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Biomedical subjects

J R Allen

Publications and source records attributed to J R Allen.

At least 91 records · Page 5Linked to original sources
PubMed1990

Viral agents of gastroenteritis. Public health importance and outbreak management.

Each year, infectious gastroenteritis causes greater than 210,000 children in the United States to be hospitalized and 4-10 million children to die worldwide. Since the mid-1970s, knowledge has increased dramatically concerning the viral agents that are responsible for much of this public health burden. Rotavirus, the most common cause of diarrhea among children, infects virtually every child in the United States by the age of 4 years and causes potentially lethal dehydration in 0.75% of children less than 2 years of age. Other recently identified pathogens include the enteric adenoviruses, calicivirus, astrovirus, and the Norwalk family of agents. Conclusive diagnosis of these viruses requires electron microscopic examination of stool specimens, a laboratory technique that is available only at a few large centers, including CDC. Stool samples from an outbreak that are submitted to CDC for detection of viral pathology should be collected in bulk from 10 ill persons during their first 48 hours of illness, while feces are still liquid, and should be stored at 4 C (not frozen). Acute- and convalescent-phase serum samples should be collected from the same persons, plus from an equal number of controls, during the first week of illness and 3 weeks thereafter. Control measures for outbreaks of viral gastroenteritis should focus on the removal of an ongoing common source of infection (e.g., an ill food handler or the contamination of a water supply) and on the interruption of person-to-person transmission that can perpetuate an outbreak in a population after the common source has been removed. Because improvements in environmental hygiene may not be accompanied by reductions of endemic diarrhea caused by viruses, immunization may play an important role in future control; vaccine trials for rotavirus are in progress. In anticipation of vaccine development and use, CDC recently began national surveillance for the viral agents of gastroenteritis. Health-care facilities involved in the detection of rotavirus or the other viral agents of diarrhea can participate.

Acute Disease↗
PubMed1990

Human lactation: forearm trabecular bone loss, increased bone turnover, and renal conservation of calcium and inorganic phosphate with recovery of bone mass following weaning.

The calcium (Ca) metabolism of established human lactation was studied in 40 adult women (mean age 32.4 years) who had been breast-feeding for 6 months (Lac) and in 40 age-matched controls (Con) using fasting urine and blood biochemistry and forearm single-photon bone mineral densitometry (BMD). Serial studies were performed up to 6 months after weaning in Lac women and repeated once in Con women. During lactation the significant findings were (1) a selective reduction (7.1%, P less than 0.03) in BMD at the ultradistal site containing 60% trabecular bone, but not at two more proximal, chiefly cortical bone sites; (2) increased bone turnover affecting bone resorption [fasting hydroxyproline excretion, Lac 2.22 +/- 0.12 mumol/liter GF (mean +/- SEM), Con 1.19 +/- 0.04, P less than 0.001] and affecting bone formation (plasma alkaline phosphatase, Lac 81.9 +/- 2.5 IU/liter, Con 53.5 +/- 2.7, P less than 0.001, and serum osteocalcin, Lac 14.0 +/- 0.7 microgram/liter, Con 7.3 +/- 0.4, P less than 0.001); and (3) renal conservation in the fasting state of both Ca and inorganic phosphate (Pi) with a resultant moderate increase in plasma Pi but not in plasma Ca (total or ionized). There were no differences between the groups in serum parathyroid hormone (PTH, intact and midmolecule assays), 25-hydroxy- and 1,25-dihydroxyvitamin D, nephrogenous cyclic AMP production, or plasma creatinine.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Basophils in skin reactions of mast cell-deficient mice infested with Dermacentor variabilis.

Acquired resistance to ticks in guinea pigs has been found to be associated with basophil-rich skin reactions. Mice, which are generally believed to possess few, if any basophils, also acquire resistance following repeated tick infestations and this has been found to be associated with increased numbers of dermal mast cells. Mast cell-deficient W/Wv mice have, however, also been shown capable of acquiring resistance after two infestations with Dermacentor variabilis larvae. In the studies described here, we have examined, with the electron microscope, skin reactions in W/Wv and +/+ mice undergoing their third infestation with Dermacentor variabilis. Basophils, along with neutrophils and eosinophils, were identified using established criteria. The possibility that basophils contribute to various pathogenetic mechanisms in these and other strains of mice is discussed.

