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Biomedical subjects

J R Higgins

Publications and source records attributed to J R Higgins.

At least 37 records · Page 2Linked to original sources
PubMed1998

Circulating vascular cell adhesion molecule-1 in pre-eclampsia, gestational hypertension, and normal pregnancy: evidence of selective dysregulation of vascular cell adhesion molecule-1 homeostasis in pre-eclampsia.

OBJECTIVE: Our purpose was to investigate circulating levels of vascular cell adhesion molecule-1 in the peripheral and uteroplacental circulations during normotensive and hypertensive pregnancies. STUDY DESIGN: This prospective observational study involved 2 patient groups. Group 1 consisted of 22 women with pre-eclampsia and 30 normotensive women followed up longitudinally through pregnancy and post partum. There were an additional 13 women with established gestational hypertension. Group 2 consisted of 20 women with established pre-eclampsia and 19 normotensive control subjects undergoing cesarean delivery. Plasma levels of vascular cell adhesion molecule-1 were measured in blood drawn from the antecubital vein (group 1) and from both the antecubital and uterine veins (group 2). Data were analyzed by analysis of variance. RESULTS: In group 1 vascular cell adhesion molecule-1 levels did not change significantly throughout normal pregnancy and post partum. Women with established pre-eclampsia had increased vascular cell adhesion molecule-1 levels compared with the normotensive pregnancy group (P = .01). Vascular cell adhesion molecule-1 levels were not elevated in women with established gestational hypertension. In group 2 significantly higher levels of vascular cell adhesion molecule-1 were detected in the uteroplacental (P < .0001) and peripheral (P < .0001) circulations of pre-eclamptic women by comparison with normotensive women. In the pre-eclamptic group there was a tendency toward higher vascular cell adhesion molecule-1 levels in the peripheral circulation than in the uteroplacental circulation (P = .06). In contrast to vascular cell adhesion molecule-1, circulating levels of E-selectin and intercellular adhesion molecule-1, other major leukocyte adhesion molecules expressed by the endothelium, were not different in pre-eclamptic and normotensive pregnancies. CONCLUSION: Established pre-eclampsia is characterized by selective dysregulation of vascular cell adhesion molecule-1 homeostasis. This event is not an early preclinical feature of pre-eclampsia, does not persist post partum, is not a feature of nonproteinuric gestational hypertension, and is not observed with other major leukocyte adhesion molecules. Induction of vascular cell adhesion molecule-1 expression in pre-eclampsia may contribute to leukocyte-mediated tissue injury in this condition or may reflect perturbation of other, previously unrecognized, functions of this molecule in pregnancy.

Adult↗
PubMed1998

Hemostasis in the uteroplacental and peripheral circulations in normotensive and pre-eclamptic pregnancies.

OBJECTIVE: Our purpose was to determine the hemostatic changes in the uteroplacental and peripheral circulations in normotensive and pre-eclamptic pregnancies. STUDY DESIGN: This prospective, observational study involved 2 patient groups. Group 1 consisted of 30 normotensive women and 22 women with pre-eclampsia who were followed up longitudinally through pregnancy and post partum. Group 2 consisted of 20 women with established pre-eclampsia and 19 normotensive control subjects, all undergoing cesarean section. Plasma levels of thrombin-antithrombin III complex, soluble fibrin, plasmin-alpha2-antiplasmin complex, and fibrin-degradation product (D-dimer) were measured in blood drawn from the antecubital vein (group 1) and from both the antecubital and uterine veins (group 2). Data were analyzed by analysis of variance. RESULTS: In group 1 levels of thrombin-antithrombin III complex, soluble fibrin, and fibrin-degradation product were significantly higher during normal pregnancy than at 6 weeks post partum. Plasmin-alpha2-antiplasmin complex levels did not change. No differences between the pre-eclamptic and normotensive pregnancy groups were found for any of the hemostatic markers. In group 2 normotensive women undergoing cesarean section, thrombin-antithrombin III complex and soluble fibrin levels were significantly higher in the uterine vein than in the antecubital vein. In group 2 women with pre-eclampsia, thrombin-antithrombin III complex and fibrin-degradation product levels were significantly higher in the uterine vein than in the antecubital vein. In addition, plasmin-alpha2-antiplasmin complex and fibrin-degradation product levels were higher and soluble fibrin levels were lower in the uterine vein in the pre-eclamptic group than in the normotensive group. CONCLUSION: Both the coagulation and fibrinolytic systems are activated during normal pregnancy. Activation of these systems is more marked in the uteroplacental circulation than in the systemic circulation in both normotensive and pre-eclamptic pregnancies. An abnormal pattern of hemostasis occurs in the uteroplacental circulation in pre-eclampsia.

