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Biomedical subjects

A Berg

Publications and source records attributed to A Berg.

At least 127 records · Page 7Linked to original sources

Nurses' reflections about dementia care, the patients, the care and themselves in their daily caregiving.

In this study the aim was, through interviews, to disclose 13 nurses' personal knowledge about the patients, themselves, and care provision, using a phenomenological-hermeneutic analysing method. Caring for people with severe dementia meant an intertwined life world emanating from making and doing together and the delicate interpretative work that the care provision required. The intertwined life world consisted of the interaction between the nurses' and the patients' separate lives, their common life and the environment, culminating in mutual dependency. Making together signifies the relationship being based on the nurses' knowledge and skills as nurses i.e., the task they had to perform. Doing together signifies the relationship being based on the oneness of the nurses and the patients with severe dementia as ordinary human beings. The delicate interpretation process required, to adapt care to the individual patient, was based on knowledge about the patient's personality, life history and disease progression in combination with the nurses' interpretation of the current situation. The nurses searched for meaning and that, in turn, meant that the patient's inner world was determined by the nurses and thus the patient was seen as being in their hands. It seems important to further understand the human aspects of both the nurse and the patient and to examine this dynamic, ongoing, vulnerable interpretation process, critically, in order to achieve high quality nursing care for the patients with severe dementia, and an experience of well-being in nurses everyday working lives.

Adult↗

Anaphylactoid reactions and nephrotic syndrome--a considerable risk during factor IX treatment in patients with haemophilia B and inhibitors: a report on the outcome in two brothers.

Anaphylaxis/anaphylactoid reactions have recently been reported after few treatments with factor IX concentrates in patients with haemophilia B at the same time as inhibitors to factor IX were demonstrated. In some of these cases nephrotic syndrome has appeared during immune tolerance induction (ITI) with high doses of factor IX concentrates. Gene deletions seem to be associated with a high risk of developing antibodies to factor IX. This report presents two brothers with deletion of 1 bp in exon f of the factor IX gene. Both showed anaphylactoid reactions and they were desensitized using slow i.v. injections of factor IX. At the time of anaphylaxis, inhibitors of factor IX in a low titre could be demonstrated. The elder brother responded well after a short time on ITI and has no spontaneous bleedings on regular prophylaxis although in a somewhat higher dose than expected. On the other hand, in spite of comparable regimens, the younger brother has so far been resistant to ITI. Moreover, during treatment with extremely high doses of factor IX concentrate he developed nephrotic syndrome which only slowly subsided after treatment with corticosteroids and withdrawal of factor IX.

Anaphylaxis↗

Budd-Chiari syndrome following repair of a giant omphalocele.

We report a case of Budd-Chiari syndrome following repair of a giant omphalocele. Thrombosis of hepatic veins and of retrohepatic inferior vena cava may result from direct pressure on the hepatic venous outlet after visceral reduction and final abdominal wall closure.

Anticoagulants↗

The inflammatory reaction in elective flap surgery.

The inflammatory response in three different flap procedures was investigated by measuring the preoperative and postoperative levels of C-reactive protein, leukocyte count, and body temperature. Patients scheduled for delayed breast reconstruction were operated on with the lateral thoracodorsal flap, the latissimus dorsi flap, or the pedicled TRAM flap. All patients received 2 gm of intravenous cloxacillin for antibiotic prophylaxis and 1 gm of paracetamol four times a day as basic treatment for postoperative pain. Within each treatment group, significant postoperative changes in C-reactive protein levels, leukocyte count, and body temperature were noted when compared with preoperative values. The highest C-reactive protein level (130 mg/ml) was found in the TRAM group on the third postoperative day. The kinetic pattern of C-reactive protein was similar for the latissimus dorsi flap and lateral thoracodorsal flap procedures, but the maximum C-reactive protein levels were significantly lower, 74 and 44 mg/ml respectively. Small (0.5 to 0.9 degrees C) but significant differences in body temperature were also noted on the second and third postoperative day. The TRAM flap group had the highest, the latissimus dorsi flap group intermediate, and the lateral thoracodorsal flap group the lowest value. The postoperative C-reactive protein levels seem to reflect the extent of the surgical trauma.

Acute-Phase Reaction↗

Similarities and differences of the immune response to exercise and trauma: the IFN-gamma concept.

