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PubMed1989

The leukaemia research fund data collection survey: the incidence and geographical distribution of acute myeloid leukemia.

This paper reports on the 2,362 cases of acute myeloid leukemia (AML) accumulated by the Leukaemia Research Fund Data Collection Survey between January 1, 1984, and June 30, 1988 providing the recent geographical distribution and descriptive epidemiology of the AML group of conditions. Statistical approaches to this data set are described. The study shows sex differences in distribution for those aged under 55 years compared to older age groups, with variable male: female incidence in different age bands and a male excess in those over 55 years. A nonsignificant excess of females was noted in those under 5 years. The rates presented for 1984-1986 are higher than those previously described for England and Wales. Statistically significant variation in incidence was seen both between counties and districts. At electoral ward level regression analyses were suggestive of links between AML and higher social class and living close to estuaries.

Adolescent↗
PubMed1997

Epidemiology and clinical management of meningococcal disease in west Gloucestershire: retrospective, population based study.

OBJECTIVE: To study changes in the epidemiology and management of meningococcal disease in one health district during a period of high local incidence of disease. DESIGN: Prospective case ascertainment and data collection over 14 years, with retrospective analysis of cases. SETTING: West Gloucestershire (population 320,000). SUBJECTS: Residents developing meningococcal disease between 1 January 1982 and 31 December 1995. RESULTS: 252 cases of invasive meningococcal disease were identified, of which 102 (40%) were officially notified and 191 (76%) were confirmed by culture from a deep site. The observed disease incidence of 5.6/100,000/year was about 2.7 times the national incidence (as measured by either statutory notifications or reference laboratory reports). The period 1983-90 was characterised by a prolonged localised outbreak due to serogroup B serotype 15 sulphonamide resistant (B15R) strains. General practitioners gave benzylpenicillin before hospital admission to 18% of patients who presented with meningococcal disease in the first half of the study period and to 40% who presented in the second half. The overall case fatality rate was 6.7% (17/252). Four deaths were directly or indirectly related to lumbar puncture. Of 120 patients whose lumbar puncture yielded meningococci, nine (8%) showed no abnormality on initial examination. CONCLUSIONS: Neither laboratory records nor formal notifications alone can give an accurate estimate of the incidence of meningococcal disease. Because of the dangers of lumbar puncture, the frequency of misleading negative initial findings, and the advent of new diagnostic techniques, the need for samples of cerebrospinal fluid should be critically questioned in each case of suspected meningococcal disease.

Adolescent↗
PubMed1994

Expression of neurotrophin genes in human fibroblasts: differential regulation of the brain-derived neurotrophic factor gene.

Brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF) and neurotrophin-3 (NT-3) are structurally related survival and differentiation factors for distinct sets of peripheral and central neurons. We previously reported that BDNF and NGF gene expression are differentially regulated in mouse L929 fibroblasts. Here we examine expression of these three neurotrophins in human fibroblasts. Northern blots detected BDNF and NT-3 mRNAs in fibroblasts derived from lung (WI-38), calvarium and foreskin. WI-38 cells and foreskin fibroblasts expressed 1.6 kb as well as 4 kb BDNF mRNAs whereas only the smaller BDNF mRNA was detected in calvarium fibroblasts. NGF mRNA was present in foreskin and calvarium but not lung fibroblasts. In WI-38 cells serum treatment increased levels of BDNF mRNA within 2 hr. Cycloheximide did not inhibit the increase. Treatment with 12-O-tetradecanoyl phorbol-13-acetate (TPA) transiently suppressed BDNF mRNA. Treatment with both serum and TPA first stimulated and then transiently suppressed BDNF mRNA. TPA and/or serum did not significantly affect BDNF mRNA in calvarium fibroblasts. These results show that human fibroblasts derived from different tissues express and regulate neurotrophin genes differentially.

Blotting, Northern↗
PubMed1986

Correlation of plasma serotonin changes with platelet aggregation in an in vivo dog model of spontaneous occlusive coronary thrombus formation.

