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Effective Transitional Therapy For Adolescent And Young Adult Patients With Cancer: An Integrative Literature Review, Katherine Jones Masterton, Joseph D. Tariman Phd Jul 2016

Effective Transitional Therapy For Adolescent And Young Adult Patients With Cancer: An Integrative Literature Review, Katherine Jones Masterton, Joseph D. Tariman Phd

Joseph D Tariman PhD, RN, ANP-BC, FAAN

Abstract
BACKGROUND:
The adolescent and young adult (AYA) cancer community has demonstrated a need for psychosocial help transitioning from acute cancer care to survivorship while navigating appropriate developmental challenges.
OBJECTIVES:
The purpose of this integrative literature review is to examine the transition of AYAs from life as patients with cancer to life as cancer survivors and to evaluate the most effective, therapeutic ways to make this transition.
METHODS:
This integrative literature review focused on articles published from 2008-2015 using PubMed, CINAHL®, and PsycINFO. Key search terms were cancer, [adaptation, psychological], adolesc*, and young adult. Outcomes were evaluated using the Adaptation …


Predictors Of Adolescent Male Body Image Dissatisfaction: Implications For Negative Health Practices And Consequences For School Health From A Regionally Representative Sample, James Leone, Joyce Fetro, Mark Kittleson, Kathleen Welshimer, Julie Partridge, Stacia Robertson Aug 2015

Predictors Of Adolescent Male Body Image Dissatisfaction: Implications For Negative Health Practices And Consequences For School Health From A Regionally Representative Sample, James Leone, Joyce Fetro, Mark Kittleson, Kathleen Welshimer, Julie Partridge, Stacia Robertson

Mark J Kittleson

BACKGROUND: Adolescent males are more likely to sustain intentional and unintentional injuries, be involved in a physical confrontation, and be successful in suicide attempts. Body image dissatisfaction (BID) has been linked as a possible contributing factor to these negative health behaviors and risks; however, research is limited with males. The interaction of intrapersonal, interpersonal, and social variables in a holistic model has yet to be explored for males. Variables precipitating adolescent males to develop an unhealthy body image and act on negative health behaviors, such as body image drug use, were the impetus for this study. METHODS: A randomized cross-sectional …


Verbal Learning And Memory In Adolescent Cannabis Users, Alcohol Users And Non-Users, Nadia Solowij, Katy A. Jones, Megan E. Rozman, Sasha M. Davis, Joseph Ciarrochi, Patrick C. L Heaven, Dan I. Lubman, Murat Yucel Jul 2015

Verbal Learning And Memory In Adolescent Cannabis Users, Alcohol Users And Non-Users, Nadia Solowij, Katy A. Jones, Megan E. Rozman, Sasha M. Davis, Joseph Ciarrochi, Patrick C. L Heaven, Dan I. Lubman, Murat Yucel

joseph Ciarrochi

Rationale Long-term heavy cannabis use can result in memory impairment. Adolescent users may be especially vulnerable to the adverse neurocognitive effects of cannabis. Objectives and methods In a cross-sectional and prospective neuropsychological study of 181 adolescents aged 16–20 (mean 18.3 years), we compared performance indices from one of the most widely used measures of learning and memory—the Rey Auditory Verbal Learning Test—between cannabis users (n=52; mean 2.4 years of use, 14 days/month, median abstinence 20.3 h), alcohol users (n=67) and non-user controls (n=62) matched for age, education and premorbid intellectual ability (assessed prospectively), and alcohol consumption for cannabis and alcohol …


Reflection Impulsivity In Adolescent Cannabis Users: A Comparison With Alcohol-Using And Non-Substance-Using Adolescents, Nadia Solowij, Katy A. Jones, Megan E. Rozman, Sasha M. Davis, Joseph Ciarrochi, Patrick C. L Heaven, Nicole Pesa, Dan I. Lubman, Murat Yucel Jul 2015