Similar to physical fitness, fitness of the immune system requires training. Animals that have been raised under sterile conditions have a poor immune system and fail to thrive. "Immune training" is normally provided by contact with live microorganisms or immunizations. Increasing evidence has suggested that moderate sports can decrease the frequency of infections while excessive, exhausting exercise can lead to the opposite, a situation that has been described by a J-curve. Following prolonged exhausting exercise, a transient partial suppression of several immune functions can be shown, and it has been suggested that this period provides a window for invasion of microbes. On the basis of data showing that endotoxin-inducible interferon-gamma (IFN-gamma) production is virtually abrogated for a short period following excessive exercise, we present the hypothesis that the rigorous regulatory blockade of one of the ways of IFN-gamma induction may be critically involved in causing the transient immunosuppression following exhaustive exercise stress.

Animals↗

Effect of PGE1, PGI2, and PGF2 alpha analogs on collagen gel compaction in vitro and interstitial pressure in vivo.

Acute inflammation in skin is accompanied by increased negativity of interstitial fluid pressure (PIF), which will increase capillary fluid filtration and thereby potentiate edema formation. A series of studies indicates that the connective tissue cells in rat dermis are involved in the control of PIF and mediate this response. The present study describes a novel effect of prostaglandin (PG) E1 isopropyl ester, carbaprostacyclin (PGI2 analog), and latanoprost (PGF2 alpha analog) on edema formation and PIF in parallel with their action on the fibroblast-populated collagen gel contraction assay. The prostaglandins were injected subdermally in pentobarbital-anesthetized rats. PIF was measured with a servo-controlled counterpressure system after circulatory arrest had been induced with saturated potassium chloride. Circulatory arrest was induced to limit edema formation that would raise interstitial fluid volume and thereby attenuate a possible increased negativity of PIF. PGE1 (0.91 mM) and carbaprostacyclin (1.28 mM) lowered PIF from a control value of -0.8 +/- 0.4 mmHg to -3.0 +/- 0.4 (P < 0.01) and -3.7 +/- 0.9 (P < 0.01) mmHg, respectively, within 45 min in a dose-dependent manner. Edema formation was measured in separate experiments. PGE1 and carbaprostacyclin significantly increased interstitial fluid volume (extravascular 51Cr-EDTA space) at concentrations as low as 0.1 and 1.1 microM, respectively. Latanoprost had no effect on PIF or edema formation. However, latanoprost reversed, in a dose-dependent manner, an increased negativity of PIF accompanying the anaphylactic reaction to dextran. In the gel contraction assay with human diploid fibroblasts (AG 1518), a corresponding specificity was observed where PGE1 and carbaprostacyclin effectively inhibited gel contraction although latanoprost had no effect. Thus the present data demonstrate a novel effect of prostaglandins and provide further evidence for active modulation of PIF via loose connective tissue cells.

Alprostadil↗

Micropuncture measurements of interstitial fluid pressure in rat nasal mucosa during early inflammatory reactions.

Interstitial fluid pressure (Pif) has been studied in rat nasal mucosa during early inflammatory reactions induced by dextran anaphylaxis and local application of histamine. Pif was measured by using sharpened micropipettes connected to a servo-controlled counterpressure system. Access to the nasal mucosa was obtained from the facial side of the head through a small cavity drilled in the nasal bone. During dextran anaphylaxis, Pif increased significantly from control values of 2.2 +/- 0.4 to 3.8 +/- 0.21 mmHg (P < 0.05) within 1 h. Corresponding Pif values for histamine were 1.6 +/- 0.9 and 2.9 +/- 0.9 mmHg (P < 0.05), respectively. These measurements support the hypothesis that a major driving force for the rapid exudation across inflamed respiratory mucosa is a hydrostatic pressure gradient created by increased mucosa Pif. When the transvascular fluid shifts accompanying the inflammatory reactions are prevented by circulatory arrest, Pif decreased significantly to subatmospheric values, -0.8 +/- 0.8 and -3.3 +/- 1.2 mmHg in the dextran and histamine group, respectively (P < 0.05). The decrease in Pif in the nasal mucosa after inflammatory stimuli, during circulatory arrest, provides further evidence for "active" modulation of Pif through changes in mechanical properties of the interstitial matrix. The decrease in Pif seen under these circumstances reveals a possible mechanism participating in the rapid and initial edema formation after inflammatory provocations.

Animals↗

Summary report on the ISOBM TD-4 Workshop: analysis of 56 monoclonal antibodies against the MUC1 mucin. San Diego, Calif., November 17-23, 1996.

