Search PubMed⌕ Search

Biomedical subjects

L Neale

Publications and source records attributed to L Neale.

15 recordsLinked to original sources
PubMed2002

Congenital anomalies in the offspring of women with type 1, type 2 and gestational diabetes.

AIM: To determine the frequency of major congenital anomalies in the offspring of women with gestational diabetes (GDM), classified according to their postpartum glucose tolerance status. METHODS: A prospective study of pregnancies in women with Type 1 diabetes (n = 221), Type 2 diabetes (n = 317) and GDM (n = 1822) between 1985 and 2000 (15 years). Congenital anomalies were detected by antenatal ultrasound or postnatal examination. RESULTS: The frequency of major congenital anomalies in the offspring was 5.9% (95% confidence interval (CI) 3.2-9.8) for women with Type 1 diabetes; 4.4% (95% CI 2.4-7.3) for women with Type 2 diabetes; and 1.4% (95% CI 0.9-2.0) for women with GDM. Two hundred and thirty-seven women with GDM (13%) had diabetes diagnosed on early (6-week) postpartum glucose tolerance testing. The frequency of major congenital anomalies in their offspring was 4.6% (95% CI 2.3-8.2), compared with 0.9% (95% CI 0.5-1.5) for the remainder of the GDM group (P < 0.0001). CONCLUSIONS: GDM is not a homogeneous group with regard to the risk of major congenital anomalies. In those with diabetes on early postpartum testing, who are likely to have had unrecognized Type 2 diabetes antedating their pregnancy, the rate of major congenital anomalies is the same as for women with established Type 1 or Type 2 diabetes. In the remainder of the GDM group, the rate does not differ from the non-diabetic background rate.

Blood Glucose↗
PubMed2002

Hypertensive disorders of pregnancy in women with Type 1 and Type 2 diabetes.

AIMS: Hypertensive disorders in pregnancy are common in women with Type 1 diabetes and can be associated with adverse fetal outcomes, but little is known about hypertension in pregnancy in women with Type 2 diabetes. The aim of this study was to compare the incidence and outcomes of, and risk factors for, hypertension in pregnancy in women with Type 1 and Type 2 diabetes. METHODS: One hundred consecutive singleton pregnancies in women with Type 2 and 100 in women with Type 1 diabetes were studied. Hypertension in pregnancy was classified according to Australasian Society for the Study of Hypertension in Pregnancy guidelines. Outcomes of pregnancy examined included birth weight, rates of caesarean section, premature delivery and special care unit admission, and perinatal mortality. RESULTS: The overall incidence of hypertension in pregnancy was similar in Type 2 and Type 1 diabetes (41% vs. 45%), but the distribution of subtypes differed (P = 0.028). Women with Type 2 diabetes had more chronic hypertension (diagnosed at < 20 weeks gestation), but less preeclampsia than women with Type 1 diabetes. Hypertension in pregnancy was strongly associated with a number of adverse outcomes, but the impact of hypertension was significantly less for Type 2 diabetes than it was for Type 1 (premature delivery, P < 0.005; admission to Special Care Unit, P < 0.01; caesarean section, P = 0.05). This was, in part, because the frequency of adverse outcomes was greater in women with preeclampsia. Nulliparity, poor glycaemic control at presentation, and early pregnancy blood pressure and not smoking were risk factors for hypertension of similar magnitude in both types of diabetes. Significant effects of duration of diabetes and obesity were not seen in Type 2 subjects, but were in Type 1 (P < 0.01, P < 0.05, respectively). Early pregnancy albumin excretion rate was increased more frequently in Type 2 subjects than in Type 1 (P < 0.035), but was less strongly associated with the development of preeclampsia (P < 0.035). CONCLUSIONS: The incidence of hypertension in pregnancy is similar in Type 2 and Type 1 diabetes, but the different population characteristics are reflected in a significantly different pattern of types of hypertension. Hypertension has less impact on adverse outcomes in Type 2 diabetes. Some risk factors for hypertension also differ between Type 2 and Type 1 diabetes.

Adult↗
PubMed1995

All trans retinoic acid enhances human LAK activity.

All trans retinoic acid has various effects on normal and malignant cells. Lymphokine-activated killer (LAK) activity can be derived from T lymphocytes and natural killer cells. This study shows that all trans retinoic acid significantly enhances this activity by increasing production of tumour necrosis factor and gamma interferon, which results in enhanced expression of the p55 part of the interleukin 2 receptor. This effect is dependent on the concentration of all trans retinoic acid and the length of time of culture.

Cells, Cultured↗
PubMed1989

Human mononuclear cell function after 4 degrees C storage during 1-G and microgravity conditions of spaceflight.

Future space missions of long duration may require that autologous leukocytes be stored in flight for infusion to restore normal immune competence in crewmembers. Peripheral blood mononuclear cells (PBMNCs), as leukocyte concentrates in autologous plasma and 2% dextrose, were stored in the microgravity conditions provided by the U.S. Space Shuttle Columbia (Mission 61-C). Activity of PBMNC after space flight was compared with that from a series of preflight ground control experiments, which demonstrated in culture a progressive daily loss in mitogen-stimulated protein synthesis at 24 h and thymidine uptake at 72 h after storage for 7 d at 4 degrees C. Post-storage viabilities were at least 90% as determined by trypan dye exclusion. A progressive reduction in the percentage of PBMNC expressing cell-surface phenotype markers, which was similar for monocytes, B cells, and T-cell subsets, also occurred after storage. The ability of PBMNC, stored for 8 d in Columbia's middeck, to become activated and proliferate in vitro was similar to that of cells that remained in identical flight lockers on the ground as 1-G controls, thus indicating that PBMNCs were not adversely affected by storage under microgravity conditions.

