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Biomedical subjects

S Crawford

Publications and source records attributed to S Crawford.

At least 73 records · Page 4Linked to original sources
PubMed1995

Promoting dietary change.

The discouraging failure rate of counselling patients for dietary change suggests that traditional methods require some reconsideration. These have been frequently based on generalized assumptions regarding patients' health values, their need for knowledge, level of literacy, and ability to translate abstract concepts into daily food. Similarly, both patient and counsellor often insufficiently examine the environmental context of the dietary changes to determine whether or not they are feasible. This brief overview examines ways in which nutrition counselling can be enhanced to ensure that patients are enabled to develop a heart-healthy diet through active problem solving and directed development of self-efficacy in the skills they will need for lasting change.

Counseling↗
PubMed1994

Role of endomyocardial biopsy in rejection surveillance after heart transplantation in neonates and children.

OBJECTIVES: The aim of this study was to retrospectively evaluate the sensitivity of noninvasive surveillance (physical examination, echocardiography) of rejection in accurately predicting histologically documented rejection episodes. Additionally, the usefulness of routine scheduled biopsy and its safety in pediatric patients was explored. BACKGROUND: Endomyocardial biopsy has been utilized as the standard for rejection surveillance after heart transplantation in adults, but its role in documenting clinically suspected rejection and in routine surveillance of pediatric patients has not been agreed upon. METHODS: Heart transplantation was performed in 14 neonates and 21 children. The immunosuppressive regimen consisted of cyclosporine, azathioprine and prednisone. All patients underwent routine noninvasive rejection surveillance that included clinical examination and echocardiography. In the neonates, biopsy was performed quarterly beginning 6 months after transplantation, after cessation of prednisone therapy. In the children, biopsy was performed 15 times in the 1st year. A minimum of five biopsy samples were interpreted using the Working Formulation for Heart Transplant Rejection. RESULTS: In the neonates, 37 biopsies were performed. Evidence of rejection was present in only three biopsy samples obtained during eight episodes (38%) of clinically suspected rejection. In 29 biopsies performed when rejection was not clinically suspected, each biopsy was free of cellular infiltrate. In the children, 291 biopsies were performed. Evidence of rejection was present in only seven biopsies (41%) from 17 episodes of clinically suspected rejection. Cellular rejection was discovered during routine rejection surveillance biopsies in asymptomatic patients in 23 (8.4%) of 274 biopsies. CONCLUSIONS: In neonates with clinically suspected rejection, endomyocardial biopsy identified which patients did not require rejection therapy. Endomyocardial biopsy surveillance did not detect any unsuspected cases of rejection. In children, noninvasive rejection surveillance was less reliable even in asymptomatic patients, suggesting that periodic endomyocardial biopsy should be utilized.

Biopsy↗
PubMed1994

Measuring depressive symptoms in the frail elderly.

To determine the usefulness of the Center for Epidemiological Studies Depression Scale (CES-D) as a measure of depressive symptoms among frail and disabled elderly, we conducted a first- and second-order confirmatory factor analysis testing the four-factor structure of the CES-D and the existence of a single underlying second-order factor. We also examined the relative contribution of the somatic factor of the total symptom score, and relationships of age, race, functional status, and health with the four factors. We found that the factor structure is replicated when used with frail elderly, and scores are not distorted by the disproportionate influence of somatic items. Age and health do not affect the somatic subscale more than the other three subscales. Functional limitations are associated with higher somatic scores. We conclude that the CES-D is an appropriate tool to measure depressive symptoms in frail elderly.

Activities of Daily Living↗
PubMed1993

Natural remedies.

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Ethinyl Estradiol↗
PubMed1993

Policy on welfare.

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Animal Welfare↗
PubMed1993

Cranial magnetic resonance imaging in severe preeclampsia vs eclampsia.

OBJECTIVE: This study was undertaken to evaluate the hypothesis that severe preeclampsia and eclampsia are associated with unique cranial magnetic resonance images. DESIGN: Case series of women with severe preeclampsia and eclampsia. SETTING: Referral center. PATIENTS: Sixteen women with severe preeclampsia and 10 women with eclampsia. RESULTS: Half of the women with severe preeclampsia had abnormal scans with nonspecific foci of increased signal in the deep cerebral white matter on T2-weighted images. However, women with eclampsia had either a multifocal area of increased signal at the gray-white matter junction on T2-weighted images or cortical edema and hemorrhage. These findings are consistent with necropsy descriptions of cortical edema and petechial hemorrhage. Basal ganglion lesions were also common. CONCLUSIONS: These findings appear to be unique to eclamptic women and should be considered of diagnostic significance in contrast to the nonspecific changes in patients with severe preeclampsia. Cranial magnetic resonance imaging may, thus, be of value in cases with diagnostic uncertainty, atypical presentation, or focal neurologic deficit.

