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Biomedical subjects

L Gilbert

Publications and source records attributed to L Gilbert.

At least 37 records · Page 2Linked to original sources
PubMed2000

Inhibition of osteoblast differentiation by tumor necrosis factor-alpha.

Tumor necrosis factor-alpha (TNF-alpha) has a key role in skeletal disease in which it promotes reduced bone formation by mature osteoblasts and increased osteoclastic resorption. Here we show that TNF inhibits differentiation of osteoblasts from precursor cells. TNF-alpha treatment of fetal calvaria precursor cells, which spontaneously differentiate to the osteoblast phenotype over 21 days, inhibited differentiation as shown by reduced formation of multilayered, mineralizing nodules and decreased secretion of the skeletal-specific matrix protein osteocalcin. The effect of TNF was dose dependent with an IC50 of 0.6 ng/ml, indicating a high sensitivity of these precursor cells. Addition of TNF-alpha from days 2-21, 2-14, 7-14, and 7-10 inhibited nodule formation but addition of TNF after day 14 had no effect. Partial inhibition of differentiation was observed with addition of TNF on only days 7-8, suggesting that TNF could act during a critical period of phenotype selection. Growth of cells on collagen-coated plates did not prevent TNF inhibition of differentiation, suggesting that inhibition of collagen deposition into matrix by proliferating cells could not, alone, explain the effect of TNF. Northern analysis revealed that TNF inhibited the expression of insulin-like growth factor I (IGF-I). TNF had no effect on expression of the osteogenic bone morphogenic proteins (BMPs-2, -4, and -6), or skeletal LIM protein (LMP-1), as determined by semiquantitative RT-PCR. Addition of IGF-I or BMP-6 to fetal calvaria precursor cell cultures enhanced differentiation but could not overcome TNF inhibition, suggesting that TNF acted downstream of these proteins in the differentiation pathway. The clonal osteoblastic cell line, MC3T3-E1-14, which acquires the osteoblast phenotype spontaneously in postconfluent culture, was also studied. TNF inhibited differentiation of MC3T3-E1-14 cells as shown by failure of mineralized matrix formation in the presence of calcium and phosphate. TNF was not cytotoxic to either cell type as shown by continued attachment and metabolism in culture, trypan blue exclusion, and Alamar Blue cytotoxicity assay. These results demonstrate that TNF-alpha is a potent inhibitor of osteoblast differentiation and suggest that TNF acts distal to IGF-I, BMPs, and LMP-1 in the progression toward the osteoblast phenotype.

Adaptor Proteins, Signal Transducing↗
PubMed2000

Fear and violence: raising the HIV stakes.

Through focus group methodology, the study examines three contexts that delineate the co-occurrence of intimate partner violence and sexual risk behaviors among 68 women on methadone. First, it explores the ways in which the presence of physical abuse in an intimate relationship prevents women from asking their partners to use a condom. Second, it describes the ways in which the couple's drug involvement increases the risk of physical and sexual violence, and concomitant sexual HIV risks. Third, it discusses the context in which sexual assault and rape occur in these established intimate relationships and how these abusive events increase women's risks of becoming infected with HIV. The research is guided by feminist theory, which affords powerful insight into the contexts in which women are put at risk for HIV and partner violence. The study provides a discussion on the implications of the findings to HIV prevention for women who are risk for both HIV and partner violence.

Adult↗
PubMed1998

Dispensing doctors and prescribing pharmacists: a South African perspective.

Adopting an historical and international perspective, this article explores and analyses the relationship and controversy between pharmacists and dispensing doctors in South Africa. In order to gain a better insight into this troublesome relationship, a combination of qualitative and quantitative methods has been employed. The findings reveal a deep ongoing sense of competition, which is manifest in the form of public debate and continuous attempts to protect professional task domains. Most of the pharmacists interviewed in this study mentioned the "dispensing doctor" as the main problem facing the community pharmacist in South Africa. Meanwhile, the medical profession, as a united front, is fiercely protecting its "inherent" right to dispense medicines. Using the South African scenario, issues such as occupational task boundaries, "business" versus "professional" systems as well as the role of the state are discussed in relation to professional dominance, jurisdiction and autonomy.

Attitude of Health Personnel↗
PubMed1998

Pharmacy's attempts to extend its roles: a case study in South Africa.

