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Biomedical subjects

S Taylor

Publications and source records attributed to S Taylor.

At least 289 records · Page 16Linked to original sources
PubMed1993

CHOP-Bleo plus interferon for stage IV low-grade lymphoma.

BACKGROUND: Alpha interferon (IFN) is an effective single agent for patients with low-grade lymphoma, but until 1982 had not been integrated with standard chemotherapy for these patients. Since relapse from complete remission (CR) is the rule for patients with advanced stage low-grade lymphoma, a maintenance IFN schedule was explored for patients in CR. PATIENTS AND METHODS: From 1982-1987, 127 patients with stage IV low-grade lymphoma were treated with cyclophosphamide, doxorubicin, vincristine, prednisone, and bleomycin (CHOP-Bleo) for 9-18 mo. (median 13 mo.), followed by interferon alfa-n-1 (Wellferon) maintenance therapy for 24 mo. for CRs. RESULTS: The overall response rate for the entire treatment program was 73% CR and 23% partial remission. The median follow up was 59 months. At 5 years, survival was 74%, failure-free survival (FFS) 47%, and FFS of CRs 60%. Compared to a group of 96 patients with similar pretreatment clinical features treated with CHOP-Bleo from 1972-1982, this represents a significant improvement for both overall FFS (p = 0.01) and FFS of CRs (P < 0.01). Toxicity from the IFN maintenance was generally acceptable, but even at the modest dose employed in this trial (3 x 10(6) U/m2 three times weekly), dose modification was required in more than 30% of patients, usually because of fatigue. CONCLUSIONS: The integration of IFN and conventional chemotherapy is feasible and effective. Maintenance IFN prolongs remission duration for patients with stage IV low-grade lymphoma.

Adult↗
PubMed1993

Update on nutrition and psoriasis.

BACKGROUND: It has been established that severe psoriasis may lead to nutrient depletion, especially of protein, folate, and iron. Nutrient loss occurs due to the accelerated loss of nutrients from the hyperproliferation and desquamation of the epidermal layer of skin in psoriasis. We have proposed that nutritional support as a secondary form of therapy may be beneficial in aiding some psoriasis patients return to a state of remission. METHODS: To determine how frequently nutritional abnormalities occur in hospitalized psoriasis patients, a retrospective analysis was done of the nutritional status of 50 patients admitted for the treatment of psoriasis. Chart records were analyzed and laboratory data were interpreted in consideration of concurrent medical problems. Protein status and anemia were the primary nutritional indicators studied. RESULTS: We found that of those parameters that may be used as indicators of nutritional status, 18% of the patients had a decreased total protein, 16% of the patients had a decreased serum albumin, 38% had an elevated mean corpuscular volume, and 39% had a decreased hematocrit. CONCLUSIONS: Our findings support the concept that wide-spread psoriasis places the patient at risk to develop minor nutritional abnormalities in protein and folate status even when accounting for confounding medications and coexistent diseases.

Adolescent↗
PubMed1993

Update on factitious disorders.

OBJECTIVE: Since factitious disorders entered the official psychiatric nomenclature in DSM-III and DSM-III-R, there has been a proliferation of reports and commentary about this unusual disorder. We present an update of the recent literature. METHOD: The psychiatric and medical literature was searched. Clinical reports and critical/theoretical papers were reviewed; eighty-five are summarized here. RESULTS: Available data is descriptive and anecdotal. Reports focus on the following four topics, which are discussed here: 1) diagnostic issues, 2) the newly proposed DSM-IV category of factitious disorder by proxy, 3) epidemiology and course, 4) new developments in treatment and management. CONCLUSIONS: Factitious disorders are uncommon but serious illnesses that present diagnostic and management dilemmas. Deriving systematic information about these illnesses is a major challenge.

Adult↗
PubMed1993

Decreased sensitivity to cAMP in the in vitro generation of memory splenic cytotoxic T-lymphocytes from aged mice: role of phosphodiesterase.

The effects of increased intracellular concentration of cyclic AMP (cAMP) on cellular immune function of young and aged mice were examined by using an in vitro anti-influenza cytotoxic T-lymphocyte (CTL) assay. We found that increasing intracellular concentrations of cAMP with either the cAMP analog, N,6O2'-dibutyryl cAMP, or the beta adrenergic agonist, metaproterenol, significantly inhibited the in vitro development of memory CTL activity of young mice. The development of CTL activity of aged mice, however, was less sensitive to the effects of these agents. We found that the S-isomer of cAMPS, a cAMP analog resistant to the effects of PDE, caused equivalent inhibition of CTL activity in the young and aged mice. This suggested that the cause of the decreased cAMP sensitivity in aging was increased PDE activity. In subsequent experiments, we found that the PDE from T-cells of aged mice have higher KM and higher Vmax for cAMP than the PDE from T-cells of young mice. Because beta-agonists probably act as a counter-regulatory hormone at an inflammatory site, the decreased sensitivity to cAMP in aging may be a compensatory response to the age-related decline in immune function.

