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Abstract
Both testosterone (T) and its metabolite, 5alpha-dihydrotestosterone (DHT), can facilitate male sexual behavior in the lizard Anolis carolinensis. The present study addresses the role of DHT synthesis in regulating male sexual behavior by inhibiting 5alpha-reductase, the enzyme that converts T into DHT. In two separate experiments (one replacement and one maintenance paradigm), breeding adult males were castrated and implanted with capsules of T, DHT, or a control capsule (blank, BL). The animals were then injected with the 5alpha-reductase inhibitor, FCE, or with steroid suspending vehicle (SSV) as a control. Both experiments produced similar results. Overall, T was most effective in eliciting courtship and copulatory behaviors above control levels. In both experiments, treatment with FCE attenuated the T-induced effects on courtship behavior, whereas the inhibition of 5alpha-reductase activity resulted in modest and inconsistent effects on the latency to intromission and the proportion of copulating males. DHT treatment did not significantly increase courtship or copulatory behaviors above control levels. These results suggest that (a) 5alpha-reductase activity is necessary but that DHT alone is not sufficient for stimulating courtship in male A. carolinensis; and (b) courtship behavior is more sensitive than copulatory behavior to the activity of the androgen metabolizing enzyme.
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Vidal-Puig AJ, Grujic D, Zhang CY, Hagen T, Boss O, Ido Y, Szczepanik A, Wade J, Mootha V, Cortright R, Muoio DM, Lowell BB. Energy metabolism in uncoupling protein 3 gene knockout mice. J Biol Chem 2000; 275:16258-66. [PMID: 10748196 DOI: 10.1074/jbc.m910179199] [Citation(s) in RCA: 501] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Uncoupling protein 3 (UCP3) is a member of the mitochondrial anion carrier superfamily. Based upon its high homology with UCP1 and its restricted tissue distribution to skeletal muscle and brown adipose tissue, UCP3 has been suggested to play important roles in regulating energy expenditure, body weight, and thermoregulation. Other postulated roles for UCP3 include regulation of fatty acid metabolism, adaptive responses to acute exercise and starvation, and prevention of reactive oxygen species (ROS) formation. To address these questions, we have generated mice lacking UCP3 (UCP3 knockout (KO) mice). Here, we provide evidence that skeletal muscle mitochondria lacking UCP3 are more coupled (i.e. increased state 3/state 4 ratio), indicating that UCP3 has uncoupling activity. In addition, production of ROS is increased in mitochondria lacking UCP3. This study demonstrates that UCP3 has uncoupling activity and that its absence may lead to increased production of ROS. Despite these effects on mitochondrial function, UCP3 does not seem to be required for body weight regulation, exercise tolerance, fatty acid oxidation, or cold-induced thermogenesis. The absence of such phenotypes in UCP3 KO mice could not be attributed to up-regulation of other UCP mRNAs. However, alternative compensatory mechanisms cannot be excluded. The consequence of increased mitochondrial coupling in UCP3 KO mice on metabolism and the possible role of yet unidentified compensatory mechanisms, remains to be determined.
