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Biomedical subjects

M Marecki

Publications and source records attributed to M Marecki.

7 recordsLinked to original sources

Cell-associated HIV-1 messenger RNA and DNA in T-helper cell and monocytes in asymptomatic HIV-1-infected subjects on HAART plus an inactivated HIV-1 immunogen.

OBJECTIVE: We examined the effect of an HIV-1-specific immune-based therapy on cell-associated HIV-1 DNA and RNA. DESIGN: Five HIV-1-infected subjects receiving HIV-1 immunogen plus HAART were compared with three HIV-1-infected subjects who received incomplete Freund's adjuvant (IFA) plus HAART. METHODS: Cell-associated HIV-1 RNA or DNA in lymphocytes and monocytes was determined using a dual immunophenotyping/in situ hybridization assay with or without in situ PCR amplification. RESULTS: Cell-associated HIV-1 RNA in CD4 cells correlated with plasma RNA overall. CD4, HIV-1 gag-pol messenger (m)RNA+ cells decreased in the immunogen plus HAART group compared with the IFA plus HAART group. Decreases in HIV-1 DNA+ CD4 cells were observed in the immunogen plus HAART compared with the IFA plus HAART group. Decreases in HIV-1 gag-pol mRNA+ monocytes were observed in the immunogen plus HAART group compared with the IFA plus HAART group. Consistent with the findings in CD4 cells, decreases in HIV-1 DNA+ monocytes were observed in the immunogen plus HAART group compared with the IFA plus HAART group. CONCLUSIONS: These preliminary observations support the rationale for examining the combination of immune-based therapies and antiretroviral drugs for effective HIV-1 control.

AIDS Vaccines↗

Protozoan infection in the perinatal period.

Protozoan infections represent an area of concern for advanced practice nurses, particularly those working in rural areas or urban environments with refugee populations and those caring for patients with immunodeficiency-related diseases. Some of these infections have major effects on the fetus and neonate yet pose minimal problems to the mother. Protozoan infections are increasing in prevalence because of poor sanitation, overcrowding, increased foreign travel, and high-risk sexual behaviors. There is a need for public education to promote awareness and prevention of such infections. This emerging public health problem has been reported sporadically in the medical and perinatal nursing literature. This paucity of information may be partly due to the difficulty in diagnosing and managing these infections in the perinatal patient. The article discusses the more common infections caused by protozoa, amebae, and sporozoa: trichomoniasis, giardiasis, amebiasis, and toxoplasmosis.

Female↗

Diagnosis of human immunodeficiency virus type 1 infection in infants by immune complex dissociation p24 assay.

Using immune complex dissociation (ICD), we retrospectively examined serum and plasma of 206 infants aged 0 to 4 months who were perinatally exposed to human immunodeficiency virus (HIV). All samples were analyzed in a blinded manner. Infection status was determined based on the results of HIV culture and Centers for Disease Control and Prevention classification. The overall diagnostic sensitivity of the assay was 59% (93 samples, 73 infants), and specificity was 100% (160 samples, 133 infants). When the samples were analyzed according to age, sensitivity was highest at age 1 to 2 months (17 of 21 infants, 81%). Sensitivities at other ages were 53% at < 1 month, 55% at 2 to 3 months, and 48% at 3 to 4 months (9 of 17, 11 of 20, and 12 of 25 cases, respectively). In 11 evaluable cases there was a possible correlation of p24 antigen quantitation (in picograms per milliliter) with disease progression. We conclude that, as determined in this study, the ICD p24 is a rapid diagnostic assay for HIV infection with a sensitivity of >80% at 1 to 2 months of age and 100% specificity, as evaluated, up to 4 months of age.

Antigen-Antibody Complex↗

Neonatal nurses' knowledge of and attitudes toward caring for cocaine-exposed infants and their mothers.

The knowledge, attitudes, and backgrounds of 215 nurses employed in the nurseries of six hospitals were studied by means of a questionnaire survey. The nurses' attitudes toward the mothers of cocaine-addicted infants were found to be generally negative and/or judgmental and their knowledge to be low. More experience with nursing cocaine-addicted infants and greater acuity of the neonatal unit in which the nurse worked correlated with more positive attitudes toward the infants but not toward their mothers. Knowledge and attitude correlated positively with formal education, inservice education, and self-education, but the correlations were weak.

Adult↗

Need priorities of adrenalectomy patients as perceived by patients, nurses, and physicians.

Patients in this study identified needs they considered important. Perceived need priorities of adrenalectomy patients need to be identified and met both pre- and postoperatively by health team members. Patient-centered nursing and medical conferences should be arranged to provide comprehensive patient care. Establishment of guidelines, based on need priorities perceived by the patient, will provide a master care plan which can assist nurses and physicians in meeting patient needs. These guidelines are important since patients need not only an immediate care plan, but also a long-term plan of care designed to meet individual needs and ever-changing problems of the long-term illness. The study findings show that patients, nurses, and physicians differ in their perception of need priorities of adrenalectomy patients. Nurses and physicians must take heed of patient concerns. Nurses, especially, must realize the needs of the patient in order to provide support, counseling, and education. The necessity for total awareness of patients' needs and perceptions is illustrated by one cancer patient's comments: "Although the disease was diagnosed early and responded successfully to treatment, there was a numbness and fear, the cold chills that accompanied the awareness of the diagnosis and later the altered perception of life, of friends and associates that grew out of the realization that death was never far away. "A human organism with a malignant neoplasm is more than a body with a disease. It is also a reacting individual who has feelings about his illness, and these feelings influence the way he perceives his medical personnel and utilizes his advice and care." It is important that all members of the health team acquire a better understanding of the various need theories and the importance of perceiving the needs of patients as the patient perceives them. In addition, it is essential for health team members to continually refer to the relevant literature concerning needs to improve the quality of total patient-family care.

Adrenalectomy↗

Early sibling attachment.

A sample of 30 predominantly three- and four-year-old siblings were videotaped during their first meeting with a new sibling at the time of the mother's discharge from the hospital. The first five minutes of interaction were divided into 20, 15-second intervals, and each interval was coded for the presence or absence of 28 behaviors believed to be related to the early attachment process. The exploration behaviors of siblings showed considerable uniformity. The sibling's age, sex, or participation in sibling preparation classes produced no marked differences in behavior. Recommendations are made for further research.

Attention↗

Biofeedback-assisted relaxation to reduce stress in labor.

OBJECTIVE: To test the feasibility and effectiveness of incorporating biofeedback-assisted relaxation techniques into routine instruction in Lamaze classes. DESIGN: A quasi-experimental design (static groups comparison) was used. SETTING: Lamaze classes. PARTICIPANTS: A convenience sample of 33 subjects recruited from 12 Lamaze classes. MEASURES: Duration of first-stage labor, amount of sedation and analgesia during first-stage labor, number of complications, and 1- and 5-minute Apgar scores of the neonates. RESULTS: The experimental subjects reported greater stress during labor than did the control subjects. CONCLUSIONS: Although the supplementary instruction in reducing stress seemed to promote relaxation during the prenatal classes, it did not reduce distress during labor and delivery because no mothers attempted to use the technique at that time.

Adult↗