Epidemiologic and biological characteristics of salmonellosis in three dairy herds.
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Animals↗
Biomedical subjects
R J Anderson
Publications and source records attributed to R J Anderson.
Comparison of VIDAS enzyme-linked fluorescent immunoassay using Moore swab sampling and conventional culture method for Salmonella detection in bulk tank milk and in-line milk filters in California dairies.
A comparison of the VIDAS Salmonella (SLM) assay using the manufacturer's recommended sampling method or a Moore swab sampling method demonstrated that the Moore swab method detected a greater number of positive samples (83.0% vs. 67.92%). When results using a conventional culture technique were compared to the VIDAS SLM assay using Moore swab sampling, there was good agreement (97.5%). When the VIDAS SLM assay was used to test in-line milk filters and compared to results from the conventional culture method, there was also good correlation between test results (95.57%). Overall, the VIDAS SLM assay using a modified sampling method compared favorably to the conventional culture method and had the advantages of taking less time to obtain a negative or presumptive positive result, being less technically complicated and requiring less screening of non-lactose fermenting colonies from negative samples.
Animals↗
Is patients' perception of time spent with the physician a determinant of ambulatory patient satisfaction?
BACKGROUND: Time management in ambulatory patient visits is increasingly critical. Do patients who perceive a longer visit with internists report increased satisfaction? METHODS: Prospective survey of 1486 consecutively encountered ambulatory visits to 16 primary care physicians (PCPs) in an academic primary care clinic. Patients were queried regarding demographics, health status, perception of time spent before and after ambulatory visits, whether the physician appeared rushed, and visit satisfaction. Physicians were queried regarding time spent, estimated patient satisfaction, and whether they felt rushed. RESULTS: In 69% of 1486 consecutive visits, patient previsit expectation of visit duration was 20 minutes or less. Patient and PCP postvisit estimates of time spent significantly exceeded patient previsit time expectation. Patients who estimated that they spent more time than expected with the PCP were significantly more satisfied with the visit. When patient postvisit estimate of time spent was less than the previsit expectation, visit satisfaction was significantly lower independent of time spent. Patient worry about health and lower self-perceived health status were significantly associated with patient expectation for longer visits. Primary care physicians felt rushed in 10% of encounters. Although PCPs estimated patient satisfaction was significantly lower when they felt rushed, patient satisfaction was identical when PCPs did and did not feel rushed. Patients indicated that PCPs appeared rushed in 3% of encounters, but this perception did not affect patient satisfaction. CONCLUSION: Perceived ambulatory visit duration and meeting or exceeding patient expectation of time needed to be spent with the physician are determinants of patient satisfaction in an ambulatory internal medicine practice.
Ambulatory Care↗
Susceptibility of cattle to infection with Ehrlichia equi and the agent of human granulocytic ehrlichiosis.
OBJECTIVE: To determine susceptibility of cattle to infection with Ehrlichia equi and the agent of human granulocytic ehrlichiosis (HGE). DESIGN: Experimental disease and prevalence survey. ANIMALS: 6 cattle, 2 horses, and 2,725 serum samples from healthy cattle. PROCEDURE: 2 cattle and 1 horse were inoculated with E equi, 2 cattle and 1 horse were inoculated with the HGE agent, and 2 cattle served as sham-inoculated controls; inoculated animals were evaluated via clinical, hematologic, serologic, and real-time polymerase chain reaction tests. Prevalence of antibodies against E equi in 2,725 healthy cattle was determined by use of an indirect immunofluorescent technique. RESULTS: No abnormal clinical or hematologic findings or inclusion bodies within granulocytes were observed in the cattle after inoculation, and results of all polymerase chain reaction tests were negative. Seroconversion in inoculated cattle developed 10 to 12 days after inoculation (reciprocal titers, 160). Both horses developed clinical signs of ehrlichiosis. Five of 2,725 (0.18%) cattle were seropositive for E equi, with titers ranging from 20 to 80. All seropositive cattle originated from the same tick-rich region in the Sierra Nevada foothills. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that cattle are not susceptible to infection with E equi or the agent of HGE and that prevalence of exposure to E equi in healthy cattle is low. Therefore, E equi and the agent of HGE are likely of negligible importance for cattle in North America.