Reflection Impulsivity In Adolescent Cannabis Users: A Comparison With Alcohol-Using And Non-Substance-Using Adolescents, Nadia Solowij, Katy A. Jones, Megan E. Rozman, Sasha M. Davis, Joseph Ciarrochi, Patrick C. L Heaven, Nicole Pesa, Dan I. Lubman, Murat Yucel

joseph Ciarrochi

Rationale Reflection impulsivity-a failure to gather and evaluate information before making a decision-is a critical component of risk-taking and substance use behaviours, which are highly prevalent during adolescence. Objectives and methods The Information Sampling Test was used to assess reflection impulsivity in 175 adolescents (mean age 18.3, range 16.5-20; 55% female)-48 cannabis users (2.3 years use, 10.8 days/month), 65 alcohol users, and 62 non-substance-using controls-recruited from a longitudinal cohort and from the general community and matched for education and IQ. Cannabis and alcohol users were matched on levels of alcohol consumption. Results Cannabis users sampled to the lowest degree of …


Adolescent Peer Crowd Self-Identification, Attributional Style And Perceptions Of Parenting, Patrick Heaven, Joseph Ciarrochi, Wilhelmina Vialle, Ieva Cechavicuite Jul 2015

Adolescent Peer Crowd Self-Identification, Attributional Style And Perceptions Of Parenting, Patrick Heaven, Joseph Ciarrochi, Wilhelmina Vialle, Ieva Cechavicuite

joseph Ciarrochi

No abstract provided.


On Being Aware And Accepting: A One-Year Longitudinal Study Into Adolescent Well-Being, Joseph Ciarrochi, Todd Kashdan, Peter Leeson, Patrick Heaven, Carlie Jordan Jul 2015

On Being Aware And Accepting: A One-Year Longitudinal Study Into Adolescent Well-Being, Joseph Ciarrochi, Todd Kashdan, Peter Leeson, Patrick Heaven, Carlie Jordan

joseph Ciarrochi

The nature and potential benefit of awareness and experiential acceptance in adolescence remains neglected and understudied. To address this gap in the literature, 776 students (50% female) in Grade 10 completed measures of mindfulness, emotional awareness, and experiential acceptance, as well as measures of major personality traits. To study prospective changes, assessments of emotional well-being were completed across a 1-year interval. Analyses revealed that “Acting with Awareness” (engaging fully in one’s current activity with undivided attention), emotional awareness, and experiential acceptance where all linked to prosocial tendencies and uniquely predicted increases in well-being across the year. Observing experience (noticing, observing, …


Prepubertal Organochlorine Pesticide Concentrations And Age Of Pubertal Onset Among Russian Boys, Thuy Lam, Paige Williams, Mary Lee, Susan Korrick, Linda Birnbaum, Jane Burns, Oleg Sergeyev, Boris Revich, Larisa Altshul, Donald Patterson, Wayman Turner, Russ Hauser Jun 2015

Prepubertal Organochlorine Pesticide Concentrations And Age Of Pubertal Onset Among Russian Boys, Thuy Lam, Paige Williams, Mary Lee, Susan Korrick, Linda Birnbaum, Jane Burns, Oleg Sergeyev, Boris Revich, Larisa Altshul, Donald Patterson, Wayman Turner, Russ Hauser

Mary M. Lee

BACKGROUND: In animal studies, organochlorine pesticide (OCP) exposure alters pubertal development; however, epidemiological data are limited and inconsistent. OBJECTIVE: To evaluate the associations of serum OCP concentrations [hexachlorobenzene (HCB), beta-hexachlorocyclohexane (beta-HCH), and p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE)] with male pubertal onset. METHODS: In Chapaevsk, Russia, a town environmentally contaminated with OCPs, 350 8-9 year old boys with measured OCPs were enrolled during 2003-2005 and were followed annually for eight years. We evaluated three measures of pubertal onset: testicular volume (TV) > 3 mL in either testis, or stage 2 or greater for genitalia (G2+), or pubic hair (P2+). We used multivariable interval-censored models to …


