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Biomedical subjects

J Gardner

Publications and source records attributed to J Gardner.

At least 127 records · Page 7Linked to original sources
PubMed2000

The HIPAA lurks. Just when CIOs thought it was safe for business as usual....

Just when healthcare chief information officers thought it was safe to return to business as usual, along comes the administrative simplification provisions of the Health Insurance Portability and Accountability Act of 1996. Those regulations, which will require providers to reconfigure patient records into an electronic format, will be anything but simple for hospitals, systems and insurers.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed2000

It may be politics over policy in 2000.

Thanks to election-year realities, it's likely to be politics over policy on Capitol Hill in 2000. Congress and the Clinton administration have plenty of unfinished healthcare business, but with the pressures of the campaign trail, expect a shortened legislative window of opportunity. While healthcare remains high on everyone's agenda, the likelihood of compromise remains low.

Health Policy↗
PubMed2000

Effect of pre-existing cytotoxic T lymphocytes on therapeutic vaccines.

Therapeutic vaccines which aim to induce CD8(+) cytotoxic T lymphocyte (CTL) responses will often be required to perform in the presence of pre-existing CTL which recognize epitopes within the vaccine. Here we explore the ability of a viral vaccine vector presenting several co-dominant CTL epitopes to prime CTL responses in animals that have a pre-existing CTL response to one of the epitopes in the vaccine. The vaccine was usually capable of inducing multiple new responses, suggesting that immunodomination effects of pre-existing CTL may generally be minimal following vaccination. However, when large numbers of pre-existing CTL were present, a novel type of immune modulation was observed whereby (1) the vaccine failed to prime efficiently new CTL responses that were restricted by the same MHC gene as the pre-existing responses, and (2) vaccine-induced CTL responses restricted by other MHC genes were enhanced. These results may have implications for therapeutic multi-epitope vaccines for diseases like HIV and melanoma, which aim to broaden CTL responses.

Adoptive Transfer↗
PubMed2000

Childhood diethylene glycol poisoning treated with alcohol dehydrogenase inhibitor fomepizole and hemodialysis.

Diethylene glycol (DEG), a commonly used solvent, has been implicated in multiple poisoning deaths, the most recent being the Haitian acetaminophen tragedy. Unlike the more commonly seen ethylene glycol ingestion, little is understood of DEG metabolism or kinetics in humans. This has made the clinical presentation, biochemical correlates, and treatment options unclear. Patients presenting less than 12 hours after DEG ingestion may not show metabolic acidosis, whereas those presenting later may show florid metabolic acidosis. Kinetic data lend support to these observations. We report a case of DEG ingestion in a 17-month-old girl who was managed with activated charcoal, fomepizole (a recently available alcohol dehydrogenase inhibitor), and hemodialysis (HD). Pre-HD and post-HD DEG levels support clearance of DEG with HD.

Antidotes↗
PubMed2000

Circumstances of post-neonatal deaths in Ceara, Northeast Brazil: mothers' health care-seeking behaviors during their infants' fatal illness.

Promotion of oral rehydration therapy (ORT) for the treatment of diarrheal diseases and the WHO case management strategy for acute respiratory infections (ARI) have contributed to significant reductions in infant mortality, but these two conditions remain the leading causes of infant deaths in most developing countries. Identification of the factors contributing to these deaths may contribute to reduce infant mortality from preventable causes. To gain insight into the circumstances and maternal and health services factors that may contribute to infant deaths we used a verbal autopsy method to interview mothers of all infants who died during the previous 12 months (June 1995-May 1996) in 11 municipalities in the State of Ceara, Northeast Brazil. Our results revealed that one-third of the deaths occurred in a hospital and two-thirds at home. Almost all the infants who died at home, however, had been examined one or more times by a doctor, and 36% of them had been hospitalized during the disease episode that resulted in death. For most (85%) of these children the causes of death were diarrhea or acute respiratory infection, and it is likely that death could have been averted if appropriate treatment had been initiated promptly. Three major groups of factors that alone or in combination appeared to contribute to most deaths were delays in seeking medical care on behalf of the parents, medical interventions reported as ineffective by mothers and delays in providing medical care to children who arrived at the hospital too late in the day to be scheduled for consultation. Our findings suggest that government efforts to further reduce infant mortality in Ceara should focus on health education interventions that address quality of home care, recognition of signs of severity and danger and importance of seeking timely medical care: and on improving the quality of care provided at community health centers and hospitals. Measures likely to improve infants' chance of survival include: ensuring prompt access to medical consultation for young children brought to health centers or hospitals with potentially life-threatening symptoms related to infections, health education to mothers on the need for continued home care after discharge and to return to the medical care facility if the child does not recover, and that they have access to medicine prescribed by hospital physicians. Further benefits could be obtained by using community health workers, now integrated into the Family Medicine Program (PSF) health teams, to provide health education, supervise home care, refer mothers to health centers and facilitate their access to hospitals.