This paper examines the role expansion of community pharmacy in South Africa against the background of phenomena such as professional dominance and boundary encroachments. The study demonstrates pharmacy's thrust towards an extended and more meaningful role, making a clear distinction between the role extension concerning the granting of additional powers to prescribe medications, and that of a wider range of activities. It confirms previous claims that the opposition from the medical profession is particularly fierce when it relates to the pharmacist's ability to prescribe. The successful granting of special permits to a selected group of pharmacists to practice an extended role can be explained by the fact that it has been restricted to rural, under-served areas. The developments to date signify a partial success by the pharmacy profession towards its role extension. However, this is likely to remain limited due to the forces operating against it. Considering this context, the development of "health centres" might prove to be an alternative venue for the integration of pharmacists into the health care team.

Attitude of Health Personnel↗
PubMed1998

Community pharmacy in South Africa: a changing profession in a society in transition.

The analysis of community pharmacy as a profession in transition acquires an additional dimension in South Africa, since it is inextricably linked to its social characteristics as well as to the political transformation taking place. Using data collected by means of a documentary search, interviews with key informants and a survey of community pharmacists, the paper presents the relevant societal features and explores some of the complexities associated with the existing as well as the potential future role of community pharmacy in the context of changing health services in a society in transition. It concludes that the changes in community pharmacy and the role it can play in the provision of Primary Health Care to all the people of South Africa are linked to the greater transition in society and its future health care services.

Adolescent↗
PubMed1998

A profile of sexual health behaviors among college women.

This study examined the risk taking and preventive behaviors related to sexually transmitted diseases among sexually active college women. Self-report questionnaires were distributed at two mid-Atlantic universities yielding a final sample of 556 students. Data were collected regarding frequencies of pelvic examinations, numbers of vaginal, oral, and anal sex partners, and number of partners who had forced sex against their will. Also, frequencies of tests for sexually transmitted disease and HIV before having sex with new partners, methods of protection and birth control, and types of relationships were assessed. Finally, subjects reported the types of questions asked before having sex with a new partner and diagnoses of sexually transmitted diseases. Because most college-aged women are sexually active and vulnerable to a host of short- and long-term complications from sexually transmitted infections, educational interventions, in addition to promoting condom use, must focus on the need for regular pelvic examinations, screenings for sexually transmitted disease/HIV (self and partner), and lower risk sexual activity.

Adolescent↗
PubMed1998

Partner violence and sexual HIV-risk behaviors among women in an inner-city emergency department.

This study examines the relationship between partner violence and sexual risk behaviors in a sample of predominantly Latina and African American women who sought medical care from a New York City hospital emergency department. Eligibility criteria selected women between the ages of 18 and 55, who were sexually active in the past 90 days, and were triaged to nonemergency care. The interview addressed demographics, partner violence, childhood abuse, sexual behavior, and drug and alcohol use. Multiple logistic regression analysis was used to assess the association between partner violence and history of having a sexually transmitted disease (STD) and of having sex with a risky partner. Nearly one half of the 143 respondents (46.1%, n = 66) reported that they had experienced physical, sexual, or life-threatening abuse by a boyfriend or spouse in the past and 17.5% reported that abuse had occurred within the past year. In the univariate analyses, abused women were more likely than nonabused women to report having had an STD; engaging in sex with a risky partner; having more than one sexual partner; and being tested for HIV. After controlling for confounding variables, abused women were almost five times more likely than their counterparts to have reported an STD and four times more likely to engage in sex with a risky sexual partner. The relationship between partner violence and sexual risk behaviors among women seeking treatment in an emergency department suggests the need for the development of HIV-risk reduction strategies that address the needs of women in abusive relationships.

Adolescent↗
PubMed1998

The role of the community pharmacist as an oral health adviser--an exploratory study of community pharmacists in Johannesburg, South Africa.

The aim of this study was to examine to what extent community pharmacists are currently acting as dental advisers, and to determine whether they would be willing to extend this role in the future. The data were collected by means of a random survey of community pharmacists in Johannesburg, and included: incidence and nature of dental enquiries; dental knowledge with respect to preventive measures; willingness to engage in promotion of oral health and prevention of oral disease. The results reveal an anomaly. On one hand community pharmacists seemed to be handling a substantial amount and range of inquiries related to oral health and dental disease, and were willing to fulfil a meaningful role as oral health advisers. On the other hand, however, they have received very little education on these matters and seemed to operate in isolation from dentists and other health professionals, which raises doubts about their ability to play a meaningful role in primary health care. Nevertheless, it is quite feasible for community pharmacists to play the role as envisaged, provided additional training and networking with dentists, oral hygienists, dental therapists and other relevant health professionals takes place.

