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Biomedical subjects

M E Wilson

Publications and source records attributed to M E Wilson.

At least 37 records · Page 2Linked to original sources

Development of the chicken as a model for prenatal stress.

Exposing a pregnant mammal to stressors causes behavioral and physiological alterations in her offspring ("prenatal stress"); however, elucidation of the underlying mechanism is hindered by an inability to control maternal compounds that may affect the fetus. We designed this experiment to determine if the autonomously developing chicken embryo could be developed as a model for prenatal stress. On d 16 of incubation, eggs were treated with: 1) 60 ng corticosterone (CORT), 2) elevated incubation temperature (40.6 degrees C) for 24 h (HEAT), or 3) no treatment (Control). Chicks from all three treatments hatched at similar weights; however, HEAT chicks weighed less by 100 d of age and remained lighter until the end of the study (P < 0.05). At 8 d post-beak trimming, adrenal gland weight was not different (P > 0.20) among treatments, basal plasma corticosterone concentrations tended (P < 0.06) to be greater for CORT chicks than either the Control or HEAT chicks, and CORT chicks were heavier than HEAT chicks (P < 0.005) but not Control chicks (P > 0.20). At 11-wk, HEAT birds had heavier adrenal glands than did Control birds (P < 0.01). At 16 wk of age, Control cocks performed more (P < 0.01) pecking aggression than either HEAT or CORT cocks, whereas CORT cocks were chased more often and chased another cock less often than either HEAT or Control cocks (P < 0.01). Treatments did not alter the behavior of the hens (P > 0.10). Administration of corticosterone during incubation replicated some, but not all, of the effects seen in prenatal stress in mammals.

Adrenal Glands↗

Travel vaccines and elderly persons: review of vaccines available in the United States.

Aging is associated with alterations in immune responses and may lead to clinically significant changes in the safety, immunogenicity, and protective efficacy of certain vaccines. This review summarizes published data regarding the effects of age on responses after immunization with vaccines generally administered before travel. The specific vaccines discussed in detail include hepatitis A, typhoid, yellow fever, Japanese encephalitis, and rabies vaccines. There is some evidence of diminished serological responses to hepatitis A and rabies vaccines in older individuals. In addition, increased toxic effects following yellow fever vaccination in elderly recipients have recently been reported. However, many travel-related vaccines have never been studied specifically in elderly populations. Consideration of potential age-related differences in responses to travel vaccines is becoming increasingly important as elderly persons more frequently venture to exotic destinations.

Aged↗

Posttravel hepatitis A: probable acquisition from an asymptomatic adopted child.

We report a case of acute hepatitis A in an adoptive parent that was probably acquired from a recently adopted child with asymptomatic, active infection. Prospective adoptive parents should be protected against hepatitis A because of potential exposure during travel and the risk of unrecognized active infection in adopted children.

Adoption↗

Strategies to decrease tuberculosis in us homeless populations: a computer simulation model.