The role of platelets in contributing to occlusive coronary artery thrombus formation remains unresolved. A large number of studies have utilized in vitro techniques to study platelet aggregation. This report describes a model of spontaneous in vivo thrombus formation which involves application of current in the left circumflex coronary artery of the dog. Changes in mean coronary blood flow velocity (50% above control) are used to predict the point at which current can be discontinued without interrupting the ongoing process of thrombus formation. Thrombus formation proceeds to total vessel occlusion within 62 +/- 18 minutes after discontinuation of current. Coronary sinus plasma serotonin concentrations are used as an in vivo index of platelet aggregation during thrombus formation. Plasma serotonin levels increased only slightly above baseline levels during initial thrombus formation. Coronary sinus serotonin levels rose markedly after cessation of current, reaching a peak just prior to total vessel occlusion. The marked increase in serotonin concentration observed in the latter stages of thrombus formation strongly suggests that platelet aggregation is a significant factor in the evolution of an occlusive coronary thrombus.

Adenosine Diphosphate↗
PubMed2005

The use of email in a child and adolescent mental health service: are staff ready?

All staff members of a child and adolescent mental health service were invited to participate in a survey about the use of email. Sixty-two of the 105 staff members responded to the survey, a participation rate of 59%. Of the respondents, 32 were allied health staff, 10 were nurses, seven were administrative staff, six were medical staff, three were operational staff and four were acting in a combination of these roles. The respondents reported extensive work-related email usage and considered that they were confident in using email despite low levels of training. However, they did not feel that they understood the legal and ethical issues involved. Furthermore, there was limited incorporation of email into standard record keeping. The majority of respondents thought that increased use of email would lead to a greater workload, a consequence they considered would probably increase over time. Many commented on the quick and practical use of this medium, but were wary about using email with individuals outside the service organization, especially if it were to contain clinical material. There was low use of email directly with clients, and clinicians were ambivalent about incorporating email into therapy. The results suggest that it is timely to consider the utility and appropriateness of email communication with clients and external service providers, and to formulate guidelines and procedures to ensure the confidentiality of client information and the safety of clients and staff.

Adolescent↗
PubMedDate not supplied

Blood group antigens as tumor markers, parasitic/bacterial/viral receptors, and their association with immunologically important proteins.

Blood group antigens (BGAs) are chemical moieties on the red blood cell (RBC) membrane. Some BGAs (e.g., A, B, H, Lewis, P, I) are widely distributed throughout the body and may not be primarily erythroid antigens. Statistical correlations with ABO blood groups and disease have been made for years and have been highly controversial. It is not known if BGAs have a biological function. There are increasing reports of BGAs [e.g., Le(x) (an isomer of Le(a)), Le(y) (an isomer of Le(b)), T, Tn, "A-like"] appearing as "new" antigens on malignant tissue. Their presence and membrane density appears to correlate with the metastatic potential of the tumor. This often parallels loss of normal BGAs (e.g., ABH) from the tissue. Some of these antigens have been shown to influence the humoral and cellular response and have been used in assays to determine preclinical cancer, and in tumor immunotherapy. Interactions of some parasites and bacteria with human cells have been shown to depend on the presence of certain BGAs. P. vivax malarial parasites only enter human RBCs when the Fy6 Duffy blood group protein is present on the RBCs. Certain E. coli will only attach to the epithelial cells of the urinary tract if P or Dr BGAs are present in the epithelial cells. The P antigen is also the RBC receptor for Parvovirus B19. Leb has recently been found to be the receptor for H. pylori in the gastric tissue. The high frequency BGA, AnWj, is the RBC receptor for H. influenzae. BGAs have been shown to be associated closely with some important complement proteins. Ch/Rg BGAs have been found not to be true BGAs but are RBC-bound C4 (C4d). Knops/McCoy/York BGAs have been located on the C3b/C4b receptor (CR1). The high frequency BGAs of the Cromer (Cr) system are located on decay accelerating factor (DAF or CD55). Cartwright (Yt) BGAs are located on RBC acetylcholinesterase molecules. DAF and acetylcholinesterase are on phosphatidylinositol-glycan (PIG) linked proteins. When the PIG anchor is missing from RBCs, as in paroxysmal nocturnal hemoglobinuria, the affected RBCs lack all Cr, Yt, JMH, Hy/Gy, Do and Emm BGAs. The most important ligand for P, E and L selectins is sialyl-Le(x). This interaction is the tethering stage that start the leukocytes' journey from the circulation into the tissue. It appears that malignant cells may move through tissue in a similar way and may explain the close association of Le(x) with metastasis. Thus, there are increasing data suggesting a biological role for BGAs unrelated to the RBC.