Animals↗
Eosinophilic fasciitis presenting as pitting edema of the extremities.
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Aged↗
Thermostable (SULT1A1) and thermolabile (SULT1A3) phenol sulfotransferases in human osteosarcoma and osteoblast cells.
Sulfate conjugation is an important pathway in the metabolism of many drugs, xenobiotic compounds, and hormones. Sulfotransferases (SULTs) catalyze these reactions and have been detected and characterized in various human tissues including the liver and small intestine. Substrates for SULTs that include estrogen and thyroid hormones have well-established roles affecting skeletal integrity and disease processes. We performed the following studies to determine the presence of SULTs in human osteoblast-like cells, and to compare their characteristics to SULTs expressed in other human tissues. Four osteosarcoma cell lines (SaOS-2, U2-OS, PR, and HOS-TE85) were screened for the presence of four different SULT activities. Predominant activities were found for SULT1A1 in SaOS-2 cells, and SULT-1A3 in HOS-TE85 cells. Several biochemical properties of each enzyme that included apparent K(m) values, thermal stabilities, and responses to the inhibitors 2,6-dichloro-4-nitrophenol and NaCl were used to further characterize the SULT activities. High-performance liquid chromatography (HPLC) of the reaction products confirmed the known products of SULT1A1 and SULT1A3. When the mature human osteoblast HOB-03-CE6 cell line was tested for activity alone, the predominant activity was SULT1A3, with minimal SULT1A1. The results indicate that SULT1A1 and SULT1A3 are present in human osteosarcoma and mature osteoblast cell lines, and that the characteristics of the osteosarcoma cell SULTs are similar to those expressed in other human tissues. SULTs may have regulatory roles in the deactivation of thyroid hormones or estrogenic compounds in bone, and thus may affect hormone action and bone responses in the human skeleton.
Arylsulfotransferase↗
Renal replacement therapy in intensive care: one size does not fit all.
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Acute Kidney Injury↗
Precision of three topography instruments in keratoconus subjects.
PURPOSE: To determine the test-retest reliability of three popular and commercially available Placido-ring videokeratography instruments in subjects with keratoconus. METHODS: Nine subjects (16 eyes) with keratoconus of varying degrees of severity had up to four images per eye generated, in random order, from the EyeSys Model II, Dicon CT 200 and the Keratron Corneal Analyzer. Test-retest analyses for the images were sampled at four locations: 1.5 mm nasal, inferior, temporal, and superior from center. The average standard deviation of all points was used to determine the short-term variability of the measurements. RESULTS: The short-term variability (in diopters) of the Dicon, EyeSys, and Keratron was 0.61 to 3.31 D, 0.94 to 1.51 D, and 0.58 to 2.85 D, respectively, for axial distance maps and 1.07 to 6.82 D, 0.79 to 1.77 D, and 1.23 to 3.03 D for tangential curvature maps. CONCLUSION: Results support the notion of a loss in repeatability for all three instruments when corneal irregularity is present, which reduces test-retest reliability.
Cornea↗
Construction, genotypic and phenotypic characterization, and immunogenicity of attenuated DeltaguaBA Salmonella enterica serovar Typhi strain CVD 915.
A promising live attenuated typhoid vaccine candidate strain for mucosal immunization was developed by introducing a deletion in the guaBA locus of pathogenic Salmonella enterica serovar Typhi strain Ty2. The resultant DeltaguaBA mutant, serovar Typhi CVD 915, has a gene encoding resistance to arsenite replacing the deleted sequence within guaBA, thereby providing a marker to readily identify the vaccine strain. CVD 915 was compared in in vitro and in vivo assays with wild-type strain Ty2, licensed live oral typhoid vaccine strain Ty21a, or attenuated serovar Typhi vaccine strain CVD 908-htrA (harboring mutations in aroC, aroD, and htrA). CVD 915 was less invasive than CVD 908-htrA in tissue culture and was more crippled in its ability to proliferate after invasion. In mice inoculated intraperitoneally with serovar Typhi and hog gastric mucin (to estimate the relative degree of attenuation), the 50% lethal dose of CVD 915 (7.7 x 10(7) CFU) was significantly higher than that of wild-type Ty2 (1.4 x 10(2) CFU) and was only slightly lower than that of Ty21a (1.9 x 10(8) CFU). Strong serum O and H antibody responses were recorded in mice inoculated intranasally with CVD 915, which were higher than those elicited by Ty21a and similar to those stimulated by CVD 908-htrA. CVD 915 also elicited potent proliferative responses in splenocytes from immunized mice stimulated with serovar Typhi antigens. Used as a live vector, CVD 915(pTETlpp) elicited high titers of serum immunoglobulin G anti-fragment C. These encouraging preclinical data pave the way for phase 1 clinical trials with CVD 915.
