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Biomedical subjects

J Anderson

Publications and source records attributed to J Anderson.

At least 397 records · Page 22Linked to original sources

Modified vincristine, doxorubicin, and dexamethasone regimen in the treatment of resistant or relapsed chronic lymphocytic leukemia. An Eastern Cooperative Oncology Group study.

BACKGROUND: Thirty-six patients with relapsing or refractory chronic lymphocytic leukemia were entered into a Phase II study of the Eastern Cooperative Oncology Group. METHODS: A modified VAD regimen was given: a 96-hour infusion of 1.6 mg vincristine and 36 mg/m2 doxorubicin with dexamethasone 40 mg by mouth daily for 4 days every 3 weeks. The treatment was continued until two cycles beyond maximal response, which was evaluated after two and six cycles. RESULTS: Of the 33 evaluable patients, 7 (21%) achieved a partial response (PR), with no complete remissions. One-third of the patients (11 of 33) had progressive disease and 15 of 33 (45%) had stable disease, as defined by the National Cancer Institute Working Group criteria. The median duration of PR was 6.5 months, with a median survival time of 14.8 months. A PR was achieved by 3 of 19 patients (16%) who had received prior vincristine +/- doxorubicin and 4 of 14 patients (28%) who had not received vincristine or doxorubicin. Of the nine patients whose disease was refractory to prior therapy, five (55%) achieved a PR. The neurotoxicity of VAD was reduced by decreasing the frequency of the dexamethasone, but 22 of 36 (61%) patients still became infected. Only on infection (2.8%) was life threatening, and there were no infectious deaths. CONCLUSIONS: Because fludarabine has shown superior responses, VAD should be reserved for patients who do not respond to alkylating agents and fludarabine and in whom alternative treatments are not appropriate.

Adult↗

Costs of clinical mastitis and mastitis prevention in dairy herds.

A stratified random sample of 50 Ohio dairy herds, monitored for 1 year between March 1988 and May 1989, was used to estimate the component costs of clinical mastitis per cow-year overall and by organism, the component costs of an episode of clinical mastitis overall and by organism, and the incidence of clinical mastitis by organism. Each herd was visited monthly by a veterinarian who conducted on-farm interviews and completed standardized data-collection forms designed to elicit economic information about the on-farm costs of clinical mastitis and mastitis prevention. Producers collected milk samples prior to treatment of clinical mastitis cases. Culturing methods allowed identification of 18 specific mastitis pathogen classifications. Annual costs estimated were on a per cow-year and clinical episode basis. The monthly mean population of cows monitored was 4,068. Mastitis prevention cost $14.50/cow-year, whereas the cost incurred by producers because of clinical cases of mastitis was $37.91. Organisms prevalent in the cows' environment caused the most costly types of mastitis. Disregarding contaminated samples and episodes for which no milk samples were taken, mastitis for which 2 organisms were isolated accounted for 35.5% of costs of clinical mastitis, followed by cases for which Escherichia coli (21.3%) was isolated, cases for which culturing yielded no growth (8.6%), and cases for which esculin-positive Streptococcus spp (6.4%), Klebsiella spp (5.7%), esculin-negative CAMP-negative Streptococcus spp (5.1%), Enterobacter spp (4.8%), coagulase-negative Staphylococcus spp (4.1%), coagulase-positive Staphylococcus spp (3.0%), S agalactiae (2.5%), and Bacillus spp (1.2%) were isolated.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Residential care for elderly people: a decade of change.

