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Molecular basis for subtypic differences of the "a" subunit of coagulation factor XIII with description of the genesis of the subtypes.

The "a" subunit of human coagulation factor XIII (F13A) exhibits genetic polymorphism defined by four common alleles, F13A*1A, *1B, *2A, and *2B. We have previously suggested on the basis of the isoelectric focusing patterns of the four allele products that point mutations at two separate sites and one intragenic crossing over might be involved in the genes of F13A polymorphism. Here, we report nucleotide substitutions associated with F13A polymorphism. A C/T transition of the second nucleotide of codon 564 in exon 12 is responsible for the difference between F13A*1A and *1B and that between F13A*2A and *2B, and a set of two base changes in codons 650 and 651 in exon 14 leads to the differences between F13A*1A and *2A and those between F13A*1B and *2B. The four combinations of the point mutations at the two exons thus correspond to the four alleles, two of which were generated by the point mutations from ancestral monomorphic gene. The results suggest strongly that intragenic crossing over must be involved in the genesis of the fourth allele. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods discriminating these base changes in exons 12 and 14 are also presented.

Alleles↗

Serum factors activating the alternative complement pathway in autoimmune disease: description of two different factors from patients with systemic lupus erythematosus.

Serum factors which activated the alternative pathway of complement were detected in 10 of 26 patients with systemic lupus erythematosus (SLE), three of 18 patients with mixed connective tissue disease, one patient with scleroderma, and one with Sjögren's syndrome. This activation was detected by conversion of factor B and C3 into split products and by lysis of glutathione-sensitized human erythrocytes under conditions where classical pathway activation was blocked. The serum factors capable of activating the alternative pathway could be seperated into 7S and 19S-type molecules by sucrose density gradient ultracentrifugation. In two patients with SLE, serum factors were isolated by ion-exchange chromatography, preparative electrophoresis, and molecular sieve chromatography. The serum 7S factor was immunochemically identical to the C3 nephritic factor (C3NeF) of hypocomplementemic chronic glomerulonephritis. Antisera to other complement components failed to react with this purified material. The 7S factor was able to activate the alternative pathway in C2 deficient serum, and in normal human serum under conditions where classical pathway was blocked, but was unable to do so in sera depleted of factor B, factor D, and C3. The activity could be removed by antiserum to C3NeF. In contrast, the serum 19S activator of the alternative pathway was not reactive with antiserum to C3NeF. It had a fast gamma mobility on electrophoresis and the activity could be removed by absorption with anti-IgG and anti-IgM. It was suggested that the 19S factors could consist, in part, of immune complexes.

Absorption↗

Informant personality descriptions of postintimate stalkers using the five factor profile.

Psychological descriptions of stalkers are few, especially nonforensic cases. As direct assessment is often hindered by lack of cooperation, assessment by informants may be a next-best approach. Indirect assessment may be most fruitfully applied among postintimate stalkers using instruments that are specifically validated for this purpose. Accordingly, in this study, we documented the psychological profile of 112 male postintimate stalkers as judged by ex-partners and/or subsequent victims using the Five Factor Personality Inventory (Hendriks, Hofstee, & de Raad, 1999b) and indexes of attachment and psychopathology. As compared to the Dutch norms, postintimate stalkers were described as extremely low on Agreeableness and moderately low on Conscientiousness and Emotional Stability. Most often insecurely attached with underlying negative self-representations, they were characterized as relatively functional people with strong sensitivities to rejection, abandonment, and loss.

Adult↗

Milwaukee shoulder syndrome. Fifteen additional cases and a description of contributing factors.

Fifteen additional patients with Milwaukee shoulder syndrome are described, bringing our total series to 30 cases. The condition occurred predominantly in elderly women and was characterized by severe glenohumeral joint degeneration and dissolution of the fibrous rotator cuff. Synovial fluids contained few leukocytes, but were often blood tinged. Basic calcium phosphate crystal aggregates and particulate collagens were noted in nearly all fluids, and collagenase activity was detectable in some, but not all, fluids. The knee joints were involved with a similar process in about half of our patients. In contrast to primary osteoarthritis, lateral tibiofemoral compartment involvement was common. Factors that may predispose to this syndrome included deposition of calcium pyrophosphate dihydrate crystals, direct trauma or chronic joint overuse, chronic renal failure, and denervation.

