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Biomedical subjects

R Glass

Publications and source records attributed to R Glass.

At least 37 records · Page 2Linked to original sources

Income distribution, socioeconomic status, and self rated health in the United States: multilevel analysis.

OBJECTIVE: To determine the effect of inequalities in income within a state on self rated health status while controlling for individual characteristics such as socioeconomic status. DESIGN: Cross sectional multilevel study. Data were collected on income distribution in each of the 50 states in the United States. The Gini coefficient was used to measure statewide inequalities in income. Random probability samples of individuals in each state were collected by the 1993 and 1994 behavioural risk factor surveillance system, a random digit telephone survey. The survey collects information on an individual's income, education, self rated health and other health risk factors. SETTING: All 50 states. SUBJECTS: Civilian, non-institutionalised (that is, non-incarcerated and non-hospitalised) US residents aged 18 years or older. MAIN OUTCOME MEASURE: Self rated health status. RESULTS: When personal characteristics and household income were controlled for, individuals living in states with the greatest inequalities in income were 30% more likely to report their health as fair or poor than individuals living in states with the smallest inequalities in income. CONCLUSIONS: Inequality in the distribution of income was associated with an adverse impact on health independent of the effect of household income.

Adolescent↗

Where children sit in motor vehicles: a comparison of selected European and American cities.

OBJECTIVES: To ascertain whether there are differences in child seating location between selected cities in the US and continental Europe, and if differences exist, to ascertain what factors predict them. SETTING: Boston and New Orleans, which have no laws regarding child seating location, and Paris, Frankfurt, and Brussels, which for approximately 20 years have had laws requiring children under the ages of 10 or 12 to sit in the rear. METHODS: Observations were made in the first quarter of 1997 at several locations in or near each city. The vehicle seating capacity, total number of occupants, the seating location of adults and children, and driver shoulder belt use were recorded for each vehicle with at least one child. The predictors of a vehicle having a child in the front were estimated using logistic regression. RESULTS: Data on 5501 children riding in 3778 vehicles were collected. Adjusting for differences in vehicle seating capacity, occupant mix, and driver shoulder belt use, vehicles in the European cities are significantly less likely to have a child in the front seat than vehicles in the American cities. CONCLUSIONS: Cities with no history of laws prohibiting children from sitting in the front, vehicles with low seating capacity, vehicles with no adult (other than the driver) or many child passengers, and unbelted drivers were associated with a higher likelihood of children riding in the front seat. It is feasible for a society to insist, through custom and/or law, that children sit in the back seat.

Automobiles↗

Reducing risks to children in vehicles with passenger airbags.

This review examines the risk that passenger airbags pose for children and discusses behavioral and technologic measures aimed at protecting children from airbag deployment. Although airbags reduce fatal crash injuries among adult drivers and passengers, this safety technology increases mortality risk among children younger than age 12. The magnitude of the risk is multiplied when children are unrestrained or restrained improperly. As new vehicles are resold to buyers who tend to be less safety-conscious than new car owners, the number of children endangered by passenger airbag deployment may increase. For vehicles already in the fleet, strong measures are required to secure children in the rear seat and increase the proper use of appropriate restraint systems through police enforcement of laws. One promising strategy is to amend child passenger safety laws to require that parents secure children in the rear seats. For future vehicles, a mandatory performance standard should be adopted that suppresses airbag deployment automatically if a child is located in the front passenger seat. Other promising improvements in airbag design also are discussed. Major changes in passenger airbag design must be evaluated in a broad analytical framework that considers the welfare of adults as well as children.

Adult↗

Serodiagnosis of human and animal pythiosis using an enzyme-linked immunosorbent assay.