OBJECTIVE: To determine the changes between 1979 and 1990 in demography and dependency levels in elderly people in residential care. DESIGN: Censuses of those aged 65 years and over in any type of residential care at midnight on 11 December 1979 and 27 November 1990. SETTING: Leicestershire District Health Authority (population 865,133, 1991 census), coterminous with county and social services boundaries. MAIN OUTCOME MEASURES: Age, sex, length of stay, and dependency levels (measured by activities of daily living). RESULTS: In 1990 (1979), 6079 (4678) elderly people were enumerated in 241 (133) establishments, a 30% increase in the numbers of elderly people in residential care and an 82% increase in the number of establishments between 1979 and 1990. Dependency levels rose between 1979 and 1990 in all but the geriatric sector, the greatest increases being found in private residential homes where the largest percentage increase in the number of residents had occurred. CONCLUSIONS: Dependency levels in residential care have risen substantially, particularly in the private sector, even beyond levels expected from the greater numbers of elderly people. With the impending move to community care, dependency levels are likely to rise further, and more appropriate staff training and medical input to homes will become necessary.

Activities of Daily Living↗

Hodgkin disease in patients 60 years of age or older. Histologic and clinical features of advanced-stage disease. The Cancer and Leukemia Group B.

BACKGROUND: This article reviews the salient pathologic and clinical features of 171 patients with Stage III-IV disease who were 60 years of age or older who were treated on four Hodgkin disease (HD) protocols from 1969 to 1988. METHODS: Pretherapy sections were reviewed centrally for correlation of the histologic classification with anatomic sites of involvement and survival. RESULTS: The diagnosis of HD was confirmed in 114 (66.7%) patients. Non-Hodgkin lymphomas (NHL) and a miscellaneous non-HD group accounted for 52 (30.4%) and 5 (2.9%) of the cases. The overall median survival times of patients with Stage III-IV HD and NHL who were 60 years of age or older in the four protocols were not significantly different (1.5 versus 1.3 years, respectively; P = 0.28). There also was no significant correlation between the survival of these patients with HD and either the Rye classification, 19 specific histologic parameters, or the British National Lymphoma Investigation grading system for HDNS. In the last protocol, the 5-year survival rate of patients with HD who were 60 years of age or older was lower than that of patients 40-59 years of age or that of those younger than 40 years of age (31% versus 63% versus 79%, respectively, P < 0.0001). Patients with HD entered into the two most recent protocols showed lower incidences of involvement of cervical and iliac-inguinal-femoral lymph nodes and skin-subcutaneous tissues than the patients with NHL who were misdiagnosed as HD. Moreover, patients with Stage III-IV HD in the most recent protocol who were 60 years of age or older had lower rates of involvement of the cervical and mediastinal-hilar lymph nodes and a higher rate of involvement of the gastrointestinal tract than younger patients. CONCLUSIONS: Patients with Stage III-IV HD and NHL who are 60 years of age or older differ with respect to the rates of involvement of specific anatomic sites but not in survival when treated with HD protocols. In contrast, patients of different age groups with Stage III-IV HD disease differ with regard to the rates of involvement of anatomic sites and survival.

Age Factors↗

Peripheral T-cell lymphoma in childhood and adolescence. A clinicopathologic study of 22 patients.

BACKGROUND: Peripheral T-cell lymphoma (PTCL), although the most common T-cell lymphoma in adults, is relatively rare in childhood, and only small series have been reported. METHODS/RESULTS: Twenty-two cases of PTCL were studied that occurred in patients 18 months to 20 years of age. Nine were seen when the condition was diagnosed, and the other 13 were referred after they had relapses. The stage at diagnosis was I or II (45%), III (41%), and IV (14%). Patients with Stage IV disease were younger than those with Stage I or II disease (2.5 versus 14.8 years, P = 0.04). Twelve patients had extranodal disease when the diagnosis was made; the skin was the most common site. Ten tumors were classified as diffuse large cell type; five, as diffuse anaplastic large cell type; and seven, as diffuse mixed cell type. Twenty of the 21 tumors tested were CD30 (Ki-1 or Ber-H2) antigen positive. Of the nine patients seen when the diagnosis was made and treated by the authors, three had a relapse (median, 12 months), a 2-year relapse-free survival (RFS) rate of 61%. For the total group, the RFS was longer for patients older than 12 years of age compared with those who were younger (20 versus 12 months, P = 0.05). Overall, six patients remained in their first complete remission. Sixteen patients had a relapse, and 13 of these underwent bone marrow transplantation (BMT). Six of these remained in complete remission (median, 18 months after BMT). Overall, only 6 of 22 patients died (median survival, > 60 months). CONCLUSION: It was concluded that aggressive therapy, including BMT for relapses, can provide prolonged disease control in most children with PTCL.

