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Biomedical subjects

S Edwards

Publications and source records attributed to S Edwards.

324 records · Page 18Linked to original sources

Immunisation with recombinant AMA-1 protects mice against infection with Plasmodium chabaudi.

The Plasmodium merozoite surface antigen apical membrane antigen-1 (AMA-1) has previously been shown to provide partial protection to Saimiri and rhesus monkeys immunised with recombinant Plasmodium fragile or parasite-derived Plasmodium knowlesi AMA-1, respectively. In the study reported here we have used the Plasmodium chabaudi/mouse model system to extend our pre-clinical assessment of an AMA-1 vaccine. We describe here the expression of the full-length Plasmodium chabaudi adami AMA-1 and the P. chabaudi adami AMA-1 ectodomain using both baculovirus and Escherichia coli. The ectodomain expressed in E. coli, which contained an N-terminal hexa-his tag, was purified by Ni-chelate chromatography and refolded in vitro in the presence of oxidised and reduced glutathione to generate intramolecular disulphide bonds. In a series of vaccine trials, in both inbred and outbred mice, highly significant protection was obtained by immunising with the refolded AMA-1 ectodomain. Protection was shown to correlate with antibody response and was dependent on intact disulphide bonds. Passive transfer of antibodies raised in rabbits against the refolded AMA-1 ectodomain was also protective. In view of this demonstration that E. coli expression of a soluble P. chabaudi AMA-1 domain can generate a vaccine that is effective in mice, we are pursuing a similar approach to generating a vaccine against P. falciparum for testing in human volunteers.

Animals↗

Bullous pemphigoid and epidermolysis bullosa acquisita: presentation, prognosis, and immunopathology in 11 children.

The immunobullous diseases bullous pemphigoid (BP) and epidermolysis bullosa acquisita (EBA) are very rare in childhood. Although case studies have been detailed, there are no reports of a large series of patients documenting the effectiveness of treatment and long-term prognosis. We report the clinical presentation, immunopathologic features, disease course, and long-term prognosis of BP and EBA in a series of 11 children. The initial diagnoses based on clinical features were BP (5), EBA (3), and chronic bullous disease of childhood (CBDC) (3). These were subsequently revised from BP to EBA (2), CBDC to BP (2), and CBDC to BP or EBA (1) following the results of direct and indirect immunofluorescence and immunoblotting. Analysis of IgG subclasses in eight cases showed that the predominant subclasses were IgG1 (8) and IgG4 (6). The clinical features appeared to be highly variable, and in patients presenting with inflammatory blistering, laboratory studies were required in order to differentiate between BP and EBA. All patients improved on treatment with corticosteroids and/or sulfones, although treatment regimens showed wide variation. Their diseases tended to remit within 2 years, and their long-term prognosis was good.

Adolescent↗

Survey of health and use characterization of pesticide appliers in Minnesota.

We surveyed 1,000 randomly selected state-licensed pesticide appliers to improve our understanding of pesticide use and its potential health effects. Participants were stratified by pesticide class (herbicides, insecticides, fungicides, fumigants) to determine potential differences in health characteristics among different pesticide groups. A subset of 60 applicators, divided by pesticide class used, were studied for exposure-related cholinesterase (ChE) depression. ChE depression in excess of 20% was most frequent in fumigant applicators who did enclosed-space application, in addition to other pesticide application procedures (p < .05). Survey data demonstrated that the prevalence of all common chronic diseases considered together was significantly increased (p = .015) in fumigant appliers, compared with all other pesticide use groups. The frequency of chronic lung disease was also significantly increased in the fumigant applier group (p = .027). Curiously, two cases of a rare hematopoietic neoplasm--hairy cell leukemia--were identified in our study group (annual incidence 0.67/100,000 in Minnesota). Whether there is an association between this unique tumor and agricultural work is uncertain, and further study is needed in this regard.

Adult↗

Assessing the comprehension and production of language in young children: an account of the Reynell Developmental Language Scales III.

