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Biomedical subjects

E A Jacobs

Publications and source records attributed to E A Jacobs.

15 recordsLinked to original sources

Effects of culture on back pain in Australian aboriginals.

STUDY DESIGN: A cross-sectional survey was conducted. OBJECTIVES: To describe the occurrence of back pain and associated behaviors and disabilities in a semitraditional Australian aboriginal community. SUMMARY OF BACKGROUND DATA: There are few studies of back pain in isolated and nonindustrial societies. METHODS: The authors lived with, observed, and interviewed most adult members of a small aboriginal community and placed information about spinal pain in context of aboriginal beliefs and practices. RESULTS: Nearly half the adults in this community experienced long-term private spinal pain, but because of their cultural beliefs, did not commonly make this pain public. CONCLUSIONS: Cultural beliefs and practices influence how people respond to back pain in themselves and in others, including how and whether they present to health professionals or seek involvement of others.

Adolescent

Signs of emotional disturbance three years after early hospitalization.

Tested by a retrospective study the hypothesis that children in the 6-36 months age range in case of lengthy (> 3 days) or repeated (more than once) hospitalization are susceptible to persistent emotional disturbances. Families of children with such a "risky" hospitalization history were approached by mail, several years (M = 36 months, SD = 10) after the latest discharge. The parents of these children (N = 40; mean age 59 months) and of a control group without a risky hospitalization history (N = 73; mean age 58 months) reported about current problem behavior of their child. Scores on the Behaviour Checklist (Richman et al., 1982) were significantly (p < .05) elevated in the sample. Specific signs were poor concentration, immoderate attention seeking, deficits of bowel control, and fearfulness. Cases of surgery significantly exceeded others in signs of disturbance. Although the protective value of parental attendance could not be demonstrated in this study, on the basis of prior research, rooming-in is recommended as a necessary precaution in the 6-36 months age range.

Affective Symptoms

Humans' choices in situations of time-based diminishing returns: effects of fixed-interval duration and progressive-interval step size.

Four adult humans made repeated choices between two time-based schedules of points exchangeable for money: a fixed-interval schedule and a progressive-interval schedule that began at 0 s and increased in fixed increments following each point delivered by that schedule. Under reset conditions, selection of the fixed schedule not only produced a point but also reset the progressive interval to 0 s. Reset conditions alternated with no-reset conditions, in which the progressive-interval duration was independent of fixed-interval choices. Fixed-interval duration and progressive-interval step size were varied independently across conditions. Subjects were exposed to all step sizes in ascending order at a given fixed-interval value before the value was changed. Switching from the progressive-interval schedule to the fixed-interval schedule was systematically related to fixed-interval duration, particularly under no-reset conditions. Switching occurred more frequently and earlier in the progressive-schedule sequence under reset conditions than under no-reset conditions. Overall, the switching patterns conformed closely to predictions of an optimization account based upon maximization of overall reinforcement density, and did not appear to depend on schedule-controlled response patterns or on verbal descriptions of the contingencies.

Adult

Suppression of human granulocyte-macrophage colony formation in vitro by natural killer cells.

This study has demonstrated the ability of human bone marrow natural killer (NK) cells to inhibit the formation of granulocyte-macrophage colonies from autologous bone marrow derived committed progenitors in vitro. NK cell activity was demonstrated in all marrow samples and could be significantly increased by pretreatment of the bone marrow mononuclear cells with IFN-alpha. Bone marrow preincubated with IFN-alpha produced significantly fewer colonies in both Day 7 and Day 14 colony assays compared with untreated marrow. Removal of active NK cells by Leu 11b and complement significantly increased the number of colonies observed in both Day 7 and Day 14 assays, but this was not the case when NK cell-depleted marrow was treated with IFN-alpha prior to the GM assays. These results have further shown that NK cells and IFN-alpha are involved in regulating granulopoiesis by demonstrating that IFN-alpha can inhibit granulocyte/macrophage colonies in the presence or absence of NK cells in the bone marrow.

Antigens, Differentiation, T-Lymphocyte

The role of polysomnography in the differential diagnosis of chronic insomnia.

The authors examined the accuracy of the differential diagnosis of chronic insomnia with and without sleep laboratory studies in a consecutive series of 123 patients. All patients were evaluated by means of a sleep/wake log, a sleep habits questionnaire, structured psychiatric and clinical interviews, and a minimum of two consecutive nights of polysomnography. Notwithstanding a high rate of Research Diagnostic Criteria (RDC)-diagnosed psychopathology (63%) in this sample, the major finding was that in 49% of the patients laboratory results added to, refuted, and/or failed to support the clinical impression. This resulted in substantial modification of the initial diagnostic formulation and therefore in increased specificity of diagnosis.

Chronic Disease

Recognizing the adolescent drug abuser.