Adult↗
PubMed1993

Computer-aided treatment design of a distal upper extremity soft tissue tumor with electron beam radiotherapy.

We present here a novel approach for the planning and treatment of a distal upper extremity soft tissue tumor. Utilizing computed tomography (CT) based electron dose calculations, a customized compensating wax bolus was designed in order to deliver sufficient dose coverage to the tumor volume while sparing the draining lymphatics of the patient's hand and digits. A clinical case is presented as well as the design and construction of the compensator. Outcome and clinical implications are discussed.

Adult↗
PubMed1993

Determining the pattern of community care: is coresidence more important than caregiver relationship?

Researchers have previously emphasized the importance of kinship tie to explaining the pattern of care received by a disabled elder. For example, it has been argued that spouses are a distinct group of caregivers, i.e., they provide more care with less help from others and experience more stress. However, based on the theory of primary group structures and functions, this study hypothesized that coresidence rather than the kinship tie is more important in determining the pattern of caregiving. When spouses are compared to other coresiding caregivers, patterns of informal care and use of formal services are similar. Variance in amounts of informal care is explained by elder gender and frailty level rather than by caregiver relationship. Similarly, level of frailty was the only important predictor of use of formal services.

Activities of Daily Living↗
PubMed1993

Mononuclear cell reconstitution in the lung after marrow transplantation. Lack of influence of cytomegalovirus pneumonia, irradiation, and graft-versus-host disease.

The number and types of mononuclear cells obtained by bronchoalveolar lavage from 105 marrow transplant patients with and without cytomegalovirus pneumonia were studied to determine whether: (1) CMV pneumonia was associated with local recruitment of lymphocytes and lymphocytes of particular subtypes to the lung, and (2) whether local recruitment was affected by the known risk factors for the development of CMV pneumonia, namely acute graft-versus-host disease and total body irradiation. Results showed a significant increase in the number of lymphocytes (P = 0.014) and in the number of lymphocytes marking for CD8 (P = 0.0045) and CD16 (P = 0.052) in BAL from all patients compared with BAL from normal subjects. However, no significant differences were observed in BAL cellular characteristics between patients with and without pneumonia nor between patients with CMV or other etiologies of pneumonia. There were also no significant differences in BAL characteristics when patients were analyzed for the presence of acute GVHD, the use of TBI, or the type of transplant. These results do not provide evidence for local recruitment of lymphocytes to the lung unique of patients with CMV pneumonia nor to patients with GVHD and CMV pneumonia, in contrast to what is observed in murine CMV pneumonia.

Acute Disease↗
PubMed1993

Interleukin-2, interferon-gamma and natural killer cell activity in bronchoalveolar lavage fluid from marrow transplant recipients with cytomegalovirus pneumonia.

Cytokines interleukin-2 (IL-2) and interferon-gamma (IFN-gamma) were measured from bronchoalveolar lavage (BAL) fluid and sera of 41 marrow transplant recipients and eight healthy volunteers as controls. Although IL-2 and IFN-gamma were detected in 32 and 10 patient sera respectively, IL-2 or IFN-gamma was detected in BAL of only five patients. There was no correlation of the presence of either cytokine with cytomegalovirus pneumonia, pneumonia of other etiology or absence of pneumonia. Local lung production of IL-2 and IFN-gamma as measured in BAL did not correlate with natural-killer cell activity and had no apparent role in the pathogenesis of lung disease after marrow transplant.

Adolescent↗
PubMed1992

Docking of dogs.

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Animal Welfare↗
PubMed1991

A novel 110-kDa maternal CAAX box-containing protein from Xenopus is palmitoylated and isoprenylated when expressed in baculovirus.

We describe a unique 110-kDa protein, xlcaax-1, that is a member of a group of membrane-associated proteins such as the ras and ras-related proteins and nuclear lamins. Many of these proteins are involved in signal transduction or cell signaling, possess a C-terminal CAAX box, and undergo fatty acid acylation (Glomset, J. A., Gelb, M. H., and Farnsworth, C. C. (1990) Trends Biochem. Sci. 15, 139-142). The ras and ras-related proteins bind GTP and in most cases are both isoprenylated and palmitoylated. The xlcaax-1 protein possesses a C-terminal CAAX sequence that is identical to the N-ras protein. In addition to the CAAX box, xlcaax-1 contains a series of basic amino acids upstream of the CAAX sequence similar to several nonpalmitoylated forms of the ras-related proteins. When the xlcaax-1 cDNA is expressed in a baculovirus expression system, the product undergoes isoprenylation and palmitoylation utilizing a mechanism similar to that of the ras proteins. In addition, the xlcaax-1 protein is isoprenylated, and a minor fraction is palmitoylated in Xenopus XTC tissue culture cells. We have also demonstrated that the protein is associated with membrane fractions in full-grown Xenopus oocytes and in Xenopus XTC tissue culture cells and that membrane association is isoprenylation-dependent. The presence of maternal molecules possessing signal transduction potential is an attractive mechanism for modulating the effects of growth factors and other signal molecules during development.

