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Biomedical subjects

L Burke

Publications and source records attributed to L Burke.

At least 19 recordsLinked to original sources
PubMed2003

The impact of maternal depression on familial relationships.

Depression is one of the most prevalent psychiatric illnesses. It is particularly common in women of childbearing age. It is recurrent and tends to have a chronic course and is often comorbid in nature. It is important to view depression within its social context, as it is a disease, which impacts not only the individual but also the wider community. Evidence abounds as to the negative impact of maternal depression on children, husbands/partners, and family. Children of depressed women show deficits in social, psychological, and cognitive domains and are at increased risk for depression themselves and other psychiatric illness such as conduct disorder. They are also at an increased risk for child abuse. The mechanisms by which maternal depression may lead to child psychopathology including genetics, poor parenting, modelling, and environment are explored. Many children with depressed mothers cope well and escape negative effects; consequently the concept of resilience is elucidated. Research shows that a significant percentage of men become depressed when their wives/partners are depressed particularly if they have postnatal depression. There is an increase in marital discord and conflict within families of depressed women, all of which can have a deleterious effect on children. Children with two depressed parents are at an elevated risk of a negative outcome as compared to those with only one depressed parent. Finally the various interventions, management, and recommendations are examined.

Adaptation, Psychological↗
PubMed2001

Identification of cervical intraepithelial neoplasia (CIN) using UV-excited fluorescence and diffuse-reflectance tissue spectroscopy.

BACKGROUND AND OBJECTIVE: The diagnostic potentials of ultraviolet-excitation fluorescence spectroscopy and diffuse-reflectance spectroscopy of tissue are assessed in a study to identify cervical intraepithelial neoplasia (CIN) in vivo. A multivariate algorithm is used to classify tissue into normal tissues, CIN I, and CIN II/III categories, based on spectral characteristics of biopsied tissue sites. STUDY DESIGN/MATERIALS AND METHODS: An optical instrument with the capability of measuring fluorescence and diffuse-reflectance spectra from 120 locations uniformly distributed over the surface of the cervix is described. Using this device, these optical spectra of the cervix were measured on women referred for colposcopy due to an abnormal Pap smear. RESULTS: UV fluorescence differentiates CIN II/III lesions from normal squamous tissue with a sensitivity and specificity of 91 and 93%, respectively. CIN I is distinguished from normal tissue with a sensitivity of 86% and a specificity of 87%. CONCLUSION: Optical spectroscopy shows promise for the detection of pre-cancerous cervical lesions in vivo. The fluorescence and reflectance methods are complementary in their ability to differentiate different tissue types, making the use of the two techniques together more diagnostic than the use of either method separately.

Algorithms↗
PubMed2001

Synchronous pulmonary adenocarcinoma and extranodal marginal zone/low-grade B-cell lymphoma of MALT type.

A case of synchronous adenocarcinoma of lung and extranodal marginal zone/low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) is reported. Primary pulmonary non-Hodgkin's lymphoma is relatively rare, however, the majority of these lesions are low-grade B-cell lymphomas of MALT. After the stomach, the lung is the second most common location for such latter lesions. Lung adenocarcinoma in selected countries is fast becoming the leading form of non small-cell lung carcinoma. To our knowledge, this synchronous occurrence in the lung has not been previously reported. Such associations have been primarily limited to gastric lesions where an association with Helicobacter pylori infection has been identified. This case report highlights the importance of adjunctive diagnostic investigations such as molecular techniques in conclusive analysis of synchronous cases such as ours.

Adenocarcinoma↗
PubMed2001

Severe hypothermia with cardiac arrest: complete neurologic recovery in a 4-year-old child.

A 4-year-old girl was lost for 17 hours in a snowstorm. Upon discovery, her core temperature was 72 degrees F (22 degrees C). While undergoing endotracheal intubation in the emergency department, she experienced sudden ventricular fibrillation and cardiac arrest. Closed chest cardiopulmonary resuscitation (CPR) was instituted, and standard rewarming measures were begun. Despite this, neither core temperature, nor the patient's arrhythmia, changed. An infraumbilical "mini-laparotomy" incision was made, with placement of a large silicone peritoneal dialysis catheter into the abdomen. This was then connected to a rapid infuser device, with the delivery of 1L of warmed, normal saline every 90 seconds. The core temperature reached 29 degrees C in 15 minutes, and a palpable pulse was detected. Lavage was continued until core temperature reached 34 degrees C, at which time transport to the pediatric intensive care unit was arranged. She was extubated the next day and discharged home, on the fourth hospital day, with apparent complete neurologic recovery. This is the first report of the successful use of rapid high-volume peritoneal lavage for the treatment of accidental severe hypothermia in a pediatric patient.

Child, Preschool↗
PubMed2001

Altered immune response in adult women exposed to diethylstilbestrol in utero.