Aging↗
PubMed1993

"Would I be able to ... "? Teaching clients to assess the availability of their community living life style preferences.

A three-phase program was developed to involve six institutionalized adults with mild mental retardation in their transition to community living. In Phase I, subjects were interviewed to determine their community living life style preferences and were found to be reliable and skillful in stating their preferences. In Phase II, the subjects' 10 strongest preferences were identified. In Phase III, they were taught to obtain preference availability information from group home representatives and report these findings to their social worker. A simultaneous replication design across two component skills, questioning and reporting, revealed that both increased after training and generalized to community group homes. The 5 subjects available for follow-up maintained their posttraining performance. Implications of these results in extending choice and decision-making technology were discussed.

Adult↗
PubMed1992

Antibody-catalyzed rearrangement of the peptide bond.

The generation of antibodies from a bifunctional cyclic phosphinate transition-state analog provided agents capable of efficiently catalyzing both steps of the overall conversion of a substrate containing an asparaginyl-glycyl sequence through a succinimide intermediate to the products aspartyl-glycyl and the rearranged isoaspartyl-glycyl sequence. This reaction provides a potential means in addition to amide cleavage for the deactivation of protein or peptide biological functions in vivo.

Antibodies, Catalytic↗
PubMed1992

Hospital-acquired infection with vancomycin-resistant Enterococcus faecium transmitted by electronic thermometers.

OBJECTIVES: To describe an epidemic of vancomycin-resistant Enterococcus faecium causing bacteremia and bacteriuria, to identify the source of infection, to delineate risk factors associated with acquisition of the organism, and to determine antibiotic sensitivities for the organism. DESIGN: Investigation of an epidemic, including a case-control study. SETTING: Medical-surgical intensive care unit and ward in a university medical center. PATIENTS: Nine patients infected or colonized with vancomycin-resistant Enterococcus faecium and 20 noninfected controls. MEASUREMENTS: Clinical data, environmental surveillance cultures, and in-vitro microbiologic studies. RESULTS: Colonization or infection by vancomycin-resistant E. faecium was associated with an increased duration of treatment with ceftazidime, 13.2 compared with 4.6 days, and a greater number of nonisolated days of hospitalization in the intensive care unit, 19.9 compared with 6.4 days for infected and noninfected patients, respectively (P less than 0.05). Environmental surveillance cultures recovered the organism repeatedly from the rectal probe handles of three electronic thermometers used exclusively on nonisolated patients in the intensive care unit. Restriction endonuclease analysis of plasmid DNA showed that all clinical and environmental isolates were identical. Infection control measures, including isolation of colonized or infected patients and removal of the rectal thermometer probes suspected to be responsible for transmission, resulted in termination of the outbreak. In-vitro, time-kill studies showed that the combination of ciprofloxacin, rifampin, and gentamicin resulted in bactericidal activity against the organism. CONCLUSIONS: This nosocomial outbreak of infection due to a highly vancomycin-resistant strain of Enterococcus is the first epidemic in which an electronic thermometer has been implicated as the vehicle of transmission for an infectious agent.

Adolescent↗
PubMed1992

Immunogenicity of combined diphtheria, tetanus, and pertussis vaccine given at 2, 3, and 4 months versus 3, 5, and 9 months of age.

In the UK an accelerated schedule for immunisation against diphtheria, tetanus, and pertussis (injections at 2, 3, and 4 months of age) was introduced in 1990 to replace the more widely spaced schedule of 3, 5, and 9 months. There is concern, however, that the new schedule may be less immunogenic and therefore less protective than the old schedule. We have measured serum concentrations of antibodies against diphtheria, pertussis, and tetanus in infants immunised according to the two regimens. Both schedules resulted in protective concentrations of antibody against tetanus and diphtheria and in satisfactory antibody responses to three pertussis antigens (filamentous haemagglutinin, pertussis toxin, fimbriae). However, immunisation by the old schedule led to significantly higher antibody concentrations against both diphtheria and tetanus than did immunisation by the new schedule (p less than 0.01). In infants immunised with the new schedule, postimmunisation antibody concentrations against tetanus toxoid and against two pertussis antigens (pertussis toxin and fimbriae) were significantly lower in infants in whom preimmunisation (maternally derived) antibody concentrations were high (p less than 0.02). The findings suggest that with an accelerated immunisation schedule maternal antibodies can have an inhibitory effect on the responses to immunisation against tetanus and pertussis.

