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Brown H, Turner G, Rogerson S, Tembo M, Mwenechanya J, Molyneux M, Taylor T. Cytokine expression in the brain in human cerebral malaria. J Infect Dis 1999; 180:1742-6. [PMID: 10515846 DOI: 10.1086/315078] [Citation(s) in RCA: 124] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Evidence from clinical studies and murine models supports a role for cytokines in the pathogenesis of human cerebral malaria (CM). In this study, reverse transcriptase-polymerase chain reaction (RT-PCR) was used to investigate expression of mRNA for transforming growth factor (TGF)-beta, interleukin (IL)-1beta, and tumor necrosis factor (TNF)-alpha in human postmortem tissue. Immunohistochemistry was used to examine the distribution of cytokine protein. TGF-beta was expressed in normal brain, in CM, and in meningitis and encephalitis. IL-1beta was absent from normal brain but was detected in CM and other cerebral infections. TNF-alpha mRNA was expressed only in CM, although TNF-alpha protein was also seen in meningitis. Cytokine mRNA expression in the brain did not correlate with the density of parasitized erythrocytes detected using RT-PCR for major surface protein-2. This report of RT-PCR on postmortem human tissues infected with CM demonstrates induction of the proinflammatory cytokines TNF-alpha and IL-1beta in the brain.
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Wardle J, Taylor T, Sutton S, Atkin W. Does publicity about cancer screening raise fear of cancer? Randomised trial of the psychological effect of information about cancer screening. BMJ (CLINICAL RESEARCH ED.) 1999; 319:1037-8. [PMID: 10521195 PMCID: PMC32262 DOI: 10.1136/bmj.319.7216.1037] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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128
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Thamer M, Ray NF, Taylor T. Association between antihypertensive drug use and hypoglycemia: a case-control study of diabetic users of insulin or sulfonylureas. Clin Ther 1999; 21:1387-400. [PMID: 10485510 DOI: 10.1016/s0149-2918(99)80039-3] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Antihypertensive drugs are commonly prescribed for the treatment of patients with both diabetes and hypertension. However, the role of selected agents in the development of hypoglycemia remains controversial. The main objective of this study was to evaluate the effect of antihypertensive agents on the risk of hypoglycemia in diabetic patients receiving insulin or sulfonylurea therapy. A matched case-control study was conducted using Pennsylvania Medicaid data. Five control subjects, matched for sex and age, with no reported medical condition of hypoglycemia, were randomly selected for each case patient admitted for hypoglycemia in 1993, resulting in a total of 404 cases and 1375 controls. With these sample sizes, we were able to detect a difference of 10% (P < 0.05) for our primary outcome measure, hospitalization for hypoglycemia. The relative risk of hypoglycemia was estimated using an unconditional logistic regression. The risk of hypoglycemia was 5.5 times greater (95% confidence interval [CI], 4.0 to 7.6) in insulin versus sulfonylurea users and was not influenced by use of angiotensin-converting enzyme (ACE) inhibitors overall. However, use of the ACE inhibitor enalapril was associated with an increased risk of hypoglycemia (odds ratio, 2.4; 95% CI, 1.1 to 5.3) in sulfonylurea users, suggesting that analyzing the unintended side effects of a class of drugs can sometimes mask the adverse effects of individual drugs. Use of beta-blockers was not associated with an increased risk of hypoglycemia, providing further empiric evidence that beta-blockers are an appropriate treatment for persons with concomitant diabetes and hypertension. Per capita health care costs were approximately 3 times higher in patients hospitalized for hypoglycemia compared with controls (P < 0.05). Hospitalization for hypoglycemia is expensive and may be prevented with appropriate monitoring of diabetic patients taking selected antihypertensive agents such as enalapril.
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Sullivan AD, Nyirenda T, Cullinan T, Taylor T, Harlow SD, James SA, Meshnick SR. Malaria infection during pregnancy: intrauterine growth retardation and preterm delivery in Malawi. J Infect Dis 1999; 179:1580-3. [PMID: 10228088 DOI: 10.1086/314752] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
In sub-Saharan Africa, malaria infection in pregnancy contributes to low birth weight through intrauterine growth retardation (IUGR) and preterm delivery (PTD). It was hypothesized that malaria-associated PTD and IUGR have differing etiologies due to timing of infection. In a prospective cohort of primigravid women enrolled at the antenatal clinic of Mangochi District Hospital in Malawi, the associations were investigated between antenatal or delivery parasitemias and IUGR or PTD. Among 178 singleton deliveries, 35% of infants were preterm or had IUGR. Cord blood parasitemia (odds ratio [OR]=3.34; 95% confidence interval [CI], 1.3-8.8], placental parasitemia (OR=2.43; 95% CI, 1.2-5.1), and postdelivery maternal peripheral parasitemia (OR=2.78; 95% CI, 1.3-6.1) were associated with PTD. Parasitemia and/or clinically diagnosed malaria in the antenatal period was associated with IUGR (OR=5.13; 95% CI, 1.4-19.4). Delivery parasitemias had borderline associations with IUGR. The risk patterns observed suggest that the timing and severity of infection influences the occurrence of IUGR or PTD.
