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Biomedical subjects

R Gallimore

Publications and source records attributed to R Gallimore.

18 recordsLinked to original sources
PubMed2005

Relationship of granulocyte colony stimulating factor with other acute phase reactants in man.

The non-specific acute phase response in mice is associated with increased resistance to bacterial infection, which is critically mediated by granulocyte colony stimulating factor (G-CSF), but the behaviour of G-CSF in the human acute phase response is not known. Cardiothoracic surgery is a powerful acute phase stimulus and we show here that this procedure caused increased production of G-CSF, in addition to increases in the circulating concentrations of the proinflammatory cytokine interleukin (IL)-6 and the acute phase plasma proteins C-reactive protein (CRP) and serum amyloid A protein (SAA). Values of G-CSF correlated positively with IL-6 concentrations and circulating neutrophil counts, but not with CRP values. These results confirm that G-CSF is a physiological component of the acute phase response in humans that shares some of the same regulatory controls as IL-6, but its downstream effects are on neutrophils, not hepatic acute phase protein synthesis. Our observations are compatible with a protective role against bacterial infection for G-CSF in the human acute phase response, and support investigation of the prophylactic use of G-CSF in at-risk patients.

Acute-Phase Proteins↗
PubMed2000

Models of child-family interactions for children with developmental delays: child-driven or transactional?

Child-driven and transactional models of child-family interactions were tested with 80 children who had developmental delays and their families. Children's cognitive competence, personal-social competence, behavior and communication "hassle," and family accommodations to the children were assessed at child ages 3, 7, and 11. Accommodations were summarized as internal (within the family) and external (use of outside resources) intensity and types. Results indicate that the longitudinal relationships between children's cognitive competence, personal-social competence, behavior and communication hassle, and family accommodations are best explained by a child-driven model. Implications for early intervention and for the need to consider both child and family outcomes are discussed.

Child↗
PubMed1998

Parents' developmental expectations and child characteristics: longitudinal study of children with developmental delays and their families.

The relation between child characteristics and parents' developmental expectations for their children with developmental delays at ages 3, 7, and 11 was examined. Parents' developmental expectations were moderately stable over time, tending to decline as children matured. As hypothesized, parents' developmental expectations were associated with child characteristics at age 3 and became increasingly correlated with child characteristics over time. Results of regression analyses generally support the hypothesis that early child characteristics, but not early parent expectations, are the best predictors of parents' developmental expectations and child outcomes at child age 11. The one exception was the prediction of children's daily living competence by a combination of early parent expectations and children's Gesell DQ scores.

Child↗
PubMed1997

Acute phase proteins, C-reactive protein and serum amyloid A protein, as prognostic markers in the elderly inpatient.

AIM: to study the clinical significance and potential utility of measuring serum amyloid A protein (SAA) compared with the classical acute phase protein, C-reactive protein (CRP). METHOD: a 3 month prospective study on 66 women, mean age 83 years (range 69-106) and 33 men, mean age 84 years (range 69-95), admitted to the geriatric medicine unit at Hammersmith Hospital. CRP and SAA were determined on admission and at intervals throughout hospital stay; outcome end-points were death during the study, detection of infection, duration of admission and early re-admission to hospital after discharge. RESULTS: CRP and SAA responses were highly correlated (r = 0.75, P = 0.0001). However, the SAA response was greater than that of CRP in most individuals, with a median ratio of initial SAA to CRP of 2.2 in patients with infective pathology and 1.6 in those with inflammatory pathology. Median (range) SAA on admission was 98 (0.1-940) mg/ml in patients with infection and was twice that observed in patients with other causes of inflammation, median value 50 (0.6-699) mg/l. There was no difference between median CRP on admission in patients with infection or inflammation, median value 53 (0.1-235) and 51.5 (5-246) mg/l respectively. Initial and peak levels of CRP, but not of SAA, were significantly greater in patients who subsequently died, whereas high levels of both proteins predicted length of admission and early re-admission. CONCLUSION: major elevations of the serum concentrations of CRP and SAA indicated serious disease and predicted poor outcome. Measurement of SAA as well as CRP enhanced the clinical utility of monitoring the acute phase response in 7% of patients with a diagnosis of infection.

