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Biomedical subjects

C A Abbott

Publications and source records attributed to C A Abbott.

34 records · Page 2Linked to original sources
PubMed1998

Multicenter study of the incidence of and predictive risk factors for diabetic neuropathic foot ulceration.

OBJECTIVE: To investigate longitudinally prognostic factors for foot ulceration in a large population of diabetic patients with established neuropathy. RESEARCH DESIGN AND METHODS: A double-blind multicenter study of a potential new agent for diabetic neuropathy provided the opportunity for this 1-year investigation since intervention demonstrated no efficacy in the condition. A total of 1,035 patients with NIDDM and IDDM were included. Inclusion criteria were vibration perception threshold (VPT) at the great toe > or = 25 V in at least one foot and < or = 50 V in both feet, normal peripheral circulation, and no previous foot ulceration. VPT and clinical components of the Michigan diabetic polyneuropathy (DPN) score were assessed at baseline and subsequent visits. RESULTS: After 1 year, the incidence of first foot ulcers for the total population was 7.2%. Neuropathy parameters were the same between the treatment and placebo groups at baseline and were unchanged at 1 year; therefore, baseline data were combined for multiple regression analysis. VPT, age, and Michigan DPN scores for muscle strength and reflexes were significant independent predictors for first foot ulceration (P < 0.01). For each 1-U increase in VPT values at baseline, the hazard of the first foot ulcer increased by 5.6%. Similarly, for each 1-U increase in muscle strength and reflex components of the Michigan DPN scores, the hazard of the first foot ulcer increased by 5.0%. CONCLUSIONS: Tests of VPT and Michigan DPN scores for muscle strength and reflexes are useful clinical predictors for foot ulceration in diabetic patients with established neuropathy. The rate of subsequent ulceration in the following year was alarmingly high, however, despite standardized foot care education at baseline and regular follow-up visits.

Adult↗
PubMed1997

A randomised controlled trial of topical glycopyrrolate, the first specific treatment for diabetic gustatory sweating.

The treatment of gustatory sweating in diabetes mellitus is usually with oral anti-cholinergic drugs, but these frequently lead to unacceptable side effects. Glycopyrrolate is an anti-muscarinic agent that can be applied topically and is efficacious in gustatory sweating occurring in other conditions. In a double-blind placebo-controlled crossover study, we assessed the value of glycopyrrolate in 13 diabetic patients with gustatory sweating. Sweating was measured by a sweat challenge, and diaries recorded by the patients throughout the 2 weeks of each treatment period. Compared to placebo, glycopyrrolate reduced the sweat response to a challenge by 82% (p < 0.01). The frequency of episodes of gustatory sweating during the treatment period was also reduced by 51% (p < 0.01), with a nearly 100% reduction in the frequency of episodes of severe sweating (p < 0.01). In conclusion, topically applied glycopyrrolate is a very effective treatment in reducing both the severity and frequency of diabetic gustatory sweating.

Administration, Topical↗
PubMed1995

Serum paraoxonase activity, concentration, and phenotype distribution in diabetes mellitus and its relationship to serum lipids and lipoproteins.

Human serum paraoxonase is physically associated with HDL and has been implicated in the detoxification of organophosphates and possibly in the prevention of LDL lipid peroxidation. We investigated the serum activity and concentration of paraoxonase in 78 patients with type 1 diabetes mellitus, 92 with type 2 diabetes, and 82 nondiabetic control subjects. Paraoxonase activity was generally lower in diabetics than in control subjects. This decrease was unrelated to differences in paraoxonase phenotype distribution or its serum concentration. Rather, the difference in paraoxonase activity was explained by its specific activity, which was lower in diabetics, indicating either the presence of a circulating inhibitor or disturbance of the interaction of paraoxonase with HDL affecting its activity. Paraoxonase specific activity was lowest in patients with peripheral neuropathy, suggesting an association of paraoxonase with neuropathy. In control subjects but not patients with diabetes, paraoxonase correlated with HDL cholesterol and apolipoprotein A-1. Our results indicate that the low paraoxonase activity in diabetes is due to decreased specific activity. In other studies low serum paraoxonase activity has been associated with increased susceptibility to atherosclerosis, and the present results also suggest an association with peripheral neuropathy, which could be due to reduced capacity to detoxify lipid peroxides in diabetes.

Adult↗
PubMed1994

Genomic organization, exact localization, and tissue expression of the human CD26 (dipeptidyl peptidase IV) gene.

