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Biomedical subjects

E Robinson

Publications and source records attributed to E Robinson.

At least 127 records · Page 7Linked to original sources
PubMed1995

Hypertension and sleep apnea in black South Africans. A case control study.

Despite relatively consistent findings that patients with hypertension have higher than anticipated prevalences of sleep apnea/hypopnea (SAH), inadequately controlled factors such as age and obesity have been implicated as possibly accounting for these findings. All-night polysomnograms were performed on 20 hypertensive black South Africans, a group with increased risk for this disease. They were matched with a control group of black subjects in respect of age, gender, body mass index (BMI), neck circumference and scores on a sleep questionnaire. While the groups failed to differ significantly in terms of demographic variables, nor in regard to 8/9 anthropometric measures, the hypertensive group had a significantly higher apnea/hypopnea index (AHI) (P = .01), longer duration of AH (P = .01) and lower mean minimum arterial oxygen saturation levels (P = .005). Of the anthropometric measures, only age and neck circumference were found to be cofactors for AHI and were accounted for in the analysis. Five of the hypertensive patients and two of the controls had an AHI > 10, giving a prevalence odds ratio of 3 (95% confidence interval: 0.66-14.50). The present study appears to be the first in black African subjects and with prevalence findings largely comparable to those obtained in other ethnic groups. There was a trend for more severe SAH to occur in this subgroup of five hypertensives (AHI = 14-30) than in controls (maximum AHI = 12). While data are lacking to link antihypertensive medication to SAH in humans, further study is necessary before discarding this factor.

Adult↗
PubMed1995

Gastrin sensitivity of primary human colorectal cancer: the effect of gastrin receptor antagonism.

The purpose of this study was to determine the effect of the gastrin receptor antagonist, CR2093, on basal and gastrin-stimulated growth of primary human colorectal adenocarcinomas and to relate this to gastrin receptor expression. Tumour cells, derived from surgical specimens by enzymatic disaggregation, were grown on matrices of type I collagen and irradiated fibroblasts. Gastrin receptor expression was measured by using a mouse monoclonal antibody directed against the gastrin receptor and an avidin-biotin immunocytochemical method. Increased growth in the presence of gastrin-17 (used at physiological concentrations and as assessed by [3H] thymidine uptake) was shown in 16/34 (47%) tumours. CR2093 significantly reversed this stimulated growth (P < 0.05, one way analysis of variance) in 9/16 (56.3%) of the tumours and inhibited the basal growth of 11/34 (32.4%). Basal growth inhibition was reversed by gastrin-17 in 82% (9/11) of tumours. Gastrin receptor expression was widespread, but was not related to the degree of growth response to gastrin, and there was no significant correlation between intensity of receptor expression and inhibition of basal growth by CR2093. In conclusion, both gastrin-stimulated and basal growth of primary human colorectal can be inhibited by gastrin receptor antagonism, but gastrin receptor expression does not predict the sensitivity of tumours to (i) the proliferative effects of gastrin or (ii) the inhibitory effects of a gastrin receptor antagonist on basal growth. Antigastrin agents may have clinical value in the treatment of gastrin-sensitive colorectal tumours, and gastrin receptor expression may be related to endogenous gastrin production by colorectal tumour cells.

Amino Acids↗
PubMed1995

Gamete-specific methylation correlates with imprinting of the murine Xist gene.

We have investigated the potential role of DNA methylation as a regulator of imprinted Xist expression in mouse preimplantation embryos. The active paternal allele was found to be unmodified in sperm at CpG loci near the 5' end of the gene transcription unit. In contrast, on the inactive maternal allele, these same sites are initially methylated in the oocyte and then remain modified in the early embryo. In the male germ line, these methyl moieties are removed during spermatogenesis, and this occurs before the programmed reactivation of Xist in the testis. This represents a clear-cut example of a potential methylation imprinting signal that is reprogrammable and gamete derived.

Alleles↗
PubMed1995

Immunohistochemical detection of oncogene proteins and neuroendocrine differentiation in different stages of prostate cancer.

