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Biomedical subjects

D Reed

Publications and source records attributed to D Reed.

At least 19 recordsLinked to original sources
PubMed2000

Sequence heterogeneity of TT virus and closely related viruses.

TT virus (TTV) is a recently discovered infectious agent originally obtained from transfusion-related hepatitis. However, the causative link between the TTV infection and liver disease remains uncertain. Recent studies demonstrated that genome sequences of different TTV strains are significantly divergent. To assess genetic heterogeneity of the TTV genome in more detail, a sequence analysis of PCR fragments (271 bp) amplified from open reading frame 1 (ORF1) was performed. PCR fragments were amplified from 5 to 40% of serum specimens obtained from patients with different forms of hepatitis who reside in different countries (e.g., China, Egypt, Vietnam, and the United States) and from normal human specimens obtained from U.S. residents. A total of 170 PCR fragments were sequenced and compared to sequences derived from the corresponding TTV genome region deposited in GenBank. Genotypes 2 and 3 were found to be significantly more genetically related than any other TTV genotype. Moreover, three sequences were shown to be almost equally related to both genotypes 2 and 3. These observations suggest a merger of genotypes 2 and 3 into one genotype, 2/3. Additionally, five new groups of TTV sequences were identified. One group represents a new genotype, whereas the other four groups were shown to be more evolutionary distant from all known TTV sequences. The evolutionary distances between these four groups were also shown to be greater than between TTV genotypes. The phylogenetic analysis suggested that these four new genetic groups represent closely related yet different viral species. Thus, TTV exists as a "swarm" of at least five closely related but different viruses. These observations suggest a high degree of genetic complexity within the TTV population. The finding of the additional TTV-related species should be taken into consideration when the association between TTV infections and human diseases of unknown etiology is studied.

Base Sequence↗
PubMed1999

Do elderly women have more physical disability than men do?

This study investigated whether the commonly observed higher prevalence of physical disability among women is due to higher incidence rates or to other factors such as selective mortality or poor recovery. Methods included observed measures of prevalent lower body physical disability and potential risk factors at baseline (1989-1991) and 4-year follow-up of 2,025 community-dwelling adults aged 55 years and older in Marin County, California. Incidence, recovery, and mortality rates were determined at the follow-up examination. Results indicated that women had higher age-specific and age-adjusted prevalence rates at both examinations (odds ratios = 1.66 and 1.60, p<0.001) but that incidence rates were not significantly different (odds ratio = 1.12, 95% confidence interval: 0.77, 1.64). In the classic formulation, prevalence = incidence x duration, the higher prevalence rates in women could not be due to a higher incidence rate, but could be explained by longer duration due to lower recovery and mortality rates in women. Incident physical disability was predicted by prevalent chronic illnesses, poor vision, obesity, physical inactivity, poor memory, fewer social activities, and higher depression scores, but not by sex. Prevention efforts should concentrate on reducing known risk factors in both men and women and on promoting higher recovery rates among women.

Aged↗
PubMed1999

cDNA and protein characterization of human MAGE-10.

MAGE genes are frequently expressed in several types of human malignancy and code for antigens recognized by cytotoxic T lymphocytes. We have previously described a monoclonal antibody (MAb), named 6C1, that recognizes the MAGE-1 protein and cross-reacts with a 72-kDa protein present in lysates of melanoma cells such as MZ2-MEL. To identify this protein, we have screened an expression library prepared from MZ2-MEL cells. Several clones that encoded a protein recognized by antibody 6C1 contained a sequence identical to that of MAGE-10, another member of the MAGE-A gene family. Full-length MAGE-10 cDNA clones, obtained after screening additional cDNA melanoma libraries, were found to be approximately 2.5 kb in length. In vitro translation and transient transfection experiments indicated that MAGE-10 codes for a protein of approximately 72 kDa. This product was recognized by MAb 6C1 as well as by a polyclonal serum raised against a MAGE-10 peptide, thus demonstrating its identity with MAGE-10. Analysis of MAGE-10 mRNA by RT-PCR confirmed its presence in testis and placenta but not in other normal tissues. Expression of MAGE-10 in melanoma tumors was found to parallel that of MAGE-1. Western blot analysis with the polyclonal anti-MAGE-10 antibody showed the presence of MAGE-10 in lysates of purified trophoblast cells. Immuno-cytochemistry of cultured melanoma cells indicated that MAGE-10 is a nuclear protein.

Antibodies, Monoclonal↗
PubMed1999

Efficient adenoviral transfer of NF-kappaB inhibitor sensitizes melanoma to tumor necrosis factor-mediated apoptosis.

