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Biomedical subjects

B Foley

Publications and source records attributed to B Foley.

At least 37 records · Page 2Linked to original sources

Detection of sporadic cases of Norwalk-like virus (NLV) and astrovirus infection in a single Irish hospital from 1996 to 1998.

BACKGROUND: 'Norwalk-like viruses' (NLV) and astroviruses are recognised as the most important etiologic agents of viral gastroenteritis, excluding rotaviruses. However, neither of these two groups of viruses is routinely screened for in Irish hospital laboratories. OBJECTIVE: The objective of this study was to examine faeces collected from patients with non-bacterial, non-rotaviral gastroenteritis and examine if NLVs and astroviruses could be identified as the causative agents of the illness. STUDY DESIGN: Faecal specimens were collected from a single Irish hospital from February 1996 to June 1998. Three hundred and sixty samples were tested for the presence of NLVs using newly designed inosine-containing degenerate primers. Two hundred and three faecal specimens from paediatric patients were screened for the presence of astroviruses. RESULTS: the results of the screening study were that 29 (8%) specimens were found to be positive for NLV by reverse transcription polymerase chain reaction (RT-PCR) and 15 (7%) specimens from paediatric patients were found to be positive for astroviruses. Genotyping of the NLV-positive samples determined that four of the isolates were from genotype I (G1) and 25 were G2. The G2 positive specimens were further subtyped by oligonucleotide probing and the majority (n = 21) were found to be subtype P2-B, with four isolates being typed as P2-A. No P1-B isolates were found. CONCLUSIONS: This is the first report of detection of sporadic cases of NLV and astrovirus in Ireland. The results obtained highlight the need for continued surveillance of these viruses and the development of rapid detection systems for use in clinical laboratories.

Adolescent↗

Quantifying GPIIb/IIIa receptor binding using 2 monoclonal antibodies: discriminating abciximab and small molecular weight antagonists.

BACKGROUND: Dosing of glycoprotein (GP) IIb/IIIa receptor antagonists is frequently based on the inhibition of platelet aggregation, which may be influenced by the agonist used or concurrent medications. Here we describe a monoclonal antibody-based technique to quantify total and ligand-occupied GPIIb/IIIa receptors. METHODS AND RESULTS: In vitro binding of monoclonal antibodies, LYP18 (Mab1) and 4F8 (Mab2), to the GPIIb/IIIa complex, was characterized using purified receptor and to platelets by flow cytometry. Patients undergoing coronary angioplasty received a single 20 mg dose of the oral GPIIb/IIIa antagonist, xemilofiban, or matching placebo, and antibody binding was compared with inhibition of platelet aggregation. Mab1 and Mab2 were bound to purified GPIIb/IIIa and to unoccupied, inactivated receptor on platelets. Mab2 identified the beta3 subunit, whereas Mab1 was complex-specific. Neither antibody interfered with the other's binding, suggesting that they identified distinct sites. Mab1 identified 53 300+/-5423 GPIIb/IIIa sites per platelet, whereas Mab2 identified 50 120+/-5066 sites per platelet. Mab1 binding was inhibited by abciximab in a dose dependent manner (IC50, 0.85+/-0.1 microg/mL), whereas Mab2 binding was unaffected. In contrast, the 2 small molecular weight antagonists, SC-57101A (IC50, 0.22+/-0.06 micromol/L) and eptifibatide (IC50, 0.35+/-0.14 micromol/L) inhibited Mab2 but not Mab1 binding. In patients treated with xemilofiban, Mab1 binding was unaltered but Mab2 binding decreased from 37 930+/-2061 sites per platelet at baseline to 8318+/-870 sites per platelet 6 hours after dosing (P<0.0001). Platelet aggregation to adenosine diphosphate (20 micromol/L) fell to 3+/-3% of baseline in line with the inhibition of Mab2 binding (correlation coefficient 0.8, P<0.0001). CONCLUSIONS: Mab1 and Mab2 bind to GPIIb/IIIa and are differentially displaced by abciximab and small molecular weight antagonists. These antibodies may be used to monitor receptor number and occupancy during administration of a GPIIb/IIIa antagonist.