The progression of prostatic adenocarcinoma from localized disease to metastatic carcinoma appears to be a multi-step sequence. The expression of common oncogenes/oncosuppressor genes and the mediating effect of neuroendocrine tumor cells may play a role in this progression. The expression of the more frequently investigated oncogenes/oncosuppressor genes (p53, c-myc, c-erbB-2, bcl-2) and the presence of neuroendocrine cells were assessed in prostatic cancer tissue from patients with localized and metastatic cancer. These oncogenes/oncosuppressor genes were evaluated according to tumor stage and grade and their relationship to one another. Grade was not related to any of the oncogene markers or to the presence of neuroendocrine cells. Advancing stage was associated with a significant increase in p53 expression, while other markers remained constant in all stages. Neuroendocrine cells, p53, c-myc, c-erbB-2 and bcl-2 were rarely co-expressed at any stage of prostate cancer.

Carcinoma↗
PubMed1995

Passive immunization of rhesus macaques against SIV infection and disease.

To evaluate the role of humoral immunity against simian immunodeficiency virus (SIV), we tested whether passive immunization with plasma from SIVmac251 vaccine-protected or healthy infected animals would protect rhesus monkeys against intravenous infection with ten 50% animal infectious doses of the cell-free homologous virus. The challenge dose of this SIVmac251 virus stock had previously caused persistent infection in all (21 of 21) nonimmunized controls. A plasma pool was obtained from a donor that had been immunized with an inactivated whole SIVmac251 vaccine produced in human T cells. This plasma pool contained low levels of SIVmac binding and neutralizing antibody but had a high titer of antibodies recognizing human cell proteins. Given 4 or 18 hr before intravenous challenge, this plasma completely protected three of eight recipients from infection and delayed virus detection in one recipient. The five unprotected animals had only a transient or undetectable p27 antigenemia and low virus load in their PBMCs, and all survived at least 7 months after infection. By contrast, no protection was observed in 6 monkeys given inactivated, pooled plasma or purified immunoglobulin (Ig) from healthy SIVmac251-infected animals. This plasma pool and the Ig preparation contained high levels of SIV-binding and neutralizing antibody but no reactivity to human cellular components. Five of the six recipients had persistent antigenemia after challenge and four died acutely from simian AIDS in 4-7 months. These studies suggest that passive transfer of antibody to human cellular antigens can confer protection against SIVmac whereas passive transfer of neutralizing antibodies without human cellular antibodies does not protect against the homologous virus and may enhance infection.

Animals↗
PubMed1995

Chemokine expression in rheumatoid arthritis (RA): evidence of RANTES and macrophage inflammatory protein (MIP)-1 beta production by synovial T cells.

Earlier studies from this laboratory provided evidence for restricted cytokine expression in the T cell population in RA tissues. Specifically, IL-2, IL-4, IL-6 and interferon-gamma (IFN-gamma) gene expression levels were low. The selective chemoattractant and activation effects of chemokines on leucocytes identify them as potentially ideal candidates in mediating selective inflammatory processes in RA. Accordingly, we undertook studies to examine constitutive chemokine gene expression in RA tissues. RANTES, monocyte chemotactic protein-1 (MCP-1) and MIP-1 beta gene expression was examined in both the T and non-T cell populations in RA peripheral blood (PB), synovial fluid (SF) and synovial tissues (ST). Our results identified elevated levels of both RANTES and MIP-1 beta gene expression in circulating RA PB and SF T cells. By contrast, MCP-1 expression was virtually absent in RA PB, yet elevated MCP-1 mRNA levels were detected primarily in the non-T cell populations of the SF and ST samples. Histological examination of affected rheumatoid joints revealed extensive RANTES and MIP-1 beta expression in sites of lymphocyte infiltration and cell proliferation, namely the synovial lining and sublining layers. Fractionation or RA ST patient samples revealed that RANTES expression was restricted to the T cells, whereas MIP-1 beta expression was detected in both T and non-T fractions. These data suggest that MCP-1, MIP-1 beta and RANTES may have a central role in the trafficking of reactive molecules involved in immunoregulation and in the inflammatory processes in RA.

Arthritis, Rheumatoid↗
PubMed1995

Clinical characteristics of patients with a second primary tumor in the endometrium or ovary.

