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Biomedical subjects

Susan Parker

Publications and source records attributed to Susan Parker.

12 recordsLinked to original sources
PubMed2006

Serum lipid and lipoprotein alterations represent recovery of liver function after hepatectomy.

BACKGROUND: The assessment of liver function during human liver regeneration is necessary to prevent unexpected liver failure and to prepare for further treatment. We selected patients prospectively and measured serum lipid and lipoprotein levels to identify which lipids and lipoproteins could represent recovery of liver function in human liver regeneration. METHODS: Thirty selected patients who underwent hepatectomy were divided into three groups depending on the serum hyaluronate (HA) level and the type of liver resection. RESULTS: We found three patterns of lipid and lipoprotein alterations after hepatectomy. Among the lipids and lipoproteins examined, the serum beta-lipoprotein and low-density lipoprotein (LDL) levels were significantly different among the groups at 7 days after hepatectomy. The alteration of the apolipoprotein (Apo) B level was similar to that of LDL. The LDL level was correlated with both beta-lipoprotein and Apo B before hepatectomy (r=0.653 and 0.894, respectively) and at 7 days after hepatectomy (r=0.841 and 0.943, respectively). CONCLUSION: Serum HA before hepatectomy can reflect postoperative liver function depending on the type of liver resection. Recovery of the beta-lipoprotein and LDL levels can reflect the recovery of liver function in human liver regeneration within the early period in association with the Apo B level.

Aged↗
PubMed2006

The Parent Positive programme: opportunities for health visiting.

Health visitors have a key role in programmes that support and enhance parenting as part of their public health work. This paper reports the findings of an in-depth study that explored how 12 purposefully sampled health visitors who had undergone training in the Parent Positive programme viewed their role after training and how they felt that it had influenced their practice. Participants reported that the training developed their communication skills, enabled them to make the links between public health and family focussed work, gave their role greater clarity and provided them with an opportunity to reflect on their practice with others. The paper identifies the implications for practice and the initial and continuing education of health visitors.

Community Health Nursing↗
PubMed2006

Dementia: a brief review.

Dementia is an increasingly common diagnosis in our aging population, and the numbers are expected to rise exponentially in coming years. Alzheimer's disease alone now affects 4.5 million people in the US, while millions more are currently affected by vascular dementia, Lewy Body disease and frontotemporal dementia. Each of these is a distinct entity, though overlapping symptoms and comorbidities occur frequently. Within the past two decades research has progressed rapidly on multiple fronts, including epidemiology, etiology, pathology, diagnosis and treatment. It is important for clinicians to recognize early signs and symptoms of dementia, and to note critical differences among them. Dementia research has moved beyond description of symptoms and clinicopathological correlation to the elucidation of risk factors, the pathobiology of the disease process, and most important, to the first generation of dementia treatments. Our purpose here is to review the current state of knowledge and directions of research for the four major dementias noted above. We are entering an era of dementia care that will be based upon the identification of potentially modifiable risk factors and early disease markers, and the application of new disease-specific diagnostic tools and treatment modalities.

Alzheimer Disease↗
PubMed2004

Lack of induction of autoantibody responses following immunization with cytomegalovirus (CMV) glycoprotein B (gB) in healthy CMV-seronegative subjects.

Possible correlations have been proposed between autoimmune diseases, such as systemic lupus erythematosus (SLE), and infection with human cytomegalovirus (CMV). The recent observation that an adenovirus expressing the immunodominant envelope glycoprotein of CMV, glycoprotein B (gB), may be capable of inducing autoantibodies in certain mouse strains has prompted interest in exploring potential relationships between gB immunization and autoimmune disease. We examined whether a recombinant CMV gB vaccine, or a gB canarypox vectored vaccine (ALVAC-CMVgB), administered to a total of 76 CMV-seronegative subjects, was capable of inducing cross-reactive antibodies to Smith antigen (Sm), ribonucleoprotein complex (RNP), and the U1-70 kDa component of the RNP complex. Using immunofluorescence, EIA and immunoblot analyses, we failed to identify induction of autoantibodies following vaccination with gB, whether administered alone as a purified protein subunit with adjuvant, or in combination with expression in a vectored approach using a recombinant canarypox. These data reinforce the favorable safety profile of CMV gB vaccines.

Adolescent↗
PubMed2004

The significance of third-generation HCV RIBA-indeterminate, RNA-negative results in voluntary blood donors screened with sequential third-generation immunoassays.