Association Between Chlorinated Pesticides In The Serum Of Prepubertal Russian Boys And Longitudinal Biomarkers Of Metabolic Function, Jane Burns, Paige Williams, Susan Korrick, Russ Hauser, Oleg Sergeyev, Boris Revich, Thuy Lam, Mary Lee Jun 2015

Association Between Chlorinated Pesticides In The Serum Of Prepubertal Russian Boys And Longitudinal Biomarkers Of Metabolic Function, Jane Burns, Paige Williams, Susan Korrick, Russ Hauser, Oleg Sergeyev, Boris Revich, Thuy Lam, Mary Lee

Mary M. Lee

Organochlorine pesticides (OCPs) have been linked to adult metabolic disorders; however, few studies have examined these associations in childhood. We prospectively evaluated the associations of baseline serum OCPs (hexachlorobenzene, beta-hexachlorocyclohexane, and p,p'-dichlorodiphenyldichloroethylene) in Russian boys with subsequent repeated measurements of serum glucose, insulin, lipids, leptin, and calculated homeostatic model assessment of insulin resistance (IR). During 2003-2005, we enrolled 499 boys aged 8-9 years in a prospective cohort; 318 had baseline serum OCPs and serum biomarkers measured at ages 10-13 years. Multivariable generalized estimating equation and mediation regression models were used to examine associations and direct and indirect (via body mass …


Use Of A State Inpatient Forensic System Under Managed Mental Health Care, William Fisher, Barbara Dickey, Sharon-Lise Normand, Ira Packer, Albert Grudzinskas, Hocine Azeni Oct 2014

Use Of A State Inpatient Forensic System Under Managed Mental Health Care, William Fisher, Barbara Dickey, Sharon-Lise Normand, Ira Packer, Albert Grudzinskas, Hocine Azeni

Ira K Packer

OBJECTIVES: One of the goals of managed mental health care has been to lower the use of inpatient psychiatric treatment. In the past, interventions that have limited hospitalization for persons with severe mental illness have led to greater involvement of these individuals with the criminal justice and forensic mental health systems. The authors examined associations between Medicaid managed mental health care in Massachusetts and rates of admission to the inpatient forensic mental health service maintained by the state's mental health department. METHODS: A total of 7,996 persons who were receiving services from the department before and after the introduction of …


Measurement Of Mullerian Inhibiting Substance Facilitates Management Of Boys With Microphallus And Cryptorchidism, Madhusmita Misra, David Maclaughlin, Patricia Donahoe, Mary Lee Sep 2014

Measurement Of Mullerian Inhibiting Substance Facilitates Management Of Boys With Microphallus And Cryptorchidism, Madhusmita Misra, David Maclaughlin, Patricia Donahoe, Mary Lee

Mary M. Lee

Mullerian inhibiting substance (MIS) is a gonadal hormone expressed in a sexually dimorphic pattern. In males, serum MIS reflects Sertoli cell function and provides an estimate of seminiferous tubular integrity. We examined the role of MIS determination in the evaluation of boys with microphallus (n = 62) and/or cryptorchidism (n = 156). MIS was normal in 69.2% of boys with isolated microphallus compared with 38.1% of boys with microphallus and coexisting cryptorchidism (P < 0.05). In the cryptorchid group, MIS was normal in 46.8%, low in 24.4%, and absent in 28.8%. Normal values for age were associated with testicular tissue, whereas …


Evaluation Of Short And Tall Stature In Children, Benjamin Nwosu, Mary Lee Sep 2014

Evaluation Of Short And Tall Stature In Children, Benjamin Nwosu, Mary Lee

Mary M. Lee

Children and adolescents whose heights and growth velocities deviate from the normal percentiles on standard growth charts present a special challenge to physicians. Height that is less than the 3rd percentile or greater than the 97th percentile is deemed short or tall stature, respectively. A growth velocity outside the 25th to 75th percentile range may be considered abnormal. Serial height measurements over time documented on a growth chart are key in identifying abnormal growth. Short or tall stature is usually caused by variants of a normal growth pattern, although some patients may have serious underlying pathologies. A comprehensive history and …


Transient Hyperthyroidism In An Adolescent With Hydatidiform Mole, Madhusmita Misra, Lynne Levitsky, Mary Lee Sep 2014

Transient Hyperthyroidism In An Adolescent With Hydatidiform Mole, Madhusmita Misra, Lynne Levitsky, Mary Lee

Mary M. Lee

No abstract provided.