Acute-Phase Proteins↗
PubMed1996

Family responses to children with early developmental delays. II: Accommodation intensity and activity in early and middle childhood.

Families were interviewed about functional accommodations made to sustain daily routines for a child with disabilities. Accommodation intensities were unchanged from ages 3 to 7 and declined from 7 to 11. However, number of accommodation types increased dramatically from 3 to 11. By late childhood, on average, families broadened the scope of their accommodations but reduced the intensity with which they made them. Accommodations are a continuing feature of family adaptation to developmental disabilities in late childhood rather than a feature of certain developmental periods. They are most consistently associated with child characteristics that directly impact the daily routine.

Activities of Daily Living↗
PubMed1993

The social construction and subjective reality of activity settings: implications for community psychology.

A major focus of the article is the idea that activity settings are in part social constructions of the participants. The socially constructed "meaning" of an activity setting is a complex mix of ecological, cultural, interactional, and psychological features. These features may be observed and assessed, directly and indirectly, in terms of personnel, cultural values, tasks, scripts for conduct, and motives and purposes of actors. Empirical illustrations and extensions to community psychology are drawn from research with different populations: Native Hawaiian children and families, Spanish-speaking children and Mexican and Central American immigrant parents, Euro-American families with a developmentally delayed child, and Euro-American families who intentionally adopted nonconventional child-rearing values and practices.

Adult↗
PubMed1993

Family responses to young children with developmental delays: accommodation activity in ecological and cultural context.

In this study 680 accommodations or proactive efforts to sustain a family environment in 10 ecocultural domains were reliably scored for 102 Euro-American families of young children with developmental delays. The families reported substantial accommodation activity. Results showed that accommodations (a) in the domains of child care and service access were correlated with children's problems that impact the daily routine; (b) in the domains of subsistence changes, seeking information, and roles of fathers were related to parents' job and career circumstances, with more modest links to socioeconomic status; and (c) were not associated with child developmental test scores. Accommodation to children with delays and disabilities is a family-level variable that complements the more common research focus on individual parent stress and coping.

Adaptation, Psychological↗
PubMed1990

C-reactive protein and bacterial infection in preterm infants.

Serum C-reactive protein (CRP) concentration was measured by a new solid phase ligand-binding radiometric monoclonal antibody immunoassay in a prospective study of 193 consecutively born preterm infants. In 104 with no clinical or laboratory evidence of infection the median CRP in cord serum was 0.125 mg/l (range 0.011-6.0 mg/l), at 24 h it was 1 mg/l (0.016-7.0) and at 48 h 2 mg/l (0.400-8.0). The present highly sensitive assay has enabled these normal ranges to be defined for the first time, at levels below the threshold of non-labelled immunoassays and of all commercially available CRP assays. The values in cord serum were significantly lower than in normal healthy adults (median 0.8 mg/l, range 0.07-29 mg/l, n = 468). Arterial catheterisation and endotracheal intubation, in the absence of infection, did not appear to elevate CRP, nor did cerebral germinal layer or intraventricular haemorrhage. Among nine infants with confirmed septicaemia eight had a serum CRP level raised at least once during the first 48 h and serum CRP in the other one increased 250-fold in 24 h before treatment was started. Using this assay, serum CRP is a useful and rapidly available adjunct to clinical assessment in diagnosis and exclusion of bacterial infection in the early neonatal period, has encouraged us to withhold or discontinue antibiotics and also has a role in monitoring response to treatment.

Antibodies, Monoclonal↗
PubMed1989

The social construction of ecocultural niches: family accommodation of developmentally delayed children.

