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Biomedical subjects

A Roy

Publications and source records attributed to A Roy.

At least 163 records · Page 9Linked to original sources
PubMed1998

Natural history of severe duodenal ulcer disease.

BACKGROUND: A subset of patients with chronic duodenal ulcer has severe ulcer diathesis in the form of frequent relapses and complications like perforation and hemorrhage. We observed the effect of drug treatment on the natural history of this subset. METHODS: Of 526 patients diagnosed to have chronic duodenal ulcer by endoscopy, 23 patients with severe diathesis were available for long follow-up (mean period 36 months). Each patient was assessed clinically and endoscopically every 2 months for at least 12 months and then every 3 months or when symptomatic. Helicobacter pylori status was assessed during endoscopy. The effect of antisecretory drugs and anti-H. pylori therapy on natural history was determined. RESULTS: Thirteen of 23 patients (56%) had refractory ulcers; six responded to double dose of H2-receptor antagonists (H2RA) for 8 weeks and six to omeprazole 40 mg daily for 4-8 weeks. Of 20 patients (87%) who were H. pylori-positive, 15 completed triple-drug therapy; of these, 10 patients eradicated H. pylori. These 10 patients were followed up for 24 months; there were no ulcer relapses within the first 12 months but 8 of them relapsed between 12 and 24 months (total number of relapses 8). Reinfection with H. pylori occurred in 3 patients. In the other 10 patients who remained H. pylori-positive, there were 19 episodes of ulcer relapse in 7 patients over 24 months, in spite of maintenance therapy with H2RA (p < 0.05). CONCLUSIONS: Refractoriness in patients with severe ulcer disease is usually episodic and amenable to larger doses of omeprazole or H2RA. Anti-H. pylori therapy improves the natural history but its effect in preventing ulcer relapse is short lasting (less than 12 months). Recurrence of infection is a problem in our population.

Adult↗
PubMed1998

Efficacy of pentoxifylline with aspirin in the treatment of frostbite in rats.

The efficacy of pentoxifylline--a haemorrheologic agent along with aspirin--an analgesic agent was evaluated in the amelioration of the tissue damage due to experimentally induced frostbite in 5 groups (20 each) of rats with body weights ranging between 175 and 200 g. Frostbite was produced experimentally in the hind limbs by exposing the animals to -15 +/- 1 degrees C for 1 h using the harness technique, with simultaneous recording of rectal and environmental temperatures. The degree of tissue damage was assessed on the basis of tissue necrosis after 15 days. Administration of pentoxifylline (40 mg/kg bw) 30 min before and 30 min after the cold exposure followed by two doses of the same daily for the next 5 days along with aspirin (5 mg/kg bw) twice daily for the same duration only after cold exposure, resulted in significant improvement in the degree of tissue preservation. The findings of this preliminary study have brought to light the potential usefulness of these drugs in the treatment of frostbite. The combined pharmacological properties of these two drugs might have altered the haemorrheologic status of blood and produced the curative beneficial effect in improving tissue survival following experimentally induced frostbite in rats.

Animals↗
PubMed1998

[Anti-actin antibodies in acute viral hepatitis A in children].

UNLABELLED: Hepatitis A Virus (HAV) infection has been proposed as a possible trigger of autoimmune hepatitis type I. We have previously reported the presence of anti-actin antibodies en protracted hepatitis A. At present the presence of anti-actin antibodies in acute uncomplicated hepatitis A is unknown. The aim of this study was to evaluate the incidence and persistence of anti-actin antibodies un children with acute hepatitis A. MATERIALS AND METHODS: 38 patients, 21 female and 17 male, with mean age of 6.5 years (range 2-13 years) were included. All patients were anti HAV IgM positive. The patients were clinically controlled and laboratory determinations such as ALT/AST, gammaglobulin, gamma GT, nuclear, smooth muscle (anti-actin specificity) and liver-kidney-microsome type I (anti-LKM) antibodies, were evaluated at admission and at the first, third and fifth month. Anti-actin antibodies were determined by indirect immunofluorescense (IIF) on rat kidney, stomach and liver sections and also on monolayers of cultured fibroblasts. Titers higher than 1/40 were considered positive. RESULTS: 18 patients (47.3%) were anti-actin positive in the first determination (titers 1/40 and 1/80). In 4 patients (12.9%) these antibodies remained positive up to one month. All patients were negative 5 months after the onset of illness. ANA and anti-LKM were negative in all cases. CONCLUSIONS: 1) This data demonstrate the presence of anti-actin antibodies in children with uncomplicated HAV hepatitis. 2) The antibodies remained positive for a short period of time. 3) Titers were lower than in autoimmune hepatitis type I. 4) Taken together these results suggest that anti-actin antibodies would be an expression of non specific stimulation of lymphocyte B.

