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Biomedical subjects

J Golding

Publications and source records attributed to J Golding.

At least 109 records · Page 6Linked to original sources
PubMed1994

Early regeneration in vitro of adult mouse sciatic axons is dependent on local protein synthesis but may not involve neurotrophins.

The sensory axons of the adult mouse sciatic nerve were shown to regenerate after a local test crush lesion in vitro in a serum-free medium. The average outgrowth distance of the leading axons after culturing for 3 days was 2.8 +/- 0.1 mm, which was shorter than in vivo (3.8 +/- 0.2 mm). With the use of a compartmentalised culture system we could show that regeneration was partially dependent on local protein synthesis in the injury region. The initial stages of regeneration did not seem to involve neurotrophins since both K252a and K252b, selective and nontoxic inhibitors of the neurotrophin actions, failed to inhibit axonal growth. The present in vitro model system offers favourable conditions to investigate the early events of the regeneration process in an adult mammalian peripheral nerve.

Animals↗
PubMed1994

Perinatal mortality survey in Jamaica: aims and methodology.

The Jamaican Perinatal Mortality Survey was designed to identify the true perinatal mortality rate, and assess the factors which could contribute towards a reduction in perinatal mortality on the island. All births in a 2-month period (n = 10527) were compared with all perinatal deaths occurring over a 12-month period (n = 2069). Over half the deaths (n = 1058) received a detailed post-mortem examination. Use of the Wigglesworth classification identifies the major component of perinatal death in this country to be associated with intrapartum asphyxia (44% of deaths). Deaths due to congenital malformations and miscellaneous causes contribute relatively little (< 10%) to the overall mortality rate. Over a quarter of deaths apparently occur before the onset of labour, and a fifth are prematurely liveborn but die of causes related to immaturity.

Autopsy↗
PubMed1994

Associations between social and environmental factors and perinatal mortality in Jamaica.

Social and environmental factors in Jamaica were compared between 9919 mothers delivering in a 2-month period a singleton who survived the early neonatal period and 1847 mothers who were delivered of a singleton perinatal death in a contiguous 12-month period. Logistic regression showed independent positive statistically significant increased odds of having a perinatal death among mothers who lived in rural parishes, older mothers (aged 30 +), single parents, no other children in the household, large number of adults in the household, mother unemployed, the major wage earner of the household not being in a managerial, professional or skilled non-manual occupation, the household not having sole use of toilet facilities, smaller mothers and those classified as obese or undernourished. Variations were found for different categories of death. Intrapartum asphyxia deaths were not related to union (marital) status, occupation of major wage earner, number of adults nor to the use of the toilet. Antepartum fetal deaths did not vary significantly with occupation of major wage earner or maternal height, but did show a relationship with maternal education, mothers with lowest levels having reduced risk. Deaths from immaturity were significantly related only to occupation of major wage earner, number of children in the household, number of social amenities available (negative relationships) and maternal age (< 17 at highest risk). In conclusion there was little to indicate that social deprivation per se was related to perinatal death, although specific features of the environment showed strong relationships.

Adolescent↗
PubMed1994

Past obstetric history and risk of perinatal death in Jamaica.

Singleton survivors born to multigravidae in the whole island of Jamaica in 2 months (September-October 1986) were compared with singleton perinatal deaths occurring to multigravidae throughout the island in the 12-month period September 1986 to August 1987. Past obstetric history was obtained from the mothers using a structured questionnaire. Deaths were categorised using the Wigglesworth classification. Logistic regression was used to compare current outcomes in women who had had at least one previous pregnancy. Antepartum fetal deaths with (1) outcome of last pregnancy; (2) previous Caesarean section; (3) previous stillbirth; and (4) increasing gravidity. In the presence of these factors maternal age ceased to be statistically significant. Deaths from immaturity were strongly associated with the past obstetric history, with increased risks for pregnancies to mothers with a history of previous miscarriage, perinatal death and premature live births. In general, however, the higher the gravidity the lower the risk. In the presence of these factors, maternal age showed no significant association. Intrapartum asphyxia was also associated with the outcome of the last pregnancy, history of prior stillbirth or neonatal death. First pregnancies were at significantly higher risk than second pregnancies (P < 0.05). For perinatal deaths as a whole, and in the presence of maternal age, the following were statistically significant independent factors: (1) the outcome of the immediately preceding pregnancy (high risks associated with prior miscarriage, stillbirth and premature live births); (2) previous Caesarean section (increased risk); (3) previous perinatal deaths; and (4) more than one prior early fetal loss. The results indicated that prior poor obstetric history bears similar risks of subsequent adverse outcome in the developing as in the developed world. There was no variation in risk, however, with interpregnancy interval or previous termination. Much of the variation in risk of perinatal death with maternal age among multigravidae appears largely to be secondary to past obstetric history.