Adult↗
PubMed1998

Pre-eclampsia--still a disease of theories?

The pathophysiology of pre-eclampsia remains poorly understood. Moreover, there is no reliable predictive test and no effective prophylactic therapy for this disease. Advances have, however, recently been made in our understanding of the genetics of pre-eclampsia and in the processes which lead to abnormal trophoblastic invasion in pre-eclampsia. Prediction and prevention are intimately linked, and both problems will only be solved by further unravelling of the complex pathophysiology of pre-eclampsia.

Female↗
PubMed1998

Ambulatory blood pressure monitoring in pregnancy.

Hypertensive disorders of pregnancy remain a major cause of maternal and perinatal morbidity and mortality. Diagnosis and management of these disorders has relied on conventional blood pressure measurement, a technique fraught with error and uncertainty. Ambulatory blood pressure measurement is a promising new technique that has the potential to overcome the inaccuracies of conventional blood pressure measurement. Several ambulatory blood pressure monitors have been validated in pregnant populations, and normal reference ranges have been established. More recent research has focused on the potential clinical roles of ambulatory blood pressure measurement in pregnancy. This review addresses the limitations of conventional blood pressure measurement and reviews the current literature on the application of ambulatory blood pressure measurement in pregnancy.

Blood Pressure Monitoring, Ambulatory↗
PubMed1997

Can 24-hour ambulatory blood pressure measurement predict the development of hypertension in primigravidae?

OBJECTIVE: To assess the role of 24-hour ambulatory blood pressure measurement in the mid-second trimester as a predictive test for the development of hypertension in pregnancy. DESIGN: Prospective intervention. SETTING: The Rotunda Hospital, Dublin. PARTICIPANTS: One thousand one hundred and two healthy primigravid women. INTERVENTION: 24-hour ambulatory blood pressure measurement at 18 to 24 weeks of gestation. MAIN OUTCOME MEASURES: The development of pre-eclampsia or gestational hypertension. RESULTS: A total of 1048 women had sufficient readings to be included in the final analysis. Of these, 23 (2.2%) developed pre-eclampsia, 64 (6.1%) developed gestational hypertension and 961 (91.7%) remained normotensive. Significantly higher ambulatory blood pressures were recorded in both the pre-eclamptic and gestational hypertensive group compared with the normotensive group. In addition, the gestational hypertensive group had significantly higher clinically measured blood pressure compared with the normotensive group. There were no differences between the pre-eclamptic and the gestational hypertensive group for any of the blood pressure parameters analysed. The best overall predictor for pre-eclampsia was 24-hour mean diastolic pressure which using a cutoff level of 71 mmHg gave a test with a sensitivity of only 22% and a positive predictive value of 15%. CONCLUSION: Because the absolute differences are small and the overlap between the hypertensive and normotensive groups large, ambulatory blood pressure measurement, in a healthy primigravid population, between 18 and 24 weeks of gestation is not a useful predictor of hypertension.

Adult↗
PubMed1992

Shared antigenic epitopes of the major core proteins of human and simian immunodeficiency virus isolates.

Antigenic epitopes on the major core (gag) protein of isolates of simian and human immunodeficiency virus (SIV and HIV) were compared using a panel of eleven mouse monoclonal antibodies (Mabs) that recognized nine distinct gag epitopes. Viral isolates used for comparison were HIV-1IIIb, HIV-2ROD, and SIV isolates from macaque (SIVmac), sooty mangabey (SIVsm-UCD), African green monkey (SIVagm), and stump-tailed macaque (SIVstm-UCD). The relatedness of the various HIV and SIV isolates, as determined by Mabs to core protein epitopes, paralleled that ascertained by genetic sequencing.

