Trends in deaths from malignant neoplasia of liver are poor indicator of hepatitis C infection.
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Hepatitis C↗
Biomedical subjects
H E Harris
Publications and source records attributed to H E Harris.
Surveillance of hepatitis B: an example of a vaccine preventable disease.
The objectives of surveillance for vaccine preventable disease vary with the stage of the vaccination programme. Pre-implementation data is required to estimate the burden of disease and to decide on the appropriate vaccination strategy. Post-implementation data is required to monitor effectiveness but when high coverage is achieved surveillance must be able to accurately identify remaining pockets of susceptible persons. Sources of data include clinical and laboratory reporting. In most countries, all vaccine preventable diseases (including acute viral hepatitis) are notifiable by law. Such systems are prone to under-reporting but are usually satisfactory for monitoring trends. To encourage the rapid tracing and vaccination of contacts of acute hepatitis B, a sensitive case definition and timely reporting system are required. A clinical definition (e.g. for viral hepatitis) may be too broad, however, to assess the impact of vaccination and additional laboratory criteria may be necessary. As a country nears elimination, the predictive value of any case definition will fall and laboratory confirmation will always be required to target policy appropriately. Serological surveillance is another method for estimating disease incidence. This may be useful for hepatitis B as tests can distinguish vaccine induced immunity from natural infection and acute from prevalent cases. To monitor vaccine impact, age-coded specimens can be collected on an intermittent basis. Where the incidence is low, however, this approach, will be very expensive. Surveillance of vaccine preventable disease therefore requires flexible surveillance systems which are able to adapt to changes in incidence of infection and in control policy. The use of multiple data sources and supportive information from special studies is essential for the valid interpretation of routine data.
England↗
How accurate are antenatal weight measurements? A survey of hospital and community clinics in a South Thames Region NHS Trust.
The accuracy of antenatal weight data recorded in obstetric notes was investigated in the 45 hospital and community antenatal clinics within a South Thames Region NHS Trust. In order to assess the reliability and validity of all 60 clinic scales triplicate measurements of body weight for low- and high-weight subjects were recorded on each clinical scale and on a calibrated standard scale. The quality of weighing practice during antenatal care was investigated by means of semi-structured interviews conducted with all 33 midwives who currently provide antenatal care within the Trust. Beam balances had the highest reliability and validity, whereas scales with spring mechanisms were the least accurate. Only 40% of the clinics surveyed had access to beam balances, yet most of the maternal weight measurements recorded during antenatal care are likely to be out by no more than 1-1.5% of body weight. Weighing practice was generally inconsistent, and serial measurements of maternal body weight collected during pregnancy are probably too imprecise to provide a sensitive screen for conditions associated with unusual weight gain and too inaccurate to assess compliance with guidelines for weight gain.
Body Weight↗
Are overweight women at increased risk of obesity following pregnancy?
Longitudinal studies suggest that women who already have a high BMI are at greater risk of maternal obesity than their lighter counterparts. The aim of the present study was to investigate this possibility by examining the relationship between reproductive history and maternal BMI in a community of 627 women from South Africa with a high prevalence of obesity. Standardized questionnaires were used to obtain detailed sociodemographic and behavioural information, while maternal weight and height were both measured at the time of the interview. Analysis of covariance (ANCOVA) showed that maternal age (r2 0.015, P = 0.001), smoking status (r2 0.012, P = 0.036), and social support (r2 0.011, P = 0.006) were all independently associated with maternal BMI. If overweight women were at increased risk of maternal obesity, then the positive relationship between reproductive history and maternal BMI should be enhanced in this relatively obese community, yet the ANCOVA models showed no independent association between gravidity and maternal BMI after controlling for the effects of confounding factors. Although previous longitudinal studies have found a positive association between prepregnant weight and long-term weight gain, this relationship might arise because overweight women gain more weight over a fixed period of time than normal weight women, and therefore they may appear to be at greater risk of pregnancy-related weight gains. Overweight women are at greater risk of weight gain generally, but there is little unequivocal evidence to suggest that they are at any increased risk of maternal obesity, when compared with women of lower BMI.