Abortion, Spontaneous↗
PubMed1994

Medical conditions present during pregnancy and risk of perinatal death in Jamaica.

In an attempt to identify causes of perinatal mortality and thence devise preventative strategies on the island of Jamaica, a study was made of the 1847 singleton perinatal deaths occurring over the 12-month period between 1 September 1986 and 31 August 1987. Complications of the pregnancy were elicited by questioning the mother as well abstracting data from the antenatal and clinical obstetric records. The deaths were classified using the Wigglesworth categorisation and the three largest groups were chosen for special study: antepartum fetal deaths, deaths of live birth from immaturity and deaths from intrapartum asphyxia. The medical features of the pregnancies were compared with data similarly obtained from 9919 women delivering singletons in the 2 months of September and October 1986 and who survived the first week of life. Unadjusted statistically significant associations were found with maternal syphilis, vaginal infection or discharge, bleeding in the first two trimesters, bleeding in the third trimester, lowest haemoglobin, highest diastolic and first diastolic blood pressures, highest level of proteinuria, diabetes and antenatal eclampsia. Logistic regression taking account of social, environmental and health behaviour variables showed the following significant relationships. Antepartum fetal death was associated with adjusted odds ratio (AOR) for syphilis 2.88 [95% confidence interval (CI): 1.91, 4.32], bleeding in third trimester 3.86 [2.73, 5.44], highest diastolic blood pressure (P < 0.0001), highest level of proteinuria (P < 0.0001), lowest Hb (P < 0.0001) and antenatal eclamptic fits AOR 4.62 [1.47, 14.50]. Deaths from immaturity were independently associated with bleeding < 28 weeks AOR 3.50 [2.39, 5.13], bleeding 28 + weeks AOR 1.93 [1.16, 3.22], highest diastolic blood pressure (P < 0.01) and highest level of proteinuria (P < 0.0001). Infection featured in deaths associated with intrapartum asphyxia, with syphilis AOR 2.17 [1.44, 3.26] and vaginal infection/discharge (P < 0.01) independently associated; other strong associations were bleeding < 28 weeks AOR 2.10 [1.57, 2.81], bleeding 28 + weeks AOR 2.32 [1.62, 3.33], highest diastolic blood pressure (P < 0.0001), first diastolic blood pressure (P < 0.0001) and antenatal eclampsia AOR 6.70 [2.63, 17.13]. For all perinatal deaths combined, independent features were syphilis AOR 2.06 [1.49, 2.85], vaginal infection/discharge (P < 0.001), bleeding < 28 weeks AOR 2.01 [1.60, 2.53], bleeding 28 + weeks AOR 2.65 [2.02, 3.48], highest diastolic blood pressure (P < 0.0001), first diastolic blood pressure (P < 0.0001), proteinuria (P < 0.0001) and antenatal eclampsia AOR 4.22 [1.76, 10.14]. The results help identify areas for monitoring and identifying pregnancies at highest risk.

Asphyxia Neonatorum↗
PubMed1994

Antenatal and perinatal care in Jamaica: do they reduce perinatal death rates?

