Search PubMed⌕ Search

Biomedical subjects

A Marsh

Publications and source records attributed to A Marsh.

At least 55 records · Page 3Linked to original sources

Coffee shops and clinics: the give and take of doing HIV/AIDS research with injecting drug users.

We discuss recruiting and interviewing injecting drug users and using research as health promotion in the context of collecting information related to human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS) from a convenience sample of 200 injecting drug users, half in treatment and half not, in 1989 and 1990 in Perth, Western Australia. A variety of recruiting methods were used including advertising, referral by agency staff, 'snowballing' and approaches to personal contacts and others known to inject by the interviewer. Snowballing and personal contacts were the most successful means of recruiting those not in treatment, while advertising was comparatively unsuccessful with this group because of the importance of establishing the credibility of the study and the interviewer among injecting drug users before they will volunteer to be involved. The promotion of behavioural risk reduction among respondents during the interview is detailed. We argue that the traditionally rigid separation between research and intervention is inappropriate in the HIV/AIDS context. When lives are potentially at stake, any contact with injecting drug users, especially those not in treatment (where may receive HIV/AIDS education), must be used as an HIV/AIDS prevention opportunity, and the interview is an ideal opportunity. The employment of research as community intervention is also discussed.

HIV Infections↗

Ribosomal DNA probe for differentiation of Babesia microti and B. gibsoni isolates.

The objective of this study was to determine whether different isolates of Babesia microti could be distinguished from morphologically similar isolates of B. gibsoni by using a ribosomal DNA (rDNA) probe. A Babesia-specific rDNA probe was obtained by polymerase chain reaction amplification of sequences from B. microti DNA using universal primers directed against highly conserved portions of the eukaryotic 16S-like rRNA gene. The chemiluminescent rDNA probe hybridized to Southern blots of restriction endonuclease-digested DNA preparations of different isolates of B. gibsoni from infected dogs and B. microti from infected humans and white-footed mice. Restriction fragment length polymorphisms served to differentiate these species. Although the hybridization patterns seen with DNAs from six B. microti isolates did not vary, those of the five B. gibsoni isolates did indicate genotypic variation. We concluded that isolates of B. microti and B. gibsoni can be differentiated on the basis of restriction fragment length polymorphism detected with a chemiluminescent rDNA probe.

Animals↗

A conceptual validation study of the texture response on the Rorschach.

This study addresses the Rorschach texture response (T). The authors proposed a developmental line incorporating tactile self-soothing functions and tactile aspects of interpersonal closeness and related it to T. It was hypothesized that T would be linearly related to one's reliance on tactile cues cognitively by categorizing objects according to texture and behaviorally by touching and stroking. Subjects were 81 women, between the ages of 18 and 30. The results confirm the notion that T is related to both cognitive and behavioral reliance on tactile cues. It was also hypothesized that high T subjects, more than others, would increase their use of tactile cues and touching when stressed, but this hypothesis was not supported. The results were considered to be consistent with the proposed developmental line but not for differential regression along the line. They also supported T as being related to a tactile mode of information processing.

Adolescent↗

Age and injecting drug use in Perth, Western Australia: the Australian national AIDS and injecting drug use study.

Young injecting drug users (IDUs) in Australia are a group about whom little is known. It is suggested, however, that their drug using behaviours and life styles put them at particular risk for HIV/AIDS. Data collected in Perth from 195 respondents in the Australian National AIDS and Injecting Drug Use Study was analyzed with emphasis on the distinctions between young and older injecting drug users. It was found that, relative to those aged 23 or over, IDUs under 23 used more stimulants and LSD and fewer opiates and benzodiazepines; were more likely to inject all or most of their drugs; were less likely to have been in treatment; had more sex partners; were less likely to have changed their drug taking behaviour because of AIDS; were less likely to use alone; shared needles less frequently but shared at least some of the time; and had less knowledge of AIDS and were more pessimistic about the long term outcomes of AIDS. Such characteristics need to be taken into account if effective intervention and prevention strategies for this group are planned.

Acquired Immunodeficiency Syndrome↗

The haemodynamic effects of bronchoscopy. Comparison of propofol and thiopentone with and without alfentanil pretreatment.

The haemodynamic response to bronchoscopy under general anaesthesia was investigated. Forty patients were allocated at random to receive either thiopentone or propofol; half the patients in each group received in addition 18 micrograms/kg of alfentanil one minute before induction of anaesthesia. The heart rate, noninvasive blood pressure and Holter ECG was monitored in all patients. Significant increases in heart rate (p less than 0.05), systolic and diastolic arterial pressures (p less than 0.01) occurred in the thiopentone only group, following bronchoscopy. Systolic and diastolic arterial pressure decreased in patients receiving thiopentone plus alfentanil, following induction of anaesthesia and laryngoscopy (p less than 0.05). No significant haemodynamic changes were seen in either of the groups which received propofol. ST segment changes on subsequent Holter analysis were seen in four patients, but there were no significant differences between the groups. Anaesthesia with propofol alone provides adequate haemodynamic stability for bronchoscopy and the addition is superfluous.

Aged↗

The effects of swabbing the skin on apparent blood ethanol concentration.

The swabbing of the arm with ethanol before venepuncture significantly raised the apparent blood ethanol concentration, when compared to the unswabbed arm. In contrast, when isopropanol was substituted for ethanol in these studies, no change in the blood ethanol concentration was determined.

1-Propanol↗

Dietary intake and clinical, anthropometric and biochemical indices of malnutrition in elderly demented patients and non-demented subjects.

