Search PubMed⌕ Search

Biomedical subjects

A Beck

Publications and source records attributed to A Beck.

At least 127 records · Page 7Linked to original sources
PubMed1999

On the origin of the olfactory receptor family: receptor genes of the jawless fish (Lampetra fluviatilis).

In vertebrates, recognition of odorous compounds is based on a large repertoire of receptor subtypes encoded by a multigene family. Towards an understanding of the phylogenetic origin of the vertebrate olfactory receptor family, attempts have been made to identify related receptor genes in the river lampreys (Lampetra fluviatilis), which are descendants of the earliest craniates and living representatives of the most ancient vertebrates. Employing molecular cloning approaches led to the discovery of four genes encoding heptahelical receptors, which share only a rather low overall sequence identity but several of the characteristic structural hallmarks with vertebrate olfactory receptors. Furthermore, in situ hybridization studies demonstrated that the identified genes are expressed in chemosensory cells of the singular lamprey olfactory organ. Molecular phylogenetic analysis confirmed a close relationship of the lamprey receptors to vertebrate olfactory receptors and in addition demonstrated that olfactory genes of the agnathostomes diverged from the gnathostome receptor genes before those split into class I and class II receptors. The data indicate that the lamprey receptors represent the most ancient family of the hitherto identified vertebrate olfactory receptors.

Amino Acid Sequence↗
PubMed1999

[Functional treatment of acute Achilles tendon rupture. A histological, immunohistological and ultrasonographic analysis of the animal model].

In 105 rabbits the course of healing was examined at 1, 2, 4, 8 and 12 weeks (21 rabbits per group) after an experimental Achilles tendon rupture. The following treatment modalities were compared: a. operative functional treatment (resorbable suture, Kleinert technique) b. operative functional treatment with fibrin glue c. primary functional treatment. For the functional (after)-treatment a special orthosis was applied. A 7.5 MHz Ultrasound probe was used for the ultrasonographic evaluation. The histological specimens were stained after Masson-Goldner with Azan. Collagen Type III was depicted immunohistologically with polyclonal antibodies. A semiquantitative fibrocytes count was performed. The histological results showed a smooth healing in the prim. functional treatment group reaching parallel orientation of collagen fibers at 12 weeks. In the fibrin glue-group the fibrin was resorbed after 4 weeks without essential influence to the course of healing. In the suture-group a secondary gapping of the tendon stumps was detectable. At 12 weeks the histological evaluation in all groups showed approximately normal tendon pattern. Immunohistochemically all groups showed cell-associated positive reactions for type III-collagen after 1 week with a maximum after 2 weeks. The semiquantitative fibrocyte count in the primary funct. group showed a maximal number after 1 week, in the fibrin glue- and suture-groups the maximal number could be found after 2 weeks. Sonographically an increase in tendon thickness was detectable up to the 4th weeks in all groups. The secondary gapping of the tendon stumps in the suture group could be detected sonographically. The echogenicity of the tendon during the course of healing showed increasing homogeneity and parallelism in all groups. At 12 weeks the echogenicity was comparable in all groups. The experiment could prove the equivalence of the primary functional treatment to operative therapy in Achilles tendon rupture.

Achilles Tendon↗
PubMed1999

Sumatriptan treatment for migraine in a health maintenance organization: economic, humanistic, and clinical outcomes.

This study was undertaken to assess the impact of 12 months of sumatriptan therapy (6 mg subcutaneously) for migraine on health care use, health-related quality of life, productivity, patient satisfaction with the medication, and clinical efficacy in a health maintenance organization (HMO). One hundred forty-eight patients received open-label sumatriptan for 12 months for the treatment of migraine. Medical records were reviewed to obtain information on the frequency of migraine-related health care use during the 12 months before and during sumatriptan treatment. Patients completed questionnaires on their productivity at work, health-related quality of life, and satisfaction with medication at baseline and after 3, 6, and 12 months of sumatriptan treatment. For each migraine, patients recorded pain severity scores before and after taking sumatriptan and the time between dosing and onset of meaningful relief. Sumatriptan was associated with significant reductions in migraine-related use of general outpatient services, telephone calls, urgent care services, and emergency department visits (P < 0.05); a significant increase in the use of pharmacy services (P < 0.05); and significant and sustained improvements in health-related quality-of-life scores compared with baseline (P < 0.001). Patients lost significantly less time from work and were significantly more satisfied with sumatriptan compared with their usual therapy (P < 0.05). Two hours after dosing, 81% of patients experienced reduction of moderate or severe pain to mild or no pain, and 90% of all patients experienced meaningful relief of pain. The use of sumatriptan for 12 months in an HMO was associated with reductions in health care use and improved health-related quality of life, productivity, and patient satisfaction with medication.