Information concerning 9919 singleton pregnancies delivered in Jamaica in the 2-month period of September and October 1986 and surviving the early neonatal period were compared with 1847 singleton perinatal deaths occurring in the 12-month period from 1 September 1986 to 31 August 1987, classified according to the Wigglesworth schema. Logistic regression was used to assess features of antenatal and intrapartum care that were associated with the different groups of perinatal death after taking account of environmental, maternal and medical factors. In Jamaica, 67% of all mothers took iron during pregnancy. These mothers appeared to have a lower risk of perinatal death. This does not appear to be an artefact related to the gestation at which the mother delivers, and was particularly associated with antepartum fetal deaths. Commencement of antenatal care in the first trimester appeared to reduce the risk of all perinatal deaths, and for intrapartum asphyxia in particular. It is speculated that the mechanism may involve early detection and treatment of anaemia and syphilis. Quality of perinatal care available in the area of residence, as measured by the presence of consultant obstetricians and a paediatric consultant unit, is shown to be significantly related to a reduction in deaths from intrapartum asphyxia, but it appeared not to be related to antepartum fetal deaths.

Asphyxia Neonatorum↗
PubMed1994

The epidemiology of antepartum fetal death in Jamaica.

All perinatal deaths occurring over a 12-month period on the island of Jamaica were classified using the Wigglesworth schema. In all, there were 584 antepartum fetal deaths (incidence 10.7 per 1000 total births). Comparison of the 558 singleton deaths with 9919 singleton survivors revealed, using logistic regression, strong associations with union (marital) status, maternal employment status, the composition of the household, the sole use of a toilet by the household, the parish of residence, whether the mother was trying to get pregnant and the mother's age (the older the mother the higher the risk). Independent of these factors were strong statistically significant relationships with syphilis, diabetes, maternal anaemia, third-trimester bleeding, highest diastolic blood pressure of 90mm or more and highest proteinuria of ++ or more. Mothers who had taken prophylactic iron were at substantially lower risk compared with those who had not. We conclude that appropriate identification and treatment of syphilis, diabetes, anaemia and hypertension give the best chance of reduction of the high antepartum fetal death rate on the island.

Female↗
PubMed1994

Perinatal deaths as a result of immaturity in Jamaica.

During the 12-month period from 1 September 1986 to 31 August 1987 an attempt was made to collect information on all perinatal deaths occurring on the island of Jamaica. Of the 2069 late fetal and early neonatal deaths identified, 19% fell into the Wigglesworth definition of 'deaths from immaturity'. Twins were 11 times more likely to die of immaturity than were singletons, and twins comprised 18% of all deaths in this group. Comparison of the singleton deaths from immaturity, with 9919 singletons born on the island during the 2-month period of September and October 1987 and who survived the first 7 days, revealed several strong risk factors. These included history of previous miscarriages, stillbirth, early neonatal death or preterm delivery, and complications of bleeding and hypertension (highest diastolic, proteinuria and eclampsia all having independent associations). None of these factors 'explained' a strong negative relationship with the number of young children in the household. There was an apparent protective effect of maternal folic acid ingestion which warrants further investigation.

Cohort Studies↗
PubMed1994

Deaths associated with intrapartum asphyxia in Jamaica.

The Jamaican Perinatal Mortality Survey compared all 2069 perinatal deaths occurring during the 12 months between 1 September 1986 and 31 August 1987 with 10,086 survivors born in the 2 months of September and October 1986. The Wigglesworth classification identified 44% of the deaths as attributable to intrapartum asphyxia (IPA), and this grouping was largely confirmed by post-mortem examination where it had been carried out. About half of these babies weighted 2500 g+ and death should have been largely preventable. Comparison of the 813 IPA singleton deaths with 9919 singleton survivors using logistic regression showed independent associations with maternal employment status, the number of children in the household, maternal height, whether or not the mother was trying to get pregnant, or had ever used an intrauterine contraceptive device. Medical conditions such as syphilis, untreated vaginal infection, bleeding < 28 weeks, bleeding 28+ weeks, highest diastolic and first diastolic blood pressures and eclamptic fits antenatally were all strongly associated. Mothers who commenced antenatal care in the first trimester were at reduced risk as were those who took iron during pregnancy. There were substantial reductions in mortality in areas where better medical facilities were available. To this model, features of previous obstetric history were offered, but the only variables which entered were those relating to prior perinatal deaths and immediately preceding miscarriage and termination. Examination of specific features in the management of labour and delivery is a logical basis for the introduction of changes in practice. Caesarean section is unlikely to be appropriate but it is suggested that more active interventions in terms of use of forceps and/or vacuum extraction may be useful.

