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Biomedical subjects

K Kenney

Publications and source records attributed to K Kenney.

16 recordsLinked to original sources

Syphilis partner notification with men who have sex with men: a review and commentary.

BACKGROUND: Eight US cities experienced large outbreaks of syphilis among men having sex with men (MSM), beginning during 2000-2001. Provider-assisted partner notification via disease intervention specialists has traditionally composed a large part of syphilis control efforts. OBJECTIVES: Report current effectiveness of syphilis partner notification for MSM and identify related problems and solutions. RESULTS: One thousand five hundred seventeen MSM diagnosed with syphilis claimed 10,254 sex partners. Many claimed anonymous partners (median = 65%), or provided insufficient locating information (median = 42%). Median cases found per index case were 0.09 (total = 116), although an additional 197 partners had been previously treated. Principal impediments to partner notification fell into 3 areas: (1) diagnosis outside health department settings delayed interviews, (2) partners were often anonymous, and (3) mistrust among MSM, public health professionals, and health care providers in private settings. CONCLUSIONS: Characteristics of the current outbreaks among MSM make traditional partner notification more difficult than in the past. Some modifications, complements, and even alternatives to partner notification are either planned or in operation.

Cities↗

An enzyme-linked immunosorbent assay to quantify 14-3-3 proteins in the cerebrospinal fluid of suspected Creutzfeldt-Jakob disease patients.

The detection of 14-3-3 protein by Western immunoblot is a sensitive and specific cerebrospinal fluid marker of Creutzfeldt-Jakob disease (CJD). We developed a quantitative enzyme-linked immunosorbent assay (ELISA) that reliably detects 14-3-3 in cerebrospinal fluid. In a prospective study of 147 cerebrospinal fluid samples, the mean 14-3-3 concentration among pathologically confirmed CJD patients (28.0+/-20.6 ng/ml, n = 41) is significantly higher than the mean in the cerebrospinal fluid of those with other neurological disorders (3.1+/-2.9 ng/ ml, n = 84). At a cutoff value of 8.3 ng/ml, the ELISA has a sensitivity of 92.7% and a specificity of 97.6%. The 14-3-3 ELISA supports a diagnosis of CJD in patients who fulfill clinical criteria for possible CJD.

14-3-3 Proteins↗

Increased levels of epsilon and gamma isoforms of 14-3-3 proteins in cerebrospinal fluid in patients with Creutzfeldt-Jakob disease.

We established four hybridoma cell lines producing monoclonal antibodies (MAbs) against 14-3-3 proteins. Immunoblot analysis revealed that epsilon and gamma isoforms were specifically increased in premortem cerebrospinal fluid samples from patients with sporadic Creutzfeldt-Jakob disease. Furthermore, dot immunoblot analysis showed that MAbs were more specific for native antigen than polyclonal antibodies were.

14-3-3 Proteins↗

The 14-3-3 brain protein in cerebrospinal fluid as a marker for transmissible spongiform encephalopathies.

BACKGROUND: There is no practical and reliable premortem test for Creutzfeldt-Jakob disease and the related transmissible spongiform encephalopathies. Two proteins, designated 130 and 131, which have been detected in low concentrations in cerebrospinal fluid from patients with Creutzfeldt-Jakob disease, appear to be sensitive and specific markers for the disease. Attempts to identify these proteins, however, have been unsuccessful. We hypothesized that they may be present in the normal brain. METHODS: We detected proteins 130 and 131 in normal human brain, partially sequenced their amino acids, and found that they matched the brain protein known as 14-3-3. We then developed a simple, rapid immunoassay for this protein and tested it in cerebrospinal fluid samples from 71 humans and 30 animals with spongiform encephalopathies and in control samples from 186 humans and 94 animals. RESULTS: The immunoassay detected the 14-3-3 protein in cerebrospinal fluid from 68 of the 71 patients with Creutzfeldt-Jakob disease (96 percent, 95 percent confidence interval, 92 to 99 percent). Among 94 patients with other dementias, the specificity was 96 percent. If one excludes the three patients with dementia who had strokes within one month before testing, the specificity was 99 percent. The test was positive in 12 of 24 patients with viral encephalitis. In animals the sensitivity of the assay was 87 percent and the specificity was 99 percent. CONCLUSION: In patients with dementia, a positive immunoassay for the 14-3-3 brain protein in cerebrospinal fluid strongly supports a diagnosis of Creutzfeldt-Jakob disease. This finding, however, does not support the use of the test in patients without clinically evident dementia.

14-3-3 Proteins↗

Relationship of lumbar strength in shipyard workers to workplace injury claims.

STUDY DESIGN: Strength testing of lumbar extensors of shipyard workers without back injury claims was accomplished to compare isolated lumbar strength with the severity of their workplace physical demands and the incidence of workplace back injury during a 2-year period. OBJECTIVES: To determine if strength is a predictor of workplace injury and if there is a relationship between the physical demands of the job and strength. SUMMARY OF BACKGROUND DATA: The role of preplacement strength testing has not been clarified as a potential means for predicting workplace injury. It has not been clarified whether work activity affects the strength of the worker. METHODS: One hundred fifty-two shipyard workers were strength tested for isometric lumbar extensor strength. They had been classified as to the severity of their job demands according to the Physical Demand Characteristics. All workers at this industry were likewise classified. Those workers who were tested were followed for 2 years to evaluate for claims of back injury. RESULTS: There was a higher incidence of low back injuries in the heavy and very heavy classification. There was, however, no difference in strength among those workers classified in medium, heavy, and very heavy work. Nine percent of those workers tested had back pains during the following 2 years. All but two had higher-than-average strength. CONCLUSIONS: There is no evidence that preplacement back strength testing would predict workplace claims of injury.

