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PubMedDate not supplied

Expedited permanency planning: evaluation of the Kentucky Adoptions Opportunities Project.

This article presents the evaluation findings of a Kentucky Adoptions Opportunities Project (KAOP), a three-year project funded by the U.S. Department of Health and Human Services, Administration on Children, Youth and Families, Children's Bureau. The primary goal of the KAOP was implementation of three permanency planning activities: (1) risk assessment/concurrent planning, (2) one child/one legal voice, and (3) early placement in kinship or foster/adoptive homes. These activities were designed to expedite a permanency placement decision within 12 months for high-risk children. The evaluation of 124 high-risk children in the KAOP revealed that the majority of children had one or both parents coping with multiple risk factors, including mental illness, substance abuse, mental retardation, or family violence. The major barriers to permanency are discussed, as well as the policy and practice implications in the context of Adoption and Safe Families Act of 1997.

Adoption↗
PubMedDate not supplied

Transracial adoption and foster care placement: worker perception and attitude.

This study explores black child welfare workers' perceptions of transracial adoption (TRA) and foster care placement (FCP). Informants were asked to discuss their attitudes toward the placement of black children with white families, as well as their perception of the Multiethnic Placement Act of 1994 and the supplemental Interethnic Adoption Provision of 1996. This study expands existing research regarding the viability of TRA and FCP by incorporating the previously ignored perceptions of social service professionals who are charged with the responsibility of providing child and family services. Findings illuminate the significant role that prioritization of client need plays in the perceptions of workers.

Adoption↗
PubMed2002

Prognostic significance of adoptive immunotherapy with tumor-associated lymphocytes in patients with advanced gastric cancer: a randomized trial.

PURPOSE: We performed adoptive immunotherapy (AIT)with tumor-associated lymphocytes (TALs) in combination with chemotherapy in patients with advanced-stage gastric cancer in a randomized controlled study and investigated whether or not an improved survival effect is observed with AIT. EXPERIMENTAL DESIGN: Forty-four consecutive patients with stage IV gastric cancer [staged according to the International Union against Cancer classification] were prospectively assigned to the control group (chemotherapy alone) or the AIT group (AIT plus chemotherapy). Patients in the AIT group received an adoptive transfer of cultured TALs in combination with low-dose cisplatinum/5-fluorouracil chemotherapy, whereas patients in the control group received chemotherapy alone. RESULTS: The 50% survival rates were 11.5 and 8.3 months in the AIT and control groups, respectively. The overall survival of patients in the AIT group was significantly better than that of patients in the control group, as analyzed by the log-rank test (P < 0.05). Multivariate analysis with Cox's proportional hazards model revealed that AIT provided an independent prognostic factor, indicating that AIT influenced patient survival in a positive manner. CONCLUSIONS: AIT with TALs in combination with chemotherapy was effective in prolonging survival in patients with stage IV gastric cancer.

Aged↗
PubMedDate not supplied

The emerging role of adoption reunion registries: adoptee and birthparent views.

Since the 1980s, government-sponsored adoption reunion registries have emerged as key access points for individuals separated by adoption to secure information and initiate efforts to be reunited with their birth-families. Despite the prevalence of such registries, little information is available about their operational effectiveness. This article presents data from a survey of adult adoptees and birthparents who used the services of a statewide reunion registry.

Adoption↗
PubMed2002

Adoptive transfer of BALb/c mouse splenocytes reduces lesion severity and induces intestinal pathophysiologic changes in the Mycobacterium avium Subspecies paratuberculosis beige/scid mouse model.

Successful immune reconstitution would enhance resistance of beige/scid mice to chronic infection with Mycobacterium avium subspecies paratuberculosis, but may cause damage to intestinal tissue. Therefore, we investigated the effect of adoptive transfer of BALB/c mouse splenocytes on lesion severity and intestinal physiology in beige/scid mice infected with M. paratuberculosis. Mice were inoculated intraperitoneally (i.p.) with M. paratuberculosis, and two weeks later were inoculated i.p. with viable spleen cells from immune-competent BALB/c mice. Mice were necropsied 12 weeks after infection when engraftment of lymphocytes, clinical disease, pathologic lesions, and intestinal electrophysiologic parameters were evaluated. Lymphocytes were rare in control beige/scid mice not inoculated with spleen cells. In contrast, high numbers of CD4+, CD8+, and B220+ lymphocytes were detected in the spleen of all beige/scid mice (n = 24) inoculated with spleen cells, indicating that adoptive transfer resulted in successful engraftment of donor lymphocytes (immune reconstitution). Immune reconstitution of M. paratuberculosis-infected beige/ scid mice significantly reduced the severity of clinical disease and pathologic lesions, and numbers of bacteria in the liver. However, intestinal electrophysiologic parameters studied in vitro indicated that intestinal tissues from reconstituted beige/scid mice had reduced short-circuit current responses (due to reduced ion secretion) following electrical, glucose, and forskolin stimulation. These abnormal responses suggested that neural or epithelial cells in the intestine were damaged. We conclude that successful immune reconstitution of beige/scid mice enhance their resistance to M. paratuberculosis infection, but may cause pathophysiologic changes associated with intestinal inflammation.