Asphyxia Neonatorum↗
PubMed1994

The epidemiology of perinatal death in Jamaica.

Information from the Jamaican Perinatal Mortality Survey was used to identify features of mothers and their pregnancies that were independently associated with perinatal death. Social, biological, environmental, life style and medical aspects of mothers and their pregnancies were collected on two inter-locking subsamples: (1) all births on the island of Jamaica in the 2 months of September and October 1986, the 'cohort months', and (2) all fetal deaths of weight 500 g or more, together with all neonatal deaths, in the 12-month period from 1 September 1986 to 31 August 1987. Singleton survivors from the cohort months were compared with all perinatal deaths in the 12-month period using logistic regression. The first model omitted items concerning past obstetric history, but these were included in the second model. In total, 21 variables entered the first model and 24 the second. The only item that became non-significant when past obstetric history was included was maternal age. The final model compared 1017 perinatal deaths with 7672 survivors. It consisted of the following: union (marital) status (married being at lower risk, P < 0.01), maternal employment status (housewives at lowest risk, P < 0.001), number of adults in household (the more the higher the risk, P < 0.05), the number of children aged < 11 (the more the lower the risk, P < 0.0001), use of toilet facilities (shared with other households increased risk, P < 0.001), maternal height (tall women at reduced risk, P < 0.001), mother's report that she was trying to get pregnant (P < 0.001), maternal alcohol consumption (drinkers had lower risk, P < 0.05), maternal syphilis (higher risk, P < 0.0001), bleeding before 28 weeks (higher risk, P < 0.0001), bleeding at 28 weeks or more (higher risk, P < 0.0001), first diastolic blood pressure (80 mm + at higher risk, P < 0.0001), highest diastolic blood pressure (100 mm + at increased risk, P < 0.0001), highest proteinuria (++ or more at increased risk, P < 0.0001), vaginal discharge/infection (untreated at increased risk, P < 0.001), pre-eclampsia diagnosed in antenatal period (increased risk, P < 0.01), maternal diabetes (increased risk, P < 0.05), start of antenatal care (first trimester at reduced risk, P < 0.01), iron taken (reduced risk, P < 0.0001), type of perinatal care available in parish of residence (reduced risk if consultant obstetricians and paediatricians available at all times, P < 0.0001), number of miscarriages and terminations (the more the higher the risk, P < 0.0001), previous stillbirth (higher risk, P < 0.0001), previous early neonatal death (higher risk, P < 0.001), previous Caesarean section (higher risk, P < 0.01). The implications for reduction in perinatal mortality rates are discussed.

Cohort Studies↗
PubMed1994

The contribution of twins to perinatal mortality in Jamaica.

The Jamaican Perinatal Mortality Survey collected data that have been used in this paper to estimate: (1) the rate of multiple deliveries on the island; (2) the way in which this varies with demographic features; and (3) the causes of perinatal mortality among twins on the island. The survey consisted of two phases: a study of all births in the months of September and October 1986 (the cohort months) and a study of all perinatal deaths in the 12 months from 1 September 1986 to 31 August 1987. Among the 10,408 pregnancies in the cohort months, 99(1.0%) were multiple pregnancies. The twinning rate showed statistically significant trends with maternal age and parity but no association with social factors. Among the 2020 perinatal deaths occurring in the 12-month period, 173 (8.6%) were twins, with particularly high contribution to the Wiggles-worth group 'deaths from immaturity'. Mortality rate of twins was significantly lower if mothers resided in areas where there were good obstetric and paediatric facilities.

Adolescent↗
PubMed1994

Spontaneous lymphocyte proliferation in human T-cell lymphotropic virus type I (HTLV-I) and HTLV-II infection: T-cell subset responses and their relationships to the presence of provirus and viral antigen production.