Animals↗
PubMed1999

Tobacco and the risk of acute leukaemia in adults.

Self-reported smoking histories were collected during face-to-face interviews with 807 patients with acute leukaemia and 1593 age- and sex-matched controls. Individuals who had smoked regularly at some time during their lives were more likely to develop acute leukaemia than those who had never smoked (odds ratio (OR) = 1.2, 95% confidence interval (CI) 1.0-1.4). The association was strongest for current smokers, defined here as smoking 2 years before diagnosis (OR = 1.4, 95% CI 1.1-1.7). With respect to the numbers of years smoked, risk estimates were raised in all groups except those who had smoked for fewer than 10 years. Similarly, the odds ratio decreased as the number of years 'stopped smoking' increased, falling to one amongst those who had given up smoking for more than 10 years. No significant linear trends were found, however, with either the numbers of years smoked or the numbers of years stopped smoking, and no significant differences were found between AML and ALL.

Acute Disease↗
PubMed2004

A short form of the metacognitions questionnaire: properties of the MCQ-30.

The metacognitions questionnaire (MCQ) measures individual differences in a selection of metacognitive beliefs, judgments and monitoring tendencies considered important in the metacognitive model of psychological disorders. The development and properties of a shortened 30-item version of the MCQ, the MCQ-30, are reported. Construct validity was evaluated by confirmatory and exploratory factor analysis. Overall, the fit indices suggested an acceptable fit to a five-factor model consistent with the original MCQ. Exploratory factor analysis supported a five-factor structure, which was almost identical to the original solution obtained in previous studies with the full MCQ. The five factors are cognitive confidence, positive beliefs about worry, cognitive self-consciousness, negative beliefs about uncontrollability of thoughts and danger, and beliefs about need to control thoughts. The MCQ-30 showed good internal consistency and convergent validity, and acceptable to good test-retest reliability. Positive relationships between metacognitions and measures of worry and obsessive-compulsive symptoms provided further support for the validity of the measure and the metacognitive theory of intrusive thoughts. The psychometric properties of MCQ-30 suggest that the instrument is a valuable addition to the assessment of metacognitions that has the advantage of being more economical to use compared with the original MCQ.

Adolescent↗
PubMed1977

Mothers' experiences of induction.

Mothers of a random sample of 2182 legitimate live births were interviewed about their experiences of pregnancy, labour, and delivery. Of these, 24% reported that their labours were induced, and data about this from a subsample of mothers tallied with information obtained through the doctors in charge in 88% of cases. All but 3% of the mothers who were induced perceived some medical reason for the induction. The proportion of inductions in the 24 study areas ranged from 6% to 39%. A relatively small proportion of labours in "teaching" hospitals, small hospitals with less than 100 beds, and GP maternity hospitals were induced, but a comparatively high proportion of private patients had an induction. There was no clear association between induction and the mother's age or parity. Despite being given more pain relief, those who were induced reported similar intensities of pain during the first and second stages of labour to those whose labour started spontaneously; they also reported that they had "bad pains" for a similar period. The period they had contractions was shorter for the induced than for those starting spontaneously, and the intensity of pain at delivery was rated somewhat less by those who were induced.There was no difference between induced babies and others in the proportion who were held by their mothers immediately after their birth. Two-fifths of the mothers who were induced would have liked more information about induction; and a similar proportion said they had not discussed induction with a doctor, midwife, or nurse during their pregnancy. Only 17% of the mothers who had an induction said they would prefer to be induced if they had another baby. This contrasts with 63% of those who had epidural analgesia who would opt for the same procedure next time, while 83% of those who had had a baby in hospital, and 91% of those having had a home birth, would want their next baby in the same type of place.