The clinical characteristics of patients with second primary tumors in the ovary and endometrium were compared to those with single primary tumors treated at our Center during the same period of time. Despite the fact that the patients were under medical surveillance for the first primary tumor, most second tumors were diagnosed following patient symptoms and complaints, and not at a routine follow-up appointment. Patients with a second primary endometrial cancer had a more advanced stage of disease at diagnosis as compared to those with single endometrial cancer. This was not found to be true for patients with second ovarian cancer. Patients with primary breast cancer and colon cancer, lymphoma or melanoma were found to be at higher risk for developing a second primary tumor in the endometrium or ovary as compared to those with a primary tumor at other sites. Although there are no proven means for the early detection of these gynecologic malignancies, it seems prudent to draw the attention of medical practitioners to the need for a better gynecologic evaluation for women with cancer at other sites during their follow-up visits. Studies on the efficacy of currently available diagnostic techniques should be carried out to evaluate their yield in this high risk group.

Breast Neoplasms↗
PubMed1995

Factors associated with glycemia and microvascular complications among James Bay Cree Indian diabetics of Quebec.

We conducted a chart review of physician diagnosed diabetics to obtain plasma glucose levels (fasting plasma glucose and glycosylated hemoglobin) over a retrospective 30 month time span and data on the presence or absence of current renal or ophthalmic microvascular complications. Multiple logistic regression was used to determine factors associated with the presence of microvascular complications. Poor glycemic control reflected by a need of insulin therapy (odds ratio (OR) = 2.7, confidence internal (CI): 1.1, 6.7), increased serum triglyceride levels (OR = 4.5, CI: 2.0, 9.9) and duration of illness of more than five years (OR = 3.0, CI: 1.2, 7.8) were found to be associated with the presence of microangiopathies. Process of care and temporary reversion to traditional lifestyle and diet did not influence glycemic control. Our results points towards a need for an increased awareness of lipid disorders in diabetic patients and a better understanding of how social and psychological factors are related to metabolic outcomes.

Adult↗
PubMed1995

Neighborhood Women's Health Watch: partners in community care.

A successful program for delivering prenatal care in rural Hawaii incorporated women volunteers from the local community known as the "Neighborhood Women's Health Watch" (NWHW). Knowledgeable about the cultural mores among the various Asian American and Pacific Islander ethnic groups within the community, these respected women established strong collegial relationships with a public health nursing team to assist in various monitoring and care activities designed for pregnant and postpartum women. This article will address recruitment, training, and role functions of the NWHW, including recommendations for the development of similar programs.

Community Health Nursing↗
PubMed1994

Full dose vincristine (without 2-mg dose limit) in the treatment of lymphomas.

BACKGROUND: Most current lymphoma protocols limit vincristine dose to 2 mg per single dose. Because a lower dose of vincristine may be associated with poorer outcome, there is some rationale to increase the dose of vincristine. METHODS: The feasibility of full dose vincristine (i.e., 1.4 mg/m2 without 2-mg dose limit) was prospectively evaluated in lymphoma patients treated with various combinations. After an initial dose of 1.4 mg/m2, patients were carefully monitored, and dose was modified according to toxicity. RESULTS: One hundred and four consecutive patients (31 with Hodgkin's disease and 73 with non-Hodgkin's lymphoma), aged 18-78 years were evaluated. The first dose was greater than 2 mg in 90% of the patients. The mean actual dose (percent of projected dose) was 100% in the first course and gradually decreased to 64% in the eighth course. The mean actual dose intensity of vincristine (percent of projected dose intensity) during the initial six cycles of prednisone, methotrexate, calcium leucovorin, doxorubicin, cyclophosphamide, etoposide, and mechlorethamine, vincristine, procarbazine, prednisone (ProMACE/MOPP), cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), and MOPP/doxorubicin, bleomycin, and vinblastine (MOPP/ABV) was 82% and MOPP/doxorubicin, bleomycin, and vinblastine was 82%, 83%, and 87%, respectively. Symptoms of neuropathy developed in 92% of the patients and were usually of mild or moderate severity. Toxicity included World Health Organization (WHO) Grades 3 and 4 constipation in 10 (10%), and WHO Grade 3 peripheral neurotoxicity in 16 (15%) patients. Rapid improvement was usually noticed within a few weeks after withdrawal of vincristine. The median duration of symptoms from discontinuation of vincristine was 3 months for paresthesiae and motor weakness and 5 months for muscle cramps. CONCLUSIONS: Full dose vincristine in lymphoma protocols is feasible but is associated with increased toxicity. The therapeutic advantage of full dose vincristine has yet to be proven.

