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Biomedical subjects

D Shaffer

Publications and source records attributed to D Shaffer.

At least 127 records · Page 7Linked to original sources
PubMed1988

The epidemiology of teen suicide: an examination of risk factors.

The information presented here is on the incidence of suicide in the United States and in other countries where reporting procedures are reliable. The problem of underreporting is discussed and put into perspective. Secular trends in suicide incidence are presented, and it is shown how these have varied a great deal for different age groups. Age, ethnic, and cultural differences in incidence are demonstrated, and explanatory theories for these differences are put forward. The phenomenon of cluster suicide is described, and possible explanations for this are discussed. The limitations of death certificate data and the advantages (and limitations) of the psychological autopsy method are presented. Results from previous psychological autopsy studies on epidemiologically sound samples are summarized. Results (preliminary) from a current psychological autopsy study on consecutive adolescent suicides in the New York Metropolitan area are presented. Family history data and diagnostic profiles of completed suicides are emphasized.

Adolescent↗
PubMed1988

Studies in small bowel transplantation. Prevention of graft-versus-host disease with preservation of allograft function by donor pretreatment with antilymphocyte serum.

Donor pretreatment with antilymphocyte serum (ALS) effectively prevents graft-versus-host disease (GVHD) in a unidirectional (parent-to-F1 hybrid) rat small bowel transplantation model. ALS must be administered prior to or at the time of transplantation, and the intraperitoneal route is more effective than subcutaneous administration. Donor pretreatment with ALS uniformly prevents GVHD without impairing subsequent allograft function as measured by absorption of dietary energy and nitrogen, weight gain, and bowel morphology. These rodent studies suggest that ALS treatment of donors as well as recipients in small bowel transplantation may be a highly effective, simple, and easily applicable method to prevent or ameliorate GVHD in human small bowel transplantation.

Animals↗
PubMed1988

Prediction of intellectual deficits in children with acute lymphoblastic leukemia.

Possible predictors of reported lower cognitive functioning in irradiated children with acute lymphoblastic leukemia (ALL) were investigated. Thirty-four subjects, 5-14 years old, with ALL in continuous complete remission and without evidence of current or past central nervous system disease, were examined 9-110 months after diagnosis, using standard measures of intelligence and academic achievement. Subjects with a history of post-irradiation somnolence syndrome were significantly older at diagnosis than nonsomnolent subjects. Intelligence (IQ) was found to be unrelated to history of somnolence syndrome. IQ and achievement were unrelated to age at irradiation, irradiation-examination interval, and radiation dosages. The strongest predictor of IQ by far is parental social class. The importance of controlling for social class differences when searching for treatment effects on IQ and achievement is stressed.

Achievement↗
PubMed1988

Immunologic and metabolic effects of caval versus portal venous drainage in small-bowel transplantation.

We compared the immunologic and metabolic effects of systemic (i.e., caval) versus portal venous drainage of small-intestinal allografts in rats. Survival times in either unidirectional rejection or graft-versus-host disease models were not significantly altered by the route of venous drainage. Portoportal and portacaval isografts and controls were then pair-fed after transplantation. After 6 weeks of pair-feeding, weight gain, plasma amino acid concentration, and the histologic appearance of the liver were similar among the three groups. Hepatic protein synthesis was greater in pair-fed rats with portoportal isografts, although this difference disappeared in the fasted state. Our data suggest that there is little immunologic or metabolic advantage of portal versus systemic venous drainage of small-intestinal allografts in rats. Because the latter is technically simpler, it may be preferable in small-bowel transplantation.

Animals↗
PubMed1987

Immunoregulation by antigen/antibody complexes. I. Specific immunosuppression induced in vivo with immune complexes formed in antibody excess.

Specific immune complexes, prepared at different ratios of antibody to antigen, were examined for their effects on the antibody response of BALB/c mice to the cell wall polysaccharide antigen (PnC) extracted from Streptococcus pneumonia R36a. Mice immunized with complexes formed in antigen excess developed a PnC-specific antibody response that was equivalent to that in mice injected with free antigen. On the other hand, mice injected with complexes formed in antibody excess developed very little PnC-specific antibody. Furthermore, administration of immune complexes (formed in antibody excess) resulted in suppression of the response to an immunogenic dose of PnC given concurrently or 1 day after injection of immune complexes but not when the antigen was given 1 day before injection of the immune complexes. Injections of free antibody (TEPC-15) also resulted in suppression of the response to antigenic challenge; however, suppression was greatest when the antibody was injected concurrently with the antigen, suggesting that the suppression was mediated through the formation of immune complexes in vivo. The suppression appears to be specific for the antigen (PnC), since in mice injected with TEPC-15/PnC complexes (formed in antibody excess) and challenged with PnC coupled to sheep RBC, only the response to PnC was suppressed.

Animals↗
PubMed1987

Infectious complications with the use of cyclosporine versus azathioprine after cadaveric kidney transplantation.

Infectious complications within 1 year of cadaveric kidney transplantation were compared in 45 patients treated with azathioprine, prednisone, and antilymphocyte globulin and 38 patients treated with cyclosporine and prednisone. Although there was no difference in the 1 year patient or graft survival rate, cyclosporine-treated patients had significantly fewer wound infections, infection-related transplant nephrectomies, and infection-related graft failures than azathioprine-treated patients. The cyclosporine-treated diabetic recipients had more nonviral pneumonias and opportunistic infections but fewer cases of infection-related transplant nephrectomy than did the azathioprine-treated diabetic patients. Our data suggest cyclosporine is associated with reduced infectious morbidity after cadaveric kidney transplantation in nondiabetic patients.