Mullerian Inhibiting Substance In Humans: Normal Levels From Infancy To Adulthood, Mary Lee, Patricia Donahoe, Tomonobu Hasegawa, Bernard Silverman, Gretchen Crist, Sharon Best, Yukihiro Hasegawa, Richard Noto, David Schoenfeld, David Maclaughlin Sep 2014

Mullerian Inhibiting Substance In Humans: Normal Levels From Infancy To Adulthood, Mary Lee, Patricia Donahoe, Tomonobu Hasegawa, Bernard Silverman, Gretchen Crist, Sharon Best, Yukihiro Hasegawa, Richard Noto, David Schoenfeld, David Maclaughlin

Mary M. Lee

Mullerian-inhibiting substance (MIS) is a gonadal hormone synthesized by Sertoli cells of the testis and granulosa cells of the ovary. To facilitate the use of MIS for the evaluation of intersex disorders and as a tumor marker in women with MIS-expressing ovarian tumors, we measured MIS in 600 serum samples from males and females. These data show that mean MIS values for males rise rapidly during the first year of life and are highest during late infancy, then gradually decline until puberty. In contrast, MIS values in females are lowest at birth and exhibit a minimal increase throughout the prepubertal …


Mullerian Inhibiting Substance In The Diagnosis And Management Of Intersex And Gonadal Abnormalities, Michael Gustafson, Mary Lee, Lara Asmundson, David Maclaughlin, Patricia Donahoe Sep 2014

Mullerian Inhibiting Substance In The Diagnosis And Management Of Intersex And Gonadal Abnormalities, Michael Gustafson, Mary Lee, Lara Asmundson, David Maclaughlin, Patricia Donahoe

Mary M. Lee

Mullerian inhibiting substance (MIS), a gonadal hormone important in sexual differentiation, is high (10 to 70 ng/mL) in human male serum postnatally for several years before declining during the peripubertal period, but is undetectable in female serum until the onset of puberty. The sexually dimorphic secretion of MIS suggested possibilities for its use in several clinical settings. Thirty-one patients with intersex and gonadal anomalies from 17 institutions were therefore evaluated between 1989 and 1992 with an MIS enzyme-linked immunosorbent assay (ELISA). Serum MIS levels correlated with the presence of testicular tissue in two patients with suspected anorchia, five patients with …


Consensus Statement On The Use Of Gonadotropin-Releasing Hormone Analogs In Children, Jean-Claude Carel, Erica Eugster, Alan Rogol, Lucia Ghizzoni, Mark Palmert, Mary Lee Sep 2014

Consensus Statement On The Use Of Gonadotropin-Releasing Hormone Analogs In Children, Jean-Claude Carel, Erica Eugster, Alan Rogol, Lucia Ghizzoni, Mark Palmert, Mary Lee

Mary M. Lee

OBJECTIVE: Gonadotropin-releasing hormone analogs revolutionized the treatment of central precocious puberty. However, questions remain regarding their optimal use in central precocious puberty and other conditions. The Lawson Wilkins Pediatric Endocrine Society and the European Society for Pediatric Endocrinology convened a consensus conference to review the clinical use of gonadotropin-releasing hormone analogs in children and adolescents. PARTICIPANTS: When selecting the 30 participants, consideration was given to equal representation from North America (United States and Canada) and Europe, an equal male/female ratio, and a balanced spectrum of professional seniority and expertise. EVIDENCE: Preference was given to articles written in English with long-term …


The Role Of Mullerian Inhibiting Substance In The Evaluation Of Phenotypic Female Patients With Mild Degrees Of Virilization, Madhusmita Misra, David Maclaughlin, Patricia Donahoe, Mary Lee Sep 2014