Attitude to Health↗
PubMed2000

Mutations in Sox18 underlie cardiovascular and hair follicle defects in ragged mice.

Analysis of classical mouse mutations has been useful in the identification and study of many genes. We previously mapped Sox18, encoding an SRY-related transcription factor, to distal mouse chromosome 2. This region contains a known mouse mutation, ragged (Ra), that affects the coat and vasculature. Here we have directly evaluated Sox18 as a candidate for Ra. We found that Sox18 is expressed in the developing vascular endothelium and hair follicles in mouse embryos. Furthermore, we found no recombination between Sox18 and Ra in an interspecific backcross segregating for the Ra phenotype. We found point mutations in Sox18 in two different Ra alleles that result in missense translation and premature truncation of the encoded protein. Fusion proteins containing these mutations lack the ability to activate transcription relative to wild-type controls in an in vitro assay. Our observations implicate mutations in Sox18 as the underlying cause of the Ra phenotype, and identify Sox18 as a critical gene for cardiovascular and hair follicle formation.

Alleles↗
PubMed2000

An arthrogenic alphavirus induces monocyte chemoattractant protein-1 and interleukin-8.

Cytokines and chemokines play important roles in both autoimmune and infectious arthritides. Here we describe the cytokines and chemokines induced by Ross River (RR) virus infection of synovial fibroblasts and macrophages in vitro. RR virus is the aetiological agent of epidemic polyarthritis (EPA), a principally acute and chronic rheumatic disease affecting up to 7,000 Australians annually. Infected fibroblasts increased expression of mRNA coding for monocyte chemoattractant protein-1 (MCP-1), interleukin-8 (IL-8), and granulocyte-macrophage colony-stimulating factor. MCP-1, IL-8, macrophage inflammatory protein-2, and to a lesser extent interferon gamma-induced protein-10 mRNA were upregulated in infected macrophages. Expression of MCP-1 is consistent with the predominantly monocytic effusion found in EPA synovia.

Alphavirus Infections↗
PubMed2000

Impact of western corn rootworm (Coleoptera: Chrysomelidae) on sweet corn and evaluation of insecticidal and cultural control options.

The western corn rootworm, Diabrotica virgifera virgifera LeConte, is an important pest of corn, Zea mays L., causing yield losses from root damage, plant lodging, and silk feeding. Because little is known about its impact on sweet corn, we conducted research to evaluate the combined effects of insecticide, planting date, and cultivar on root damage, plant lodging, and yield in central New York sweet corn. We also examined the influence of planting date and cultivar on the emergence of adult western corn rootworms. The research was conducted in 1994 and again in 1995 by using a split-split plot experimental design with insecticide as main plot, planting date as subplot, and cultivar as sub-subplot. The effect of cultivar on beetle emergence was not significant. Root damage was not correlated with adult emergence in 1994 but was positively correlated in 1995. In 1994, there was no interaction of the main factors, and all factors had a significant impact on root damage. In 1995 there was an interaction of insecticide and planting date, and of cultivar and planting date. Generally, root damage was reduced by insecticide and later planting. Plant lodging was affected by the interaction of insecticide and planting date, and the interaction of cultivar and planting date, for both years of the study. As with root damage, lodging was reduced with insecticide treatment and later planting but also was dependent on cultivar. In 1994 and especially in 1995, silk clipping by adult western corn rootworms precluded much inference about how yield was influenced by larval feeding damage on roots. The number of emerging western corn rootworm adults was lower and later in later plantings.

Animals↗