Adult↗
PubMed1999

Diastolic function and tachycardia in hypertensive children.

We investigated the prevalence and potential predictors of Doppler echocardiographic evidence of diastolic function in untreated hypertensive children. Doppler and M-mode echocardiographic values from 42 children (mean age 13, range 5-17 years) from a pediatric hypertension clinic were retrospectively reviewed and compared to data from 39 age and gender matched normotensive children in a control group. Compared to the participants in the control group, hypertensive patients had increased mean body mass index (29 v 19 kg/M2, P < .0001), peak mitral A velocity (57 v 42 cm/sec, P < .0001), isovolumic relaxation time (65 v 42 msec, P < .0001, resting heart rate (90 v 74 bpm, P < .0001), mitral E deceleration time (150 v 137 msec, P = .006), indexed left ventricular mass index (32 v 26 g/M2.7, P < .0001), relative left ventricular wall thickness (0.32 v 0.29, P = .02), and decreased ratio of peak mitral E velocity/peak mitral A velocity (1.7 v 2.1, P = .0001). Mean age, height, mitral E velocity, mitral A deceleration time, fractional shortening, and indexed left ventricular diastolic dimension were similar in patients and control group children. In the hypertensive patients, multivariate analysis demonstrated that heart rate (P = .0008) and systolic blood pressure (P = .03) were significant predictors of peak A velocity. In addition, heart rate (P = .0003), body mass index (P = .04), and indexed left ventricular diastolic dimension (P = .04) predicted the ratio of peak E/peak A velocity. None of the measures of diastolic function correlated with left ventricular mass index or relative wall thickness. Furthermore, none of the analyzed variables predicted isovolumic relaxation time or mitral E deceleration time. We conclude that untreated hypertensive children have Doppler indices suggestive of impaired left ventricular relaxation. Resting heart rate was the strongest predictor of abnormal diastolic indices.

Adolescent↗
PubMed1999

Practical methods to increase use of advance medical directives.

OBJECTIVE: To compare the effectiveness of two means for increasing the use of advance medical directives: written materials only versus written materials and an educational videotape. DESIGN: Population-based, randomized controlled trial with 3-month follow up. SETTING: Kaiser Permanente Colorado Region, a not-for-profit group-model health maintenance organization. PARTICIPANTS: A population-based sample of all 1,302 members aged 75 years and older who used the Franklin Medical Office, excluding 55 persons who died or disenrolled during the study period or were identified by their physicians as blind or cognitively impaired. INTERVENTIONS: All subjects were mailed a 10-page cartoon-illustrated educational pamphlet on patient choices, a selection of Colorado advance medical directive forms, and a guide to their completion; 619 subjects also were mailed a 20-minute videotape on advance directives. Both groups had access to a study nurse for assistance in completing and placing advance medical directives. MEASUREMENTS AND MAIN RESULTS: The main outcome measure is the proportion of subjects who placed a directive in their medical record for the first time. Placement rates increased almost identically, from 21.2% to 35.0% in the written materials-only group and from 18.9% to 32.6% in the group receiving the videotape (95% confidence interval for difference -0.04, 0.04, p =.952). CONCLUSIONS: In an elderly population with a substantial baseline placement rate, mailing of written materials substantially increased placement of an advance directive in the medical record, but the addition of a videotape did not. Mailing the video did increase the use of treatment trials and made patients more aware of reasons not to use advance directives.

Advance Directives↗
PubMed1999

Identification of multiple protective epitopes (protectopes) in the central conserved domain of a prototype human respiratory syncytial virus G protein.

A recombinant fusion protein (BBG2Na) comprising the central conserved domain of the respiratory syncytial virus subgroup A (RSV-A) (Long) G protein (residues 130 to 230) and an albumin binding domain of streptococcal protein G was shown previously to protect mouse upper (URT) and lower (LRT) respiratory tracts against intranasal RSV challenge (U. F. Power, H. Plotnicky-Gilquin, T. Huss, A. Robert, M. Trudel, S. Stahl, M. Uhlén, T. N. Nguyen, and H. Binz, Virology 230:155-166, 1997). Panels of monoclonal antibodies (MAbs) and synthetic peptides were generated to facilitate dissection of the structural elements of this domain implicated in protective efficacy. All MAbs recognized native RSV-A antigens, and five linear B-cell epitopes were identified; these mapped to residues 152 to 163, 165 to 172, 171 to 187 (two overlapping epitopes), and 196 to 204, thereby covering the highly conserved cysteine noose domain. Antibody passive-transfer and peptide immunization studies revealed that all epitopes were implicated in protection of the LRT, but not likely the URT, against RSV-A challenge. Pepscan analyses of anti-RSV-A and anti-BBG2Na murine polyclonal sera revealed lower-level epitope usage within the central conserved region in the former, suggesting diminished immunogenicity of the implicated epitopes in the context of the whole virus. However, Pepscan analyses of RSV-seropositive human sera revealed that all of the murine B-cell protective epitopes (protectopes) that mapped to the central conserved domain were recognized in man. Should these murine protectopes also be implicated in human LRT protection, their clustering around the highly conserved cysteine noose region will have important implications for the development of RSV vaccines.