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Eames NW, Baker R, Hill N, Graham K, Taylor T, Cosgrove A. The effect of botulinum toxin A on gastrocnemius length: magnitude and duration of response. Dev Med Child Neurol 1999; 41:226-32. [PMID: 10355805 DOI: 10.1017/s0012162299000493] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Thirty-nine ambulant children (22 with hemiplegia, 17 with diplegia) with spastic cerebral palsy receiving isolated gastrocnemius muscle injection with botulinum toxin A were studied prospectively. The children had a mean age of 6 years (range 3 to 13 years). Measurement of gastrocnemius muscle length was used to estimate the dynamic component of each child's spasticity and to quantify the response. There was a strong correlation between the dynamic component of spasticity before injection and the corresponding magnitude of the response after injection. Children undergoing repeated injections showed similar correlations. A strong correlation was found between the duration of response and the dynamic component. Children with hemiplegia showed twice the duration for a given dynamic component compared with those with diplegia when injected with the same total dose per unit body weight. Long-term lengthening did not occur for the cohort, although some patients showed a response at a 12-month follow-up. By delaying shortening, the injections may have a role in delaying the need for surgery. Injections were well tolerated with few side effects.
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Metz DP, Farber DL, Taylor T, Bottomly K. Differential role of CTLA-4 in regulation of resting memory versus naive CD4 T cell activation. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 1998; 161:5855-61. [PMID: 9834064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Regulation of peripheral T cell responses is critical for preserving self tolerance. Memory T cells have a lower threshold for activation through the TCR and are thought to be less dependent on costimulation than naive T cells, suggesting a requirement for more stringent regulation of memory T cells. We have recently shown that CD4 engagement apart from the TCR results in the inactivation of memory, but not naive, CD4 T cells. We show here that this inhibition requires ligation of CTLA-4, in that blocking CTLA-4-B7 interactions restores memory CD4 T cell responsiveness. Early signaling through CTLA-4 is possible because resting memory, but not naive, CD4 T cells contain intracellular stores of CTLA-4 that are continuously recycled between the cytoplasm and the cell surface. This mechanism ensures that low intensity TCR engagements, which are thought to be important for peripheral T cell longevity, do not cause memory T cell activation but instead raise their threshold for costimulatory signals. This may give memory T cells an extended lifespan with a reduced risk of inappropriate activation.
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MESH Headings
- Abatacept
- Animals
- Antibodies, Monoclonal/metabolism
- Antibodies, Monoclonal/pharmacology
- Antigen-Presenting Cells/immunology
- Antigen-Presenting Cells/metabolism
- Antigens, CD
- Antigens, Differentiation/biosynthesis
- Antigens, Differentiation/metabolism
- Antigens, Differentiation/physiology
- B7-1 Antigen/biosynthesis
- B7-1 Antigen/pharmacology
- Binding Sites, Antibody
- CD28 Antigens/immunology
- CD28 Antigens/metabolism
- CD3 Complex/immunology
- CD4-Positive T-Lymphocytes/cytology
- CD4-Positive T-Lymphocytes/immunology
- CTLA-4 Antigen
- Cell Line
- Cell Membrane/immunology
- Cell Membrane/metabolism
- Cytoplasm/immunology
- Cytoplasm/metabolism
- Female
- Fibroblasts/immunology
- Fibroblasts/metabolism
- Histocompatibility Antigens Class II/biosynthesis
- Histocompatibility Antigens Class II/genetics
- Immune Tolerance/immunology
- Immunoconjugates
- Immunologic Memory/immunology
- Immunosuppressive Agents/pharmacology
- Intracellular Fluid/immunology
- Intracellular Fluid/metabolism
- Lymphocyte Activation/immunology
- Mice
- Mice, Inbred BALB C
- Mice, Mutant Strains
- Receptors, Fc/metabolism
- Solubility
- T-Lymphocyte Subsets/cytology
- T-Lymphocyte Subsets/immunology
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Kelley DE, Bidot P, Freedman Z, Haag B, Podlecki D, Rendell M, Schimel D, Weiss S, Taylor T, Krol A, Magner J. Efficacy and safety of acarbose in insulin-treated patients with type 2 diabetes. Diabetes Care 1998; 21:2056-61. [PMID: 9839094 DOI: 10.2337/diacare.21.12.2056] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To demonstrate the efficacy, tolerability, and safety of acarbose compared with placebo in patients with type 2 diabetes inadequately controlled with diet and insulin. RESEARCH DESIGN AND METHODS A multicenter randomized double-blind placebo-controlled parallel-group comparison study was conducted. The trial was 26 weeks with a 2-week screening period and a 24-week period of treatment with acarbose or placebo, with forced titration from 25 mg t.i.d. to 50 mg t.i.d. after 4 weeks, and titration of 50 mg t.i.d. to 100 mg t.i.d. after 12 weeks based on glucose control. The dosage of insulin was to remain stable. The primary efficacy variable was mean change from baseline in HbA1c, and secondary efficacy variables included mean changes in fasting and postprandial plasma glucose and triglyceride levels. RESULTS The addition of acarbose to the treatment of patients receiving background insulin and diet therapy resulted in a statistically significant reduction in mean HbA1c of 0.69% compared with placebo. There were statistically significant reductions in postprandial plasma glucose and glucose area under the curve, and in postprandial serum triglyceride levels in the acarbose-treated patients. Gastrointestinal side effects were more frequently reported in the acarbose-treated patients. There were no significant differences in hypoglycemic events or liver transaminase elevations between groups. CONCLUSIONS This study demonstrated that the addition of acarbose to patients with type 2 diabetes who are inadequately controlled with insulin and diet is safe and generally well tolerated and that it significantly lowers HbA1c and postprandial glucose levels.