Adoptive Transfer↗
PubMed2002

[Clinical observation on adoptive immunotherapy with autologous cytokine-induced killer cells for advanced malignant tumor].

BACKGROUND & OBJECTIVE: Cytokine-induced killer (CIK) cells have the characteristics of rapid proliferation, high efficiency, and broad spectrum in killing of tumor cells. However, there was few report about its clinical application on treatment for cancer patients. The current study was designed to evaluate the effect of adoptive transfer of autologous CIK cells on the patients with advanced malignant tumor. METHODS: Peripheral blood mononuclear cells of the patients with advanced malignant tumor were separated by fractionation on Ficoll-Hypaque gradient, then cultured in the medium containing IFN-gamma, IL-2, and CD3McAb for 7 days in vitro, and than the cultured auto-CIK cells were transfused back to the patients. The numbers of transferred CIK cells per patient were 5-15 x 10(9) in one course of treatment. Among these patients, 47 cases received chemotherapy, 3 cases received radiotherapy before CIK cells transfusion. The interval between chemoradiotherapy and immunotherapy was over 2 to 4 weeks. RESULTS: Among 63 patients receiving CIK cells immunotherapy, the total effective rate (PR + MR) was 44.46% (28). In the patients with increasing of CEA level in serum, 14 cases showed reduction of serum CEA and 1 cases remained increasing after the treatment with CIK cell. In the patients with increasing of AFP level in serum, similarly, 9 cases showed reduction of serum AFD and 1 case remained increasing. The absolute members of CD3, CD4, and CD8T cells increased to over 45% after being treated with CIK cells. Among treated patients, the appetite of 51 cases and performance and sleep of 32 cases got improved. Among 18 cases, 13 cases showed the pain relief. CONCLUSION: Adoptive immunotherapy of auto-CIK cells can significantly enhance cellular immune functions and improve subjective symptoms, but without side effects, so this is a safe and effective treatment for the patients with malignant tumor.

Adult↗
PubMedDate not supplied

The health of children adopted from Romania.

OBJECTIVE: To determine the medical condition of Romanian adoptees and the effects of the Romanian orphanage system on their health. DESIGN: Case series. SETTING: The international adoption clinics at the University of Minnesota, Minneapolis, and the New England Medical Center, Tufts University, Boston, Mass. PARTICIPANTS: Sixty-five Romanian adoptees who were brought to the United States during a 12-month period beginning in October 1990. MAIN OUTCOME MEASURES: Incidence of hepatitis B, intestinal parasites, tuberculosis, syphilis, human immunodeficiency virus type 1, growth failure, and developmental delay. RESULTS: Although the adopted children were presumably chosen from the most vital and attractive adoptees, only 15% were judged to be physically healthy and developmentally normal. Fifty-three percent had serological evidence of past or present hepatitis B infection, and 20% of screened children tested positive for hepatitis B surface antigen. In children aged 7 months or older, the overall prevalence of chronic hepatitis B was 23%. Intestinal parasites were found in 33% of subjects, and 45% of infected children had two or more pathogens identified. All the children tested for human immunodeficiency virus type 1 were negative. Two patterns of growth failure were observed that resembled the two subtypes of psychosocial short stature that occur in association with prolonged psychological harassment or emotional deprivation. Infants' length, weight, head circumference, and weight-for-height were adversely affected by institutionalization. Older children's height was reduced. Only 10% of children older than 12 months were developmentally normal. CONCLUSION: Romanian adoptees are an extraordinarily high-risk pediatric group as a consequences of decades of government-sanctioned child neglect and abuse.

Adoption↗
PubMed2003

[Concepts of adoptive immunotherapy in stomach cancer patients after radical surgery].

Although there has been a sufficiently steady trend towards a decrease in the incidence of carcinoma of the stomach (CS), the problem related with treatment of this malignant tumor remains acute up to now in many countries. Presently, the surgical method, i.e. gastrectomy in the volume of D2 (with splenectomy being an element of it) remains the basic treatment for CS of stages I-III. A removal of an essential portion of the lymphoid tissues brings about a pronounced, prolonged and hard-to-correct immunodeficiency, which, in its turn, aggravates the risk of postoperative infectious complications and cuts the relapse-free life period. The method, offered by us, makes it possible to obtain the lymphocine-activated cells from the mononuclear cell population of the spleen, removed in operation, and to use them in the adoptive immunotherapy for the purpose of improving the life duration and quality for this category of patients. However, elaboration of methods combining the activation of both non-specific and specific anti-tumor immunity through designing the anti-tumor auto-vaccines based on dendrite cells is the most promising direction in the adoptive immunotherapy for a radically operated CS.

