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Biomedical subjects

A Carlson

Publications and source records attributed to A Carlson.

51 records · Page 3Linked to original sources
PubMed1988

Diabetes control program implementation: on the importance of staff involvement.

The Stockholm County Council adopted a diabetes control program in 1979. Eleven percent of the 94 PHC centers had fully implemented the program by 1983. In this study we have tried to analyse roadblocks to the implementation of the program. Twenty primary health care centers were studied through questionnaires to physicians and nurses in the centers. Ten of the centers had implemented the program and ten had not. The percentage of trained staff; work-load; and demografic factors were similar in the two groups. The two groups of centers differed significantly with regard to interaction among the staff and involvement in decision making. The results imply that the staff should be involved in the process of planning and organizing the routines needed, in order to facilitate the local implementation of a program in each unit.

Adolescent↗
PubMed1988

Splenocyte natural killer cell activity and metastatic potential are inversely dependent on estrous stage.

We have previously shown that the timing of surgical removal of an estrogen-receptor-bearing mammary adenocarcinoma within the estrous cycle of the female C3HeB/FeJ mouse profoundly influences the frequency of subsequent tumor cell metastasis. In order to investigate the role of the immune response in this phenomenon, we measured splenic natural killer (NK) cell activity and interleukin-2 (IL-2) production in 80 female cycling mice, 16 to 18 weeks old, assigned to one of four estrous stages as determined by relative quantity of vaginal cellularity; proestrus, estrus, metestrus, and diestrus. After prolonged synchronization on 12-hours-on, 12-hours-off light-dark circadian schedules, daily vaginal smears were obtained for 2 weeks to characterize estrous cycling. On the day the animals were killed, vaginal smears were performed and single-cell suspensions were prepared from the harvested spleens. Direct cytotoxicity of spleen cells against the YAC tumor target was assessed immediately in a 3 1/2 hour 51Cr release assay and expressed as NK activity in lytic units (LU 20%). IL-2 production was determined in a bioassay with the IL-2-dependent CTLL-2 cell line. Significant differences in NK activity among estrous stages mimicking the variation found in frequency of surgical cure from mammary adenocarcinoma were observed (p = 0.035; one-way analysis of variance), with the time of lowest metastatic potential corresponding precisely with the time of highest splenocyte NK activity. These both occurred during the proestrus and estrus stages, characterized by high fertility, ovulation, and peak FSH, LH, and estrogen concentrations. In addition, NK activity was found to correlate significantly with IL-2 production (r = 0.4, p less than 0.0005). These results indicate that important components of the cellular immune response to cancer vary rhythmically with hormonal changes in the host and may represent one of the factors affecting the delicate balance between host and tumor that alters the frequency of postsurgical metastatic dissemination.

Animals↗
PubMed1987

Lipoxygenase pathway inhibition impairs the allograft response.

The inflammatory response may play a critical role in determining the ultimate fate of the allograft. Certain inflammatory mediators derived from the arachidonic acid lipoxygenase pathway (e.g., leukotriene B4), stimulate T cell function in vitro, but their role in allograft rejection is unknown. Nordihydroguaiaretic acid (NDGA) inhibits both the lipoxygenase (LO) pathway and T cell function in vitro. In this study, we investigated the effects of systemic LO inhibition with NDGA on the in vivo generation of allospecific and natural killer (NK) effector cells and arachidonic acid metabolites from sponge matrix allografts in mice. In control animals, generation of both allospecific cytolytic and NK cells increased progressively up to 12 days after grafting. Sponge cell synthesis of both leukotriene B4 (LTB4) and the cyclooxygenase product prostaglandin E2 (PGE2) could also be detected over this period. Recipient NDGA treatment (50 mg/kg/day) impaired both the accumulation and the specific cytotoxic potential of lymphocytes in allograft. Compared with control animals (1196 +/- 30 pg/10(6) cells), cells from recipients of NDGA produced significantly less LTB4 (55 +/- 10 pg/10(6) cells, p less than 0.01) but produced normal amounts of PGE2 (340 +/- /255 +/- 22 pg/10(6) cells, p = NS), thus proving the specificity of the NDGA treatment on LO pathway function. We conclude that cells capable of metabolizing arachidonic acid by both pathways accumulate in sponge allografts, but LO activity is specifically suppressed by systemic NDGA. Furthermore, systemic LO inhibition reduces the nonspecific inflammatory component, as well as allospecific cytolytic and NK generation, without compromising animal survival. These studies suggest that suppression of specific components of the inflammatory response associated with allograft rejection by LO inhibition may be a useful approach to selective immunosuppression.