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Taylor T. 'Purgatory on earth': an account of breast cancer from nineteenth-century France. SOCIAL HISTORY OF MEDICINE : THE JOURNAL OF THE SOCIETY FOR THE SOCIAL HISTORY OF MEDICINE 1998; 11:381-402. [PMID: 11623582 DOI: 10.1093/shm/11.3.381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The subject of this article is the terminal illness of Zelie Martin who died from breast cancer in 1877. She was a Catholic woman of Normandy, a professional lace-maker, and the mother of five daughters. Her extensive correspondence, which records her fatal illness, is the main source for this study. Her accounts of the disease are compared with medical texts of the period. Religious responses to illness, and the suppport offered by family members are also described.
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Rosenstock J, Brown A, Fischer J, Jain A, Littlejohn T, Nadeau D, Sussman A, Taylor T, Krol A, Magner J. Efficacy and safety of acarbose in metformin-treated patients with type 2 diabetes. Diabetes Care 1998; 21:2050-5. [PMID: 9839093 DOI: 10.2337/diacare.21.12.2050] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To demonstrate the efficacy, tolerability, and safety of acarbose compared with placebo in patients with type 2 diabetes inadequately controlled with diet and metformin (2,000 or 2,500 mg/day in divided doses). RESEARCH DESIGN AND METHODS This study had a multicenter randomized double-blind placebo-controlled parallel-group comparison design. The trial lasted 31 weeks and consisted of a 1-week screening period, a 6-week placebo pretreatment period, and a 24-week period of acarbose or placebo, with a forced titration from 25-50 mg t.i.d. and a titration of 50-100 mg tid that was based on glucose control. The primary efficacy variable was the mean change from baseline in HbA1c. Secondary efficacy variables included mean changes from baseline in fasting and postprandial plasma glucose, serum insulin, and triglyceride levels. RESULTS The addition of acarbose to patients on background metformin and diet therapy showed a statistically significant reduction in mean HbA1c of 0.65%. There were statistically significant reductions in fasting and postprandial plasma glucose and serum insulin levels compared with placebo. Gastrointestinal side effects were more frequently reported in the acarbose-treated patients. No significant differences in liver transaminase elevations were observed between patients treated with acarbose and those treated with placebo. CONCLUSIONS The results of this study demonstrate that the addition of acarbose to patients with type 2 diabetes who are inadequately controlled with metformin and diet is safe and generally well tolerated and that it significantly lowers HbA1c and fasting and postprandial glucose and insulin levels.
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135
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Taylor T, Tremblay T. Planned change in the evolution of cataract surgery. CANADIAN OPERATING ROOM NURSING JOURNAL 1998; 16:31-6. [PMID: 10085821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
The subject of this paper is a description of how perioperative nurses and other health care professionals worked together to meet the demands of change. New technologies and new techniques in cataract surgery with lens replacement has decreased dramatically the amount of operating room (OR) time required. With the reduction in OR time, the process of moving cataract patients through the perioperative experience became chaotic. Change was necessary. Planned change and teamwork made the change process less chaotic and more rewarding.
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Metz DP, Farber DL, Taylor T, Bottomly K. Differential Role of CTLA-4 in Regulation of Resting Memory Versus Naive CD4 T Cell Activation. THE JOURNAL OF IMMUNOLOGY 1998. [DOI: 10.4049/jimmunol.161.11.5855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Regulation of peripheral T cell responses is critical for preserving self tolerance. Memory T cells have a lower threshold for activation through the TCR and are thought to be less dependent on costimulation than naive T cells, suggesting a requirement for more stringent regulation of memory T cells. We have recently shown that CD4 engagement apart from the TCR results in the inactivation of memory, but not naive, CD4 T cells. We show here that this inhibition requires ligation of CTLA-4, in that blocking CTLA-4-B7 interactions restores memory CD4 T cell responsiveness. Early signaling through CTLA-4 is possible because resting memory, but not naive, CD4 T cells contain intracellular stores of CTLA-4 that are continuously recycled between the cytoplasm and the cell surface. This mechanism ensures that low intensity TCR engagements, which are thought to be important for peripheral T cell longevity, do not cause memory T cell activation but instead raise their threshold for costimulatory signals. This may give memory T cells an extended lifespan with a reduced risk of inappropriate activation.
