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Biomedical subjects

K Edwards

Publications and source records attributed to K Edwards.

At least 91 records · Page 5Linked to original sources
PubMed1995

The clinical diagnosis and treatment of important childhood diseases in rural Papua New Guinea.

This study used multiple standardized instruments to evaluate the quality of the clinical management of the common childhood diseases in rural Papua New Guinea. The findings indicate major inadequacies in the quality of history taking, examination, record keeping, diagnosis and treatment of the common causes of childhood morbidity and mortality. To improve case management by health workers in rural clinical situations everything possible must be done to make good clinical management easy and practical. This should involve provision of practical reinforcing tools, training and supervision which target rural health workers as valuable human resources, and community education which maximizes the contribution that community members can make to early diagnosis and good management.

Case Management↗
PubMed1994

Interactions between fatty acids and lipoprotein lipase: specific binding and complex formation.

Lipoprotein lipase is the extrahepatic lipase responsible for the hydrolysis of triglycerides in chylomicrons and very low-density lipoproteins. Its enzymic activity and its location on the surface of endothelial cells are affected by the presence of fatty acids, implying that the protein possesses binding sites for that ligand. In this study, we examine the binding of fatty acids to LpL and describe factors that must be considered when the dissociation constant of the acceptor-ligand equilibrium is close to the critical micelle concentration of the fatty acid. The interaction of fatty acids with lipoprotein lipase (LpL) was studied by two methods. A new direct method, based on the LpL-induced increase in the apparent critical micelle concentration of the sodium soap of the fatty acid, indicates the presence of multiple high-affinity binding sites. In the second method, the specific binding of fatty acids to LpL was measured by quantitating the blue shift in the tryptophan fluorescence of LpL that occurs upon binding the ligand. Both methods suggest the existence of 4-6 fatty acid binding sites on LpL with a dissociation constant on the order of 10(-6)-10(-7) M. Further analysis of the blue shift indicates that at higher concentrations of fatty acid, large complexes are formed consisting of 260-310 molecules of fatty acid per LPL monomer. In contrast, no large complexes are formed with fatty acids that form crystals above their solubility limit.

Animals↗
PubMed1994

Agreement between large and small cuffs in sphygmomanometry: a quantitative assessment.

OBJECTIVE: The objective of this study is to quantify agreement and differences between blood pressure (BP) measurements by large cuffs (15 x 33 cm) and small cuffs (12 x 23 cm) in a representative sample of the U.S. population with varying arm circumferences. METHODS: The arm circumference and blood pressure (12 readings of each) of 85 subjects were measured, the latter with a mercury column sphygmomanometer. Data were classified according to arm circumference (small arm circumference, < or = 29 cm; large arm circumference, > 29 cm). Results were submitted to ANOVA, linear regression, difference between means (aggregate agreement), upper and lower limits of agreement at 95% confidence intervals, and intraclass correlation (individual-subject agreement/quantification of agreement). RESULTS: Small cuffs overestimated BP obtained from the large cuffs for the sample population as a whole, regardless of arm circumference. Limits of agreement at the lower end of 95% confidence interval were not clinically acceptable (SBP -1.56 to 11.05 mm Hg; DBP -2.06 to 8.63 mm Hg). However, measurements by both cuffs agreed among subjects with small arm circumferences (< or = 29 cm). CONCLUSION: Arm circumference plays an important role in determining proper cuff size for BP measurement. The small cuff overestimates BP in patients with large arm circumferences (> 29 cm), which represents more than 75% of the U.S. adult population. However, measurements of BP with the large cuff are not significantly different from those of small cuff measurements in subjects with small arm circumferences (< or = 29 cm). Therefore, we propose that the large cuff be used for routine BP measurement of the adults in the United States.

Adult↗
PubMed1994

Comparison of the effect of three doses of a synthetic surfactant on the alveolar-arterial oxygen gradient in infants weighing > or = 1250 grams with respiratory distress syndrome. American Exosurf Neonatal Study Group II.