BACKGROUND: One of the problems associated with the use of anti-HCV immunoblot assays is the interpretation of indeterminate results without detectable HCV RNA. The purpose of this study was to examine the significance of third-generation RIBA (RIBA-3)-indeterminate, RNA-negative results in voluntary blood donors. STUDY DESIGN AND METHODS: Since June 2000 all Australian Red Cross Blood Service testing sites have used an anti-HCV sequential immunoassay testing strategy whereby donors who are reactive on the primary screening immunoassay are tested on a secondary immunoassay and if reactive on both assays, further tested by immunoblot. From the four testing sites that use RIBA-3, the result profiles of donors who were RIBA-3-indeterminate, HCV RNA-negative were analyzed. RESULTS: From 2,661,786 donations screened for anti-HCV during the study period, 102 RIBA-3-indeterminate, RNA-negative donors were identified, most of whom were reactive to either c33p (69.6%) or c22p (27.5%). The RIBA-3-indeterminate, RNA-negative donors showed a significantly higher screening immunoassay signal strength to assay cutoff (S/CO) distribution than those with biologic false-reactive (BFR) results (1.853 vs. 1.524, p < 0.05) but a significantly lower distribution than RIBA-3-positive, RNA-negative (1.853 vs. 4.546, p < 0.05) or RNA-positive (1.853 vs. 6.467, p < 0.05) donors. The RIBA-3-indeterminate, RNA-negative donors showed a similar distribution of c33c and c22p band intensities compared with RIBA-3-positive, RNA-negative donors but significantly lower distribution of band strengths compared to the RIBA-3-positive, RNA-positive group. Compared to the indeterminate donors with previous anti-HCV-negative or BFR results, the indeterminate donors not previously screened for anti-HCV showed higher immunoassay S/CO ratio distributions, a higher proportion with c22p reactivity (16.2% vs. 36.7%), and higher frequency of risk factors (46.4% vs. 75.0%). CONCLUSIONS: Our analysis suggests that a combination of indicators can be used to help clarify RIBA-3-indeterminate, RNA-negative results. Specifically, donors with high S/CO ratios on a screening immunoassay, RIBA-3 reactivity to c22p or c33c with band intensity of 2+ or greater, without a previous history of negative or BFR donations and with an identifiable risk factor, have a high probability of representing true anti-HCV rather than nonspecific reactivity.

Blood Banking↗
PubMed2003

Improved efficiency of national HIV, HCV, and HTLV antibody testing algorithms based on sequential screening immunoassays.

BACKGROUND: Traditional strategies for clarifying the antibody status of donors giving repeatedly reactive (RR) results on primary screening immunoassays (IA1) have usually involved direct testing by immunoblot. However, such strategies can generate nonspecific in determinate results. The aim of this report is to present the results of an alternative strategy based on the use of sequential immunoassays (SI) before immunoblot testing. STUDY DESIGN AND METHODS: The efficiency of traditional and SI strategies was compared in terms of the number of IA1 RR samples requiring immunoblot testing and the percentage of immunoblot tests giving indeterminate results. In addition, the biologic false- reactive overlap between the PRISM assays selected as IA1 and candidate secondary screening immuno- assays (IA2) was calculated to determine the most efficient IA1/IA2 combinations. RESULTS: There was a significant decrease in the proportion of IA1 RR samples requiring immunoblot testing under the SI strategy when compared with existing site-specific strategies for HIV (0.49 vs. 0.08, p < 0.05), HCV (0.85 vs. 0.42, p < 0.05), and HTLV (0.69 vs. 0.05, p < 0.05) algorithms. In addition, there was a significant decrease in the percentage of immunoblot tests giving indeterminate results for HIV and HTLV under the SI strategy. However, there was no significant difference in the proportion of confirmed positive results for HIV, HCV, or HTLV before and after national SI algorithm implementation. For the anti-HIV IA2s, there was considerable variation of biologic false-reactive overlap with the PRISM HIV O plus chemiluminescent immunoassay (range, 1.6-15.6%). CONCLUSIONS: The results presented in this report demonstrate that the sequential use of screening immunoassays before immunoblot testing can significantly reduce both the number of immunoblot tests and proportion of indeterminate results, without impacting sensitivity, thereby improving algorithm efficiency and simplifying donor management.

Algorithms↗
PubMed2002

Randomized, controlled human challenge study of the safety, immunogenicity, and protective efficacy of a single dose of Peru-15, a live attenuated oral cholera vaccine.