Antibodies, Monoclonal↗
PubMed1990

Studies with canine sera that contain antibodies which recognize human immunodeficiency virus structural proteins.

In a serological survey, using the immunoblotting technique, we found that substantial numbers of dog sera from both normal and diseased dogs, including dogs with neoplasia, reacted with one or more human immunodeficiency virus (HIV) recombinant proteins. A total of 144 dog sera were tested, and 72 (50%) of them reacted with one or more HIV recombinant structural proteins. Ten dog sera were also tested for reactivity with simian immunodeficiency virus (SIV), feline immunodeficiency virus (FIV), and caprine arthritis encephalitis virus (CAEV). Six dog sera reacted with at least the major core protein of HIV, while one of the dog sera tested reacted with SIV core protein, and there were no reactions with the viral proteins of either FIV or CAEV. Cell extracts from canine peripheral blood lymphocytes cocultivated with human cells and an extract of human cells infected with HIV were immunoblotted against dog sera which previously tested positive or negative on HIV recombinant protein commercially available Western blot strips. Two lymphocyte lysates and the HIV-infected Hut cell lysate reacted with the Western blot strip-positive dog serum; however, no reactions were seen with the Western blot strip-negative dog serum.

Animals↗
PubMed1989

Studies on the structure and intrinsic innervation of the normal human prostate.

Prostates from eight adult males (age range 17-63 years) were employed in this investigation. Six glands were obtained from multiorgan transplantation donors at the time of organ harvesting, and two additional glands, at routine post-mortem. Microscopic examination has shown that the majority of acini in the peripheral parts of the gland were individually relatively small and lined by an epithelium two to three cells in thickness. In contrast, acini in the central part of the gland were usually large and contained numerous prominent epithelial folds within the lumen. On the basis of morphology, a clear distinction between peripheral and central acini was not observed. The distribution of autonomic ganglia both within and adjacent to the prostate was studied, and nerve cell bodies containing both acetylcholinesterase (AChE) activity and neuropeptide immunoreactivity were identified. The distribution and density of AChE-positive nerves associated with smooth muscle in either the peripheral or central parts of the prostate were indistinguishable. In addition, the majority of acini in peripheral and central regions possessed a rich subepithelial plexus of autonomic nerves. VIP-positive nerve fibers were found in relation to the epithelium lining acini in central and peripheral regions of the gland. In contrast, nerves possessing NPY immunoreactivity occurred only in relation to the smooth muscle trabeculae of the prostate.

Acetylcholinesterase↗
PubMed1988

Grading for angioplasty.

An increasing proportion of patients with lower limb arterial disease are being treated by transluminal angioplasty. There have been various estimates of the numbers of potentially treatable patients, but none have been accompanied by detailed selection criteria. Based on patients' arteriograms, we present a clear grading system of suitability for angioplasty aimed at allowing ready interpretation and comparison of data. We have used these grades to examine prospectively the suitability for angioplasty of 118 consecutive patients undergoing arteriography for the first time. Thirty-five per cent of patients with claudication, and 30% of those with rest pain or trophic lesions appeared suitable for angioplasty. Forty-five per cent of claudicants and 40% patients with rest pain or trophic lesions could have their symptoms relieved by appropriate angioplasty of aortoiliac disease alone in the presence of distal disease, or of isolated femoropopliteal lesions. These figures have important implications for the provision of interventional radiological services throughout the United Kingdom.

Adult↗
PubMed1986

Sudden cardiac death in Air Force recruits. A 20-year review.

We reviewed the clinical and autopsy records of the 19 sudden cardiac deaths that occurred among the 1,606,167 US Air Force healthy, medically screened recruits (90% male; 17 to 28 years old) during a 42-day basic training period between 1965 and 1985. Sixteen (all male) died suddenly of underlying structural heart disease, whereas no anatomic cause of death was identified in the remaining three. Thirty-two nonsudden, noncardiac deaths occurred during the same period, and only two had structural heart disease. Strenuous physical exertion was associated with sudden death in 17 of 19 cases (0.017 deaths per 50,000 exercise-hours), and the most frequent underlying etiology was myocarditis. Sudden cardiac death, a rare event in healthy young adults, is usually associated with exertion.

Adolescent↗