OBJECTIVE: Between 1940 and 1970, 1.5 million female fetuses were exposed to diethylstilbestrol in utero. Numerous deleterious effects on reproductive anatomic and physiologic characteristics have been documented in these women. However, the effects of this exposure on nonreproductive systems, which may have lifelong consequences as this cohort of women progresses beyond the childbearing years, have received little attention. On the basis of an earlier preliminary observation of altered immune reponse, we hypothesized that diethylstilbestrol-exposed women may show abnormalities in T-cell-mediated immune response. STUDY DESIGN: Thirteen women exposed to diethylstilbestrol in utero were compared with 13 age- and menstrual cycle phase-matched control subjects with respect to the in vitro T-cell response to the mitogens phytohemagglutinin, concanavalin A, and interleukin 2. RESULTS: As compared with controls, tritiated thymidine incorporation by T cells harvested from diethylstilbestrol-exposed women was increased 3-fold over a range of concentrations in response to concanavalin A (P <.001), increased by 50% over a range of concentrations in response to phytohemagglutinin (P <.001), and increased 2-fold in response to the endogenous mitogen interleukin 2 (P <.05). CONCLUSIONS: In vitro evidence suggests that women exposed to diethylstilbestrol have alterations in T-cell-mediated immunity. These changes require further attention with regard to their characterization, their role in the pathogenesis of cancer and autoimmunity, and their presence in normal women exposed to diethylstilbestrol in utero.

Adult↗
PubMed2001

Relative risk of high grade squamous intraepithelial lesion associated with prior abnormal Pap smears.

OBJECTIVE: Pap smear frequency remains controversial, especially for women with consecutive negative smears. We undertook the current study to ascertain the association of high grade squamous intraepithelial lesions (HSIL) and prior abnormal Paps. STUDY DESIGN: Women with biopsy-proven HSIL (cervical intraepithelial neoplasia 2 and 3) diagnosed between September 1996 and December 1997 and age-matched controls with a negative Pap obtained during the same time period were selected. RESULTS: Sixty-three cases (mean age = 32 years) of HSIL and 69 controls (mean age = 33 years) constituted the study population. Any prior abnormal diagnosis conferred a 15-fold increased risk of HSIL on the current Pap (50/63 vs. 14/69, P < .0001). When limited to the 60 women with at least three prior Paps, the odds ratio for HSIL on the current Pap with any prior abnormal was 18 (28/31 vs. 10/29, P < .0001). Three cases had at least three consecutive negative Paps prior to the diagnosis of HSIL. CONCLUSION: Women with one or more prior negative Pap smears had a significantly decreased risk of HSIL on the current Pap. Consecutive negative Paps did not appear to further decrease the risk; 10% of HSIL patients had had three or more consecutive prior negative Paps. To detect HSIL at its earliest stage, women should be advised to continue annual Pap screening in spite of consecutive negative results.

Adolescent↗
PubMed2001

Two models of ethanol withdrawal kindling.

The phenomenon of ethanol withdrawal kindling was examined using two different paradigms of ethanol treatment in rats and mice. In the first protocol, male Wistar rats were treated by ethanol inhalation for 14 days before withdrawal. Ethanol exposure was repeated three times with two days abstinence between treatments. In the second protocol, male C57BL/6 mice were fed liquid diet (Lieber DeCarli) containing 6.5%(v/v) ethanol for ten days. Feeding was repeated five times separated by 24 hr intervals. After both treatments, either spontaneous or handling-induced withdrawal behaviours were significantly intensified by sequential withdrawals. These results support the kindling hypothesis of ethanol withdrawal and provide models to develop potential pharmacological tools to attenuate enhanced withdrawal severity and to study the molecular mechanisms underlying this phenomenon.

Alcohol Withdrawal Seizures↗
PubMed2000

The insulator protein CTCF represses transcription on binding to the (gt)(22)(ga)(15) microsatellite in intron 2 of the HLA-DRB1(*)0401 gene.

The insulator and transcription factor CTCF is a highly conserved 11 zinc finger protein possessing multiple specifities in DNA sequence recognition. CTCF regulates transcription of several genes, like the human oncogene c-myc or the chicken lysozyme gene by binding extremely divergent DNA sequences with different sets of its 11 zinc fingers. Recently, an insulator function was demonstrated for several CTCF binding elements. Here we show that CTCF binds to the (gt)(22)(ga)(15) microsatellite repeat A9 in intron 2 of the HLA-DRB1(*)0401 gene. Reporter gene activity is repressed by the A9 element. This repression is dependent on coexpressed CTCF and is even stronger compared with the CTCF binding site F1 of the chicken lysozyme gene, for which a silencer activity has been shown. This is the first report suggesting a function for microsatellite sequences in regulating specific gene expression.

Animals↗
PubMed1999

Glycerol hyperhydration improves cycle time trial performance in hot humid conditions.

