Search PubMed⌕ Search

Biomedical subjects

B Vaughn

Publications and source records attributed to B Vaughn.

12 recordsLinked to original sources
PubMed2000

Prospective long-term study of vagus nerve stimulation for the treatment of refractory seizures.

PURPOSE: To determine the long-term efficacy of vagus nerve stimulation (VNS) for refractory seizures. VNS is a new treatment for refractory epilepsy. Two short-term double-blind trials have demonstrated its safety and efficacy, and one long-term study in 114 patients has demonstrated a cumulative improvement in efficacy at 1 year. We report the largest prospective long-term study of VNS to date. METHODS: Patients with six or more complex partial or generalized tonic-clonic seizures enrolled in the pivotal EO5 study were prospectively evaluated for 12 months. The primary outcome variable was the percentage reduction in total seizure frequency at 3 and 12 months after completion of the acute EO5 trial, compared with the preimplantation baseline. Subjects originally randomized to low stimulation (active-control group) were crossed over to therapeutic stimulation settings for the first time. Subjects initially randomized to high settings were maintained on high settings throughout the 12-month study. RESULTS: The median reduction at 12 months after completion of the initial double-blind study was 45%. At 12 months, 35% of 195 subjects had a >50% reduction in seizures, and 20% of 195 had a >75% reduction in seizures. CONCLUSIONS: The efficacy of VNS improves during 12 months, and many subjects sustain >75% reductions in seizures.

Electric Stimulation Therapy↗
PubMed1999

Role of arachidonyl triglycerides within lipid bodies in eicosanoid formation by human polymorphonuclear cells.

Increasing evidence suggests that the subcellular and glycerolipid localization of esterified arachidonic acid (AA) is a key factor in regulating its availability to lipases. The goal of the current study was to determine the potential of AA stored in triglycerides (TG) to serve as a substrate for lipases and 5-lipoxygenase during neutrophil (polymorphonuclear leukocytes, PMN) activation. PMN containing high concentrations of AA in TG were generated by culturing PMN in vitro with high concentrations of exogenous AA (eAA) for 12 h. Cellular AA increased 2- and 4-fold in PMNs incubated with 5 and 20 microM AA, respectively, and this increase was almost exclusively observed in neutral lipids (NL). Further analysis revealed that 88% of the AA in the NL fraction was associated with TG. Subsequent experiments were designed to determine whether this AA in TG could be mobilized and metabolized to eicosanoids during cell activation. TG pools of AA were increased as previously described and then PMN were stimulated with ionophore, A23187. In contrast to the 43-fold increase in TG AA after eAA loading (20 microM), free AA increased by only 1.9-fold after cell stimulation. Similarly, leukotriene (LT)B(4) production increased only 2-fold after loading TG with large quantities of AA. The magnitude of increase in free AA released and in LTB(4) formation was similar to the magnitude of increase in AA mass in phospholipase (PL), suggesting that PL, and not TG, served as the source of released AA and subsequent product generation. To confirm that AA in TG did not serve as a source for eicosanoid production, cellular pools of AA were differentially labeled with [(14)C]AA and [(3)H]AA, and the [(3)H]AA-to-[(14)C]AA ratio of LTB(4) and 20-hydroxyl LTB(4) produced during cell stimulation was measured. The [(3)H]AA/[(14)C]AA ratios of LTs were markedly different from the ratios in TG, thus providing further evidence that AA pools in TG are not a major source of AA for LT generation.

Arachidonic Acids↗
PubMed1995

A double-blind, randomized, placebo-controlled, crossover trial of pentoxifylline for the prevention of chemotherapy-induced oral mucositis.

Oral mucositis is a frequent side effect of cancer therapy. No effective method of prophylaxis is currently available. We conducted a randomized, double-blind, placebo-controlled, crossover trial of pentoxifylline to evaluate its potential in preventing mucositis in cancer patients receiving chemotherapy. Ten cancer patients were randomized for treatment with a 15-day course of 400 mg of pentoxifylline given orally four times daily. Concurrent chemotherapy consisted of bolus cisplatin and infusional 5-fluorouracil. Mucositis was evaluated with the use of the Oral Assessment Guide developed at the University of Nebraska. Patients completing two cycles of chemotherapy--one with pentoxifylline and one with placebo--were evaluated for prophylaxis efficacy. Comparison of the oral assessment scores of the two cycles with a two-sided Student's t test failed to demonstrate a cytoprotective effect for pentoxifylline over placebo. We conclude that pentoxifylline as given in this study is ineffective for preventing mucositis in patients receiving cisplatin and 5-FU.

Administration, Oral↗
PubMed1989

Psychoanalytic reconstructions and empirical data: reciprocal contributions.