Conventional serodiagnosis of Pythium insidiosum infections involves the use of the immunodiffusion (ID) test. This test specifically diagnoses human and animal pythiosis. The test, however, has limited sensitivity and does not detect some culturally proven cases of the disease. Because of the increased recognition of pythiosis among humans and animals, we developed and evaluated an enzyme-linked immunosorbent assay (ELISA) using a soluble antigen from broken hyphae of P. insidiosum. Studies were carried out with sera from five humans and eight animals with culturally and/or histologically proven pythiosis. Some of these sera were negative in the ID test for pythiosis. Heterologous case sera from thirteen humans and two horses, plus 5 sera from healthy humans and 17 from healthy animals, were tested. Of the pythiosis case sera tested, the ID test detected only 8 of 13 (61.5%), whereas the ELISA detected all of them (100%). The ID and ELISA tests were entirely specific and gave negative results or low titers respectively, with sera from humans and animals with heterologous fungal infections or with no apparent illness. No correlation was found between the height of the ELISA titers and negative or positive sera in the ID test. Our results indicate that the ELISA is a reliable serodiagnostic test for pythiosis. It is as specific as the ID test but more sensitive.

Animals↗

Oral rehydration therapy for diarrhea: an example of reverse transfer of technology.

On November 13 and 14, 1996, a scientific symposium on oral rehydration therapy (ORT) was held at the Johns Hopkins University School of Hygiene and Public Health in Baltimore, MD. The purpose of the meeting was to review the current treatment practices for the treatment of this disease in the United States. The group noted that diarrhea resulted in 300 to 400 deaths per year among children, approximately 200 000 hospitalizations, 1.5 million outpatient visits, and costs >$1 billion in direct medical costs. ORT is well established therapy for the treatment and prevention of dehydration due to diarrhea. The principles of ORT treatment include early adequate rehydration therapy using an appropriate oral rehydration solution (ORS), replacement of ongoing fluid losses from vomiting and diarrhea with ORS, and frequent feeding of appropriate foods as soon as dehydration is corrected. The effective use of ORT has saved millions of lives around the world. However, in the United States, ORT is grossly underused. Contrary to the recommendations of the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC), health care providers overuse intravenous hydration, prolong rehydration, delay reintroduction of feeding, and inappropriately withhold ORT, especially with children who are vomiting. The expert panel noted that the majority of deaths, hospitalization, and visits to emergency departments could be prevented by the appropriate use of ORT. They generated guidelines for the treatment and prevention of dehydration secondary to diarrhea. These measures, together with training providers, could substantially reduce diarrhea mortality and decrease hospitalizations of children by 100 000 per year in the next 5 years.

Dehydration↗

Hyperstimulation of leukocytes by plasma from cardiopulmonary bypass patients is diminished by alpha-MSH pretreatment.

Cardiopulmonary bypass (CPB) results in a diffuse inflammatory response characterized in part by hyperstimulation of leukocytes. We have previously shown that this hyperstimulation appears to be due, in part, to an increase in the release of biological response modifiers (BRMs) such as cytokines. In the present study, we evaluated the ability of a naturally occurring immunocyte inhibitory substance, alpha-melanocyte-stimulating hormone (alpha-MSH), to prevent the hyperstimulation caused by CPB. Monocytes and granulocytes were pretreated with alpha-MSH (10(-6) M) before exposing the cells to plasma obtained from patients who had undergone CPB, as CPB plasma would stimulate native monocytes and granulocytes in a manner similar to that observed in CPB patients. Pretreatment of these cells with alpha-MSH significantly diminished the hyperstimulation induced by CPB plasma in a concentration-dependent manner. In contrast, when the cells were first or simultaneously exposed to CPB plasma and then to alpha-MSH, alpha-MSH had no effect. Furthermore, use of the specific neutral endopeptidase inhibitor, phosphoramidon, significantly increased the efficacy of alpha-MSH in inhibiting CPB-induced immunocyte activation. The data demonstrate that pretreatment of monocyte/macrophages and granulocytes with alpha-MSH effectively inhibits the immune hyperstimulation induced by CPB-plasma exposure. In addition, the data strongly suggest that preexposure to other naturally occurring immune inhibitory substances may diminish the hyperstimulation associated with CPB. The study also further confirms that this hyperstimulation may, in part, be due to BRMs released from immunocytes.

Cardiopulmonary Bypass↗

Detection of astroviruses from stool samples in Japan using reverse transcription and polymerase chain reaction amplification.