Eight competitive cyclists [mean peak oxygen consumption, (VO2(peak)) = 65 ml x min(-1) x kg(-1)] undertook two 60-min cycle ergometer time trials at 32 degrees C and 60% relative humidity. The time trials were split into two 30-min phases: a fixed-workload phase and a variable-workload phase. Each trial was preceded by ingestion of either a glycerol solution [1 g x kg(-1) body mass (BM) in a diluted carbohydrate (CHO)-electrolyte drink] or a placebo of equal volume (the diluted CHO-electrolyte drink). The total fluid intake in each trial was 22 ml x kg(-1) BM. A repeated-measures, double blind, cross over design with respect to glycerol was employed. Glycerol ingestion expanded body water by approximately 600 ml over the placebo treatment. Glycerol treatment significantly increased performance by 5% compared with the placebo group, as assessed by total work in the variable-workload phase (P < 0.04). There were no significant differences in rectal temperature, sweat rate or cardiac frequency between trials. Data indicate that the glycerol-induced performance increase did not result from plasma volume expansion and subsequently lower core temperature or lower cardiac frequencies at a given power output as previously proposed. However, during the glycerol trial, subjects maintained a higher power output without increased perception of effort or thermal strain.

Adult↗
PubMed1999

Nutrition for sport. Getting the most out of training.

BACKGROUND: Sports nutrition involves the application of eating strategies to promote good health and adaptation to the training program, to recovery quickly after each exercise session and to perform optimally during competition. OBJECTIVE: This article explores the many myths about sports nutrition principles and provides answers to the most common questions that arise in sports nutrition. DISCUSSION: Good nutrition practices will enhance the performance and enjoyment of sport and exercise activities at all levels.

Body Composition↗
PubMed1999

Risk factors and correlates of dating violence: the relevance of examining frequency and severity levels in a college sample.

To determine whether categorizing levels of violence along dimensions of frequency and severity would result in informative distinctions among individuals using dating violence, reported use of physical violence, along with variables theorized to be related to use of force in intimate relationships, was assessed in a sample of 617 college students (males = 290; females = 327). When participants' scores were analyzed by dichotomizing them along the lines of ever versus never using dating violence, numerous past findings were replicated. However, participants using a higher frequency of force were distinguished by needing to control their partner and by less inhibition in expressing their anger. Higher severity of force by an individual was predicted only by a need to control his/her dating partner. Implications for these findings were discussed.

Adaptation, Psychological↗
PubMed1998

Allelic deletion analysis of the FHIT gene predicts poor survival in non-small cell lung cancer.

The fragile histidine triad (FHIT) gene at chromosome 3p14.2 is a candidate tumor suppressor gene linked to cancers of the lung, breast, colon, pancreas, and head and neck. Reports of frequent allelic deletion and abnormal transcripts in primary lung tumors plus recent evidence that it is targeted by tobacco smoke carcinogens suggest that it plays an important role in lung carcinogenesis. Non-small cell lung carcinoma still maintains a poor 5-year survival rate with the stage of disease at presentation as a major determinant of prognosis. We examined for allelic deletion at the FHIT locus in a series of 106 non-small cell lung carcinomas for which a full clinical, epidemiological, and 5-year survival profile was available. We found an allelic deletion frequency of 38% at one or two intragenic microsatellites. Allelic deletion of FHIT was related to tumor histology with 4 of 20 adenocarcinomas (20%) displaying loss of heterozygosity (LOH) compared with 12 of 22 (55%) nonadenocarcinomas (P = 0.03). We found that 63% of tumors with LOH of FHIT also had p53 missense mutations whereas only 26% with LOH had wild type p53 negative sequence (P = 0.02). We also found a significant trend toward poorer survival in patients with LOH of at least one locus of the FHIT gene (log rank, P = 0.01). This survival correlation is independent of tumor stage, size, histological subtype, degree of differentiation, and p53 mutation status. Our data support the hypothesis that the loss of the FHIT contributes to the molecular pathogenesis of human lung cancer and is an indicator of poor prognosis.

Acid Anhydride Hydrolases↗
PubMed1998

Incidence and predictors of cervical dysplasia in patients with minimally abnormal Papanicolaou smears.

OBJECTIVE: To estimate the incidence of dysplasia in patients with Papanicolaou smears showing atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions (SIL) and to identify clinical predictors of dysplasia in these patients. METHODS: Patients referred for ASCUS and low-grade SIL were reviewed retrospectively. All patients were evaluated with immediate colposcopy. A multivariate logistic regression analysis was performed to identify clinical predictors of histologic SIL and histologic high-grade SIL. RESULTS: One hundred thirty-seven (34%) of 406 consecutive patients had histologic SIL. Regression analysis identified age (under 35 versus 35 years or above) and initial smear (low-grade SIL versus ASCUS) as statistically significant predictors of histologic SIL and high-grade SIL (P < .001). When patient outcomes were analyzed by age and initial Papanicolaou smear results, the subgroup of patients 35 years or older with ASCUS had low incidences of histologic SIL (14%) and high-grade SIL (1%). The other subgroups (under 35 years with ASCUS, under 35 years with low-grade SIL, and 35 years or older with low-grade SIL) had incidences of histologic SIL and histologic high-grade SIL of at least 28% and 14%, respectively. CONCLUSION: The high incidence of dysplasia in patients with minimally abnormal Papanicolaou smears suggests that immediate colposcopy might be appropriate for many of these patients. Age and initial Papanicolaou smear are predictive of dysplasia and might be used to select patients who have low incidence of dysplasia and might not require immediate colposcopy.

Adult↗