Adolescent↗
PubMed1994

Increased risk of lung cancer after breast cancer radiation therapy in cigarette smokers.

BACKGROUND: Ionizing radiation is a lung carcinogen in a variety of settings, including after breast cancer radiation therapy. The authors explored whether cigarette smoking and breast cancer radiation therapy have a multiplicative effect on the risk of subsequent lung cancer. METHODS: This case-control study investigated women registered with primary breast cancer in the Connecticut Tumor Registry who developed a second malignancy between 1986 and 1989. Those diagnosed with a subsequent primary lung cancer were compared with those diagnosed with a subsequent nonsmoking, nonradiation-related second malignancy, and age-adjusted odds ratios were calculated with logistic regression. RESULTS: No radiation effects were observed within 10 years of initial primary breast cancer. Among both smokers and nonsmokers diagnosed with second primary cancers more than 10 years after an initial primary breast cancer, radiation therapy was associated with a 3-fold increased risk of lung cancer. A multiplicative effect was observed, with women exposed to both cigarette smoking and breast cancer radiation therapy having a relative risk of 32.7 (95% confidence interval [CI], 6.9-154). The radiation carcinogenic effect was observed only for the ipsilateral lung and not for the contralateral lung both in smokers and nonsmokers. CONCLUSIONS: Breast cancer radiation therapy, as delivered before 1980, increased the risk of lung cancer after ten years in nonsmokers, and a multiplicative effect was observed in smokers. For both smokers and nonsmokers, this effect was observed only for the ipsilateral lung and not the contralateral lung. Modern techniques, however, significantly decrease the radiation dose to the lungs, which may decrease the risk of lung cancer. Nonetheless, due to the available choices in early-stage breast cancer treatment, current practices may need to be revised for young breast cancer patients who smoke.

Breast Neoplasms↗
PubMed1994

An evaluation of an education programme, for prevention and early diagnosis of malignancy in Israel.

A community-wide health education programme for the prevention and early detection of cancer was performed in the Krayot municipalities, north of Haifa, Israel, during the years 1985-86. In order to assess its effectiveness, an evaluation programme was conducted. The knowledge, attitudes and behaviour of women who had been exposed to the education programme and of a control group, were compared before the programme started and 2.5 years later, after it ended. The programme was conducted in five clinics and included changes in the functioning of the clinics and their teams to be used in the interaction with the insured women. A piloted questionnaire was used to evaluate knowledge, attitudes and behaviour of these women. Emphasis was placed on smoking, sun tanning, self-examination of breast and other aspects of possible early detection of cancer. The education programme was ineffective not only with regard to behaviour but also in relation to knowledge on the relationship between health behaviour and cancer. The need for the establishment of more effective means for health education is eminent. If health education programmes are to succeed, we must understand what motivates or prevents compliance with recommended health behaviour.

Adolescent↗
PubMed1994

Comparing comfort and wearability: custom-made vs. self-adapted mouthguards.

Several studies have shown that mouthguards can reduce orofacial injuries among athletes. Comfort and wearability factors were compared among 40 high-school athletes for custom-made and self-adapted mouthguards. Both offered adequate protection, but overall the participants preferred the custom-made mouthguard.

Adolescent↗
PubMed1994

Treatment of muscle invasive bladder cancer. Is there a role for neoadjuvant chemotherapy?

PURPOSE: Because 5-year survival with advanced bladder cancer is still poor, the search for optimal treatment continues as dose the necessity of clarifying goals of treatment. PATIENTS AND METHODS: We compared the outcome of 3 different but widely accepted treatment protocols for bladder cancer in order to find which, if any, was superior, with particular emphasis upon the performance of the newest treatment, neoadjuvant chemotherapy. Data on 224 bladder patients treated at our institution (1975 to 1991) with 1 of the 3 protocols was analyzed. Those protocols were: 1. radiotherapy > 60 Gy (143 patients); 2. low dose radiotherapy followed by cystectomy (25 patients); 3. chemotherapy followed by either definitive radiotherapy or surgery (56 patients). Because the latter group was also a chronologically newer group with a shorter possible follow-up, we compared all treatments on the basis of 2-year survival, using Kaplan-Meier life tables. We briefly reviewed those modalities which are bladder-sparing because of the significance to quality of life of this factor. RESULTS: Two-year survival figures for the patients were: 63% for those who received only radiotherapy; 72% for those undergoing cystectomy: 68% for the group to whom neoadjuvant chemotherapy was administered. The differences were not statistically significant. However, 23% of those patients treated neoadjuvantly were alive with intact bladders at 2 years. CONCLUSION: These results do not suggest that a superior survival advantage is associated with any of these 3 protocols and neoadjuvant chemotherapy, in particular, cannot be seen as conferring a new and important survival advantage. However, neoadjuvant chemotherapy followed by radiotherapy does permit bladder conservation and, given that life span will often be reduced, the importance of helping to keep the remainder of the patient's life as comfortable as possible, can hardly be overestimated.

