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Richard Jackson

Publications and source records attributed to Richard Jackson.

8 recordsLinked to original sources
PubMed2003

Progression of atherosclerosis is associated with variation in the alpha1-antitrypsin gene.

OBJECTIVE: Alpha1-Antitrypsin (AAT) protects elastic tissue and may play a role in atherogenesis. The association of atherosclerosis progression with common AAT variants was considered in 2 clinical trials. METHODS AND RESULTS: We examined the association of AAT V213A, S and Z deficiency alleles, and the functional 3' UTR 11478G>A with change in minimal luminal diameter, a measure of focal disease, in the Lopid Coronary Angiography Trial gemfibrozil study of post-bypass men. S or Z carriers (n=14) showed strong progression of disease on placebo (11.5%) but responded well to treatment (3% regression). 11478A carriers treated with placebo or gemfibrozil showed significantly more disease progression (n=8, -14.5% and n=16, -4.0%, respectively) than 11478GG men (n=107, -7.0% and n=108, -1.4%, respectively; overall, P=0.003). VV213 men treated with gemfibrozil (n=68) showed -4.8% progression, whereas A213 carriers (n=55) showed +1.4% regression of disease (P=0.001). No V213A effect was seen on placebo (P=0.11). In the Diabetes Atherosclerosis Intervention Study fenofibrate trial of angiographic progression in type 2 diabetes, the association of 11478A with increased disease progression was confirmed in the treatment group, but not the gemfibrozil-treated A213 association with regression, suggesting a pharmacogenetic difference. CONCLUSIONS: Disease progression is associated with variation in AAT, and low AAT levels promote atherogenesis.

3' Untranslated Regions↗
PubMed2003

Screening strategies for the identification of multiple antibody-positive relatives of individuals with type 1 diabetes.

The objective of this study was to determine the extent to which different screening strategies could identify a population of nondiabetic relatives of a proband with type 1 diabetes who had two or more immunologic markers from the group consisting of islet cell antibodies (ICA), micro insulin autoantibodies (MIAA), GAD65 autoantibodies (GAA), and ICA512 autoantibodies (ICA512AA). Relatives of subjects with type 1 diabetes were screened for ICA as part of the Diabetes Prevention Trial-Type 1. A total of 71,148 samples were also tested for GAA and ICA512AA. IAA results were available on 17,207 of these samples using a protein A/protein G MIAA assay as well. The study population was defined to be those in which all four antibodies were tested. There were 1010 (5.9%) relatives with a single autoantibody on initial screening and 394 (2.3%) with two or more autoantibodies. GAA was more sensitive than ICA [GAA, 91% (357 of 394); ICA, 82% (324 of 394)] in the detection of multiple antibody-positive individuals. The addition of ICA512AA to GAA as a screening test increased sensitivity to 97% (381 of 394), whereas adding ICA512AA to ICA as a screening test increased sensitivity to 93% (367 of 394). GAA and ICA identified somewhat nonoverlapping subgroups of multiple antibody-positive subjects. Thus, the substitution of GAA or ICA for the other failed to detect 8-17% of multiple antibody subjects. Higher ICA titers were associated with increased percentages of multiple antibody-positive subjects; 86% of subjects having Juvenile Diabetes Foundation titers of at least 160 were positive for two or more antibodies. A screening strategy combining GAA and ICA512AA resulted in a higher sensitivity than using any marker individually, although statistically it was not significantly higher than using GAA alone. Screening for any three antibodies guaranteed that all multiple antibody-positive subjects were detected. Screening for two antibodies at one time and testing for the remaining antibodies among those who are positive for one resulted in a sensitivity of 99% for GAA and ICA, 97% for GAA and MIAA or GAA and ICA512AA, 93% for ICA512AA and ICA, 92% for MIAA and ICA, and 73% for ICA512AA and MIAA. From a laboratory perspective, screenings for GAA, ICA512AA, and MIAA are semiautomated tests with high throughput that, if used as initial screen, would identify at first testing 67% of the 2.3% of multiple antibody-positive relatives (100% if antibody-positive subjects are subsequently tested for ICA) as well as 4.7% of relatives with a single biochemical autoantibody, some of whom may convert to multiple autoantibody positivity on follow-up. Testing for ICA among relatives with one biochemical antibody would identify the remaining 33% of multiple antibody-positive relatives. Further follow-up and analysis of actual progression to diabetes will be essential to define actual diabetes risk in this large cohort.

