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Biomedical subjects

G Anderson

Publications and source records attributed to G Anderson.

At least 199 records · Page 11Linked to original sources
PubMed1993

An unusual perilobular pattern of pulmonary interstitial fibrosis associated with Crohn's disease.

Pulmonary pathology associated with inflammatory bowel disease is rare, and seldom biopsied. In this report, we describe a case of pulmonary interstitial fibrosis associated with Crohn's disease. Biopsy showed a unique pattern, with cellular fibroblastic proliferation and fibrosis affecting interlobular septa, spreading into the parenchymal interstitium from the periphery, with associated lymphoid aggregates and thickening of arterial adventitia.

Adult↗
PubMed1993

A comparative study of HLA-DRB1 typing by standard serology and hybridization of non-radioactive sequence-specific oligonucleotide probes to PCR-amplified DNA.

A double-blind study was carried out to evaluate the relative performance and reliability of the PCR/SSOP assay compared to conventional serological typing in identifying HLA-DR alleles. A total of 268 consecutive samples were entered into the study. In 14 (5.2%) of the cases, HLA-DR serology could not be performed due to poor cell viability, while in seven (2.6%) of the cases, PCR/SSOP typing could not be performed due to poor amplification or to contamination with exogenous DNA. Among samples that were successfully typed by both methods, serologic typing correctly identified 455/465 (97.9%) DR antigens, while PCR/SSOP correctly identified 464/465 (99.8%) DR alleles (p = 0.0117, McNemar's test). The majority of discrepancies in serologic typing resulted from a lack of discriminative alloantisera to identify DR6 or DR103. For the overall sample set (N = 268), serology provided accurate results in 244 (91.0%) cases, while PCR/SSOP provided accurate results in 260 (97.0%) cases (p = 0.0037). The results of this study demonstrate that PCR/SSOP typing for HLA-DRB1 alleles provides results that are equal to or surpass serological typing for HLA-DR antigens. In addition, the PCR/SSOP approach offers the advantages of better reagent availability, lower cost, more rapid turn-around time, and greater accuracy, all of which would warrant its use as an HLA typing method of choice.

Alleles↗
PubMed1993

Bovine colostrum immunoglobulin concentrate for cryptosporidiosis in AIDS.

Lactobin-R is a commercial hyperimmune bovine colostrum with potent anticryptosporidial activity. It was administered to a 4 year old child with AIDS and severe diarrhoea associated with cryptosporidiosis. There was significant clinical improvement in the diarrhoea and permanent elimination of the parasite from the gut as assessed through serial jejunal biopsy and stool specimens.

AIDS-Related Opportunistic Infections↗
PubMed1993

Correlation between respiratory symptoms and pulmonary function in asbestos-exposed workers.

Studies of respiratory questionnaire efficacy have emphasized reliability of responses; few have validated symptom response with objective measures of pulmonary function. To determine whether respiratory symptoms are associated with diminished pulmonary function, symptoms reported on the American Thoracic Society (ATS-DLD-78A) questionnaire were correlated cross-sectionally with measured spirometric volumes in 816 asbestos-exposed workers. Cough, phlegm, wheeze, and dyspnea were inversely related to pulmonary function. Cough, phlegm, and chronic bronchitis were associated with a 2 to 8% reduction (p < 0.001) in predicted values for forced vital capacity (FVC) and forced expiratory volume (FEV1); wheeze and dyspnea were clinically more significant, with an 11 to 17% reduction (p < 0.001). Wheeze, dyspnea, and roentgenographic fibrosis were all significant independent predictors of risk for restrictive impairment. These results support the validity of the ATS questionnaire as an epidemiologic tool and emphasize the importance of clinical history in assessing respiratory status.

Aged↗
PubMed1993

Competition versus regulation: its effect on hospitals.

While factors other than competition and regulation influence hospital's behavior, these two strategies have dominated the health policy debate. To examine the impact of these two competing strategies on patients and hospitals, the authors examine experiences in Baltimore, which has followed a regulatory strategy since the early 1970s, and Minneapolis/St. Paul, which has pursued a competitive strategy during the same time frame. Compared with the national average, both strategies had only a minor impact on containing hospital costs per capita, but they influenced hospital productivity, cost per discharge, and utilization in different ways.

Baltimore↗
PubMed1993

Integrating biological and behavioral perspectives in the study and care of autistic individuals: the future.