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MacDonald KS, Fowke KR, Kimani J, Dunand VA, Nagelkerke NJ, Ball TB, Oyugi J, Njagi E, Gaur LK, Brunham RC, Wade J, Luscher MA, Krausa P, Rowland-Jones S, Ngugi E, Bwayo JJ, Plummer FA. Influence of HLA supertypes on susceptibility and resistance to human immunodeficiency virus type 1 infection. J Infect Dis 2000; 181:1581-9. [PMID: 10823757 DOI: 10.1086/315472] [Citation(s) in RCA: 183] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/1999] [Revised: 01/26/2000] [Indexed: 11/03/2022] Open
Abstract
Certain human leukocyte antigens, by presenting conserved immunogenic epitopes for T cell recognition, may, in part, account for the observed differences in human immunodeficiency virus type 1 (HIV-1) susceptibility. To determine whether HLA polymorphism influences HIV-1 susceptibility, a longitudinal cohort of highly HIV-1-exposed female sex workers based in Nairobi, Kenya, was prospectively analyzed. Decreased HIV-1 infection risk was strongly associated with possession of a cluster of closely related HLA alleles (A2/6802 supertype; incidence rate ratio [IRR], 0.45; 95% confidence interval [CI], 0.27-0.72; P=.0003). The alleles in this supertype are known in some cases to present the same peptide epitopes for T cell recognition. In addition, resistance to HIV-1 infection was independently associated with HLA DRB1*01 (IRR, 0.22; 95% CI, 0.06-0.60; P=.0003), which suggests that anti-HIV-1 class II restricted CD4 effector mechanisms may play an important role in protecting against viral challenge. These data provide further evidence that resistance to HIV-1 infection in this cohort of sex workers is immunologically mediated.
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Abstract
The neural song system in zebra finches develops for approximately the first 2 months after hatching. During that time, male-biased sexual dimorphisms emerge in the volume of song control nuclei as well as in the number and size of neurons within them. Brain derived neurotrophic factor (BDNF) has been documented in song control nuclei at various stages of development. Its high affinity receptor (tyrosine kinase B; trkB) is also in the song system, at least at around I month of age. The present study was designed to more completely describe the timing and potential location of BDNF action by investigating trkB expression during sexual differentiation of the song control nuclei. The pattern of immunoreactivity to a trkB antibody was examined in male and female zebra finches at post-hatching days 3-60. Labeling in somata and neuropil appeared to define the telencephalic components of the motor pathway (high vocal center and robust nucleus of the archistriatum) for song production in males from days 30 to 60, and in females on days 45 and 60 (high vocal center). These results are consistent with the hypothesis that the receptor, and its ligand BDNF, play a role in processes related to song learning in both sexes, including perhaps the motor component exhibited by developing males.
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O'Bryant EL, Wade J. Arborization of dewlap motoneurons in the green anole lizard (Anolis carolinensis) is not sexually dimorphic. Neurosci Lett 2000; 281:115-8. [PMID: 10704756 DOI: 10.1016/s0304-3940(00)00858-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Male anoles extend a bright red throat fan, called a dewlap, during both courtship and aggressive encounters. Female anoles perform this behavior less often than males and only in aggression towards both sexes. The cartilage, muscle fibers, and motoneuron somata controlling the display are larger in males than females. In the present study, we used the Golgi technique in an effort to characterize more completely the morphology of these dewlap motoneurons, and to investigate whether the dendritic arborization is different between the sexes. In addition to describing the morphology, we report that the length of processes, and numbers of primary processes and branch points are comparable in males and females. This similarity in arborization represents an intriguing contrast to other sexually dimorphic neuromuscular systems.
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Rogers MR, Hoffman MA, Wade J. Notable multicultural training in APA-approved counseling psychology and school psychology programs. CULTURAL DIVERSITY AND MENTAL HEALTH 2000; 4:212-26. [PMID: 9713161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
On the basis of the initial work of M.R. Rogers, J. Martin, and L. Druckman (1994) regarding exemplary multicultural training occurring at school psychology programs, the authors examined salient aspects of 5 American Psychological Association (APA)-approved counseling psychology and 5 APA-approved school psychology programs nominated for their reputation for multicultural training. Twenty-two percent of the program faculty represented a racial-ethnic minority group, at least 2 faculty members per program were involved in multicultural teaching, and 90% of the programs offered a multicultural course. Program faculty at the notable programs were actively involved in relevant research, routinely made presentations at national conferences regarding their scholarship, regularly participated in campuswide multicultural committees, and generally reported their university training environment to be supportive of multicultural issues.
