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Biomedical subjects

B E Robinson

Publications and source records attributed to B E Robinson.

At least 73 records · Page 4Linked to original sources
PubMed1990

Hematopoietic growth factors: overview and clinical applications, Part III.

The growth and differentiation of blood cells is regulated by a group of at least 12 glycoproteins, collectively known as hematopoietic growth factors. Advances in protein biochemistry and molecular genetics have provided the tools for the bulk production of these hormones for clinical application. Clinical trials of macrophage colony-stimulating factor, granulocyte macrophage colony-stimulating factor, granulocyte colony-stimulating factor, and interleukin-3 have all demonstrated significant effects on the peripheral blood counts of the recipients. The clinical usefulness of at least two of these agents in ameliorating post-chemotherapy myelosuppression, in the treatment of other cytopenias, and in enhancing engraftment after bone marrow transplantation has already been demonstrated. Potential applications to the therapy and diagnosis of other clinical disorders is under study. The history of the elucidation of these growth factors, our current understanding of their properties, interactions, and clinical effects, and the potential prospects for their future use in the manipulation of human blood cell production are the subject of this review.

Animals↗
PubMed1990

Isolation of Gardnerella vaginalis from the reproductive tract of four mares.

A gram-variable pleomorphic bacillus was isolated from the reproductive tracts of 4 mares during routine prebreeding soundness examinations. Using a commercial bacterial identification system, these organisms were identified as Streptococcus acidominimus. However, colonial and Gram-staining characteristics did not support this identification. Subsequent testing indicated the organism was similar to Gardnerella vaginalis. Additional growth and biochemical analysis performed in our laboratory and at the Michigan Department of Public Health and by the Center for Disease Control, Atlanta, Georgia, confirmed the identification of G. vaginalis.

Animals↗
PubMed1990

Cunninghamella bertholletiae: an unusual agent of zygomycosis.

Cunninghamella bertholletiae shares many of the features typical of the other agents causing zygomycoses. Those who are immunocompromised constitute the major patient population at risk; the agents as a group are aggressive, the disease is often disseminated, and the pathologic picture of vascular invasion and tissue infarction is common. Unlike other agents of zygomycoses, Cunninghamella bertholletiae infection remains difficult to treat successfully even after early diagnosis and appropriate therapy.

Humans↗
PubMed1989

Outcomes of cardiopulmonary resuscitation in the elderly.

STUDY OBJECTIVE: To determine the success rate of cardiopulmonary resuscitation in the elderly and to define characteristics of elderly patients for whom cardiopulmonary resuscitation is effective. DESIGN: Retrospective chart review. SETTING: Five Boston health-care institutions: two acute-care hospitals; two chronic-care hospitals; and one long-term-care institution. PATIENTS: Five hundred and three consecutive patients aged 70 and over who received cardiopulmonary resuscitation. MEASUREMENTS AND MAIN RESULTS: Of 503 patients, 112 (22%) survived initially but only 19 (3.8%) survived to hospital discharge. The poorest outcomes were for patients with unwitnessed arrests (1 of 116 survived), terminal arrhythmias such as asystole and electromechanical dissociation (1 of 237 survived), and patients with cardiopulmonary resuscitation lasting more than 15 minutes (1 of 360 survived). Only 2 (0.8%; CI, 0.0% to 2.0%) of 244 patients with out-of-hospital cardiopulmonary arrests left the hospital alive. Of 259 patients with in-hospital arrests, 17 (6.5%; CI, 3.4% to 9.6%) survived to discharge. Most survivors had ventricular arrhythmias and were resuscitated within minutes. Initial survivors with either impaired consciousness or functional impairment after the arrest had significantly worse chances of survival than patients without these impairments. CONCLUSION: Cardiopulmonary resuscitation is rarely effective for elderly patients with cardiopulmonary arrests that are either out-of-hospital, unwitnessed, or associated with asystole or electromechanical dissociation.

Age Factors↗
PubMed1989

Response of parents to learning that their child is homosexual and concern over AIDS: a national study.