Animals↗
PubMed1990

Nutritional assessment of children with juvenile chronic arthritis.

Nutritional assessment was performed in 38 children with juvenile chronic arthritis (polyarticular [15]; pauciarticular [13]; systemic [10]). This included anthropometric measurements (height, weight, mid-upper arm circumference and four skinfolds) and a 7 day weighed food record. The children were classified according to current type of arthritis which in some cases was not the same as the initial onset type. Mean height Z scores were significantly below the Z score population mean of 0 in the systemic (P = 0.02) and polyarticular (P = 0.009) groups. Mean weight Z scores were also below the mean in the polyarticular group (P = 0.001) but the systemic group did not reach significance. Mean energy intakes were significantly below the recommended dietary intake (RDI) in the systemic (P = 0.01) and polyarticular (P = 0.001) groups. Mean intakes of calcium and zinc were below the RDI of 100% in the polyarticular group (P = 0.0001). Thirteen (34%) of children were taking some form of self-prescribed vitamin and/or mineral supplement. Vitamin C was the most commonly used supplement, despite dietary intakes greatly exceeding the RDI. Nutritional assessment is essential in the management of patients with JCA, in particular those with systemic or polyarticular disease.

Adolescent↗
PubMed1990

Muscle responses of thoroughbreds to conventional race training and detraining.

Ten healthy sedentary Thoroughbreds with previous race training experience were trained conventionally for 9 weeks. Muscle biopsy samples were obtained before and after training and after 6 weeks of detraining pasture rest. Biopsy samples were obtained from the right deltoid, triceps, vastus lateralis, middle gluteal, biceps femoris, and semitendinosus muscles. The deep-frozen biopsy samples were analyzed for activities of succinate dehydrogenase (SDH), 3-hydroxy-acylcoenzyme A dehydrogenase (HAD), and phosphorylase (PHOS) and for glycogen concentration. The triceps and gluteal muscle samples were also serially sectioned and stained for myofibrillar actomyosin adenosine triphosphatase (ATPase) activity after alkaline (pH 10.3) and sequential acidic (pH 4.34) ATPase inactivation. Fiber types I (alkaline preincubation), IIA1, IIA2, and IIA3 (sequential acidic preincubation over 5 minutes) were identified and were evaluated for fiber-type distribution and fiber areas. Increases in response to training were observed in deltoid and vastus muscle SDH and gluteal muscle HAD activities, and deltoid muscle glycogen concentration (P less than 0.05 to P less than 0.01). Changes in PHOS activity were not observed. Type-IIA1, -IIA2, and -IIA3 fiber areas in triceps muscle were increased in response to training (P less than 0.05 to P less than 0.01). Changes in fiber-type distribution did not occur in response to training. Changes in muscle enzyme activities, glycogen concentration, fiber types, and fiber areas were not seen from posttraining to detraining. Further increases were observed when detraining values were compared with pretraining values in deltoid, triceps, vastus, gluteal, and biceps femoris muscle SDH activities and in gluteal muscle glycogen concentration (P less than 0.05 to P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

3-Hydroxyacyl CoA Dehydrogenases↗
PubMed1989

The natural history of transfusion-associated infection with human immunodeficiency virus. Factors influencing the rate of progression to disease.

Patients infected by the human immunodeficiency virus (HIV) as a result of blood transfusions are unique in that their dates of infection are well defined and their medical conditions before infection are known. To characterize the natural history of transfusion-associated HIV infection, we studied 694 recipients of blood from 112 donors in whom AIDS later developed and from 31 donors later found to be positive for HIV antibody. Of the recipients tested, 85 were seronegative, 116 were seropositive, and 19 had AIDS. Of 101 HIV-seropositive recipients followed for a median of 55 months after infection, 54 had Centers for Disease Control Class IV disease, including 43 with AIDS. Life-table analysis suggested that AIDS will develop in 49 percent of infected recipients (95 percent confidence limits, 36 to 62 percent) within seven years after infection. As compared with recipients without AIDS, the 43 recipients with AIDS had received more transfusions at the time of infection (median, 21 vs. 7; P = 0.01). HIV-infected blood donors in whom AIDS developed were grouped according to whether AIDS developed within 29 months (the median) after donation (Group 1) or 29 or more months after donation (Group 2). As compared with the 31 recipients of blood from Group 2 blood donors, the 31 recipients of blood from Group 1 donors were more likely to have AIDS four years after infection (49 percent vs. 4 percent; P = 0.005) and illnesses resembling acute retroviral syndrome (14 of 24 vs. 5 of 22; P = 0.03). We conclude that most recipients of HIV-infected blood become seropositive, that AIDS develops in about half these recipients within seven years, and that the risk may be higher when AIDS develops in the blood donor soon after donation.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Immunology of interactions between ticks and laboratory animals.