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Desai N, Philpott-Howard J, Wade J, Casewell M. Infection control training: evaluation of a computer-assisted learning package. J Hosp Infect 2000; 44:193-9. [PMID: 10706802 DOI: 10.1053/jhin.1999.0673] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
An evaluation of the training module of an interactive infection control computer-assisted learning (CAL) software program was carried out with ward-based nurses, third-year medical students and infection control personnel. All nursing staff, 87% of the medical students and all infection control staff found the programme easy and enjoyable to use. The module was accessed 3101 times on the hospital network in 18 months with usage settling to between 100-150 times per month. There was a higher level of use by night-duty and weekend staff. Medical students gained as much infection control knowledge from using the CAL package (increase in correct responses from 63.5% to 83.4%;P<0.0001) as they did from a formal lecture (increase in correct responses from 62.1% to 79.5%;P<0.0001). We conclude the training module which is accessible on the hospital wards and across the academic network, is a convenient and effective way for staff and students to gain a basic understanding in evidence-based infection control practices, at locations and times suitable for them.
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Heeb S, Itoh Y, Nishijyo T, Schnider U, Keel C, Wade J, Walsh U, O'Gara F, Haas D. Small, stable shuttle vectors based on the minimal pVS1 replicon for use in gram-negative, plant-associated bacteria. MOLECULAR PLANT-MICROBE INTERACTIONS : MPMI 2000; 13:232-7. [PMID: 10659714 DOI: 10.1094/mpmi.2000.13.2.232] [Citation(s) in RCA: 269] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The minimal replicon of the Pseudomonas plasmid pVS1 was genetically defined and combined with the Escherichia coli p15A replicon, to provide a series of new, oligocopy cloning vectors (5.3 to 8.3 kb). Recombinant plasmids derived from these vectors were stable in growing and nongrowing cells of root-colonizing P. fluorescens strains incubated under different environmental conditions for more than 1 month.
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Wade J, Pletsch PK, Morgan SW, Menting SA. Hysterectomy: what do women need and want to know? J Obstet Gynecol Neonatal Nurs 2000; 29:33-42. [PMID: 10660275 DOI: 10.1111/j.1552-6909.2000.tb02754.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The purpose of this article is to describe women's experiences of hysterectomy and to identify their fears, concerns, and met as well as unmet health care needs. DESIGN Narrative data of women's hysterectomy experiences were collected via a written survey. SETTING Data were collected from women living in southeastern Wisconsin. PARTICIPANTS Participants were 102 women who had undergone hysterectomy within the previous 2 years. The mean age of the women was 43 and mean time since hysterectomy was 13 months. Eighty percent of the women had undergone both hysterectomy and oophorectomy, and 78% were taking hormone replacement therapy. MAIN OUTCOME MEASURES A questionnaire of women's hysterectomy needs and a demographic questionnaire were used to collect data via mail. The data from three open-ended questions were content analyzed. RESULTS Seven themes about women's experiences of hysterectomy were identified: (a) positive aspects, (b) hormone replacement therapy, (c) insufficient information, (d) changes in sexual feelings and functioning, (e) emotional support, (f) psychologic sequelae, and (g) feelings of loss. CONCLUSIONS Women wanted treatment choices, a part in decision-making, accurate and useful information at an appropriate time, provider support, and access to professional and lay support systems. The essentials for hysterectomy care are outlined and include the characteristics of care that women desire, the informational content that women want, health care systems that support patient satisfaction, and the outcomes women want.
