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Mitra M, Akobirshoev I, Valentine A, McKee K, McKee MM. Severe maternal morbidity in deaf or hard of hearing women in the United States. Prev Med 2024; 180:107883. [PMID: 38307211 DOI: 10.1016/j.ypmed.2024.107883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVE Prior studies on severe maternal morbidity (SMM) have often excluded women who are deaf or hard of hearing (DHH), even though they are at increased risk of pregnancy complications and adverse birth outcomes. This study compared rates of SMM during delivery and postpartum among DHH and non-DHH women. METHODS This nationally representative retrospective cohort study used hospital discharge data from the 2004-2020 Health Care and Cost Utilization Project Nationwide Inpatient Sample. The risk of SMM with and without blood transfusion during delivery and postpartum among DHH and non-DHH women were compared using modified Poisson regression analysis. The study was conducted in the United States in 2022-2023. RESULTS The cohort included 9351 births to DHH women for the study period, and 13,574,382 age-matched and delivery year-matched births to non-DHH women in a 1:3 case-control ratio. The main outcomes were SMM and non-transfusion SMM during delivery and postpartum. Relative risks were sequentially adjusted for sociodemographic characteristics, hospital-level characteristics, and clinical characteristics. In unadjusted analyses, DHH women were at 80% higher risk for SMM (RR = 1.81, 95% CI 1.63-2.02, p < 0.001) during delivery and postpartum compared to non-DHH women. Adjustment for socio-demographic and hospital characteristics attenuated risk for SMM (RR = 1.54, 95% CI 1.38-1.72, p < 0.001). Adjustment for the Elixhauser comorbidity score further attenuated the risk of SMM among DHH women (RR = 1.13, 95% CI 1.01-1.26, p < 0.05). CONCLUSION The findings of this study demonstrate a critical need for inclusive preconception, prenatal, and postpartum care that address conditions that increase the risk for SMM among DHH people.
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Affiliation(s)
- Monika Mitra
- Lurie Institute for Disability Policy, Heller School for Social Policy and Management, Brandeis University, 415 South St. MS 035, Waltham, MA 02453, USA.
| | - Ilhom Akobirshoev
- Lurie Institute for Disability Policy, Heller School for Social Policy and Management, Brandeis University, 415 South St. MS 035, Waltham, MA 02453, USA
| | - Anne Valentine
- Lurie Institute for Disability Policy, Heller School for Social Policy and Management, Brandeis University, 415 South St. MS 035, Waltham, MA 02453, USA
| | - Kimberly McKee
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Michael M McKee
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
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Bell SG, Rowe M, Kobernik EK, McKee K, LeBar W, Bell JD. Using ThinPrep Papanicolaou test samples to evaluate sexually transmitted infection screening practices. J Am Soc Cytopathol 2021; 10:571-576. [PMID: 34548251 DOI: 10.1016/j.jasc.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/22/2021] [Accepted: 07/23/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION We sought to evaluate the use of Papanicolaou samples as a screening tool for sexually transmitted infections (STIs). METHODS Retrospective chart review analyzing Papanicolaou samples for STI. Samples were processed and results compared to clinical data to assess this technique's viability. Cases and controls were matched by sample date. Characteristics of women with STI testing were compared in bivariate analyses. RESULTS We analyzed 50 STI-positive and 50 date-matched samples. Thirteen (26.0%) of the STI-positive patients were not screened at their visit. Women without STI screening were older (39.5 vs. 30.0 years, P = 0.001); non-Hispanic White (65.9% vs. 46.4%, P = 0.05); and married (60.0% vs. 26.9%, P = 0.005) than women with STI screening. Fifty-eight were offered and accepted STI testing at their visit; 37 samples were STI-positive: 17 (29.3%) Mycoplasma genitalium (Mgen), 10 (17.2%) chlamydia, 6 (10.3%) trichomoniasis, 1 (1.7%) gonorrhea, and 3 (5.2%) had two STIs. Among the 42 patients without STI testing, 12 (28.6%) had positive samples: 6 (14.3%) chlamydia, 5 (12.0%) Mgen, and 1 (2.4%) trichomoniasis. CONCLUSIONS Over one-quarter of STI-positive patients were not screened; though low-risk by current screening criteria, a significant number may harbor untreated STIs; using Papanicolaou samples may allow for increased screening in this population.
