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Biomedical subjects

E Kennedy

Publications and source records attributed to E Kennedy.

At least 55 records · Page 3Linked to original sources
PubMed1994

Assessing the linkages between low body mass index and morbidity in adults: evidence from four developing countries.

The study explores the relationship between low BMI and illness patterns in four developing countries. Using probit analysis, the study finds small but statistically significant effect of low BMI on proneness to morbidity in Pakistan and Kenya but none in the Philippines and Ghana. The circularity of causation between low BMI and illness was addressed by using the instrumental variable approach. The study also finds that the threshold at which morbidity begins to rise is not consistent with the suggested cut-off of BMI 18.5 kg/m2. The cut-offs were meaningful only in the case of Pakistan, but even here, the sizes of relationships are quite small although statistically significant.

Adolescent↗
PubMed1994

Rapid heterologous desensitization of muscarinic and thrombin receptor-mediated phospholipase D activation.

Activation of the M3 muscarinic receptor in 1321N1 human astrocytoma cells leads to increased phospholipase D (PLD)-catalyzed hydrolysis of phosphatidylcholine, which is maximal within 1 min of exposure to agonist. Studies examining the kinetics of phosphatidylethanol formation indicate that there is no further PLD activation beyond this time. Thrombin, a mitogen for quiescent 1321N1 cells, also activates PLD only transiently. The PLD response does not recover for up to 1 hr and cells that have been exposed to carbachol or thrombin do not respond to subsequent challenge with the heterologous agonist. In contrast to the desensitization observed with agonists, phorbol-12-myristate-13-acetate induces a sustained stimulation of PLD. In addition, cells pretreated with carbachol or thrombin show a normal response to phorbol-12-myristate-13-acetate, suggesting that the enzymatic activity of PLD is not compromised. Guanosine-5'-O-(3-thio)triphosphate activation of PLD in cell-free homogenates is also unaffected by prior treatment of the cells with agonist. Agonist-stimulated PLD activation in 1321N1 cells is mediated by protein kinase C (PKC). Thrombin and carbachol cause comparable changes in redistribution of both PKC-alpha and PKC-epsilon. The increase in membrane-associated PKC-alpha is transient and is reinitiated by addition of the heterologous agonist, whereas PKC-epsilon remains membrane associated for at least 60 min and is not further increased by addition of the heterologous agonist. We suggest that desensitization of PLD activation results from the down-regulation of an as yet undefined mediator required for agonist receptor coupling to PLD and that PKC-epsilon might participate in this down-regulation.

Astrocytoma↗
PubMed1993

Views from Capitol Hill--11 congressional leaders paint varying reform scenarios. Interview by Marybeth Burke.

The following exclusive interviews with top congressional health care leaders were conducted by Washington-based reporter Marybeth Burke. In the interviews, Burke found that congressional health care leaders are optimistic yet cautious that comprehensive health care reform legislation will pass in 1993 under President Clinton. Some members of Congress believe that the election of a president committed to action on the issue drastically improves the outlook for reform. Others say that long-term controversy over reform will not resolve itself overnight. Lawmakers expect the issue to heat up quickly as soon as Clinton hands Congress a legislative reform package, but they are reluctant to predict quick enactment.

Competitive Medical Plans↗
PubMed1993

Red cell and plasma concentrations of fluoxetine and norfluoxetine.

To study the distribution of fluoxetine and norfluoxetine in blood compartments we determined their concentrations in red cells and plasma after the addition of 500 ng/ml of each compound to human blood in vitro. Red cell and plasma fluoxetine concentrations were 493 +/- 79 ng/ml and 454 +/- 53 ng/ml, respectively (P > 0.1). To assess the potential implications of this distribution on routine monitoring of these compounds in plasma, we determined fluoxetine and norfluoxetine concentrations in red cells and plasma in 6 patients receiving various doses of fluoxetine. While in 4 patients the concentrations of fluoxetine and norfluoxetine in red cells and plasma were comparable, 2 patients had higher concentrations of both compounds in red cells. Variations in the distribution of fluoxetine and norfluoxetine in blood compartments are relatively small. Plasma levels may reflect the drug concentration in whole blood more reliably for fluoxetine and norfluoxetine than for tricyclic antidepressants.

Chromatography, High Pressure Liquid↗
PubMed1992

Health and nutrition effects of cash crop production in developing countries: a comparative analysis.

The paper presents results of a comparative analysis of the health and nutritional effects of cash crop production in 6 countries--The Gambia, Guatemala, Kenya, Malawi, the Philippines, and Rwanda. The 6 country case studies were conducted during the same time period and used a similar, although not identical, research protocol. Participation in cash crop schemes resulted in increases in household income. Short-term increases in household income did not result in a decrease in the incidence of illness in preschool-aged children nor in the total time that preschoolers were ill. Increases in household income did result in increases in the preschooler's energy consumption; however, the income/calorie consumption links, although significant, were weak. The household income gains did not have an immediate or large impact on preschooler nutritional status. While, in the longer term, increases in income may bring about improvements in preschooler health, in the short term, it appears that increases in income must be accompanied by improvements in the health environment in order to have a significant effect in reducing preschooler morbidity and improving child nutritional status.

Agriculture↗
PubMed1992

LTC financing: is it time for change?

This month, Provider asks leaders in health care policy to address health care reform and the value of grassroots lobbying efforts. Following are interviews with national congressional leaders, administration officials, and ACHA and other industry leadership on these issues.

Aged↗
PubMed1991

Cytotoxic effects of children's faeces: relation to diarrhoea due to Clostridium difficile and other enteric pathogens.