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Wade J, Swender DA, McElhinny TL. Sexual differentiation of the zebra finch song system parallels genetic, not gonadal, sex. Horm Behav 1999; 36:141-52. [PMID: 10506538 DOI: 10.1006/hbeh.1999.1537] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Mechanisms regulating sexual differentiation of the zebra finch song system present an intriguing puzzle. Masculine development of brain regions and behavior can be induced in genetic females by posthatching estradiol treatment. That result is consistent with the hypothesis that estradiol, converted within the brain from testicular androgen via the aromatase enzyme, masculinizes neural structure and function. In contrast, treatment during specific stages of development with the aromatase inhibitor Fadrozole has not prevented masculine development, and the presence of testicular tissue in genetic females did not induce masculine organization of neuroanatomy or singing behavior. Fadrozole treatments in those previous studies were limited, however, and most genetic females had both ovarian and testicular tissue. The present experiments were designed to provide increased aromatase inhibition and to reliably produce genetic females with only testicular tissue. Eggs received a single injection at a later age or with higher doses of Fadrozole than had been used previously. Some embryos were exposed to Fadrozole more frequently by either injecting eggs on 2 days of development or dipping them for 10-12 days in Fadrozole. Finally, in some individuals from Fadrozole-treated eggs, the left gonad was removed, leaving each genetic male and female with a single right testis. None of these treatments significantly affected development of the song system compared to appropriate control groups. These results suggest that sexual differentiation of the zebra finch song system is not regulated by embryonic aromatase activity or by gonadal secretions and instead involves events that need not be mediated by steroid hormones.
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Geddes CC, Cole E, Wade J, Cattran D, Fenton S, Robinette M, Stewart R, Hemming A, Cattral M, Garcia A, Cardella CJ. Factors influencing long-term primary cadaveric kidney transplantation--importance of functional renal mass versus avoidance of acute rejections--the Toronto Hospital experience 1985-1997. CLINICAL TRANSPLANTS 1999:195-203. [PMID: 10503098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
1. The 5-year actuarial graft, patient and functional graft survival rates were analyzed in 743 consecutive primary cadaveric kidney transplants from The Toronto Hospital between January 1985-December 1997. 2. Recipient age > or = 55 years, male recipient sex, recipient diabetes mellitus, CIT > 36 hours and delayed graft function were found to significantly decrease patient survival. 3. Recipient age > or = 55 years, sensitization to HLA antigens (peak PRA > 50%), donor/recipient HLA antigen mismatches, CIT > 36 hours, delayed graft, function and 6-month SCr > 200 mumol/L were found to significantly decrease graft survival. 4. Acute rejection episodes had no significant impact on overall 5-year patient or graft survival. 5. The observation that serum creatinine > 200 mumol/L had a major adverse influence on long-term outcome reflects the importance of functional renal mass on graft survival.
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Contreras ML, Wade J. Interactions between nerve growth factor binding and estradiol in early development of the zebra finch telencephalon. JOURNAL OF NEUROBIOLOGY 1999; 40:149-57. [PMID: 10413446 DOI: 10.1002/(sici)1097-4695(199908)40:2<149::aid-neu2>3.0.co;2-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The zebra finch telencephalon exhibits rapid and substantial development in the first few weeks after hatching. In parallel, the rate of estradiol synthesis is very high in the zebra finch forebrain, and estradiol can have potent neurotrophic effects in specific telencephalic regions, including those that control the learning and production of song. In an attempt to elucidate mechanisms regulating telencephalic development, potentially including a role for the large capacity for estrogen production, (125)I-nerve growth factor (NGF) binding was measured in homogenates of telencephalon from zebra finches age 3, 15, 30, 60, and 120 days. The highest density of low- and high-affinity (125)I-NGF binding sites was observed in 3-day-old finches. Using an aromatase inhibitor, Fadrozole, to reduce estradiol levels in 1 to 4-day-old zebra finches significantly decreased both high- and low-affinity (125)I-NGF binding sites. Conversely, treating adult or 8 to 14-day-old hatchlings with estradiol increased high-affinity (125)I-NGF binding sites. These results are consistent with the hypothesis that estradiol influences the level of NGF receptors, and suggest one mechanism through which the steroid could affect brain development. The data also indicate that estradiol and NGF activity may be important for very early development of the telencephalon.