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137
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Woods NF, Saver B, Taylor T. Attitudes toward menopause and hormone therapy among women with access to health care. Menopause 1998; 5:178-88. [PMID: 9774765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVE To explore the relationship between women's attitudes toward menopause and hormone therapy and paradigms of menopause as a natural life event versus a biomedical phenomenon. DESIGN Women (N = 2092) sampled from physicians' practices in Washington state completed mailed questionnaires with a response rate of 72%. RESULTS Women's attitudes toward menopause were unrelated to their adoption of a biomedical versus developmental paradigm of menopause. In contrast, women's adoption of the view that menopause was an endocrine deficiency and that symptoms should be treated with hormones were correlated. Endorsement of the endocrine deficiency model of menopause was related to women's attitudes toward hormone therapy as more efficacious, less risky, and requiring daily use of a drug. Women's experiences of a hysterectomy and hormone use were associated with their attitudes. CONCLUSIONS Women's attitudes toward menopause are multidimensional and not influenced wholly by adoption of a biomedical or developmental paradigm. Women embraced menopause as part of life and simultaneously accepted changes in their endocrine production. Attitudes toward hormone therapy were closely aligned with adoption of a biomedical view of menopause and use of hormone therapy.
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138
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Taylor T, Specker B, Robbins J, Sperling M, Ho M, Ain K, Bigos ST, Brierley J, Cooper D, Haugen B, Hay I, Hertzberg V, Klein I, Klein H, Ladenson P, Nishiyama R, Ross D, Sherman S, Maxon HR. Outcome after treatment of high-risk papillary and non-Hürthle-cell follicular thyroid carcinoma. Ann Intern Med 1998; 129:622-7. [PMID: 9786809 DOI: 10.7326/0003-4819-129-8-199810150-00007] [Citation(s) in RCA: 141] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Treatment of differentiated thyroid cancer has been studied for many years, but the benefits of extensive initial thyroid surgery and the addition of radioiodine therapy or external radiation therapy remain controversial. OBJECTIVE To determine the relations among extent of surgery, radioiodine therapy, and external radiation therapy in the treatment of high-risk papillary and non-Hürthle-cell follicular thyroid carcinoma. DESIGN Analysis of data from a multicenter study. SETTING 14 institutions in the United States and Canada participating in the National Thyroid Cancer Treatment Cooperative Study Registry. PATIENT 385 patients with high-risk thyroid cancer (303 with papillary carcinoma and 82 with follicular carcinoma). MEASUREMENTS Death, disease progression, and disease-free survival. RESULTS Total or near-total thyroidectomy was done in 85.3% of patients with papillary carcinoma and 71.3% of patients with follicular cancer. Overall surgical complication rate was 14.3%. Total or near-total thyroidectomy improved overall survival (risk ratio [RR], 0.37 [95% CI, 0.18 to 0.75]) but not cancer-specific mortality, progression, or disease-free survival in patients with papillary cancer. No effect of extent of surgery was seen in patients with follicular thyroid cancer. Postoperative iodine-131 was given to 85.4% of patients with papillary cancer and 79.3% of patients with follicular cancer. In patients with papillary cancer, radioiodine therapy was associated with improvement in cancer-specific mortality (RR, 0.30 [CI, 0.09 to 0.93 by multivariate analysis only]) and progression (RR, 0.30 [CI, 0.13 to 0.72]). When tall-cell variants were excluded, the effect on outcome was not significant. After radioiodine therapy, patients with follicular thyroid cancer had improvement in overall mortality (RR, 0.17 [CI, 0.06 to 0.47]), cancer-specific mortality (RR, 0.12 [CI, 0.04 to 0.42]), progression (RR, 0.21 [CI, 0.08 to 0.56]), and disease-free survival (RR, 0.29 [CI, 0.08 to 1.01]). External radiation therapy to the neck was given to 18.5% of patients and was not associated with improved survival, lack of progression, or disease-free survival. CONCLUSIONS This study supports improvement in overall and cancer-specific mortality among patients with papillary and follicular thyroid cancer after postoperative iodine-131 therapy. Radioiodine therapy was also associated with improvement in progression in patients with papillary cancer and improvement in progression and disease-free survival in patients with follicular carcinoma.
