Biomedical subjects

W P Fehder

Publications and source records attributed to W P Fehder.

10 recordsLinked to original sources

PubMed2001

Interactions between the nervous and immune systems.

Substantial morphologic and functional evidence exists that supports the reciprocal interactions that occur between the nervous and immune systems. The nervous and immune systems have been increasingly found to use a common chemical language in the form of neuropeptides, cytokines, and hormones. Sophisticated immunologic techniques such as the identification and detection of immune cell surface markers enable researchers to determine the origin and activity of diverse cells in the blood and central nervous system. These techniques have elucidated the activity of immune cells in the central nervous system (CNS) that was previously thought to be privileged from immune surveillance in the presence of an intact blood brain barrier. Immune cells in the CNS play a central role in several degenerative diseases such as Alzheimer's disease, Huntington's disease, Multiple sclerosis, AIDS dementia complex, and nerve destruction associated with trauma. Immune cells also play a role in demyelinating peripheral nerve disorders. Cytokines and neuropeptides secreted by peripheral immune cells have profound effects on behavior that is mediated by the CNS. The close integration between immune and nervous system responses is being increasingly recognized in physiologic and pathologic conditions.

Brain↗

PubMed1999

Alterations in immune response associated with anxiety in surgical patients.

Anesthesia practitioners have begun to focus on the immune function of their patients as more research is done on the interface between anesthesia, surgery, and immune alterations. The anxiety associated with anesthesia and surgery produces alterations in immune function through several mechanisms which affect recovery from surgery and wound healing. Immune status may be assessed by traditional measures such as complete blood count and differential as well as using newer technologies such as flow cytometry, lymphocyte proliferation assays and natural killer cell cytotoxicity. Anxiety produces immune changes through sympathetic adrenal medullary and hypothalamic pituitary adrenal cortical mechanisms, as well as through the neurotransmitter substance P. Anxiety also produces changes in immune function through alteration in health behaviors such as increased smoking, increased alcohol consumption, drug use, and changes in diet and sleep. Recommendations for psychological and pharmacological measures that are effective in reducing stress-induced immunosuppression among this group of patients are provided. The future use of substance P antagonists, which are currently under investigation, as well as cytokine manipulation, hold promise for further measures to reduce immune alterations associated with anxiety.

Anesthesia↗

PubMed1998

Development and evaluation of a chromatographic procedure for partial purification of substance P with quantitation by an enzyme immunoassay.

We have developed a simple chromatographic procedure for the partial purification of substance P (SP) from acidified plasma and serum samples. We have evaluated a sensitive antigen competition enzyme immunoassay (EIA) for the quantitation of SP. The chromatographic procedure has recovery efficiencies ranging from 94.8 to 125%. The immunoreactivity of unknown amounts of purified SP subjected to the preparative procedure yielded a coefficient of variance of 9.4%. The EIA yielded reproducible standard curves having an interassay (n = 8) correlation coefficient of 0.984. The evaluation of normal adult control serum yielded a mean value of 51 pg/ml (range, 35 to 61 pg/ml). The evaluation of 3.33 x concentrates of serum-derived partially purified SP provided uncorrected SP values of 117 to 201 pg/ml, which fell within the midpoint of the three-decalog standard curve. These studies indicate that both the preparative and quantitative procedures are required for the detection of SP in plasma or serum samples collected from patients with several clinical disorders.

Adult↗

PubMed1997

Immune responses in mothers of term and preterm very-low-birth-weight infants.

Differences in the levels of immune cell subsets present in peripheral blood have been demonstrated based on sociodemographic factors such as age and race. Postpartal women, who are recovering from the immune changes that are concomitant with pregnancy, have lymphocyte and monocyte values that differ from other populations. A subgroup of postpartal women, mothers who deliver preterm very-low-birth-weight (VLBW) (< or = 1,500 g) infants, may have further differences in values of immune cell subsets and in immune functioning either because of hormonal factors or lifestyle changes or because of the stress they experience after their infant's birth and for the first few months of infant caretaking. This study examined anxiety, depression, and immune cell phenotypes in 30 mothers of VLBW infants and in 30 mothers of healthy term infants over the first 4 postpartal months to determine if mothers of preterm VLBW infants differed from mothers of healthy term infants in psychological and immunologic parameters. Additionally, lymphocyte proliferation and natural killer cell functional assays were performed in a subset of mothers. Mothers of VLBW infants had increased anxiety and decreased lymphocyte proliferation compared to mothers of term infants. When lymphocyte and monocyte subsets were compared over time between the two groups of mothers differences were found in CD8, CD20, CD3-/CD56+, CD14, and HLA class II Ia on monocytes. Mothers with high-fat diets had lower percentages of some monocytes (CD14), lymphocytes (CD4+/CD45RA+), and natural killer cells (CD3-/CD57+) during the first 4 postpartal months.