CD26 is a lymphocyte cell surface antigen which is increased during T-cell activation and is also expressed in other tissues. It is an atypical serine protease belonging to the prolyl oligopeptidase family. CD26 has been implicated in a variety of biological functions including T-cell activation, cell-to-cell adhesion, and recently in HIV infection. This paper describes, through the isolation and partial sequencing of eight human CD26 genomic clones, the first information on the genomic organization of the prolyl oligopeptidase family. We have established that the human CD26 gene spans approximately 70 kilobases (kb) and contains 26 exons, ranging in size from 45 base pairs (bp) to 1.4 kb. The nucleotides that encode the serine recognition site (G-W-S-Y-G) are split between two exons. This clearly distinguishes the genomic organization of the prolyl oligopeptidase family from that of the classical serine protease family. The 5' flanking domain of the CD26 gene contains neither a TATA box nor a CAAT box, but a 300 bp region extremely rich in C and G (72%) contains potential binding sites for several transcriptional factors. The human CD26 gene encodes two messages sized at about 4.2 and 2.8 kb. These are both expressed at high levels in the placenta and kidney and at moderate levels in the lung and liver. Only the 4.2 kb mRNA was expressed at low levels in skeletal muscle, heart, brain, and pancreas. Fluorescence in situ hybridization on metaphase chromosome spreads located the human CD26 gene to the long arm of chromosome 2(2q24.3).

Amino Acid Sequence↗
PubMed1994

Intraoperative nursing activities performed by surgical technologists.

In this study of delegated intraoperative nursing activities performed by surgical technologists (STs) in low-risk and high-risk surgical procedures, 343 OR directors, perioperative nurses, and STs from rural, community, and medical center hospitals reported that STs frequently perform activities related to surgical counts, the sterile field, and equipment and supplies. Surgical technologists do not frequently perform tasks related to patient transportation, teaching, medication administration, OR environment, patient monitoring, and patients' rights. The investigator used nine competency statements of intraoperative nursing as a framework for the research instrument. Data analysis determined that the levels of risk in patient situations affects how frequently STs perform transportation, teaching, sterile field, OR environment, and patients' rights activities.

Clinical Competence↗
PubMed1994

Functional assessment in ankylosing spondylitis: evaluation of a new self-administered questionnaire and correlation with anthropometric variables.

We describe the development of a new self-administered questionnaire for assessment of specific disability in ankylosing spondylitis (AS). The questionnaire was derived both from discussion with patients and from previous published material and covered four main areas of function: mobility, bending down, reaching up and neck movements, and posture. Four categories of response were available similar to the Stanford Health Assessment Questionnaire and the questionnaire was similarly scored providing a range of scores from 0-3. The questionnaire was found to be acceptable, understandable, easy to complete and fulfilled recognized criteria for reproducibility and validity. A significant improvement in functional score as a result of treatment was found in a longitudinal study of physiotherapy in 42 subjects with AS (pre-treatment score 1.23 +/- 0.79, post-treatment 1.07 +/- 0.75 P < 0.01). The areas which showed the most improvement were mobility, bending and posture. Functional scores correlated well with some anthropometric variables, particularly cervical movements, finger to floor distance and chest expansion. Both spinal and peripheral joint impairment contributed to functional disability.

Anthropometry↗
PubMed1993

Is paraoxonase related to atherosclerosis.

Human serum paraoxonase is responsible for the hydrolysis of organophosphate anticholinesterases, however, whether the enzyme has a physiological role other than the detoxication of insecticides and nerve gases has remained uncertain. Recently, evidence has begun to accumulate of a relationship between the serum activity of paraoxonase and atherosclerosis. Paraoxonase may a fundamental role in lipoprotein metabolism, preventing oxidative changes to low-density lipoprotein which render the particle atherogenic.

Arteriosclerosis↗
PubMed1993

Relationship between serum butyrylcholinesterase activity, hypertriglyceridaemia and insulin sensitivity in diabetes mellitus.

1. The activity of serum butyrylcholinesterase ('pseudocholinesterase', EC3.1.1.8) was investigated in 56 patients with type 1 diabetes mellitus, 51 patients with type 2 diabetes mellitus and 101 healthy control subjects. 2. Butyrylcholinesterase activity was significantly elevated in both type 1 (8.10 +/- 3.35 units/ml) and type 2 (7.22 +/- 1.95 units/ml) diabetes compared with the control subjects (4.23 +/- 1.89 units/ml) (P < 0.001). 3. In the patients with type 1 and type 2 diabetes, serum butyrylcholinesterase activity was correlated with log serum fasting triacylglycerol concentration (r = 0.41 and r = 0.43, respectively, P < 0.001). In the type 2 population serum butyrylcholinesterase activity was also correlated with insulin sensitivity (r = -0.51, P < 0.001). 4. Serum butyrylcholinesterase activity was unrelated to age, gender, serum gamma-glutamyltranspeptidase activity, body mass index, or treatment for diabetes in both the diabetic populations. 5. In 37 non-diabetic patients with butyrylcholinesterase deficiency serum triacylglycerol levels were in the normal range. 6. These results are consistent with the view that butyrylcholinesterase may have a role in the altered lipoprotein metabolism in hypertriglyceridaemia associated with insulin insensitivity or insulin deficiency in diabetes mellitus.