Adolescent↗

Measurement of intrinsic bone quality in vivo by reflection ultrasound: correction of impaired quality with slow-release sodium fluoride and calcium citrate.

The intrinsic (material) quality of cancellous and cortical bone was evaluated in vivo from the measurement of reflection ultrasound velocities in the ulna. In cancellous bone, the reflection ultrasound velocity was inversely correlated with age in normal women (r = -0.48, p = 0.001), with a significantly lower mean value in 32 normal postmenopausal women than in 14 premenopausal women (3124 versus 3341 m/s, p < 0.0001). In 32 untreated osteoporotic women the cancellous bone velocity was lower than in normal postmenopausal subjects (2906 versus 3124 m/s, p = 0.0001). Following treatment with slow-release sodium fluoride plus calcium citrate (mean 2.4 years in 33 osteoporotic patients with no fracture during treatment), the cancellous bone velocity was significantly higher than in untreated osteoporotic women (3082 versus 2906 m/s, p = 0.0002) and was not significantly different from that in normal postmenopausal women. The cortical bone velocity displayed similar trends, but the changes did not attain statistical significance. The measurements were repeated approximately 9 months later in 9 untreated and in 20 treated patients; in 5 additional patients, the measurements were made both before and after 9 months of treatment with slow-release sodium fluoride and calcium citrate. The cancellous bone velocity increased significantly (p = 0.046) in these patients, from 3008 m/s before treatment to 3112 m/s after the first 9 months of treatment. The velocity rose significantly from 3037 to 3167 m/s (p = 0.017) in patients treated for a short time (12-30 months at first measurement), but it did not change in untreated patients or those treated for more than 30 months. Thus, the material quality of cancellous bone decreases with normal aging and is reduced further with the osteoporotic process. This impaired quality may be corrected by treatment with slow-release sodium fluoride plus calcium citrate.

Analysis of Variance↗

Phase II trial of etoposide and cisplatin in patients with refractory and relapsed non-Hodgkin's lymphoma: Cancer and Leukemia Group B study 8351.

A phase-II study was conducted by the Cancer and Leukemia Group B (CALGB) in patients with refractory and relapsed non-Hodgkin's lymphoma (NHL) to assess the activity of the combination of etoposide and cisplatin. Sixty-five patients were entered on study, and 51 patients were evaluated for this report. The treatment regimen consisted of etoposide, 80 mg/m2 IV daily times 5 and cisplatin 20 mg/m2 IV daily times 5, repeated every 21 days. All patients had failed 1-3 prior chemotherapeutic regimens, had measurable disease, and had a performance status of 0-2. In the 51 evaluable patients, there were 4 complete responses (8%) and 12 partial responses (23%), for an overall response rate of 31% (95% Cl: 19%, 46%). In addition, 15 patients (29%) had some improvement in disease and 6 (12%) had stable disease. Failure-free survival for the 51 eligible patients was 40% at 3 months, 23% at 6 months, and 15% at 1 year. Significant toxicity was observed with this regimen. Severe neutropenia occurred in 20 patients (39%), severe anemia in 8 patients (16%), and severe thrombocytopenia in 18 patients (35%). One patient died of infection. Severe neurotoxicity (1) and hemorrhage (3) were also seen. The etoposide, cisplatin combination is active in NHL; however, in this dose and schedule their combined activity is only minimally better than published reports of etoposide alone. Further studies of related combinations are under evaluation by the CALGB.

Adolescent↗

Contamination of genetically engineered CHO-cells by epizootic haemorrhagic disease virus (EHDV).