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139
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McAlinden MG, Magowan J, Wilson DJ, Insley G, Ferris P, Prendergast PJ, Rice J, Blayney AW, Dalstra M, Walsh M, McGloughlin T, Grace P, Colgan D, Bray D, McCormack BAO, Reilly R, Tancred D, Carr AJ, McCormack BAO, Leyland NS, Meenan J, Boyd A, Akay M, O’Dwyer B, McCormack BAO, Dunne NJ, Ryan K, Orr JF, Stungo B, Brennan EG, O’Hare NJ, Walsh MJ, Jordan MF, Rasheed AM, Kelly C, Kay E, Bouchier-Hayes DJ, Leahy A, Maher SA, O’Reilly D, Foley J, Gillan MA, Cole JS, Raghunathan S, O’Reilly MJG, Kenny T, Foley J, Hourigan TF, Lyons GM, Cox SL, Kernohan WG, Fitzpatrick C, Kernohan WG, Dempsey GJ, Millar I, Kelly S, Charlwood AP, O’Brien S, Beverland DE, Kavanagh A, McGloughlin T, Neligan MF, McKenna J, Laracy P, Moran D, O’Beirne J, Charlwood AP, Kelly S, Nixon JR, Beverland DE, Kenny P, Maher SA, Murphy LA, Prendergast PJ, O’Rourke SK, O’Donoghue D, Gilchrist MD, Caulfield B, O’Brien B, Simms C, Lyons CG, Brady CL, Badran S, Clifford PM, Burden DJ, Orr JF, Taylor D, Hill R, Griffin S, De Barra E, Brook I, Reytil P, Blades M, O’Reilly JP, Masterson BF, Macauley D, Toner M, Walker J, Gillan J, Boyd A, Meenan J, Akay M, Leyland NS, Murphy H, McNamara P, Jones E, Kelly P, Rajah L, Dhaif B, Colville J, Waide DV, Waide DV, Lawlor G, McCormack A, Carr AJ, McCartney W, McNamara BP, Connolly P, Devitt A, McElwaine J, O’Reilly P, Maher SA, Eames MHA, Cosgrove AP, Baker RJ, Condron J, Coyle E, Nugent D, Webb J, Black ND, Mclntyre M, Lowery M, O’Malley M, Vaughan L, Sweeney PC, Lyons GM, McGiven R, Collins AD, Gibson MJ, Lyons GM, Clernon GF, Wilcox DJ, Shanahan A, Buckley PJ, Hanna S, McGrellis N, Orr JF, Fennel B, Hill R, Akinmade A, Mitchell A, Pintado MR, Douglas WH, Ryan EE, Savage EJ, Orr JF, Mitchell E, Silbermann M, Mullett H, Ranjith P, Burke T, Hill R, Dorreil P, Watters EP, Spedding PL, Grimshaw J, M Bowler DJ, Felle P, Allen D, McCormack BAO, Moran R, Lennon AB, McCormack BAO, Prendergast PJ, Thompson NS, Cosgrove AP, Baker RJ, Saunders JL, Taylor T, Grimson J, Grimson W, Azuaje F, Black ND, Adamson K, Lopes P, Dubitzky W, Wu X, White J, Murtagh F, Campbell JG, Adamson K, O’Tiarnaigh RI, Cormack WA, Hume A, Starck JL, Lardillier P, Kernohan WG, Mao WE, Bell D, Chambers MGA, McCammon C, Leane GE, Lyons GM, Lyons DJ, Lacrox D, Murphy LA, Prendergast PJ, FitzPatrick DP, McClorey M, Meenen J, O’Brien FJ, Lee TC, Pellegrini F, Dickson GR, Taylor D. Royal academy of medicine in Ireland section of bioengineering. Ir J Med Sci 1998. [DOI: 10.1007/bf02937426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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140
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Taylor T. The role of the retrieval team in severe asthma. PAEDIATRIC NURSING 1998; 10:28-30. [PMID: 10095662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Retrieval teams, consisting of staff trained in the transfer of critically ill, patients, step into the breach when local hospitals lack the facilities or expertise needed. Tracy Taylor uses a case study to illustrate their effectiveness.
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141
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Cooper DS, Specker B, Ho M, Sperling M, Ladenson PW, Ross DS, Ain KB, Bigos ST, Brierley JD, Haugen BR, Klein I, Robbins J, Sherman SI, Taylor T, Maxon HR. Thyrotropin suppression and disease progression in patients with differentiated thyroid cancer: results from the National Thyroid Cancer Treatment Cooperative Registry. Thyroid 1998; 8:737-44. [PMID: 9777742 DOI: 10.1089/thy.1998.8.737] [Citation(s) in RCA: 188] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The ideal therapy for differentiated thyroid cancer is uncertain. Although thyroid hormone treatment is pivotal, the degree of thyrotropin (TSH) suppression that is required to prevent recurrences has not been studied in detail. We have examined the relation of TSH suppression to baseline disease characteristics and to the likelihood of disease progression in a cohort of thyroid cancer patients who have been followed in a multicenter thyroid cancer registry that was established in 1986. The present study describes 617 patients with papillary and 66 patients with follicular thyroid cancer followed annually for a median of 4.5 years (range 1-8.6 years). Cancer staging was assessed using a staging scheme developed and validated by the registry. Cancer status was defined as no residual disease; progressive disease at any follow-up time; or death from thyroid cancer. A mean TSH score was calculated for each patient by averaging all available TSH determinations, where 1 = undetectable TSH; 2 = subnormal TSH; 3 = normal TSH; and 4 = elevated TSH. Patients were also grouped by their TSH scores: group 1: mean TSH score 1.0-1.99; group 2: mean TSH score 2.0-2.99; group 3: mean TSH score 3.0-4.0. The degree of TSH suppression did not differ between papillary and follicular thyroid cancer patients. However, TSH suppression was greater in papillary cancer patients who were initially classified as being at higher risk for recurrence. This was not the case for follicular cancer patients, where TSH suppression was similar for all patients. For all stages of papillary cancer, a Cox proportional hazards model showed that disease stage, patient age, and radioiodine therapy all predicted disease progression, but TSH score category did not. However, TSH score category was an independent predictor of disease progression in high risk patients (p = 0.03), but was no longer significant when radioiodine therapy was included in the model (p = 0.09). There were too few patients with follicular cancer for multivariate analysis. These data suggest that physicians use greater degrees of TSH suppression in higher risk papillary cancer patients. Our data do not support the concept that greater degrees of TSH suppression are required to prevent disease progression in low-risk patients, but this possibility remains in high-risk patients. Additional studies with more patients and longer follow-up may provide the answer to this important question.