The effect of a 50% increment or decrement in the recommended 5 ml/kg dose of a commercially available surfactant (Exosurf Neonatal) on the alveolar-arterial oxygen gradient was investigated in a multicenter, double-blind, placebo-controlled rescue trial conducted at 15 hospitals in the United States. Two doses of three different volumes (2.5, 5.0, and 7.5 ml/kg) were compared with two 5.0 ml/kg doses of air in 281 infants weighing > or = 1250 gm who had respiratory distress syndrome requiring mechanical ventilation and an arterial/alveolar oxygen ratio < 0.22. The first dose was given between 2 and 24 hours of age, and the second dose was given 12 hours later to all infants who still required mechanical ventilation. Infants were stratified at entry by gender and the magnitude of the arterial/alveolar oxygen ratio. The air placebo arm of the study was terminated early when reductions in mortality rates were proved in another rescue trial of this surfactant in infants with the same birth weights. For the first 48 hours, administration of a 2.5 ml/kg dose of surfactant provided less improvement in the alveolar-arterial oxygen gradient than doses of 5.0 and 7.5 ml/kg, which were equivalent. Similar results were observed in mean airway pressure (p < 0.05). There were no significant differences among the three dosage groups in mortality rate, air leak, bronchopulmonary dysplasia, and other complications of prematurity. There were no pulmonary hemorrhages in any group. Reflux of surfactant occurred more frequently in the 5.0 and 7.5 ml/kg groups. These results indicate that more sustained improvements in oxygenation are provided, with equal safety, by the standard two 5.0 ml/kg rescue doses of this surfactant than by the 2.5 ml/kg dose. No further benefit is gained from two larger doses given 12 hours apart.

1,2-Dipalmitoylphosphatidylcholine↗
PubMed1994

Avoiding neonatal death: an intervention study of umbilical cord care.

During a study of pregnancy in a poor rural tropical area, a high prevalence of neonatal fever and umbilical cord infection was detected. Interim analysis showed that this was associated with subsequent development of neonatal sepsis. Therefore an intervention was introduced in two stages. In the first stage, acriflavine spirit and new razor blades were supplied to mothers, along with instructions for use, through antenatal clinics. In the second stage, when excessive cord bleeding was reported, umbilical cord clamps were added to the pack. The packs were associated with reduction of serious morbidity in the neonatal period. The study demonstrates the importance of umbilical cord care in the aetiology of life threatening neonatal morbidity in village births in a developing country and the effect of a simple intervention in reducing morbid episodes in the neonate.

Body Temperature↗
PubMed1994

A randomized comparison of three bivalent Streptococcus pneumoniae glycoprotein conjugate vaccines in young children: effect of polysaccharide size and linkage characteristics.

Because most childhood invasive pneumococcal disease occurs before the age of 2 years, the development of a pneumococcal vaccine that is immunogenic in infants is a priority. We assessed the safety and serum antibody responses to two dose levels of three bivalent pneumococcal capsular polysaccharide (CPS)-protein conjugate vaccines incorporating the poorly immunogenic serotypes 6A and 23F. The conjugate vaccines differed in CPS size and chemical linkage, but all used a nontoxic cross-reactive mutant diphtheria toxin (CRM197) as the protein carrier. 118 young children 18 to 30 months of age received a single immunization with one of the three glycoconjugates or with licensed pneumococcal vaccine. Sera were obtained before and 1 month after immunization and analyzed by enzyme-linked immunosorbent assay for serotype-specific antibody titers. The 23F CPS was more immunogenic than the 6A CPS in all vaccine formats. The most immunogenic 23F conjugate vaccine consisted of native CPS directly linked to the carrier protein; smaller CPS or the use of a six-carbon linker did not appear to enhance immunogenicity in these young children. Conjugation of two pneumococcal CPSs is associated with an increase in immunogenicity, and the characteristics of the CPS and of the CPS-protein linkage appear to influence the antibody response.

Bacterial Vaccines↗
PubMed1994

Detection of Rochalimaea henselae DNA in specimens from cat scratch disease patients by PCR.