CONTEXT: The rate of tuberculosis (TB) among US homeless persons may be 20 times that of the general adult population. Studies suggest that the majority of urban homeless TB cases are attributable to ongoing transmission of TB. Optimal TB-control strategies in both chronically and transiently homeless populations are not known. OBJECTIVE: To examine the effects of TB-control strategies on projected TB cases and deaths in US homeless populations using a computer-based simulation model. DESIGN, SETTING, AND POPULATION: The US general population and a theoretical population of 2 million homeless individuals in 1995 were divided into 18 clinical states based on the risk for or presence of TB and human immunodeficiency virus (HIV) infection in a semi-Markov model. MAIN OUTCOME MEASURES: Prevalence of transiently and chronically homeless individuals with active TB and deaths from TB as a function of public health measures taken to control and eliminate TB, including improvement of treatment effectiveness, improvement in access to treatment, and vaccination with BCG. RESULTS: A 10% increase in access to treatment among homeless persons with active TB produced larger declines in predicted TB cases and deaths after 10 years (cases and deaths among chronically homeless persons decreased 12.5% and 19.8% and among transiently homeless persons dropped 35.9% and 32.4%, respectively) than improvements in the effectiveness of treatment programs (cases and deaths among chronically homeless persons declined 7.2% and 3.1% and among transiently homeless persons dropped 10.9% and 4.1%, respectively). A 10% increase in access to treatment among homeless persons with latent TB infection led to a 6.7% decline in TB among chronically homeless persons and a 5.7% decline among transiently homeless persons, while a 10% improvement in effectiveness of treatment for latent TB infection was associated with declines of 3.0% and 3.3%, respectively. When treatment for latent TB infection was modeled to be the same in vaccinated and nonvaccinated populations, BCG vaccination led to TB case declines of 15.4% and 21.5% in chronically and transiently homeless populations, respectively. CONCLUSIONS: Overcoming barriers faced by homeless individuals in accessing TB treatment programs will be crucial to reducing the burden of TB in this high-risk group. Increased treatment access, improvement in the effectiveness of treatment programs, and BCG vaccination of HIV-negative homeless individuals have the best chance to markedly decrease TB morbidity and mortality.

Antitubercular Agents↗

Oxidative responses of human and murine macrophages during phagocytosis of Leishmania chagasi.

Leishmania chagasi, the cause of South American visceral leishmaniasis, must survive antimicrobial responses of host macrophages to establish infection. Macrophage oxidative responses have been shown to diminish in the presence of intracellular leishmania. However, using electron spin resonance we demonstrated that murine and human macrophages produce O2-during phagocytosis of opsonized promastigotes. Addition of the O2- scavenger 4-hydroxy-2,2,6,6-tetramethylpiperidine-N-oxyl to cultures resulted in increased infection, suggesting that O2- enhances macrophage leishmanicidal activity. The importance of NO. produced by inducible NO synthase (iNOS) in controlling murine leishmaniasis is established, but its role in human macrophages has been debated. We detected NO. in supernatants from murine, but not human, macrophages infected with L. chagasi. Nonetheless, the iNOS inhibitor N(G)-monomethyl-L-arginine inhibited IFN-gamma-mediated intracellular killing by both murine and human macrophages. According to RNase protection assay and immunohistochemistry, iNOS mRNA and protein were expressed at higher levels in bone marrow of patients with visceral leishmaniasis than in controls. The iNOS protein also increased upon infection of human macrophages with L. chagasi promastigotes in vitro in the presence of IFN-gamma. These data suggest that O2- and NO. each contribute to intracellular killing of L. chagasi in human and murine macrophages.

Animals↗

Combined effects of diets with reduced calcium and phosphate and increased fluoride intake on vertebral bone strength and histology in rats.

Ingested fluoride is incorporated into bone apatite and can affect the structural integrity of bone. Fluoride absorption in the gut and incorporation into bone is affected by the presence of other ions, including calcium. We hypothesized that a low calcium phosphate diet combined with high fluoride intake would have independent detrimental effects on vertebral bone strength. We measured the vertebral biomechanical properties and bone histology for rats given controlled diets with varied fluoride and calcium phosphate intakes for either 16 or 48 weeks. Diets were designed to produce mild calcium deficiency while keeping Ca:P ratio constant. Hence calcium deficiency was accompanied by a proportional phosphate deficiency. Calcium phosphate deficiency (25% of normal) significantly diminished vertebral strength only in younger rats. As the rats grew older, the effects of calcium phosphate deficiency were mitigated. Calcium phosphate deficiency reduced vertebral strength in young rats primarily by reducing the trabecular bone volume. The highest fluoride intake (50 mg/L) significantly diminished vertebral strength, but there was no effect of lower fluoride intakes on bone strength. In contrast to calcium phosphate deficiency, high fluoride intake had no effect on trabecular bone volume but instead increased the amount of unmineralized osteoid, particularly in older rats. This impairment of mineralization by fluoride appeared to be the primary cause of the diminished vertebral strength. The detrimental effects of fluoride on vertebral bone strength were not amplified by calcium phosphate deficiency.