Adult↗
PubMed1999

Costs of drug abuse to society.

BACKGROUND: The costs of substance abuse in the USA are enormous and varied. Seldom are they comprehensively assessed. A new study jointly published by the National Institute on Drug Abuse (NIDA) and the National Institute on Alcoholism and Alcohol Abuse (NIAAA) has done just this. AIMS: Researchers for the economic cost of alcohol and drug abuse in the United States, 1992 used systematic cost-of-illness measurement methods to evaluate the burden drug abuse and dependency place on the US economy. This burden includes widespread disability, morbidity, premature death, and diversion of economic resources to drug-related activities. Conceptualizing, identifying, and measuring this burden was a major undertaking; the report describes the methods in detail. METHOD: Costs are measured as the value of resources used (direct costs) or lost during a one year period. As adopted here, the human capital approach estimates an individual's value to society in terms of his or her production potential. The value of future lost earnings is discounted to present time. Finally, the study adopts a societal point of view that is consistent with the recommendations of the Panel on Cost-Effectiveness in Health and Medicine that was convened by the U.S. Public Health Service in 1993. Therefore, this study considers all health and non-health outcomes and costs created by drug abuse and dependency for the entire population. RESULTS: For drug abuse, the annual cost in 1992 is estimated at $98 billion. By 1995, this estimate rose to $110 billion after adjusting for inflation and population change. For 1988, a previous and similar study estimated a cost of $58 billion. The distribution of costs is of particular concern.

Journal Article↗
PubMed2000

Endogenously produced nitric oxide inhibits endothelial cell growth as demonstrated using novel antisense cell lines.

Proliferation of endothelial cells is a vital component of vascular repair and angiogenesis. The endothelial cell mediator, nitric oxide (NO) has been reported both to inhibit and to promote endothelial cell proliferation. In this study we have generated cell lines which constitutively express antisense RNA to a region of inducible nitric oxide synthase (iNOS) from a murine endothelial cell line, sEnd-1. In response to stimulation with lipopolysaccharide (LPS) and interferon-gamma (IFN-gamma) these antisense cells had no detectable RNA for endogenous iNOS, barely detectable iNOS protein and produced 82% less NO than did the control transfected line. Stimulation of the control transfected line caused significant NO production and inhibition of cell growth whereas for the antisense line, producing little NO in response to stimulation, proliferation remained the same as for unstimulated cells. No differences in cell death were observed between unstimulated and LPS/IFN-gamma stimulated cells. The data presented in this study directly demonstrate that NO derived endogenously from iNOS inhibits proliferation of endothelial cells. This approach overcomes problems in other studies where NO donors or non-isoform specific inhibitors of NO synthase have been used.

Animals↗
PubMed1989

Concomitant infection with Neisseria gonorrhoeae and Chlamydia trachomatis in pregnancy.

Gonorrhea is an important marker for endocervical chlamydial infections in nonpregnant women. Concomitant infection rates as high as 50% have been reported. There are few data on concomitant infection rates in pregnant patients. The purpose of this study was to examine the prevalence of endocervical chlamydial infections in pregnant women with gonorrhea. Patients with cervical cultures positive for Neisseria gonorrhoeae at their initial prenatal visit had endocervical specimens for Chlamydia trachomatis culture obtained before anti-gonorrheal therapy. Control patients were selected at random from the same prenatal population. The prevalence of C trachomatis in patients with gonorrhea was significantly greater than that in the control population (46 versus 5%; P less than .001). Patients with gonorrhea were younger, less often married, and more often black than the control population, but these demographic differences did not account for the large difference in the chlamydial prevalence. Erythromycin 500 mg four times daily provided an excellent cure rate without intolerable side effects. Pregnant patients being evaluated or treated for gonorrhea should also be considered at high risk for concomitant cervical chlamydial infection.