Antibodies, Bacterial↗
PubMed1992

Electroencephalographic sleep abnormalities in schizophrenia. Relationship to positive/negative symptoms and prior neuroleptic treatment.

Polysomnographic abnormalities in schizophrenia are not well characterized and their associations with schizophrenic symptomatology have not been adequately assessed. To address these issues, we recorded electroencephalographic sleep in 20 drug-naive schizophrenics, 20 drug-free but previously medicated schizophrenics, and 15 normal controls. Drug-naive and previously medicated patients had significantly greater impairment of sleep continuity and shorter rapid eye movement latency when compared with controls. In the previously medicated group, findings were significantly influenced by duration of drug-free status. Rapid eye movement latency was inversely correlated with the severity of negative symptoms (r = -.52) but was unrelated to depressive symptoms. Slow-wave sleep did not differ between schizophrenic patients and normal controls and was unrelated to any clinical parameter. Mechanisms underlying the observed associations between rapid eye movement sleep abnormalities and negative symptoms in the acute phase of schizophrenic illness need to be explored.

Adult↗
PubMed1992

Parental and family predictors of behavior problems in inner-city black children.

Studied contributions of maternal psychological distress, family stress load, maternal and family risk factors, and family coping strategies in predicting behavior problems in 441 inner-city black primary-grade children. Results indicated maternal psychological distress and high family stress load were associated with high child behavior problems. Family coping strategies offered no protection against risk, while coping with life difficulties by reframing them was detrimental to child behavioral adjustment. Active help-seeking strategies (i.e., family mobilization, acquiring social supports) served to moderate the effects of maternal psychological distress and family risk attributes for boys, but exacerbated the effects of dysfunctional maternal social and psychiatric histories for girls. Implications for understanding vulnerability and resilience in inner-city black children and recommendations for future research are discussed.

Adaptation, Psychological↗
PubMed1992

Twenty-four-hour intragastric pH patterns in ICU patients on ranitidine.

Thirty critically ill patients with mixed diagnoses underwent continuous intragastric pH monitoring for 72 hr while confined to a shock/trauma intensive care unit. The first 24 hr were monitored under no specific acid-suppressing therapy (placebo control). During the second and third consecutive 24-hr periods, patients received continuous infusion of intravenous ranitidine in the dose of 6.25 mg/hr and 12.5 mg/hr, respectively. Results of the placebo-control 24-hr study revealed that one third (N = 10) of the patients were gastric acid hyposecretors (24-hr median intragastric pH values above pH 4.0). In the normosecreting group (N = 20), both ranitidine schedules significantly elevated 24-hr median pH values, when compared to placebo (placebo 24-hr median intragastric pH 1.75; ranitidine 6.25 mg/hr 24-hr median intragastric pH 4.625, P < 0.0001; ranitidine 12.5 mg/hr 24-hr median intragastric pH 6.29, P = 0.0099). Five patients (18%) failed to adequately respond to the ranitidine 12.5 mg/hr dose (24-hr median intragastric pH < 4.0). These findings suggest that a significant percentage of intensive care unit patients are not in need of acid-suppressing therapy as prophylaxis against stress-induced ulceration. Conversely, other patients may require more intensive acid-suppressing regimens because of failure to respond to high dose H2-antagonist therapy.

Adolescent↗
PubMed1992

Severity of unipolar depression and choice of treatment.

The National Institute of Mental Health (NIMH) Treatment of Depression Collaborative Research Program (Elkin et al., Archives of General Psychiatry, 46, 971-982; 1989) reported treatment-by-severity interactions favouring pharmacotherapy for more depressed outpatients, on a minority of relevant comparisons. The present study reports secondary analyses from a similar, preexisting data set in which treatment-by-severity interactions are systematically investigated with depressed outpatients treated either with nondirective psychotherapy, behaviour therapy, pharmacotherapy, or relaxation/placebo. Despite multiple severity measures and variable severity cut scores, no treatment was differentially effective in improving more severely depressed patients. Also, there was little difference across symptom severity levels in the proportions of recovered patients between treatment groups. Finally, dynamic cluster analysis demonstrated that the proportion of pharmacotherapy nonresponders (20%) did not differ from the proportion of nonresponders in behaviour therapy or placebo groups. It is concluded that this failure to replicate the NIMH trial findings can not be attributed to treatment differences, populations or statistical power. The suggestion that pharmacotherapy be the treatment of choice for more severely depressed outpatients appears to be unjustified on the basis of available evidence.

Adult↗
PubMed1992

Radiation hybrid map spanning the Huntington disease gene region of chromosome 4.

