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Biomedical subjects

R H Stevens

Publications and source records attributed to R H Stevens.

At least 19 recordsLinked to original sources
PubMed2000

Isolation of viruses from stools in stem cell transplant recipients: a prospective surveillance study.

We prospectively examined stool specimens for enteric viruses in 75 stem cell transplant recipients (autologous 48, allogeneic 27) to determine the frequency and significance of these infections. Only six patients (8%) had a positive isolate. Five of these were allograft recipients (18%) compared to one autograft recipient (2%) (P = 0.02). Unrelated donor BMT recipients were at the highest risk for a viral isolate (OR = 10.5). Adenovirus was the commonest isolate (four patients). One patient each had an echovirus, enterovirus and small round structured virus identified. No correlation was found between the severity of gastro-intestinal symptoms and detection of a viral pathogen. There was no correlation with GVHD or CMV status. The only risk factor identified for isolation of an enterovirus was allogeneic BMT from an unrelated donor. There was a negative correlation with PBSC grafts. All the patients infected with an enteric virus had concomitant infection with other pathogens, compared to only 18% of uninfected patients (P = 0.001). The non-relapse mortality of the infected patients was 50% and only 7% in the uninfected patients (P = 0.01, OR = 12.5), although the isolated virus was the direct cause of death in one patient only. This study indicates a low rate of enteric virus isolation in recipients of PBSC grafts, both autologous and allogeneic. However, unrelated donor BMT is associated with a higher risk of enteric virus infection and an adverse outcome. Bone Marrow Transplantation (2000) 25, 277-282.

Adenoviridae↗
PubMed2000

Total and specific IgE (house dust mite and intestinal helminths) in asthmatics and controls from Gondar, Ethiopia.

BACKGROUND: The role, if any, of parasitosis in the development of asthma remains incompletely understood; both 'protective' and 'predictive' associations have been reported. We report a study which examined immunoglobulin (Ig) E responses to two common helminths in asthmatics living in Ethiopia. OBJECTIVE: To compare the frequencies of specific IgE antibodies to Ascaris and Necator species and to Der p 1 among 84 adult asthmatics and a referent group of nonasthmatics. METHODS: A case-control analysis. RESULTS: Total IgE levels were not different between the two groups. The presence of specific IgE to Der p 1 was strongly associated with asthma (P = 0.001). Raised levels of Ascaris-(P = 0.010) and Necator- (P = 0.001) specific IgE antibodies were more common among referents; there were no associations between specific IgE production to Der p 1 and either of the two parasites. CONCLUSION: These findings confirm the association between Der p 1 sensitization and asthma among urban, adult Ethiopians. While they also indicate a negative relationship with two indicators of helminth infestation it appears that this is not mediated through the immunological response to common aeroallergens.

Adolescent↗
PubMed2000

Public health practice in schools of public health: is there a fit?

Public health practice has been a part of schools of public health for a long time and yet it is still an emerging field of scholarship. Practice faculty often are isolated in their schools and not part of the mainstream. This article explores the elements of culture that are necessary to support a practice focus in a school of public health.

Faculty, Medical↗
PubMed1998

Managing information technology in academic medical centers: a "multicultural" experience.

Based on a session at the 1997 conference on Information Resources and Academic Medicine sponsored by the Association of American Medical Colleges, this article illustrates how the beliefs and concerns of academic medicine's diverse professional cultures affect the management of information technology. Two scenarios--one dealing with the standardization of desktop PCs, the other with publication of syllabi on an institutional intranet--form the basis of this exercise. Four prototypical members of a hypothetical medical center community--the chairman of surgery, a senior basic scientist, the chief information officer of an affiliated hospital, and the chief administrative officer--offer their perspectives on each scenario. Their statements illustrate many of the challenges of planning, deploying, and maintaining effective information technology in the "multicultural" environment of academic medical centers.

Academic Medical Centers↗
PubMed1995

A study of public health nursing directors in state health departments.