Animals↗
Potential transition state phosphoramidate inhibitors of beta-tubulin as antifilarial agents.
Transition state phosphoramidate inhibitors of beta-tubulin were designed as potential antifilarial agents. The reaction of 2-aminobenzimidazole with diisopropyl phosphite and carbon tetrachloride at a low temperature gave the unexpected 1-diisopropoxyphosphoryl-2-aminobenzimidazole, which on heating gave the novel benzimidazole derivative, 2-(diisopropoxyphosphoryl)aminobenzimidazole. Both products were fully characterized and the synthetic procedure to both compounds was optimized. The procedure was used to prepare the related 5-benzoyl-2-(diisopropoxyphosphoryl)aminobenzimidazole and 5-benzoyl-2-(diethoxyphosphoryl)aminobenzimidazole (1d). In a preliminary trial against Brugia pahangi compound 1d was found to have no antifilarial activity. This lack of activity may be attributed to its extreme insolubility and thus low bioavailability. The synthesis of analogous, more soluble, phosphorothioate-substituted benzimidazoles using the same methods may yield compounds with greater antifilarial activity.
Amides↗
Disease conditions most frequently evaluated among the homeless in Dallas.
Responding to the medical needs of the homeless population across the United States exact large costs on the health care system. To provide effectively for such vulnerable populations, health care systems require creative and efficient strategies of service organization tailored to the specific needs of the homeless. However, such needs often vary by geographic region due to the inherent diversity of the population. Currently, no published medical evaluation of the urban homeless in Texas exists. Therefore, this study examines 93,074 diagnoses given to 20,331 homeless patients seen in a seven-year period in a primary care mobile and fixed clinic system. The most frequent disease conditions evaluated in this cohort of patients are reported. These findings may be useful to clinical site managers and health care planners contemplating an outreach program for the homeless.
Adolescent↗
The prevalence of comorbid depression in adults with diabetes: a meta-analysis.
OBJECTIVE: To estimate the odds and prevalence of clinically relevant depression in adults with type 1 or type 2 diabetes. Depression is associated with hyperglycemia and an increased risk for diabetic complications; relief of depression is associated with improved glycemic control. A more accurate estimate of depression prevalence than what is currently available is needed to gauge the potential impact of depression management in diabetes. RESEARCH DESIGN AND METHODS: MEDLINE and PsycINFO databases and published references were used to identify studies that reported the prevalence of depression in diabetes. Prevalence was calculated as an aggregate mean weighted by the combined number of subjects in the included studies. We used chi(2) statistics and odds ratios (ORs) to assess the rate and likelihood of depression as a function of type of diabetes, sex, subject source, depression assessment method, and study design. RESULTS: A total of 42 eligible studies were identified; 20 (48%) included a nondiabetic comparison group. In the controlled studies, the odds of depression in the diabetic group were twice that of the nondiabetic comparison group (OR = 2.0, 95% CI 1.8-2.2) and did not differ by sex, type of diabetes, subject source, or assessment method. The prevalence of comorbid depression was significantly higher in diabetic women (28%) than in diabetic men (18%), in uncontrolled (30%) than in controlled studies (21%), in clinical (32%) than in community (20%) samples, and when assessed by self-report questionnaires (31%) than by standardized diagnostic interviews (11%). CONCLUSIONS: The presence of diabetes doubles the odds of comorbid depression. Prevalence estimates are affected by several clinical and methodological variables that do not affect the stability of the ORs.