The Role Of Mullerian Inhibiting Substance In The Evaluation Of Phenotypic Female Patients With Mild Degrees Of Virilization, Madhusmita Misra, David Maclaughlin, Patricia Donahoe, Mary Lee

Mary M. Lee

Mullerian inhibiting substance (MIS) is a sexually dimorphic gonadal hormone with proven efficacy in the evaluation of boys with cryptorchidism and children with intersex conditions. We examined the role of MIS determination in the evaluation of 65 phenotypic females with mild virilization. Among the 28 subjects with MIS values elevated above the normal female range, all had abnormal gonadal tissue: ovotestes in 11, testes in 7, dysgenetic gonads in 7, and MIS-secreting ovarian tumors in 3. Among the 37 children with serum MIS in the normal female range, 19 had detectable MIS and 18 had unmeasurable MIS. In the former …


Mis/Amh In The Assessment Of Cryptorchidism And Intersex Conditions, Mary Lee, Madhusmita Misra, Patricia Donahoe, David Maclaughlin Sep 2014

Mis/Amh In The Assessment Of Cryptorchidism And Intersex Conditions, Mary Lee, Madhusmita Misra, Patricia Donahoe, David Maclaughlin

Mary M. Lee

Mullerian inhibiting substance (MIS), also known as anti-Mullerian hormone (AMH), causes Mullerian duct involution during male sexual differentiation and also has a postnatal regulatory role in the gonads. Serum MIS/AMH has a gonad specific pattern of expression and its concentrations are sexually dimorphic in children; hence measurement of serum MIS/AMH helps in the evaluation of children with gonadal disorders. In boys with cryptorchidism (non-palpable gonads), serum MIS/AMH correlates with testicular tissue. A measurable value is predictive of undescended testes while an undetectable value is highly suggestive of anorchia. In minimally virilized phenotypic females, MIS/AMH helps differentiate between gonadal and non-gonadal …


Predictors Of Serum Dioxin Levels Among Adolescent Boys In Chapaevsk, Russia: A Cross-Sectional Pilot Study, Russ Hauser, Paige L. Williams, Larisa Altshul, Susan Korrick, Lynne Peeples, Donald G. Patterson Jr., Wayman E. Turner, Mary M. Lee, Boris Revich, Oleg Sergeyev Sep 2014

Predictors Of Serum Dioxin Levels Among Adolescent Boys In Chapaevsk, Russia: A Cross-Sectional Pilot Study, Russ Hauser, Paige L. Williams, Larisa Altshul, Susan Korrick, Lynne Peeples, Donald G. Patterson Jr., Wayman E. Turner, Mary M. Lee, Boris Revich, Oleg Sergeyev

Mary M. Lee

BACKGROUND: Toxicological studies and limited human studies have demonstrated associations between exposure to polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs) and polychlorinated biphenyls (PCBs) and adverse developmental and reproductive health effects. Given that children may be particularly susceptible to reproductive and developmental effects of organochlorines, and the paucity of information available regarding childhood exposures to dioxins in particular, we undertook a pilot study to describe the distribution of, and identify potential predictors of exposure to, dioxin-like compounds and dioxins among adolescent boys in Chapaevsk, Russia. The pilot study was also designed to guide the development of a large prospective cohort study …


Diagnostic Utility Of Mullerian Inhibiting Substance Determination In Patients With Primary And Recurrent Granulosa Cell Tumors, Andrew Lane, Mary Lee, Arlan Fuller, David Kehas, Patricia Donahoe, David Maclaughlin Sep 2014

Diagnostic Utility Of Mullerian Inhibiting Substance Determination In Patients With Primary And Recurrent Granulosa Cell Tumors, Andrew Lane, Mary Lee, Arlan Fuller, David Kehas, Patricia Donahoe, David Maclaughlin