There is good reason to believe that the resistance to ixodid ticks acquired by guinea pigs, rabbits and mice is immunologically mediated. One proposed mechanism for this resistance, which may well be common to all these laboratory animals, involves cutaneous hypersensitivity reactions. Basophils accumulate at tick attachment sites in the skin of resistant animals and degranulate in response to tick salivary antigens, releasing histamine and other mediators. The mediators may directly cause ticks to cease salivating and feeding and then to detach, or they may induce reflex grooming reactions by the host, leading to the removal of ticks from the itching skin. There are gaps in the evidence supporting this hypothesis, and it is likely that other modes of tick resistance remain to be described. However, it should be recognized that, although there have been a few details added to the story in the last fifty years, William Trager's original classic observations and conclusions still stand as the core of the current dogma.

Animals↗
PubMed1989

Intraabdominal surgery during pregnancy.

Intraabdominal surgical disease during pregnancy can present a challenge in diagnosis and management for the obstetrician and surgeon. To examine the complications to the fetus and mother and the consequences of a delay in operative intervention, we retrospectively studied all pregnant patients over a 17-year period who had undergone abdominal surgery at one institution. A total of 92 abdominal operations were performed on 90 patients. During the same period, 41,532 deliveries occurred. One in 451 deliveries involved surgical procedures during pregnancy. Thirty-seven patients had surgery for acute appendicitis; 20 patients were operated on for ovarian abnormalities. Postoperatively, there were two maternal deaths: one from cardiac arrhythmia and the other from hepatic failure. The most common postoperative complication was premature labor (19 patients, 21 percent). In 16 of these patients, early tocolysis was begun without fetal loss. There were five fetal deaths. Forty-seven of 72 patients had term deliveries. Intraabdominal surgery during pregnancy carries an acceptable risk to the mother and fetus; complications are related to disease severity and operative delay rather than to the operative procedure itself.

Abdomen↗
PubMed1989

Maternal weight gain, smoking and other factors in pregnancy as predictors of infant birth-weight in Sydney women.

Two hundred and four (204) women attending a Sydney maternity hospital and their babies were followed throughout pregnancy in a study, which aimed: 1) to describe the distribution of maternal weight gain in present day Australian women and 2) to determine the effect of weight gain and other factors on birth-weight. Maternal weights and skinfold thicknesses were measured serially to give an indication of weight gain. Mean weight gain from conception to term was 14.2kg and mean birth-weight was 3,442g. Maternal predictors of birth-weight such as maternal weight gain, parity, age, education, height, public or private booking status, smoking, prepregnancy weight, and sex of the infant and gestational age were explored using simple and multiple regression analysis. Weight gain was predictive of birth-weight, each kg increase in total weight gain resulting in about a 30g increase in birthweight. Other strong predictors were gestational age, maternal smoking, sex of the infant and maternal parity. Maternal height was less strongly predictive and age and prepregnant weight were not predictive. Smoking mothers had infants who were 268g lighter than those of nonsmoking mothers. However, smokers were also younger, shorter, had less education and were more likely to book as public patients than nonsmokers. After adjusting for all other predictors, the birth-weight of infants whose mothers smoked, was still 224g less than that for nonsmoking mothers.

Adolescent↗
PubMed1989

Are herbal teas safe for infants and children?

The use of herbal teas is now widespread in our community--even among children. The effect of dosing children with these products is unknown. The authors feel that the potential hazards associated with herbal teas need to be exposed.