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Schmidtmann ET, Holbrook FR, Day E, Taylor T, Tabachnick WJ. Culicoides variipennis (Diptera: Ceratopogonidae) complex in Virginia. JOURNAL OF MEDICAL ENTOMOLOGY 1998; 35:818-824. [PMID: 9775615 DOI: 10.1093/jmedent/35.5.818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Immature Culicoides variipennis (Coquillett) were sampled from aquatic habitats throughout Virginia, reared to adults, and examined by isozyme electrophoresis to assess their taxonomic status. Data from 22 counties showed that C. v. variipennis is widespread and common, the predominant taxon throughout Virginia, and genetically similar to C. v. variipennis in Maryland. Because C. v. variipennis is considered an inefficient vector of the bluetongue viruses, this observation is consistent with the low seroprevalence of bluetongue in indigenous livestock of the mid-Atlantic region. Culicoides v. sonorensis Wirth & Jones, considered to be the primary North American vector of the bluetongue viruses, was recovered in large numbers only from a wastewater lagoon at a dairy in southeastern Virginia, but also was detected at low levels in 6 other counties. Comparison of genetic distances and patterns of discriminating alleles among Virginia populations of C. v. variipennis and C. v. sonorensis showed that respective subspecies are genetically distinct and show no evidence of introgression, irrespective of geographic- and habitat-level sympatry. The persistence of a pure C. v. sonorensis population in a dairy wastewater lagoon may reflect physico-chemical factors that influence the distribution of immature C. variipennis complex populations. A better understanding of the distribution of the C. variipennis complex will benefit regionalization of U.S. exports of livestock and livestock germplasm to bluetongue-free countries.
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Sherman SI, Brierley JD, Sperling M, Ain KB, Bigos ST, Cooper DS, Haugen BR, Ho M, Klein I, Ladenson PW, Robbins J, Ross DS, Specker B, Taylor T, Maxon HR. Prospective multicenter study of thyroiscarcinoma treatment: initial analysis of staging and outcome. National Thyroid Cancer Treatment Cooperative Study Registry Group. Cancer 1998; 83:1012-21. [PMID: 9731906 DOI: 10.1002/(sici)1097-0142(19980901)83:5<1012::aid-cncr28>3.0.co;2-9] [Citation(s) in RCA: 263] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND A novel prognostic staging classification encompassing all forms of thyroid carcinoma was created for the National Thyroid Cancer Treatment Cooperative Study (NTCTCS) Registry, with the goal of prospective validation and comparison with other available staging classifications. METHODS Patient information was recorded prospectively from 14 institutions. Clinicopathologic staging was based on patient age at diagnosis, tumor histology, tumor size, intrathyroidal multifocality, extraglandular invasion, metastases, and tumor differentiation. RESULTS Between 1987 and 1995, 1607 patients were registered. Approximately 43% of patients were classified as NTCTCS Stage I, 24% Stage II, 24% Stage III, and 9% Stage IV. Patients with follicular carcinoma were more likely to have "high risk" Stage III or IV disease than those with papillary carcinoma. Of 1562 patients for whom censored follow-up was available (median follow-up, 40 months), 78 died of thyroid carcinoma or complications of its treatment. Five-year product-limit patient disease specific survival was 99.8% for Stage I, 100% for Stage II, 91.9% for Stage III, and 48.9% for Stage IV (P < 0.0001). The frequency of remaining disease free also declined significantly with increasing stage (94.3% for Stage I, 93.1%for Stage II, 77.8% for Stage III, and 24.6% for Stage IV). The same patients also were staged applying six previously published classifications as appropriate for their tumor type. The predictive value of the NTCTCS Registry staging classification consistently was among the highest for disease specific mortality and for remaining disease free, regardless of the tumor type. CONCLUSIONS The NTCTCS Registry staging classification provides a prospectively validated scheme for predicting short term prognosis for patients with thyroid carcinoma.