Abciximab↗

Percutaneous catheter and guidewire fragmentation with local administration of recombinant tissue plasminogen activator as a treatment for massive pulmonary embolism.

The purpose of this article is to report four patients with massive pulmonary embolism treated with percutaneous catheter and guidewire fragmentation and local administration of recombinant tissue plasminogen activator (r-TPA). Four patients with massive pulmonary embolism initially underwent pulmonary angiography. Thrombus fragmentation was performed with both standard angiographic guidewires and catheters followed by local infusion of 41-200 mg of r-TPA. Pulmonary angiography was repeated after treatment. All patients survived with improvement in their clinical status and eventual discharge from hospital. Angiography in all patients post treatment demonstrated improvement in pulmonary perfusion (mean Miller score before treatment 22.5; mean Miller score after treatment 5.75). No patient had a significant complication. Mechanical fragmentation of the thrombus followed by local infusion of r-TPA was an effective treatment for massive pulmonary embolism in these four patients with no significant complications.

Aged↗

Passivity vs. militancy: a Q methodological study of nurses' industrial relations on Merseyside (England).

This paper describes a Q methodological study of accounts of nurses' industrial relations expressed by a sample of nurses (n = 60) drawn from the geographical area of Merseyside, United Kingdom (UK). The participants completed a 65-item Q sort made up of statements which could be ranked in terms of their relevance to an understanding of their industrial relations situation. Of interest was the importance of the narrative accounts which nurses draw upon in making sense of their employment relations, having the potential to underpin or delimit their actions. The notion of industrial action was an important focus of this research. Q methodology was chosen to allow the meaningful investigation of such subjectivity, with interesting tensions between differing notions of professionalism and militancy apparent from the analysis. Six accounts of industrial relations, which are available to be drawn on by nurses, are described and interpreted within a social constructionist framework. Some implications for the conduct of nurses' industrial relations in the UK are contemplated.

England↗

Surviving cancer competently intervention program (SCCIP): a cognitive-behavioral and family therapy intervention for adolescent survivors of childhood cancer and their families.

Psychological reactions to having had childhood cancer often continue after treatment ends, for survivors and their parents. Based on our previous research, we developed an intervention program for adolescent survivors of childhood cancer, their parents, and siblings. Surviving Cancer Competently: An Intervention Program--SCCIP--is a one-day family group intervention that combines cognitive-behavioral and family therapy approaches. The goals of SCCIP are to reduce symptoms of distress and to improve family functioning and development. SCCIP is described and data from a pilot study of 19 families are presented. Program evaluation data indicated that all family members found SCCIP helpful. Standardized measures administered before the intervention and again at 6 months after SCCIP showed that symptoms of posttraumatic stress and anxiety decreased. Changes in family functioning were more difficult to discern. Overall, the results were promising with regard to the feasibility of the program and its potential for reducing symptoms of distress for all family members.

Adaptation, Psychological↗

VP4 and VP7 genotyping of rotavirus samples recovered from infected children in Ireland over a 3-year period.

Between September 1995 and August 1998, the incidence and diversity of the main human rotavirus genotypes (G1, G2, G3, and G4 and P[8], P[4], P[6], and P[9]) among Irish children were determined by using established and adapted reverse transcriptase PCR-based genotyping methods. From a total of 193 rotavirus-positive specimens collected from nine hospitals we successfully identified the P type in 182 (94%) of the samples and the G type in 165 (85.5%) of the samples. Only four samples could not be assigned a G or P type. Two P types existed in Ireland, P[8] (78%) and P[4] (16%), and their relative incidence varied over the 3 years of this study. No P[6] or P[9] types were detected. G1 was the most predominant G type (55%), and the incidences of G2, G3, and G4 isolates were 15.5, 1, and 11%, respectively. Three percent of the samples tested had a mixed G type. A P and G type was assigned to 158 (81.8%) of samples. Of the typeable samples, G1 P[8] was the most prevalent (65%), whereas G2 P[4] (17%), G3 P[8] (1%), G4 P[8] (12%), and mixed types (all G1/ G4 P[8]) (4%) were detected less frequently. In the third year a significant genotypic shift from G1 P[8] to G2 P[4] and G4 P[8] was observed. During the study, we noticed that the inclusion of random primers during cDNA synthesis greatly increased the specificity of the PCR typing assays. No correlation was seen between the contributing hospitals and a specific genotype. In conclusion, the coverage of infection given by the recently licensed tetravalent vaccine would be significantly high in Ireland, although future monitoring of genotypic changes among Irish isolates should be encouraged.

