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Biomedical subjects

J Smith

Publications and source records attributed to J Smith.

At least 937 records · Page 52Linked to original sources
PubMed1989

Clinical collection and use of peripheral blood stem cells in pediatric patients.

Peripheral blood stem cells have been used in lieu of marrow as autologous cellular support after marrow-ablative radio/chemotherapy. Autologous marrow support allows the use of higher, more effective doses of therapy. Peripheral blood stem cells (PBSC) offer the potential for this form of "transplant" in patients with marrow involved with disease. PBSC use also allows the avoidance of marrow harvest under general anesthesia. Previous reports of PBSC use have been limited to adults. This article describes peripheral blood stem cell collection in children, and documents the successful use of such cells in a 21/2-year-old boy and a 3-year-old girl with progressive stage IV neuroblastoma involving the marrow. Collections were performed using a Fenwal CS3000 blood cell processor primed with fresh frozen plasma and red cells, using a low flow rate to avoid citrate toxicity. The transplant was performed using collections that were negative or low in neuroblastoma cells (as detected by anti-neuron-specific enolase and antineuroblastoma monoclonal antibodies) after preparation with high-dose cyclophosphamide, etoposide, and cisplatin. Posttransplant recovery was uneventful, and engraftment was comparable to that in 4 patients treated with a similar preparative regimen followed by infusion of autologous marrow. Using careful technique, PBSC support in lieu of marrow may be a viable treatment modality in pediatric neuroblastoma or other solid tumors, particularly when the marrow is involved with disease.

Blood Transfusion, Autologous↗
PubMed1989

Mechanisms of the relation between perinatal problems, early childhood illness, and psychopathology in late childhood and adolescence.

Data on perinatal and early childhood somatic and psychological risk factors of a random sample of children were gathered in early to middle childhood and employed to examine the long-term risk of emotional and behavioral problems of late childhood and adolescence. 3 issues were addressed: First, can syndromic specificity of such effects be identified on scaled and diagnostic measures of syndromes? Second, are these effects attributable to excess risk of low-income children for both perinatal and later childhood problems? Third, are the intervening mechanisms identifiable as intellectual impairment, vulnerability to poor health, poor maternal caretaking, maternal rejection, or maternal stress associated with marital problems? Findings indicated that elevated risk was present for all syndromes, both at the scale level and at the diagnostic level. None of the examined intervening mechanisms fully accounted for the effects of early risks.

Adolescent↗
PubMed1989

Relationship of lychnis ringspot virus to barley stripe mosaic virus and poa semilatent virus.

Barley stripe mosaic virus (BSMV), poa semilatent virus (PSLV), and lychnis ringspot virus (LRSV) have previously been assigned to the hordeivirus group because of similarities in their particle morphology, physicochemical properties and serological analyses. However, the serological relationships of the three viruses have not been determined by direct comparison. The present study evaluated the relatedness of these viruses by Western and dot immunoblotting and by nucleic acid hybridizations. Serological analyses of the coat proteins separated by gel electrophoresis and of intact virus particles bound to nitrocellulose membranes revealed that BSMV and PSLV are distantly related, but that they are more closely related to each other than to LRSV. The genomic RNAs of the viruses failed to cross-hybridize in northern hybridization tests conducted at different temperatures. These comparisons showed that BSMV, PSLV and LRSV are distinct viruses with little nucleotide sequence relatedness. Thus our data provide additional support for their inclusion as separate members of the hordeivirus group.

Antigens, Viral↗
PubMed1989

Etiology, prognosis, and hemostatic function after cerebral infarction in young adults.

We retrospectively evaluated 66 patients younger than 40 years of age who presented with acute nonhemorrhagic cerebral infarction (n = 63) or transient ischemic attacks (n = 3) to determine the possible etiology and long-term outcome at a mean follow-up interval of 3 years after initial presentation. A probable cause for the stroke was identified in 24 patients (36%); this group included one woman with a history of recurrent spontaneous abortions and a positive test for the presence of the lupus anticoagulant. We performed detailed hemostatic investigations at follow-up in 38 (90%) of the remaining 42 patients in whom the cause of the stroke was unknown or uncertain; results of the basic hemostatic screening tests (including that for fibrinogen) were uniformly normal. All 38 patients demonstrated a normal fibrinolytic response as measured by tissue plasminogen activator release to a standard venous occlusion stress test; concentration of the inhibitor of tissue plasminogen activator was not increased. No abnormalities in the concentrations of the inhibitory proteins C or S or antithrombin III were identified, and none of the 38 patients had evidence of a lupus anticoagulant. Neurologic recovery was complete or the residual disability mild in 46 of 59 (78%) patients. Overall prognosis was excellent and independent of whether a precipitating factor for the stroke could be identified.