Aged↗
PubMed1994

Natural killer cell function and expression of beta 7 integrin in psoriatic arthritis.

OBJECTIVE: To examine the cytotoxic activity of natural killer (NK) cells from peripheral blood (PB) and synovial fluid (SF) of patients with psoriatic arthritis (PsA). The influence of selected inflammatory mediators on the cytolytic function and integrin expression of NK cells was also studied. METHODS: Paired samples of PB and SF lymphocytes (PBL and SFL) were obtained from 8 patients with PsA for comparison of NK activity between PBL and SFL. In 6 patients the phenotype of NK cells was determined by flow cytometry using monoclonal antibodies (Mab) to natural killer associated antigen (NKH-1) and the beta 7 integrin, HML-1 (human mucosal lymphocyte adhesion molecule). RESULTS: NK activity of PB samples was significantly greater than paired SF (p = 0.015). SF NK activity was enhanced by overnight culture with interleukin 2 (IL-2) (p < 0.05). A trend towards reduction of NK activity by prostaglandin E2 (PGE2) was noted (p = 0.06) whereas interleukin 6 (IL-6) and indomethacin had no significant effect. NK activity did not correlate with the percentage of NK cells in PB or SF. However, all SF samples contained a greater proportion of monocytes than PB samples. The expression of HML-1 on NK cells correlated with expression HML-1 on CD3+ cells (r = 0.82) and was greater in SF than PB in PsA and RA patients. Effects of IL-2 on HML-1 expression by NK cells were variable in the 3 patients studied. CONCLUSION: In PsA, HML-1 is an activation marker on NK cells. IL-2 expands or maintains the population of HML-1/NKH1 positive cells and increases NK cytolytic activity. However, cytolytic activity of activated NK cells may be inhibited by monocyte derived PGE2.

Adult↗
PubMed1994

A district urinary catheter policy. Why have one?

A catheter audit was performed at the Central Manchester Trust, which found that there was excessive ordering, inappropriate catheter selection by size, materials, balloon size and poor guidelines on catheter storage. From these findings and from the available literature, we have proposed guidelines on catheter selection with the aim of offering the best patient care and to provide cost efficiency which may be of benefit to other hospitals.

Adolescent↗
PubMed1994

Hodgkin's disease in childhood: treatment modalities, outcome and epidemiological aspects. The Northern Israel Cancer Center experience.

PURPOSE: A retrospective analysis of Hodgkin's disease (HD) in children treated at the Northern Israel Cancer Center between 1971 and 1990 was conducted. PATIENTS AND METHODS: Records of 102 patients < 18 years of age at diagnosis were reviewed. Patient characteristics were similar to those previously reported. There were 54 boys and 48 girls (1.1:1 boy:girl ratio), with more boys < 10 years of age. Forty-four patients were of Arab ancestry and 58 were Jewish; incidence rates were similar in both groups. The most common histological types were nodular sclerosing and mixed cellularity, the latter being more commonly diagnosed in the younger age group. RESULTS: The outcome of various treatment modalities in childhood HD were evaluated. Sixty-five patients (64%) had stage I or II and 37 (34%) had stage III or IV at diagnosis. Patients with stage I-II received radiotherapy alone (20 patients), chemotherapy alone (10 patients), or a combined approach of chemotherapy plus radiotherapy (35 patients). Survival rates and median disease-free intervals were statistically similar in all three modalities. However, relapse rates were higher among patients receiving radiotherapy alone or chemotherapy alone (35% and 38%, respectively) compared with patients receiving chemotherapy plus radiotherapy (14%). CONCLUSIONS: We conclude that a combined approach of chemotherapy plus radiotherapy is advantageous over radiotherapy alone or chemotherapy alone.

Adolescent↗