Combined Modality Therapy↗
PubMedDate not supplied

[Adjuvant adoptive immunotherapy in patients with stage III and resected stage IV melanoma: a pilot study].

Adoptive immunotherapy trials with tumor infiltrating lymphocytes (TIL) and interleukin-2 (IL-2) were carried out in the treatment of advanced melanoma with a 34% of overall responses (OR). However, theoretically it should be of greater benefit as adjuvant therapy, especially in high-risk stages (stage III and resected stage IV). In a pilot study, 22 patients (aged 23-72 years) with stage III-IV melanoma who underwent radical metastasectomy were reinfused with TIL cultivated and expanded in vitro with IL-2 from surgically removed metastases. IL-2 (starting dose 12 x 10(6) IU/m2) was co-administered as a continuous infusion according to West's scheme. A total of 8/22 (36.3%) patients were disease-free (DF) at a median follow-up of 5 years. DF survival (DFS) and overall survival (OS) in the remaining 14 patients were 44% and 37% and 52% and 45% at 2 and 3 years, respectively. The CNS was the only site of disease recurrence in 57% of patients who relapsed. DF patients received a higher median dose of IL-2 than those who progressed (total dose 110 x 10(6) vs 86 x 10(6) IU/m2, respectively). The progressive reduction in IL-2 dosage allowed all patients to complete treatment without permanent grade 4 toxicity. The effects of tumor immunosuppression in lymphocytes inside the tumor (TCR z and e chains, p56lck, FAS and FAS-ligand) confirmed that the potential function of TIL, immunodepressed at the time of metastasectomy, was significantly restored after in vitro, culture with IL-2. Adjuvant adoptive immunotherapy with TIL and IL-2 seems to improve DFS and OS, in comparison with literature data. Further studies are required to determine its role in the adjuvant treatment of patients with high-risk melanoma.

Adult↗
PubMed1992

Influence of age on the induction of oral tolerance in mice and its adoptive transfer by spleen cells.

1. Seven-week-old B6D2F1 mice were highly susceptible to the induction of oral tolerance to ovalbumin (Ova), whereas 70-week-old mice were totally refractory. 2. Immune responsiveness (secondary antibody formation) to intraperitoneal immunization to Ova was the same in 7-week- or 70-week-old B6D2F1 mice. 3. In B6D2F1 mice, the adoptive transfer of spleen cells from old donors into young recipients hindered, and, reciprocally, transfer of spleen cells from young donors into old recipients facilitated the induction of oral tolerance. 4. In BALB/c mice, which are refractory to oral tolerance to Ova, the adoptive transfer of spleen cells from neonate or young donors into old recipients failed to modify the lack of susceptibility to the induction of oral tolerance.

Aging↗
PubMed1992

Anti-CD2 monoclonal antibodies prevent spontaneous and adoptive transfer of diabetes in the BB/Wor rat.

We studied the effects of anti-CD2 monoclonal antibodies (MAb) on spontaneous and induced autoimmune diabetes mellitus in diabetes-prone (DP) and diabetes-resistant (DR) BB/Wor rats. In DP rats, all anti-CD2 MAb prevented spontaneous diabetes and the adoptive transfer of diabetes with Con-A--stimulated acute diabetic spleen cells; OX34 prevented Poly I:C induced accelerated onset of diabetes and the adoptive transfer of diabetes with Con-A--stimulated RT6.1+ T cell depleted DR splenocytes. In DP rats, all anti-CD2 MAb except OX53 depleted CD4+ T cells, without depleting natural killer cells or CD8+ T cells. OX34 injected DR rats were profoundly depleted of CD4+ T cells without evidence of decreased CD8+ T cells, but were not protected against the induction of diabetes by RT6.1+ T-cell depletion and Poly I:C injections. We conclude that anti-CD2 MAbs protect against BB/Wor autoimmune diabetes by depleting CD4+ T cells, preventing the activation of effector cells, or by blocking CD2/ligand interaction between effector and target cells.

Animals↗
PubMed2003

[Growth and development aspects of international adoption].

With the increase in the number of children being adopted by Israeli families from abroad, the medical system has to face heretofore unfamiliar medical and developmental challenges. Many of the biological mothers of these children were substance abusers and suffered from a variety of illnesses and nutritional deficiencies during their pregnancy. Their infants and young children were placed in orphanages at a very young age. The ensuing emotional and environmental deprivation in many cases impacted negatively on their neurological, physical and emotional development. Whereas our previous survey dealt with the purely medical aspects of international adoption, the current review deals with the growth and developmental issues involved in raising these children.