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Affiliation(s)
- Sarah G Bell
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
| | - Meghan Rowe
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Emily K Kobernik
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Kimberly McKee
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan
| | - William LeBar
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Jason D Bell
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
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Bell S, Rowe M, Kobernik E, McKee K, LeBar W, Bell J. Using thinprep® pap smear samples to evaluate sexually transmitted infection screening practices. Am J Obstet Gynecol 2020. [DOI: 10.1016/j.ajog.2020.08.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Reinhard J, Lin S, McKee K, Yurchenco P, Ruegg M. CONGENITAL MUSCULAR DYSTROPHIES. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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McKee K, Admon LK, Winkelman TNA, Muzik M, Hall S, Dalton VK, Zivin K. Perinatal mood and anxiety disorders, serious mental illness, and delivery-related health outcomes, United States, 2006-2015. BMC Womens Health 2020; 20:150. [PMID: 32703202 PMCID: PMC7376899 DOI: 10.1186/s12905-020-00996-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 06/18/2020] [Indexed: 11/06/2022]
Abstract
Background National estimates of perinatal mood and anxiety disorders (PMAD) and serious mental illness (SMI) among delivering women over time, as well as associated outcomes and costs, are lacking. The prevalence of perinatal mood and anxiety disorders and serious mental illness from 2006 to 2015 were estimated as well as associated risk of adverse obstetric outcomes, including severe maternal morbidity and mortality (SMMM), and delivery costs. Methods The study was a serial, cross-sectional analysis of National Inpatient Sample data. The prevalence of PMAD and SMI was estimated among delivering women as well as obstetric outcomes, healthcare utilization, and delivery costs using adjusted weighted logistic with predictive margins and generalized linear regression models, respectively. Results The study included an estimated 39,025,974 delivery hospitalizations from 2006 to 2015 in the U.S. PMAD increased from 18.4 (95% CI 16.4–20.0) to 40.4 (95% CI 39.3–41.6) per 1000 deliveries. SMI also increased among delivering women over time, from 4.2 (95% CI 3.9–4.6) to 8.1 (95% CI 7.9–8.4) per 1000 deliveries. Medicaid covered 72% (95% CI 71.2–72.9) of deliveries complicated by SMI compared to 44% (95% CI 43.1–45.0) and 43.5% (95% CI 42.5–44.5) among PMAD and all other deliveries, respectively. Women with PMAD and SMI experienced higher incidence of SMMM, and increased hospital transfers, lengths of stay, and delivery-related costs compared to other deliveries (P < .001 for all). Conclusion Over the past decade, the prevalence of both PMAD and SMI among delivering women increased substantially across the United States, and affected women had more adverse obstetric outcomes and delivery-related costs compared to other deliveries.
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Affiliation(s)
- Kimberly McKee
- Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, MI, 48104-1213, USA.
| | - Lindsay K Admon
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA.,University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, USA.,Program on Women's Healthcare Effectiveness Research, University of Michigan, Ann Arbor, MI, USA
| | - Tyler N A Winkelman
- Division of General Internal Medicine, Hennepin Healthcare, Minneapolis, MN, USA.,Hennepin Healthcare Research Institute, Minneapolis, MN, USA
| | - Maria Muzik
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA.,University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, USA.,Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Stephanie Hall
- Department of Learning Health Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Vanessa K Dalton
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA.,University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, USA.,Program on Women's Healthcare Effectiveness Research, University of Michigan, Ann Arbor, MI, USA
| | - Kara Zivin
- University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, USA.,Program on Women's Healthcare Effectiveness Research, University of Michigan, Ann Arbor, MI, USA.,Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.,VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.,Department of Health Policy & Management, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Mitra M, McKee MM, Akobirshoev I, Valentine A, Ritter G, Zhang J, McKee K, Iezzoni LI. Pregnancy, Birth, and Infant Outcomes Among Women Who Are Deaf or Hard of Hearing. Am J Prev Med 2020; 58:418-426. [PMID: 31952943 PMCID: PMC7039738 DOI: 10.1016/j.amepre.2019.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 10/10/2019] [Accepted: 10/11/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Being deaf or hard of hearing can be marginalizing and associated with inequitable health outcomes. Until recently, there were no U.S. population-based studies of pregnancy outcomes among deaf or hard of hearing women. In light of inconsistent findings in the limited available literature, this study sought to conduct a more rigorous study using population-based, longitudinal linked data to compare pregnancy complications, birth characteristics, and neonatal outcomes between deaf or hard of hearing and non-deaf or hard of hearing women. METHODS Researchers conducted a retrospective cohort study in 2019 using the Massachusetts Pregnancy to Early Life Longitudinal data system. This system links all Massachusetts birth certificates, fetal death reports, and delivery- and nondelivery-related hospital discharge records for all infants and their mothers. The study included women with singleton deliveries who gave birth in Massachusetts between January 1998 and December 2013. RESULTS The deaf or hard of hearing women had an increased risk of chronic medical conditions and pregnancy complications including pre-existing diabetes, gestational diabetes, pre-eclampsia and eclampsia, and placental abruption. Deliveries to deaf or hard of hearing women were significantly associated with adverse birth outcomes, including preterm birth, low birth weight or very low weight, and low 1-minute Apgar score or low 5-minute Apgar score. No significant differences were found in size for gestational age, fetal distress, or stillbirth among deaf or hard of hearing women. CONCLUSIONS Findings from this 2019 study indicate that deaf or hard of hearing women are at a heightened risk for chronic conditions, pregnancy-related complications, and adverse birth outcomes and underscore the need for systematic investigation of the pregnancy- and neonatal-related risks, complications, costs, mechanisms, and outcomes of deaf or hard of hearing women.