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O'Bryant EL, Wade J. Sexual dimorphisms in a neuromuscular system regulating courtship in the green anole lizard: effects of season and androgen treatment. JOURNAL OF NEUROBIOLOGY 1999; 40:202-13. [PMID: 10413450 DOI: 10.1002/(sici)1097-4695(199908)40:2<202::aid-neu6>3.0.co;2-a] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
During the breeding season, male green anoles (Anolis carolinensis) court females by extending a red throat fan called a dewlap. Motoneurons controlling this sexually dimorphic behavior are located in two portions of the brain stem: (a) the vagal portion of nucleus ambiguus (AmbX), and (b) the region containing the glossopharyngeal portion of nucleus ambiguus and the ventral motor nucleus of the facial nerve (AmbIX/VIImv). These motoneurons project to the ceratohyoideus muscle via the ramus pharyngo-laryngeus IX+X. To investigate the effects of season on and androgen regulation of neural and peripheral structures controlling dewlap extension, two experiments were conducted: (a) During the breeding and nonbreeding seasons, motoneuron number, soma size, and nucleus size were investigated in intact males and females and in castrated males treated with a testosterone propionate (TP) or a blank Silastic capsule. (b) Cross-sectional area of the nerve and muscle fiber size, number, and density were investigated in the four treatment groups during the breeding season only. No significant differences were found in motoneuron number. In the breeding season, subtle male-biased sex differences existed in both AmbX and AmbIX/VIImv soma size. Nerve cross-sectional area and muscle fiber size and number were substantially larger in males than females. Muscle fiber density was higher in females. No consistent effects due to season or androgen treatment were detected, although characteristics of motoneurons were in some cases slightly larger in the nonbreeding season. These results suggest that, while parallels to behavior exist between the sexes, morphological changes in adulthood in the dewlap motoneurons and muscle do not normally regulate courtship behavior in the male green anole.
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Abstract
Ten percent of head injuries quality as "severe," requiring prompt diagnosis and treatment. This level I trauma center uses an aggressive approach to treatment of severe head injuries and, when indicated, intervenes with decompressive craniectomy. This article explains decompressive craniectomy, including indications, procedures, and protocols. The case studies presented highlight two patients with profound head injuries. Additionally, cranioplasty replacement of autograft flap is explained and discussed.
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Romeo RD, Wade J, Venier JE, Sisk CL. Androgenic regulation of hypothalamic aromatase activity in prepubertal and postpubertal male golden hamsters. Endocrinology 1999; 140:112-7. [PMID: 9886814 DOI: 10.1210/endo.140.1.6420] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Doses of testosterone that fully activate male reproductive behavior in castrated adult male hamsters fail to elicit mounting and intromissions in prepubertal castrates, even when circulating levels of testosterone are equivalent in the two age groups. We hypothesize that this differential responsiveness to testosterone is mediated at least in part by the efficacy with which testosterone in the hypothalamus is aromatized to estradiol, an important hormone mediating male sexual behavior. Therefore, hypothalamic aromatase activity, as measured by the conversion of [3H]testosterone to [3H]estradiol in tissue homogenates, was assessed in four separate experiments: 1) intact prepubertal and adult male golden hamsters, 2 and 3) castrated adult or prepubertal males that received either a 0- or 2.5-mg dose of testosterone, and 4) castrated adult and prepubertal males treated with the 2.5-mg dose oftestosterone. These studies demonstrate that hypothalamic aromatase activity is significantly higher in adult males compared with prepubertal males, and that hypothalamic aromatase activity is increased by testosterone to the same extent in both the adult and prepubertal male hamster. Therefore, the failure of testosterone-treated castrated prepubertal male hamsters to engage in the full suite of male reproductive behaviors is not due to the inability of testosterone to be converted into estradiol in the hypothalamus. Differences in the ability of testosterone to increase aromatase activity in other brain regions, or differences in the action of testosterone and/or estradiol on other cellular processes must account for the inability of testosterone to facilitate male reproductive behavior in juvenile males.