Animals↗
PubMed1999

Routine clinical outcome measures for patients with severe mental illness: CANSAS and HoNOS.

BACKGROUND: Two recently developed measures intended for clinical use are HoNOS (Health of the Nation Outcome Scales), measuring social functioning, and CANSAS (Camberwell Assessment of Need Short Appraisal Schedule), for measuring need. AIMS: We investigated the association between CANSAS and HoNOS. RESULTS: For some domains there were substantial associations, with high HoNOS rating correlated with CANSAS rating of the presence of a need. For other areas the agreement was less than might be expected. Seven factors were identified within the 22 CANSAS domains, and the presence of needs in the Drug/alcohol and Activities of daily living factors was associated with high scores in the related HoNOS domains. CONCLUSIONS: CANSAS and HoNOS assessments differ. HoNOS can track changes in social functioning over time, but may be less useful for treatment planning, and should not be used to infer the level of morbidity in a case-load. CANSAS indicates when treatment should be commenced or continued. It can also be used as a case-load measure, but may be insufficiently sensitive to be used as an outcome measure at the individual level.

Adult↗
PubMed1999

Evaluating mental health policy in England. Care Programme Approach and supervision registers.

BACKGROUND: The Care Programme Approach (CPA) and supervision register policies in England are intended to prioritize patients to receive specialist mental health care. AIMS: To describe and evaluate the practical application of the policies. METHOD: A questionnaire survey of key informants in mental health provider trusts and an analysis of aggregated data collected by health authorities using the Mental Illness Needs Index as a measure of population need. RESULTS: On average, 1175 per 100,000 total population are subject to the CPA (95% CI = 1055-1309) and 8.6 per 100,000 (95% CI = 7.5-9.9) are on supervision registers. Wide local variations in the number of people subject to the CPA and supervision registers are not explained by variations in population need. CONCLUSIONS: Prioritization to receive specialist mental health services is carried out inconsistently, and inequitable use of resources may result.

Community Mental Health Services↗
PubMed1999

Advances in reverse transcription polymerase chain reaction analysis of cellular mRNA levels of transforming growth factor-beta1 by capillary electrophoresis with laser-induced fluorescence detection.

The prosclerotic transforming growth factor beta1 (TGF-beta1) is a key factor in the induction and maintenance of fibrosis in different organs. To assess relative changes in TGF-beta1 mRNA levels, the comparative kinetic reverse transcription-polymerase chain reaction strategy was used. In this method, cellular mRNA levels of the target and a house-keeping gene are reverse transcribed, amplified by the polymerase chain reaction (PCR) and the kinetics of PCR amplification are compared. Since the current determination of the PCR products, using electrophoretic separation in polyacrylamide gel, staining and scanning of the gel, is time-consuming (> or = 5 hours) and inaccurate, we have developed a method using capillary gel electrophoresis (CGE) in combination with laser-induced fluorescence (LIF) detection for quantification of PCR-products. Using the CGE-LIF method, a minute aliquot of the PCR reaction mixture is separated and quantified within 10 min. Comparison of the values with those obtained by polyacrylamide gel electrophoresis demonstrates the improved sensitivity (> 1000 fold) and accuracy of the proposed method. The CGE-LIF procedure offers a convenient way of automated, comparative analysis of low levels of mRNA via reverse transcription PCR in low cell numbers or small amounts of tissue samples.

Electrophoresis, Capillary↗
PubMed1999

Posttraumatic stress disorder in primary care.

BACKGROUND: Primary care providers are aware of the importance of identifying depression and anxiety in their patients. The diagnosis of posttraumatic stress disorder (PTSD), however, is less of a priority. METHODS: Primary care physicians and nurse practitioners in an outpatient facility of a large health maintenance organization administered a psychiatric screening questionnaire to patients whom they suspected had depression or anxiety. Patients with positive results were referred for immediate consultation with a clinical psychologist. RESULTS: One hundred fourteen (38.6%) of the 296 patients referred for consultation met Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) diagnostic criteria for PTSD. The most frequent traumas associated with PTSD were adult domestic violence and childhood abuse. Patients with a diagnosis of PTSD were frequent users of medical services in the 12 months before diagnosis. The majority of patients sought treatment in primary care settings, not mental health settings. CONCLUSIONS: Patients with PTSD often visit outpatient primary care settings. Medical providers may identify symptoms of depression or anxiety but may not recognize PTSD because of the high degree of overlap between these conditions, and the lack of familiarity with PTSD diagnostic criteria. We provide screening questions that may help physicians detect PTSD in their practices.