Anthropometric and biochemical indices of nutritional status and weighed dietary intake have been studied in hospitalized patients with senile dementia, demented patients living in the community and age-matched control subjects who were not cognitively impaired. Demented patients were lighter than control subjects, and had a lower body mass index, skinfold thickness, mid-arm circumference and arm muscle bulk. The hospitalized patients were more seriously affected than those living in the community, and body weight was significantly negatively correlated with duration of hospitalization. Over a 6-month period the hospitalized patients showed a further weight loss, while those living in the community did not. Both groups of demented patients had higher intakes of energy, protein, vitamins and minerals than the control subjects. The diet of the hospitalized patients was slightly, but not significantly, superior to that of the patients living in the community. Biochemical evidence of specific vitamin inadequacy was equally prevalent in all three groups of subjects, and there were no significant correlations between the degree of cognitive impairment or behavioural disorder and any of the indices of nutritional state. Clinical signs suggestive of malnutrition were not correlated with either biochemical evidence of deficiency or cognitive impairment and behavioural disturbance.

Aged↗

The activation of red blood cell transketolase in groups of patients especially at risk from thiamin deficiency.

Erythrocyte transketolase activation by thiamin diphosphate has been studied in elderly patients with moderate or severe chronic dementia, acute alcoholic admissions and chronic alcoholics with evidence of brain damage, mostly of the Wernicke-Korsakoff type. Significantly more patients in each group than controls showed abnormal activation of transketolase, not only by 0.3 mM thiamin diphosphate (TDP) but also in further activation by increase to 3 mM. This indicated the presence in a proportion of the alcoholic and the demented patients of an abnormal enzyme variant, similar to that previously found in vitro. The modified transketolase activation test may warn not only of marginal thiamin deficiency but also independently, of susceptibility to brain damage in patients at risk.

Adult↗

Adaptation of coenzyme stimulation assays for the nutritional assessment of vitamins B1, B2 and B6 using the Cobas Bio centrifugal analyser.

Adaptation of coenzyme stimulation assays for the nutritional assessment of thiamine, riboflavin and pyridoxine on the Cobas Bio centrifugal analyser are described. Whole blood was collected into acid-citrate dextrose, which preserves the erythrocytes, prior to assay for several days. Washed erythrocytes stored at -70 degrees C and subsequently thawed, showed altered enzyme activities. The methods offer improved precision over existing procedures and take advantage of the high throughput capabilities of the instrumentation.

Anorexia Nervosa↗

The effect of lithium on choline transport in human erythrocytes.

Erythrocytes from lithium treated patients were separated according to the time they had been circulating in the plasma. Choline transport and choline content were measured in the erythrocyte fractions separated according to age, in order to investigate the relationship between decreased choline transport and increased choline content seen in lithium treated patients. The most recently formed erythrocytes of normal subjects had the greatest choline content and the most active choline carrier. The erythrocytes of lithium treated patients had reduced choline carrier activity and increased choline content in all age bands. However the greatest accumulation of choline and least inhibited choline carrier activity was seen in the most recently formed cells. The alteration in phospholipid concentrations measured could not of themselves account for elevated erythrocyte choline levels seen in lithium treated patients. It is concluded that the increase in choline content levels in lithiated erythrocytes does not have a simple inverse relationship with the deficiency in choline transport. The inhibition of the choline carrier is caused by modification due to circulation in lithiated plasma rather than a lack of its synthesis in reticulocytes.

Choline↗

Headaches after childbirth.

71 women were examined daily for the presence of headache in their first post partum week. Post natal headache (PNH) occurred in 27, (39%) of the women and was most frequent on days 4-6 post partum. PNH was significantly associated with a previous or family history of migraine and pre-menstrual migraine. Although 83% of those with PNH had a migraine diathesis, they did not describe their headache as one of their usual migraines as it was considerably milder. Headaches were more frequent among multigravida but as rather more multigravida had a previous migraine diathesis this may reflect a sampling bias. PNH subjects had significantly more tension and depression suggesting that at least some PNH may be tension headache. Around 3 or 4 days post partum, women began to lose weight and the onset of headache often coincided with the start of this weight loss. 12 women with, and 12 without PNH took part in a metabolic study, and collected sequential 24 h urine samples from days 2-7 post partum. Potassium and oestrogen excretion were increased on day 3, and progesterone on days 3, 4 and 5. Differences in the excretion pattern of these hormones might reflect small changes in renal function and further work measuring plasma hormone levels could help to clarify this. PNH, like pre-menstrual headache and pill withdrawal headache may represent a further example of the triggering effect that a fall in sex hormone level has on the migraine diathesis.

Adolescent↗

A psychofeedback approach to schizophrenia.

Annitto (1981) has criticized my work on the nature of hallucinations (March 1979). One of his points--the need to take the patient's affective state into account--is valid. His other criticisms--that I propose to use my outline of hallucination types for diagnostic purposes and that I have blamed the patient--are serious misconstructions of my work. A number of psychological techniques used for alleviating hallucinations in an acute schizophrenic patient are described. A psychofeedback approach, based on the biofeedback model used in psychosomatic medicine, is proposed as a modifying treatment for some schizophrenic patients.

Affect↗

Premorbid social competence and the revolving door phenomenon in psychiatric hospitalization.

The relation between premorbid social competence and length of initial hospitalization was examined in 381 male state hospital patients in four diagnostic categories: schizophrenic, affective reaction, psychoneurotic, and personality disorder. A significant relation was discovered between diagnosis and outcome, with schizophrenic patients having the longest and personality disorder patients the shortest lengths of initial hospitalization. Premorbid social competence was related to outcome, as assessed both by length of initial hospitalization, and by whether the patient was rehospitalized. These two outcome measures were found to be positively related, thus supporting the developmental formulation that premorbid social competence is indicative generally of prognosis. The findings were employed to generate the inference that patients at differing levels of premorbid social competence require different treatment modalities.

Adult↗