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Hollander PA, Elbein SC, Hirsch IB, Kelley D, McGill J, Taylor T, Weiss SR, Crockett SE, Kaplan RA, Comstock J, Lucas CP, Lodewick PA, Canovatchel W, Chung J, Hauptman J. Role of orlistat in the treatment of obese patients with type 2 diabetes. A 1-year randomized double-blind study. Diabetes Care 1998; 21:1288-94. [PMID: 9702435 DOI: 10.2337/diacare.21.8.1288] [Citation(s) in RCA: 388] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Obesity is an important risk factor for type 2 diabetes. Weight loss in patients with type 2 diabetes is associated with improved glycemic control and reduced cardiovascular disease risk factors, but weight loss is notably difficult to achieve and sustain with caloric restriction and exercise. The purpose of this study was to assess the impact of treatment with orlistat, a pancreatic lipase inhibitor, on weight loss, glycemic control, and serum lipid levels in obese patients with type 2 diabetes on sulfonylurea medications. RESEARCH DESIGN AND METHODS In a multicenter 57-week randomized double-blind placebo-controlled study, 120 mg orlistat or placebo was administered orally three times a day with a mildly hypocaloric diet to 391 obese men and women with type 2 diabetes who were aged > 18 years, had a BMI of 28-40 kg/m2, and were clinically stable on oral sulfonylureas. Changes in body weight, glycemic control, lipid levels, and drug tolerability were measured. RESULTS After 1 year of treatment, the orlistat group lost 6.2 +/- 0.45% (mean +/- SEM) of initial body weight vs. 4.3 +/- 0.49% in the placebo group (P < 0.001). Twice as many patients receiving orlistat (49 vs. 23%) lost > or = 5% of initial body weight (P < 0.001). Orlistat treatment plus diet compared with placebo plus diet was associated with significant improvement in glycemic control, as reflected in decreases in HbA1c (P < 0.001) and fasting plasma glucose (P < 0.001) and in dosage reductions of oral sulfonylurea medication (P < 0.01). Orlistat therapy also resulted in significantly greater improvements than placebo in several lipid parameters, namely, greater reductions in total cholesterol, (P < 0.001), LDL cholesterol (P < 0.001), triglycerides (P < 0.05), apolipoprotein B (P < 0.001), and the LDL-to-HDL cholesterol ratio (P < 0.001). Mild to moderate and transient gastrointestinal events were reported with orlistat therapy, although their association with study withdrawal was low. Fat-soluble vitamin levels generally remained within the reference range, and vitamin supplementation was required in only a few patients. CONCLUSIONS Orlistat is an effective treatment modality in obese patients with type 2 diabetes with respect to clinically meaningful weight loss and maintenance of weight loss, improved glycemic control, and improved lipid profile.
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Palmeri D, Auld GW, Taylor T, Kendall P, Anderson J. Multiple perspectives on nutrition education needs of low-income Hispanics. J Community Health 1998; 23:301-16. [PMID: 9693987 DOI: 10.1023/a:1018775522429] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
As part of a multi-level nutrition intervention for low-income Hispanics (LIH) and the professionals and paraprofessionals who serve them, focus groups were used to 1) identify nutrition education needs and preferred means of receiving nutrition information, 2) identify the LIH's barriers/motivators to dietary behavior change, and 3) assess the feasibility of using abuelas (Hispanic grandmothers) as educators. Nine focus groups were conducted using trained, local bilingual and bicultural moderators. Low-income Hispanics' primary concerns were their children's nutritional habits and ways to prepare quick, nutritious meals and snacks. Their major barriers to dietary change were financial limitations, lack of time, and family customs/habits. Professionals were concerned with the lack of interagency cooperation. Paraprofessionals were most interested in training on how to teach. All audiences preferred to receive nutrition education through classes with hands-on, interactive formats. Professionals and paraprofessionals noted advantages and disadvantages to using abuelas as educators. Including three populations in the needs assessment allowed comparisons of perspectives across groups and allowed the design of nutrition education programs appropriately targeted to these populations.
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Phipps C, Taylor T, Taylor E, Cúneo R, Boucher L, Yao X. Osmunda (Osmundaceae) from the Triassic of Antarctica: an example of evolutionary stasis. AMERICAN JOURNAL OF BOTANY 1998. [PMID: 21715292 DOI: 10.2307/2446424] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Compressed specimens of the fern Osmunda are described from the Triassic of the Allan Hills, Antarctica. The specimens consist of a once pinnate, deeply pinnatifid fertile frond as well as several sterile specimens. Six pinnae are present on the partial fertile rachis, with two sterile pinnae above four fertile pinnae. Both sterile and fertile specimens are virtually identical to the modern species Osmunda claytoniana. Entire fronds are fragmentary; the longest is 21 cm in length. Sterile pinnae are alternate and deeply pinnatifid, with slightly toothed pinnules and dichotomous venation. Fertile pinnae are 1-1.3 cm long, once pinnate, and lack vegetative lamina. Sporangia are clustered, each 300-375 um in diameter, and possess a transverse annulus 6-8 cells long; dehiscence is by a vertical slit. Fronds arise from a rhizome 4 cm long by 1 cm wide; two croziers are present on the rhizome. Two frond segments up to 6 cm long and three deeply pinnatifid pinnae are present on the uppermost part of one rachis. Pinnules are ~4 mm long and 2-3 mm wide. The presence of this Osmunda species in the Triassic demonstrates stasis of frond morphology, both fertile and vegetative, for the genus.