The core clinical feature of autism is a profound disturbance in the emergence of social relations, apparent as early as the very first months of life and almost always by age three years. Many different theories have been proposed to explain this dramatic developmental dysfunction, including cognitive, linguistic, arousal and, most recently, "theory of mind" hypotheses. There is great heterogeneity among autistic individuals and no single explanation captures all the clinical phenomena. Because of the divergent theories and their associated treatment approaches, parents are often burdened by conflicting advice. Field trials and other studies have provided excellent diagnostic criteria for autism for DSM-IV and ICD-10, with high sensitivity and specificity. Careful definition of the clinical phenotype is essential for neurobiological, genetic and behavioral research. While many lines of evidence point to underlying disturbances in brain maturation, no specific CNS dysfunction or biological correlate has been discovered. Rigorous research is not only essential for improving the understanding and treatment of autism; such studies may also help elucidate the normal preconditions for socialization and the pathways that allow a child to enter into the world of human relationships.

Autistic Disorder↗
PubMed1992

Invasive Haemophilus influenzae infections in men with HIV infection.

OBJECTIVE: To determine the incidence of invasive Haemophilus influenzae disease in men with the acquired immunodeficiency syndrome (AIDS) or human immunodeficiency virus (HIV) infection and the proportion of disease due to serotype b. DESIGN: Population-based, active surveillance. SETTING: San Francisco (Calif) Department of Health. PARTICIPANTS: All men 20 to 49 years of age with invasive H influenzae disease. RESULTS: The cumulative incidences of invasive H influenzae disease in men 20 to 49 years of age with AIDS and in HIV-infected men 20 to 49 years of age without AIDS were 79.2 and 14.6 per 100,000, respectively, but only 33% of cases were due to serotype b. The corresponding rates for invasive H influenzae b disease were 11.3 and 7.6 per 100,000. CONCLUSIONS: Men with AIDS or HIV infection are at increased risk of invasive H influenzae infections, including H influenzae b, but such infections are still infrequent in this population.

AIDS-Related Opportunistic Infections↗
PubMed1992

The use of the major anoxic stress response protein P34, the K isozyme of lactate dehydrogenase, and carcinoembryonic antigen in the follow-up of patients with colorectal adenocarcinoma.

BACKGROUND: This prospective study evaluated the use of the K isozyme of lactate dehydrogenase (LDH-K) as a complementary tumor marker to carcinoembryonic antigen (CEA) in patients with colorectal adenocarcinoma. METHODS: In this series, 355 patients underwent potentially curative surgery for primary colorectal adenocarcinoma. A close surveillance program of follow-up revealed 108 patients (30%) who had a serum elevation in CEA and/or LDH-K. RESULTS: The patients were divided into three groups. Group 1 consisted of 43 patients with elevations in CEA alone. Twenty-seven of 43 patients (63%) had tumor at exploratory laparotomy; and 16 patients (37%) had no evidence of disease after a median follow-up of 74 months. Group 2 consisted of 33 patients with a serum elevation of LDH-K alone. In this group, 5 of 33 patients (15%) had recurrent disease with true elevations of LDH-K. In 28 patients (85%), there were falsely elevated levels of LDH-K with no evidence of disease. Group 3 consisted of 32 patients with elevations of both serum LDH-K and CEA. In this group, 17 of 32 patients (53%) had true elevations of CEA and LDH-K with tumor recurrence, and 15 patients (47%) had false elevations with no evidence of disease. CONCLUSION: LDH-K did not complement CEA as a tumor marker for detecting recurrence in this group of patients with colorectal cancer.

Adenocarcinoma↗
PubMed1992

Studies on T cell maturation on defined thymic stromal cell populations in vitro.

We describe an in vitro system in which positive selection of developing T cells takes place on defined stromal cell preparations, which include major histocompatibility complex class II+ epithelial cells but exclude cells of bone marrow origin. In this system, maturation of double-positive T cell receptor negative (TCR-), CD4+8+ thymocytes into single-positive TCR+, CD4+ and CD8+ cells takes place together with the development of functional competence. As in vivo, this maturation is associated with the upregulation of TCR levels as cells progress from double-positive to single-positive status. We also show that class II+ epithelial cells in these cultures are less efficient than dendritic cells in mediating the deletion (negative selection) of V beta 8+ cells by the superantigen staphylococcal enterotoxin B. For the first time, this approach provides a model in which the cellular interactions involved in both positive and negative selection can be studied under controlled in vitro conditions.

Animals↗
PubMed1992

Tubal sterilization and risk of subsequent hospital admission for menstrual disorders.