We developed a reverse transcription and polymerase chain reaction (RT-PCR) method for detecting astrovirus serotypes 1, 2, 3, 5, 6 and 7 (but not serotype 4). Furthermore, we developed the specific primers for detecting serotypes 1 and 2, the most predominant serotypes in the world. Sensitivity of the first PCR with serotype common primers was about 10 times higher than that of enzyme immunoassay with monoclonal antibody (EIA-MAb). Sensitivity of the second PCR with the serotype-specific primers was even higher. The RT-PCR method was useful for detecting astroviruses from clinical samples, especially serotypes 1 and 2.

Base Sequence↗

Hyperstimulation of leukocytes by plasma from cardiopulmonary by-pass patients is diminished by morphine and IL-10 pretreatment.

OBJECTIVE: The trauma of cardiopulmonary by-pass (CPB) in cardiac surgery results in a whole body diffuse inflammatory response characterized in part by hyperstimulation of leukocytes. Partially this is due to an increase in the release of biological response modifiers such as cytokines, as noted by the immunocyte stimulatory actions of cell-free plasma obtained postoperatively from CPB patients. The present study was conducted to determine whether CPB plasma induced immunocyte hyperstimulation can be prevented with naturally occurring immune inhibitory substances, specifically, interleukin (IL)-10 and/or morphine. EXPERIMENTAL DESIGN: Controlled in vitro study of the application of drugs to naive immunocytes to block the exitation caused by CPB-plasma. SETTING: University-based tertiary care hospital. PATIENTS: Plasma was obtained from ten patients undergoing CPB. Eligibility included admission for elective cardiac surgery, which no chronic illnesses or acute processes. INTERVENTIONS: Monocytes and granulocytes were pretreated with IL-10 and/or morphine before exposure to plasma obtained from patients undergoing CPB, as CPB-plasma would stimulate naive monocytes and granulocytes in a manner similar to that previously reported in CPB-patients. MEASURES: Computer-assisted microscopic image analysis, measuring cellular conformational and velocity changes, was used to evaluate the effect of treatment on the immunocytes response to stimulation with CPB-plasma. RESULTS: Pretreatment of cells with IL-10 and/or morphine significantly diminished the hyperstimulation induced by CPB-plasma in a concentration-dependent manner. In contrast, when the cells were initially or simultaneously exposed to CPB-plasma, IL-10 and/or morphine had no effect.

Anesthesia↗

The effect of oral support on sucking efficiency in preterm infants.

OBJECTIVE: The purpose of this study was to determine the effectiveness of oral support on feeding efficiency in preterm infants who were identified by the medical team as poor feeders. METHOD: Thirteen premature infants between 34 and 40 weeks' postconceptional age were selected from a group of infants at Children's Hospital and Medical Center in Seattle, Washington. They were fed twice within a 26-hr period, once with oral support and once without. The order of occurrence of these two conditions was randomly selected without replacement to assure that an equal number of both conditions occurred during the first feed. Only the first 2 min of the feed were used in data analysis. RESULTS: A statistically significant difference (z = -2.62, p < .01, two-tailed) in volume intake occurred between the oral support condition (M = 10.9 cc) and the no oral support condition (M = 4.8 cc). CONCLUSION: This study validates the use of oral support as an effective treatment technique to enhance sucking efficiency in preterm infants.

Bottle Feeding↗

Serotypes and electropherotypes of human rotavirus in the USA: 1987-1989.

The epidemiology of rotavirus gastroenteritis was investigated for two consecutive seasons (1987-1988 and 1988-1989) in seven locales in the continental USA. The 281 representative fecal samples obtained from children with diarrhea were electropherotyped and serotyped by an enzyme immunoassay with serotype-specific monoclonal antibodies and a new amplification typing technique (polymerase chain reaction typing). Serotype 1 was predominant in both years, particularly in the North and East; serotype 3 was second in frequency and found most often in the South; serotype 2 was detected only occasionally; serotypes 4, 8, and 9 were never found. Rotavirus strains were grouped into five major electropherotypes, each corresponded to a single serotype, and the relative migration of the gene segments 7-9 could be used to distinguish serotype 1 from serotype 3. The amplification typing technique proved to be of great value in typing the 17% of rotavirus-positive specimens untypable by the serologic technique.

Antibodies, Monoclonal↗

Foodborne Snow Mountain agent gastroenteritis with secondary person-to-person spread in a retirement community.