Family ecology theories mislead if they omit a social constructivist perspective. Parents construct an everyday routine to accommodate values and goals and resources and constraints of their proximal and distal ecology. Ecocultural theory suggests that (a) the most powerful ecocultural features affect everyday routines, (b) whether ecocultural features are positive or negative is influenced by family-constructed themes, (c) "sustainability" of everyday activities is a better predictor of child and family outcome than is measured "stimulation level," and (d) comparative studies should include families engaged in different kinds of social construction processes, not only samples matched on child age or developmental level.

Child↗
PubMed1986

Real-time measurement of serum C-reactive protein in the management of infection in the elderly.

The serum concentration of C-reactive protein (CRP), a nonspecific acute phase reactant which responds sensitively to bacterial infection, was measured by homogeneous enzyme immunoassay in all patients admitted to a general hospital geriatric unit. It was then monitored frequently in those in whom infection was suspected. Results were reported rapidly to the clinical team and particularly in the context of a patient population with complex multisystem pathology, often without pyrexia, leucocytosis or other classical signs of infection, they made a significant contribution to patient management. Very high CRP levels were most commonly due to infection (75% of those over 50 mg/l and 94% of those over 100 mg/l) and the pattern of the CRP response during antimicrobial therapy provided a sensitive, objective index of its efficacy. Failure of CRP levels to fall promptly stimulated additional diagnostic investigations, revealing resistant infection, localized pus or serious noninfective pathology, particularly malignancy, and led to appropriate management. Furthermore the CRP results on admission were of considerable prognostic significance, being significantly higher (median 70 mg/l) in those patients who did not survive than in those who did (18 mg/l).

Aged↗
PubMed1985

Continuous subcutaneous insulin infusion does not induce a significant acute phase response of serum amyloid A protein.

In a study of 23 matched pairs of Type 1 (insulin-dependent) diabetic patients receiving continuous subcutaneous insulin infusion or conventional insulin injection therapy respectively, there were no significant differences in serum levels of the acute phase proteins, serum amyloid A and C-reactive protein. These results do not support the suggestion that continuous subcutaneous insulin infusion stimulates serum amyloid A production or that it carries a risk of inducing reactive systemic amyloidosis.

Adolescent↗
PubMed1985

The logical status of metacognitive training.

It is argued that knowing-how (to perform) is not dependent on knowing-that (knowing propositions about performance). Existing evidence allows any benefits from "metacognitive" training to be attributed to generalization training, not to the announcement of rules. Rules may encourage the subject to learn new tasks, but these tasks must be learned in the contexts of eventual application.

Behavior Therapy↗
PubMed1985

Histochemical demonstration of desialation and desulphation of normal and inflammatory bowel disease rectal mucus by faecal extracts.

Experiments were carried out to assess the susceptibility of normal and inflammatory bowel disease rectal mucus to desulphation and desialation by faecal extracts and by bacterial sialidase. The effects were assessed histochemically using a combined high iron diamine (HID) and alcian blue (AB) stain for sulphomucins and sialomucins. Rectal mucus in biopsies from controls (irritable bowel syndrome) and patients with ulcerative colitis or Crohn's disease was resistant to desialation by Clostridium perfringens sialidase, but susceptible to desialation and desulphation by bacteria-free extracts of normal faeces. Periodic acid-Schiff (PAS) staining of adjacent sections similarly treated showed retention of neutral mucus. One faecal extract selectively desulphated all 42 biopsies, causing the goblet cells to change from HID positive to AB positive, suggesting that most, or all HID positive cells also contain sialomucins. This alters the interpretation of previous histochemical studies. Faecal extracts from patients with active ulcerative colitis (n = 6) had desialating and desulphating effects similar to faecal extracts from normal subjects (n = 6). Ulcerative colitis (n = 21), Crohn's disease (n = 18), and control (irritable bowel syndrome) (n = 17) rectal biopsies all showed similar susceptibility to desulphation by a pooled normal faecal extract, but rectal biopsies from patients with Crohn's disease proved more resistant to desialation than control or ulcerative colitis biopsies (p less than 0.02). These studies imply that colonic mucus undergoes continual desulphation and desialation in vivo as a result of faecal enzyme activity that is probably mainly of bacterial origin. Altered susceptibility of colonic mucus to this may be important in the pathogenesis of colonic disease.