OBJECTIVE: Our objective was to investigate tubal sterilization and subsequent hospitalization for menstrual disorders. STUDY DESIGN: Automated discharge data were used in a population-based cohort study of 7253 women aged 20 to 49 years with tubal sterilization (1968 through 1983) at Group Health Cooperative of Puget Sound. Comparisons were with an age-matched cohort of 25,448 nonsterilized women and a nonmatched cohort of 5283 spouses of men with vasectomies. RESULTS: In the sterilization cohort, 282 had hospitalization for menstrual disorders (curettage, n = 191; hysterectomy, n = 66; nonsurgical, n = 25). Risk of hospitalization for menstrual disorders was 2.4 times greater after tubal sterilization (95% confidence interval 2.0 to 2.9). This risk was 6.1 times greater for sterilized women aged 20 to 24 years (95% confidence interval 0.72 to 3.2). Compared with the risk for nonsterilized women whose spouses had a vasectomy, the risk was 1.6 times greater (95% confidence interval 1.3 to 2.1). Hospitalization for menstrual disorders was not more common after unipolar sterilization than after other methods, as might have been expected if the menstrual disorder was related to impaired uteroovarian circulation. CONCLUSIONS: Tubal sterilization is associated with a greater risk of hospitalization for menstrual disorders. A biologic association is not supported by these results.

Cohort Studies↗
PubMed1992

Dissociative experiences among psychiatric inpatients.

The Dissociative Experiences Scale was administered to 299 inpatients on an acute care general adult psychiatric ward over a 2-year period. The average score was 14.6, which is significantly higher than the mean for the general population. About one in six inpatients reported very high scores above 50 on the seven most common items in the scale, indicating a high level of dissociative psychopathology. Based on the responses to four items which form a scale factor called Activities of Dissociated States, an estimate is made that 6%-8% of general adult inpatients may have multiple personality disorder. Dissociative psychopathology is common on inpatient units.

Adult↗
PubMed1992

Laryngeal candidiasis: a cause of airway obstruction in the immunocompromised child.

Laryngeal involvement with candida is usually secondary to pulmonary candidiasis and is seen in patients with impaired immunity. We report a case of isolated laryngeal candidiasis involving the vestibular folds and presenting with stridor in a one-year-old child with Down's syndrome and hypogammaglobulinaemia. Vestibular fold reduction and fluconazole achieved resolution of the disease. Candidiasis should be considered in any potentially immunodeficient child presenting with symptoms of laryngeal disease.

Airway Obstruction↗
PubMed1992

Beyond empathy: expanding expressions of caring.

In this paper, a model describing nurses' responses to patients who are suffering is presented. The nurse's level of engagement with the patient is affected by whether the caregiver is focused on him-/herself or on the sufferer (i.e. embodied with the patient) and whether the caregiver is responding reflexively or with a learned response. Four types of communication patterns are identified: engaged responses (first-level) are used in a connected relationship; when the nurse responses reflexively and is focused on him-/herself, the response is reflected; when the caregiver is patient-focused, a learned response is labelled a professional response; and a self-focused, learned response is labelled detached. Examples of each type of response are provided.

Communication↗
PubMed1992

Exploring empathy: a conceptual fit for nursing practice?

After three decades, the efficacy of empathy in the clinical setting remains undocumented. Recently, concerns have been raised that the concept may be inappropriate and even harmful to the nurse-patient relationship. An analysis of the concept indicates that empathy consists of moral, emotive, cognitive and behavioral components. By tracing the integration of this concept into nursing, we suggest that empathy was uncritically adopted from psychology and is actually a poor fit for the clinical reality of nursing practice. Other communication strategies presently devalued, such as sympathy, pity, consolation, compassion and commiseration, need to be reexamined and may be more appropriate than empathy during certain phases of the illness experience. Directions for future research are suggested.

Behavior↗
PubMed1992

Comparison of three different methods for automated classification of cervical cells.

Over 4600 exfoliated squamous cervical cells taken from appropriate Papanicolaou samples were classified as normal, mildly dysplastic, moderately dysplastic and severely dysplastic by an experienced cytopathologist. The slides were de-stained and subsequently re-stained with Feulgen Thionin-SO2 stain. Images of the nuclei were then captured, recorded and processed employing an image cytometry device. Automated classification of the cells was carried out using three different methods--discriminant function analysis, a decision tree classifier and a neutral network classifier. The discriminant function analysis method, which combined all dysplastic cells into an abnormal group, achieved a combined error rate of less than 0.4% for moderate and severe dysplastic cells, and less than 40% for mildly dysplastic cells. All three methods yielded comparable results, which approached those of human performance.

Cell Nucleus↗