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Affiliation(s)
- Monika Mitra
- Lurie Institute for Disability Policy, Brandeis University, Waltham, Massachusetts.
| | - Michael M McKee
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Ilhom Akobirshoev
- Lurie Institute for Disability Policy, Brandeis University, Waltham, Massachusetts
| | - Anne Valentine
- Lurie Institute for Disability Policy, Brandeis University, Waltham, Massachusetts
| | - Grant Ritter
- The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Jianying Zhang
- Statistician Consultant to the Lurie Institute for Disability Policy, Brandeis University, Waltham, Massachusetts
| | - Kimberly McKee
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Lisa I Iezzoni
- The Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts
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McKee K, Bassis C, Murali S, Bell J, Young V. The vaginal microbiota in pregnancy and spontaneous preterm birth. Am J Obstet Gynecol 2019. [DOI: 10.1016/j.ajog.2019.10.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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8
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Carter K, Bassis C, McKee K, Bullock K, Eastman A, Young V, Bell J. The impact of tampon use on the vaginal microbiota across four menstrual cycles. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2018.10.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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10
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McKee K, Robotin M, George J. P37 An integrated approach to viral hepatitis management in the community: tackling hepatitis B and C using a model of shared care. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30778-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Nordin S, McKee K, Wallinder M, von Koch L, Wijk H, Elf M. ENVIRONMENTAL DESIGN, ACTIVITY AND INTERACTION IN CARE FACILITIES FOR OLDER PEOPLE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S. Nordin
- Department of Education, Health and Society, Dalarna University, Falun, Sweden,
- Karolinska Institutet, Stockholm, Sweden,
| | - K. McKee
- Department of Education, Health and Society, Dalarna University, Falun, Sweden,
| | - M. Wallinder
- Department of Education, Health and Society, Dalarna University, Falun, Sweden,
| | | | - H. Wijk
- Gothenburg University, Gothenburg, Sweden
| | - M. Elf
- Department of Education, Health and Society, Dalarna University, Falun, Sweden,
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Scharler UM, Ulanowicz RE, Fogel ML, Wooller MJ, Jacobson-Meyers ME, Lovelock CE, Feller IC, Frischer M, Lee R, McKee K, Romero IC, Schmit JP, Shearer C. Variable nutrient stoichiometry (carbon:nitrogen:phosphorus) across trophic levels determines community and ecosystem properties in an oligotrophic mangrove system. Oecologia 2015; 179:863-76. [DOI: 10.1007/s00442-015-3379-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 06/16/2015] [Indexed: 11/24/2022]
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13
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Vethanayagam N, Orme S, Orrell A, McKee K, Dahlberg L, Marsh H, Harland J, Smith G, Gilhooly M, Parker SG, McGarrigle CA, Hayakawa T, Lawlor BA, Kenny RA, Frewen J, Finucane C, Savva GM, Boyle G, Coen RF, Kenny RA. Neurology and neurosciences. Age Ageing 2013. [DOI: 10.1093/ageing/aft104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Georgiev IS, Doria-Rose NA, Zhou T, Do Kwon Y, Staupe RP, Moquin S, Chuang GY, Louder MK, Schmidt SD, Altae-Tran HR, Bailer RT, McKee K, Nason M, O'Dell S, Ofek G, Pancera M, Srivatsan S, Shapiro L, Connors M, Migueles SA, Morris L, Nishimura Y, Martin MA, Mascola JR, Kwong PD. Delineating Antibody Recognition in Polyclonal Sera from Patterns of HIV-1 Isolate Neutralization. Science 2013; 340:751-6. [DOI: 10.1126/science.1233989] [Citation(s) in RCA: 181] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Chakrabarti BK, Yu F, McKee K, Labranche C, Montefiori D, Mascola JR, Wyatt RT. Priming with DNA encoding functional trimers and boosting with soluble trimeric protein elicited tier 2 neutralizing antibodies in non-human primates. Retrovirology 2012. [PMCID: PMC3441727 DOI: 10.1186/1742-4690-9-s2-p314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Longo NS, Doria-Rose N, McKee K, O'Dell S, Louder MK, Yang Z, Bailer R, Mascola JR. Isolation of broadly neutralizing HIV-1 antibodies from high-throughput single B cell culture. Retrovirology 2012. [PMCID: PMC3442081 DOI: 10.1186/1742-4690-9-s2-p91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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17
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Mok T, Park K, Geater S, Agarwal S, Han M, Credi M, McKee K, Kuriyama N, Slichenmyer W, Tan E. A Randomized Phase (PH) 2 Study with Exploratory Biomarker Analysis of Ficlatuzumab (F) A Humanized Hepatocyte Growth Factor (HGF) Inhibitory MAB in Combination with Gefitinib (G) Versus G in Asian Patients (PTS) with Lung Adenocarcinoma (LA). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33782-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Tan E, Park K, Lim WT, Ahn M, Ng QS, Ahn JS, Tan DS, Sun J, Jac J, Han M, Payumo FC, Credi M, McKee K, Cotreau MM, Bhargava P, Slichenmyer W. Phase Ib study of ficlatuzumab (formerly AV-299), an anti-hepatocyte growth factor (HGF) monoclonal antibody (MAb) in combination with gefitinib (G) in Asian patients (pts) with NSCLC. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.7571] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Mok T, Tan E, Park K, Jac J, Han M, Payumo FC, Credi M, McKee K, Cotreau MM, Bhargava P, Slichenmyer W. Randomized phase II study of ficlatuzumab (formerly AV-299), an anti-hepatocyte growth factor (HGF) monoclonal antibody (MAb) in combination with gefitinib (G) in Asian patients (pts) with NSCLC. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.tps213] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Yardley L, Beyer N, Hauer K, McKee K, Ballinger C, Todd C. Recommendations for promoting the engagement of older people in activities to prevent falls. Qual Saf Health Care 2007; 16:230-4. [PMID: 17545352 PMCID: PMC2464993 DOI: 10.1136/qshc.2006.019802] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To develop recommendations for promoting uptake of and adherence to falls-prevention interventions among older people. DESIGN The recommendations were initially developed from literature review, clinical experience of the core group members, and substantial qualitative and quantitative studies of older people's views. They were refined through a consultation process with members of the falls-prevention community, drawing on Delphi survey and nominal group techniques. Transparency was enhanced by recording and reporting aspects of the iterative consultation process such as the degree of consensus and critical comments on drafts of the recommendations. SETTING The recommendations were developed and refined at three meetings of the core group, and through internet-based consultation and two meetings involving members of the wider falls-prevention community. PARTICIPANTS The authors developed the recommendations incorporating the feedback from the researchers and practitioners responding to a broad-based internet consultation and consulted in the meetings. RESULTS A high degree of consensus was achieved. Recommendations addressed the need for public education, ensuring that interventions were compatible with a positive identity, tailoring interventions to the specific situation and values of the individual, and using validated methods to maintain longer-term adherence. CONCLUSION These recommendations represent a consensus based on current knowledge and evidence, but the evidence base from which these recommendations were developed was limited, and not always specific to prevention of falls. To increase the effectiveness of falls-prevention interventions, further research is needed to identify the features of falls-prevention programmes that will encourage older people's engagement in them.