A PCR assay was developed by using degenerate primers that allow amplification of a 414-bp fragment of DNA from the rickettsia-like organisms Rochalimaea henselae and R. quintana. Internal oligonucleotides were used as hybridization probes, permitting rapid differentiation of these two Rochalimaea species. DNAs from 12 different isolates of R. henselae were amplified with the PCR primers, and the resulting 414-bp PCR product hybridized only with the R. henselae-specific probe. DNAs from four different isolates of R. quintana were amplified and produced a PCR product of the same size that hybridized only with the R. quintana-specific probe. DNAs from isolates of R. elizabethae, R. vinsonii, Bartonella bacilliformis, and Afipia felis failed to amplify the 414-bp fragment in the PCR assay. This two-step assay was applied to DNAs extracted from 16 fresh (unfixed) lymph node biopsy specimens and nine aspirates from patients with clinical cat scratch disease (CSD) to assay for the presence of R. henselae or R. quintana DNA in these samples. Twenty-one (84%) of 25 lymph node samples from CSD patients were positive for R. henselae, while none were positive for R. quintana. The characteristic 414-bp fragment was not amplified from eight lymph node tissue samples from non-CSD cases. These results provide evidence that R. henselae, and not R. quintana, plays the central role in the etiology of CSD.

Bacteriological Techniques↗
PubMed1993

Complex segregation analysis of LDL peak particle diameter.

A predominance of small low-density lipoprotein (LDL) particles, as determined by gradient gel electrophoresis (GGE), has been proposed to be a common genetic marker for risk of coronary heart disease. Previous analyses of the families in the Berkeley data set defined a dichotomous trait based on the LDL size distribution by GGE: subjects with a predominance of small LDL particles have LDL subclass "pattern B," while those with a predominance of large LDL particles have LDL subclass "pattern A." Using this definition, previous complex segregation analyses demonstrated a single major gene effect on pattern B with a dominant or additive mode of inheritance, and reduced penetrance in young males and premenopausal women. In the present analyses, a continuous variable denoted LDL peak particle diameter is used, reflecting the size (diameter in A) of the major LDL subclass, for comparison with the dichotomous LDL subclass pattern classification. After adjusting for age and gender, the results demonstrate a single major Mendelian gene effect, but the exact mode of inheritance could not be established. Thus, analysis of the continuous variable was not superior to that of the dichotomous classification in determining the mode of inheritance of the proposed single gene controlling LDL subclasses.

Coronary Disease↗
PubMed1993

Reconstitution of non-ionic monoalkyl amphiphile-cholesterol vesicles by dilution of lipids-octylglucoside mixed micelles.

Kinetic aspects of the formation of non-ionic surfactant vesicles (NSV) using the mixed micelle dilution procedure are examined. Mixed micelles composed of a mixture of lipids, i.e. diglycerol hexadecylether (C16G2), cholesterol (CHOL), dicetylphosphate (DCP) and detergent, octylglucoside (OG), were diluted with detergent-free buffer added either instantaneously or progressively at different rates ranging from 3.47 x 10(-2) to 6.94 x 10(-4) ml/min. The resulting particles were analysed by quasielastic light scattering (QELS), high performance liquid chromatography (HPLC) on gel exclusion column and cryogenic transmission electron microscopy (cryo-TEM). NSV exhibit mean diameters (MD) varying from 100 to 600 nm depending on the kinetics of OG removal. When the dilution of mixed micelles is instantaneous the vesicles are characterized by a spherical shape and MD values close to 100 nm. They show narrow size distribution and stability for 2 months. NSV recovered with progressive micelle dilution, at fast buffer addition rates (3.47 x 10(-2) and 1.39 x 10(-2) ml/min) exhibit MD values of 170-240 nm, elongated shapes, low polydispersities and 2-month stabilities. When the rate of buffer addition is lowered to 6.94 x 10(-4) ml/min, unstable particles with larger MD values and broad size distributions are obtained. Turbidity monitoring at 350 nm and 25 degrees C was used to characterize the lipids-OG mixed aggregate rearrangements either as a function of time when detergent-free buffer was continously added to the mixed micelles or after equilibrium setting when the micelles were instantaneously diluted. In the latter case the intermediate aggregates were also analysed by QELS. For continuous dilutions, the molecular composition of aggregates, [OG/lip]agg, as well as the OG concentration in the aqueous medium, [OG]bulk, were determined at the break points observed on the plots of optical density (OD) versus total OG concentration ([OG]tot). [OG/lip]agg and [OG]bulk values are independent of the rate of buffer addition, suggesting that the micelle to NSV transition is not mainly limited by the kinetics of the molecular processes involved during detergent removal from the mixed aggregates. The examination of the apparent partition coefficient of OG between the aqueous phase and the lipidic aggregates shows, however, that OG depletion from the bilayered structures is more difficult than its elimination from the mixed micelles. QELS analysis of the intermediate lipids-detergent aggregates, performed with time, demonstrates very slow supramolecular rearrangements during the vesicle closure. These rearrangements explain the significant increase in both size and polydisperity of the final vesicles observed with slow rates of buffer addition.