Adult↗
Characterization of adhesion molecule expression in the pathogenesis of homologous collagen-induced arthritis in the DA rat.
We have investigated the inflammatory cell infiltrates and adhesion molecule expression in the synovial fluid (SF) and synovial membranes (SM) of rats with homologous collagen-induced arthritis. Immunohistochemical staining revealed that the majority of the cells in the SF were granulocytes, expressing CD11b and CD11c. In SM, the majority of the cells were monocytes/macrophages. CD49d and CD49f were expressed mainly in the erosion zone in SM, and ICAM-1 was expressed in the lining layer, in the capillaries, and in the erosion zone. In SF 7% of the cells were ICAM-1 positive. CD2 was more abundant in SM than in SF. These findings might explain the difference in granulocyte counts between SF and SM. CD49d and CD49f expression might retain lymphocytes and monocytes in SM, while granulocytes not expressing CD49d and CD49f are not retained.
Animals↗
The impact of pregnancy on the long-term weight gain of primiparous women in England.
OBJECTIVES: To investigate the impact of pregnancy on long-term weight gain of primiparous mothers in England, and to identify potential risk factors for maternal obesity. DESIGN: A retrospective, repeat-pregnancy study which examined the change in maternal body weight from the beginning of the first successful pregnancy to the beginning of the second. SUBJECTS: Two hundred and forty-three mothers, all of whom had been weighed during the first trimester of their first and second pregnancies, and none of whom had fallen pregnant less than 12 months after the birth of their first child. MEASUREMENTS: Sociodemographic, behavioural, medical, obstetric and perinatal data, together with antenatal measurements of maternal body weight and height, were extracted from each mother's obstetric notes. A comprehensive survey of weighing scales used at all antenatal clinics was undertaken. RESULTS: After accounting for the effect of ageing, there was no significant long-term increase in mean maternal body weight following the first pregnancy (95% Confidence Intervals: -0.82-0.28kg). While most mothers (70.8%) gained 1.0 kg or less, 24.7% gained more than 1.54 kg. Even after accounting for the maximum error in clinic scales, 14.8% of the mothers gained 1.54 kg or more in association with their first pregnancy. Mothers with higher BMIs at the beginning of their first pregnancy, who gained more weight during pregnancy, gave birth to heavier babies and had longer intervals between their pregnancies, gained significantly more weight from one pregnancy to the next. CONCLUSIONS: Pregnancy has little impact on the mean weight gain of primiparous women from England, who have a low prevalence of obesity (BMI > or = 26.0, 25.5%). Nevertheless, pregnancy may be associated with a permanent increase in maternal body weight simply because it is a period of positive energy balance during which some women gain excessive weight. Other factors, such as prepregnant BMI, determine whether long-term weight gain actually occurs.
Adult↗
The reliability of hand-written and computerised records of birth data collected at Baragwanath hospital in Soweto.
This study examined the reliability of hand written and computerised records of birth data collected during the Birth to Ten study at Baragwanath Hospital in Soweto. The reliability of record-keeping in hand-written obstetric and neonatal files was assessed by comparing duplicate records of six different variables abstracted from six different sections in these files. The reliability of computerised record keeping was assessed by comparing the original hand-written record of each variable with records contained in the hospital's computerised database. These data sets displayed similar levels of reliability which suggests that similar errors occurred when data were transcribed from one section of the files to the next, and from these files to the computerised database. In both sets of records reliability was highest for the categorical variable infant sex, and for those continuous variables (such as maternal age and gravidity) recorded with unambiguous units. Reliability was lower for continuous variables that could be recorded with different levels of precision (such as birth weight), those that were occasionally measured more than once, and those that could be measured using more than one measurement technique (such as gestational age). Reducing the number of times records are transcribed, categorising continuous variables, and standardising the techniques used for measuring and recording variables would improve the reliability of both hand-written and computerised data sets.
Data Collection↗
Methodological considerations in the design of an obstetric database abstracted from medical records.