This study was a survey of 402 parents of gay and lesbian children from the northeastern, southern, midwestern, and western regions of the United States. Of particular interest was parental response to the knowledge of their child's homosexuality and the AIDS outbreak. Although parents suffered emotional upset upon learning of their children's homosexuality, many progressed through a five-stage grief process that ended with acceptance. Fear of the spread of AIDS, that their offspring might contract AIDS, or that their child might suffer from the backlash related to AIDS were concerns for most parents. Attitudes toward AIDS were not very different between mothers and fathers. However, older parents were more likely to have more positive attitudes toward AIDS than younger parents, and liberal parents were more likely to have a more positive outlook than their conservative counterparts.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Stimulation of murine colony-forming cells with high proliferative potential by the combination of GM-CSF and CSF-1.

Granulocyte-macrophage colony-stimulating factor (GM-CSF) has previously been shown to stimulate granulocyte, macrophage, and megakaryocyte lineages to act as an erythroid burst-promoting activity and to stimulate limited replication of spleen colony-forming cells. Here we demonstrate that murine GM-CSF alone or in combination with macrophage colony-stimulating factor (CSF-1) can stimulate colony-forming cells in bone marrow (BM) that have a high proliferative capacity. In cultures of BM from mice treated with 5-fluorouracil (FU) eight days before sampling, GM-CSF alone or in combination with CSF-1 stimulated the formation of large macrophage colonies with diameters greater than 0.5 mm. CSF-1 alone, at 800 units or greater, also stimulated larger colonies; however, these colonies were always less than 1.1 mm in diameter, whereas GM-CSF in combination with CSF-1 stimulated many colonies with diameters between 1 and 4 mm. At all doses of CSF-1 tested, the combination of factors resulted in a synergistic increase in colonies with diameters greater than 1.0 or 2.0 mm. Analysis of the incidence of colony-forming cells in the BM of normal mice and mice 2, 4, 6, and 8 days after FU treatment demonstrated that the progenitor cells stimulated by GM-CSF alone or in combination with CSF-1 were depleted by FU treatment in vivo and regenerated more rapidly than did the macrophage progenitors (M-CFC) stimulated by CSF-1 alone. This is similar to the properties of the previously described high-proliferative potential, colony-forming cell (HPP-CFC) that is responsive to interleukin-3 plus CSF-1 but not the HPP-CFC stimulated by hematopoietin 1 plus CSF-1. These data suggest that GM-CSF plus CSF-1 act synergistically to stimulate a population of progenitor cells that have a high proliferative potential and have properties similar to those of the population of HPP-CFC stimulated by interleukin-3 plus CSF-1.

Animals↗
PubMed1987

Recombinant murine granulocyte macrophage colony-stimulating factor has megakaryocyte colony-stimulating activity and augments megakaryocyte colony stimulation by interleukin 3.

Recombinant murine granulocyte macrophage colony-stimulating factor (rGM-CSF) has been produced in Escherichia coli and purified to homogeneity. GM-CSF has an established role as an in vitro regulator of granulocyte and macrophage colony formation. We have determined that rGM-CSF also has intrinsic activity as a megakaryocyte colony-stimulating factor and that rGM-CSF augments the effect of interleukin 3 (IL-3) on megakaryocyte colony formation. The dose-response curve for megakaryocyte colony induction with rGM-CSF showed plateau megakaryocyte stimulation at 9 ng/ml. When IL-3 (at a plateau dose for megakaryocyte colony induction) was added to rGM-CSF over a 0-22-ng/ml dose range, the resultant megakaryocyte colony stimulation approximated the sum of the levels of stimulation produced by either factor alone. These results establish GM-CSF as a multilineage growth factor with definite megakaryocyte colony-stimulating activity and indicate that both GM-CSF and IL-3 are important in the regulation of megakaryocytopoiesis.

Animals↗
PubMed1987

Stromal cell regulation of lymphoid and myeloid differentiation.