Sixteen research groups participated in the ISOBM TD-4 Workshop in which the reactivity and specificity of 56 monoclonal antibodies against the MUC1 mucin was investigated using a diverse panel of target antigens and MUC1 mucin-related synthetic peptides and glycopeptides. The majority of antibodies (34/56) defined epitopes located within the 20-amino acid tandem repeat sequence of the MUC1 mucin protein core. Of the remaining 22 antibodies, there was evidence for the involvement of carbohydrate residues in the epitopes for 16 antibodies. There was no obvious relationship between the type of immunogen and the specificity of each antibody. Synthetic peptides and glycopeptides were analyzed for their reactivity with each antibody either by assay of direct binding (e.g. by ELISA or BiaCore) or by determining the capacity of synthetic ligands to inhibit antibody binding interactions. There was good concordance between the research groups in identifying antibodies reactive with peptide epitopes within the MUC1 protein core. Epitope mapping tests were performed using the Pepscan analysis for antibody reactivity against overlapping synthetic peptides, and results were largely consistent between research groups. The dominant feature of epitopes within the MUC1 protein core was the presence, in full or part, of the hydrophilic sequence of PDTRAPAP. Carbohydrate epitopes were less easily characterized and the most useful reagents in this respect were defined oligosaccharides, rather than purified mucin preparations enriched in particular carbohydrate moieties. It was evident that carbohydrate residues were involved in many epitopes, by regulating epitope accessibility or masking determinants, or by stabilizing preferred conformations of peptide epitopes within the MUC1 protein core. Overall, the studies, highlight concordance between groups rather than exposing inconsistencies which gives added confidence to the results of analyses of the specificity of antimucin monoclonal antibodies.

Amino Acid Sequence↗

Analysis of the role of type 1 core O-glycans in the binding of anti-MUC1 antibodies by cytofluorometry and synthetic peptide/glycopeptide binding inhibition studies.

A panel of 56 MAbs submitted to the ISOBM TD-4 (MUC1) Workshop were analysed in two systems. These systems were designed to screen for peptide type 1 core O-glycan-related reactivities. Using synthetic MUC1 mucin-related peptides and glycopeptides, the panel of MAbs were tested for relative binding affinities to type 1 core O-glycan-substituted MUC1 structures. These studies utilized a competitive binding format with a native human adenocarcinoma-derived mucin as a solid phase. This system allows for analysis of the type 1 core glycoform subspecificity of each MAb. The second approach taken in parallel, utilized MCF-7 (BrCa) and OVCAR (OVCa) cell lines which were grown in the presence or absence of phenyl-N-acetylgalactosaminide (p-gal), a blocker of mucin O-linked glycosylation. These cells were analysed by FACS to examine the role these same glycan substitutions play with regard to either the diagnostic or therapeutic application of these MAbs. By FACS analysis there was a consistent increased 'epitope exposure' for peptide-specific MAbs binding in the presence of p-gal. In addition, a single MAb (TD-4 #150) is interpreted to react with a type 1 core O-glycan, probably with Tn, TF or STn specificity.

Amino Acid Sequence↗

Health system reform and the elderly: the case of Israel.

Following the implementation of the National Health Insurance Law in January 1995, major changes have taken place in the provision of health services by Israel's sick funds and the way these services are funded. This article presents the principal changes that have occurred and assesses their impact on those aged 65 and older, using findings of a survey conducted one year after the law's enactment. While the findings show that the elderly's situation has improved in some areas, they also raise concerns that the elderly are having difficulty navigating the reformed health system and that they are not benefiting from the new competition among the sick funds.

Aged↗

Cell interactions with collagen matrices in vivo and in vitro depend on phosphatidylinositol 3-kinase and free cytoplasmic calcium.

We have investigated the role of phosphatidylinositol 3-kinase (PI3-kinase) in cellular interactions with collagenous matrices. Platelet-derived growth factor-BB (PDGF-BB) elicited a mobilization of intracellular Ca2+ in pig aortic endothelial (PAE) cells transfected with wild type PDGF beta-receptor. This response was greatly reduced in PAE cells transfected with PDGF beta-receptors mutated at positions Y740 and Y751 to prevent PI3-kinase binding. The experimental drug 1D-myo-inositol 1,2,6-trisphosphate (alpha-trinositol) induced a rapid increase and subsequent oscillations of the cytoplasmic Ca2+ concentration in cultured fibroblasts. This response was not due to an effect of alpha-trinositol on inositol 1,4,5-trisphosphate (IP3) receptors. alpha-Trinositol did not influence PDGF-BB elicited chemotaxis through collagen-coated membranes of PAE cells transfected with the wild-type PDGF beta-receptor, but restored PDGF-BB elicited chemotaxis of PAE cells transfected with the PI3-kinase binding-site mutated PDGF beta-receptor. Collagen gel contraction has been suggested to serve as a model for cellular control of interstitial fluid pressure (PIF) in dermis. The PI3-kinase inhibitors wortmannin (50 nM) and LY294002 (5 microM) inhibited the stimulation of fibroblast-mediated collagen gel contraction by 0.4 nM PDGF-BB. Injection of wortmannin in rat paw skin induced a lowering of PIF, and this effect was abolished in animals pre-treated with alpha-trinositol. Pretreatment of rats with alpha-trinositol abolished the decrease in PIF induced by injecting monoclonal anti-rat alpha 2 beta 1 integrin IgG in rat paw skin. Taken together our data indicate that cell-collagen interactions in vivo and in vitro depend on PI3-kinase, and that this dependence can be bypassed by a drug eliciting intracellular Ca2+ mobilization.