Adult↗
Elevated serum creatinine concentration--a marker for adverse operative outcome.
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Creatinine↗
Sulfation of iodothyronines by human sulfotransferase 1C1 (SULT1C1)*.
Sulfation is an important component of human thyroid hormone metabolism. The role of the human sulfotransferase 1C1 (SULT1C1) is not known. Because SULT1C1 is present in the adult thyroid, intra-thyroidal sulfation of thyroid hormones and their metabolites might occur. We tested this hypothesis by determining the ability of recombinant human SULT1C1 to catalyze iodothyronine sulfation. Apparent K(m) values for 3,3',5-triiodothyronine (T(3)), 3, 3'-diiodothyronine (3,3'-T(2)), 3',5',3-triiodothyronine (rT(3)), and 3,3',5,5'-tetraiodothyronine (T(4)) with SULT1C1 were 28.7, 10.3, 10.2, and 59.3 microM, respectively. Thermal stability and responses to inhibitors also were tested with T(3) as the substrate. Enzyme aliquots were measured simultaneously to determine SULT1C1 substrate preferences at optimal iodothyronine concentrations. SULT1C1 activity obtained with T(3) was used as 100%, and the activities with 3,3'-T(2), rT(3), T(4), and 3,5-diiodothyronine (3, 5-T(2)) were 614, 314, 25, and 4%, respectively. We report for the first time the characterization of human SULT1C1 with T(3) and the preferences of the enzyme for various iodothyronines. The presence of SULT1C1 in the adult thyroid gland raises the possibilities that the enzyme can contribute to intraglandular thyroid hormone processing and iodide reutilization.
Animals↗
DeltaguaBA attenuated Shigella flexneri 2a strain CVD 1204 as a Shigella vaccine and as a live mucosal delivery system for fragment C of tetanus toxin.
The DeltaguaBA Shigella flexneri 2a vaccine candidate, CVD 1204, was evaluated as a delivery system for the non-toxic C-terminal of tetanus toxin (fragment C), either as a polypeptide expressed in the bacteria or as a DNA vaccine. CVD 1204 was transformed with plasmid pTETnir15 which encodes the fragment C gene (tetC) under the control of the inducible prokaryotic nir15 promoter or a DNA vaccine plasmid pcDNA3tetC which encodes tetC under the eukaryotic hCMV promoter. Guinea pigs immunised intranasally (i.n.) with either recombinant strain mounted a secretory immune response against S. flexneri 2a Lipopolysaccharide (LPS) and were protected against ocular challenge with wild-type S. flexneri 2a. Both strains were effective in eliciting a serum IgG response against fragment C in guinea pigs following i.n. immunisation. Furthermore, serum from guinea pigs immunised with CVD 1204(pTETnir15) contained tetanus toxin neutralising antibodies. These results demonstrate that this S. flexneri 2a vaccine candidate can serve as a vehicle for the delivery of foreign antigens to the systemic immune system while retaining its capacity to serve as a mucosal Shigella vaccine.
Administration, Intranasal↗
Common issues in medical professionalism: room to grow.
PURPOSE: Much of the respect and trust that society grants to physicians is based on the expectation of upholding professional values. We performed this study to assess responses to common challenges to medical professionalism and to ascertain physician satisfaction with training in professionalism. METHODS: A self-administered questionnaire containing six challenges to professionalism (acceptance of gifts, conflict of interest, confidentiality, physician impairment, sexual harassment, and honesty) with multiple-choice responses was mailed to 528 medical students and 779 house officers at the University of Colorado Health Sciences Center and to 900 randomly selected Colorado physicians. Information about previous exposure to the issue depicted in the scenarios and satisfaction with, and site of, previous education in medical professionalism was obtained. An independent panel selected the best or acceptable answers to the challenges. RESULTS: In all, 961 evaluable responses were received. More than 40% of physicians reported experience with four of the six challenges. The frequency of the best or acceptable answers to the six scenarios ranged from 12% to 86%. Best or acceptable responses were more common in physicians than in house officers, and in house officers than in medical students (P < 0.001). Practice setting and specialty type had only modest effects. The physician impairment scenario was the most challenging: Only 12% of physicians provided the best answer. Most (73%) respondents reported having 10 or fewer hours of formal course work in professionalism, and many (40%) were dissatisfied with their training in professionalism. CONCLUSIONS: While everyday challenges to professionalism are commonly encountered by trainees and practicing physicians, many practitioners are dissatisfied with their training in this area and were unable to provide an acceptable answer to these challenges.