Cholesterol↗
PubMed1993

Beyond simple pessimism: effects of sadness and anger on social perception.

In keeping with cognitive appraisal models of emotion, it was hypothesized that sadness and anger would exert different influences on causal judgments. Two experiments provided initial support for this hypothesis. Sad Ss perceived situationally caused events as more likely (Experiment 1) and situational forces more responsible for an ambiguous event (Experiment 2) than angry Ss, who, in contrast, perceived events caused by humans as more likely and other people as more responsible. Experiments 3, 4, and 5 showed that the experience of these emotions, rather than their cognitive constituents, mediates these effects. The nonemotional exposure to situational or human agency information did not influence causal judgments (Experiment 3), whereas the induction of sadness and anger without explicit agency information did (Experiments 4 and 5). Discussion is focused on the influence of emotion on social judgment.

Adult↗
PubMed1993

Detection of Rochalimaea henselae in cat-scratch disease skin test antigens.

One of the diagnostic criteria for cat-scratch disease is a positive delayed-type hypersensitivity skin test reaction to an antigen prepared from purulent material aspirated from a cat-scratch disease-involved lymph node. Polymerase chain reaction coupled with DNA sequence analysis was used to identify organisms found in these skin test antigen preparations that may be responsible for eliciting this response. Two independent sources of cat-scratch disease skin test antigens yielded DNA sequences characteristic of the newly described rickettsia, Rochalimaea henselae. These results coupled with previous serologic data strongly suggest that R. henselae plays a central role in the etiology of cat-scratch disease.

Antigens, Bacterial↗
PubMed1993

Transcription of two members of a gene family encoding phenylalanine ammonia-lyase leads to remarkably different cell specificities and induction patterns.

Phenylalanine ammonia-lyase (PAL) catalyses the first committed step in the biosynthesis of phenylpropanoids, which perform a variety of functions in plant development and in their interactions with the environment. French bean contains a small family of genes encoding PAL and two of these genes, PAL2 and PAL3, have been shown to be differentially expressed at the mRNA level in bean tissues. The transcriptional activities of the PAL2 and PAL3 genes have been investigated by fusing their promoters to the reporter gene beta-glucuronidase (GUS) and transforming these constructs into Arabidopsis, potato and tobacco. The PAL2- and PAL3-GUS constructs exhibited different spatial and temporal patterns of expression during development and in response to environmental stimuli. The consistency of these data with previous mRNA analysis in bean suggests that the differential expression of these two PAL genes is, at least in part, a function of their promoter activities. New patterns of PAL2 and PAL3 promoter activities were also characterized. Some species-specific differences in GUS expression were observed and these may reflect differences in phenylpropanoid metabolism or the signals that modulate PAL gene transcription.

Arabidopsis↗
PubMed1993

Genetics of LDL subclass phenotypes in women twins. Concordance, heritability, and commingling analysis.