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Abstract
OBJECTIVE To evaluate the prevalence of self-reported sleep disturbance and its relationship to mood disturbance in chronic pain patients. DESIGN AND SETTING Survey of patients referred to a multidisciplinary outpatient pain clinic. PATIENTS The sample consisted of 105 consecutive patients (59 men and 46 women), with an average age of 41.5 (SD +/-13.4) years. MEASURES Self-report measures of sleep disturbance and visual analog scales of mood disturbance (anxiety and depression) and pain experience (intensity and unpleasantness). RESULTS Patients were grouped according to whether they considered themselves "poor" (n = 68) or "good" (n = 37) sleepers. Poor sleepers reported more difficulties initiating and maintaining sleep and greater pain intensity and pain unpleasantness than did good sleepers. The two groups did not differ on measures of depressive or anxious mood. CONCLUSION The results suggest that sleep disturbance is a prevalent complaint in chronic pain patients, but it is not always associated with an underlying mood disturbance.
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Arya R, Wade J, Stephens A. An unusual cause of abdominal pain in sickle cell disease. Blood 1998; 92:3477-8. [PMID: 9787192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
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Demetri GD, Kris M, Wade J, Degos L, Cella D. Quality-of-life benefit in chemotherapy patients treated with epoetin alfa is independent of disease response or tumor type: results from a prospective community oncology study. Procrit Study Group. J Clin Oncol 1998; 16:3412-25. [PMID: 9779721 DOI: 10.1200/jco.1998.16.10.3412] [Citation(s) in RCA: 583] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To evaluate prospectively the effectiveness of epoetin alfa as an adjunct to chemotherapy in patients with cancer based on changes in quality-of-life parameters and hemoglobin levels, and to correlate these changes with antitumor response. PATIENTS AND METHODS Two thousand three hundred seventy patients with nonmyeloid malignancies who received chemotherapy were enrolled onto this study from 621 US community-based practices. Patients received epoetin alfa 10,000 U three times weekly, which could be increased to 20,000 U three times weekly depending on the hemoglobin response at 4 weeks. Treatment continued for a maximum of 16 weeks in patients who showed evidence of hematologic response. RESULTS Two thousand two hundred eighty-nine patients (97%) were eligible for efficacy analyses. Epoetin alfa therapy was associated with improved quality-of-life parameters; these improvements correlated significantly with hemoglobin levels and were independent of tumor response. Provider-reported Karnofsky performance scores did not correlate with the improved quality-of-life changes. Epoetin alfa therapy was also associated with a significant increase in hemoglobin levels and decrease in transfusion use. Tumor type, chemotherapy agent/regimen, prior chemotherapy, baseline hemoglobin level, and baseline erythropoietin level were not predictive of a positive response to treatment. Epoetin alfa was well tolerated. CONCLUSION Epoetin alfa appears to have a beneficial impact on patient-reported functional capacity and quality of life in patients with cancer who received chemotherapy independent of tumor response. Concordantly, epoetin alfa appeared to increase hemoglobin levels and decrease transfusion use. Patients responded across all tumor types. The results suggest that epoetin alfa effectively improves functional outcomes in patients with cancer who receive chemotherapy.