Adult↗
A longitudinal study of visual function in carriers of X-linked recessive retinitis pigmentosa.
OBJECTIVE: This study was carried out to evaluate the progression of visual function impairment in carriers of X-linked recessive retinitis pigmentosa. We also assessed the relationship between the retinal findings at presentation and the extent of deterioration. DESIGN: Observational, retrospective, case series. PARTICIPANTS: Twenty-seven carriers of X-linked recessive retinitis pigmentosa. METHODS: Each carrier was clinically categorized into one of four grades (grades 0 through 3) depending on the presence or absence of a tapetal-like retinal reflex and the extent of peripheral pigmentary degeneration. A complete ophthalmologic examination was performed and data for visual acuity, visual field area, and electroretinographic measurements were collected on the most recent visit in both eyes. These were then compared with similar data obtained on their initial visits. MAIN OUTCOME MEASURES: A comparison of visual function was carried out between the initial visit and the most recent visit on each carrier. The visual acuity was measured with Snellen's acuity charts. The visual fields to targets V-4-e and II-4-e were planimeterized and used for the analysis. The electroretinographic (ERG) measures used were light-adapted single-flash b-wave amplitudes and 30-Hz red flicker for cone function, dark-adapted maximal b-wave amplitudes, and response to a low intensity blue-flash for rod function. RESULTS: None of the 11 carriers with a tapetal-like reflex only (grade 1) showed any significant change in visual acuity or fields as compared with 3 of 7 (43%) carriers with diffuse peripheral pigmentary findings (grade 3) who showed significant deterioration in visual acuity in at least one eye, and 6 of 7 (86%) who showed a significant decrease in visual field area with at least one target size in at least one eye. By comparison, only 1 of 10 carriers with a grade 1 fundus finding demonstrated a significant decrease in maximal dark-adapted ERG function as compared with 5 of 6 (83%) carriers with grade 3 in response to a single-flash stimulus and with 4 of 5 (80%) carriers in response to a single-flash blue stimulus. For the single-flash photopic response, none of the 10 carriers with grade 1 showed any significant deterioration, whereas 2 of 4 (50%) with grade 3 did show such deterioration. The ERG responses for carriers with grade 2 were in between the extent of decrease in ERG amplitudes of those in carriers with grades 1 and 3. CONCLUSIONS: In our cohort of X-linked retinitis pigmentosa carriers, those with only a tapetal-like retinal reflex at presentation had a better prognosis to retain visual function than those with peripheral retinal pigmentation. These data are useful in counseling such carriers as to their visual prognosis.
Adolescent↗
Mild renal failure is associated with adverse outcome after cardiac valve surgery.
The present study was performed to ascertain whether the presence of mild renal failure (defined as a serum creatinine concentration of 1. 5 to 3.0 mg/dL) is an independent risk factor for adverse outcome after cardiac valve surgery. An extensive set of preoperative and postoperative data was collected in 834 prospectively evaluated patients undergoing cardiac valve surgery at 14 Veterans Affairs Medical Centers. Univariate and multivariable analyses were performed to determine whether an independent association of mild renal dysfunction with adverse outcomes was present. Patients with mild renal failure had significantly greater 30-day mortality rates (P = 0.001; 16% versus 6%) and frequency of postoperative bleeding (P = 0.023; 16% versus 8%), respiratory complications (P = 0.02, 29% versus 16%), and cardiac complications (P = 0.002; 18% versus 7%) than patients with normal renal function (serum creatinine <1.5 mg/dL) when controlling for multiple other variables. The presence of a serum creatinine concentration of 1.5 to 3.0 mg/dL is significantly and independently associated with adverse outcomes after cardiac valve surgery.
Age Factors↗