The quality of maternal information contained within contemporary obstetric notes was investigated by abstracting data from the medical records of multiparous women who were admitted to a major city hospital in the South Thames Region. Potential sources of error were identified by comparing information recorded in different sections of each obstetric notes and within the obstetric notes of consecutive pregnancies. The format of the obstetric notes largely determined which variables were recorded and, to some extent, the accuracy of information collected. However, the quality of the data ultimately depended upon whether each variable was self-reported or directly measured. Self-reported variables were subject to selective omission and subjective bias, while measured variables were susceptible to inaccurate equipment and poor measurement practice. By interviewing a sample of midwives currently involved in antenatal care at the Trust it was possible to confirm that extensive variation in measurement and recording procedures routinely occurred.
England↗
Adolescents' misperceptions of the dangerousness of acetaminophen in overdose.
Clinical observations suggest that adolescents commonly and naively use acetaminophen in suicide attempts even when they do not wish to die. It is estimated that 18,500-mg acetaminophen tablets can lead to hepatotoxicity, while death is usually associated with ingestion of 50 or more tablets. A sample comprising 569 adolescent students completed an author-designed survey assessing teenagers' knowledge of acetaminophen's therapeutic and harmful effects. The findings support our original data that adolescents have ready access to acetaminophen and use it in suicide attempts, but underestimate its potential for toxicity. Forty-two percent of this sample underestimated the dose to cause harm, believing it would require 20 or more tablets, and 50% underestimated the dose to cause death, stating 100 or more pills would be necessary. Adolescents appear to seriously underestimate the dangerousness of acetaminophen in overdose, and lack knowledge regarding side effects of overdose.
Acetaminophen↗
Prenatal nutrition counseling: two caveats.
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Birth Weight↗
Adolescent psychopathy in relation to delinquent behaviors, conduct disorder, and personality disorders.
The purpose of this study was to explore the relationship between psychopathy as measured by The Revised Psychopathy Checklist (PCL-R) and delinquent behaviors, conduct disorder, and personality disorders in psychiatrically hospitalized adolescents. Thirty adolescent inpatients were assessed for psychopathy, delinquent behaviors, DSM-III-R Axis I disorders, and personality disorders using the Revised Psychopathy Checklist (PCL-R), the Diagnostic Interview for Children and Adolescents (DICA-R), and the Structured Interview for DSM-III-R Personality Disorders (SIDP-R). Significant relationships were noted between elevated PCL-R psychopathy scores and delinquent behaviors, conduct disorder, and narcissistic personality disorder. The validity of the PCL-R as a measure of psychopathy in adolescence was supported. Longitudinal studies are needed to clarify the clinical application of the PCL-R to adolescent populations.
Adolescent↗
The binary complex of pig plasma gelsolin with Mg2+-G-actin in ATP and ADP.
Pig plasma gelsolin combined with Mg-G-actin at less than 10(-8) M Ca2+ to yield a binary complex. Complexes formed from G-actin with bound ATP or ADP. They contained approx. 1 mol of non-exchangeable nucleotide per mol of actin. ATP hydrolysis was not coupled to binary complex formation, but ATP in the complex hydrolysed very slowly. The nucleotide in the binary complex behaved like one of the two nucleotide molecules in the ternary complex (two actin monomers to one gelsolin), but the actin-gelsolin interaction was weaker in the binary complex.
Actins↗
Preparation and characterization of pig plasma and platelet gelsolins.
Pig plasma gelsolin has been prepared by a revised method involving poly(ethylene glycol) precipitation, chromatography on CM-cellulose and affinity chromatography on actin-Sepharose. Pig platelet gelsolin has been prepared by chromatography on DEAE-cellulose and actin-Sepharose. Partial chemical and proteolytic cleavage shows that the two proteins are closely related in their fragmentation patterns. The amino acid sequences are identical at the N-terminus of the platelet protein, but the plasma protein has an additional nine residues on the N-terminal side of the common sequence. Calcium binding studies show that the plasma protein has similar calcium binding properties to both macrophage and platelet gelsolins.