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Affiliation(s)
- L Yardley
- University of Southampton, Southampton, Hants, UK.
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Wargovich MJ, Jimenez A, McKee K, Steele VE, Velasco M, Woods J, Price R, Gray K, Kelloff GJ. Efficacy of potential chemopreventive agents on rat colon aberrant crypt formation and progression. Carcinogenesis 2000. [PMID: 10837003 DOI: 10.1093/carcin/21.6.1149] [Citation(s) in RCA: 178] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We assessed the effects of 78 potential chemopreventive agents in the F344 rat using two assays in which the inhibition of carcinogen-induced aberrant crypt foci (ACF) in the colon was the measure of efficacy. In both assays ACF were induced by the carcinogen azoxymethane (AOM) in F344 rats by two sequential weekly injections at a dose of 15 mg/kg. Two weeks after the last AOM injection, animals were evaluated for the number of aberrant crypts detected in methylene blue stained whole mounts of rat colon. In the initiation phase protocol agents were given during the period of AOM administration, whereas in the post-initiation assay the chemopreventive agent was introduced during the last 4 weeks of an 8 week assay, a time when ACF had progressed to multiple crypt clusters. The agents were derived from a priority listing based on reports of chemopreventive activity in the literature and/or efficacy data from in vitro models of carcinogenesis. During the initiation phase carboxyl amidoimidazole, p-chlorphenylacetate, chlorpheniramine maleate, D609, diclofenac, etoperidone, eicosatetraynoic acid, farnesol, ferulic acid, lycopene, meclizine, methionine, phenylhexylisothiocyanate, phenylbutyrate, piroxicam, 9-cis-retinoic acid, S-allylcysteine, taurine, tetracycline and verapamil were strong inhibitors of ACF. During the post-initiation phase aspirin, calcium glucarate, ketoprofen, piroxicam, 9-cis-retinoic acid, retinol and rutin inhibited the outgrowth of ACF into multiple crypt clusters. Based on these data, certain phytochemicals, antihistamines, non-steroidal anti-inflammatory drugs and retinoids show unique preclinical promise for chemoprevention of colon cancer, with the latter two drug classes particularly effective in the post-initiation phase of carcinogenesis.
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Affiliation(s)
- M J Wargovich
- Division of Basic Research, South Carolina Cancer Center, Columbia, SC 29203, USA.
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Howe A, Bath P, Goudie F, Lothian K, McKee K, Newton P, Philp I, Rowse G, Seymour J, Sivakumar V. Getting the questions right: an example of loss of validity during transfer of a brief screening approach for depression in the elderly. Int J Geriatr Psychiatry 2000; 15:650-5. [PMID: 10918347 DOI: 10.1002/1099-1166(200007)15:7<650::aid-gps186>3.0.co;2-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Screening for depression in the elderly has been advocated to improve detection and management. This article summarises the trend towards briefer screening instruments, and the integration of mental health screening with other assessments. The study aimed to validate a single question depression screen which has previously shown adequate sensitivity and specificity in a new context: a multi-faceted assessment instrument used by nurse practitioners within a community sample of over 75 year olds. The GMS-AGECAT computerised interview assessment was used as a 'gold standard' to determine the accuracy of the depression question in this new setting. Three hundred and twenty-eight patients were screened by their own nurse practitioners, of whom 100 consenting patients underwent a further interview with a research assistant using the GMS-AGECAT. The prevalence of depression was 30%, the sensitivity of the question was 67%, and its specificity 60% (compared with 88% and 71% previously). Responses indicating disability and loneliness were more closely correlated with depression than the depression screen itself. Relevant factors may include: the derivation of the question, the effect of a different sample, altered reliability when used by multiple interviewers, differing patient expectations, and the wording and context of the question within the multi-faceted screening instrument. Depression screening questions need repeated validation when used in different contexts. Patient and staff expectations may influence how screening instruments are used in practice in a way that may also alter reliability. Further studies are needed to establish the causes of loss of validity when screening approaches are used in new settings.