In vitro microenvironmental influences seem to be critical for both B lymphocyte and myeloid differentiation. Studies on murine Dexter cultures and Whitlock-Witte lymphocyte cultures suggest the presence of two critical stromal regulatory cells: an alkaline-phosphatase-positive epithelioid cell and a macrophage. Further data suggest that these cells are capable of producing colony stimulating factor-1, granulocyte-macrophage CSF, a myeloid synergizing activity, and probably separate B cell growth factors. Isolation of a cell line from Dexter stroma was accomplished and this line produced CSF-1, GM-CSF, a pre-B cell and myeloid synergizing activity, and an activity acting on differentiated B cells. We speculate that the Dexter and Whitlock-Witte in vitro culture systems are regulated by factors produced by the two adherent cell types. A lineage nonspecific factor capable of inducing cells into the B lineage or synergizing with interleukin-3, GM-CSF, and CSF-1 is produced, which presumably acts on early stem cells. In addition, the cell line produces GM-CSF, CSF-1, and a factor acting on differentiated B cells. We speculate that in these culture systems, these "terminal differentiating hormones" regulate the final pathway of differentiation, whereas the pre-B-synergizing activity supports early stem cells that can then respond to the other differentiating hormones.

Animals↗
PubMed1987

Self-concept and anxiety of adolescent and adult fathers.

This study examines the relationship between the age of unmarried fathers and their self-concept and anxiety level. A total of 24 unmarried fathers (12 adolescents and 12 adults) comprised the sample. No significant differences were found between adolescent and adult fathers on self-concept or anxiety level. Findings are discussed with regard to the current status of research on adolescent fathers.

Adolescent↗
PubMed1986

Legionella feeleii-associated pneumonia in humans.

Legionella feeleii has been implicated by serologic studies as the causative agent in an outbreak of Pontiac fever and has been recovered from an institutional water source. Pneumonia caused by this agent has not been described previously. The authors have isolated L. feeleii from two immunosuppressed patients with community-acquired pneumonia and from an institutional water source. One patient survived after treatment with erythromycin. The other patient was leukopenic and died of pneumonia. Isolates exhibited typical cultural and biochemical features of L. feeleii and reacted with L. feeleii serogroup 1 antiserum. L. feeleii serogroup 1 is now known to cause not only Pontiac fever but also pneumonia in humans.

Cross Infection↗
PubMed1986

Digitalis use in a retirement community.

Complex medical problems of older patients demand that particular care be taken with their use of digitalis. Although accounting for more than 5% of the top ten prescribed drugs in the United States, studies have suggested that digitalis use might be discontinued in some patients without harm. To assess the potential impact of these observations, a survey was conducted to evaluate the extent of digitalis use in a retirement community in Florida. The community under study consisted of approximately 5600 persons, mean age 72.6 years; 97% were over age 55. The sample of 463 telephone respondents reflected the local census. Digitalis preparations had been taken by 11.4% of the sample, of whom 60% (or 6.9% of the total sample) were currently taking them. Persons taking digitalis tended to be older (P less than .002) and reported worse overall health status than those not taking the drug (P less than .025). Seventeen percent of those who had stopped use of digitalis claimed adverse symptoms or "complications." Of Florida's 10 million population, 23% are over age 60, a proportion increasing yearly. This survey suggests that digitalis use in the elderly is widespread and a potentially important area for investigating management of cardiac problems in the elderly.

Aged↗
PubMed1986

Validation of the Functional Assessment Inventory against a multidisciplinary home care team.

Systematic multidimensional assessment techniques such as the Functional Assessment Inventory (FAI) are increasingly used with the elderly for outcome measurement, prediction of service needs, and accurate description for comparative purposes. The FAI is a structured interview followed by a rating process which compares patient status against standard descriptive phrases. Patients are assessed in five areas: mental health, physical health, social resources, economic resources, and activities of daily living (ADL). The validity of the FAI was tested by comparing ratings of patient health obtained by a single investigator using only the instrument with ratings obtained by consensus from an interdisciplinary home care team providing long-term care for the patients studied. An excellent level of agreement (weighted kappas from .583 to .780) was found in all areas studied. A single significant difference in ADL rating with a high correlation coefficient (r = .85) was interpreted as due to a difference between the single rater and the team in the definition of ADL. The ease of obtaining summary ratings from clinical personnel suggests that further exploration of this rapid quantification of patient health is warranted.

Activities of Daily Living↗
PubMed1986

Dementia: a three-pronged strategy for primary care.

A common mistake is prematurely reassuring the patient and family that "nothing is wrong" if history and physical--with or without a brief mental status exam--is reasonably normal. Caregivers should be informed that although a cure for dementia is seldom found, there often are targets for medical intervention that could lead to improved mental and physical function for the patient.

Aged↗