Animals↗
PubMed1985

The centralized prenatal genetics screening program of New York City III: The first 7,000 cases.

The Prenatal Diagnosis Laboratory of New York City (PDL) is a regional program for the prevention of genetic diseases. The administrative aspects of the establishment of the laboratory were described in papers I [Hsu, 1981] and II [Hsu and Benn, 1981] in this series. We now report our experience of the first 7,000 referrals to the laboratory. The laboratory achieved a success rate of 99.5% in obtaining a diagnosis. The frequency with which a repeat amniocentesis was required was 1.9%, usually attributable to inadequate initial amniotic fluid volume or condition. Cases were completed in an average time of 20.82 days. A total of 149 (2.13%) cytogenetic abnormalities were detected. There were 59 nonmosaic autosomal trisomies and 29 sex chromosome abnormalities. The incidence of unbalanced structural abnormalities (0.186%) was much higher than that reported in surveys of newborn infants largely because of the prenatal detection of cases with supernumerary chromosomes. The incidence of balanced structural abnormalities was also considerably higher than that found in surveys of the newborn population, in part because of the detection of subtle familial pericentric inversions of common chromosome regions (inv(Y)(p11q11), inv(2) (p11q13), and inv(1)(p11q13)). The incidence of cases with multiple independent chromosome abnormalities was no higher than expected by chance. A high incidence of mosaicism, pseudomosaicism, and maternal cell contamination was found. Screening for neural tube defects accounted for the detection of a further 16 abnormalities. Nearly all women with severely abnormal fetuses (trisomy 13, 18, 21) elected to terminate their pregnancy whereas only 62% of patients with a prenatally diagnosed sex chromosome abnormality elected to terminate their pregnancies. Full details of follow-up and confirmatory studies for unusual diagnoses are reported. Utilization of prenatal diagnosis in the New York City area has increased sharply since PDL became operational. The laboratory's success illustrates the role of a prenatal diagnosis laboratory that provides a service independent of the patient's financial status. The experience further shows the high degree of acceptance of prenatal diagnosis by individuals at high risk for a child with a genetic disorder.

Amniocentesis↗
PubMed1983

Unexpected death of an infant sibling.

When infants die suddenly and unexpectedly, family structures are abruptly altered. This loss and its subsequent changes affect remaining older siblings. New "big brother" and "big sister" roles are suddenly terminated, often in a catastrophic manner. Young surviving children are sometimes unable to understand the meaning of this event, its impact on the family, and their own role in what has occurred. In this study, 26 families that had sustained the sudden and unexpected death of an infant and that had surviving children were interviewed to obtain data about surviving siblings at least 10 months following the loss. Among the 26 families, there were 35 surviving siblings (ages 16 months to 6 years). The interview schedule sought information relevant to changes in patterns of sleep, toilet training, feeding habits, peer relationships, and parent-child interaction. Among these 35 surviving siblings, parents of 28 siblings (80%) perceived changes in their child's interaction with them, 24 siblings (69%) demonstrated changes in sleep patterns following the baby's death, and 13 siblings (37%) showed changes in social interaction. Regression in toilet training and changes in feeding patterns were infrequent and not areas of major concern for parents. These behavioral changes reflected both a continuum of adjustment by the child and a persistence of parental worries.

Birth Order↗
PubMedDate not supplied

Release and recovery of porcine pepsin and bovine chymosin from reverse micelles: a new technique based on isopropyl alcohol addition.