Adolescent↗
PubMed1985

Faecal sulphatase in health and in inflammatory bowel disease.

Histochemical studies have shown a relative depletion of colonic sulphated mucins (sulphomucins) in active ulcerative colitis. One possible explanation for this could be desulphation by bacterial sulphatases. Studies have therefore been done to determine whether normal faeces contain sulphatase and if so to determine whether this activity is increased in ulcerative colitis. Using a fluorimetric assay considerable sulphatase activity (greater than 0.3 IU/g pellet weight) was found in bacteria free filtrates of the homogenates of nine of 17 faecal samples from healthy controls. This sulphatase activity had an alkaline pH optimum (pH 8.5-9.5). A similar range of faecal sulphatase activity with a similar pH optimum was found in samples from patients with ulcerative colitis (n = 39) and Crohn's disease (n = 17) and there was no correlation with disease activity in either disease. This faecal sulphatase activity may be involved in the degradation of colonic mucus and merits further study but these findings do not explain the relative depletion of colonic mucosal sulphomucins in ulcerative colitis.

Colitis, Ulcerative↗
PubMed1985

Faecal mucus degrading glycosidases in ulcerative colitis and Crohn's disease.

Because the normal faecal flora includes bacteria which can produce mucus-digesting glycosidases, it follows that increased digestion of colonic mucus by these bacterial enzymes could be important in the pathogenesis of ulcerative colitis. Faecal activities of potential mucus-degrading glycosidases have therefore been assayed in samples from patients with inflammatory bowel disease and normal controls. The enzymes alpha-D-galactosidase, beta-D-galactosidase, beta-NAc-D-glucosaminidase alpha-L-fucosidase and neuraminidase were assayed. Considerable glycosidase activity was present in most faecal samples. Similar activities of all the enzymes assayed were found in faeces from patients with ulcerative colitis, Crohn's disease and normal controls and there was no significant correlation with disease activity. These results imply that relapse of ulcerative colitis is not initiated by increased degradation of colonic mucus by faecal glycosidases but do not exclude a role for bacterial mucus degradation in the pathogenesis of ulcerative colitis.

Acetylglucosaminidase↗
PubMed1970

Contingency counseling by school personnel: an economical model of intervention.

An Attendance Counselor contacted adults (mediators) who controlled reinforcers for six chronic nonattenders (targets); agreements (deals) were made between mediators and targets that reinforcers would be provided, contingent on school attendance. Absence of the Attendance Counselor from school for a two-week period constituted a reversal condition, after which the "deals" were reinstituted. Results showed a significant increase over baseline in school attendance during the time in which deals were in effect. A second study involved 20 chronic nonattenders for whom deals were arranged as in Study One (contingency counseling), and 15 nonattenders provided more traditional attendance counseling (contact counseling). Contingency Counselors achieved results with the 20 nonattenders similar to those achieved in Study One. An experienced Contact Counselor did not achieve improved school attendance among her group of 15 nonattenders.

Journal Article↗
PubMedDate not supplied

Continuous subcutaneous insulin infusion does not provoke significant acute-phase response.

C-reactive protein (CRP), the classical acute-phase reactant, and serum amyloid A protein (SAA), the putative precursor of AA-type amyloid fibrils, were measured in 62 diabetic patients. They were all attending their regular clinic appointments and had been asymptomatic during the 2 wk preceding sampling. CRP and SAA levels were similar in 18 patients on continuous subcutaneous insulin infusion (CSII), 27 patients treated by conventional insulin therapy (CIT), nine treated by diet only, and eight treated by diet and oral hypoglycemic agents, and were almost entirely within the normal range. It is concluded that CSII does not provoke an acute-phase reaction in diabetic patients and, while caution should always be exercised with a new form of treatment, it does not seem likely that CSII will predispose to the development of reactive systemic amyloidosis.

Adult↗