Animals↗

Gongylonema infection of the mouth in a resident of Cambridge, Massachusetts.

We report a case of Gongylonema infection of the mouth, which caused a migrating, serpiginous tract in a resident of Massachusetts. This foodborne infection, which is acquired through accidental ingestion of an infected insect, such as a beetle or a roach, represents the 11th such case reported in the United States.

Adult↗

Protective immunity against the protozoan Leishmania chagasi is induced by subclinical cutaneous infection with virulent but not avirulent organisms.

Protective immunity against Leishmania major is provided by s.c. immunization with a low dose of L. major promastigotes or with dihydrofolate-thymidylate synthase gene locus (DHFR-TS) gene knockout L. major organisms. Whether these vaccine strategies will protect against infection with other Leishmania species that elicit distinct immune responses and clinical syndromes is not known. Therefore, we investigated protective immunity to Leishmania chagasi, a cause of visceral leishmaniasis. In contrast to L. major, a high dose s.c. inoculum of L. chagasi promastigotes was required to elicit protective immunity. Splenocytes from mice immunized with a high dose produced significantly greater amounts of IFN-gamma and lower TGF-beta than mice immunized with a low dose of promastigotes. The development of protective immunity did not require the presence of NK cells. Protection was not afforded by s.c. immunization with either attenuated L. chagasi or with L. major promastigotes, and s.c. L. chagasi did not protect against infection with L. major. Subcutaneous immunization with DHFR-TS gene knockouts derived from L. chagasi, L. donovani, or L. major did not protect against L. chagasi infection. We conclude that s.c. inoculation of high doses of live L. chagasi causes a subclinical infection that elicits protective immune responses in susceptible mice. However, L. chagasi that have been attenuated either by long-term passage or during the raising of recombinant gene knockout organisms do not elicit protective immunity, either because they fail to establish a subclinical infection or because they no longer express critical antigenic epitopes.

Animals↗

Regulation of GP63 mRNA stability in promastigotes of virulent and attenuated Leishmania chagasi.

GP63 is a 63-kDa glycoprotein that is abundantly expressed on the surface of all Leishmania species and is involved in several steps of promastigote infection of host cells. Leishmania chagasi has at least 18 haploid msp (major surface protease) genes encoding GP63 that are divided into three classes, mspS, mspL or mspC, according to their unique 3' UTR sequences and differential expression. All three msp classes are constitutively transcribed during virulent promastigote growth in vitro, although mspL mRNA is most abundant during logarithmic phase and mspS mRNA predominates in stationary phase. Thus, the steady state levels of the mspL and mspS mRNAs are post-transcriptionally regulated. Using Actinomycin D to arrest transcription, we found that in virulent promastigotes the half-life (t(1/2)) of mspL mRNA is coordinately modulated with growth phase, decreasing from a mean of 84 min during early logarithmic growth to a mean of 17 min at a stage intermediate between logarithmic and stationary phase. However, in attenuated promastigotes, the t(1/2) of mspL RNA remains the same throughout parasite growth. In contrast to mspL RNA, the t(1/2) of mspS and mspC RNA is constant throughout all growth phases of both virulent and attenuated promastigote growth. The presence of the translation inhibitor cycloheximide increases the t(1/2) of mspL RNA 4-6-fold in both virulent and attenuated promastigotes at all growth phases. These results indicate that the t(1/2) of mspL RNA is maintained by at least two distinct mechanisms - one activated during growth to stationary phase and the other dependent on a labile negative regulatory protein factor(s).

Animals↗

Randomized trial of enhanced anticipatory guidance for injury prevention.