Antigens, Viral↗

Impact of intravenous nitroglycerin on pulsed Doppler indexes of left ventricular filling in acute anterior myocardial infarction.

BACKGROUND: Restrictive transmitral Doppler flow patterns are associated with heart failure in acute myocardial infarction (AMI). METHODS AND RESULTS: The objective of this study was to evaluate the effect of intravenous nitroglycerin on the transmitral pulsed Doppler patterns in patients with anterior AMI. Twenty-four patients with anterior AMI were randomly assigned to receive incremental intravenous nitroglycerin or placebo over a 16-minute period with change to the other arm after a washout period. Left ventricular filling was assessed with transmitral pulsed Doppler echocardiography. According to the baseline E/A ratio, patients were divided into a restrictive group (n = 17, E/A ratio > or =21.4) and a nonrestrictive group (n = 7, E/A <1.4). In the restrictive group after administration of nitroglycerin the E/A ratio decreased (1.9+/-0.7 to 1.1+/-0.2, P < .001), E-wave peak velocity decreased (71+/-10 to 60+/-9 cm/s, P < .01), and A-wave peak velocity increased (39+/-9 to 58+/-8 cm/s, P < .01 ). In the nonrestrictive group there were no significant changes after nitroglycerin infusion in the E/A ratio (1.1+/-0.2 to 0.8+/-0.1, not significant), peak E-wave velocity (55+/-4 to 47+/-6 cm/s), and peak A-wave velocity (49+/-8 to 52+/-8 cm/s). Deceleration time increased significantly in both groups after administration of nitroglycerin. Placebo did not result in significant changes in hemodynamic or Doppler parameters in either group. CONCLUSIONS: Intravenous nitroglycerin administration was associated with reversal of restrictive left ventricular diastolic filling pattern on pulsed wave Doppler in patients with anterior AMI.

Aged↗

Evidence for copurification of HERV-K-related transcripts and a reverse transcriptase activity in human platelets from patients with essential thrombocythemia.

We have previously reported that particles resembling retroviral particles and possessing an RNA-directed DNA polymerase activity can be prepared from platelets. Furthermore, we and others have shown that these particles are present at higher levels in patients with essential thrombocythemia and polycythemia vera. We show here that these particles package RNA molecules that encode HERV-K-related pol genes. A subset of the RNA molecules that are packaged are likely to encode the RNA directed DNA polymerase activity and, because these RNAs possess long/full-length open reading frames for the reverse transcriptase and RNaseH (also for part of the integrase domains in genomic clones) of HERV-K, we propose that these transcripts are indeed strong candidates for encoding the enzyme activity found in these particles. Moreover, by using a modification of the polymerase chain reaction-based reverse transcriptase assay in which activated DNA is added during cDNA synthesis to suppress DNA polymerase-mediated RNA-directed DNA synthesis, we have found that the particle-associated enzyme behaves like a retroviral reverse transcriptase, further supporting the conclusion that retrovirus-like, perhaps HERV-K sequences, encode this enzyme activity.

Adult↗

Elevated levels of circulating soluble adhesion molecules in peripheral blood of patients with unstable angina.

We have demonstrated increased levels of the circulating soluble adhesion molecules (sCAMs), ICAM-1, VCAM-1, and E-selectin in patients with unstable angina compared with healthy controls. Our findings support the role of inflammation in clinically unstable coronary disease, and may indicate a potential role for measurement of peripheral sICAM levels as a marker for inflammatory activity in atherosclerotic plaque.