Androstadienes↗

[Sports in the heart rehabilitation group--experiences with ambulatory rehabilitation at home].

Regular physical exercise has shown to be beneficial for patients with cardiovascular disease. Therefore cardiac rehabilitation in Germany is continued for years after hospital discharge in outpatient cardiac exercise groups which meet twice a week under the guidance of a physician and a sports instructor. Before participation cardiac patients have to be examined including exercise tests and echocardiography for assessment of contraindications for exercise therapy as well as individual exercise capacity. Patients are assigned to two groups with different levels of exercise intensity according to their symptom-free work-capacity (cutoff level 1 W/kg). During exercise sessions sports-specific forms of exercise such as stretching, aerobic exercise or ball games are accompanied by psychosocial elements such as stress management. This global approach is intended to improve cardiovascular risk factors, cardiac function, and work capacity as well as to stabilize the patient psychologically in order to accelerate social integration. Recently these groups have opened towards patients after cardiac transplantation or with severe heart failure. Therefore, cardiac exercise groups play a central role in cardiac rehabilitation long after the acute cardiac event.

Ambulatory Care↗

From the Editors.

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Journal Article↗

Zinc, iron, and magnesium status in athletes--influence on the regulation of exercise-induced stress and immune function.

Intense physical exercise has been shown to be associated with immunosuppression and increased rate of infection. The immunosuppressive effect of exhaustive exercise has been attributed to a reduced helper/suppressor T-cell ratio, low salivary levels of immunoglobulin-A, decreased lymphocyte proliferative response and natural killer cell activity, and elevation of stress hormones. Yet some athletes can withstand intense training periods without health problems while others are prone to infections. Thus it has been postulated that other factors may interfere with immunoregulation. The notion that macro- and micronutrients are involved in the regulation of immunological processes and the ability to cope with muscular and systemic exercise stress has been gaining attention. Particularly trace elements have been shown to be related to cell mediated and humoral immunity such as NK-cell activity, T- and B-cell functions, and cytokine release. Many investigations have reported decreased concentrations of trace elements in blood and tissues after training and competition. However, the magnitude of losses is highly dependent on the type and intensity of exercise, the individual regulatory state, and most important, nutrition. This paper reviews the data on zinc, iron, and magnesium status in athletes and summarizes the consequences of deficiencies in these trace elements regarding exercise tolerance and immune function. These elements were chosen since there is evidence they are related to exercise-induced stress and immune function.

Animals↗

Importance of TNF-alpha and leptin in obesity and insulin resistance: a hypothesis on the impact of physical exercise.

Obesity is associated with an increased incidence of insulin resistance, dyslipoproteinemia, and hypercoagulability. In a more recently established hypothesis of body weight control and regulation of metabolism, the adipocyte secretes leptin and locally expresses TNF-alpha, the latter being responsible for the expression of metabolic cardiovascular risk factors. TNF-a mRNA expression and TNF-alpha protein are greatly increased in adipose tissue from obese animals and humans. Elevated TNF-alpha expression induces insulin resistance by downregulating the tyrosine kinase activity of the insulin receptor and decreasing the expression of GLUT-4 glucose transporters. TNF-alpha also reduces lipoprotein lipase activity in white adipocytes, stimulates hepatic lipolysis, and increases plasminogen activator inhibitor-1 content in adipocytes. Moreover, adipocytes secrete leptin, a molecule with a secondary cytokine structure whose concentrations correlate with the amount of fat tissue. Increased leptin levels downregulate appetite and increase sympathetic activity and thermogenesis in the hypothalamus. Diet-induced weight loss reduces adipose TNF-alpha expression and serum leptin levels and is associated with improved insulin sensitivity and lipid metabolism. Although exercise has also been shown to reduce leptin levels, an influence on TNF-a expression in adipocytes or muscle cells has not yet been demonstrated.

Animals↗

alpha-Trinositol prevents increased negativity of interstitial fluid pressure in rat skin and trachea induced by dextran anaphylaxis.