Public health nurses make up the largest single category of public health manpower, but confusion over where and how public health nurses should function continues. The purposes of this study were to describe the current structure of public health nursing in state health departments in the United States, and to note whether this structure had changed over the last 5 years. Data were collected through a survey sent to each of the 50 U.S. State Health Departments. Forty-eight percent of the 50 states responded to the survey. From the results, we can conclude that there is currently no uniform description of what states expect of their state nurse directors, even though these individuals lead the largest portion of the public health workforce. The public and the public health system place a large, but often unwritten and unspoken, expectation on public health nurse leaders, but in recent years erosion has occurred in public health nursing in many states. Public health nursing is well positioned to provide leadership under health care reform. The challenge now facing public health nursing leaders is to maintain or create the infrastructure, as well as the organizational culture, to maximize these opportunities.

Humans↗
PubMed1995

A random-effects model for analysis of infectious disease final-state data.

Ball (1986, Advances in Applied Probability 18, 289-310) presented an extension to the "General Epidemic Model" in which an individual's (random) infectious period could have any distribution whose Laplace transform could be specified. This paper describes the fitting of Ball's model to data on the final state of infection within households, and gives an intuitive mathematical derivation of the corresponding likelihood function. We extend the model in several ways, including an extension to allow for random-effects heterogeneity in disease transmission rate between individuals. We give an algorithm for the efficient numerical computation of maximum likelihood estimators of the transmission rates, and describe the assessment of goodness of model fit. The methodology is illustrated with recent survey data on outbreaks of Shigella sonnei in 102 households in Manchester, UK. The results are consistent with previous anecdotal evidence of the infectiousness and susceptibility of individuals within households as a function of age and sex.

Adult↗
PubMed1994

Prevalence and distribution of bacteriophage phi Aa DNA in strains of Actinobacillus actinomycetemcomitans.

phi Aa is a bacteriophage that was originally isolated by induction of a lysogenic strain of the oral bacterium Actinobacillus actinomycetemcomitans. Since the discovery of phage phi Aa, additional phages infecting several other strains of A. actinomycetemcomitans have been identified. To determine the prevalence of phi Aa or phi Aa-related temperate phages in this species, a phi Aa-specific DNA probe was prepared to screen for homologous sequences among 42 strains of A. actinomycetemcomitans. Fourteen (33%) of the 42 strains examined contained DNA sequences that hybridized with the phage phi Aa probe. A bacteriophage designated phi Aa33384 was isolated by induction from one of the strains (ATCC 33384) that contained a sequence that hybridized with the phi Aa probe. The phi Aa probe hybridized with the DNA extracted from bacteriophage phi Aa33384. The distribution of the phage phi Aa sequence among A. actinomycetemcomitans serotypes was 5/13 (38%) of the serotype a strains, 0/16 (0%) of the serotype b strains, and 9/13 (69%) of the serotype c strains. The results of this investigation suggest that the target sequence prepared from the phage phi Aa genome is fairly common in the A. actinomycetemcomitans chromosome, and that the sequence is distributed among the A. actinomycetemcomitans serotypes in a seemingly nonrandom manner.

Aggregatibacter actinomycetemcomitans↗
PubMed1994

Artificial neural network comparison of expert and novice problem-solving strategies.

The successful strategies of second-year medical students were electronically captured from computer-based simulations in immunology and infectious disease and were used to train artificial neural networks for the rapid classification of subsequent students' and experts' strategies on these problems. Such networks could categorize problem solutions of other students as successful or nonsuccessful > 85% of the time. These neural networks, however, performed poorly (as low as 13%) when classifying experienced immunologists' or internists' successful performances, suggesting an ability to distinguish between novice and expert strategies. The neural networks also identified a group of students who framed the infectious disease problems correctly, but had difficulty discriminating between differential diagnoses.

Allergy and Immunology↗
PubMed1993

Artificial neural networks as adjuncts for assessing medical students' problem solving performances on computer-based simulations.

Artificial neural networks were trained by supervised learning to recognize the test selection patterns associated with students' successful solutions to seven immunology computer-based simulations. New test selection patterns evaluated by the trained neural network were correctly classified as successful or unsuccessful solutions to the problem > 90% of the time. The examination of the neural networks output weights after each test selection revealed a progressive and selective increase for the relevant problem suggesting that a successful solution is represented by the neural network as the accumulation of relevant tests. Unsuccessful problem solutions were classified by the neural network software into two patterns of students performance. The first pattern was characterized by low neural network output weights for all seven problems reflecting extensive searching and lack of recognition of relevant information. In the second pattern, the output weights from the neural network were biased toward one of the remaining six incorrect problems suggesting that the student misrepresented the current problem as an instance of a previous problem. Finally, neural network analysis could detect cases where the students switched hypotheses during the problem solving exercises.