OBJECTIVE: To develop and evaluate an injury prevention anticipatory guidance training program for pediatric residents. DESIGN: Thirty-one residents were randomly assigned to an intervention or control group. Both groups attended a 1-hour seminar about injury prevention and the American Academy of Pediatrics TIPP (The Injury Prevention Program) materials. The intervention group also received 5 hours of experiential instruction on injury prevention content and counseling skills (SAFE Counseling Framework). Families with infants from birth to age 6 months were enrolled in the study (N = 196); they were followed up until the child was aged 12 to 18 months. Data were collected by means of baseline and follow-up interviews, audiotapes of medical visits, parent exit surveys, and home observations. SETTING: A hospital-based continuity clinic that serves families living in low-income, inner-city neighborhoods. OUTCOMES: Physician counseling and parent satisfaction, knowledge, beliefs, and behaviors. RESULTS: Parents seen by physicians in the intervention group received significantly more injury prevention counseling for 5 of the 6 safety practices, and they were significantly more satisfied with the help their physicians provided on safety topics. They were no less satisfied with their physicians' counseling on other anticipatory guidance topics. Parents' knowledge, beliefs, and home safety behaviors did not differ between the 2 groups. CONCLUSIONS: The frequency and impact of pediatric counseling can be enhanced by experiential training that targets specific injury hazards. Because low-income families face many barriers to carrying out the recommended safety practices, supplemental strategies are needed to ensure safer homes.

Accidents, Home↗

Estrogens: trophic and protective factors in the adult brain.

Our appreciation that estrogens are important neurotrophic and neuroprotective factors has grown rapidly. Although a thorough understanding of the molecular and cellular mechanisms that underlie this effect requires further investigation, significant progress has been made due to the availability of animal models in which we can test potential candidates. It appears that estradiol can act via mechanisms that require classical intracellular receptors (estrogen receptor alpha or beta) that affect transcription, via mechanisms that include cross-talk between estrogen receptors and second messenger pathways, and/or via mechanisms that may involve membrane receptors or channels. This area of research demands attention since estradiol may be an important therapeutic agent in the maintenance of normal neural function during aging and after injury.

Animals↗

Estradiol is a protective factor in the adult and aging brain: understanding of mechanisms derived from in vivo and in vitro studies.

We have shown that 17beta-estradiol exerts profound protective effects against stroke-like ischemic injury in female rats. These effects are evident using physiological levels of estradiol replacement in ovariectomized rats and require hormone treatment prior to the time of injury. The protective actions of estradiol appear to be most prominent in the cerebral cortex, where cell death is not apparent until at least 4 h after the initiation of ischemic injury and where cell death is thought to be apoptotic in nature. Middle-aged rats remain equally responsive to the protective actions of estradiol. The maintenance of responsiveness of the cerebral cortex to the neuroprotective actions of estradiol was unexpected since responsiveness of the hypothalamus to estradiol decreases dramatically by the time animals are middle-aged. We believe that the protective actions of estradiol require the estrogen receptor-alpha, since estradiol does not protect in estrogen receptor-alpha knockout mice. We have also implemented a method of culturing cerebral cortical explants to assess the protective effects of estradiol in vitro. This model exhibits remarkable parallelisms with our in vivo model of brain injury. We have found that 17beta-estradiol decreases the extent of cell death and that this protective effect requires hormone pretreatment. Finally, 17alpha-estradiol, which does not interact effectively with the estrogen receptor, does not protect; and addition of ICI 182,780, an estrogen receptor antagonist, blocks the protective actions of estradiol. We have begun to explore the molecular and cellular mechanisms of estradiol-mediated protection. In summary, our findings demonstrate that estradiol exerts powerful protective effects both in vivo and in vitro and suggest that these actions are mediated by estrogen receptors.

Aging↗

Travel-related vaccines.