Low density lipoprotein (LDL) subclass phenotype B, characterized by a predominance of small LDL as determined by gradient gel electrophoresis, has been associated with increased risk of coronary heart disease and an atherogenic lipoprotein profile. Previous studies employing complex segregation analysis have demonstrated a major, single gene effect on the inheritance of this phenotype in families. Recently, linkage between this phenotype and variation at the LDL receptor locus on chromosome 19 has been reported. However, variation in LDL subclass phenotypes has also been associated with age, gender, diabetes status, beta-blocker medication, and diet. The present study further evaluates the relative importance of genetic and nongenetic influences on LDL subclass phenotypes and on LDL peak particle diameter (as a reflection of the size of the major LDL subclass) in monozygotic and dizygotic women twin pairs. The analysis is based on 203 monozygotic and 145 dizygotic pairs of adult female twins who participated in the second examination of the Kaiser Permanente Women Twins Study. The average age was 51 years at this exam and 90% were white. Concordance analysis revealed that monozygotic cotwins shared LDL subclass phenotypes more frequently than dizygotic cotwins, and this was confirmed using logistic regression analysis after controlling for potential confounding factors. Heritability analyses suggested that approximately one third to one half of the variation in LDL peak particle diameter, a continuous variable reflecting LDL size, could be attributed to genetic influences. Commingling analysis of the frequency distribution of LDL peak particle diameter identified three distinct subgroups of subjects, one of which corresponded to those subjects with LDL subclass phenotype B.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1993

Low-income African American women expressions of their health management.

The purpose of this qualitative study of African American women living in poverty is to document the actual expression of their health problems and health management behaviors. Twenty women were interviewed three times over a 6 month period. A constant comparative analysis was conducted at each interview. Active mastery was the basic psycho-social process that described how these women successfully manage their health.

Adult↗
PubMed1992

Construction and characterisation of a yeast artificial chromosome library containing two haploid Beta vulgaris L. genome equivalents.

We have constructed a yeast artificial chromosome (YAC) library using high-molecular-weight DNA prepared from agarose-embedded protoplasts of a sugar beet (Beta vulgaris L.) cell suspension line, Ar+. This library contains 15,000 clones with an average insert size of 140 kb. Based on a sugar beet haploid genome size of 1.1 x 10(3) Mb it should represent approximately two haploid genome equivalents. The library is organised as an ordered array in duplicate microtitre plates. High-density filters, each containing 864 YAC clones, have been screened in colony hybridisation experiments. In this way, sugar beet YAC clones have been identified containing chloroplast DNA, mitochondrial DNA and two satellite DNAs. Ten pools of DNA from 1500 individual YAC clones have also been prepared for rapid PCR screening of the library. Using this approach, in combination with colony hybridisation, we have been able to isolate sugar beet YAC clones containing a transcribed low-copy-number gene.

Base Sequence↗
PubMed1992

Antibody response to Bordetella pertussis antigens after immunization with American and Canadian whole-cell vaccines.

Because of apparent differences in the incidence and epidemiology of pertussis in the United States and Canada, we measured the antibody response to four Bordetella pertussis antigens and to a whole-bacteria preparation in children immunized with American and Canadian whole-cell pertussis vaccines. All infants received combined pertussis, tetanus, and diphtheria vaccines from one of two American manufacturers or a single Canadian manufacturer. The Canadian children received either oral poliomyelitis vaccine, inactivated poliomyelitis vaccine as a separate injection, or a product that combined inactivated poliomyelitis vaccine with diphtheria, tetanus, and pertussis components. The Canadian trivalent diphtheria, tetanus, and pertussis vaccine given with oral poliovirus vaccine induced lower anti-pertussis toxin antibody titers than did the American vaccines (p < or = to 0.05) but higher antifimbriae and anti-69-kilodalton outer-membrane protein (pertactin) antibody titers (p < or = to 0.02). Canadian children immunized with inactivated poliomyelitis vaccine either as a separate injection or as a combined diphtheria, tetanus, and pertussis vaccine had consistently lower pertussis antibody titers than did those who received oral poliomyelitis vaccine (p < or = 0.001). We conclude that there is a wide range of antibody responses to B. pertussis antigens after immunization with various whole-cell pertussis vaccines, and that these responses may be influenced by concurrent administration of other vaccines.

Antibodies, Bacterial↗