Adult↗
PubMed1998

The recombinant Klebsiella pneumoniae outer membrane protein OmpA has carrier properties for conjugated antigenic peptides.

Klebsiella pneumoniae OmpA, the 40-kDa major protein of the outer membrane, was cloned and expressed in Escherichia coli. The recombinant protein was produced intracellularly in E. coli as inclusion bodies. Fusion of a short peptide to the N-terminus of native P40 facilitated high-level expression of the recombinant protein. Purified recombinant P40 was analyzed to verify purity and structural integrity. The molecular mass of purified recombinant P40 determined by electrospray mass spectrometry was 37,061 Da, in agreement with the theoretical mass deduced from the DNA sequence. Specific proliferation of recombinant-P40-primed murine lymph node cells in response to recombinant P40 stimulation in vitro indicated the presence of a T-cell epitope on recombinant P40. The induction of high serum antibody titers to a synthetic peptide derived from the attachment protein G of the respiratory syncytial virus when chemically coupled to recombinant P40 indicated that the protein had potent carrier properties.

Amino Acid Sequence↗
PubMed1998

Assessment of vulvovaginal complaints: agreement between phone and office management.

Objective: To examine the agreement between nursing phone and provider office management of vulvovaginitis.Methods: Patients who called the Kaiser Permanente Phone Call Center with vulvovaginal complaints were evaluated by a registered nurse, who took a standardized history, and made an assessment and plan; additionally, she made a judgment regarding whether she would have treated the patient over the phone. These patients were seen in the office the same day and examined and treated by a clinician following a protocol that included cultures for typical vaginal and cervical pathogens. Providers also made a judgment about phone treatment. Nurses and providers were blinded to each others' diagnosis and therapy. Kappa coefficients were used to evaluate the interexaminer agreement between nurses on the phone and providers in the office with respect to diagnosis and treatment.Results: Four hundred eighty-five patients underwent phone evaluation. Of these, 253 (52%) completed the study protocol and were considered in the final analysis. Kappa values for the diagnosis of trichomoniasis (0.05), bacterial vaginosis (0.12), candidiasis (0.22), chlamydia, herpes simplex, and urinary tract infections (0.05), and "other" (0.05) demonstrated poor agreement between nurses and providers. There was also poor agreement between phone nurses and providers regarding the necessity of an office visit (0.14).Conclusion: This prospective study challenges the notion that the telephone is an effective tool for diagnosing and treating vulvovaginal complaints. Patients with these complaints should be evaluated in the office. Alternatively, programs should be developed and analyzed to educate nurses involved in telephone triage of vulvovaginitis.

Journal Article↗
PubMed1998

Perceived ethnicity and the risk of compulsory admission.

Black-Caribbean patients are more often admitted compulsorily to psychiatric wards than patients from other ethnic groups. We tested the hypothesis that perceived ethnicity of a patient had no independent effect on the risk of compulsory admission. For all consecutive admissions over a 6-month period to acute psychiatric wards in Nottingham, medical officers responsible for the decision to admit completed a questionnaire recording clinical details of the patients and reasons for admission. The results showed that 43.2% of Black-Caribbean patients and 18.8% of White patients were admitted compulsorily (unadjusted odds ratio 3.29, 95% CI 1.71-6.33). Perceived ethnicity (Black-Caribbean) was significantly associated with being young, receiving a diagnosis of psychosis, and being perceived to be at a risk of violent acting out. A forced entry logistic regression model was used to adjust for hypothesised confounding variables such as age, sex, diagnosis, risk, socio-economic status and level of social support. A diagnosis of psychosis, risk of committing violence and being Black-Caribbean had independent effects on the risk of being compulsorily detained. The odds ratio for compulsory detention of Black-Caribbean patients was 2.16 (95% CI 1.03-4.52) after adjusting for the hypothesised confounding variables.

Adolescent↗
PubMed1998

Metabolic changes in patients with mitochondrial myopathies and effects of coenzyme Q10 therapy.

We used a standardized bicycle ergometry protocol with a stepwise increasing workload (30-100 W) to evaluate various metabolic factors for the diagnosis and metabolic monitoring of mitochondrial encephalomyopathies. All patients (n = 9) showed pathological venous lactate/pyruvate (L/P) ratios, which normalized in three patients after 6 months of coenzyme Q10 (CoQ) therapy. Thus, the L/P ratio proved to be the clinically most useful parameter in the evaluation and monitoring of mitochondrial diseases, showing higher sensitivity than lactate measurements only. CoQ may exert a favourable effect in some patients with mitochondrial diseases.

Adolescent↗