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Affiliation(s)
- A Howe
- DEPSCOPE Validation Study Group, University of Sheffield, UK.
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McKee K. Thick hearted: idiopathic hypertrophic subaortic stenosis is known to place individuals at increased risk of sudden cardiac death--a case report. Aviat Space Environ Med 2000; 71:81-2. [PMID: 10632136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
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O'Toole AJ, Deffenbacher KA, Valentin D, McKee K, Huff D, Abdi H. The perception of face gender: the role of stimulus structure in recognition and classification. Mem Cognit 1998; 26:146-60. [PMID: 9519705 DOI: 10.3758/bf03211378] [Citation(s) in RCA: 137] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The perception of face gender was examined in the context of extending "face space" models of human face representations to include the perceptual categories defined by male and female faces. We collected data on the recognizability, gender classifiability (reaction time to classify a face as male/female), attractiveness, and masculinity/femininity of individual male and female faces. Factor analyses applied separately to the data for male and female faces yielded the following results. First, for both male and female faces, the recognizability and gender classifiability of faces were independent--a result inconsistent with the hypothesis that both recognizability and gender classifiability depend on a face's "distance" from the subcategory gender prototype. Instead, caricatured aspects of gender (femininity/masculinity ratings) related to the gender classifiability of the faces. Second, facial attractiveness related inversely to face recognizability for male, but not for female, faces--a result that resolves inconsistencies in previous studies. Third, attractiveness and femininity for female faces were nearly equivalent, but attractiveness and masculinity for male faces were not equivalent. Finally, we applied principal component analysis to the pixel-coded face images with the aim of extracting measures related to the gender classifiability and recognizability of individual faces. We incorporated these model-derived measures into the factor analysis with the human rating and performance measures. This combined analysis indicated that face recognizability is related to the distinctiveness of a face with respect to its gender subcategory prototype. Additionally, the gender classifiability of faces related to at least one caricatured aspect of face gender.
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Affiliation(s)
- A J O'Toole
- School of Human Development, University of Texas at Dallas, Richardson 75083-0688, USA.
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26
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Gething L, Wheeler B, Cote J, Furnham A, Hudek-Knezevic J, Kumpf M, McKee K, Rola J, Sellick K. An international validation of the interaction with disabled persons scale. Int J Rehabil Res 1997; 20:149-58. [PMID: 9226498 DOI: 10.1097/00004356-199706000-00004] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The Interaction with Disabled Persons Scale (IDP) was devised to measure attitudes in terms of discomfort reported about social interaction with people with disabilities. The Scale has been used in Australia for ten years. This article reports results of an international validation project that was designed to determine whether psychometric characteristics and norms emerging for Australian groups apply elsewhere. A methodological proforma was developed to maximize uniformity of data collection across nine countries: Australia, Canada, Croatia, England, Germany, Hong Kong, Poland, Scotland and the United States. In most countries the Scale was administered in English; however it also was translated into Germany, Polish, French and Croat. Results indicate that across countries mean scores fell within ten points, similar moderate to high levels of item homogeneity occurred and level of prior contact with people with disabilities emerged as the strongest predictor of IDP scores. It was concluded that the IDP Scale is a valid measure that is able to discriminate between respondents within the countries included in the study.
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Affiliation(s)
- L Gething
- Nursing Research Centre for Adaptation in Health and Illness, University of Sydney, Australia
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27
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Agre P, McKee K, Gargon N, Kurtz RC. Patient satisfaction with an informed consent process. Cancer Pract 1997; 5:162-7. [PMID: 9171552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE This study evaluates patient and family member level of satisfaction with alternative approaches in obtaining informed consent before colonoscopy or upper gastrointestinal endoscopy. DESCRIPTION A convenience sample of 204 endoscopy patients at Memorial Sloan-Kettering cancer Center in new York and 102 of their family members were approached to participate in the study. All patients were 19 years of age or older, able to speak and read English, and mentally competent. After proceeding through the informed consent process using both videotape and physician discussion, participants completed a ten-question survey on their previous informed consent experience and their preferences regarding receiving consent information. RESULTS Overall, participants reported that a combination of videotape and physician explanation was preferred for receiving consent information over either method alone. The participants found that the videotape helped to make the information easier to understand and provided the appropriate amount of information about risks, benefits, and alternatives to the prospective endoscopic procedure. CLINICAL IMPLICATIONS Patient satisfaction should be a factor in determining the best method of providing informed consent information. Because this study indicates that participants are most satisfied with the method of videotape followed by physician discussion, the addition of the videotape to the informed consent process may be beneficial in preparing the participant for a meaningful dialogue with the physician. The use of the videotape also may eliminate the problem of readability of the written document and ensure that all patients receive the same information. With a concerted effort on the part of oncology healthcare providers, including oncologists, nurses, and patient education professionals, this method may hold promise for ensuring the achievement of informed consent in oncology patients.
