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Biomedical subjects

R Wallace

Publications and source records attributed to R Wallace.

At least 199 records · Page 11Linked to original sources
PubMed1967

Circulating antibody response in BCG vaccination, tuberculous infection and sarcoidosis.

The bentonite flocculation test was used to differentiate antibodies formed by BCG vaccination from those produced by infections with virulent tubercle bacilli. Of 116 BCG-vaccinated nurses, only two (1.7%) showed antibody titres higher (1:128) than the threshold titre of 1:64 established for tuberculous patients.The bentonite test was also used to follow the course of infection in 54 patients with tuberculosis. A good correlation was found between the clinical course of the disease and O.T.-bentonite titres on repeated serological testing.Tuberculosis-like antibodies were demonstrated in sarcoidosis patients. These antibodies, however, are globulins (7S), in contrast to the macroglobulins (19S) found in tuberculous patients.

Antibody Formation↗
PubMed1966

A study of tuberculosis antibodies by bentonite flocculation.

Bentonite particles sensitized with concentrated human Old Tuberculin were used for detection of circulating antibodies to M. tuberculosis in human sera.There was no sharp distinction between the titres of patients with active and inactive tuberculosis, but progressively higher antibody titres accompanied increased severity of infection. The sera of 95.3% of the patients studied had a titre of 1:8 or higher. This level was considered to be the minimal significant titre indicative of the presence of metabolically active bacilli in old and new lesions. Tuberculin-negative controls and syphilitic sera were negative. A common zone of incidence in the 1:8-1:32 range was found where differentiation between tuberculin-positive healthy people and patients with tuberculosis was not possible; however, titres of 1:64 or more were found only in tuberculous patients. The antibody under study is heat-labile.

Antibodies, Bacterial↗
PubMedDate not supplied

Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial.

CONTEXT: Alendronate sodium reduces fracture risk in postmenopausal women who have vertebral fractures, but its effects on fracture risk have not been studied for women without vertebral fractures. OBJECTIVE: To test the hypothesis that 4 years of alendronate would decrease the risk of clinical and vertebral fractures in women who have low bone mineral density (BMD) but no vertebral fractures. DESIGN: Randomized, blinded, placebo-controlled trial. SETTING: Eleven community-based clinical research centers. SUBJECTS: Women aged 54 to 81 years with a femoral neck BMD of 0.68 g/cm2 or less (Hologic Inc, Waltham, Mass) but no vertebral fracture; 4432 were randomized to alendronate or placebo and 4272 (96%) completed outcome measurements at the final visit (an average of 4.2 years later). INTERVENTION: All participants reporting calcium intakes of 1000 mg/d or less received a supplement containing 500 mg of calcium and 250 IU of cholecalciferol. Subjects were randomly assigned to either placebo or 5 mg/d of alendronate sodium for 2 years followed by 10 mg/d for the remainder of the trial. MAIN OUTCOME MEASURES: Clinical fractures confirmed by x-ray reports, new vertebral deformities detected by morphometric measurements on radiographs, and BMD measured by dual x-ray absorptiometry. RESULTS: Alendronate increased BMD at all sites studied (P<.001) and reduced clinical fractures from 312 in the placebo group to 272 in the intervention group, but not significantly so (14% reduction; relative hazard [RH], 0.86; 95% confidence interval [CI], 0.73-1.01). Alendronate reduced clinical fractures by 36% in women with baseline osteoporosis at the femoral neck (>2.5 SDs below the normal young adult mean; RH, 0.64; 95% CI, 0.50-0.82; treatment-control difference, 6.5%; number needed to treat [NNT], 15), but there was no significant reduction among those with higher BMD (RH, 1.08; 95% CI, 0.87-1.35). Alendronate decreased the risk of radiographic vertebral fractures by 44% overall (relative risk, 0.56; 95% CI, 0.39-0.80; treatment-control difference, 1.7%; NNT, 60). Alendronate did not increase the risk of gastrointestinal or other adverse effects. CONCLUSIONS: In women with low BMD but without vertebral fractures, 4 years of alendronate safely increased BMD and decreased the risk of first vertebral deformity. Alendronate significantly reduced the risk of clinical fractures among women with osteoporosis but not among women with higher BMD.

Absorptiometry, Photon↗
PubMedDate not supplied

Cardiovascular risk factors in affective disorder.

100 patients with affective disorder (unipolar affective disorder and bipolar affective disorder) were evaluated for evidence of increased risk for the major cardiovascular risk factors including hypertension, hypercholesterolemia, obesity, and cigarette use. Unipolar affective disorder patients showed no evidence of increased cardiovascular risk compared to population controls. Bipolar affective disorder patients displayed increased systolic blood pressure, definite hypertension, and use of cigarettes. These findings are consistent with a link between affective disorders and excess cardiovascular mortality.

Adult↗
PubMedDate not supplied

Costs and health effects of osteoporotic fractures.

The objective of this study is to estimate the short- and long-term direct health care costs of hip, spine, and forearm fractures occurring during the remaining lifetimes of white post-menopausal women and to provide a prototype for estimating avoided costs of fractures in future cost-effectiveness analyses. A Markov model that uses population-based data and Monte Carlo simulations to estimate lifetime fracture risk, fracture-related functional impairment, and fracture-related costs for cohorts of individuals while controlling for competing causes of functional impairment and, hence, long-term costs is presented. Five cohorts of 10,000 women, each of a different age group, were simulated to obtain estimates of remaining lifetime fractures, functional impairment, and costs. Additional simulations tested the impact of discharge rates to and continued residence in nursing homes. Acute fracture care costs, nursing home annual cost, cost of community-based long-term care, and discount rates were varied in sensitivity analyses. Cohort costs were applied to the 1990 population distribution of U.S. white women to project future costs of women currently aged 45 years of age and older. Among hip, spine, and forearm fractures, hip fractures were determined to account for 36-50% of remaining lifetime fractures depending on age group of the cohort. Similarly, hip fractures were determined to account for 67-79% of fracture-related dependent functioning, 87-100% of fracture-related nursing home placement, and 87-96% of short-term fracture costs. Among white U.S. women aged 45 or older, an estimated 5.2 million hip, spine, and forearm fractures; 2 million person-years of fracture-related functional impairment; and $45.2 billion total direct medical costs can be expected in the next 10 years. Women aged 65-84 were estimated to experience the largest number of fractures, person-years of fracture-related impaired function, and fracture care costs in the next 10 years. Estimated lifetime cost was particularly sensitive to assumptions about fracture-related nursing home utilization rates. The future health and economic impact of established osteoporosis is expected to be substantial. Because we have included only three fracture sites, our estimates are likely to be conservative. Osteoporosis interventions that can reduce the need for fracture-related extended nursing home care and that are effective among women aged 65-84 are likely to be particularly cost-effective.

Aged↗