Mary M. Lee

OBJECTIVES: In this study we evaluated changes in serum Mullerian inhibiting substance (MIS) concentration in a large number of patients with granulosa cell tumors (GCT) to determine whether MIS is elevated at the time of presentation and whether MIS is an index of successful surgical resection and management of recurrences. METHODS: We retrospectively reviewed MIS levels from 17 subjects prior to tumor resection and studied serial MIS samples from 56 subjects following initial tumor resection. Clinical follow-up information was available for 36 of those with postoperative MIS values. Serum MIS was measured by an ELISA. MIS values were compared to …


Blood Lead Levels And Delayed Onset Of Puberty In A Longitudinal Study Of Russian Boys, Paige Williams, Oleg Sergeyev, Mary Lee, Susan Korrick, Jane Burns, Olivier Humblet, Julie Del Prato, Boris Revich, Russ Hauser Sep 2014

Blood Lead Levels And Delayed Onset Of Puberty In A Longitudinal Study Of Russian Boys, Paige Williams, Oleg Sergeyev, Mary Lee, Susan Korrick, Jane Burns, Olivier Humblet, Julie Del Prato, Boris Revich, Russ Hauser

Mary M. Lee

OBJECTIVE: We evaluated the association of blood lead levels (BLLs) with pubertal onset in a longitudinal cohort of Russian boys.

METHODS: A total of 489 Russian boys were enrolled in 2003-2005, at 8 to 9 years of age, and were monitored annually through May 2008. Cox proportional-hazards models were used to evaluate the association of BLLs at enrollment with time to pubertal onset during follow-up monitoring.

RESULTS: A total of 481 boys had BLLs, with a median of 3 microg/dL and 28% with values of > or =5 microg/dL. The proportion of pubertal boys increased with age, from 12% at age …


Parental Mastery Of Continuous Subcutaneous Insulin Infusion Skills And Glycemic Control In Youth With Type 1 Diabetes, Kathleen Mitchell, Kimberley Johnson, Karen Cullen, Mary M. Lee, Olga T. Hardy Sep 2014

Parental Mastery Of Continuous Subcutaneous Insulin Infusion Skills And Glycemic Control In Youth With Type 1 Diabetes, Kathleen Mitchell, Kimberley Johnson, Karen Cullen, Mary M. Lee, Olga T. Hardy

Mary M. Lee

OBJECTIVE: The purpose of this study is to determine whether parental knowledge of the continuous subcutaneous insulin infusion (CSII) device affects glycemic control as measured by hemoglobin A1c (A1C) level. SUBJECTS AND METHODS: Parents of children with type 1 diabetes mellitus (T1DM) using CSII completed a 14-item questionnaire. Questions 1-10 were knowledge-based questions that required the parent to extract specific information from their child's CSII device. Questions 11-14 asked parents to provide a self-assessment of their CSII knowledge. RESULTS: Twenty-two parents of youth with T1DM participated in the study. Ten of the youth were in the Low-A1C group (A1C/=8%). Parents …


Clinical Management Of Intersex Abnormalities, Patricia Donahoe, David Powell, Mary Lee Sep 2014

Clinical Management Of Intersex Abnormalities, Patricia Donahoe, David Powell, Mary Lee

Mary M. Lee

No abstract provided.


Physical Growth And Sexual Maturation Of Boys In Chapaevsk, Russia, Mary Lee, Oleg Sergeyev, Paige Williams, Susan Korrick, Vladimir Zeilert, Boris Revich, Russ Hauser Sep 2014

Physical Growth And Sexual Maturation Of Boys In Chapaevsk, Russia, Mary Lee, Oleg Sergeyev, Paige Williams, Susan Korrick, Vladimir Zeilert, Boris Revich, Russ Hauser

Mary M. Lee

We characterized physical growth and sexual maturation in 2,579 boys, ages 10 through 16.99 years, residing in Chapaevsk, Russia in order to establish region-specific reference data. Age-specific norms were established for height, weight, and BMI, and compared to US reference data by z-score analysis, while mean heights and weights by age were compared to published national Russian data. Compared to US boys, height was slightly lower (overall z-score -0.18) at all ages except the oldest (16-16.99 yr), while weight and BMI were moderately lower (overall z-score -0.52 and -0.61, respectively). Chapaevsk boys were significantly taller (1.15 cm) and thinner (-1.28 …