It has been suggested that the in vitro cytotoxicity of tumor necrosis factor (TNF) toward a number of transformed cell lines could make it a useful agent for anti-tumor therapy. However, many tumor cell lines are resistant to TNF-induced cell death. It has been shown that transcription factors of the NF-kappaB family, which are themselves activated by TNF, could protect cells against apoptotic cell death. To test whether melanoma cells, which are normally resistant to TNF-mediated killing, can be made susceptible by inhibiting the activation of NF-kappaB, we generated a recombinant adenovirus expressing a dominant mutant form of IkappaB alpha under the control of a CMV promoter. We show here that adenovirus-mediated inhibition of NF-kappaB function rendered melanoma cells susceptible to the cytotoxic effects of TNF, and thus that NF-kappaB-inhibiting adenoviruses could become useful adjuvants in TNF-based anti-tumor therapies.

Adenoviridae↗
PubMed1999

An action plan for tobacco control at regional level.

Smoking is the single biggest preventable cause of death in the UK; killing over 120 000 people each year, contributing to inequalities in health, exacerbating and causing poverty. Smoking has increased steadily among children since 1988 and more recently, among young adults. The current context in the UK is highly favourable for introducing comprehensive tobacco control measures. This paper summarises a regional action plan for tobacco control. Actions at district and regional levels are outlined to establish a comprehensive local tobacco control framework and complement national tobacco control measures. Measures include: a 'SWOT' analysis of current activity; systematic monitoring of smoking prevalence, attitudes to smoking, and the impact of tobacco control interventions; provision of effective smoking cessation support to a minimum standard throughout the health service; increased coverage of smoke-free public places and workplaces; enforcement of legislation on illegal sales to children and against smuggling and selling illegally imported tobacco; paid and unpaid mass media campaigns; and systematic lobbying for fiscal and legislative measures. One of the key components of the plan is the introduction of evidence-based tobacco control strategies at district levels. These should include a performance framework with clear organisational and managerial accountability and employ a co-ordinated, multiagency, partnership approach. Priority groups should be identified. Strategies should seek to engage the public to build support for tobacco control measures. Sufficient time, staff, resources and training must be allocated to tobacco control work and progress towards objectives monitored.

Adolescent↗
PubMed1999

Cognitive functioning in schizophrenia: implications for psychiatric rehabilitation.

Research in psychopathology and the cognitive neurosciences suggests new applications in psychiatric rehabilitation. Analysis of performance deficits on laboratory tasks can contribute to treatment planning, individual and family counseling, and staff consultation, much like it does in cases of brain injury and other types of central nervous system neuropathology. Recognition of the nature of cognitive impairments in schizophrenia can inform design of psychosocial techniques such as social and living skills training. Cognitive impairments are increasingly seen as potential targets for pharmacological and psychosocial treatment and rehabilitation. In this article, three key issues for application of cognitive technology in psychiatric rehabilitation of schizophrenia and related disorders are formulated as straightforward, clinically relevant questions: (1) What is the prognostic significance of cognitive impairment in acute psychosis? (2) Can cognitive functioning improve in the chronic, residual course? (3) How does cognitive improvement benefit other aspects of recovery and rehabilitation? These questions are addressed through review of previous findings and new multivariate analyses of cognitive functioning in the acute, post-acute, and chronic residual phases of schizophrenia.

Activities of Daily Living↗
PubMed1999

Effects of cognitive treatment in psychiatric rehabilitation.

Ninety subjects with severe and disabling psychiatric conditions, predominantly schizophrenia, participated in a controlled-outcome trial of the cognitive component of Integrated Psychological Therapy (IPT), a group-therapy modality intended to reestablish basic neurocognitive functions. The cognitive therapy was delivered to subjects in the experimental condition during intensive 6-month treatment periods. Control subjects received supportive group therapy. Before, during, and after the intensive treatment period, all subjects received an enriched regimen of comprehensive psychiatric rehabilitation, including social and living skills training, optimal pharmacotherapy, occupational therapy, and milieu-based behavioral treatment. IPT subjects showed incrementally greater gains compared with controls on the primary outcome measure, the Assessment of Interpersonal Problem-Solving Skills, suggesting that procedures that target cognitive impairments of schizophrenia spectrum disorders can enhance patients' response to standard psychiatric rehabilitation, at least in the short term, in the domain of social competence. There was equivocal evidence for greater improvement in the experimental condition on the Brief Psychiatric Rating Scale disorganization factor and strong evidence for greater improvement on a laboratory measure of attentional processing. There was significant improvement in both conditions on measures of attention, memory, and executive functioning, providing support for the hypothesis that therapeutic procedures that target impaired cognition enhance response to conventional psychiatric rehabilitation modalities over a 6-month timeframe.