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Winkler SM, Wade J. Aromatase activity and regulation of sexual behaviors in the green anole lizard. Physiol Behav 1998; 64:723-31. [PMID: 9817587 DOI: 10.1016/s0031-9384(98)00138-3] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Sexual behaviors in green anoles are regulated by steroid hormones. Androgens activate the display of masculine courtship and copulatory behaviors, and estradiol activates feminine receptivity. Testosterone can also facilitate receptivity in females. The present study was conducted to test the role of converting testosterone to estradiol (aromatization) in the regulation of sexual and aggressive behaviors. Adult males and females were gonadectomized and implanted with a Silastic capsule containing either testosterone propionate (T) or estradiol benzoate (E) or with an empty (blank, BL) capsule. T- and BL-treated animals were then given injections of either Fadrozole (FAD, an aromatase inhibitor) or saline (SAL). E-treated animals received saline injections. Each individual was then tested alternately with male and female stimulus animals. Overall, T stimulated masculine sexual behaviors and receptivity, but the androgen had little effect on the display of aggressive behaviors. The inhibition of aromatase activity by treatment with Fadrozole eliminated the effect of T on receptivity. In contrast, Fadrozole treatment had no effect on mounting behavior or the frequency of courtship bouts. The inhibition of aromatase activity did increase the number of dewlap extensions (the display of a red throat fan) during courtship. These results suggest that the metabolism of testosterone to estradiol is a mechanism through which androgens can facilitate receptivity, and that such aromatization of testosterone is not required for the display of masculine sexual behaviors. In addition, females performed courtship and mounting behaviors less frequently than males, suggesting that an organizational component to steroid hormone regulation of sexual behaviors may exist in the anole.
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Abstract
The "golden hour" of trauma is based on the principle that severely injured patients are more likely to survive with rapid, appropriate resuscitation and treatment. An inequality exists between sophisticated urban trauma centers and rural/community hospitals in their efforts and abilities to treat severely injured patients. A level I trauma center developed a unique program in an attempt to equalize this inequality--a mobile surgical transport team (MSTT). This article explains the origin of the MSTT, how and why the MSTT is activated, and the roles and responsibility of MSTT members. To further explain the MSTT, two contrasting case studies on trauma patients are presented.
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Wade J, Rolando N, Williams R. The significance of aerobic gram-negative bacilli in clinical specimens following orthotopic liver transplantation. LIVER TRANSPLANTATION AND SURGERY : OFFICIAL PUBLICATION OF THE AMERICAN ASSOCIATION FOR THE STUDY OF LIVER DISEASES AND THE INTERNATIONAL LIVER TRANSPLANTATION SOCIETY 1998; 4:51-7. [PMID: 9457967 DOI: 10.1002/lt.500040107] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In a prospective study of 284 liver transplant patients, we sought associations between aerobic gram-negative bacillus acquisition or infection and 35 preoperative, perioperative, and postoperative variables. Although the 128 (45%) who acquired aerobic gram-negative bacilli had longer admissions (P = 0.0001), no associations were found with pretransplant variables. Fifty-three (41%) of the 128 acquired coliforms (e.g., Escherichia coli, Klebsiella spp., or Enterobacter spp.), 50 (39%) acquired nonfermentative bacilli (e.g., Acinetobacter spp., Pseudomonas spp., or Stenotrophomonas maltophilia), and a further 25 (20%) acquired both. Acquisition progressed to infection in 58% of patients who acquired coliforms but in only 18% of patients who acquired nonfermentative bacilli (P = 0.005). Acinetobacter spp. were isolated from more patients than other bacilli but rarely caused infection. The positive predictive values for infection of acquiring coliforms or nonfermentative bacilli in clinical material were 42% and 17%, respectively. This study allowed us to determine for each clinical site the positive predictive values for infection of acquisition of different aerobic gram-negative bacilli. Our results should contribute to the rationalization of antimicrobial prescribing for this patient group.
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Wade J, Kleiner BH. Practices of excellent companies in the managed health care industry. Leadersh Health Serv (Bradf Engl) 1997; 11:31-4. [PMID: 10177369 DOI: 10.1108/09526869810199638] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The health care profession in the USA has traditionally attracted some of the best talent the country has to offer, with medical practitioners enjoying high incomes due to employer-paid medical indemnity insurance plans. There was no oversight process or quality standards governing the health care delivery process and no motivating factors to contain costs. Prior to the introduction of the Knox-Keene Act in the 1970s requiring employers to offer managed care as an alternative indemnity coverage, the only known managed care company was the Kaiser Permanente Medical Plan. Until just over a decade ago, the concept of managed care was stereotyped as a low quality method of health care delivery. Criticisms from providers themselves suggested managed care systems meant withholding medical care for the sake of profit; "production line" medicine, and compromise in the delivery of quality health care. In order to refute that notion and grow as an industry, managed health care companies were required to take steps to prove their integrity, high quality of care, and cost-effective methods. Today the industry is fast growing, setting management practices that are becoming benchmark standards for other industries too.
