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PubMed1981

Effectivity of living and non-living BCG vaccine on experimental metastatic spread in mice and the stimulation of the reticulohistiocytic system (RHS).

Heat-killed or formalin-killed BCG vaccine caused statistically significant increases in weight of lungs, spleen and liver, which were in the same range as after administration of equal doses of viable BCG vaccine. Similarly, there was no quantitative or temporal difference in the phosphatase-positive proliferations of the RHS in liver spleen and lungs when using identical doses of viable or heat- or formalin-killed BCG vaccines. The metastasis-prophylactic effect demonstrated for viable BCG was present also after administration of the killed vaccines to a statistically significant degree. The increases in organ weight, extent of phosphatase-positive proliferation foci in liver, spleen and lungs as well as the metastasis-prophylactic effect were entirely identical; they seem to be in a close relationship with each other.

Acid Phosphatase↗
PubMed1980

A study of live influenza virus vaccine in patients with chronic bronchitis. Report to Medical Research Council's Committee on Influenza and Other Respiratory Virus Vaccines. Advisory Group on pulmonary function tests in relation to live influenza virus vaccines.

A multicentre study of the effects of influenza virus RIT 4050 (H3N2) in patients with chronic bronchitis was conducted by members of an MRC Committee. The results showed that RIT 4050 vaccine virus did not cause a deterioration in clinical or physiological status in these patients within the limitation of the relatively reproducible ventilatory tests which were employed. This conclusion applied equally to those who were inoculated and became infected and to those who failed to develop serological evidence of infection. The relatively high proportion of antibody-negative volunteers not infected by the inoculated virus raises doubts concerning the value of this method of immunization for patients at risk during influenza epidemics.

Adult↗
PubMed1998

Living alone does not adversely affect nutrient intake and nutritional status of 70- to 75-year-old men and women in small towns across Europe.

This study determined the relationships between living alone and a variety of sociodemographic variables and dietary intake and nutritional status of 70- to 75-year-old men and women across Europe. Data from nine centers, collected as part of the SENECA study, were selected for analysis. Respondents were categorized as either living alone, living with a spouse/partner only, or living with a spouse/partner and/or other person(s). Analyses included chi-square statistics, t-tests, and analysis of variance, measures of relationships and differences between residential-status groups. The sample included 512 subjects who lived alone, 1017 who lived with a spouse/partner only, and 380 who lived with a spouse/partner and/or other person(s). Variables which differed significantly by living arrangement included higher vitamin A, calcium, riboflavin and water intake by both males and females living alone as compared to either those living with a spouse, those living with others, or both groups. Females who lived alone had lower energy intake than those who lived with other than a spouse/partner, and women who lived alone or as couples versus those who lived with others had lower protein and carbohydrate intakes. Males who lived alone had significantly lower intakes of vitamin C than those who lived with person(s) other than a spouse, but still they were considerably above recommended levels. Respondents who lived with a spouse/partner only were less likely to have an unfavorable BMI status than people in the other two groups. Thus, nutrient intakes of 70- to 75-year-olds across Europe are generally not adversely impacted by living alone, and relative to some nutrients, namely vitamin A, calcium, and riboflavin, their diets are better than those living in one or both of the other residential categories.

Aged↗
PubMed1999

Living donors >55 years: to use or not to use?

