Search PubMed⌕ Search

Biomedical subjects

L Fisher

Publications and source records attributed to L Fisher.

At least 37 records · Page 2Linked to original sources

The heterodimeric complex of MRP-8 (S100A8) and MRP-14 (S100A9). Antibody recognition, epitope definition and the implications for structure.

The S100 calcium-binding proteins MRP-8 (S100A8) and MRP-14 (S100A9) form a heterodimeric complex in the cytosol of monocyte and neutrophil cell types circulating in peripheral blood. This complex, but not the individual subunit proteins, is specifically recognized by mAb 27E10. Domains in MRP-8 and MRP-14 mediating heterodimeric complex formation have not yet been identified but it is predicted that the structure of the complex will be similar to homodimeric forms of other S100 proteins. This study makes use of the specificity of mAb 27E10, and an in vitro coupled transcription/translation system to further examine the formation and maintenance of the MRP-8/MRP-14 complex. Truncated mutants of MRP-14 that lack the N-terminal residues 1-4 or the extended C-terminal 'tail', both complex with MRP-8. These deleted domains of MRP-14 are therefore not essential for complex formation. Peptides from MRP-8 or MRP-14, used to induce the epitope recognized by mAb 27E10, show that a critical interaction in complex formation involves the N-terminal of MRP-8 interacting with MRP-14. Phage display analysis defined composite residues of the epitope recognized by mAb 27E10. The epitope is trans-subunit, composed of residues in the C-terminal ends of helix IV in MRP-14 and helix I of MRP-8. A further complex-specific mAb, named 5.5, recognizes the hydrophobic residues in helix IV of MRP-8, exposed during heterodimer formation. The definition of these two epitopes indicates that helices IV of MRP-8 and MRP-14 are also a prominent point of interaction and suggests that the subunit proteins will assume an antiparallel alignment in the heterodimer, similar in structure to the homodimeric forms of S100 proteins.

Antibodies, Monoclonal↗

The effects of nursing home placement on family caregivers of patients with Alzheimer's disease.

PURPOSE: This study sought to determine the effects of nursing home placement (NHP) for patients with Alzheimer's disease, compared to maintaining community placement, on changes in family caregiver health and well-being over time. DESIGN AND METHODS: We utilized a 2-year, longitudinal study with one baseline and four follow-up assessments for patients' spouses, adult offspring, and in-laws (married to offspring). Families were recruited from eight clinical outpatient centers, supported by the State of California, and followed in the community over time. A multidisciplinary clinical evaluation was undertaken by the centers, and follow-up assessments included questionnaire and interview data. RESULTS: Family caregiver health and well-being did not improve over time following NHP, and there were no significant differences in health and well-being between family caregivers who placed their ill elder in a nursing home and those who kept the elder at home or in the community. However, female family caregivers and spouses displayed greater declines in health and well-being over time, compared to other family caregivers, regardless of whether or not NHP occurred. IMPLICATIONS: Families considering NHP need to be advised of what may and may not change following NHP. In particular, spouses and female family caregivers may not experience those changes in life satisfaction and well-being that are hoped for. Variation in the effects of NHP may be more related to pre-NHP family processes and relationships than to the severity of the patient's disability, caregiver strain, patient and caregiver demographics, and use of community-based professional services.

Adaptation, Psychological↗

The continuing HIV epidemic among men who have sex with men.

OBJECTIVES: This study characterized the AIDS epidemic among urban men who have sex with men (MSM). METHODS: A probability sample of MSM was obtained in 1997 (n = 2881; 18 years and older) from New York, Los Angeles, Chicago, and San Francisco, and HIV status was determined through self-report and biological measures. RESULTS: HIV prevalence was 17% (95% confidence interval = 15%, 19%) overall, with extremely high levels in African Americans (29%), MSM who used injection drugs (40%), "ultraheavy" noninjection drug users (32%), and less educated men (< high school, 37%). City-level HIV differences were non-significant once these other factors were controlled for. In comparing the present findings with historical data based on public records and modeling, HIV prevalence appears to have declined as a result of high mortality (69%) and stable, but high, incidence rates (1%-2%). CONCLUSIONS: Although the findings suggest that HIV prevalence has declined significantly from the mid-1980s, current levels among urban MSM in the United States approximate those of sub-Saharan countries (e.g., 14%-25%) and are extremely high in many population subsegments. Despite years of progress, the AIDS epidemic continues unabated among subsegments of the MSM community.

Adolescent↗

Contributors to depression in Latino and European-American patients with type 2 diabetes.