Guidelines For The Use Of Growth Hormone In Children With Short Stature., Mary Lee Sep 2014

Guidelines For The Use Of Growth Hormone In Children With Short Stature., Mary Lee

Mary M. Lee

On the basis of the information currently available, the only conditions in which GH therapy appears to be safe and effective in increasing adult height are GH deficiency and, likely, Turner syndrome. Therapy with GH also increases the growth velocity of children with CRI and may increase adult height, but no long-term data are available. Encouraging short-term results have been reported in patients with a few other conditions, such as patients with glucocorticoid-induced growth failure, renal transplantation, and Prader-Willi syndrome, but the data are limited and no long-term studies have been reported; in many other conditions the data are either …


Correlation Of Cognitive Test Scores And Adequacy Of Treatment In Adolescents With Congenital Hypothyroidism., Mary Lee Sep 2014

Correlation Of Cognitive Test Scores And Adequacy Of Treatment In Adolescents With Congenital Hypothyroidism., Mary Lee

Mary M. Lee

PURPOSE: To measure the frequency of noncompliance and its possible effect on school achievement test and cognitive test scores in our older patients with congenital hypothyroidism. METHODS: Fifty patients born from 1976 through 1978 were studied at home when they were 14 years of age. Each patient was given a battery of psychometric and school achievement tests, and blood for hormonal assays was drawn without forewarning from 36 of the patients on the day of examination. Efforts were made to improve control after the second year. During the third summer the tests were repeated in 25 of the 29 patients …


Intracellular Cytokine Production By Dengue Virus-Specific T Cells Correlates With Subclinical Secondary Infection, Steven Hatch, Timothy Endy, Stephen Thomas, Anuja Mathew, James Potts, Pamela Pazoles, Daniel Libraty, Robert Gibbons, Alan Rothman Aug 2014

Intracellular Cytokine Production By Dengue Virus-Specific T Cells Correlates With Subclinical Secondary Infection, Steven Hatch, Timothy Endy, Stephen Thomas, Anuja Mathew, James Potts, Pamela Pazoles, Daniel Libraty, Robert Gibbons, Alan Rothman

Alan Rothman

The pathophysiology of dengue virus infection remains poorly understood, although secondary infection is strongly associated with more severe disease. In the present study, we performed a nested, case-control study comparing the responses of pre-illness peripheral blood mononuclear cells between children who would subsequently develop either subclinical or symptomatic secondary infection 6-11 months after the baseline blood samples were obtained and frozen. We analyzed intracellular cytokine production by CD4(+) and CD8(+) cells in response to stimulation with dengue antigen. We found higher frequencies of dengue virus-specific TNFalpha, IFNgamma-, and IL-2-producing T cells among schoolchildren who subsequently developed subclinical infection, compared with …


T Cell Responses To An Hla-B*07-Restricted Epitope On The Dengue Ns3 Protein Correlate With Disease Severity, Iva Zivna, Sharone Green, David Vaughn, Siripen Kalayanarooj, Henry Stephens, Dasnayanee Chandanayingyong, Ananda Nisalak, Francis Ennis, Alan Rothman Aug 2014

T Cell Responses To An Hla-B*07-Restricted Epitope On The Dengue Ns3 Protein Correlate With Disease Severity, Iva Zivna, Sharone Green, David Vaughn, Siripen Kalayanarooj, Henry Stephens, Dasnayanee Chandanayingyong, Ananda Nisalak, Francis Ennis, Alan Rothman

Alan Rothman

Dengue hemorrhagic fever (DHF), the severe manifestation of dengue virus (DV) infection characterized by plasma leakage, is more common in secondary DV infections in previously infected individuals and is associated with high levels of immune activation. To determine the Ag specificity of this immune response, we studied the response to an HLA-B*07-restricted T cell epitope, residues 221-232 of the DV NS3 protein, in 10 HLA-B*07(+) Thai children who were studied during and after acute DV infections. Peptide-specific T cells were detected in 9 of 10 subjects. The frequency of peptide-specific T cells was higher in subjects who had experienced DHF …