Actins↗
PubMed1998

[A comparative randomized prospective multicenter study of Sandimmune vs Neoral in liver transplantation].

Despite two decades of use, there are limited data on the best way to administer and monitor cyclosporine for orthotopic liver transplantation (OLT). The present study was undertaken: 1) to establish the safety of a new formulation of cyclosporine, Neoral, 2) to determine if treatment with Neoral will improve the results of liver transplantation and 3) to study the relationship between pharmacokinetic parameters and clinical outcomes after OLT. A double-blind, randomized, comparison of Sandimmune and Neoral was conducted at 5 Canadian centers in 188 consecutive adults undergoing OLT. Patients were induced with intravenous cyclosporine (CsA) then switched to Neoral or Sandimmune. Dose adjustments were made daily, or as needed, to reach a target trough CsA level (C0) of 350 ng/mL in both groups. Pharmacokinetic studies were performed on days 5, 10, 15 and 30 after transplantation. The Neoral group stopped intravenous CsA earlier (p < 0.0001), and these patients required a lower median daily oral dose (p < 0.01) to maintain comparable trough CsA levels. Five Sandimmune patients, but no Neoral patients discontinued the study because of the inability to reach target trough levels of CsA within the prescribed time (p < 0.05). At 4 months, there were no differences between the two groups with respect to patient survival, graft survival or rejection-free survival. The incidence of serious adverse events was also similar and did not correlate with CsA profiles. The Neoral group had a higher area under the drug concentration curve (AUC) and peak CsA levels (Cmax). There was a correlation between freedom from graft rejection and both AUC and Cmax at days 5 and 10 post-transplant. In contrast, there was a poor correlation between C0 and graft rejection. In summary, Neoral appears to be safe and well tolerated by patients. Cmax and/or AUC maybe better markers for monitoring cyclosporine based immunosuppression after liver transplantation.

Administration, Oral↗
PubMed1997

Genetics of suicides. Family studies and molecular genetics.

Suicidal behavior, like so much else in psychiatry, tends to cluster in families. Clinical studies show that a family history of suicide is associated with a raised risk of both attempts at suicide and completed suicide. Twin studies show that monozygotic twins have a greater concordance for suicidal behavior than dizygotic twins. Adoption studies also suggest that there may be genetic factors in suicide. Most recently, molecular genetic studies report that polymorphisms of the tryptophan hydroxylase gene are associated with suicidal behavior.

Adolescent↗
PubMed1997

Acid-sensing by carotid body is inhibited by blockers of voltage-sensitive Ca2+ channels.

The membrane potential hypothesis that the responses to hypercapnia of carotid chemosensory activity is mediated by voltage-gated Ca2+ channels was investigated by measuring directly the chemosensory output from rat and cat carotid bodies, perfused and superfused in vitro. We found that the inorganic and organic blockers of voltage-gated Ca2+ channels suppressed the hypercapnic responses, thereby supporting the membrane potential hypothesis.

Acids↗
PubMed1997

Reduced blue cone electroretinogram in cocaine-withdrawn patients.

BACKGROUND: The main reinforcing effect of cocaine is alteration of dopaminergic neurotransmission in the brain reward systems. Since dopamine is found in high concentrations in the retina, we investigated whether cocaine dependence may be associated with abnormalities of the electroretinogram. METHODS: We compared recently withdrawn cocaine-dependent patients (n = 20) with age-, sex-, and race-matched normal subjects (n = 20) for responses of cone photoreceptors to light flashes on full-field electroretinograms. RESULTS: Cocaine-dependent patients had significantly reduced blue cone electroretinogram responses compared with matched normal subjects. CONCLUSIONS: This result suggests that cocaine-withdrawn patients have a dysregulation of blue cone function. The electroretinogram may be useful in future studies of cocaine-dependent patients.