California↗
PubMed1993

Characterization and physical mapping of the genome of bacteriophage phi Aa from Actinobacillus actinomycetemcomitans.

The size, configuration and restriction map of Actinobacillus actinomycetemcomitans bacteriophage phi Aa DNA was determined by means of restriction endonuclease analysis. Digestion of the phi Aa DNA with restriction enzymes Hind III, Eco RI and Sal I produced 6, 5, and 4 fragments, respectively. Based upon the sum of the sizes of the restriction fragments of these enzymes, the DNA was estimated to be 47.2 kilobase pairs in length. A restriction map was constructed using Hind III and Sal I. Incubation with exonuclease Bal 31 for increasing lengths of time resulted in progressive hydrolysis of the DNA, as expected for a linear molecule. No sub-molar fragments or diffuse bands were observed in the agarose gels of the restriction endonuclease digests of the phi Aa DNA. Attempts at ligating the ends of the DNA were consistently unsuccessful. Therefore, we found no evidence for cohesive ends, a circular permutation of the genome or for headful packaging mechanism from a concatameric DNA precursor.

Aggregatibacter actinomycetemcomitans↗
PubMed1993

Identification of Actinobacillus actinomycetemcomitans: polymerase chain reaction amplification of lktA-specific sequences.

Actinobacillus actinomycetemcomitans has been strongly implicated in the etiology of localized juvenile periodontitis. Techniques used in the identification of this periodontal pathogen include cultural, biochemical, immunological and DNA hybridization analysis. In this study, we report the use of polymerase chain reaction (PCR) to amplify unique sequences of A. actinomycetemcomitans. Specific oligonucleotide primers LKT2 and LKT3 were designed to hybridize to the A. actinomycetemcomitans lktA gene, which encodes leukotoxin, a putative A. actinomycetemcomitans virulence factor. The LKT2 and LKT3 primers amplified lktA-specific sequences from all 12 A. actinomycetemcomitans strains tested. In another set of experiments, 13 other bacterial species, most of which are normal residents of the oral cavity, were tested with these primers. These PCR amplifications also contained 2 additional primers, RRN4 and RRN5, which served as positive controls; RRN4 and RRN5 were designed to amplify specific sequences of eubacterial 16S ribosomal DNA (rDNA). PCR amplifications of all bacterial species tested, including A. actinomycetemcomitans, yielded 16S rDNA-specific DNA fragments. Furthermore, each bacterial species tested, with the exception of A. actinomycetemcomitans, failed to amplify lktA sequences. The LKT and RRN primers were used in further PCR experiments to detect A. actinomycetemcomitans directly from gingival fluid samples. The results clearly demonstrate the simplicity, rapidity, specificity and accuracy of the LKT primers in the identification of A. actinomycetemcomitans.

Aggregatibacter actinomycetemcomitans↗
PubMed1993

Conjugal transfer of broad-host-range incompatibility group P and Q plasmids from Escherichia coli to Actinobacillus actinomycetemcomitans.

The first example of conjugal transfer of DNA from Escherichia coli to the periodontal pathogen Actinobacillus actinomycetemcomitans is presented. Derivatives of the incompatibility group P (IncP) plasmid RK2 successfully transferred from an E. coli donor to an A. actinomycetemcomitans recipient. The resulting A. actinomycetemcomitans transconjugants transferred the plasmids back to E. coli recipients. The IncP transfer functions were also used in trans to mobilize the IncQ plasmid pBK1 from E. coli to A. actinomycetemcomitans. The IncP and IncQ plasmids both transferred into A. actinomycetemcomitans at high frequencies (0.3 to 0.5 transconjugants per donor) and showed no gross deletions, insertions, or rearrangements. Determinations of MICs of various antibiotics for the A. actinomycetemcomitans transconjugant strains demonstrated the expression of ampicillin, chloramphenicol, and kanamycin resistance determinants.

Aggregatibacter actinomycetemcomitans↗
PubMed1992

Inhibition of B cell proliferation by antisense DNA to both alpha and beta forms of Fc epsilon R II.