Travelers are at increased risk for several infections, including familiar infections such as measles that are widely distributed but more common in developing countries. Vaccines can markedly decrease the risk for many of these infections and are an important part of pretravel preparation. Travel provides an opportunity to review and update routine vaccines in adults and assess risk from unusual infections. Global travel is growing. Persons who are elderly, HIV-infected, and immunocompromised account for many of the travelers. Studies that assess the immunogenicity, efficacy, and adverse effects of some of the special vaccines used primarily in travelers generally have been done in young, healthy populations. Findings in young adults do not apply to other populations in whom immune response can be slower, less effective, and less durable. Recent reports of severe adverse events in elderly persons who have received yellow fever vaccine are a reminder that widely used, old vaccines can have unexpected side effects when used in a new population. It is biologically plausible that adverse effects might be more common in the elderly, and epidemiologically plausible that occasional instances of similar adverse events in the past could have been missed. Studies on special and travel vaccines in the elderly are needed urgently to define how these vaccines should be used in older populations and whether alternative means for protection are needed.

Adult↗

A comparison of grating visual acuity, strabismus, and reoperation outcomes among children with aphakia and pseudophakia after unilateral cataract surgery during the first six months of life.

PURPOSE: The method of correcting aphakia after unilateral cataract extraction during infancy is controversial. Some authorities advocate correction with an intraocular lens (IOL) whereas others advocate correction with a contact lens (CL). We compared grating visual acuity, alignment, and reoperative outcomes in age-matched children treated with these 2 modalities at 5 clinical centers. METHODS: Twenty-five infants born in 1997 or 1998 with a dense unilateral congenital cataract who had cataract surgery coupled with (IOL group, n = 12) or without (CL group, n = 13) primary IOL implantation were enrolled in this study. All patients were prescribed half-time occlusion therapy. In July 1999, their grating visual acuities, ocular alignments, and reoperation rates were assessed. RESULTS: The mean grating visual acuity (LogMAR) for the affected eye was 0.70 +/- 0.32 for the IOL group and 0.87 +/- 0.31 for the CL group (P =.19). The mean interocular difference in grating visual acuity was 0.26 +/- 0.30 for the IOL group and 0.50 +/- 0.28 for the CL group (P =.048). The incidence of strabismus (>10 PD) was 75% in the IOL group compared with 92% in the CL group (P =.24). The incidence of reoperations was 83% in the IOL group compared with 23% in the CL group (P =.003). CONCLUSIONS: Our preliminary data suggest that correcting aphakia after unilateral congenital cataract surgery with primary IOL implantation results in an improved visual outcome but a higher rate of complications requiring reoperation. A randomized clinical trial, the Infant Aphakia Treatment Study, is planned to further study the optimal treatment for aphakia following unilateral cataract extraction during infancy.

Aphakia, Postcataract↗

Pseudophakia and polypseudophakia in the first year of life.

PURPOSE: To report a consecutive series of patients undergoing intraocular lens (IOL) implantation in the first year of life. A new procedure, referred to as temporary polypseudophakia, is reported. METHODS: A retrospective chart analysis was conducted. Ocular growth and refractive change, complications and reoperation rates, and outcomes were analyzed. RESULTS: Forty-seven eyes of 33 patients underwent IOL implantation in the first year of life. Average follow-up was 22 months (range, 7 weeks to 5 years). Thirty-two eyes of 22 patients had a single IOL implanted from 12 days to 11 months of age. Fifteen eyes of 11 infants received piggyback IOLs from 16 days to 6.8 months of age. Reoperation for complications within the anterior segment of the eye was needed in 23% of all patients (22% for single IOLs, 26% for piggyback IOLs). The average first postoperative refraction after single IOL was +7.98 D and after piggyback IOL was +1.67 D. The average last postoperative refraction was +1.76 D and -4.48 D, respectively. On average, eyes grew 2.68 mm over 17.5 months of follow-up. Eight patients were old enough for Snellen visual acuity, but each had deprivation amblyopia with visual acuities from 20/85 to 5/200. Of the remaining 25 patients, 17 had central, steady, and maintained fixation in the implanted eyes. CONCLUSION: IOL implantation in infancy is technically feasible and associated with a reoperation rate of approximately 25% in the first 2 years after implantation. Further follow-up is required before meaningful visual acuity data and long-term results can be reported.

Cataract↗