A 69-year-old woman with recurrent symptomatic pleural effusions.
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Aged↗
Biomedical subjects
R Hall
Publications and source records attributed to R Hall.
The tribal tobacco policy project: working with Northwest Indian tribes on smoking policies.
BACKGROUND: This article reports on the objectives, study design, intervention methods, baseline results, and process data from a trial involving 39 Northwest Indian tribes. METHODS: Tribes were stratified and then randomized to either early or late intervention conditions. Intervention consisted of a consultation process to assist tribes to review and modify existing tobacco policies or to develop new policies relevant for their tribe and that protect tribal members from environmental tobacco smoke. Outcome measures consist of: (a) phone interviews to assess the comprehensiveness of tribal tobacco policy, (b) surveys of tribal leaders to assess norms and attitudes regarding tobacco use, and (c) observations of tribal settings to assess policy implementation and indicants of tobacco use. RESULTS: Early and later intervention tribes were well matched on baseline measures and tribal characteristics potentially related to policy outcomes. There was considerable variability across tribes on all measures though, in general, tribal leaders expressed support for more stringent tobacco use policies. Process data indicated that early intervention tribes strengthened their tobacco policies, but generally did not do so through tobacco policy committees as originally envisioned. CONCLUSIONS: There is good potential for tobacco policy interventions with Indian tribes. Consultation processes and products, such as policy guidebooks, that are sensitive to traditional uses of tobacco and to differences among tribes can help to modify policies to reduce exposure of tribal members to environmental tobacco smoke.
Attitude↗
The influence of fluoride on the adsorption of proteoglycans and glycosaminoglycans to hydroxyapatite.
Proteoglycans and their spatial arms, the glycosaminoglycans, are known to interact with hydroxyapatite, and are considered to have a role in the regulation of mineralization. This study investigates the interactive mechanisms, with particular attention directed at the influence of fluoride on the adsorption process. Proteoglycans and glycosaminoglycans were adsorbed to hydroxyapatite in the presence of fluoride (1-20 ppm range). The adsorbates included a chondroitin 4-sulfate-rich proteoglycan extracted from rat incisor dentine, hyaluronan, chondroitin 4-sulfate, and dermatan sulfate. The order of glycosaminoglycan in decreasing affinity for hydroxyapatite was chondroitin 4-sulfate, dermatan sulfate, and hyaluronan, and the individual glycosaminoglycans showed different responses to the presence of fluoride. Graded increases in fluoride (1-4 ppm) led to 5-40% reduction of glycosaminoglycan adsorption to hydroxyapatite. The proteoglycan showed less affinity for hydroxyapatite, and demonstrated a reduction in adsorption of up to 22% with 20 ppm fluoride. The inhibitory effect of fluoride indicated an electrostatic mechanism, presumably via the calcium sites in the hydroxyapatite lattice.
Adsorption↗
Who gets repeat screening mammography: the role of the physician.
To determine rates of, and explore physician factors associated with, repeat mammography, administrative data for 791 women aged 50 years and older were examined. Three-fourths of the women (73%) received repeat mammography (i.e., a second mammogram was obtained within six to 18 months of the first). Provider factors associated with higher repeat mammography rates were: being a woman, practicing in the women's health group rather than the general internal medicine service, and being a fellow or an attending physician (p-values < 0.01). Patients of women attendings/fellows had higher repeat mammography rates than did those of men attendings/fellows, men residents, and women residents. Characteristics (gender, level of training) of providers strongly influence their patients' screening behavior.
Boston↗
Infection with Theileria annulata induces expression of matrix metalloproteinase 9 and transcription factor AP-1 in bovine leucocytes.