Acute Disease↗
PubMed1989

Patient-controlled analgesia for chronic cancer pain in the ambulatory setting: a report of 117 patients.

Patient-controlled analgesia (PCA) represents a drug-delivery system in which patients self-administer predetermined doses of opiate analgesics. We have taken advantage of recent advances in pump technology and developed a system in which patients with severe pain received a continuous narcotic infusion, along with the capability of PCA bolus for breakthrough pain. All patients were experiencing chronic pain related to cancer and were unable to obtain adequate pain control with either intermittent parenteral, oral, or rectal narcotics. Sixty-nine percent of patients were treated in the home setting, and the majority received morphine sulfate subcutaneously (SQ). Admixture stability studies using high-pressure liquid chromatography (HPLC) showed that dexamethasone, metoclopramide, and haloperidol could be added to the morphine solutions and remain stable for 1 week at room temperature. Of 117 patients entered, 95% received excellent pain control, and side effects were rare, consisting of subcutaneous needle site infection and respiratory depression. Progressive pain due to either advancing disease or development of drug tolerance could be controlled by increasing opiate infusion rates. We conclude that (1) continuous infusion opiate with PCA bolus capability can be initiated and administered safely in the home setting; (2) patients with pain related to malignancy can be managed well with this system; and (3) pain control programs can be designed, implemented, and evaluated in the private practice setting.

Adult↗
PubMed1989

Coordination of eating, drinking and breathing in adults.

The coordination of breathing and swallowing was studied in seven normal males at rest, as well as during eating and drinking. Ventilation was monitored using respiratory inductive plethysmography and swallowing was recorded by submental electromyogram. Swallowing occurred almost exclusively in expiration. Two hundred and seventy-one swallows were seen and only two occurred in inspiration. The mean expiratory duration (Te) of breaths containing a swallow was significantly greater than the mean Te of all breaths during the same period. There was no change in mean tidal volume (VT), inspiratory duration (Ti), expiratory duration (Te), mean inspiratory flow (VT/Ti) or minute ventilation (VE) between the periods of normal breathing, eating and drinking. However, breathing became more irregular during eating and drinking. The mean coefficient of variation of VT, Te, and VT/Ti was significantly greater during eating and drinking than at rest. The coefficient of variation for VT was 22 + 3 percent, 36 +/- 5 percent, and 41 +/- 5 percent during the initial period of resting breathing, eating and drinking. For VT/Ti it was 24 +/- 6 percent, 43 +/- 14 percent and 44 +/- 8 percent during resting breathing, eating and drinking. We conclude that swallowing is almost exclusively an expiratory activity. This may play a protective role in preventing aspiration. Although the level of ventilation is maintained constant during eating and drinking, the pattern of breathing becomes increasingly irregular. This may contribute to dyspnea during meals in some patients with lung disease.

Adult↗
PubMed1989

Evaluation of the generalized effects of a peer-training procedure with moderately retarded adolescents.

The use of peer-training procedures by moderately mentally retarded adolescents was evaluated in two experiments. In Experiment 1, 2 students received instruction on peer-training skills to teach a vocational task to 7 classmates. Following instruction, both peer trainers were successful in teaching their classmates to perform the target task and a second untrained (generalization) task. In Experiment 2, 1 peer trainer taught 3 peers to use picture prompts to complete one or two complex vocational tasks. Following instruction by the peer trainer, the trainees independently used novel pictures on novel tasks. The results of both experiments indicate that peer training with moderately handicapped students can be an effective instructional procedure, with generalization occurring for both the trainers (Experiment 1) and the trainees (Experiment 2).

Adolescent↗
PubMed1989

The "in vitro" effects of lithium on the immune system.

This study has examined the "in vitro" effects of Lithium Carbonate on the immune system at low (10(-3), 10(-2)mM) and therapeutic (0.5-1.5 mM) concentrations. Lithium, in the presence of a range of mitogens, was found to increase the incorporation of 3H-thymidine into peripheral blood mononuclear (PBM) cells. At concentrations greater than 1 mM IL2 production was also enhanced. Lithium was also found to increase IgG and IgM production--an estimate of B cell function, the effects being greatest at concentrations within the therapeutic range. However at these levels Lithium inhibited cAMP production. Whether Lithium acts individually on these processes or whether one reaction is merely the result of another is unclear at present.