Amino Acid Sequence↗
Covalent complexes formed between plasma gelsolin and actin with a zero-length cross-linking compound.
Actin and plasma gelsolin were covalently cross-linked with the zero-length cross-linker 1-ethyl-3-[3-(dimethylamino)propyl]carbodiimide. Two major intermolecularly linked products were identified on polyacrylamide gels. By use of 14C-labeled actin and 125I-labeled gelsolin, these were shown to be the 1:1 and 2:1 complexes of actin with gelsolin, respectively. The higher molecular weight complex predominated under all conditions tested including the presence and absence of Ca2+. In titration experiments in which actin at different concentrations was reacted with a fixed concentration of gelsolin, end points were obtained for the formation of both cross-linked species at about two actins per gelsolin, implying that a 2:1 noncovalent complex is cross-linked. In 0.1 mM Ca2+, the extent of cross-linking was independent of protein concentration down to 50 nM gelsolin. At low Ca2+ concentrations (less than 10(-8)M), the extent of cross-linking was very much reduced at micromolar gelsolin and fell to zero at about 100 nM gelsolin. The binding of actin to gelsolin to give a cross-linkable complex is therefore very strong at 0.1 mM Ca2+ but much weaker at low Ca2+ concentrations.
Actins↗
Lack of nucleotide cleavage on the binding of G-actin-ATP to plasma gelsolin.
G-Actin-ATP bound to plasma gelsolin to form a 2:1 complex. The complex contained approximately equivalent amounts of nucleotide and actin. More than 84% of this nucleotide was ATP. Half of the bound nucleotide was displaced by cold chase and the remainder did not exchange, implying that the two actins in the complex are not equivalent.
Actins↗
Plasma gelsolin caps and severs actin filaments.
Plasma gelsolin caps actin filaments at their 'barbed' ends and severs them along their length. Capping has been demonstrated both by direct visualization using gold-labeled gelsolin and by inhibition of actin polymerization onto the barbed ends of fragments of the acrosomal process of Limulus sperm. Severing activity is demonstrated by the fact that actin filaments nucleated off acrosomal fragments are shortened or removed within a few seconds by added plasma gelsolin without any obvious disruption of the actin bundles in the acrosomal processes themselves.
Acrosome↗
Plasma actin depolymerizing factor has both calcium-dependent and calcium-independent effects on actin.
The effects of pig plasma actin depolymerizing factor (ADF) on both G-actin polymerization and F-actin fragmentation have been examined by using rabbit skeletal muscle actin labeled with N-(1-pyrenyl)iodoacetamide, a sensitive fluorescent probe for monomer to filament interconversion. Fluorescence data have been compared with results obtained by viscometry and by difference absorption measurements at 232 nm. Plasma ADF nucleates actin filament assembly in a Ca2+-dependent manner; actin polymerization rates are enhanced at greater than 10(-6) M Ca2+. The calcium concentration dependence of this effect, showing a shift in ADF nucleating capacity between 10(-6) and 10(-7) M Ca2+, is that expected for an intracellular regulatory effect, but in plasma, the protein would always be saturated with Ca2+. Although the rate of polymerization is markedly enhanced in the presence of calcium ions, the extent of polymerization (as determined by the amplitude of the fluorescence change or the specific viscosity) is reduced in the presence of ADF and shows little or no Ca2+ dependence. The critical concentration of actin monomers is increased in the presence of ADF whether calcium is present or not. When ADF is added to F-actin, there is an immediate fall in fluorescence. This conversion of filaments to monomers by ADF (as defined by the fluorescence changes) is unaffected by calcium concentration. Electron micrographs of F-actin treated with ADF show that the filaments are indeed shortened at both high and low calcium concentrations. Taken together, these observations are interpreted in terms of a model in which ADF has both Ca2+-sensitive and Ca2+-insensitive binding sites for actin.
Actin Depolymerizing Factors↗
The depolymerization of actin by specific proteins from plasma and brain: a quantitative assay.
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Actins↗