Freud (1905, 1917, 1937) throughout his lifetime sought empirical scientific confirmation of the validity of his discoveries. In pursuit of this goal, he persistently emphasized the importance of establishing agreement between analytic reconstructions and the results of naturalistic child observation. The same objective lead Lichtenberg (1983), Emde (1981, 1985), and Stern (1985) to produce detailed evaluations of the impact of infant research findings on analytic developmental propositions. The present paper examines the relation among clinical reconstructions from an analysis developed through transference interpretations, empirical observations originating in the analytic patient's daughter's psychotherapy, and the results of empirical infant research that was being concurrently conducted by two of the authors. The findings from the clinical analysis of the mother, the psychotherapy of the daughter, and empirical infant research all converged on the same larger causative factor for the daughter's psychopathology--a type of maternal deprivation. Such a confluence of different sources of evidence, each identified by a different method of investigation, provides one kind of validation for psychoanalytic reconstructions, making it possible to provide that "satisfactory degree of certainty" which Freud (1937) called for in the attempt to integrate the patient's "psychic truth" with "actual" or historical truth.

Adult↗
PubMed1984

Culdocentesis and ectopic pregnancy.

Seventy-seven patients with ectopic pregnancy underwent culdocentesis; the tap was positive in 70%, negative in 10% and inadequate in 20%. A positive tap was significantly associated with a low hematocrit but was often obtained in patients without hypotension, tachycardia, peritoneal irritation or tubal rupture. While patients with peritoneal irritation were significantly more likely to have a large hemoperitoneum, many with 500 ml or more of hemoperitoneum did not have peritoneal irritation, hypotension, tachycardia, low hematocrit or tubal rupture. Culdocentesis is valuable for evaluating the patient suspected of having an ectopic pregnancy, and the absence of tachycardia, hypotension, low hematocrit or peritoneal irritation should not dissuade one from performing the test. A positive tap does not indicate tubal rupture, and a large hemoperitoneum may accumulate in its absence.

Douglas' Pouch↗
PubMed1981

The relationship of prenatal maternal anxiety to infant behavior and mother-infant interaction during the first six months of life.

The IPAT Anxiety Scale was administered to a large sample of primiparous women from an economically disadvantaged population in their third trimester of pregnancy. At birth and at three and six months postpartum, the infants and mothers were assessed using a variety of behavioral and standardized procedures. Results indicate that anxiety was not a factor in the incidence of pregnancy and delivery complications or infant anomalies. Neonatal behavior and mother-infant interaction did differ among the high anxious and the low anxious groups. These differences, however, were only significant for female infants. Results are discussed in terms of practical implications and future research.

Adolescent↗
PubMed1980

Measuring temperament in pediatric practice.

The present study reports data concerning the discriminant validity of the Carey Infant Temperament Questionnaire. Subjects were 187 primiparous women who completed a battery of psychologic tests prior to the births of their infants. They also filled out the ITQ at three and six months after the baby was born. Nine of the 20 variables derived from the prenatal test battery discriminated mothers whose babies were diagnosed as temperamentally "difficult" from those whose infants were diagnosed as temperamentally "easy" based on three-month ITQ scores. Seven of the prenatal variables similarly discriminated these two groups on the six-month ITQ. The implications of these findings for uses of the ITQ are discussed.

Anxiety↗
PubMed1979

The temporal relationship between infant heart rate acceleration and crying in an aversive situation.

The temporal relationship between heart rate (HR) acceleration and crying was examined in 16 8-16-month-old infants. Consistently, the HR acceleration began well before the onset of crying, suggesting that such acceleration is not merely a by-product of crying. The accelerations observed were above and beyond a return to baseline following orienting. The crying itself validates the association between these instances of HR acceleration and negative effect.

Affect↗
PubMed1979

Individual differences in infant-mother attachment at twelve and eighteen months: stability and change in families under stress.

100 economically disadvantaged mothers and their infants were observed in the Ainsworth and Wittig "strange situation" at 12 and 18 months. Infants were classified as secure, anxiously attached/avoidant, or anxiously attached/resistant. In addition, mothers reported occurrence of stressful events related to the stability of the caretaking environment during the 12--18 month period by completing a 44-item checklist concerning work, finances, family, neighbors, health, etc. 62 infants were assigned to the same attachment classification at both 12 and 18 months (p less than .01). Despite this stability, significantly more infants changes classification than in a recent study of stable middle-class families. With the present sample, anxious attachment was associated with less stable caretaking environments than secure attachment; change from secure to anxious attachment was associated with higher stressful-event scores than stable secure attachment.

Anxiety↗