Amino Acid Sequence↗
PubMed1991

Comparison of heterotypic protection against influenza A/Taiwan/86 (H1N1) by attenuated and inactivated vaccines to A/Chile/83-like viruses.

Children (n = 192) aged 3-19 years from 98 families completed this double-blind, placebo-controlled study comparing the efficacy of a bivalent attenuated (CR) vaccine with trivalent inactivated (TI) vaccine. Both vaccines contained A/Chile/83 (H1N1)-like antigens. After vaccination the geometric mean titer to A/Taiwan/86 (H1N1) was 1:36 in the CR group, 1:92 in the TI group, and 1:5 in the placebo group. During the influenza A/Taiwan/86 (H1N1) epidemic, 21.4% of CR recipients, 16.7% of TI recipients, and 43.9% of placebo recipients were infected with influenza A/Taiwan. TI vaccine provided better heterotypic protection than did CR vaccine for children aged 10-18 years (infection rate, 0 vs. 24%, respectively; P less than .025); in contrast, in the younger children (3-9 years), CR vaccine tended to be more protective (19% vs. 26% for TI).

Adolescent↗
PubMed1990

The effect of student residence on food choice.

This study assessed the effect of student residence on food choices and dietary practices of students enrolled in an undergraduate nutrition class at Washington State University. We compared food consumption patterns of students living on campus, off campus, and in Greek housing. We also identified differences between men and women in food consumption and dietary practices. The results suggested that students' residence and sex may influence food choice and dietary practices. Significant differences in food choice related to students' residence were found for 8 of the 27 variables included on a food frequency list. Differences in the consumption of fresh fruits and vegetables, beer, fish, unsweetened cereal, white bread, and cookies were identified. In addition, students who lived in Greek housing were found to skip meals less frequently than other students, and men were found to consume significantly more beer, sugar-sweetened soft drinks, meat, and white bread than women students. Men were also more accurate in their perception of their body weight.

Adult↗
PubMed1990

The palindromic series I repeats in the simian cytomegalovirus major immediate-early promoter behave as both strong basal enhancers and cyclic AMP response elements.

A 600-base-pair (bp) enhancer region upstream from the major IE94 gene of simian cytomegalovirus (SCMV) produces very strong basal expression of associated gene products. This domain consists of multiple sets of interspersed repetitive elements, including 11 copies of a conserved 16-bp palindromic sequence with the consensus CCATTGACGTCAATGG. These series I repeats contain an 8-bp core TGACGTCA that resembles the cyclic AMP (cAMP) response element (CRE) of cellular genes. In transient chloramphenicol acetyltransferase assays in K562 human erythroleukemia cells, a set of deleted variants of the IE94 promoter all responded up to 15-fold to induction by cAMP. However, successive removal of most of the SCMV 16-bp motifs reduced basal expression over 20-fold. The cAMP stimulation was also manifested at the steady-state RNA level after SCMV infection of K562 cells and was detectable within 1.5 h after treatment of DNA-transfected cells. Addition of a single 30-bp oligonucleotide encompassing the 16-bp palindrome conveyed up to 10-fold cAMP responsiveness onto a heterologous weak promoter but had no effect on basal expression. In contrast, two or more adjacent copies produced 20- to 40-fold increases in basal expression and provided greater than 200-fold activation in the presence of cAMP. Similar effects were obtained when the oligonucleotides were placed in a downstream location relative to the reporter gene. Studies with mutant oligonucleotides revealed that both the core CRE and the flanking sequence portions of the 16-bp elements were essential for enhancer function. Both components were also important for maximum cAMP responsiveness. Band shift assays with fractionated nuclear extracts from Raji lymphocytes revealed multiple competable complexes with cellular DNA-binding factors that recognized the series I elements. Three distinct CREB-like factors were detected that required only the core 8-bp elements for binding. We conclude that the 16-bp series I repeats provide a major contribution to the constitutive enhancer properties of the IE94 promoter and also act as functional CREs. The cAMP response properties appear likely to play a key role in reactivation of the virus from a latent state in appropriately differentiating cell types.

Animals↗