Adolescent↗
PubMed1999

The impact of wives' earnings on income inequality: issues and estimates.

We estimate the extent to which rising family income inequality can be explained by changes in the earnings of married women. We develop a decomposition equation that separates single persons from married couples (decomposition by population group) and, for married couples, distinguishes the impact of wives' earnings from other sources of income (decomposition by income source). Despite the rising correlation between husbands' and wives' earnings, changes in wives' earnings do not explain a substantial portion of the increase in family income inequality. Our results contradict those of some previous analyses. The inconsistency of recent estimates can be traced to the use of a variety of conceptually different approaches in the previous literature. We clarify these approaches by explicitly distinguishing the conceptual issues, analyzing the empirical components, and providing comprehensive estimates.

Family Characteristics↗
PubMed1998

Effects of sucralfate vs antacids on gastric pathogens: results of a double-blind clinical trial.

BACKGROUND: Unblinded studies suggested that sucralfate prophylaxis for stress ulcers is associated with a lower rate of nosocomial pneumonia than acid-reducing approaches. We performed a randomized, double-blind, double-sham clinical trial comparing the exact microbial effects of each treatment. METHODS: One hundred forty patients entered this study before major elective surgery, allowing baseline cultures of gastric and pulmonary secretions to be obtained intraoperatively. Postoperatively, the patients were treated with standard doses of either sucralfate or antacids, plus a sham of the other drug. Cultures were repeated twice daily for 3 days. Molecular epidemiological typing was used to track the appearance of specific microbes and their transmission from site to site, and clinical end points were compared. The number of patients chosen was for sufficient statistical power to detect differences in the microbial measures, as detecting differences in clinical measures would have required increasing the sample size by an order of magnitude. RESULTS: Gastric pH was affected by the form of stress ulcer prophylaxis throughout the study, and this pH effect affected the number of new gastric organisms appearing in the 2 different groups. Colonization of the airway with new gastric organisms occurred more frequently in the antacid than in the sucralfate group, and colonization of the airway with organisms of gastric origin was associated with occurrence of postoperative pneumonia. CONCLUSIONS: Both sucralfate and antacids offered safe and effective stress ulcer prophylaxis in this double-blind clinical trial of postoperative patients in an intensive care unit. In association with the drug's effects on gastric pH, more new pathogens appeared in the gastric contents of antacid-treated than sucralfate-treated patients.

Antacids↗
PubMed1998

Agricultural injuries among older Kentucky farmers: The Farm Family Health and Hazard Surveillance Study.

This population-based study reports the cumulative incidence of agricultural injuries during a 1-year period in a sample of 998 farmers aged 55 years and older living in Kentucky. A total of 98 farm-related injuries were reported among 88 older farmers for a crude injury rate of 9.03 injured farmers per 100 farmers (95% confidence interval (CI) = 7.03-11.03) over a 1-year period. The leading external causes of farm injury were falls (24.9%), machinery (22.5%), wood-cutting (14.6%), and animal-related events (14.3%). Farmers working on farms with beef cattle (alone) (odds ratio = 1.90; 95% CI = 1.02-3.55) or farms with beef cattle and tobacco (odds ratio = 2.15; 95% CI = 1.00-4.59) had a statistically significant increased risk for a farm-related injury. Farmers reporting a prior injury that limited their ability to farm were at increased risk for a farm-related injury. Approaches to using farm injury surveillance data for injury control programs in the state are discussed.

Accidents, Occupational↗
PubMed1998

Use of peer ratings to assess sociability among inpatients with severe psychiatric disorders.

OBJECTIVE: A critical component of inpatient treatment for persons with severe psychiatric disorders is an evaluation of their social impairments. Most existing methods for such evaluations involve staff input and can be both time-consuming and expensive. This paper reports on the use of peer ratings as a method for assessing sociability, an aspect of social functioning in this clinical population. METHODS: Thirty-two inpatients with severe psychiatric disorders who had spent an average of 18 months on an inpatient unit in a state facility rated the popularity of their inpatient peers by completing a 7-point scale measuring how much they enjoyed visiting with each patient. The reliability of peer ratings and their association with staff ratings of patients' behavior on the unit were assessed. RESULTS AND CONCLUSIONS: The peer ratings had excellent test-retest reliability and were highly associated with staff members' independent evaluations of patients' behavior. Peer ratings appear to have promise as a measure of social functioning among inpatients with severe psychiatric disorders.