Community Pharmacy Services↗
PubMed1998

Acceptability of the female condom among STD clinic patients.

This study examines the acceptability of the female condom among African American and Latino patients from two inner-city sexually transmitted disease (STD) clinics through focus group discussions. Prior to the initial focus group sessions, 90% (n = 90) had heard about the female condom, 8% (n = 8) had seen it, and 2% (n = 2) had used it. Among the 41 participants (22 males and 19 females) attending a second focus group session, 85.4% (n = 35) had used the female condom at least once. Female study participants who had previous experience inserting a barrier contraceptive device, such as a diaphragm, indicated that they felt more comfortable inserting the female condom than those who had never used such a device. Male participants indicated that they were more comfortable using the female condom with their steady partners than with casual partners, whereas female participants indicated no such distinctions. These and other study findings suggest that need to promote and expand the use of the female condom as a device that protects women from STD transmissions including HIV and AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Infections with Corynebacterium diphtheriae--changing epidemiology and clinical manifestations. Report of the third international meeting of the European Laboratory Working Group on Diphtheria (ELWGD), Institute Pasteur, Paris 7-8 June 1996.

A widespread epidemic of diphtheria began in 1990 in the former Soviet Union, in the context of falling immunisation rates and social disruption. Control was impeded by limited diagnostic resources in affected countries (mainly Russia) and there was a risk of spread to neighbouring countries. The European Laboratory Working Group on Diphtheria (ELWGD) was formed to assist in control of the epidemic. The ELWGD is convened by the Public Health Laboratory Service in the United Kingdom and includes 15 laboratories in Europe, one in North America (Centers for Disease Control and Prevention) and the Institute of Clinical Pathology and Medical Research, Sydney. At the group's last annual meeting in Paris, reports were presented on the progress of the epidemic, control strategies and improvements in laboratory diagnosis. The group discussed the increased carriage of, and infection with, nontoxigenic Corynebacterium diphtheriae in countries with high immunisation rates, including the United Kingdom and Australia. They also considered the possible relationship between this increase and the continued diphtheria outbreak in eastern Europe. Preliminary results of molecular typing of toxigenic and nontoxigenic isolates from many parts of the world were presented. It was agreed that further epidemiological investigation is required, using a standardised ribotyping system.

Corynebacterium diphtheriae↗
PubMed1997

The influence of parasympatholytics on the resolution of acute attacks of asthma.

PURPOSE: To evaluate the role of parasympatholytics in the resolution of acute attacks of asthma. METHODS: This study employed a prospective sequential design in which the influence of 0.5 and 1.0 mg of ipratropium bromide on peak expiratory flow rates (PEFR), hospital admissions, and length of stay (LOS) in the emergency department (ED) was evaluated. The parasympatholytic was added to a well-investigated standard therapeutic regimen that was anchored by the use of repetitive doses of albuterol, and employed pretested decision algorithms. RESULTS: One hundred and thirty-one patients received ipratropium (l) and 123 who did not (NI) served as controls. There were no significant pretreatment between group differences in gender, racial composition clinical signs and symptoms, or PEFR. The presence of ipratropium in the regimen did not influence discharge/admission patterns, LOS, the rate of improvement of the patients, or the level of PEFR achieved. CONCLUSION: Anticholinergic agents such as ipratropium are not first-line treatments for acute asthma. They do not add any therapeutic benefit to the effects of albuterol given in divided doses over 1 hour, nor do they facilitate recovery in patients whose immediate response to sympathomimetics is impaired.

Acute Disease↗
PubMed1997

Pharmacist and nurse: a team approach towards primary health care or a convenient "therapeutic alliance"?

This paper explores the nature of the therapeutic alliance between nurses and community pharmacists in the South African context. To gain a better insight into the relatively new phenomenon, a combination of qualitative and quantitative methods was employed. The partnership developed in S.A. between the nurse and the pharmacist allows the pharmacists to "expand" their professional activities without "invading" the nurses' professional domain, and reaping substantial benefits in the process. These include potential increases in profits, enlarging the clientele base and improving the image of the pharmacy, by shifting the focus from a place of disease to a place of health, as well as creating the vision of the pharmacist as a team member in providing primary health care. As far as the nurses are concerned, it grants them the possibility to practice their profession in a very convenient set-up and affords them greater professional autonomy.

Humans↗
PubMed1997

Patterns of health maintenance on Michigan equine operations.