Adult↗
PubMed1997

Impaired color vision in cocaine-withdrawn patients.

BACKGROUND: The main reinforcing effect of cocaine happens by altering dopaminergic neurotransmission in the brain reward systems. Dopamine is found in high concentrations in the retina in which it plays an important role in color vision. Therefore, we investigated whether cocaine-dependent patients might have impaired color vision. METHODS: We compared patients recently withdrawn from cocaine (n = 31) with matched normal controls (n = 31) on 2 color vision tests. RESULTS: Cocaine-withdrawn patients had significantly higher error scores than matched controls on the Farnsworth-Munsell 100-hue and Lanthony desaturated D-15 color vision tests. Also, 23 of the 31 cocaine-withdrawn patients had blue-yellow color vision losses on the Farnsworth-Munsell 100-hue test compared with 3 controls (P < .001, chi 2 test) and 15 had blue-yellow color vision loss on the Lanthony desaturated D-15 test compared with 2 controls (P < .001, chi 2 test). CONCLUSIONS: These significantly higher test error scores and blue-yellow color vision losses suggest that color vision is impaired in cocaine-withdrawn patients. Color vision testing may be useful in future studies of cocaine-dependent patients.

Adult↗
PubMed1997

Lack of relationship between preoperative measures of the severity of cirrhosis and short-term survival after liver transplantation.

The purpose of this study was to evaluate the prognostic value of clinical measures of the severity of disease in cirrhotic patients who were candidates for liver transplantation at our institution. The records of the 132 cirrhotic patients who were candidates for a first transplantation between January 1, 1987, and December 31, 1994, were reviewed. One hundred nine patients (82.6%) received grafts, and 23 (17.4%) died while on the waiting list. The variables examined included level of medical urgency at the time of enlistment, date of transplantation, serum creatinine level, variables that constitute the Child-Pugh score and Shaw's risk score (serum bilirubin and albumin, prothrombin time, ascites, encephalopathy, nutritional status, age, and operative blood loss), and 6-month survival status after transplantation. The proportion of patients who died awaiting a graft increased as a function of the Child-Pugh score at enlistment (score 5-6, 0%, n = 6; score 7-9, 7%, n = 54; score 10-11, 18%, n = 33; score 12-15, 33%, n = 39; P = .01). Six-month survival rates after transplantation were similar irrespective of the Child-Pugh score or Shaw's risk score. Stepwise multiple logistic regression models identified the degree of ascites, serum bilirubin, and operative blood loss as significant variables for the prediction of overall mortality 6 months posttransplantation (model chi 2 = 12.8; P = .025; r = 0.32), but the model explained only 10% of the outcomes observed. We concluded that the Child-Pugh score is a valid prognostic index for survival up to the time of transplantation for cirrhotic patients on the waiting list; however, clinical measures of the severity of cirrhosis are poor predictors of 6-month survival after transplantation.

Adolescent↗
PubMed1997

Phylogeny and phylogeography of the circumpolar genus Fraxinus (Oleaceae) based on internal transcribed spacer sequences of nuclear ribosomal DNA.

The DNA sequences of the nuclear internal transcribed spacers (1 and 2) of nuclear ribosomal DNA were determined for 27 taxa of Fraxinus in an attempt to reconstruct the phylogeny of the genus and interpret its biogeographic history in a phylogenetic context. Minimal intra-individual and intraspecific polymorphisms were observed and infrageneric taxa were all recovered in phylogenetic analyses. The tree topologies estimated from parsimony and neighbor-joining analyses of one- and two-parameter substitution rates were congruent and supported by high bootstrap estimates. Indels were also found to be phylogenetically informative. The phylogenetic trees obtained were in quite good agreement with the current taxonomy of the genus but homoplasy was observed in the evolution of floral characters. Polyploidy also appeared to have evolved several times in the genus. Fraxinus nigra was more closely related to European and Asian taxa than to the other American ashes. The Asian F. platypoda had a closer relationship to Asian and European ashes in section Bumelioides than to its presumed North American allies of section Melioides. With respect to the position of F. quadrangulata as sister group to the remainder to the remaining species, the subgenus Fraxinus appeared paraphyletic. Phylogeographical analysis indicated that Fraxinus likely originated in North America, with two subsequent events of intercontinental migration from North America to Asia.