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Axsmith B, Taylor T, Taylor E. Anatomically preserved leaves of the conifer Notophytum krauselii (Podocarpaceae) from the Triassic of Antarctica. AMERICAN JOURNAL OF BOTANY 1998; 85:704. [PMID: 21684953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Permineralized leaves of the Triassic podocarpaceous conifer Notophytum krauselii are described from the Fremouw Formation of Antarctica. The leaves are elongate and apetiolate with 8-12 parallel veins. The adaxial epidermis consists of rows of rectangular to pentagonal cells; the abaxial epidermis is papillate. Longitudinally oriented stomata occur on both surfaces. An adaxial palisade layer is present and auxiliary sclereids are common in the mesophyll. The vascular bundles have a weakly defined sheath and are flanked by transfusion tracheids. Bundles in the basipetal area of the leaf are capped by sclerotic tissue and subtended by resin canals. These leaves are superficially similar to those of the extant podocarp genus Nageia, but probably represent a distinct acquisition of this leaf type within the Podocarpaceae. Notophytum leaves are similar to the common compression fossil Heidiphyllum elongatum and may be closely related or even conspecific. Evidence from Antarctica suggests that Heidiphyllum and the seed cone Telemachus were produced by the same plant, and may be closely related to several other early Mesozoic conifers with multiveined leaves.
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Tanphaichitr N, Moase C, Taylor T, Surewicz K, Hansen C, Namking M, Bérubé B, Kamolvarin N, Lingwood CA, Sullivan R, Rattanachaiyanont M, White D. Isolation of antiSLIP1-reactive boar sperm P68/62 and its binding to mammalian zona pellucida. Mol Reprod Dev 1998; 49:203-16. [PMID: 9444663 DOI: 10.1002/(sici)1098-2795(199802)49:2<203::aid-mrd11>3.0.co;2-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Single-step purification of boar sperm P68/62 that is cross-reactive with a polyclonal antibody against sulfolipidimmobilizing protein 1 (SLIP1) was achieved by chromatofocusing. This method is useful for obtaining P68/62 in quantity. The two proteins, P68 and P62, were antigenically related, since the antibody generated specifically against the 68-kDa band reacted with both the 68- and 62-kDa bands. Like rat testis SLIP1, purified boar sperm P68/62 bound to sulfogalactosylglycerolipid (SGG) and inhibited sperm-egg binding in a dose-dependent manner when added exogenously to sperm-egg coincubates. This inhibitory effect occurred at the level of the zona pellucida (ZP), and further studies showed that biotinylated boar sperm P68/62 bound to the ZP of unfertilized mouse eggs. Furthermore, biotinylated boar sperm P68/62 bound to isolated ZP of unfertilized eggs from other species, including pig, rat, cat, dog, and human, as well as to ZP of intact fertilized mouse eggs and preimplantation embryos of various developmental stages, although the degree of its binding to the ZP of intact eight-cell embryos, morulae, and blastocysts was much lower than that of fertilized eggs and two-cell embryos. These results suggest that P68/62 of capacitated sperm must act together with other sperm surface proteins/molecules that regulate zona binding specificity within homologous species and in unfertilized eggs. Together with our previous findings, we suggest that rather than being a true ZP receptor, sperm P68/62 may be involved in the initial step of sperm-ZP binding that is adhesive in nature.
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Polikar R, Udpa L, Udpa SS, Taylor T. Frequency invariant classification of ultrasonic weld inspection signals. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 1998; 45:614-625. [PMID: 18244213 DOI: 10.1109/58.677606] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Automated signal classification systems are finding increasing use in many applications for the analysis and interpretation of large volumes of signals. Such systems show consistency of response and help reduce the effect of variabilities associated with human interpretation. This paper deals with the analysis of ultrasonic NDE signals obtained during weld inspection of piping in boiling water reactors. The overall approach consists of three major steps, namely, frequency invariance, multiresolution analysis, and neural network classification. The data are first preprocessed whereby signals obtained using different transducer center frequencies are transformed to an equivalent reference frequency signal. Discriminatory features are then extracted using a multiresolution analysis technique, namely, the discrete wavelet transform (DWT). The compact feature vector obtained using wavelet analysis is classified using a multilayer perceptron neural network. Two different databases containing weld inspection signals have been used to test the performance of the neural network. Initial results obtained using this approach demonstrate the effectiveness of the frequency invariance processing technique and the DWT analysis method employed for feature extraction.
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