Epstein-Barr Virus (EBV) infection activates B lymphocyte proliferation through partially understood mechanisms, resulting in phenotypic changes, including the appearance of new antigens. One such antigen is Fc epsilon R II/CD-23 which may be relevant for B cell proliferation. We have used anti-sense oligonucleotides to study the importance of the two forms of this molecule for proliferation in the EBV-transformed, Fc epsilon R II +ve lymphoblastoid B cell line, RPMI 8866. Anti-sense oligodeoxynucleotides were generated to the two forms of Fc epsilon R II; Fc epsilon R IIa (alpha) and IIb (beta) which differ only in their intracytoplasmic domains. Addition of increasing concentrations of anti-sense oligonucleotides, ranging from 1 to 30 microM, significantly decreased cellular proliferation as measured by the incorporation of [3H]thymidine (inhibition range 8-88%). Optimum inhibition of cellular proliferation was apparent at 15 microM concentration of both anti-sense Fc epsilon R IIa and IIb (Fc epsilon R IIa, mean +/- SE = 75 +/- 7% inhibition, p less than 0.001; Fc epsilon R IIb, mean +/- SE = 71 +/- 7% inhibition, p less than 0.001). Anti-sense oligonucleotides complementary to the common part of Fc epsilon R II resulted in a similar inhibition of proliferation. Sense oligonucleotides did not induce significant inhibition. Preincubation of sense and anti-sense oligonucleotides resulted in an abrogation of proliferation inhibition. Moreover, none of these oligonucleotides had any effect on a Fc epsilon R II -ve cell line. Incubation with both anti-sense IIa and IIb resulted in additive, but not synergistic inhibition of proliferation. Addition of soluble Fc epsilon R II did not reverse inhibition of proliferation, suggesting that membrane-bound or intracellular rather than soluble Fc epsilon R II was important for the induced proliferation. Analysis of cell surface expression for Fc epsilon II indicated that while there was a pronounced effect on cell number following incubation with anti-sense oligonucleotides, surface expression of Fc epsilon R II was consistent as measured over different time points. PCR analysis revealed that while most cells expressed either the alpha or the beta form of Fc epsilon R II, EBV-transformed cell lines, particularly RPMI 8866, were found to express both alpha and beta forms simultaneously. This may constitute a mechanism whereby EBV infection confers an immortal state to the cell, resulting in its uncontrolled proliferation. Cell lines expressing only one receptor form, either alpha or beta, were unaffected after incubation with anti-sense oligonucleotides.(ABSTRACT TRUNCATED AT 400 WORDS)

B-Lymphocytes↗
PubMed1992

Can artificial neural networks provide an "expert's" view of medical students performances on computer based simulations?

Artificial neural networks were trained to recognize the test selection patterns of students' successful solutions to seven immunology computer based simulations. When new student's test selections were presented to the trained neural network, their problem solutions were correctly classified as successful or non-successful > 90% of the time. Examination of the neural networks output weights after each test selection revealed a progressive increase for the relevant problem suggesting that a successful solution was represented by the neural network as the accumulation of relevant tests. Unsuccessful problem solutions revealed two patterns of students performances. The first pattern was characterized by low neural network output weights for all seven problems reflecting extensive searching and lack of recognition of relevant information. In the second pattern, the output weights from the neural network were biased towards one of the remaining six incorrect problems suggesting that the student mis-represented the current problem as an instance of a previous problem.

Allergy and Immunology↗
PubMed1991

In vitro regulation of B cell differentiation by interleukin-6 and soluble CD23 in systemic lupus erythematosus B cell subpopulations and antigen-induced normal B cells.

Polyreactive systemic lupus erythematosus (SLE) B cells were compared with antigen-induced SLE and normal B cells for their interleukin-6 (IL-6) and soluble CD23 requirements. Unlike normal B cells, secretion of antibody by SLE B cells in serum-free medium was not enhanced by exogenous IL-6. Anti-IL-6 antibodies inhibited immunoglobulin production in cultures of normal and SLE B cells, which suggests that IL-6 is required for B cell differentiation. SLE culture supernatants had elevated levels of IL-6, which explains the poor response of the SLE cells to exogenous IL-6. Soluble CD23 enhanced the responses of cells from normal subjects and SLE patients.

Adult↗