BACKGROUND: Kidney transplants using older donors are becoming increasingly accepted as a strategy for alleviating the growing donor organ shortage. Most studies to date have shown decreased graft survival associated with the use of older cadaver donors; however, studies on the effect of living donor age on graft survival are less clear-cut. METHODS: We studied the effect of donor age on patient and graft survival after 1126 consecutive cyclosporine-treated primary kidney transplants performed between January 1, 1985 and December 31, 1995. Of these grafts, 598 were from living donors (74 from donors >55 years old) and 528 from cadaver donors (54 from donors >55 years). We calculated actuarial patient survival, graft survival, and death-censored graft survival for recipients of both living donor and cadaver kidneys. Living donors were then further divided by HLA mismatch (0 vs. 1 - 6) and the presence or absence of an acute rejection episode. Multivariate analysis of factors associated with decreased graft survival was performed for recipients of both living and cadaver donor kidneys. Factors included for analysis were donor age >55 years, recipient age >50 years, the presence of diabetes mellitus, HLA mismatch (0 vs. 1 - 6), and the presence of an acute rejection episode. RESULTS: For cadaver kidneys, univariate analysis indicates that both overall (P=0.004) and death-censored (P=0.001) graft survival was significantly better with younger cadaver kidneys. This is supported by our multivariate analysis, which shows that cadaver donor age >55 years is an independent predictor of poor actuarial graft survival (P=0.0003). For living donor kidneys, univariate analysis also indicates that both overall (P=0.045) and death-censored (P=0.005) graft survival was significantly better with younger living donor kidneys. However, in the absence of acute rejection, 10-year death-censored graft survival for patients with older vs. younger living donor kidneys was 93% vs. 94%, whereas in the presence of one or more acute rejection episodes, 10-year death-censored graft survival dropped markedly to 39% with older and 54% with younger living donors. Kidneys from living donors >55 years had significantly better long-term graft survival than cadaver donors >55 years (P=0.012) and had comparable graft survival to younger cadaver donors. In contrast to our univariate analysis, multivariate analysis of our living donor data shows that decreased actuarial living donor death-censored graft survival was significantly associated only with the presence of one or more acute rejection episodes (P<0.0001). Living donor age >55 years was not independently associated with decreased graft survival. CONCLUSIONS: Ours is the largest single-center study of outcome for recipients of kidneys from living donors >55 years. Using univariate analysis, we have shown that graft survival of kidneys from older living donors is significantly better than that of kidneys from older cadaver donors and is comparable to that of kidneys from younger cadaver donors. Using multivariate analysis, we have shown that the presence of one or more acute rejection episodes significantly shortens both cadaver and living donor long-term graft survival. Most significantly, we have shown that, although the use of kidneys from cadaver donors >55 years is associated with significantly decreased long-term graft survival, no such association exists for recipients of kidneys from living donors >55 years. We feel that our data support the continued use of kidneys from older living donors.

Adolescent↗
PubMedDate not supplied

Iowa nurses' knowledge of living wills and perceptions of patient autonomy.

The principle of patient autonomy is well recognized in the nursing profession. This study extends the exploration of patient autonomy by examining nurses' knowledge about living wills. The questions addressed in this study included the following: (1) Were Iowa nurses aware of the living will statute? (2) What sources of information did nurses use to learn about this legislation? (3) What were nurses' perceptions of patients' rights? (4) What were nurses' perceptions of nurses' role involving living wills? (5) Were living wills followed? (6) If not followed, which factors contributed to the failure to honor a living will? and (7) Which communication mechanisms were used to alert nurses to a living will? A questionnaire was mailed to 10,000 actively licensed nurses in Iowa. Approximately 3,000 Iowa nurses responded to the questionnaire regarding Iowa living wills. Seventy per cent of the nurses knew that Iowa had living will legislation. No single educational source was a predominate choice for targeted information about the living will statute. Nurses were reluctant to suggest to patients that they should consider writing a living will. Nurses were also more willing to assume a passive role of suggesting that patients talk with relatives about the need for a living will but were less likely to be suggest that a patient write a living will for future health care treatment decisions. The majority of the nurses favored the patient having some control in health care treatment decisions. Three major factors were pertinent to the failure to follow a living will: family request, treating physician's refusal, and lack of information that the living will existed. The medical record was the primary means of communication regarding a living will. To enhance patient efforts at self-determination, nurses must recognize the advance directive legislation is available in their state and the potential impact that their nursing care may have on the implementation of the document.

Adult↗