Adult↗
PubMed1998

Religion and mortality among the community-dwelling elderly.

OBJECTIVES: This study analyzed the prospective association between attending religious services and all-cause mortality to determine whether the association is explainable by 6 confounding factors: demographics, health status, physical functioning, health habits, social functioning and support, and psychological state. METHODS: The association between self-reported religious attendance and subsequent mortality over 5 years for 1931 older residents of Marin County, California, was examined by proportional hazards regression. Interaction terms of religion with social support were used to explore whether other forms of social support could substitute for religion and diminish its protective effect. RESULTS: Persons who attended religious services had lower mortality than those who did not (age- and sex-adjusted relative hazard [RH] = 0.64; 95% confidence interval [CI] = 0.52, 0.78). Multivariate adjustment reduced this relationship only slightly (RH = 0.76; 95% CI = 0.62, 0.94), primarily by including physical functioning and social support. Contrary to hypothesis, religious attendance tended to be slightly more protective for those with high social support. CONCLUSIONS: Lower mortality rates for those who attend religious services are only partly explained by the 6 possible confounders listed above. Psychodynamic and other explanations need further investigation.

Activities of Daily Living↗
PubMed1997

Cognition and social functioning in schizophrenia.

This article reviews three studies investigating the relationship between information processing and social functioning in schizophrenia. The most consistent finding is the association between vigilance performance on a hybrid continuous performance/span of apprehension task and various indices of social functioning (e.g., ward behavior). However, the nature of the information processing-social functioning relationships is mutable and appears dependent on a number of factors (e.g., cross-sectional versus longitudinal designs). This article concludes with a discussion of treatment implications and future research directions.

Adolescent↗
PubMed1997

Personality, social networks, and perceived social support among alcoholics: a structural equation analysis.

In this study we tested relations among personality characteristics, social network properties, and perceived social support both concurrently and prospectively. A sample of 294 men in treatment at a Department of Veterans Affairs Alcohol Treatment Unit was assessed during treatment and 3 months after discharge. Results of the cross-sectional structural equation analyses indicated that the personality characteristics of extraversion and neuroticism were related to both social network properties and perceived social support. Characteristics of the alcoholic's social network were also related to perceived availability of support. Longitudinal analyses of perceived social support after treatment indicated that two social network properties (size of the network and the proportion of confidants) were predictive net of initial levels of social support. Extraversion and neuroticism were found to be indirectly related to perceived social support at Time 2 through their effects on social network properties and perceived social support during treatment. Implications of these findings for models of the nature and determinants of perceived social support are discussed.

Adaptation, Psychological↗
PubMed1997

Assessing family and staff caregiver outcomes in Alzheimer disease research.

Outcomes and measurement issues related to caregivers for persons with Alzheimer disease and related disorders are examined. Assumptions regarding the dynamic linkages between resident, family, and staff outcomes are reviewed, and potential sources of stress inherent in family adaptation to the institutional setting, role transitions, and emotional responses that occur with placement are examined. Family and staff caregiver outcomes that flow logically from treatment goals, and what can be expected if sources of transitional and institutional stress are ameliorated through successful family and staff-related interventions, are discussed. Instruments developed to evaluate family perceptions of care and the caregiving role in institutional settings are described. The article concludes with an analysis of measurement approaches, general measurement issues, and those more specific to family and staff caregivers, as well as recommendations for further development in this area.

Alzheimer Disease↗
PubMed1997

Hydroxyapatite-oil composites for delivering AZT in simulated body fluid.

Hydroxyapatite (HA) has been used to deliver therapeutic drugs both in vitro and in vivo at a constant rate showing zero order kinetics. This study was designed specifically to analyze the effects of wheat germ (WG) incorporation with HA on the rate of delivery of AZT from an insert system over a one month period in vitro. Insert systems which were saturated with wheat germ oil delivered AZT at a slower rate over the one month period than did half-saturated or unsaturated insert systems. All systems containing 50 mg of AZT in the outer shell delivered 80% of the 100 mg AZT dosage over the first eight days. The systems which had a 100 mg AZT insert surrounded by an oily HA shell lacking AZT delivered AZT in a linear manner over the course of one month. The amounts and rates of AZT release from composites was indirectly proportional to the amount of wheat germ oil used. The results of this study show that the lipids incorporated in the ceramic composites can be tailored to deliver a 100 mg AZT dosage for a period of one month in vitro.

Anti-HIV Agents↗