Theileria annulata infects bovine leucocytes and results in their reversible transformation such that they become immortalised and metastatic. The present study describes parasite-induced changes in host cell gene expression which have a direct bearing on this transformation process. T. annulata-infected leucocytes produce a number of novel metalloproteinase activities. One of these, previously called B1, is a 97-kDa protein which is secreted in large amounts and has been purified from protein-free, conditioned medium. An antiserum to this enzyme was used to isolate a cDNA clone. The predicted protein sequence of B1 is 81% identical to human matrix metalloproteinase 9 (MMP9), demonstrating that it is the bovine homologue of this enzyme. RNAase protection assays demonstrated that the MMP9 activity, unique to infected cells, is due to increased MMP9 mRNA levels. We also assayed the levels of transcription factor AP-1 and demonstrated that it was constitutively present in increased amounts in Theileria-infected cells. In addition we assayed the level of mRNA encoding c-Fos, a common component of AP-1 and observed that it was indeed up-regulated in infected cells. Since AP-1 is implicated in the control of the cell cycle, and MMP9 can confer metastatic properties, these results are of considerable significance with respect to the transformed phenotype induced by Theileria infection.
Amino Acid Sequence↗
Transient expression of luciferase in Entamoeba histolytica driven by the ferredoxin gene 5' and 3' regions.
We have successfully transfected Entamoeba histolytica trophozoites with constructs containing ferredoxin sequences fused to the reporter gene luciferase. We have determined the conditions and parameters necessary to maximise transient luciferase expression in our system. Our optimal construct gave values of 268 x 10(3) relative light units per second (RLU s-1) when assayed representing a stimulation of 18,000-fold over the control vector. Comparison of differing constructs allowed us to conclude that the 5' and 3' ferredoxin sequences are both necessary for optimal luciferase expression from our vectors. Transcriptional initiation occurs within the consensus sequence ATTCA in both construct and chromosomal ferredoxin promoters.
Animals↗
Theileria annulata sporozoite antigen fused to hepatitis B core antigen used in a vaccination trial.
A C terminal fragment (SR1) of SPAG-1, a sporozoite surface antigen of Theileria annulata, has been expressed as a fusion protein in the e1 loop of hepatitis B core antigen (HBcAg). This recombinant antigen (HBcAg-SR1) is produced in the form of self-assembling polyhedral particles which have been visualised under the electron microscope. Cattle immunised with HBcAg-SR1 produced high titres of neutralising antibodies. A significant T cell response to both the HBcAg and SR1 determinants was observed but evidence of a T suppressor determinant in SR1 was also revealed. Immunised cattle showed some evidence of protection to sporozoite challenge as assessed by severity of the disease. The significance of these findings for the development of a sub-unit vaccine against T. annulata is discussed.
Animals↗
Pregnancy and autoimmune endocrine disease.
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Autoimmune Diseases↗
Guidelines for prevention of thromboembolic events in valvular heart disease. Study Group of the Working Group on Valvular Heart Disease of the European Society of Cardiology.
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Anticoagulants↗
Arterial hypertension causing leg ulcers.
We report clinical and histological features of 16 consecutive patients with hypertensive leg ulcers. The lumen/wall ratio in arterioles at the edges of these hypertensive leg ulcers was compared with that in other types of chronic leg ulcers and was found to be significantly reduced (P < 0.001). Additional conditions such as venous hypertension or main vessel arterial disease contributed. Nineteen of 22 ulcers were completely healed after a mean of 4.9 months. Recognition of this condition enables correct treatment choice, which usually involves excision and grafting, and early healing.
Aged↗
The status of bladder-preserving therapeutic strategies in the management of patients with muscle-invasive bladder cancer.
The recommended treatment for medically fit patients with muscle-invading bladder cancer is usually radical cystectomy. However, transurethral resection of the tumor, partial cystectomy, irradiation and systemic chemotherapy are each effective in some patients. These latter treatments allow bladder preservation and cure as an alternative to radical cystectomy although when used unselectively the survival rates are inferior to those of radical cystectomy. The updated results of conservative surgery, radiation therapy and systemic chemotherapy as monotherapy, as well as strategies of combined modality treatment were reviewed. Based on this review many areas of consensus were reached which include: 1. The primary goal of any treatment for a patient with muscle-invading bladder cancer is survival; bladder preservation in the interest of quality of life is a secondary objective. 2. Only a small proportion of carefully selected patients may be cured by transurethral surgery alone, or by partial cystectomy alone. 3. Radiation therapy is currently the standard bladder-preserving therapy against which all other bladder-preserving methods must be compared. 4. Systemic chemotherapy as monotherapy is inadequate and cannot be recommended. 5. The addition of cisplatin-containing systemic chemotherapy to radiation therapy or conservative surgery appears to improve local control. While no multi-modality therapeutic regimen has yet been shown to be clearly optimal with regard to local efficacy and minimizing toxicity, monotherapy for bladder preservation is probably not desirable as a routine approach. 6. Deferring the patient from immediate cystectomy does not appear to compromise survival, nor does the addition of primary systemic chemotherapy appear to significantly increase the morbidity of cystectomy or radiotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)
Combined Modality Therapy↗
A population-based survey of immunisation coverage in two-year-old children.