The characterization of a contaminating virus which was detected in genetically-engineered Chinese hamster ovary (CHO) cells during the production of biologicals is described in the present paper. Under electron microscopy, the contaminating virus had a morphology resembling that of an orbivirus. The relationship was confirmed by nucleic acid analysis which showed a RNA segment pattern characteristic of orbiviruses. With an immunoperoxidase staining of monolayer cells and through sero-neutralization tests the virus was identified as being identical to Epizootic Haemorrhagic Disease Virus (EHDV), isolate 318 (untyped) from Bahrain. Potential sources of the contaminating virus and feasible procedures to avoid adventitous virus infections in cell cultures are discussed.

Animals↗

HIV infection of the BS-1 human stroma cell line: effect on murine hematopoiesis.

BS-1, a stroma cell line derived from normal human bone marrow, can support the growth of murine erythroid (BFU-E), granulocyte-macrophage (CFU-GM), and megakaryocyte (CFU-Meg) progenitor cells in a short-term in vitro coculture system. Exposure of BS-1 cell to the human immunodeficiency virus (HIV) prior to coculture results in a marked reduction in the stroma cell's ability to support murine BFU-E and CFU-GM. The effect of HIV on the BS-1 cell's hematopoietic support function (HSF) is dependent on the multiplicity of infection (m.o.i.). BS-1 stimulation of CFU-GM is significantly impaired at m.o.i. values ranging from 10 to 0.1, whereas its support of BFU-E colony formation is inhibited at m.o.i. values of 10 and 1. No effect of HIV on the BS-1 cell's HSF is observed with further log dilutions of virus. The HIV-mediated suppression of the BS-1 cell's ability to support hematopoiesis is neutralized by a monoclonal antibody (titers ranging from 1:10 to 1:50) to the Gp160 surface antigen of the virus. Suppression of BS-1 cell's HSF is again observed with log dilution (> 1:100) of the antibody. HIV suppression of the BS-1 cell's HSF correlates with replication of the virus. P24 antigen levels of 150 pG/ml are measured as early as Day 6 postinfection and rise to 360 pG/ml by Day 16 of culture. The results suggest that HIV may impair normal hematopoiesis by infecting the stroma cells of the bone marrow microenvironment and compromising their role as accessory cells in supporting the proliferation and differentiation of hematopoietic progenitor cells.

Animals↗

Cytomegalovirus infection of the BS-1 human stroma cell line: effect on murine hemopoiesis.

BS-1, a stromal cell line derived from human bone marrow, can support the growth of murine erythroid (BFU-E), granulocyte-macrophage (CFU-GM), and megakaryocyte (CFU-M) progenitor cells in a short term in vitro coculture system. Exposure of BS-1 cells to cytomegalovirus (CMV) for 3 hr prior to coculture results in a marked reduction in the stroma cell's ability to support murine hemopoiesis. CMV's effect on the BS-1 cell's hematopoietic support function is dependent on the multiplicity of infection with total suppression of BFU-E observed at a 1:1 ratio of virus to bone marrow cells. A 50% loss in the ability of BS-1 cells to support BFU-E is observed at a 0.1:1 ratio. No effect of CMV is observed with further log dilutions of virus. CMV infection of BS-1 cells affects its support of erythroid progenitor cell growth to a greater extent than its influence on the development of granulocyte-macrophage colonies. Antibody to CMV or heat inactivation of the virus reverses the inhibitory affect on BS-1 cells. The results suggest that CMV can infect a cell that constitutes one of the cellular elements of the normal bone marrow microenvironment causing a decrease in the stroma's ability to support the growth and development of normal progenitor cells.

Animals↗

An acculturation scale for Southeast Asians.