A variety of small round-structured viruses are being recognized with increasing frequency as a cause of gastroenteritis in the community, but have rarely been reported to cause outbreaks in hospitals or extended-care facilities. From March 20 through April 15, 1988, an outbreak of gastroenteritis occurred in a retirement facility in the San Francisco Bay area. Illness was characterized by diarrhea, nausea, and vomiting; two residents died. Attack rates were 46% (155 of 336) in residents and 37% (28 of 75) in employees. During the initial outbreak period, illness among residents was associated with two shrimp meals served in the facility dining hall (odds ratio = 6.7). Person-to-person transmission probably occurred: The risk of becoming ill one or two days after a roommate became ill was significantly greater than that of becoming ill at other times during the outbreak (risk ratio = 6.5). Microbiologic examinations for bacterial and parasitic enteric pathogens were negative; however, 27-nm viral particles were detected by immune electron microscopy and by blocking enzyme immunoassay to Snow Mountain agent in stools obtained at the onset of illness from one of six ill residents. Seroconversion (greater than fourfold antibody rise) to Snow Mountain agent was detected in acute- and convalescent-phase serum specimens from five of six ill residents as measured by enzyme immunoassay, but not for Norwalk agent as measured by radioimmunoassay. This report of an outbreak of Snow Mountain agent gastroenteritis in an extended-care facility documents that these difficult-to-identify 27-nm viruses can cause outbreaks in inpatient settings.

Aged↗

The effect of arthroscopic surgical lysis and lavage of the superior joint space on TMJ disc position and mobility.

The effect of arthroscopic release of temporomandibular joint (TMJ) discs was prospectively studied using a combination of preoperative tomograms, magnetic resonance imaging (MRI) scans and arthrograms, and postoperative MRI scans. Of 92 patients studied, 60 had bilateral and 32 had unilateral joint disease. All of the 152 joints studied had anterior disc displacement preoperatively. Postoperative MRI scans revealed that 92% of the patients had persistent anterior disc displacement, although 80% of the patients did have marked improvement of disc mobility. Ninety-two percent of the total patient sample had a significant reduction in pain and restoration of normal mandibular function.

Adolescent↗

Methionine synthesis in Escherichia coli: effect of the MetR protein on metE and metH expression.

Studies by Urbanowski et al. [Urbanowski, M. L., Stauffer, L. T., Plamann, L. S. & Stauffer, G. V. (1987) J. Bacteriol. 169, 1391-1397] have identified a regulatory locus, called metR, required for the expression of the metE and metH genes. We recently purified the MetR protein from Escherichia coli and showed that it could stimulate the in vitro expression of the metE gene and autoregulate its own synthesis. In the present study, the purified MetR protein has been shown to stimulate the in vitro expression of the metH gene. Also, the in vitro synthesized MetE, MetH, and MetR proteins were shown to be biologically active. The transcription start sites for the metE and metR genes have been determined, and DNA footprinting experiments have identified regions in the metE-metR intergenic sequence that are protected by either the MetR or MetJ proteins.

Bacterial Proteins↗

Studies in vivo on Escherichia coli RNA polymerase mutants altered in the stringent response.

Previous studies on two Escherichia coli rpoB mutants, carrying single amino acid substitutions at approximate amino acid positions 736 and 906 in the beta subunit, showed that these alterations in the RNA polymerase resulted in an apparent reduced response to valine-induced amino acid starvation in vivo and prevented ppGpp-mediated inhibition of transcriptional initiation at stable RNA promoters in vitro. These observations suggested that the mutations had altered either the ppGpp binding site or the promoter selectivity of the enzyme. The in vivo analysis presented here indicates that these mutants encode an RNA polymerase that responds normally to changes in the level of ppGpp; their apparent relaxedness is due to a reduced accumulation of ppGpp during isoleucine starvation. Thus, there is no indication that the mutations have altered ppGpp binding sites. These observations and the difference between in vitro and in vivo results can be explained by the assumption that the mutations produce an extended ppGpp-dependent pausing of RNA polymerase during the transcription of unstable RNA. Comparison of the vivo and in vitro effects of ppGpp on rrn transcription further suggests that these reflect different phenomena, although in both cases ppGpp inhibits rrn transcription.

DNA-Directed RNA Polymerases↗