A cross-sectional, population-based, cluster-sample survey of 187 children was conducted in the Newcastle area to assess the proportion of two-year-old children who were fully immunised, to ascertain whether administration of these vaccines was age-appropriate and to look for factors predicting incomplete immunisation. Parents or guardians were interviewed at their homes and the immunisation status of the children was verified either by the parent-held record or by the immunisation-provider-held record. Levels of full immunisation were 77 per cent at the time of interview and 72 per cent at the second birthday if Haemophilus influenzae type b (Hib) vaccine was excluded. If it was included, the full immunisation level was 51 per cent. Coverage was highest for oral polio vaccine and lowest for Hib vaccine. Twenty-nine per cent of all immunisations were given early, 44 per cent were given on time and 20 per cent were given late. Doses of vaccines due at older ages were more likely to be given late or not at all. Factors predicting incomplete immunisation were: the principal caregiver being aged under 25 years, being born outside Australia, having post-secondary qualifications, being female and having more than one child in the household. Immunisation coverage levels were not high enough to protect against outbreaks of pertussis and measles and cases of Haemophilus influenzae type b. Immunisation providers should aim to increase coverage to protect the population against all vaccine preventable diseases, and aiming at high-risk groups could more effectively do this.
Adult↗
Linkage analysis of a large pedigree with hereditary sideroblastic anaemia.
A large pedigree showing a history of pyridoxine responsive X linked sideroblastic anaemia was screened with several polymorphic DNA markers from the X chromosome. Linkage analysis between each marker and disease status was performed, giving a maximum two point lod score of 3.64 at zero recombination with the microsatellite marker PGK1P1 at Xq11.2-12. Close linkage to PGK at Xq13.3, one of the candidate regions for X linked sideroblastic anaemia, was excluded. Linkage to DNA markers distal to PGK and at Xp21 was also excluded. Multipoint linkage analysis was performed with markers located between Xq11.2-21. The maximum map specific lod score obtained was 3.56 at PGK1P1 (Xq11.2-12). Linkage remained significant over the interval 20 cM proximal to PGK1P1 and 5 cM distal to PGK1P1, with definite exclusion around the PGK locus. The most likely location of the gene involved in sideroblastic anaemia in this pedigree is therefore within the pericentromeric region of the X chromosome. This region includes the erythroid 5-aminolaevulinate synthetase gene of the haem synthesis pathway, which is a candidate gene for X linked sideroblastic anaemia located at Xp11.21.
Alleles↗
Mathematical model of oxygen transport: a teaching aid for normal physiology adaptable to extracorporeal oxygenation circuits.
The ultimate aim of most intensive care therapies is to improve tissue oxygen delivery; consequently, a detailed knowledge of this area of physiology is important to a wide range of Critical Care Staff. We describe a simple mathematical model of oxygen transport that was initially written as a training aid for extracorporeal oxygenation training. The model has subsequently proved useful for explaining the determinants of oxygen transport to a broader audience. It is based on simple linear equations and is easily displayed with a standard computer spreadsheet. Apart from its teaching value, the model can also generate a graph of oxygen saturation vs. inspired oxygen fraction for different degrees of pulmonary shunt. This provides a noninvasive method for determining the magnitude of pulmonary venous admixture and may also prove to have some clinical value.
Biological Transport, Active↗
Thyroid peroxidase autoantibody fingerprints. II. A longitudinal study in postpartum thyroiditis.