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Affiliation(s)
- P Agre
- Division of Nursing, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA
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Affiliation(s)
- M J Wargovich
- Department of Gastrointestinal Medical Oncology, University of Texas, M.D. Anderson Cancer Center, Houston 77030, USA
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Jaax N, Jahrling P, Geisbert T, Geisbert J, Steele K, McKee K, Nagley D, Johnson E, Jaax G, Peters C. Transmission of Ebola virus (Zaire strain) to uninfected control monkeys in a biocontainment laboratory. Lancet 1995; 346:1669-71. [PMID: 8551825 DOI: 10.1016/s0140-6736(95)92841-3] [Citation(s) in RCA: 127] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Secondary transmission of Ebola virus infection in humans is known to be caused by direct contact with infected patients or body fluids. We report transmission of Ebola virus (Zaire strain) to two of three control rhesus monkeys (Macaca mulatta) that did not have direct contact with experimentally inoculated monkeys held in the same room. The two control monkeys died from Ebola virus infections at 10 and 11 days after the last experimentally inoculated monkey had died. The most likely route of infection of the control monkeys was aerosol, oral or conjunctival exposure to virus-laden droplets secreted or excreted from the experimentally inoculated monkeys. These observations suggest approaches to the study of routes of transmission to and among humans.
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Affiliation(s)
- N Jaax
- United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland 21702-5011, USA
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Abstract
This paper begins by reviewing the small number of studies of staff nurses' work satisfaction. Subsequently, an examination is made of the differences in work satisfaction between staff nurses and other grades of nursing staff in psychogeriatric wards in National Health Service hospitals in Scotland. These data are part of a larger study into work satisfaction and the quality of care in these settings. Significant differences in satisfaction at work are identified between the staff nurse group and the other grades taken as a whole. Analysis of the components of job satisfaction suggests that these differences arise from: first, the experience of the work itself; second, the quality of the supervision which takes place; and third, the assessment of hospital policies, such as the transfer of staff to other wards.
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Abstract
In 1990 a symposium was held by the American College of Obstetricians and Gynecologists and the National Abortion Federation to address the national shortage of physician abortion providers. One symposium recommendation was that nurse-midwives be trained to perform first-trimester legal abortions under physician supervision. A national mail survey was conducted to determine the attitudes of nurse-midwives toward performing abortion and related procedures. One-half of the nurse-midwives who were members of the American College of Nurse-Midwives as of October 1991 were polled, and 1,208 questionnaires (71.1%) were returned, resulting in a sample representative of the general membership and students. Seventy-nine percent of respondents would not support federal and state efforts to limit access to abortion, 52% would or possibly would vote in a secret ballot to permit the performance of abortion by certified nurse-midwives; 24% would, or possibly would, incorporate abortion procedures into their practice; and 19% would, or possibly would, perform abortions in an abortion clinic. The lowest level of support to permit the certified nurse-midwife practice of abortion came from the midwest (31%) and southeast (41%) and the greatest from the west coast (65%). Supporters for the nurse-midwife performance of abortion were more likely to have practiced well-woman gynecology and provided abortion-related services such as abortion referrals, pre- and postabortion workups and the treatment of abortion-related complications. They were more likely to have inserted intrauterine contraceptive devices and laminaria, and to have performed circumcision. Opinions about the performance of abortion were not related to age, education, or student status. The majority of nurse-midwives (91%) would be willing to refer a woman to another provider for an abortion, prescribe RU 486 (57%), and perform dilation and curettage for spontaneous abortion (56%). The American College of Nurse-Midwives membership reported many different reasons for support of and opposition to professional involvement with abortion. Further research suggestions for institutional policy and individual practice are offered.
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Affiliation(s)
- K McKee
- The BirthPlace, San Diego, CA 92103
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Abstract
The chemical score is a measure of the predicted metabolic usefulness of a protein in a food based on the comparison (ratio or percentage) of the concentrations of the essential amino acids (EAAs) to a "profile" assumed to reflect the true needs of the body. The score for the limiting EAA is taken to represent the value of the food. Such a chemical score is particularly useful for therapeutic diets where bioassay (such as nitrogen-balance studies) in a large number of patients may be unethical or impractical. Although a major limitation to the chemical-score method previously was scarcity and/or imprecision of data about EAA concentrations in foods, this situation has been mitigated by modern analytic methods. The validity of a chemical score is also exquisitely sensitive to the EAA profile used for comparison. Chemical scores published for a variety of enteral and parenteral feeding products implied a low (approximately 50%) protein value. These computations were based on the EAA profile of egg protein. This pattern is sufficient, in most cases, for body needs, but it may be far more than is necessary. Recently published profiles, based on measurements in human beings of actual protein and EAA requirements, point to a more realistic chemical-score computation. These profiles accommodate age and lifestyle factors and provide greater flexibility in the formulation of therapeutic diets.
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Affiliation(s)
- S Dubin
- Biomedical Engineering and Science Institute, Drexel University, Philadelphia, PA 19104
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Abstract
This paper discusses the way in which quality of care has been measured and in particular draws attention to the vagueness of concepts such as autonomy, individuality and dignity. In our research we have put forward a number of indicators for the quality of care received by patients and, in addition, we have constructed a method by which they can be measured, through the use of standardized observation schedules. This paper therefore describes our indicators and the data collection process followed. This aspect of our work is part of a larger study into work satisfaction and quality of care in psychogeriatric wards in Scotland. Ultimately, the data will allow us to identify factors affecting high and low levels of job satisfaction as well as factors influencing good and bad quality of care. Further, we will be able to examine any association between work satisfaction and the quality of care delivered to patients. The results of this research are due to be published shortly.
