Faculty Bibliography
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Increasing use of the vaccine against zoster through recommendation and administration by ophthalmologists at a city hospital
PURPOSE: To increase the vaccination rate and identify barriers to administration of the vaccine against herpes zoster by having ophthalmologists screen and provide the vaccine. DESIGN: Prospective interventional cohort study. METHODS: setting: Academic City Hospital, Bellevue Hospital. participants: A total of 100 eligible patients based on recommended Centers for Disease Control (CDC) criteria and ability to speak English and Spanish who received the herpes zoster vaccine were compared with 66 patients who declined the vaccine. interventions: The vaccine was administered after written informed consent was obtained to complete a screening questionnaire evaluating the participants' eligibility and interest in receiving the vaccine. main outcome measures: Barriers to administration of the vaccine were evaluated. RESULTS: A total of 170 consenting patients, including 100 patients who were vaccinated, 66 patients who declined vaccination, and 4 patients who were ineligible, were analyzed. The proportion of subjects who would consider receiving the vaccine if recommended by a doctor among those who received the shingles vaccine, 98.0% (95% CI: 95%-100%), was significantly greater than the proportion in the group that declined, 74.2% (95% CI: 64%-85%) (P
PMID: 23394910
ISSN: 0002-9394
CID: 301172
Age-related changes in neutrophil structure and function
The elderly suffer higher rates of morbidity and mortality from infectious disease than younger adults. Since neutrophils are the first line of defense against infection the vulnerability to infection of the elderly may be due, at least in part, to age-related changes in neutrophils (PMNs). Previous studies have suggested that there is an age-related increase in plasma membrane microviscosity in lymphocytes and neurons of the elderly. We have explored the hypothesis that there is a similar change in plasma membrane viscosity in the neutrophil and that this alteration in the neutrophil plasma membrane leads to diminished neutrophil function. When we studied plasma membrane viscosity of neutrophils by determining the fluorescence anisotropy of 1-(4-trimethylaminophenyl)-6-diphenyl-1,3,5-hexatriene labeled cells, we were surprised to find that plasma membrane viscosity is decreased in the neutrophils of the elderly as compared to young controls (microviscosity parameter, 1.33 +/- 0.07, in the elderly, n = 21, versus 1.62 +/- 0.06, in young controls, n = 19, P less than 0.004). As expected, stimulated (FMLP 0.1 microM) O2- generation by neutrophils from the elderly was significantly decreased compared with young controls (34 +/- 7% decrease, n = 6, P less than 0.04). Both resting and stimulated neutrophils demonstrated an age-related decline in adherence to a component of the extracellular matrix, denatured collagen (gelatin, P less than 0.04, n = 22 elderly subjects). In contrast, neutrophils from the elderly adhered to fibrinogen at least as well as neutrophils from young controls. Moreover, chemotaxis to activated complement components (in zymosan activated plasma) and FMLP did not change with increased age whether studied in the Boyden chamber (92 +/- 7% control, n = 14) or under agarose (90 +/- 13% control, n = 11). These studies suggest that an age-related decrease in plasma membrane viscosity is associated with a decrease in O2- production and adherence of neutrophils to components of the extracellular matrix. Thus, age-related alterations in neutrophil structure may result in diminished neutrophil function and increased susceptibility to infection with pyogenic bacteria
PMID: 1328778
ISSN: 0047-6374
CID: 9827
NEUTROPHIL (PMN) STRUCTURE AND FUNCTION CHANGES WITH AGE [Meeting Abstract]
ISI:A1991GA27300037
ISSN: 0002-8614
CID: 51562
NEUTROPHIL STRUCTURE AND FUNCTION CHANGES WITH AGE [Meeting Abstract]
ISI:A1991FH32300342
ISSN: 0009-9279
CID: 51605