Adult↗
PubMed1987

A prospective, randomized trial of abdominal wound drainage in gastric bypass surgery.

A prospective, randomized trial was conducted in 194 morbidly obese patients who had gastric bypass to determine the effect of subcutaneous closed suction drainage on wound infection rates. There was no difference in the incidence of postoperative wound infection with the use of drains compared with simple abdominal closure. Organisms isolated from infected wounds were predominantly skin flora and did not differ between the two groups. Patients with wound infections had significantly prolonged hospitalizations compared with those without infections, but in the subgroup with wound infections there was no difference in hospitalization time between the drainage or control groups.

Abdomen↗
PubMed1986

The impact of suicide in television movies. Evidence of imitation.

Increasing evidence suggest that imitative behavior may have a role in suicide among teenagers. We studied the variation in the numbers of suicides and attempted suicides by teenagers in the greater New York area two weeks before and two weeks after four fictional films were broadcast on television in the fall and winter of 1984-1985. The mean number of attempts in the two-week periods after the broadcasts (22) was significantly greater than the mean number of attempts before the broadcasts (14; P less than 0.05), and a significant excess in completed suicides, when compared with the number predicted, was found after three of the broadcasts (P less than 0.05). We conclude that the results are consistent with the hypothesis that some teenage suicides are imitative and that alternative explanations for the findings, such as increased referrals to hospitals or increased sensitivity to adolescent suicidal behavior on the part of medical examiners or hospital personnel, are unlikely to account for the increase in attempted and completed suicides.

Adolescent↗
PubMed1986

The antibody response to specific immune complexes is under genetic control and correlates with the expression of a recurrent idiotype.

The primary antigen-specific antibody response of various strains of mice to TEPC-15/PnC immune complexes has been examined. We found that both BALB/c and C3H mice were good responders to the PnC antigen; however, C3H mice were low responders, whereas BALB/c mice were high responders to the TEPC-15/PnC complexes. Using congenic strains on the C3H and BALB/c background, we have shown that the response to the complexes is not restricted by gene products of the H-2 complex or by the Igh (allotype) locus. However, responsiveness may be controlled by genes linked to the Igh locus, since we have shown that strains that are Ighj, Ighd, and Ighf are low responders, whereas strains that are Igha, Ighb, and Ighe are high responders to the immune complex. Moreover, responsiveness correlates with the expression of the T15 Id as measured using the anti-T15 monoclonal antibody, AB1-2. Thus, strains such as BALB/c, BALB.B, BALB.K, and CB-20, which express high levels of T15 (AB1-2) Id in their PFC response to PnC are relatively high responders to TEPC-15/PnC complexes, whereas C3H, C3H.SW, and C3H-OH, which express low levels of the T15 (AB1-2) Id, are low responders to the complexes. Finally, we found that BALB/c mice are high responders to complexes formed with T15+ antibodies, whereas they are low responders to complexes formed using T15- antibodies. The results suggest that the antigen-specific response to these immune complexes is Id-restricted.

Animals↗
PubMed1986

Ten-year consistency in neurological test performance of children without focal neurological deficit.

To assess 'soft-sign' persistence and its correlates outside a referred sample, 159 members of a local birth cohort of the United National Collaborative Perinatal Project were traced and their performance on six neurological test scales was measured at age 17 by examiners blind to their status at age seven. A comparison group was also formed, who had been 'sign-free' at age seven. On four of the six tests (dysdiadochokinesis, mirror movements, dysgraphesthesia and motor slowness) index boys did significantly worse than the comparison boys; by contrast, index girls scored significantly worse than comparisons only on motor slowness.

Adolescent↗
PubMed1986

Assessment of neurological 'soft signs' in adolescents: reliability studies.

The validity and reliability of a scoring system for 'neurological soft signs' in teenagers was assessed. Six scales were adapted and fitted into the framework of a conventional neurological examination. The following emerged: each of the three multi-item scales had high internal consistency; inter-rater agreement on mirror movements of 'live' subjects was satisfactory; ratings of videotapes agreed among examiners for mirror movements and dysdiadochokinesis but not for choreiform movements; data-based cut-off scores defining present vs. absent were congruent with the ratings of outside neurologists; and each examiner was consistent in rating mirror movements and rapid alternating movements from videotapes over several months.

Adolescent↗
PubMed1985

Neurological soft signs. Their relationship to psychiatric disorder and intelligence in childhood and adolescence.

Sixty-three male and 27 female adolescents known to have had neurological soft signs at the age of 7 years were compared with controls with no soft signs at age 7. Adolescents with early soft signs had significantly lower IQs and were more likely to have a psychiatric disorder characterized by anxiety, withdrawal, and depression. All the girls and 80% (12/15) of the boys with an anxiety-withdrawal diagnosis showed early soft signs. There was no relationship between early soft signs and attention deficit or conduct disorders. Examination of the relative contributions of anxiety at age 7, IQ, and social and family disadvantage to later diagnosis showed that most of the variance was accounted for by soft signs independently of IQ. Soft signs and anxious dependent behavior at age 7 were strongly predictive of persistent psychiatric disorder characterized by anxiety and withdrawal.

Adolescent↗