Adult↗

Elevated levels of circulating soluble adhesion molecules in patients with nonrheumatic aortic stenosis.

Increased serum levels of soluble adhesion molecules are found in various disorders of inflammatory or immunologic etiology. We found elevated levels of the soluble adhesion molecules ICAM-1, VCAM-1, and E-selectin in patients with nonrheumatic aortic stenosis, suggesting that inflammation may be important in the pathogenesis of this condition, which is generally believed to be degenerative.

Aortic Valve Stenosis↗

Emotional distress among males with "syndrome X".

The present study examined traditional risk factors and various indices of emotional distress in males with positive angiograms (N = 122), "syndrome X" males with negative or nominal results on angiogram (N = 53), and age- and socioeconomic status-matched males with no manifest history of otherosclerotic disease (N = 56). Syndrome X patients reported more depression on the Ketterer Stress Symptom Frequency Checklist (KSSFC) than positive angiographic patients. And compared with healthy controls, they were more likely to be perceived by a spouse/friend as depressed and anxious on the KSSFC, scored higher on the Framingham Type A Scale, and reported more unprovoked nocturnal awakening. Syndrome X patients generally appear to be similar to patients with positive angiograms with regard to traditional risk factor history but are more distressed than healthy controls. This becomes most evident when denial is circumvented by discussion with significant others or inquiries are "framed" appropriately.

Analysis of Variance↗

Adjustment in childhood brain tumor survival: child, mother, and teacher report.

Examined the adjustment of 6- to 18-year-old children and adolescents (n = 38) 2 to 5 years postdiagnosis of brain tumor with respect to standardized measures of anxiety and depression; self-perceptions; and adaptive living skills. Child, mother, and teacher report data were used. Maternal adjustment (anxiety and depression, parenting stress) was also assessed. Children and adolescents surviving brain tumors reported themselves to be generally within the normal range. However, maternal ratings of social problems were higher than normative scores and significantly lower than norms on social problems, scholastic competence, and communication skills. Teacher ratings on the Teacher Rating Form were all within normal limits. Maternal adjustment measures were within the normal range, although the Parent-Child Dysfunctional Interaction subscale of the Parenting Stress index was elevated. No differences in scores were found between children in regular and special education, or between children who had received radiation and those who did not. This sample of survivors of pediatric brain tumors and their mothers had relatively mild problems in adjustment, supporting a competency-based view of the adaptation of pediatric patients and their families.

Adaptation, Psychological↗

Maintaining the integrity of human immunodeficiency virus sequence databases.

Human immunodeficiency virus type 1 (HIV-1) sequences are accumulating in the literature at a rapid pace. For this ever-expanding resource to be maximally useful, it is critical that researchers strive to maintain a high level of quality assurance, both in experimental design and conduct and in analyses. Here we present detailed analyses of problematic sets of HIV-1 sequences in the database that include sequence anomalies suggestive of mislabeling or sample contamination problems. These data are examined in the context of currently available HIV-1 sequence information to provide an example of how to identify potentially flawed data. Indicators of potential problems with sequences are (i) sequences that are nearly identical that are supposed to be derived from unlinked individuals and that are markedly distinct from other sequences from the putative source or (ii) sequences that are nearly identical to those of laboratory strains. We provide an outline of methods that researchers can use to perform preliminary laboratory and computational analyses that could help identify problematic data and thus help ensure the integrity of sequence databases.

Base Sequence↗

Failure of anti-T-cell receptor V beta antibodies to consistently identify a malignant T-cell clone in Sézary syndrome.