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Ehrlich DL, Braddick OJ, Atkinson J, Anker S, Weeks F, Hartley T, Wade J, Rudenski A. Infant emmetropization: longitudinal changes in refraction components from nine to twenty months of age. Optom Vis Sci 1997; 74:822-43. [PMID: 9383797 DOI: 10.1097/00006324-199710000-00022] [Citation(s) in RCA: 101] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Rapid emmetropization is described in pediatrically normal infants from 9 months of age during the following year. The infants, obtained from various categories of the Cambridge population screening program, provided a broad range of refractive errors. The large group of 254 nonanisometropic infants studied allowed the mean rate of change and dependence on the initial refraction value to be determined. Refraction was measured by cycloplegic retinoscopy. Rapid emmetropization changes occurred in the following refractive components: mean spherical equivalent (MSE), astigmatism magnitude, the horizontal astigmatism component, the infant's most positive meridian, and the infant's most negative meridian. The MSE and astigmatism rates of change (diopters/year), were highly dependent on their respective initial powers (r = -0.61 and r = -0.76). The percentage weighted mean proportional rate of change for MSE was -30% (SE 4%) and for astigmatism magnitude it was -59% (SE 14%). There was much individual variation, with some exhibiting fast emmetropization and others not. The MSE and astigmatism changes, however, were almost independent of each other. The refractive errors of the most positive and most negative meridians emmetropize because they are both derived from the MSE and half the astigmatism. With-the-rule astigmatism was more prevalent than against-the-rule astigmatism at 9 months of age, and with-the-rule astigmatism exhibited a significantly greater proportional rate of change. The relationship of emmetropization and refractive screening is considered. A new component "MOMS" is introduced, the maximum ocular meridional separation, when both eyes are considered. Thus incorporating astigmatism and anisometropia may be a good single indicator of conditions associated with later amblyopia. The almost independent emmetropization of the MSE and astigmatism components is an important result to consider in theories of emmetropization, refractive screening, clinical prescribing, and the evaluation of infants in treatment trials.
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Wade J, Gong A, Arnold AP. Effects of embryonic estrogen on differentiation of the gonads and secondary sexual characteristics of male zebra finches. THE JOURNAL OF EXPERIMENTAL ZOOLOGY 1997; 278:405-11. [PMID: 9262008 DOI: 10.1002/(sici)1097-010x(19970815)278:6<405::aid-jez8>3.0.co;2-s] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Male zebra finches sing to court females, whereas females do not normally sing. In parallel, the telencephalic brain regions that control song are larger in volume and contain larger cells in males than in females. The vocal control organ (syrinx) is also larger in males. Some evidence suggests that the sexual differentiation of both anatomy and behavior is under the regulation of gonadal hormones during early development, yet recent data conflict with the idea that the sole source of masculinization of the neural song system is the testes. In the present experiment, we treated genetic males with estradiol benzoate on embryonic day 5 and measured the volume of and neuron soma size in robust nucleus of the archistriatum (RA) and the high vocal center (HVC), two telencephalic song control nuclei. We also weighed the syrinx, the muscles of which are the target of the motor pathway containing the two brain regions. The estrogen treatment disrupted testicular morphology, and induced an oviduct in six of seven animals, but it had no effect on any of four measures of masculinization of the neural song system. These results suggest that normal testicular tissue is not required for masculine development of the neural song system.
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Wade J. Maternity rights advice. MODERN MIDWIFE 1997; 7:9-11. [PMID: 9348858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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