) for the upper extremity. Skin and core temperature were raised to 39 degrees C to 40 degrees C. Deep vein thrombosis was noted in three patients. No death or gangrene of the extremities occurred. Local infection was noted in only one patient. Fourteen patients (35%) manifested bone marrow toxicity (leukocyte count of 4000/mm3 or platelets of 100,000/mm3) in the second or third week after perfusion. Severe hematologic toxicity was seen in two instances. Dosages of DTIC greater than 40 mg/kg were associated with toxicity in 65% of the patients. No bleeding complications occurred in seven patients with thrombocytopenia. Measurement of crossover and recovery of radionuclide were not reliable indicators of subsequent systemic toxicity. Perfusion fluid balance data also were of no predictive value. Forty-seven percent of the administered DTIC was recovered in washout fluid. Of this, less than 2% was converted to its metabolites, that is aminoimidazole carboxamide and 2-azahypoxanthine. Thirty-five of 40 patients experienced mild nausea and vomiting. Transient and mild hepatotoxicity was noted in seven patients. It appears that DTIC hyperthermic isolation perfusion is a safe procedure, however, the total dosage should be below 40 mg/kg to avoid hematologic toxicity.

Adult↗