B-Lymphocytes↗
PubMed1989

Why do parents stay overnight with children in hospitals? A survey of parents at Royal Children's Hospital.

This article is concerned with factors affecting parents' decisions to stay overnight on the wards with their children in hospital. A literature review is provided of past and present policies for parental access. The results are reported of a survey of 143 parents who stayed overnight with their children at Royal Children's Hospital in Melbourne. The survey revealed that the cost and availability of off-ward accommodation did not influence the parents' decisions, the majority of children had pre-planned stays and none were in immediate danger. The paper concludes with suggestions concerning parent accommodation in children's hospitals.

Age Factors↗
PubMed1989

Report of an Air National Guard clinic's experience with screening at-risk individuals before initial physical fitness testing.

AFR 35-11, dated 10 April 1985, included standards for physical fitness performance tests with the option of a 1.5-mile run or a 3-mile walk. Since that time, ANG units have begun initial physical fitness testing of all personnel. This program brought with it new responsibilities for ANG medical units including the screening of individuals in whom health problems might indicate that they are at risk in taking the physical fitness test (PFT). The 111th TAC Clinic used a questionnaire, screened by physicians utilizing a predetermined grid of responses to designate individuals cleared for the run or walk test or as at risk. Of 823 individuals screened, 91 (11%) were designated at risk. These individuals are being further evaluated and 31 (29%) have been subsequently cleared to date. Physical testing of cleared individuals was accomplished, and both running and walking courses were carefully monitored by ambulance crews. Four casualties came to medical attention (blisters, severe fatigue, dizziness, and indigestion). The patient with severe fatigue was a patient on medical hold, S/P myocardial infarction, who had not been medically cleared to participate. The patient with light-headedness was found to have newly diagnosed hypertension. In view of the relatively small number of casualties incurred during this initial PFT, it is felt that the screening process employing a questionnaire evaluated by medical personnel is an appropriate method of minimizing risk.

Female↗
PubMed1989

Functional characteristics of macrophages in glomerulonephritis in the rat. O2- generation, MHC class II expression, and eicosanoid synthesis.

Macrophage infiltration is important in the pathogenesis of acute proliferative glomerulonephritis (gn). The state of activation of macrophages during gn may be central to their role in injury. To study this, a method for extracting macrophages from nephritic glomeruli in active in situ gn was developed. MHC Class II (Ia) antigen expression, superoxide (O2-) generation, and eicosanoid synthesis were compared with thioglycollate elicited peritoneal macrophages (TEM). At the height of inflammation there were 407 +/- 83 macrophages/glomerulus. Compared with TEM, Ia expression, and in vitro production of O2- were enhanced. Synthesis of prostaglandin E2 was greatly reduced (day 6 gn, 62 +/- 10 ng/mg; TEM 663 +/- 128 ng/mg cell protein). Thromboxane synthesis was relatively conserved (day 6 gn, 109 +/- 28 ng/mg; TEM 201 +/- 53 ng/mg). Leukotriene B4 (LTB4) was undetectable (day 6 gn, less than 13 ng/mg; TEM 119 +/- 56 ng/mg). This large influx of activated macrophages in glomeruli may be fundamental to pathogenesis of glomerular inflammation.

Animals↗
PubMed1989

A low-cost competitive approach to weight reduction in a Native American community.

Native Americans from two Indian communities, Zuni and Pine Hill, New Mexico, participated in a weight loss competition that utilized promotional, educational and motivational techniques to bring about changes in dietary and exercise behaviors. This evaluative study documents the impact of age, sex, tribal affiliation, initial weight, educational level, employment status, dietary attitude and exercise patterns on program completion and goal attainment. Of 271 participants, 122 (45 percent) completed the competition and lost five pounds or more ('finishers/goal weight achievers'); 127 (47 percent) completed the competition but failed to lose five pounds ('finishers/non-goal achievers'); and 22 (8 percent) did not complete the competition ('non-finishers'). Non-finishers had significantly fewer years of formal education and were more likely to be self-employed or unemployed than finishers. Finishers/goal weight achievers had a significantly greater proportion of males, a greater initial weight and an increased compliance with record-keeping compared to finishers/non-goal achievers. The relative success of the Zuni-Pine Hill 'Eat Right' weight loss competition establishes its importance as a public health model for health behavior change in communities with similar population profiles.

Adult↗