Benzoates↗
PubMed1988

Operation Everest II: alterations in the immune system at high altitudes.

We investigated the effects on immune function after progressive hypobaric hypoxia simulating an ascent to 25,000 ft (7620 m) over 4 weeks. Multiple simultaneous in vitro and in vivo immunologic variables were obtained from subjects at sea level, 7500 ft (2286 m), and 25,000 ft during a decompression chamber exposure. Phytohemagglutinin-stimulated thymidine uptake and protein synthesis in mononuclear cells were reduced at extreme altitudes. Mononuclear-cell subset analysis by flow cytometry disclosed an increase in monocytes without changes in B cells or T-cell subsets. Plasma IgM and IgA but not IgG levels were increased at altitudes, whereas pokeweed mitogen-stimulated in vitro IgG, IgA, and IgM secretion was unchanged. During exposure to 25,000 ft, in vitro phytohemagglutinin-stimulated interferon production and natural killer-cell cytotoxicity did not change statistically, but larger intersubject differences occurred. IgA and lysozyme levels (nasal wash) and serum antibodies to nuclear antigens were not influenced by altitude exposure. These results suggest that T-cell activation is blunted during exposure to severe hypoxemia, whereas B-cell function and mucosal immunity are not. Although the mechanism of altered in vitro immune responsiveness after exposure to various environmental stressors has not been elucidated in humans, hypoxia may induce alterations in immune regulation as suggested by in vitro immune assays of effector-cell function.

Adult↗
PubMed1980

Agglutinins to bacteria in Crohn's disease.

Sera from patients with Crohn's disease were tested for antibodies against organisms which are thought to cause inflammatory bowel disease in animals, or have been implicated in human Crohn's disease. Control sera were collected from healthy individuals and patients with ulcerative colitis. Sera from Crohn's disease and controls failed to agglutinate Clostridium colinum or Campylobacter sputorum subsp. mucosalis and two strains of Mycobacterium paratuberculosis (M26 and M27). Most of the sera agglutinated a Citrobacter freundii variant, Mycobacterium paratuberculosis (M28) and Mycobacterium avium (M41) but Crohn's disease sera did not differ from controls. A complement fixation test against Chlamydia gave more positive reactions in patients with Crohn's disease and colitis than in healthy controls. There was a clear difference between the sera from patients with Crohn's disease and other sera, including ulcerative colitis, in agglutination tests with the commensal coccoid rods of the genera Eubacterium and Peptostreptococcus; in these tests 54% of sera from Crohn's disease were positive compared with 11% in ulcerative colitis and none of the sera from healthy controls. All the results were essentially negative with the exception of those from Eubacterium and Peptostreptococcus and these bacteria merit investigation.

Agglutination Tests↗
PubMed1980

Composition of bronchopulmonary secretions from patients with bronchiectasis.

Pulmonary function tests were carried out on 17 patients with bronchiectasis and six indices were selected to grade severity. Average concentrations of nine plasma proteins were determined by quantitative immunoelectrophoresis in specimens of sputum and serum from each patients. Wide patient-to-patient variation in concentration was encountered which appeared to follow a continuous progression unrelated to clinical severity. Patients at the upper end of the scale appeared to be responding by exudation and a pulmonary hypersensitivity reaction may be occurring in their lungs. There was evidence of selective concentration in sputum of alpha 1-antichymotrypsin and IgA although IgA concentrations were lower than would be expected in patients with chronic bronchitis. It is suggested that sputum IgA levels could be explored as a diagnostic criterion in those patients who could equally be suffering from chronic bronchitis.

Adult↗
PubMed1975

Soluble proteins of bronchopulmonary secretions from patients with cystic fibrosis, asthma, and bronchitis.

The concentrations of nine plasma proteins were determined by quantitative immunoelectrophoresis in sputum specimens from 29 patients with cystic fibrosis (CF) and from 24 patients with severe asthma and chronic bronchitis. The results suggested that the population of CF patients could be divided into two groups in spite of an absence of difference in clinical status between the groups. Average concentrations of seven plasma proteins in sputum of group I CF patients were identical with those in sputum of patients with bronchitis, but the average concentrations of six of these proteins in sputum from group II CF patients were higher than those in specimens from the bronchitic patients and were similar to corresponding concentrations in sputum from patients with asthma, all of whom were examined while in status asthmaticus. The average concentrations of 14 secretory proteins were the same in all sputum specimens whether or not they were produced by patients with cystic fibrosis, asthma or bronchitis. It was concluded that the concentrations in the bronchopulmonary secretions of proteins associated with host defence were not diminished in patients with cystic fibrosis, and failure to produce adequate concentrations of proteins with antimicrobial activity was unlikely to be responsible for the above average susceptibility to chest infection in cystic fibrosis. It is suggested that there exists a group of CF patients in whom a pulmonary allergic reaction generates an inflammatory response as severe as that characterizing status asthmaticus and that this response could be detrimental.

Adult↗