Beverages↗
PubMed1988

Transmission of human immunodeficiency virus (HIV) by blood transfusions screened as negative for HIV antibody.

Since early 1985, blood donations in the United States have been screened for antibody to human immunodeficiency virus (HIV). To identify instances of HIV transmission by antibody-negative donations, we investigated 13 persons seropositive for HIV who had received blood from 7 donors who were screened as negative for HIV antibody at the time of donation. Twelve of the 13 recipients had no identifiable risk factors for HIV infection other than the transfusions they had received. On evaluation 8 to 20 months after transfusion, HIV-related illnesses had developed in three recipients, and the acquired immunodeficiency syndrome had developed in one. All seven donors were found to be infected with HIV. On interview, six reported a risk factor for HIV infection, and five had engaged in high-risk activities or had had an illness suggestive of acute retroviral syndrome within the four months preceding their HIV-seronegative donation. Thus, these donors had apparently been infected only recently, and so were negative at the time of blood donation according to available antibody tests. We conclude that there is a small but identifiable risk of HIV infection for recipients of screened blood. To minimize this risk, the reasons for deferral of donation need to be communicated more effectively to blood donors who are at high risk of HIV infection, and new assays that detect HIV infection earlier should be evaluated for their effectiveness in screening donated blood.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Risk of human immunodeficiency virus transmission from heterosexual adults with transfusion-associated infections.

The risk of human immunodeficiency virus (HIV) transmission was studied by interviewing and testing the serum of heterosexual contacts and casual family contacts of adults with transfusion-associated HIV infections. Two (8%) of 25 husbands and ten (18%) of 55 wives who had had sexual contact with infected spouses were seropositive for HIV. Compared with seronegative wives, the seropositive wives were older (median ages, 54 and 62 years; P = .08) and actually reported somewhat fewer sexual contacts with their infected husbands (means, 156 and 82; P greater than .1). There was no difference in the types of sexual contact or methods of contraception of the seropositive and seronegative spouses. There was no evidence of HIV transmission to the 63 other family members. Although most husbands and wives remained uninfected despite repeated sexual contact without protection, some acquired infection after only a few contacts. This is consistent with an as yet unexplained biologic variation in transmissibility or susceptibility.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Lifestyle factors in monozygotic and dizygotic twins.

In examining genetic influences on biological variables using twins, it may be important to examine the distribution between and within twin pairs of demographic and lifestyle factors that may themselves affect the biological variable being studied. We explored the distribution of demographic and lifestyle factors that may affect blood lipid levels or ischaemic heart disease (IHD) risk among a sample of 106 monozygotic (MZ) and 94 like-sex dizygotic (DZ) twin pairs. In our sample, MZ twins were statistically significantly different from DZ twins only in marital status, cigarette smoking habits, and the ratio of polyunsaturated to saturated fat (P:S ratio) in their dietary intake. The latter variable was among many dietary variables examined (using 4-day weighed food diaries), and the size of the difference in intake was small. When comparisons were made of the similarities within twin pairs, we found members of MZ twin pairs to be statistically significantly closer than DZ twins in educational achievement, occupation, cigarette smoking, and exercise habits, and the number of days a week on which alcohol was consumed. These last three variables were consistently closer among twins with closer contact than among those with a smaller degree of current shared environment. For 12 of the 13 nutrients examined, the within-pair correlations were higher for MZ than for DZ twins, although our test for significant genetic variance showed statistical significance only for intake of complex carbohydrates. We conclude that MZ twins share demographic and lifestyle factors that might influence the risk of IHD and blood lipid levels to a greater degree than do DZ twins, although it is difficult to say if these similarities in lifestyle result from genetic influences or not. Nevertheless, ascribing differences between correlations in MZ and DZ twin pairs for lipid levels as being purely "genetic"--as implicit in conventional measures of heritability--is likely to overestimate the influence of genetic factors.

Adolescent↗
PubMed1988

Twin study of genetic and environmental effects on lipid levels.