Adolescent↗
PubMed2002

Empyema: development of a critical pathway.

Over the past 20 years at the authors' institution, the management of empyema has evolved. The authors recently have developed a critical pathway in an effort to facilitate diagnosis, guide therapy, and reduce cost. Currently, the average length of stay using this pathway is 4 to 5 days with decreased cost compared to the historic length of stay and a national children's hospital database. The authors review steps to develop a critical pathway as well as discuss their pathway for empyema management.

Arkansas↗
PubMed2002

Percutaneous subclavian central venous catheterization in children younger than one year of age.

Children younger than one year of age frequently require central venous lines (CVLs) for total parenteral nutrition, intravenous antibiotics, and chemotherapy. In many instances surgical cut-down has been favored over percutaneous access. The purpose of this study was to demonstrate the safety and success of percutaneous central venous access in children less than one year of age. Percutaneous access of the subclavian vein was obtained by Seldinger technique. Using the medical procedure code index we reviewed the charts of those patients less than one year of age from January 1, 1999 through December 31, 1999 requiring central venous access. Age, diagnosis, number of CVLs required, site placed, success rate, and weight were recorded. In 1999 a total of 84 patients younger than one year of age received a total of 110 CVLs. In patients less than 6 months of age the success rate for percutaneous access of the subclavian vein was 78.8 per cent and for those children over 6 months the success rate was 96 per cent. The average weight for those less than 6 months was 3.1 kg and for those older than 6 months was 7.63 kg. There were no complications from the procedure. Percutaneous CVL placement in children younger than one year of age is safe and effective. This paper details our technique and reviews infant venous anatomy in the subclavian area.

Catheterization, Central Venous↗
PubMed2002

Land use planning: why public health must be involved.

The way that land is used has a direct impact on public health. Legislators and other with responsibility for land use planning need to be aware of the public health connection and need to promote effective land use planning as a means of improving the public's health. This article discusses the public health/land use connection and the role that local, state, and national legislators can play in promoting land use planning that supports the public's health. It also provides an example of a collaborative local land use initiative aimed at addressing a public health problem in a city and at providing a model that other locations can use in making land use conform to sound public health policy. Finally, it provides an overview of initiatives to promote healthy land use in the New York metropolitan area by Regional Plan Association, a private non-profit planning organization.

Community Health Planning↗
PubMed2002

Will biomonitoring change how we regulate toxic chemicals?

Biomonitoring is the assessment of human exposure to environmental chemicals by measuring the chemicals or their metabolites in human specimens such as blood, urine, saliva, or tissue. It has become a powerful public health tool. This article discusses the practical application of biomonitoring to address a public health problem in a state, to explain how biomonitoring differs from predicting exposure through environmental monitoring, to describe the influence biomonitoring has had on promulgating regulations aimed at protecting public health, and to discuss the position biomonitoring holds in the legal landscape as well as its promise in forging laws that will regulate toxic chemicals more effectively.

Cotinine↗
PubMed1998

The validity of button fastening as a test of hand disability in myotonic dystrophy.

This study evaluated the validity of testing button fastening ability as a measurement of hand disability in patients with myotonic dystrophy. Forty subjects with myotonic dystrophy were tested on their ability to fasten four shirt buttons. The association between button fastening ability, strength of selected proximal upper limb muscles and lateral pinch grip was determined. A significant association (F(4,35) = 7.55, p < 0.01) was demonstrated between proximal upper limb strength and button fastening ability, but there was no relationship with lateral pinch grip strength. Myotonia was not a factor affecting button fastening performance. Comparison of these results with those of a group of 13 subjects with other neuromuscular diseases showed button fastening disability in myotonic dystrophy could not be attributed solely to proximal upper limb weakness but is a valid measure of hand disability. A standard for normal button fastening performance was also determined.

Journal Article↗