The new anti-inflammatory agent alpha-trinositol (D-myo-inositol-1,2,6-trisphosphate), is suggested to act on the cellular adhesion receptor towards extracellular matrix components, the beta1-integrins, and may therefore represent a novel principle for therapy of the phenomena associated with acute inflammation. Increased negativity of interstitial fluid pressure (p(if)) is a major driving force for the rapid edema formation in trachea and skin associated with dextran anaphylaxis in the rat. We therefore used this experimental model to study the effect of alpha-trinositol in skin and trachea of pentobarbital anesthetized rats. p(if) was measured with sharpened glass capillaries (3-7 microm) connected to a servocontrolled counterpressure system. alpha-Trinositol (10 mg) was given before or after dextran. Circulatory arrest was induced 2 min after i.v. dextran to limit the increased capillary fluid filtration associated with the anaphylactic reaction. This increased filtration will otherwise raise interstitial volume and thereby p(if) and cause an underestimation of a potential increased negativity of p(if). In the trachea, p(if) was 0.0 +/- 1.0 mmHg (S.D.) and -1.4 +/- 0.5 mmHg in controls given saline vehicle and alpha-trinositol (P > 0.05), respectively, and fell to -8.5 +/- 2.7 mmHg after dextran (P < 0.01). alpha-Trinositol given 2 min prior to or after dextran resulted in p(if) of -1.7 +/- 1.2 mmHg (P > 0.05 versus control, P < 0.01 versus dextran) and -4.7 +/- 3.0 mmHg (P < 0.01 versus control and dextran), respectively. In skin, i.v. dextran caused p(if) to fall from -0.6 +/- 0.5 to -4.6 +/- 1.9 mmHg (P < 0.001). When alpha-trinositol was given prior to dextran the corresponding figures were -0.4 +/- 0.8 and -0.9 +/- 1.1 mmHg, respectively (P > 0.05). Subdermal administration of alpha-trinositol after i.v. dextran and circulatory arrest normalized p(if) in concentration of 100, 10 and partly at 1 mg/ml. Thus, alpha-trinositol prevented the increased negativity of p(if) induced by dextran anaphylaxis when administered prior to as well as after dextran showing that the alpha-trinositol also could influence an already started inflammatory reaction.

Anaphylaxis↗

Physical activity and lipoprotein metabolism: epidemiological evidence and clinical trials.

Prospective epidemiological studies have proven a close link between the lipoprotein profile and cardiovascular morbidity and mortality. As physical activity is accepted as a significant factor improving physical fitness and lipoprotein metabolism, there is evidence that physically active men have a lower cardiovascular risk due to their higher metabolic fitness. Physical activity and physical fitness are generally linked to higher HDL cholesterol and lower LDL cholesterol as well as lower triglyceride and insulin levels. However, in cross-sectional studies the differences in lipoprotein cholesterol evaluated by routine measures in healthy physically active individuals and sedentary controls are only minor compared to therapeutical aims. The impact of exercise and training is often more significant when the effect of exercise on lipoprotein subfractions and apolipoprotein levels are taken into account. Dramatic differences can be documented in concentrations of cardioprotective HDL subset2 and atherogenic small, dense LDL subset6 levels in relation to the individual status of aerobic fitness and body composition in adults. These observations indicate that the preventive and therapeutical use of physical activity is of particular significance in a population of cardiovascular risk or patients with reduced daily activity. Our own experience in clinical trials shows that even in short-term programs (4 weeks to 6 months) changes in activity and eating behavior may lead to important improvements of the metabolic risk and lipid profile. Understanding the complex interaction between exercise and metabolic control of the lipid profile as well as the correlation with other risk parameters will improve the knowledge of prescribing exercise programs in patients at risk.

Adult↗

A 1H NMR study of the paramagnetic active site of the CuA variant of amicyanin.

The dinuclear paramagnetic center of the CuA variant of the cupredoxin amicyanin has been investigated using 1H NMR. The hyperfine-shifted resonances have been assigned using a combination of 1D NOE difference and 2D WEFT-NOESY spectroscopy. The shifts experienced by the assigned resonances have been used to calculate hyperfine coupling constants for these protons from which the spin density distribution on the ligands at the CuA center is obtained. A comparison with published data for the paramagnetic form of wild type amicyanin highlights a number of similarities and differences between these evolutionary related sites. In both cases 50-60% of the unpaired spin density is distributed on the ligands, which in the case of the CuA center involves two cysteine and two histidine ligands. The two weak axial interactions at the CuA center carry less than 1% spin density.

Amino Acid Sequence↗