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Affiliation(s)
- A J Gilloran
- Department of Applied Social Science, University of Stirling, Scotland
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Tagari P, Chee P, Chan C, McKee K, Black C, Nicholson D, Ford-Hutchinson AW. Quantitation of eosinophil Major Basic Protein cytotoxicity to rodent respiratory epithelium. Agents Actions 1992; 37:171-3. [PMID: 1295362 DOI: 10.1007/bf02028100] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Eosinophil Major Basic Protein (MBP) may be a potent effector in damaging airway epithelium and inducing acute (2-3 h) hyperresponsiveness to agonists in primates. Accordingly, interactions between human eosinophil MBP and guinea-pig airway epithelium were quantitated biochemically. MBP was extracted from human eosinophils and purified by size-exclusion HPLC. This resulted in a single protein band on electrophoresis, which cross-reacted with antisera raised to peptides derived from the predicted sequence of human MBP. This human MBP caused modest, but statistically significant, damage to respiratory epithelium (16.4% increase in efflux of 51Cr from guinea-pig tracheal rings) after 3 h of incubation with 10(-4) M concentration, but not with lower concentrations. These data demonstrates that MBP cytotoxicity to intact epithelium can be rapidly measured in vitro, and suggests that rodent airway epithelium may be relatively resistant to the cytotoxic effects of MBP.
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Affiliation(s)
- P Tagari
- Department of Pharmacology, Merck Frosst Institute for Therapeutic Research, Pointe Claire-Dorval, Quebec, Canada
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Sjogren MH, Purcell RH, McKee K, Binn L, Macarthy P, Ticehurst J, Feinstone S, Caudill J, See A, Hoke C. Clinical and laboratory observations following oral or intramuscular administration of a live attenuated hepatitis A vaccine candidate. Vaccine 1992; 10 Suppl 1:S135-7. [PMID: 1335645 DOI: 10.1016/0264-410x(92)90568-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Clinical observations made after immunising volunteers with a live attenuated hepatitis A vaccine are described. The candidate vaccine was prepared with the HM175 strain of hepatitis A virus and shown to be safe, immunogenic and efficacious in experimental animals. When the candidate vaccine was tested by oral administration in humans at increasing doses--10(4), 10(5), 10(6) and 10(7) median tissue culture infective doses (TCID50)--an antibody response was not observed at any dose. Volunteers who received similar doses by the intramuscular route developed antibody to hepatitis A three weeks after immunization with 10(6) or 10(7) TCID50. The antibody response was sustained for the 12 weeks of the observation period. All volunteers remained healthy with normal results from liver tests throughout the monitoring period. Further clinical observations of this product are in progress.
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Affiliation(s)
- M H Sjogren
- Division of Medicine, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702
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Foberg U, Frydén A, Isaksson B, Jahrling P, Johnson A, McKee K, Niklasson B, Normann B, Peters C, Bengtsson M. Viral haemorrhagic fever in Sweden: experiences from management of a case. Scand J Infect Dis 1991; 23:143-51. [PMID: 1853161 DOI: 10.3109/00365549109023392] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The first recognized case in Scandinavia with potential man to man transmission of viral haemorrhagic fever occurred in Linköping, Sweden, in January 1990. Following a visit to Kenya a 21-year-old male student suffered a very severe illness including extremely prolonged high grade fever, rash, disseminated intravascular coagulation with thrombocytopenia and severe bleedings. This necessitated one month of intensive care support including respirator treatment. The patient was discharged after 2 1/2 months in good condition, with a partial femoral nerve paresis. About 100 medical personnel were exposed to aerosol or blood before a strict containment regimen was established. No secondary cases occurred.
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Affiliation(s)
- U Foberg
- Department of Infectious Diseases, Faculty of Health Sciences, University Hospital, Linköping, Sweden
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Tulp OL, Hansen CT, McKee K, Michaelis OE. Effects of diet and phenotype on adipose cellularity and 5'-deiodinase activity of liver and brown adipose tissue of diabetic SHR/N-cp rats. Comp Biochem Physiol A Comp Physiol 1991; 99:457-62. [PMID: 1678339 DOI: 10.1016/0300-9629(91)90033-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
1. Groups of lean and obese male SHR/N-cp rats were fed isoenergetic diets containing 54% carbohydrate as cornstarch (CS) or sucrose (SU) plus other nutrients from 5 weeks of age, and measures of adiposity, thyroxine 5' deiodinase (T4-5'DI) activity, and tissue and plasma triiodothyronine (T3) content determined at 9.5 months of age. 2. Body weights (BW) of obese greater than lean, and were greater when fed the SU than CS diet in both phenotypes. Phenotype effects (obese greater than lean) were present for fat pad weights and adipose cellularity in most primary adipose tissue depots, and diet effects (SU greater than CS) were present for epididymal and retroperitoneal depots in both phenotypes. 3. Interscapular brown adipose tissue (IBAT) and IBAT:BW ratios of obese greater than lean, and diet effects (SU greater than CS) were present for lean but not obese rats. Liver T4-5'DI activity and plasma and tissue T3 of lean greater than obese, while IBAT 5'DI activity of obese greater than lean in the CS diet. 4. These results indicate that obesity occurs in the SHR/N-cp rat as the result of hypertrophy and hyperplasia of adipose tissue, and that isoenergetic substitution of simple for complex carbohydrate exaggerates fat accretion in lean but not obese rats. Moreover, the obesity occurs in spite of greater mass, cellularity, and T4-5'DI activity of IBAT, consistent with a thermogenic defect in the obese phenotype of this strain.