Butyrylcholinesterase↗
PubMed1992

A single beta-globin locus control region element (5' hypersensitive site 2) is sufficient for developmental regulation of human globin genes in transgenic mice.

The beta-globin gene complex is regulated by an upstream locus control region (LCR) which is responsible for high-level, position-independent, erythroid-cell-specific expression of the genes in the cluster. Its role in the developmental regulation of beta-like globin gene transcription remains to be established. We have examined the effect of a single LCR element, hypersensitive site 2 (HS2), on the developmental regulation of the human fetal gamma and adult beta genes in transgenic mice. In mice bearing HS2A gamma beta and HS2G gamma A gamma-117 delta beta human globin gene constructs, switching from gamma- to beta-gene expression begins at about day 13.5 of gestation and is largely completed shortly after birth. The larger construct also demonstrates a switch in G gamma- to A gamma-gene expression during the gamma-to-beta switch similar to that observed during normal human development. We conclude that HS2 alone is sufficient for developmental regulation of the human beta-globin genes.

Aging↗
PubMed1991

Regulation of human fetal and adult globin genes in mouse erythroleukemia cells.

We have examined whether transfected mouse erythroleukaemia (MEL) cells can be used to examine differential expression of human gamma- and beta-globin genes. These cells, which express only their adult globin genes, will transcribe the human adult beta gene but not the fetal gamma genes when they are introduced on an intact human chromosome 11 by cell fusion. However, MEL cells stably transfected with the human A gamma gene attached to one of the active elements (HS2) of the beta-globin locus control region (LCR) readily produce gamma-globin mRNA in amounts equivalent to those seen with a comparable beta gene insert. When both beta and gamma genes are attached to HS2, equal amounts of beta A gamma mRNAs are produced, irrespective of the gene order. Furthermore, when HS2 is inserted into the 5' end of a 40-kb cosmid containing the G gamma A gamma-117 delta beta genes in their normal chromosomal organization (but with the Greek HPFH -117 A gamma gene mutation), it directs expression of readily detectable amounts of G gamma A gamma and beta-globin mRNAs in MEL cells. Therefore, under these circumstances we have observed no competition between beta and gamma genes for expression in MEL cells. These findings suggest that MEL cells are capable of perpetuating regulatory information involved in developmental control when it is provided by an intact chromosome, but are incapable of reconstructing such information on transfected DNA.

Adenine Phosphoribosyltransferase↗
PubMed1989

Delegating intraoperative activities. A pilot study.

The purpose of phase one of this descriptive study was to obtain information about the research process. We identified problems associated with the pilot and examined the feasibility of completing phase two of the study at the national level. The pilot provided insight into the weaknesses and strengths of the tool design. It also identified interesting trends and data regarding delivery of intraoperative nursing care. The pilot study supported the ultimate goals of the research project, and we plan to continue with phase two of the study. Further research is needed to substantiate the findings and solidify the implications for perioperative nursing.

Clinical Competence↗
PubMed1987

The impaired nurse. Part II: Management strategies.

The perioperative nurse manager faces an ethical dilemma when faced with an impaired colleague. An effort to support impaired practitioners and to ensure patient safety and quality of care seem incompatible. To facilitate both, violations of the state nurse practice act must be reported, and the employee terminated if your documentation is adequate and treatment options you offer are not pursued. This harsh approach is necessary when the impaired practitioner puts patient care at risk. Kindness promotes chemical dependency, and the harsh action may be the only event that breaks through the denial. Fifteen percent of impaired practitioners who receive coordinated, supportive, and confrontational management are not motivated to seek treatment. Nurses must remember, however, that the remaining 85% respond positively to an established and comprehensive chemical dependency policy. Defined decision-making strategies concerning chemical dependency at the state and local level motivate practitioners to seek treatment to avoid licensure action. Perioperative nurses must meet the challenge to effectively manage chemical dependency. Employing recovering nurses in a structured framework is creative resource management. The ability to conserve talented and skilled practitioners preserves the nurturing strength of nurses and increases professional cohesion.

Drug and Narcotic Control↗
PubMedDate not supplied

CD26.

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Adenosine Deaminase↗