Monoclonal antibodies (MAbs) reacting with the human T cell receptor (TCR) V beta or V alpha region have been shown to be almost as specific as a private idiotypic MAb in identifying T cell clones. When available, V beta-specific MAbs offer the ease of immunofluorescence analysis to identify and quantitate expanded malignant or nonmalignant T cell populations without requiring polymerase chain reaction (PCR) technology to evaluate expression of V beta gene families. The V beta expression of peripheral blood lymphocytes from twenty-three consecutive patients with Sézary syndrome has been analyzed by reverse transcriptase (RT)-PCR. Ten patients had malignant T cell clones that expressed a TCR V beta corresponding to a commercially available anti-V beta antibody. Immunofluorescence staining with anti-V beta MAbs showed a direct correlation with RT-PCR results in seven of ten patients. No false positive reactivity was noted on immunofluorescence staining with any MAb. Cells from three patients, however, did not react with the corresponding anti-V beta MAb. These three cases expressed a TCR V beta from gene families containing a single member, ie, V beta 14, V beta 18, and V beta 20, yet MAbs reported to be specific for these regions failed to react with the T cell clone from these patients. Sequencing of the PCR product in these cases confirmed the RT-PCR results. Cells from two patients expressed a TCR using V beta 5.1-D beta 1.1 genes with different J-C segments. One patient's cells reacted with an anti-V beta 5.1 MAb (LC4) whereas the other patient's cells bound one-tenth the amount of this same MAb. These results indicate that currently available anti-TCR V region MAbs may not react consistently with T cell clones expressing the corresponding V region or may react with a low affinity making detection difficult. Differences in the J-C junction or in CDR3 may influence the binding of these MAbs. Until the false negative rate is reduced and the fine specificity and affinity of these MAbs is better characterized, both PCR and MAb studies will be required to reliably identify and quantitate clonal T cell populations.

Amino Acid Sequence↗

Autologous blood use in reduction mammaplasty: is it justified?

A study was undertaken to evaluate the current use of autologous blood predonation within 3 weeks of reduction mammaplasty in our institution. A retrospective study of 153 consecutive patients undergoing reduction mammaplasty between April of 1987 and October of 1992 was analyzed. Nine patients were excluded because of inadequate data, leaving 81 patients in the autologous blood predonation study group and 63 patients in the control group. The two groups were similar with regard to age, preintervention hemoglobin levels, technique of reduction mammaplasty, average number of grams excised per side, estimated blood loss, and duration of hospital stay. Those in the study group, despite preoperative iron therapy initiated just prior to the time of autologous blood donation, had significantly lower preoperative hemoglobin levels (p < 0.001). Seventy-two percent of those patients who donated blood preoperatively received all their blood intraoperatively or within 1 day of surgery. Eleven percent received 1 of their 2 units donated, and the remaining 17 percent were not transfused. Despite 83 percent of the study group patients receiving all or some of their predonated blood, their postoperative hemoglobin levels were not significantly different from those of the control group. We concluded that under our current program, autologous blood predonation for reduction mammaplasty is not beneficial to the patient in the immediate perioperative period.

Adult↗

Frequency of transient reductions in left ventricular ejection fraction at rest in coronary artery disease.

To determine the prevalence of decreases in left ventricular (LV) ejection fraction (EF) at rest in patients with coronary artery disease (CAD), including those with stable angina (n = 21), unstable angina (n = 13), and recent myocardial infarction (n = 11), continuous assessment of LV function for 162 +/- 136 minutes was performed using a new nuclear device. The results were compared with those of a group of normal subjects (n = 10) monitored for 80 +/- 28 minutes. Episodes of EF reduction of > 7% from baseline for a total duration of > 5% monitored time occurred in 0 of 10 normal subjects; episodes were more frequent in patients with stable angina (10 of 21, 48%; p = 0.01), with recent myocardial infarction (7 of 11, 64%; p = 0.004), and with unstable angina (11 of 13, 85%; p = 0.0001). The number of EF decreases per hour in patients after myocardial infarction (1.7 +/- 2.5 [SD]) and unstable angina (1.2 +/- 0.7) was significantly more frequent than in normal subjects (0.3 +/- 0.4), but was not different from that in patients with stable angina (0.8 +/- 1.0). The duration of the decrease in EF, expressed as minutes per hour of monitored time in normal subjects (0.7 +/- 1.0%), was significantly less than in patients with unstable angina (10 +/- 8%). Patients with stable angina (6 +/- 9%) and recent myocardial infarction (6 +/- 6%) were not significantly different from normal subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