The Reynell Developmental Language Scales III have been designed to test the language abilities of children from 18 months to 7 years. They have been standardized on a large, representative sample of children in the United Kingdom and thereby provide a robust measure of language achievement. These Scales provide clinicians with the means of comparing the performance of children who have been referred for therapy, or who are in therapy, with the performance of a large group of normally developing children. The Scales reflect the developmental progression of normal child language in the early years, focusing on key features of child language acquisition at different stages as well as on features which are known to distinguish language impaired-children from language-normal children. While not claiming that the tests are fully comprehensive, the authors maintain that they afford the clinician with a means of looking at components of language while also gaining some insights into the child's ability to integrate vocabulary and grammar. It is recognized that no test can fully assess every aspect of language; essentially a test must be practical in terms of design and, for screening purposes, sufficiently comprehensive to be used with a large section of children referred. In addition to fulfilling these criteria, the Scales have been designed to provide some diagnostic indicators of areas of difficulty. The aims of the original Scales were to provide a measure of verbal ability that could be compared with mental age, and to provide separate scores for production and comprehension. These aims have also been realized in the new version. Additionally a test has been provided that is consonant with information gained from the intensive research in the field of child language that has taken place since the original Scales were devised. The Scales can reveal information about a child's language abilities not readily available from observation and serve a useful function in both identifying disorder and evaluating therapy. Clinicians are increasingly being asked to demonstrate effectiveness of therapy but are hampered by inappropriate outcome measures (Law 1997). It is hoped that the RDLS III provides a test that is valid and reliable and one that can contribute to both the characterization of speech and language disorders and the measurement of treatment efficacy.

Child↗

Peripherally inserted central catheters. Guidewire versus nonguidewire use: a comparative study.

To date, no research articles have been published that explore the practice of using guidewires for placement of peripherally inserted central catheters. The literature contains speculations regarding the pros and cons of guidewire use. However, no studies to date have compared patient outcomes when peripherally inserted central catheter lines are inserted with and without guidewires. To examine the use of guidewires for peripherally inserted central lines, a comparative study was conducted at two acute care facilities, one using guidewires for insertion and one inserting peripherally inserted central catheter lines without guidewires. 109 catheters were studied between January 1, 1990 and January 1, 1991. The primary focus of this study was to examine whether guidewire use places patients at higher risk for catheter-related complications, particularly phlebitis. No significant differences in phlebitis rates between the two study sites were found. Other catheter-related and noncatheter-related complications were similar between the two facilities. The results of this study do not support the belief that guidewire use increases complication rates.

Adolescent↗

Breast-feeding and HIV.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗

Susceptibility of wild rabbits (Oryctolagus cuniculus) in the United Kingdom to rabbit haemorrhagic disease (RHD).

Adult wild rabbits from the southern UK, previously unexposed to rabbit haemorrhagic disease (RHD), were experimentally challenged with a UK strain of the virus in laboratory conditions. Initial serum antibodies were measured by an haemagglutination inhibition test and all seropositive rabbits, with reciprocal titres > 10, were protected against fatal infection. These results are consistent with the behaviour of laboratory and commercially bred rabbits in similar circumstances, and are relevant to consideration of the overall impact of RHD in wild populations.

Animals↗

Philosophy in nursing.

This article identifies three ways in which the term 'philosophy' is commonly used in the context of nursing. The four main areas of philosophical inquiry are described, together with an indication of philosophical questions that fall within the province of nursing.

Ethics, Nursing↗

Reasonable refusal?--an ethical dilemma.

Ethical decision-making can lead to fairer and collegiate decisions, which are made collectively with the patient. This paper considers the role of the nurse in the ethical decision-making process. The experience of being involved in the decision-making process is shared. The importance of nurses becoming involved in ethical decision-making in an impartial and non-judgmental way is advocated.

Critical Care↗

Haemodynamic monitoring of the pregnant woman in intensive care.

A brief summary of the reasons why a pregnant woman may require intensive care is outlined. The clinical relevance of the physiological changes occurring in pregnancy is discussed. The haemodynamic differences and their relevance to monitoring are highlighted.

Adult↗