After complete solubilization by the direct method, porcine pepsin was not released from AOT in isooctane reverse micelles even under aqueous-phase conditions which would not ordinarily allow uptake. Similarly, bovine chymosin, once forward-transferred at a pH below its isoelectric point, was not back-transferred into an aqueous contact phase buffered at a pH value above its isoelectric point. These results show that there is significant hysteresis in the forward- and backward-transfer processes and further imply that kinetics, and not equilibrium, control uptake or release processes for these enzymes. The addition of 10-15% isopropyl alcohol to the aqueous phase increases the rate of protein release dramatically and allows for nearly complete back-transfer of porcine pepsin and 70% back-transfer of bovine chymosin. IPA addition does not destroy the functional integrity of the system since forward transfer of bovine chymosin still occurs at pH values below (but not above) the pI of the protein.

1-Propanol↗
PubMedDate not supplied

Polyagglutination due to combined T and Tk activation.

The development of polyagglutination in vivo in two patients with an unusual presentation of features of both T and Tk activation is described. The problems of laboratory diagnosis of these red blood cell anomalies and the impact of these anomalies in clinical management is discussed.

Absorption↗
PubMedDate not supplied

Health attitudes, self-monitoring of blood glucose, metabolic control and residual insulin secretion in type 1 diabetic patients.

The aim of the present cross-sectional study was to determine in patients who have had insulin-dependent diabetes mellitus for a long time, the relationship between residual insulin secretion and self-monitoring of blood glucose, psychological factors, and blood glucose control (HbA1c). In 97 patients with a disease duration of 9-16 years a sample from a 24-h urine collection was analysed for C-peptide excretion. In 35 of these patients an excretion greater than or equal to 0.2 nmol/24 h was detected. They were matched for age at onset and disease duration with patients without any detectable C-peptide excretion. Twenty-nine matched pairs were obtained and 22 of them have been further investigated. HbA1c was lower in the C-peptide excretors than in the non-excretors (6.9 +/- 0.3 vs 7.9 +/- 0.3%) (p less than 0.025). The patients were interviewed by means of a questionnaire dealing with their 'health beliefs'. It was shown that in the group with residual insulin secretion there was a significantly lower perceived risk of developing kidney disease (p less than 0.025) than in the group without residual insulin secretion, but in all other items measured there was no difference between the two groups. Furthermore, in the group with residual insulin secretion we found a correlation (p less than 0.01) of low HbA1c with high frequency of self-monitoring of blood glucose and high perceived vulnerability.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Diabetes care organization, process, and patient outcomes: effects of a diabetes control program.

Effects of a diabetes control program were evaluated in 17 primary health centers after 18 months' participation (17 nonparticipating centers served as controls). Studied were the effects of the program on the organization of diabetes care, on the process of care in terms of services delivered to patients, and on the outcomes of care as measured by improved self-care, dietary knowledge, and HbA1c values. While findings showed that patients from the intervention centers received a higher quality of service and monitored their blood glucose levels more often than did patients from the control centers, they did not demonstrate significantly better metabolic control. The reasons for this, and ways to improve the program are discussed.

Community Health Centers↗
PubMedDate not supplied

Evaluation of cross-protection afforded by a Salmonella Choleraesuis vaccine against Salmonella infections in pigs under field conditions.

This field study investigated the efficacy of a Salmonella Choleraesuis live vaccine (Argus SC) to reduce the number of infections with Salmonella. Twelve groups of about 380 pigs each were randomly allocated to either vaccination (V) or no vaccination (C). The vaccine was applied orally at 3 and 16 weeks. Forty pigs per group were blood sampled at 3, 10, 16, and 24 weeks to detect possible antibodies against Salmonella. The prevalence of Salmonella in the lymph nodes was the major variable. In the V groups, only 0.6% of the lymph nodes were positive, whereas 7.2% were positive in the C groups (p < 0.001). The percentage of seropositive pigs at 24 weeks (cut-off OD > 10) was 26% and 9% in the V and C groups, respectively (p < 0.001). The present study documented that vaccination with a live modified S. Choleraesuis vaccine is a useful tool to lower the prevalence of Salmonella in swine herds.

Animals↗