Radiation hybrid (RH) mapping was used to construct a map of 11 markers in the distal 4 Mb of the short arm of chromosome 4, the region containing the Huntington disease gene. Two different methods for deriving the order of the markers were compared and both arrived at the same order as being the most likely. This order is also consistent with both the physical map constructed using pulsed-field gel electrophoresis (PFGE) and the meiotic linkage map. Comparing the RH map to the map determined by PFGE provided the means to equate RH map units (centirays) with actual physical distance in kilobases of DNA. In addition, a simple procedure for reducing the complexity of human DNA in radiation hybrids is described. One cell line isolated using this procedure contains, as its only human DNA, approximately 2 Mb surrounding the Huntington disease gene.

Chromosome Mapping↗
PubMed1992

Technical report: percutaneous cholecystostomy in acute acalculous cholecystitis.

Acute acalculous cholecystitis is a significant cause of morbidity and mortality in patients with other serious illnesses (Howard, 1981) and the mortality rate after surgical cholecystostomy may reach 15% (McGahan and Lindfors, 1989). Radiologically controlled percutaneous cholecystostomy is a safe, minimally invasive, procedure which may be curative (McGahan and Lindfors, 1989; Berger et al., 1989). Both cases described here were successfully treated by percutaneous cholecystostomy. A modified Seldinger technique was used in one and a direct 'trocar' puncture in the other. Percutaneous cholecystostomy, which is technically relatively straightforward, is now the treatment of choice for acute acalculous cholecystitis.

Acute Disease↗
PubMed1992

The Huntington's disease candidate region exhibits many different haplotypes.

Analysis of 78 Huntington's disease (HD) chromosomes with multi-allele markers revealed 26 different haplotypes, suggesting a variety of independent HD mutations. The most frequent haplotype, accounting for about one third of disease chromosomes, suggests that the disease gene is between D4S182 and D4S180. However, the paucity of an expected class of chromosomes that can be related to this major haplotype by assuming single crossovers may reflect the operation of other mechanisms in creating haplotype diversity. Some of these mechanisms sustain alternative scenarios that do not require a multiple mutational origin for HD and/or its positioning between D4S182 and D4S180.

Alleles↗
PubMed1992

Rapid assay for immune complex bound antigens from urine of cancer patients.

Concentrated urine from patients with various types of cancer was fractionated by S-500 gel filtration chromatography to yield high molecular weight (mw) immune complexes (IC) and lower mw immunoglobulin (Ig) fractions. Column fractions were assayed for the presence of IgM and IgG by immunoblot probing using anti-human IgM and anti-human IgG alkaline phosphatase conjugates. These results were used to define IC fractions (those from high mw S-500 fractions which were positive for immunoglobulin) and Ig fractions (those from medium mw S-500 fractions which were positive for immunoglobulin). Antigen components of high mw S-500 IC fractions were then determined by immunoblot probe using medium mw S-500 Ig fractions as the antibody probe (i.e. autoantibody). This method for identification of immune complex antigens has the potential to probe for tumor-associated antigens, autoantigens, or foreign antigens from starting material which contains both immune complex and free immunoglobulin.

Antigen-Antibody Complex↗
PubMed1992

Isolation and sequence of two genes associated with a CpG island 5' of the factor VIII gene.

Many disease loci have been linked to the telomeric end of the long arm of the human X-chromosome, Xq28. We have isolated and sequenced cDNA sequences corresponding to two novel genes that map to Xq28. These genes, c6.1A and c6.1B, are transcribed in opposite directions from a CpG island that lies approximately 70 kilobases (kb) upstream (5') of the factor VIII locus. One of these genes, c6.1A, is highly conserved between species and expressed abundantly in many human and mouse tissues, whereas, c6.1B is moderately conserved and has a restricted tissue distribution of expression. The Xq28 gene c6.1A has an autosomal homologue that is transcriptionally inactive in B-cell lines. An open reading frame (ORF) predicting a peptide of 293 amino acids is observed for c6.1A but c6.1B does not possess a single long ORF. No striking homologies to existing genes could be found for either of the two new loci. Expressed sequences that are physically close to the factor VIII gene are candidates for disease loci that map to this region of Xq28. The relevance of these genes to disease loci was investigated using DNA and RNA from hemophilia A patients bearing deletions that extend in a 5' direction away from factor VIII. The results imply that neither of these genes are primarily responsible for the development Xq28-linked diseases. However, c6.1A and c6.1B define a region of Xq28 that is deleted in two brothers that suffer from mental handicap and dysmorphism as well as hemophilia A. Thus, this region is likely to contain loci that are important for physical and mental development.

Amino Acid Sequence↗