Adult↗

PubMed1996

Stress, immune function, and relationship to pregnancy outcome.

Pregnancy and the postpartal period are a time of immunosuppression. The normal immunosuppression that occurs during the puerperium may be aggravated by stress. Normal mechanisms of immunosuppression are discussed, and the research related to stress and childbearing is examined in this article.

Antibody Formation↗

PubMed1995

Delayed reporting of the rape victim.

1. Delayed reporting of rape may be due to impaired cognitive processing, altered states of consciousness, or cognitive dissonance. 2. DNA may speak for the victim who does not remember a rape due to being unconscious. 3. Women with psychosis may incorporate a rape into their delusional system.

Adult↗

PubMed1993

Anesthesia for the homeless.

Healthcare for the homeless is often crisis-oriented and fragmented. Homelessness may be associated with ongoing healthcare problems such as tuberculosis, human immunodeficiency virus (HIV), acquired immune deficiency syndrome (AIDS), and substance abuse. The purpose of this study was to identify the anesthesia services required by homeless individuals from an urban area. The anesthesia records of all individuals (N = 40) identified as being homeless and receiving care at one New York City medical center during a 12-month period were reviewed. Approximately one-half (47.5%) of the 40 patients in the study did not require general anesthesia but intubation only. Most of these intubations were for cardiac/respiratory arrests of unknown cause, drug/alcohol overdose, or multiple trauma. Of the 21 patients requiring surgery, 15 had emergency procedures such as splenectomy, appendectomy, exploratory laparotomy, incarcerated hernia repair, and reduction of fractures. The findings of this study support previous research which indicates that most homeless people enter into care for emergency rather than elective services.

Adolescent↗

PubMedDate not supplied

Immune alterations associated with epidural analgesia for labor and delivery.

PURPOSE: Epidural analgesia is frequently used for the laboring woman and commonly regarded as safe. The association of epidural analgesia with fever, in the absence of infection, in this population can result in unnecessary sepsis workups in both neonates and mothers. Studies in other populations of patients have found that epidural anesthesia may be associated with alterations in white blood cell count parameters. This study was designed to determine if epidural analgesia is associated with alterations in immune profile or immune function in healthy afebrile postpartum women. DESIGN: This prospective quasi-experimental study examined a convenience sample of normal afebrile postpartum women in two groups for differences in immune profile and immune function based on whether they received epidural analgesia during labor and delivery. METHODS: Mothers who agreed to participate in the study and met inclusion criteria had blood drawn for immune profile and immune function studies within 24 hours of their delivery. This study looked at immune phenotypic profile, lymphocyte proliferative response, and NK lysis assays. RESULTS: No differences in immune profile or immune function were found based on administration of epidural analgesia. CLINICAL IMPLICATIONS: Nurses can be confident that the white blood cell count and other phenotypic measures of leukocytes are not affected by epidural analgesia. Thus the epidural analgesic technique appears not to alter immune measures of infection in postpartum women. In evaluating fever in postpartum mothers and neonates, nurses should consider prior receipt of epidural analgesia and measures of immune profile. In addition to fever and white blood cell counts, other signs and symptoms of infection should also be evaluated in postpartum women when infection is suspected.

Analgesia, Epidural↗

PubMedDate not supplied

Weight, nutrition, and immune status in postpartal women.

Postpartal weight loss, nutritional intake, and immune status were examined in 65 women. Although 80% of the women lost weight and were not overweight by the 4th postpartal month, the majority had diets that were inadequate in fat content (> or = 30% of calories from fat) or protein content (< or = 12% of calories from protein), or in terms of caloric intake (< or = 1,200 calories or > or = 2,200 calories). Differences in some immune cell subsets were noted between women with high-fat and normal-fat diets. Women with high-fat diets had lower percentages of specific immune cell subsets than women with normal-fat diets. Protein intake was not related to immune cell phenotypes.

Adult↗

PubMedDate not supplied

Substance P as an immune modulator of anxiety.

Peripheral blood concentrations of the proinflammatory peptide substance P (SP) have been shown to increase in response to psychological anxiety in human subjects. In this study, we examined changes in SP levels in peripheral blood in response to the anxiety of a diagnostic medical procedure. The levels of SP were found to he higher in subjects with high initial anxiety as compared to subjects with low initial anxiety as measured on the Multiple Affect Adjective Checklist. Changes in the percentages of CD-8-expressing T lymphocytes were found to correlate with alterations in measures of anxiety as well as SP. These changes persisted for 3 days following the diagnostic procedure. The results of the study seem to indicate that SP may serve as a mediator in stress-induced immune reactions.

Anxiety↗