Asia↗
PubMed1997

Genetic studies of suicidal behavior.

Suicidal behavior, like so much else in psychiatry, tends to cluster in families. Clinical studies show that a family history of suicide is associated with a raised risk of both attempts at suicide and completed suicide. Twin studies show that monozygotic twins have a greater concordance of suicidal behavior than dizygotic twins. Adoption studies also suggest that there may be genetic factors in suicide. Most recently, molecular genetic studies report that polymorphisms of the tryptophan hydroxylase gene are associated with suicidal behavior.

Adolescent↗
PubMed1997

Personality disorders in people with learning disabilities: a community survey.

The prevalence of personality disorders has been determined by studies of both the general population and mental handicap hospitals. The present study attempts to determine the prevalence of personality disorders in a community sample and to check the implications for treatment. A community sample of learning disability service users was surveyed by obtaining a rating from a good informant to establish demographic data, level of functioning and the nature of personality disorders, if any, using the ICD-10 version of the Standardized Assessment of Personality (SAP). Fifty per cent of the sample had personality abnormalities, and 31% had sufficient impairment of the social and occupational domains and personal distress to warrant a diagnosis of personality disorder. These findings are compared with previous studies. Paranoid, schizoid, impulsive and dissocial personality abnormalities were seen to be associated with a high referral rate to psychiatric services and needed considerable therapeutic input. The prevalence of personality abnormalities in community populations with a learning disability is high. The SAP is a useful instrument for screening. This subpopulation makes significant demands on community psychiatric services.

Adult↗
PubMed1997

Health gain through health checks: improving access to primary health care for people with intellectual disability.

People with intellectual disability were identified through the local register and through liaison with general practitioners (GPs). A consultation exercise was conducted with users and carers to ascertain their experiences and perspectives of primary health care (GP services). A comprehensive health check was devised and administered to about 120 people to detect physical disorders, especially cardiovascular risk factors. A standardized checklist was used to determine the population of people with psychological and psychiatric problems. Case notes were reviewed after nearly one year to determine physical and psychological health gain. Significant gains were noted with regard to physical disorders. In contrast, mental health problems were underreported and participants had achieved few gains on follow-up. The reasons and implications for future service planning are discussed.

Body Mass Index↗
PubMed1997

Manifestations of depression in people with intellectual disability.

The symptoms of 36 people with varying degrees of intellectual disability (ID) who had had an ICD-10 depressive syndrome in the preceding year were compared with 46 non-depressed people with comparable degrees of ID. Throughout the spectrum of ID, symptoms of depressed affect and sleep disturbance were significantly different between the groups. While symptoms in people with mild ID were reflected in the standard diagnostic criteria, this was not the case in people with moderate and severe ID. With increasing disability there was a move towards 'behavioural depressive equivalents' such as aggression, screaming and self-injurious behaviour. Diagnostic criteria for depression among people with severe ID, should place more emphasis on behavioural 'depressive equivalents'.

Depressive Disorder↗
PubMed1997

A case-control study of social risk factors for depression in American patients.

OBJECTIVE: To describe the social risk factors for depression and their interaction with recent life events in depressed American patients. METHODS: Forty patients with a major depressive episode were compared with 40 normal controls. Risk factors for depression were assessed, recent life events recorded, and their interaction examined. RESULTS: Significantly more depressed patients than controls had a poor marriage before the onset of depression and were unemployed. The depressed patients had also recently experienced significantly more life events. The only significant interaction was that employed depressed patients had experienced more recent life events than unemployed depressed patients. CONCLUSION: In addition to recent life events, having a poor marriage and being unemployed may be social risk factors for depression in American patients.

Adult↗