Cytotoxicity of faecal extracts was demonstrated in 47 of 88 children (54%) referred for microbiological investigation of stools. Cytotoxic Clostridium difficile and vertotoxigenic Escherichia coli (VTEC) were the pathogens identified most commonly but cytotoxicity was also found in association with Campylobacter jejuni, Salmonella spp, Shigella sonnei, Giardia lamblia, rotavirus, adenovirus and poliovirus type 1 which had been acquired by oral immunization. In two patients, one of whom had cystic fibrosis, cytotoxicity of faecal extracts was associated with isolation of Pseudomonas aeruginosa. In five of 13 patients with diarrhoea and cytotoxic C. difficile, other pathogens were also present, in agreement with the view that C. difficile are more readily recovered when the intestinal flora have been altered by colonization with other micro-organisms. There was no correlation between previous treatment with antibiotics and isolation of C. difficile. Cytotoxicity neutralized by antitoxin, usually to C. sordellii, is used to detect cytotoxic C. difficile. We suggest that cytotoxicity not neutralized in this way should be an indication for further investigation of stools for the presence of other pathogens such as VTEC or viruses.

Adolescent↗
PubMed1991

Survival of patients with acquired immune deficiency syndrome and disseminated Mycobacterium avium complex infection with and without antimycobacterial chemotherapy.

The contribution of disseminated Mycobacterium avium complex (DMAC) infection to the morbidity and mortality of patients with acquired immune deficiency syndrome (AIDS) is unclear. Previous studies that suggested the decreased survival of patients with AIDS and DMAC had incomplete information on patient immunologic status and follow-up. We studied patients with AIDS and DMAC and compared their survival with that of AIDS patients without DMAC but with other comparable risk factors for survival. Case and control subjects were similar in terms of CD4 cell count, prior AIDS status, history of antiretroviral therapy, history of Pneumocystis carinii prophylaxis, and year of diagnosis. A group of 39 patients with untreated DMAC had significantly shorter survival, mean of 5.6 +/- 1.1 months (median 4 months), than 39 matched patients with AIDS but without DMAC, mean 10.8 +/- 1.3 months (median 11 months, p less than 0.0001). The survival of 16 additional patients with DMAC who received antimycobacterial therapy, mean of 9.5 +/- 1.4 months (median 8 months), was not significantly shorter than that of an additional 16 matched control subjects, mean 11.7 +/- 1.9 months (median 11 months, p = 0.58). Patients with treated DMAC survived significantly longer than those with untreated DMAC (p less than 0.01). We conclude that untreated DMAC significantly shortens survival. Moreover, these results indicate that patients with DMAC who receive antimycobacterial therapy do not experience the shortened survival seen in untreated DMAC.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Distribution of primaquine in human blood: drug-binding to alpha 1-glycoprotein.

To clarify the distribution of the antimalarial primaquine in human blood, we measured the drug separately in the liquid, cellular, and ultrafiltrate phases. Washed red cells resuspended at a hematocrit of 0.4 were exposed to a submaximal therapeutic level of 250 ng/ml of carbon 14-labeled primaquine. The tracer was recovered quantitatively in separated plasma and red cells. Over 75% of the total labeled drug was found in red cells suspended in saline solution, but only 10% to 30% in red cells suspended in plasma. The plasma effect was not mediated by albumin. Studies with alpha 1-acid glycoprotein (AGP), tris(2-butoxyethyl)phosphate, an agent that displaces AGP-bound drugs, and cord blood known to have decreased AGP established that primaquine binds to physiologic amounts of the glycoprotein in plasma. Red cell primaquine concentration increased linearly as AGP level fell and as the free drug fraction rose. We suggest that clinical blood levels of primaquine include the red cell fraction or whole blood level because (1) erythrocytic primaquine is a sizable and highly variable component of the total drug in blood; (2) this component reflects directly the free drug in plasma, and inversely the extent of binding to AGP; (3) the amount of free primaquine may influence drug transport into specific tissues in vivo; and (4) fluctuations of AGP, an acute-phase reactant that increases greatly in patients with malaria and other infections, markedly affect the partition of primaquine in blood. Because AGP binds many basic drugs, unrecognized primaquine-drug interactions may exist.

Carbon Radioisotopes↗
PubMed1989

An examination of the relationship between childhood depression and social competence amongst primary school children.

Forty-three primary school children who scored in the clinical range of the Children's Depression Inventory were compared with 43 children who were categorized as fearful but not depressed and a control group of 43 children who were classed as nondepressed-nonfearful. Subjects were matched across groups on the basis of grade and sex. The analyses were performed twice, initially with a depressed sample that excluded any depressed-fearful children and again with a depressed group that included such children. The results revealed that, independent of whether the depressed category included children who were also fearful, the depressed group reported lower levels of assertiveness and greater submissiveness, less adequate social skills performance, received lower ratings of peer popularity, fewer positive nominations from peer sociometry and more negative nominations. Depressed children were much more likely to be rejected or isolated by their peers than were their fearful or control counterparts.

Child↗
PubMed1987

Towards a general measure of distortion.

An approach to the measurement of distortion in hearing aids is presented. Distortion is first defined in general terms. The technique is then applied to the specific problem of predicting the detectability of non-linear distortion. Distortion indices have been obtained for two common, but very different forms of distortion: peak clipping (common to most conventional hearing aids); and, quantization (a form of distortion common to digital systems including digital hearing aids). Distortion indices were derived for the two forms of distortion in steady-state vowels. The results showed good agreement between the distortion indices at the just-detectable level of distortion.

Acoustics↗