Data from two 12 month prospective monitoring programs that followed management, economics and animal health from randomly-sampled equine operations in Michigan were used to determine patterns of health maintenance. Health maintenance measures were grouped, and average uses per year were computed for the most-common measures reported: respiratory, Potomac Horse Fever, neurological and multiple-system vaccinations, deworming, and general farrier work. Factors examined for potential association with health maintenance measure use were numbers of equids and horse-days on the operation, average age of equids, disease prevention management procedures, and operation and individual equine activities. The most-common vaccinations reported were respiratory vaccines (administered an average of 0.9 times per equid per year, of which 61% were for rhinopneumonitis). Multiple-system, Potomac Horse Fever and neurological vaccines were given on average 0.9, 0.9 and 0.7 times per equid per year, respectively. Deworming treatments were administered approximately 2.7 times per equid per year, of which 64% were ivermectin. Overall farrier work was reported 3.3 times per equid per year, trimming was done 2.9 times and shoeing was done 1.5 times per equid per year. In general, operations with active equids engaged in training, breeding or showing showed increased use of health maintenance measures. Overall use of health maintenance measures in the Michigan equine operations monitored did not appear to reach recommended levels, because many operations reported no use of these measures. However, on operations where health maintenance measures were reported, operators were using these measures at or near recommended levels.

Aging↗
PubMed1997

Protection of chimpanzees from high-dose heterologous HIV-1 challenge by DNA vaccination.

Novel approaches for the generation of more effective vaccines for HIV-1 are of significant importance. In this report we analyze the immunogenicity and efficacy of an HIV-1 DNA vaccine encoding env, rev and gag/pol in a chimpanzee model system. The immunized animals developed specific cellular and humoral immune responses. Animals were challenged with a heterologous chimpanzee titered stock of HIV-1 SF2 virus and followed for 48 weeks after challenge. Polymerase chain reaction coupled with reverse transcription (RT-PCR) results indicated infection in the control animal, whereas those animals vaccinated with the DNA constructs were protected from the establishment of infection. These studies serve as an important benchmark for the use of DNA vaccine technology for the production of protective immune responses.

AIDS Vaccines↗
PubMed1997

Sex trading and psychological distress among women recruited from the streets of Harlem.

OBJECTIVES: This study examines the relationship between sex trading and psychological distress and the implications of that relationship for prevention of human immunodeficiency virus among a sample of young women recruited from the streets of Harlem. METHODS: Interviews were conducted with 346 predominantly drug-using women, aged 18 to 29 years, of whom 176 had exchanged sex for money or drugs in the previous 30 days and were categorized as "sex traders." Psychological distress was measured by using the Brief Symptom Inventory. RESULTS: Sex traders scored significantly higher than non-sex traders on the General Severity Index and on eight of the nine subscales of the Brief Symptom Inventory. Multivariate analysis indicated that after adjustments were made for age; ethnicity; pregnancy; recent rape; perceived risk for acquired immunodeficiency syndrome; current, regular crack use; and current, regular alcohol use, sex traders scored 0.240 units higher on the General Severity Index than non-sex traders. CONCLUSIONS: Poor mental health and drug dependence may under-mine the motivation and ability of these sex traders to adopt safer sex behavior. Therefore, interventions need to be integrated with mental health services and drug treatment to reduce risk behavior in this population.

Adolescent↗
PubMed1997

Childhood abuse as a risk for partner abuse among women in methadone maintenance.

This study examines the relationship between childhood abuse and partner abuse among a sample of predominantly African-American and Hispanic women, who were patients in methadone clinics in Harlem and the South Bronx. A structured questionnaire addressing demographics, psychosocial and physical health characteristics, depression, childhood abuse, and domestic violence was administered to 151 women. Over half of the women (60%, n = 98) reported lifetime physical, life-threatening, or sexual abuse by a spouse or boyfriend. Multiple logistic regression analysis was used to assess the associations between childhood physical abuse and abuse by a spouse or boyfriend and between childhood sexual abuse and abuse by a spouse or boyfriend. After controlling for potential confounders, women who reported childhood physical abuse were almost nine times more likely to report having been abused by a spouse or boyfriend (OR = 8.74, CI, = 3.25 to 23.57). Women who reported childhood sexual abuse were almost four times more likely to report having been abused by a spouse or boyfriend (OR = 3.93, CI = 1.46 to 10.59). Depression and need for social support were significantly associated with partner abuse, while current heroin use was inversely associated with partner abuse. The high rate of domestic violence and the strong association between childhood and partner abuse found in this study suggest areas for intervention in chemical dependency among women.

Adult↗