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Biomedical subjects

L B Green

Publications and source records attributed to L B Green.

9 recordsLinked to original sources

CXC chemokine redundancy ensures local neutrophil recruitment during acute inflammation.

Previous publications demonstrated that elevated systemic levels of interleukin (IL)-8 decrease local neutrophil recruitment. We tested whether sustained, high plasma levels of IL-8 would prevent local inflammation after inflammatory insults. Mice carrying the transgene for human IL-8 were separated on the basis of their plasma levels of IL-8 into IL-8-positive (plasma levels >90 ng/ml) and IL-8-negative (IL-8 below detection). Presence of the IL-8 transgene did not improve survival or morbidity nor did it alter peritoneal neutrophil recruitment induced by the cecal ligation and puncture model of sepsis. In an acute lung injury model created by intratracheal injection of acid, IL-8-positive mice showed no reduction in alveolar neutrophil recruitment. There was no difference in the local recruitment of neutrophils when either thioglycollate or glycogen was injected intraperitoneally. We examined the chemotactic response to murine chemokines to test how neutrophil recruitment occurs in the setting of elevated plasma IL-8 and found that neutrophils from both IL-8-positive and -negative mice respond equally well to recombinant KC or macrophage inflammatory protein (MIP)-2. We measured KC and MIP-2 in the peritoneum after thioglycollate injection and demonstrated that IL-8-positive mice have significantly higher levels of the chemokines compared to the IL-8-negative mice. Antibody inhibition of KC and MIP-2 in the IL-8-positive mice significantly decreased peritoneal neutrophil recruitment in response to thioglycollate, clarifying their important role in the local neutrophil recruitment. Our data demonstrate that despite the presence of high plasma levels of IL-8, neutrophils may still be recruited to sites of local inflammation because of chemokine redundancy.

Acute Disease↗

Diabetes mellitus in the transition to adulthood: adjustment, self-care, and health status.

A cross-sectional study of health and adjustment among 18 to 22-year-old patients with insulin-dependent diabetes mellitus (IDDM) is reported. Objectives were to examine coping with IDDM in this age group; to identify predictors of health status, treatment adherence, and health care use; and to provide a retrospective evaluation of the persistence of IDDM-specific adjustment from earlier through later adolescence. Multiple validated measures, interviews of independent informants, and biochemical assays were used to assess psychological, behavioral, and metabolic status. Patients and parents completed a retrospective measure of the patient's adjustment to IDDM during earlier adolescence. Findings (n = 81) indicated: (1) normal rates of general psychopathology but some evidence of poorer adjustment to IDDM relative to other age groups, (2) poor diabetic control and high incidence of microalbuminuria, (3) specific factors associated differentially with treatment compliance, health care use, diabetic control, and microalbuminuria among late adolescents, and (4) evidence that poor adjustment to IDDM in earlier adolescence persists into the transition to adulthood. The findings imply that late adolescents with IDDM are at risk of various unfavorable behavioral and health outcomes and that adjustment to the disease during earlier adolescence may be a predictor of subsequent health-related behavior and health status. A longitudinal study is needed to confirm these findings.

Adaptation, Psychological↗

Fear of hypoglycemia in children and adolescents with diabetes.

Extended a study of diabetic adults which showed that fear of hypoglycemia is common and may affect diabetic control. That study evaluated the psychometric properties of the Hypoglycemic Fear Survey (HFS), an instrument designed to measure fear of hypoglycemia. The present study evaluated the psychometric properties of the HFS with diabetic youth. The HFS was completed by 128 Ss on arrival at a diabetes summer camp, by 127 Ss at the end of the 7-day camp, and by 74 Ss 12 weeks after camp. The results support the internal consistency and test-retest reliability of the HFS with this age group. Factor analytic and multiple regression techniques support the construct validity of the scale. HFS scores enhanced prediction of diabetic control. The HFS appears to be useful as a research tool with children and adolescents, although cross-validation is needed before clinical use can be justified.

Adolescent↗

A model for the integration of community-based health and social services.

This article describes a program designed by a case management organization and home health agency to improve the delivery of home care to the elderly. The results of a modified experimental-control study indicate that the cost of the services to the experimental group, who received comprehensive assessments, consolidated case management and joint monitoring, was less than the control group with an accompanying improvement in the quality of care. It is suggested that the program may be a practical model for local, community social service and health agencies seeking a way to increase continuity of care, improved quality, and reduce costs without difficult organizational and system changes.

Aged↗