A study of 106 pairs of monozygotic (MZ) and 94 pairs of dizygotic (DZ) twins tested the hypothesis that part of the previously described genetic influence on blood lipid levels can be ascribed to closer similarities among MZ than among DZ twin pairs in environmental factors that affect lipid levels. Participants were adult twin volunteers (age 17-66; 64 male and 136 female pairs) who were selected from the NH & MRC Twin Registry or were respondents to advertisements. They completed a 4-day weighed food diary from which mean nutrient intake was derived. Information on lifestyle and demographic variables was obtained by questionnaire and a nonfasting blood sample was taken for measures of total, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol and the HDL2 and HDL3 subfractions. Height and weight were measured, and body mass index (BMI) was calculated (kg/m2). Estimates of the heritability of sex-adjusted lipid levels were 0.72 for total cholesterol, 0.79 for HDL cholesterol, 0.69 for HDL2, 0.20 for HDL3, 1.06 for LDL cholesterol, and 0.44 for sex-adjusted BMI. In all cases except for HDL3, genetic variance was statistically significant. After adjusting for the effects of environmental variables in three different ways, the estimates of heritability were somewhat lower for total cholesterol, HDL2, and BMI, and those for HDL cholesterol (borderline) and LDL cholesterol (definitely) remained statistically significant but were decreased. A genetic influence on HDL3 was not found. Adjusted heritability estimates obtained from one method of analysis were 0.35 for total cholesterol, 0.49 for HDL, 0.04 for HDL2, -0.34 for HDL3, 0.66 for LDL, and 0.32 for BMI. These results suggest that the assumptions made in the classical twin study approach are not appropriate when examining genetic effects on lipid levels or BMI, or indeed on any biological variable that may be affected by environmental factors that tend to be more similar in MZ twins than in DZ twins. In these circumstances, more complex models may be needed to differentiate between genetic and environmental influences.

Adolescent↗
PubMed1988

A model-based approach to characterize the incubation period of paediatric transfusion-associated acquired immunodeficiency syndrome.

Traditional statistics, such as the average, currently provide a misleading statistical description of the incubation periods of paediatric transfusion-associated acquired immunodeficiency syndrome (TA-AIDS). Two types of length-biased sampling, left censoring and right censoring, occur in the 37 cases diagnosed before 1986 and reported to the Centers for Disease Control by 15 September 1986. To correct for these problems, we propose a truncated Weibull distribution with use of a maximum likelihood technique. This approach suggests that the mean incubation period of paediatric TA-AIDS cases is 2.4 years with a 90 per cent confidence interval ranging from 1.5 years to 7.2 years. The mode is 1.25 years. These estimates are much shorter than those recently published for adults, therefore the success of TA-AIDS prevention strategies may be seen sooner in the paediatric age group.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Immunocytochemical identification of bovine Langerhans cells by use of a monoclonal antibody directed against class II MHC antigens.

We undertook a study to develop a reliable light microscopic technique for identifying Langerhans cells (LC) in bovine epidermis. Monoclonal antibodies (MCA) detecting bovine class II MHC antigens were used in conjunction with an avidin-biotin-peroxidase complex (ABC) immunocytochemical staining method. The specificity of the MCA for LC was confirmed ultrastructurally by use of gold-labeled second antibody. Epidermal sheets and epidermal single-cell suspensions examined by light microscopy confirm that bovine epidermal LC express class II antigens. Anti-bovine class II MCA is a dependable reagent for identification of LC in normal bovine epidermis.

Animals↗
PubMed1988

Prevention of AIDS and HIV infection: needs and priorities for epidemiologic research.

By the end of 1987, almost 50,000 cases of acquired immunodeficiency syndrome (AIDS) will have been reported in the United States. Although the primary epidemiology of the disease has been described, much work remains to be done to complete our understanding of the dynamics of transmission and infection with the causative virus, human immunodeficiency virus (HIV). At the state and local level, the highest priorities for epidemiologic research are to understand better the precise populations at risk of prevalent and incident HIV infection, and to use this information to direct and monitor specific prevention programs that are likely to be effective for the populations at risk. These parallel efforts-sophisticated investigative epidemiologic research and applied epidemiologic and serosurveillance studies-must be expanded rapidly and continued for the forseeable future if we are to accomplish the goal of preventing further spread of HIV.

Acquired Immunodeficiency Syndrome↗