This article reports the development of an acculturation scale for Southeast Asian immigrants. From factor analyses of responses on 13 items obtained from samples of three different Southeast Asian ethnic groups, i.e., Cambodians, Laotians, and Vietnamese, two subscales were derived: (1) proficiency in languages (land of origin versus English), and (2) language, social and food (LSF) preferences. Inter-item reliability of the scales was demonstrated for each of the three ethnic groups, with Cronbach alpha coefficients of 0.76 or above. Construct validity was also established within each of the three ethnic groups by demonstrating expected associations of the subscales with current age, years in the USA, total years of education, percentage of lifetime in the USA, and age on entering the USA. Multivariate analyses within each of the ethnic groups revealed that, once controlling for years of education, percentage of lifetime in the USA, and type of health care coverage, although not significant for the Cambodians (P = 0.08) males tended to show higher scores for the proficiency in language subscale in comparison to females. Similar multivariate analyses for the LSF preference subscale showed that although slightly higher for the males, the differences between the genders was not significant for the Cambodians (P = 0.78); both the Laotian (P = 0.23) and Vietnamese (P = 0.01) females showed higher scores in comparison to males although only just reaching significance for the Vietnamese.

Acculturation↗

Transesophageal cardioversion.

With the use of a novel quadripolar esophageal electrode system, we have attempted 131 transesophageal cardioversions in 105 patients: 109 episodes were atrial fibrillation, 16 episodes were atrial flutter, 2 episodes were supraventricular tachycardia, and 4 episodes were ventricular tachycardia. The mean predicted transesophageal impedance (+/- SEM) of 52.6 +/- 1.1 omega was significantly lower than the mean predicted transthoracic impedance (+/- SEM) of 63.1 +/- 1.6 omega (n = 104; p < 0.01). Of the 88 patients who presented with atrial fibrillation as the initial arrhythmia, successful transesophageal cardioversion (maximal delivered transesophageal energy of 100 J in 84 patients and 200 J in 4 patients) was recorded in 70 (79.5%); transesophageal cardioversion required a mean delivered energy of 63.1 +/- 4.2 J and a mean peak current of 20.3 +/- 0.6 A. Transthoracic countershock (maximal delivered energy of 360 J) was attempted in 17 of 18 patients when the transesophageal approach had been unsuccessful; countershock was successful in 10 patients, which yielded an overall success rate of 92.0% (mean successful delivered energy [transesophageal and transthoracic] of 85.3 +/- 7.8 J). All episodes of atrial flutter, supraventricular tachycardia, and ventricular tachycardia were successfully terminated with the use of the esophagus. This esophageal electrode system permits low-energy countershock of atrial and ventricular tachyarrhythmias.

Adult↗

A competitive ELISA for the detection of anti-tubule antibodies using a monoclonal antibody against bluetongue virus non-structural protein NS1.

A monoclonal antibody directed against the largest bluetongue virus (BTV) non-structural protein (NS1) was used in a competitive ELISA to detect antibodies to tubules (composed of NS1) in serum samples. Anti-tubule antibodies were detected at approximately 10 days post-infection in BTV infected sheep but no such antibodies were detected in sheep injected with inactivated BTV vaccines. Tubules are also produced during the replication of other related orbiviruses, including epizootic haemorrhagic disease of deer virus (EHDV). However, antibodies to the EHDV tubules were not detected in antisera from EHDV infected animals using the BTV NS1 specific monoclonal antibody and this assay system, confirming the serogroup-specific nature of this assay. This assay may prove useful not only for confirming the inactivated nature of experimental vaccines but also for the detection of viral replication and hence measurement of protection in vaccine potency trials following virulent BTV challenge. If inactivated BTV vaccines are ever widely adopted this test could provide a valuable means of discriminating between vaccinated and infected animals.

Animals↗

Color flow Doppler: imaging the upper extremity.