Adoption↗
PubMed1992

[Augmentation of therapeutic effect of adoptive immunotherapy through a synergy between transferred killer cells and host's fresh lymphocytes].

Among several approaches to augment the therapeutic effect of adoptive immunotherapy, we focused the antitumor synergy between transferred killer cells and host's fresh lymphocytes. Immunotherapy models using murine tumors or clinical experiments revealed that preadministration of immunostimulator such as OK-432, followed by chemotherapeutic agents such as cyclophosphamide, can induce host's non-cytotoxic fresh lymphocytes that act synergistically with cultured killer cells against autologous tumor cells. Immuno-chemo-lymphocytotherapy (a sequential treatment with OK-432, chemotherapy and adoptive immunotherapy) is useful to treat the patients with advanced cancer even if the number of transferred lymphocytes is limited.

Animals↗
PubMed2004

Update: measles among children adopted from China.

As of May 24, 2004, investigators have identified 10 confirmed measles cases associated with adoptees who traveled to the United States from China during March 2004. No cases have been reported since April 18, and all the ill persons have recovered without complications. CDC is now recommending that the temporary suspension of adoptions from the affected orphanage in China be ended and standard adoption procedures be resumed.

Adoption↗
PubMed1992

[Toxocariasis (visceral larva migrans). A report of a case in an adopted child].

A case of asymptomatic toxocariasis in a Brazilian adopted child with hypereosinophilia is described. The diagnosis is confirmed by measuring specific IgG antibodies anti-Toxocara and, in the light of growing adoptions of children coming from low standard of living extra-European countries, the authors note the importance of investigating also on those parasitosis until today rather infrequent in our country.

Adoption↗
PubMed2004

CD4+ T cells tumor specific response exists in L615 leukemia mice: adoptive transfer in combination with cyclophosphamide.

AIM: L615 leukemia cell line is a transplantable acute lymphocytic leukemia model with the CD4 positive phenotype. In this study, we explored whether tumor response specific T cells can be separated from the live leukemia mice or not. METHODS: The mutant HGPRT- L615 cell line was first established. The splenocytes from HGPRT- L615 leukemia mice were cultured and expanded in mixed tumor-lymphocytes culture manner. The expanded T cells were sorted with FACScan. Then their killing capacity, IFN-gamma release as well as antitumor capacity in adoptive transfer experiments were analyzed. RESULTS: The expanded response T cells are mostly CD4 positive. The CD4 positive T cells showed high release of IFN-gamma upon stimulation but lacked significant cytotoxicity. In immunochemotherapy model, these CD4 positive T cells can cure most leukemia mice. CONCLUSIONS: We demonstrated the feasibility of separation of tumor response specific CD4+ T cells from CD4+ L615 leukemia mice. These CD4+ T cells can cure leukemia mice upon adoptive transfer in combination with cyclophosphamide pretreatment.

Adoptive Transfer↗
PubMed2004

Role of L-lysine HCl in adoptive immune therapy towards development of suitable tuberculosis vaccination.

L-Lysine HCI is being proposed to be a possible biocompatible adjuvant to enhance immune response by virtue of its probable non-specific bridging action and cellular proliferation properties. This proposal has been tried to be substantiated by designing an in vitro culture protocol, varying the concentration of L-lysine HCI and its further in vivo application. Splenic lymphocyte population has been extracted from mice and co-cultured with extracted mice macrophage population in presence of either Bacille Calmette Guerrin (BCG) or Hepatitis B surface antigen (HbsAg) and added L-lysine hydrochloride in culture media. Post incubation of these cultures, "taught" cell population has been adoptively transferred in naïve mice. These mice were then challenged by respective antigen dose, Change in Immune response with this challenge was noted. Antibody titre was followed in all the experiments as a measure of immune response. In adoptive immune transfer experiment of with HbsAg (AIT-HbsAg), similar to that with BCG (AIT-BCG), after the incubation period, antibody titre was higher in added lysine containing cultures in comparison with the control ones. Post transfer followed by antigen challenge, in AIT-BCG the expected augmentation in immune response was hardly visible. But in AIT-HbsAg, with the help of lysine booster, the animals responded better as far as the antibody titre is concerned.

Animals↗
PubMedDate not supplied

Oral health care for the internationally adopted child: a case report.

While the health considerations of the internationally adopted child have been widely discussed in the medical scientific literature, there has not been substantial discourse on the oral health needs of international adoptees. The purpose of this case report is to review some of the medical implications associated with international adoption and, more importantly, highlight some of the potential oral health complications present in this at-risk group of children.

Adoption↗