It is not known whether epitopes recognized by autoantibodies in an individual remain constant or change over time, especially during perturbations of the humoral immune response. To address this question, we studied the epitopic profile ("fingerprint") of autoantibodies to thyroid peroxidase (TPO) in the sera of 19 women during the postpartum period. Fingerprints were determined in competition studies using 4 recombinant F(ab). At delivery and at 3 time intervals over the subsequent 9-12 months, the pool of F(ab) inhibited autoantibody binding to TPO by 80-100%, consistent with the definition by these F(ab) of a TPO immunodominant region (A1, A2, B1, and B2 domains). Despite a wide spectrum among individuals, the TPO epitopic fingerprints for all 19 women were relatively unchanged throughout the postpartum period. Fingerprint constancy occurred regardless of fluctuations in serum TPO autoantibody levels. When assessed numerically as a ratio of inhibition by the A domain F(ab) to inhibition by the B domain F(ab), the A/B domain ratios in individual women ranged from 0.2 (predominantly B domain) to more than 3.0 (predominantly A domain). However, for each individual woman, the A/B epitopic ratio was conserved throughout the study interval. Our TPO autoantibody epitopic fingerprint data have potential implications for understanding the humoral autoimmune response in man. First, the present study indicates a remarkable lack of spreading of B cell epitopes during a state of perturbation of the immune system over a period of 1 yr. Second, and perhaps more important, despite marked variations in TPO epitopic profiles among different individuals, their constancy over time suggests that TPO autoantibody fingerprints may be inherited.
Autoantibodies↗
Role of complement in the pathogenesis of postpartum thyroiditis: relationship between complement activation and disease presentation and progression.
The aim of this study was to assess whether the presentation and progression of autoimmune postpartum thyroiditis (PPT) was related to the degree of thyroid peroxidase autoantibody (TPO-ab)-mediated activation of the complement cascade. One hundred and forty-eight thyroid autoantibody-positive women have been followed during their postpartum year. Seventy-five women remained euthyroid during this time whilst the remaining 73 showed one or more episodes of thyroid dysfunction. Fourteen women showed hyperthyroid PPT, 23 showed a biphasic PPT and the remaining 36 showed hypothyroid PPT. Hyperthyroid PPT was always transient but 29 of the 59 women with hypothyroidism remained hypothyroid or still required thyroxine replacement therapy at the conclusion of the study. Thyroid autoantibodies were measured by enzyme-linked immunosorbent assay (ELISA), free triiodothyronine and free thyroxine by the Amerlex M methods and thyrotrophin by the Amerlite TSH (monoclonal) assay. Complement component C3b, immobilized as a result of classical complement pathway activation in the presence of TPO/TPO-ab complexes in vitro, was measured by ELISA. Bioactive TPO-ab were calculated as the product of the C3 index and TPO-ab level. Basal levels of complement C3 activation were seen in the euthyroid TPO-ab-positive women (C3 index 0.06 at delivery rising to 0.36 at 12 months postpartum; bioactive TPO-ab activity 0.4 kIU/l at delivery rising to 10.4 kIU/l at 12 months' postpartum (N = 75). These parameters were elevated progressively as the severity of the clinical syndrome increased. In 14 hyperthyroid PPT women the C3 index was 0.47 at 8 months' postpartum (bioactive TPO-ab activity = 20 kIU/I; p vs euthyroid group, NS).(ABSTRACT TRUNCATED AT 250 WORDS)
Autoantibodies↗
Promoting tobacco control policies in northwest Indian tribes.
A culturally sensitive consultative process to facilitate adoption by tribal councils of more effective tobacco control policies was developed and evaluated. Thirty-nine Northwest Indian tribes were randomized to early intervention or late intervention conditions. Early intervention tribes received a policy workbook and consultation by means of meetings and telephone calls. Late intervention tribes were assessed but received no assistance or encouragement regarding tobacco use policies. The stringency of the policies was assessed via telephone at baseline and after intervention. At postintervention, there were consistent, and generally statistically significant, differences in adoption of more stringent and comprehensive smoking policies for early intervention tribes compared with late intervention tribes. The intervention could be used in other Indian settings.
Cultural Characteristics↗
Package seals. Causes and avoidance of defects.
Defective heat sealing can result in leakage, packs that are difficult to open, or contamination of the contents. This article comments on materials, machinery, and maintenance to provide an understanding of the causes of sealing problems.
Consumer Behavior↗