Adult↗

Familial Creutzfeldt-Jakob disease with a five-repeat octapeptide insert mutation.

We report a familial form of Creutzfeldt-Jakob disease, associated with a unique insert mutation of the PRNP gene in an American family of Ukrainian origin. Ten family members exhibited early age at onset and long-duration illnesses characterized primarily by personality changes, cognitive impairment, and spasticity. The proband, presenting at age 42 years, exhibited a fairly stable, nonprogressive course over 7 years, followed by precipitous decline and death in the eighth year. Other affected family members exhibited marked clinical heterogeneity. Each tested affected member had an insert mutation consisting of five extra octapeptide repeats between codons 51 and 91 of the PRNP gene on chromosome 20. Examination of two autopsy cases showed classic spongiform change, neuronal loss and astrocytosis in one case, and minimal pathologic abnormality in the other case. This report documents a new insert mutation of the PRNP gene, and confirms the early age of onset, characteristically prolonged clinical course, and clinical and pathologic heterogeneity seen in such mutations.

Adult↗

Applied physiology of water-skiing.

Water-skiing is a physically demanding sport involving highly coordinated movements, extreme upper body torques, sustained isometric contractions and near maximal stresses on the anaerobic system. Due to the physical demands of the sport, elite skiers have developed physiological characteristics similar to other elite athletes. However, until recently little research has focused on the kinesiology, physiology and physical conditioning of water-skiing.

Exercise Therapy↗

The effect of lumbar belts on isolated lumbar muscle. Strength and dynamic capacity.

STUDY DESIGN: This study analyzed the effect of lumbar support belts on functional performance. OBJECTIVE: To compare lumbar muscle strength and lifting capacity with and without a lumbar belt. SUMMARY OF BACKGROUND DATA: Industrialized settings have begun to encourage the use of lumbar support belts for their employees. It is believed that the belts may decrease the risk of injury and enhance the functional performance of the individual. METHODS: Twenty-two subjects (average age, 27.5 years) were tested on four separate days to evaluate the effect of a commercially available belt on isolated lumbar isometric strength and functional dynamic lifting capacity. All subjects had no history of low back problems. The order of testing with and without a belt was randomized for both conditions. On the first 2 days, subjects performed a seven-angle isometric lumbar extension strength test, 1 day with and 1 day without a lumbar belt. On the following 2 days, subjects were tested to evaluate functional capacity with and without a lumbar belt. The functional capacity evaluation was performed by progressively lifting weighted canisters from various levels. Heart rates were monitored to ensure that a maximum effort was achieved over the different days. RESULTS: T tests revealed that isometric lumbar strength and functional lifting capacity was not significantly affected by the belt. CONCLUSION: The use of a lumbar belt does not enhance isometric lumbar muscle strength or dynamic lifting capacity.

Adult↗

Intracerebral distribution of infectious amyloid protein in spongiform encephalopathy.

We studied the regional distribution of infectious amyloid protein by western immunoblots of brain tissue extracts from 37 patients with different forms of spongiform encephalopathy, i.e., 16 sporadic cases, 18 familial cases with a variety of mutations, and 3 iatrogenic cases. In sporadic and familial Creutzfeldt-Jakob disease, amyloid protein concentrations were usually highest in the frontotemporal regions of the cerebral cortex, whereas iatrogenic Creutzfeldt-Jakob disease and Gerstmann-Sträussler-Scheinker syndrome had as high or higher concentrations in the deep cerebral nuclei and cerebellum. As a group, familial cases had lower amyloid protein concentrations than either sporadic or iatrogenic cases, and fatal familial insomnia patients had the lowest concentrations found in any form of disease. This hierarchy of amyloid protein concentrations corresponds to the experimental transmission rates observed for each form of disease and is consistent with the concept that the protein molecule is an integral component of the infectious agent. Regional amyloid protein pattern analysis of brain and spinal cord may help to distinguish sporadic from environmentally acquired infections, as for example, cases of human disease suspected to have arisen from exposure to sheep or cows infected with scrapie or bovine spongiform encephalopathy.

Aged↗

A new (two-repeat) octapeptide coding insert mutation in Creutzfeldt-Jakob disease.

We report a family in which the proband died of clinically typical, neuropathologically verified Creutzfeldt-Jakob disease; her still-living mother suffers from a progressive dementia of many years' duration, and her maternal grandfather died after a similar illness. The proband, her mother, and two of three young first-degree relatives all have an identical insert mutation in the PRNP gene consisting of a twice-repeated 24-nucleotide sequence in the region between codons 51 and 91.

Aged↗

Types of repairs used by normally developing and language-impaired preschool children in response to clarification requests.

Competent communicators learn to regulate and modify speech within a conversational dyad. Speech modifications may entail selecting appropriate words, reducing the complexity of utterances, or elaborating for clarification [Leonard Top. Lang. Disord. 4:28-37 (1983)]. This study was designed to examine how 4- to 5 1/2-year-old language-impaired children respond to clarification requests; how their repairs differ from two groups of matched controls; and how type of request affects the repair. Fifteen boys served as subjects, five with language impairments and 10 controls with normal language, half matched for age and cognition and half matched for verbal competence. Three types of requests were used: requests for confirmation, neutral requests, and requests for specific constituent repetition. All three groups of children in this study overwhelmingly used revisions to repair their original utterances. The repair strategies used by the language-impaired children did not differ from the controls. The clinical implications of the findings are discussed.

Age Factors↗