Peru-15 is a live attenuated oral vaccine derived from a Vibrio cholerae O1 El Tor Inaba strain by a series of deletions and modifications, including deletion of the entire CT genetic element. Peru-15 is also a stable, motility-defective strain and is unable to recombine with homologous DNA. We wished to determine whether a single oral dose of Peru-15 was safe and immunogenic and whether it would provide significant protection against moderate and severe diarrhea in a randomized, double-blind, placebo-controlled human volunteer cholera challenge model. A total of 59 volunteers were randomly allocated to groups to receive either 2 x 10(8) CFU of reconstituted, lyophilized Peru-15 vaccine diluted in CeraVacx buffer or placebo (CeraVacx buffer alone). Approximately 3 months after vaccination, 36 of these volunteers were challenged with approximately 10(5) CFU of virulent V. cholerae O1 El Tor Inaba strain N16961, prepared from a standardized frozen inoculum. Among vaccinees, 98% showed at least a fourfold increase in vibriocidal antibody titers. After challenge, 5 (42%) of the 12 placebo recipients and none (0%) of the 24 vaccinees had moderate or severe diarrhea (> or = 3,000 g of diarrheal stool) (P = 0.002; protective efficacy, 100%; lower one-sided 95% confidence limit, 75%). A total of 7 (58%) of the 12 placebo recipients and 1 (4%) of the 24 vaccinees had any diarrhea (P < 0.001; protective efficacy, 93%; lower one-sided 95% confidence limit, 62%). The total number of diarrheal stools, weight of diarrheal stools, incidence of fever, and peak stool V. cholerae excretion among vaccinees were all significantly lower than in placebo recipients. Peru-15 is a well-tolerated and immunogenic oral cholera vaccine that affords protective efficacy against life-threatening cholera diarrhea in a human volunteer challenge model. This vaccine may therefore be a safe and effective tool to prevent cholera in travelers and is a strong candidate for further evaluation to prevent cholera in an area where cholera is endemic.

Adolescent↗
PubMed2002

Preventing & dealing with ESRD claim denials.

Nephrology practices and dialysis clinics should structure their billing procedures and specifically designate staff for tracking claims and appealing denials. Timeliness are careful navigation of denial process procedures are keys to optimizing reimbursement. Clearly, the dynamic nature of health care reimbursement demands that facilities become even more savvy in managing challenging reimbursement issues. Billing staff who know how to prevent denials whenever possible and confidently manage appeals when denials occur are instrumental to ensuring appropriate payment for medical services.

Humans↗
PubMed2000

The decorin high glucose response element and mechanism of its activation in human mesangial cells.

The decorin gene encodes a proteoglycan with putative structural and regulatory functions whose expression is markedly increased in human mesangial cells (HMC) exposed to high concentrations of glucose (15 to 30 mM). The gene has two promoters (P1 and P2) upstream of two alternative first exons. Transcripts driven by both promoters are present in HMC maintained in 4 mM D-glucose medium. After exposure to 30 mM D-glucose for 7 to 21 d, transcripts driven by P1 are markedly increased, whereas those driven by P2 decrease. Culture in 4 mM D-glucose medium containing transforming growth factor-beta1 (TGF-beta1) (1.25 ng/ml) has the same effect. However, addition of an excess of TGF-beta neutralizing antibody to the 30 mM D-glucose cultures only partly suppressed increased decorin transcription from P1. In transformed HMC transfected with a reporter (p-SAEP) driven by P1 or P2, P1 activity increased twofold on treatment with either 30 mM D-glucose or TGF-beta1 in 4 mM medium. P2 had little activity under any conditions. 5' deletion of P1 showed that basal transcriptional activity lies within the proximal 378 bp, while the major high glucose and TGF-beta response element is located in the -683 to -583-bp region. A putative cAMP response-like sequence (TGACGTTT) lies within this region. Electrophoretic mobility shift assays revealed the same pattern of multiple complexes between oligonucleotides containing this sequence and nuclear proteins extracted from HMC maintained in either 4 or 30 mM D-glucose conditions, but the latter were more prominent. cAMP response element binding protein (CREB) was identified as one transcription factor forming these complexes but other factors remain unidentified. Increased levels of phospho-(Ser 133) CREB were found in HMC exposed to 30 mM D-glucose. High glucose also activated and led to nuclear translocation of p42/44 mitogen-activated protein kinase and p38 mitogen-activated protein kinase, both of which can activate CREB by phosphorylation of serine 133.

Cell Line↗