OBJECTIVE: To determine the independent and cumulative contributions of diabetes and other life stresses on depression and anxiety in Latino and European-American (EA) patients with diabetes. RESEARCH DESIGN AND METHODS: A total of 75 Latino and 113 EA patients with type 2 diabetes, recruited from managed care settings, were assessed regarding three groups of potential stresses: demographics (age, sex, and education), disease status (functional impact, time since diagnosis, comorbidities, HbA(1c), and BMI), and family stress (financial stress, spouse conflict resolution, and family closeness). Dependent variables were depression (Center for Epidemiological Studies-Depression scale [CES-D]) and anxiety (Symptom Checklist [SCL-90]). Multiple regression equations assessed the independent contribution of each predictor on depression and anxiety. RESULTS: For both ethnic groups, education, functional impact, and financial stress significantly and independently predicted depression; poor spouse conflict resolution was a fourth significant predictor for EA patients only. The equations accounted for a high percentage of variance (43- 55%). Excluding education, the same variables predicted anxiety for both ethnic groups. The disease status and family stress variable groups significantly predicted outcomes independently. The relationships among these variables and depression and anxiety generally occurred for all patients, not only for those classified as likely depressed. CONCLUSIONS: The findings suggest the utility of considering many life stresses, not just diabetes alone, that combine to affect depression and anxiety. We suggest that these effects are experienced cumulatively as general psychological distress for all patients with diabetes, not just those classified as likely depressed. Taken together, the findings emphasize a life-centered, patient-focused approach to the treatment of depression, rather than an exclusive disease-related perspective.

Adult↗

Psychosocial therapies in diabetes: report of the Psychosocial Therapies Working Group.

OBJECTIVE: To review key advances in the behavioral science literature related to psychosocial issues and therapies for persons with diabetes, to discuss barriers to research progress, and to make recommendations for future research. RESEARCH DESIGN AND METHODS: Key findings from the literature on psychosocial research in diabetes are reviewed separately for children and adults. Specific issues covered include psychosocial adjustment and psychiatric disorders, neurocognitive functioning, quality of life, and psychosocial therapies. Barriers that must be addressed to allow research in this area to progress are discussed. Recommendations are then made concerning high-priority areas for advancing research in the field. CONCLUSIONS: A substantial amount of behavioral science research has demonstrated that psychosocial factors play an integral role in the management of diabetes in both children and adults. Research has also shown the efficacy of a number of psychosocial therapies that can improve regimen adherence, glycemic control, psychosocial functioning, and quality of life. More research in this area is needed to develop psychosocial intervention programs for specific patient populations and to demonstrate the cost-effectiveness of these approaches.

Adolescent↗

Disease management status: a typology of Latino and Euro-American patients with type 2 diabetes.

The number of indicators of chronic disease management is large and no practical framework is available to guide selection for use in intervention programs. In addition, it is often difficult to integrate multiple disease management indicators into a comprehensive picture of patient functioning. The authors present a heuristic framework for creating a profile of disease management and an empirically based descriptive typology of disease management behavior. From the literature, they identified 5 domains of disease management indicators: biologic, general health and functional status, emotional tone, quality of life, and behavioral. They selected 11 scales and assessed 187 patients with type 2 diabetes. Five statistically replicable patient disease management types were derived from exploratory and confirmatory cluster analyses and a descriptive narrative was created for each: balanced (33%), problematic (6%), coasters (34%), discouraged (16%), and distressed (11%). The typology describes different presentations of disease management that can be linked with patient-tailored interventions for patients with type 2 diabetes.

California↗

Resolving disease management problems in European-American and Latino couples with type 2 diabetes: the effects of ethnicity and patient gender.

The management of type 2 diabetes requires major life style changes. How patients and family members resolve disagreements about disease management affects how well the disease is managed over time. Our goal was to identify differences in how couples resolved disagreements about diabetes management based on ethnicity and patient gender. We recruited 65 Latino and 110 European-American (EA) couples in which one spouse had type 2 diabetes. Couples participated in a 10-minute videotaped, revealed differences interaction task that was evaluated with 7 reliable observer ratings: warm-engagement, hostility, avoidance, amount of conflict resolution, off-task behavior, patient dominance, and dialogue. A series of 2 x 2, Ethnicity x Sex ANOVAs indicated significant effects for Ethnicity and for the Ethnicity x Sex interaction, but not for Sex. Latino couples were rated as significantly more emotionally close, less avoidant, less hostile toward each other, and had less dominant patients than EA couples; however, Latino couples achieved significantly less problem resolution and were more frequently off-task than EA couples. These findings were qualified by patient gender. The findings highlight important differences

Adult↗