Spontaneous lymphocyte proliferation (SLP) during in vitro culture of mononuclear cells (MCs) characterizes over half of asymptomatic individuals infected with human T-cell lymphotropic virus type I (HTLV-I) or HTLV-II. Both CD4 and CD8 T-cell subsets within MC cultures are activated during SLP, as judged by high-density CD25 (CD25bright) expression; it is unclear, however, whether both cell subsets can directly undergo SLP. In the present investigation, the SLP capacities of purified CD8 and CD4 cells were examined in subjects infected with HTLV-I (n = 19) or HTLV-II (n = 54) in relation to the SLP status of MCs from each subject. No increase in SLP was observed for CD8 or CD4 cells from SLP-negative (SLP-) HTLV-infected subjects, whereas robust SLP characterized CD8 cells from all SLP-positive (SLP+) individuals, regardless of HTLV type. In contrast, SLP+ CD4 cells characterized only 23% (7 of 31) of HTLV-II+ SLP+ individuals, whereas SLP+ CD4 cells characterized 100% of HTLV-I+ SLP+ individuals. In cocultures of HTLV-II+ SLP+ CD8 cells and autologous SLP- CD4 cells, sizable proportions of both CD8 cells and CD4 cells coexpressed CD25bright, suggesting that SLP- CD4 cells were activated in the presence of SLP+ CD8 cells. PCR analysis for tax sequences detected provirus in most CD4- and CD8-cell preparations from HTLV-seropositive individuals, regardless of type and the SLP status of cell subsets. To determine whether SLP was associated with activation of viral genes, levels of HTLV-I and HTLV-II core antigen (Ag) in supernatants were measured. Viral Ag production and SLP responses were significantly correlated for both CD4 and CD8 cells in both HTLV-I and HTLV-II infections. However, inhibition of CD8- or CD4-cell SLP by cyclosporin A or anti-Tac (anti-CD25) did not reduce Ag production, indicating that Ag production is not coupled to SLP. These findings show that CD4 cells from SLP+ HTLV-I+ and SLP+ HTLV-II+ individuals differ in SLP capacity, that the absence of SLP does not indicate a lack of infection, and that production of viral Ag is associated with, but not dependent on, SLP.

Base Sequence↗
PubMed1994

Characterization of circulating CD4+ CD8+ lymphocytes in healthy individuals prompted by identification of a blood donor with a markedly elevated level of CD4+ CD8+ lymphocytes.

During flow cytometric analysis of lymphocytes from healthy donors, we identified a donor (donor A) with 22% CD4+ CD8+ cells (versus values of < 4% for 65 other controls). To determine if CD4+ CD8+ cells from donor A and other controls were similar, we first defined the phenotypic profile of control CD4+ CD8+ cells. Enriched CD4+ CD8+ cell populations for 10 controls were prepared by a two-step positive selection scheme with anti-CD4-coated magnetic beads and anti-CD8-coated culture flasks; the selected population averaged 69% CD4+ CD8+ cells and 31% CD4+ CD8- cells. For all 10 controls, two subsets of CD4+ CD8+ cells, CD4dim CD8bright and CD4bright CD8dim, were observed. Phenotypic profiles of these two CD4+ CD8+ subsets were defined by pairing anti-CD8 with other monoclonal antibodies, and the profiles were compared with each other and with those of CD4+ CD8-, CD4- CD8bright, and CD4- CD8dim cells. CD8bright and CD4bright CD8dim cells differed in their proportions of CD62-L+ cells and in their levels of CD11a and CD2 expression. Both CD4+ CD8+ subsets resembled CD4+ CD8- cells in CD45RA, CD45RO, and CD25 expression; the comparable CD- CD8+ cells in CD62-L expression; and CD4- CD8bright cells in CD11b, CD11b, CD16/56, and CD28 expression. CD38 expression in both CD4+ CD8+ subsets was decreased compared with those of other cell subsets. Whereas control CD4+ CD8+ cells averaged 33% CD4dim CD8bright, CD4+ CD8+ cells from donor A were > 90% CD4dim CD8bright. Donor A CD4dim CD8bright cells exhibited proportional decreases in CD25 and CD62-L expression and increases in CD11b and CD54 expression compared with those of control CD4dim CD8bright cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Donors↗