Aged↗

Endemic, multiply resistant Staphylococcus aureus in a pediatric population. Clinical description and risk factors.

During a seven-year period, 38 children acquired multiply resistant Staphylococcus aureus (MRSA) after admission to a pediatric service. Eighteen children were thought to be colonized. Twenty-three infectious episodes occurred in the remaining 20 children. Infections included endocarditis (n = 2), pneumonia (n = 8), burn infection (n = 1), postoperative wound infection (n = 6), intra-abdominal abscess (n = 1), catheter sepsis (n = 2), urinary tract infection (n = 1), conjunctivitis (n = 1), and central nervous system shunt infection (n = 1). When patients infected with MRSA were compared by multivariate analysis with control subjects matched for age and unit of admission, patients with MRSA were hospitalized longer, underwent more surgical procedures, received more intravenous alimentation, and were more likely to require a tracheostomy; no correlation was found with administration of antibiotics. Twenty-six of the 34 discharged patients remained colonized with MRSA. Mortality in the infected patients was 20% (4/20), with a 38% (3/8) mortality rate for MRSA pneumonia.

Child↗

Length of stay and antipsychotic treatment costs of patients with acute psychosis admitted to hospital in Spain. Description and associated factors. The Psychosp study.

OBJECTIVE: The aim of this study was to describe the length of stay, cost of drug treatment, diagnostic tests and other therapeutic measures in acute psychotic patients admitted to acute in-patient psychiatric units and to analyse the factors associated with these. METHODS: A retrospective review was made of medical records of 200 patients admitted for acute psychosis in eight Spanish hospitals. Information was collected concerning the length of stay, cost of drug treatment and diagnostic tests; bivariate and multivariate analysis was made of factors associated with length of stay and cost of antipsychotic drug treatment. RESULTS: The average admission cost ranged between 2,830.29 and 3,624.95 euros, with a wide variability among hospitals. Of this cost, 94.3% corresponded to fixed costs, 3.4% to diagnostic tests and 2.4% to drug treatment (84.2% of this latter cost corresponded to antipsychotic drugs). Age younger than 25 years and a diagnosis of schizophrenia were associated with longer hospital stays; longer length of stay, the presence of aggressiveness/agitation, a diagnosis of schizophrenia, age younger than 25 years and the use of atypical antipsychotics were associated with higher costs in antipsychotic drug treatment. CONCLUSIONS: The hospital admission cost of an acute psychotic episode is mostly dependent on the structural costs derived from in-patient treatment. The differences in costs seem to be related to the different length of stay schemes used by the various hospitals rather than to the clinical characteristics of patients or the drugs used.

Acute Disease↗

A chronic bioassay with the estuarine amphipod Corophium volutator: test method description and confounding factors.

Methods of conducting a chronic sediment toxicity test with the estuarine amphipod Corophium volutator are described. They consist of a 49-day exposure, after which mortality, growth and reproduction are determined. Pilot experiments were used to optimize test design parameters such as temperature, duration, feeding and refreshing regimes, and effects of indigenous organisms. By way of further validation, the present study focused on the effects of four different parameters: oxygen saturation, salinity, ammonium and nitrite. These confounding factors might play an important role especially if the test is used for risk assessment of field-contaminated sediments. It is concluded that the present experimental design is well suited for chronic sediment exposures with C. volutator. The test can be performed at a broad range of salinity values, provided that controls are performed at the same salinity. Results further demonstrate that with the endpoints growth and reproduction this chronic test procedure is a factor 7-18 more sensitive to ammonium and nitrate than the standardized acute bioassay (endpoint mortality).

Amphipoda↗

Biosecurity in 116 Danish fattening swineherds: descriptive results and factor analysis.