Determinants Of Inapparent And Symptomatic Dengue Infection In A Prospective Study Of Primary School Children In Kamphaeng Phet, Thailand, Timothy Endy, Kathryn Anderson, Ananda Nisalak, In-Kyu Yoon, Sharone Green, Alan Rothman, Stephen Thomas, Richard Jarman, Daniel Libraty, Robert Gibbons Aug 2014

Determinants Of Inapparent And Symptomatic Dengue Infection In A Prospective Study Of Primary School Children In Kamphaeng Phet, Thailand, Timothy Endy, Kathryn Anderson, Ananda Nisalak, In-Kyu Yoon, Sharone Green, Alan Rothman, Stephen Thomas, Richard Jarman, Daniel Libraty, Robert Gibbons

Alan Rothman

BACKGROUND: Dengue viruses are a major cause of morbidity in tropical and subtropical regions of the world. Inapparent dengue is an important component of the overall burden of dengue infection. It provides a source of infection for mosquito transmission during the course of an epidemic, yet by definition is undetected by health care providers. Previous studies of inapparent or subclinical infection have reported varying ratios of symptomatic to inapparent dengue infection.

METHODOLOGY/PRINCIPAL FINDINGS: In a prospective study of school children in Northern Thailand, we describe the spatial and temporal variation of the symptomatic to inapparent (S:I) dengue illness ratio. Our …


T Cell Receptor Vbeta Gene Usage In Thai Children With Dengue Virus Infection, Susan Gagnon, Anita Leporati, Sharone Green, Siripen Kalayanarooj, David Vaughn, Henry Stephens, Saroj Suntayakorn, Ichiro Kurane, Francis Ennis, Alan Rothman Aug 2014

T Cell Receptor Vbeta Gene Usage In Thai Children With Dengue Virus Infection, Susan Gagnon, Anita Leporati, Sharone Green, Siripen Kalayanarooj, David Vaughn, Henry Stephens, Saroj Suntayakorn, Ichiro Kurane, Francis Ennis, Alan Rothman

Alan Rothman

T lymphocyte activation during dengue is thought to contribute to the pathogenesis of dengue hemorrhagic fever (DHF). We examined the T cell receptor Vbeta gene usage by a reverse transcriptase-polymerase chain reaction assay during infection and after recovery in 13 children with DHF and 13 children with dengue fever (DF). There was no deletion of specific Vbeta gene families. We detected significant expansions in usage of single Vbeta families in six subjects with DHF and three subjects with DF over the course of infection, but these did not show an association with clinical diagnosis, viral serotype, or HLA alleles. Differences …


Cytokine Gene Expression And Protein Production In Peripheral Blood Mononuclear Cells Of Children With Acute Dengue Virus Infections, Susan Gagnon, Masuko Mori, Ichiro Kurane, Sharone Green, David Vaughn, Siripen Kalayanarooj, Saroj Suntayakorn, Francis Ennis, Alan Rothman Aug 2014

Cytokine Gene Expression And Protein Production In Peripheral Blood Mononuclear Cells Of Children With Acute Dengue Virus Infections, Susan Gagnon, Masuko Mori, Ichiro Kurane, Sharone Green, David Vaughn, Siripen Kalayanarooj, Saroj Suntayakorn, Francis Ennis, Alan Rothman

Alan Rothman

Plasma leakage in dengue hemorrhagic fever (DHF) is associated with elevated plasma levels of cytokines. To define further the contribution of immune activation to DHF and the source of cytokines, we analyzed the production of cytokines in peripheral blood mononuclear cells (PBMC) obtained from children with dengue, using RT-PCR and immunostaining. Tumor necrosis factor-alpha (TNF-alpha) and TNF-beta expression was detected in all samples by PCR and in < 50% of samples by immunostaining. Interferon-gamma (IFN-gamma) expression was detected in < 50% of samples by either method. Interleukin-2 (IL-2) and IL-4 expression was detected in a few samples by immunostaining but was not …