Adult↗
PubMed1975

Ultrastructural and serological studies on the resistance of activated B cells to the cytotoxic effects of anti-immunoglobulin serum. Patch and cap formation of surface immunoglobulin on mitotic B lymphocytes.

Previous studies have shown that rabbit anti-mouse immunoglobulin sera (anti-Ig) which kill non-activated B lymphocytes in the presence of complement, are incapable of doing so when the cells are activated by antigen or mitogen into mitosis. Results reported here indicate that the resistance is not dependent on either the source of antiserum or complement, or on the presence of a mitotic inhibitor, colcemid. Immunoperoxidase staining-electron microscopy techniques were applied to assess whether there was any conspicuous difference between unstimulated versus mitogen-stimulated, mitotic cells with respect to density or distribution of cell surface Ig. No such differences were found; furthermore, mitotic cells showed rapid classical 'patch and cap' formation of cell surface Ig when incubated with anti-Ig at room temperature, indicating the retention of fluid membrane dynamics by lymphocytes in this stage of the cell cycle. In contrast to this cytotoxic resistance, T or B lymphocytes in mitosis were found to be as sensitive, or more so, to lysis by various other antisera when compared to non-mitotic cells. Thus the resistance of mitotic B cells to the cytotoxic effects of anti-Ig serum seems unique and appears independent of any conspicuous quantitative or qualitative change in cell surface Ig.

Animals↗
PubMed1988

The controversial role of decortication in the management of pediatric empyema.

Open surgical procedures for pleural empyema remain controversial in children. The pediatric literature generally recommends a prolonged trial of antibiotics and closed tube thoracostomy drainage. We report a favorable experience with a selective approach to open drainage in 22 children, many of whom had an empyema already organizing at admission. Open drainage was considered in children whose conditions failed to improve after 3 to 5 days of therapy with antibiotics and closed drainage. The method of drainage was selected according to the pathologic phase of the empyema: five children with fibrinopurulent empyema were successfully managed by limited decortication, and 17 with organizing empyema received decortication. Clinical improvement was usually dramatic; most of the children became afebrile by postoperative day 3 and were discharged by postoperative day 10. There were no deaths. Three children (14%) had complications of postoperative air leak or infection. Streptococcus pneumoniae (5) and Hemophilus influenzae (3) were the most common single pathogens. The presence of anaerobic bacteria in 8 of 22 children (36%) was associated with rapid organization of the empyema and the need for decortication. Decortication procedures have a low risk and are effective in children with empyema. They should be considered as definitive therapy, rather than as a last resort.

Adolescent↗
PubMedDate not supplied

Beliefs about worry and intrusions: the Meta-Cognitions Questionnaire and its correlates.

This report describes the development of the Meta-Cognitions Questionnaire to measure beliefs about worry and intrusive thoughts. Factor analyses of the scale demonstrated five empirically distinct and relatively stable dimensions of meta-cognition. Four of the factors representing beliefs were: Positive Beliefs About Worry: Negative Beliefs About the Controllability of Thoughts and Corresponding Danger; Cognitive Confidence; and Negative Beliefs about Thoughts in General, including Themes of Superstition, Punishment and Responsibility. The fifth factor represented Meta-Cognitive processes-Cognitive Self-Consciousness-a tendency to be aware of and monitor thinking. The measure showed good psychometric properties on a range of indices of reliability and validity. Scores on the questionnaire subscales predicted measures of worry proneness, proneness to obsessional symptoms, and anxiety. Regression analyses showed that the independent predictors of worry were: Positive Beliefs about Worry; Negative Beliefs About the Controllability of Thoughts and Corresponding Danger: and Cognitive Confidence. Significant differences in particular MCQ subscales were demonstrated between patients with intrusive thoughts, clinical controls and normals. The implications of these findings for models of worry and intrusive thoughts are discussed.