Biosecurity measures are important for the herd's protection against diseases and also to provide nationwide protection against the introduction of exotic diseases. In this paper, we describe the farmers' choices and routines regarding biosecurity in Danish fattening herds. Overall, 116 Danish swine fattening herds in three areas of different pig density were interviewed. Of these herds, 78% purchased weaners from one sow herd only, whereas 10% purchased from >5 sow herds during 1 year. Large herds (>500 finishers) purchased weaners more often than smaller herds (< or =500 finishers). Only two swine producers purchased weaners from a market. Almost all herds (95%) received weaners from one sow herd at one time, and only one herd received from >5 sow herds in one batch. Twenty-one percent did not use an effective barrier between the loading area and the stables when delivering pigs for slaughter. Entry rooms (in which clothing and boots are changed) were common at the farm, and the numbers of visitors were generally low (<10 visitors a year). Factor analysis was performed to find underlying structures of the biosecurity measures in the herd; four factors were chosen (eigenvalue > 3.10). A site scoring high on factor 1 was a large SPF herd, which received weaners from a single source, had biosecurity requirements for the transport vehicles, and had a high level of biosecurity for visitors. A site scoring high on factor 2 was a multi-site farm, which had personnel working on more than one of the sites, only received weaners from one sow herd, had delivering herds placed close to the participating site, and transported animals themselves. A site scoring high on factor 3 was a site which hired commercial transport for slaughter, was situated far from the abattoir and had a high level of biosecurity when loading pigs. A production site scoring high on factor 4 was a large site, which used all-in/all-out management, washed and disinfected between each group, and purchased many weaners.

Abattoirs↗

A descriptive analysis of factors contributing to binge eating.

This study was designed to examine temporally proximal and remote antecedents as well as immediate and delayed consequences of binge eating behavior. Participants included 16 undergraduate females who reported engaging in binge eating at least two times per week and experiencing a sense of lack of control during binge eating episodes on the Questionnaire of Eating and Weight Patterns. Results indicated that the most frequent proximal antecedents to binge eating were negative emotions such as feeling depressed, angry, empty, hopeless, worried, or dissatisfied. The most frequent consequences of binge eating included relief from negative feelings and thoughts and decrease in hunger or craving. The results of this study suggest that the function of binge eating can be identified through assessment of antecedents and consequences with real time recording and retrospective reports. Treatment implications are discussed.

Adult↗

Identification and description of environmental factors that influence participation of children with cerebral palsy.

Physical, social, and attitudinal environment may restrict participation in children with cerebral palsy (CP). Here we discuss existing/possible approaches in order to identify and describe this environment. We used a critical review of evidence from the World Health Organization Literature Review on Environmental Factors; a search of electronic databases; and talked to specialists in order to find unpublished papers and 'grey' literature. Both children with disabilities and their parents identified a range of barrier and facilitator factors. These included psychosocial pressures (family, school), financial difficulties, and inadequate public services. Observational studies suggest that building structure, loss of income, and provision of specific equipment have a direct impact on levels of child participation. Some available instruments attempt to capture environmental factors by client survey or objective measurement; most relate to adult contexts, but there are a few child-specific instruments for surveying attitudes of children to peers with disabilities and for observation of the school environment. Defining and measuring potential environmental determinants of participation for children with CP needs further development; and here we propose how this might be done.

Activities of Daily Living↗

Mothers' working models of infant feeding: description and influencing factors.

This study examined four aspects of mothers' working models of infant feeding: (1) infant behaviour that cues feeding decisions; (2) infant self-regulative behaviour; (3) importance of infant self-regulative behaviour and maternal effort directed to it; and (4) maternal effort and value given to task-oriented and efficient feeding. The relation of these aspects to maternal experience, age, formal education, family income, and feeding method was also explored. Subjects were 122 mothers of healthy, term infants between 14 and 60 days old. A telephone interview obtained demographic and attribute data and assessed the four aspects with 30 scaled items. Crying before and sleepiness during feeding were relatively compelling cues for maternal action. Most mothers gave only moderate ratings to the importance of infant self-regulative behaviour and to task-oriented and efficient feeding. Parity and feeding method affected response to specific items, with primiparae more concerned about length and regularity of feedings. Mothers who bottle-fed their infants were more concerned about maintaining a feeding once initiated than mothers who breast-fed their infants. Four-factor analysis yielded two item clusters with good internal consistency: Cluster a. Maternal Effort to Accomplish Feeding Goals; and Cluster b. Importance of Infant Self-Regulative Behaviour. Cluster a. and b. were strongly correlated. Feeding method influenced both clusters, and the interaction of parity and feeding method had an effect on Cluster a. Mothers with lower family income had higher scores on Cluster b; multiparae with lower family income on Cluster a. How and when infant self-regulation develops as a goal is a question in need of study.