Dynamic values of key vessel diameter, blood velocity, and flow rate in the upper extremity were obtained in 20 healthy volunteers by means of color flow Doppler imaging with a 7.5 MHz transducer. Recordings were made of the brachial, radial, posterior radial recurrent, ulnar, and digital arteries. Radial and ulnar vessels were evaluated at both wrist and midcarpal levels. Diameter and velocity changes were followed throughout the cardiac cycle, and a true mean flow was computed. Mean diameters of the digital vessels ranged from 0.9 mm in the small finger to 1.3 mm in the thumb. Brachial flows ranged from 4.6 to 89.9 ml/min, radial flows from 0.9 to 15.3 ml/min, and ulnar flows from 0.6 to 79.9 ml/min. At the midcarpal level, flows ranged from 0.2 to 68.4 ml/min for the ulnar artery and from 0.8 to 42.9 ml/min for the radial artery. Variability between individuals was also demonstrated in artery dominance: eleven ulnar dominant, seven radial dominant, and two equal (within 25% of each other). The accuracy and ease of use of this technique in measurement of vessels are limited when vessels are less than 1.5 mm in diameter although the technique provides quantitative values to 0.5 mm.

Adult↗

Hypertension in individuals with insulin-dependent diabetes mellitus.

Hypertension is known to place the individual with IDDM at high risk for the development of both renal and cardiovascular disease. Recent data suggest that aggressive antihypertensive therapy (angiotensin I converting enzyme inhibitors, prazosin, and calcium channel blockers) have significantly improved overall prognosis and long-term survival for individuals with IDDM. Because in individuals with IDDM the development of both hypertension and renal disease has its roots in childhood, it is important that early and effective antihypertensive treatment begin there.

Child↗

Normality, deviance and minor psychiatric morbidity in the community. A population-based approach to General Health Questionnaire data in the Health and Lifestyle Survey.

This paper investigates factors affecting the distribution of psychiatric morbidity in the community. It identifies a close relationship between mean Chronic General Health Questionnaire (CGHQ) scores in subdivisions of a large random sample of the community (the Health and Lifestyle Survey, N = 6317) and the prevalence in these groups of abnormal, above-threshold CGHQ scores. The frequency distributions of CGHQ scores in these different populations move up and down as a whole: like other physiological and behavioural attributes, these mental health outcomes in individuals are associated with characteristics of the populations in which they arise. Populations thus carry a collective responsibility for their own mental health and well-being. This implies that explanations for the differing prevalence rates of psychiatric morbidity must be sought in the characteristics of their parent populations; and control measures are unlikely to succeed if they do not involve population-wide changes.

Adolescent↗

Effects of angiotensin II on insulin sensitivity: a placebo-controlled study.

1. There is evidence that hyperinsulinaemia increases the aldosterone response to angiotensin II, and that angiotensin-converting enzyme inhibitor drugs enhance peripheral glucose utilization, but the direct effects of angiotensin II on insulin sensitivity have not been reported previously. 2. In a randomized, double-blind, placebo-controlled, cross-over study, 12 healthy male subjects attended on 3 study days for the evaluation of the effects of a subpressor (1 ng min-1kg-1) and pressor (5 ng min-1kg-1) infusion of angiotensin II on whole-body insulin sensitivity using the euglycaemic hyperinsulinaemic clamp. Frequent measurements of blood pressure and heart rate were recorded and blood samples were collected for determination of serum insulin, C-peptide and K+ concentration, plasma renin activity and plasma angiotensin II concentration. 3. Plasma angiotensin II concentrations (means +/- SD) were 11 +/- 5 pg/ml after placebo, and 27 +/- 9 and 125 +/- 28 pg/ml after low and high dose angiotensin II, respectively. The higher dose of angiotensin II was associated with significant increases in blood pressure (e.g. 13 mmHg systolic blood pressure at 150 min) and serum aldosterone concentration. Whole-body insulin sensitivity was 10.5 +/- 2 mg of glucose min-1kg-1 after placebo, and 10.5 +/- 2.2 and 10.9 +/- 3.4 mg of glucose min-1kg-1 after low and high dose angiotensin II (not significant). 4. Angiotensin II had no effect on hyperinsulinaemia-induced reductions in serum potassium and triacylglycerol concentrations. 5. Thus, acute infusion of angiotensin II for 3 h, with or without an increase in blood pressure, has no effect on whole-body insulin sensitivity.

Adult↗