Adolescent↗
PubMed2002

Increasing incidence and descriptive epidemiology of extranodal non-Hodgkin lymphoma in parts of England and Wales.

INTRODUCTION: The incidence of non-Hodgkin lymphoma (NHL) arising from extranodal tissue has been reported to be increasing in Western countries and yet the epidemiology of this heterogeneous disease has been poorly described. PATIENTS AND METHODS: : Cases of extranodal NHL were reported to a specialist population-based registry covering neoplastic hematological conditions in parts of England and Wales from 1986 to 1993. RESULTS: Nearly one third of all NHL, 3556 cases, were extranodal in origin giving a world standardised incidence rate of 1.9/10(5) per year. The most common sites were the skin, stomach and small intestine and high-grade malignancies were predominant. An excess in male incidence was observed for extranodal NHL overall, at all ages, and for most sites. Time-trend analyses indicated significant increases in incidence for all extranodal NHL and NHL of the gastrointestinal tract, skin, central nervous system and male genital organs. Incidence rates increased proportionally more for middle-aged persons, especially females, and for skin lymphomas excluding mycosis fungoides and Sezary disease. CONCLUSION: These results suggest that the rise in incidence of extranodal NHL may be due, at least in part, to an increase specifically in B-cell skin lymphomas and that particular environmental factors such as sunlight might be involved rather than the increases being the results of improvements in diagnostic practices.

Adolescent↗
PubMed1990

The inter-regional epidemiological study of childhood cancer (IRESCC): case-control study of children with central nervous system tumours.

Tumours of the central nervous system comprise 23% of all childhood cancers and form the most common group of solid malignancies. Little is know about their aetiology. The present report concerns the results of a case-control study of 78 incident cases of central nervous system tumours in children. No case-control differences were detected for the following: pre-natal diagnostic X-rays, general anaesthetics during pregnancy, pregnancy infections, pregnancy drugs (including sedatives, tranquillizers and anti-convulsants), alcohol consumption in pregnancy, child's birthweight, breast-feeding, childhood illnesses, previous medication in the child. A significant excess of case mothers had suffered from diseases of the nervous system (RR 2.6). There was a deficit of children who had been immunised among the case children which approached significance, and an excess of congenital abnormalities among cases which also approached significance. There was a small excess of neoplastic disease among case parents. The results of this study suggest that in our patients genetic rather than environmental factors are more important, but the small numbers included in the present study meant that no definite conclusions could be reached.

Abnormalities, Multiple↗
PubMed1994

A Sec62p-related component of the secretory protein translocon from Drosophila displays developmentally complex behavior.

The isolation and characterization of a Drosophila melanogaster gene (Dtrp1) that encodes a protein displaying the properties of both a structural and functional homolog of the yeast endoplasmic reticulum membrane-bound translocation protein Sec62p is reported. We show that Dtrp1 can not only rescue the lethality associated with a SEC62 gene knockout in yeast, but also complement the sec62-associated defective transport of a precursor polypeptide from the cytoplasm into the lumen of the endoplasmic reticulum. Expression of the Dtrp1 gene throughout Drosophila development is characterized by peaks in mid-embryo-genesis and mid-pupation, followed by a sustained period of mRNA accumulation in adults. The examination of male reproductive tissues showed a very high level of preferential expression of a 1.6 kb message, while a 2.2 kb message was confined almost exclusively to the non-reproductive tissues. Within the reproductive tract itself the 1.6 kb message was expressed in testes, ejaculatory duct and particularly strongly in the paragonial glands. Since these latter organs are specialized secretory tissues we suggest that the 1.6 kb message may encode a protein isoform that performs a unique, tissue-specific role in the protein translocation pathway. Such observations may indicate a hitherto unexpected diversity in components of the protein translocation pathway in respect to stage, tissue and, potentially, substrate specificity.

Amino Acid Sequence↗