Adolescent↗

Gastric ulcers in standardbred racehorses: prevalence, lesion description, and risk factors.

This study was performed to estimate the prevalence of gastric ulcers in Standardbred racehorses, to describe the lesion score and location, and to identify potential risk factors. Two hundred seventy-five (275) Standardbred horses from 5 training centers and 2 racetracks in Quebec, Canada, were studied. Historical data for the 2 months before examination were recorded for each horse, and the presence of gastric ulcers was determined by gastroscopy. A previously reported scoring system that used grades 0-3 for gastric lesions was used. Overall, 121 horses (44.0%; 95% CI, 38.1-50.1%) had gastric ulcers. The prevalence of gastric ulcers was significantly higher (P < .0001) in actively racing horses (63.3%; 95% CI, 54.7-71.2%) than in horses at rest. Multivariate analysis defined that horses in racing (OR = 9.29; 95% CI, 3.55-24.3) were significantly more likely to have gastric ulcers than horses at rest and that trotters (OR = 2.23; 95% CI, 1.28-3.86) were more likely to have gastric ulcers than pacers. The number of lesion sites (P < .0001) and poor body condition (P < .0001) were significantly associated with lesion scores. Gastric ulcers are highly prevalent in Standardbred racehorses. Furthermore, actively racing horses and trotters are more likely to have gastric ulcers. Also, poor body condition in Standardbred racehorses may be an indication that gastric ulcers are present and that lesion scores are high. The cause-and-effect relationship between poor body condition and the presence of gastric ulcers is unclear.

Aging↗

The daily spiritual experience scale: development, theoretical description, reliability, exploratory factor analysis, and preliminary construct validity using health-related data.

Spirituality and religiousness are gaining increasing attention as health research variables. However, the particular aspects examined vary from study to study, ranging from church attendance to religious coping to meaning in life. This frequently results in a lack of clarity regarding what is being measured, the meaning of the relationships between health variables and spirituality, and implications for action. This article describes the Daily Spiritual Experience Scale (DSES) and its development, reliability, exploratory factor analyses, and preliminary construct validity. Normative data from random samples and preliminary relationships of health-related data with the DSES also are included. Detailed data for the 16-item DSES are provided from two studies; a third study provided data on a subset of 6 items, and afourth study was done on the interrater reliability of the item subset. A 6-item version was used in the General Social Survey because of the need to shorten the measure for the survey. A rationale for the conceptual underpinnings and item selection is provided, as are suggested pathways for linkages to health and well-being. This scale addresses reported ordinary experiences of spirituality such as awe, joy that lifts one out of the mundane, and a sense of deep inner peace. Studies using the DSES may identify ways in which this element of life may influence emotion, cognition and behavior, and health or ways in which this element may be treated as an outcome in itself a particular component of well-being. The DSES evidenced good reliability across several studies with internal consistency estimates in the .90s. Preliminary evidence showed that daily spiritual experience is related to decreased total alcohol intake, improved quality of life, and positive psychosocial status.

Adaptation, Psychological↗

Adult tics in Gilles de la Tourette's syndrome: description and risk factors.

We studied 58 adults with Gilles de la Tourette's syndrome diagnosed during childhood. Tics persisted in all patients but were moderate/severe in only 24%, compared with 60% at the time of worst function. Coprolalia persisted in 4%, compared with 22% at the time of worst function. For most patients, worst function occurred in adolescence (mode = 13 years). In spite of a high frequency of school and behavioral problems during development, 98% graduated high school and 90% were full-time students or fully employed. Features predictive of mild tic severity in adulthood were mild tics during the patient's worst pre-adulthood function and mild tics during early and late adolescence. Childhood tic severity had no predictive value, and likewise, coprolalia during development did not increase the risk for adult moderate/severe tics.

Adult↗