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Affiliation(s)
- O L Tulp
- Department of Nutrition and Food Sciences, Drexel University, Philadelphia, PA 19104
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Chan CC, McKee K, Tagari P, Chee P, Ford-Hutchinson A. Eosinophil-eicosanoid interactions: inhibition of eosinophil chemotaxis in vivo by a LTD4-receptor antagonist. Eur J Pharmacol 1990; 191:273-80. [PMID: 1964905 DOI: 10.1016/0014-2999(90)94159-u] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Chemotaxis of guinea-pig eosinophils in vivo has been studied in the guinea-pig conjunctiva. Guinea-pig eosinophils were labelled with 111In oxine and injected i.v. into recipient animals. Circulating radioactivity remained constant over a period of 4 h but dropped transiently in response to a bolus injection (1 nmol) of platelet activating factor (PAF), suggesting that the 111In-labelled eosinophils had retained their responsiveness to PAF. Leukotriene D4 (LTD4, 1 nmol/eye) and PAF (10 nmol/eye), but not histamine (5 nmol/eye), induced a significant 2.5-fold increase in conjunctival radioactivity, a measure of eosinophil chemotaxis in vivo, after 17 h. Antigen challenge (250 micrograms/eye) in ovalbumin-sensitized animals produced larger responses (8-fold increases) at the same time point. A specific LTD4 receptor antagonist MK-571 (10 micrograms/eye) completely inhibited in vivo chemotactic responses to LTD4, and partially inhibited (54%) the responses to ovalbumin (observations subsequently confirmed by histological studies). As eosinophils may play an important role in allergic diseases, the results with MK-571 indicate that selective and potent LTD4 receptor antagonists may provide a novel therapy for allergic conjunctivitis, rhinitis and asthma.
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Affiliation(s)
- C C Chan
- Department of Pharmacology, Merck Frosst Centre for Therapeutic Research, Pointe-Claire/Dorval, Quebec, Canada
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Nichols BL, McKee K, Putman M, Henry JF, Nichols VN. Human lactoferrin supplementation of infant formulas increases thymidine incorporation into the DNA of rat crypt cells. J Pediatr Gastroenterol Nutr 1989; 8:102-9. [PMID: 2732854 DOI: 10.1097/00005176-198901000-00019] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Lactoferrin has been identified as the factor in human colostrum that accounts for the increased incorporation of thymidine into DNA in a rat crypt enterocyte bioassay. Commercially available infant formulas used in the refeeding of infants who have severe dietary intolerance associated with mucosal atrophy were tested in this bioassay. In contrast to human milk, no stimulation was observed with these formulas in the assay. All formulas inhibited basal thymidine incorporation. The degree of inhibition of the basal assay progressed from 14% with cow's-milk formula to 30% with soy-based formulas to 45% with hydrolyzed casein formulas. When the formulas were supplemented with lactoferrin to match the level of that in human milk, the result was a 35% relative increase in thymidine incorporation into DNA. The quantitative level of response was primarily influenced by the baseline inhibitions associated with the specific formulas. The most profound effect was observed with the hydrolyzed casein formula, when lactoferrin supplementation reversed the baseline inhibition but did not result in a response greater than that seen in control basal bioassays. The supplementation of infant formulas with lactoferrin improved the thymidine incorporation in rat crypt enterocytes; a response equivalent to that of human milk, however, would require a redesign of other formula components to reduce basal inhibition.
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Affiliation(s)
- B L Nichols
- U.S. Department of Agriculture, Children's Nutrition Research Center, Houston, TX 77030
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Abstract
The incidence of Pneumocystis carinii infection of the lung was determined in 100 consecutive autopsies on patients with hematologic malignancies and in a control group of 50 patients with acute myocardial infarction and chronic obstructive pulmonary disease. Thirteen instances of infection were found in the study group and one instance in the control group. Of the 14 patients with P. carinii infection, five were classified as uncomplicated P. carinii pneumonia with typical host response and five had no evidence of any host response to the presence of the organisms. Four cases were impossible to assess because of complicating bacterial, viral, or fungal pneumonia. The five patients with the typical histologic response to the presence of P. carinii organisms all showed diffuse pulmonary densities on the chest radiographs in accordance with the classic descriptions of P. carinii pneumonia. The five without any evidence of host response to the presence of P. carinii organisms showed no evidence of parenchymal disease on chest radiographs. The finding of P. carinii organisms in the lung is not necessarily an indication of clinically significant disease and, from this study, it seems that chest radiography is of considerable importance in determining the significance of such infestation.
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McKee K. Neurotic bodily pain in children. Am J Nurs 1970; 70:130-1. [PMID: 5196144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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