Adolescents are at high risk for using and abusing illicit drugs. Guidelines for recognizing drug abusers are presented as well as a staging process for progression of drug use. The family physician is in an ideal position to identify young users/abusers and to assist them and their families in obtaining much needed assistance.

Adolescent

Defective in vitro immunoglobulin production in response to pokeweed mitogen in patients with Hodgkin's disease pretreatment and in remission.

In vitro production of IgG and IgM from peripheral blood lymphocytes and B-cell enriched fractions was assessed in a group of Hodgkin's disease (HD) patients and normal controls using pokeweed mitogen (PWM) stimulation. Our studies demonstrated a significant (P less than 0.01) reduction in the absolute number of helper (OKT4 positive) T cells and a significant alteration in the helper/suppressor T-cell ratio (0.89 +/- 0.15) compared to normal (1.83 +/- 0.31). Results from PWM stimulation experiments demonstrated that HD patients produced significantly lower IgG (P less than 0.01) and IgM (P less than 0.01) levels than controls. Synthesis of IgM but not IgG induced by PWM was subnormal after addition to patient B-cell cultures of autologous irradiated T cells or allogeneic irradiated normal T lymphocytes. Irradiated T cells from HD patients were as effective as normal T cells in helping PWM induced IgG and IgM synthesis by normal B cells. Our results suggest that in HD impaired circulating B-cell function is partly due to T-suppressor cell activity and furthermore that B-cell subpopulations producing different immunoglobulin isotypes may either be defective or vary in their susceptibility to T-cell suppression.

Adult

Towards enzyme replacement in GM2 gangliosidosis: organ disposition and induced central nervous system uptake of human beta-hexosaminidase in the cat.

The rapid plasma clearance of human placental beta-hexosaminidase in the cat is due mainly to a receptor-mediated mechanism recognizing terminal N-acetyl glucosaminyl and mannosyl residues on glycoproteins. Using a sensitive single radial immunodiffusion assay, specific for human beta-hexosaminidase, we have shown that, in normal cats, the liver is responsible for most of the clearance of human beta-hexosaminidase. Two hours after injection of approximately 6 X 10(6) U beta-hexosaminidase/kg bw, 70-90% of the enzyme was recovered in the liver. Spleen, kidney, lung, bone, bone, pancreas, adrenals, testes and ovaries, cardiac and skeletal muscle, lymph nodes, and placenta, however, also participated in the clearance, although specific uptake in most organs was < 5% of that of liver. Exogenous beta-hexosaminidase was also present in bile, indicating that the hepatocytes are involved in clearance. Injection of terminal mannose-rich S. cerevisiae mannans (50-150 mg/kg bw), prolonged the plasma half-life of the enzyme (t 1/2 up to 290 min). In these animals, beta-hexosaminidase uptake by liver was reduced to < 10% of controls but uptake by other organs was not proportionally or uniformly reduced, suggesting the existence of different uptake mechanisms in different tissues. Permeability of the blood-brain barrier was induced by exposing cats to 100% O2 at 2.5 ATA for 90 min. Injection of 6 X 10(6) U beta-hexosaminidase/kg bw during or immediately after exposure resulted in apparent uptake of enzyme by nervous tissue, qualitatively detectable by immunologic methods, but below the limits of sensitivity of the radial immunoassay(ie < 150 U/gr). When enzyme uptake by liver was inhibited by injection of ovomucoid or mannans, however, the hyperbaric oxygen-induced apparent uptake of beta-hexosaminidase by brain, cerebellum, and spinal cord was 200-500 U/gr of blood-free tissue, suggesting that the transport mechanism involved (presumably at the level of the nervous system vascular endothelium) is different from the carbohydrate-dependent hepatic uptake. The mechanism by which hyperbaric oxygenation induces permeability of the blood-brain barrier is not clear. The combination of this procedure (routinely used in human therapy) with specific inhibition of hepatic uptake, however, appears to be a promising approach for lysosomal enzyme targeting to the central nervous system.

Animals

Changes in the permeability of the blood-brain barrier under hyperbaric conditions.

Hyperbaric oxygen therapy (HBO) has been used in the treatment of cerebral edema with variable results. Two different actions of HBO, one decreasing and the other increasing cerebral edema, have been postulated. We examined the permeability of the blood-brain barrier (BBB) in rats and cats. Animals of each species were treated for 90 min/d with 100% oxygen at a pressure of 2.5 atm for 5 consecutive days. Following treatment, cadmium-free ferritin was injected intravenously. Sections of the brain were prepared for electron microscopic evaluation of the capillaries and their neighboring structures. Perivascular edematous zones were observed. Ferritin particles penetrated through the capillary endothelium and into the pericapillary structures. Hyperbaric oxygenation appears to increase the permeability of cerebral vessel walls in normal animals. Further work on this phenomenon may provide a more rational basis for the treatment of cerebral edema with HBO.

Animals