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Biomedical subjects

B Wild

Publications and source records attributed to B Wild.

At least 19 recordsLinked to original sources
PubMed2007

[A pilot project with clowns in psychiatric clinics].

BACKGROUND: This project examines whether visits of specially trained clinic clowns, as established in pediatrics, would also be useful in psychiatry. METHODS: We describe the effects of a 6-week phase with one clown visit per week in a ward for acutely ill geriatric patients. The patients and medical team were also questioned about their attitudes towards the clowns. RESULTS: We found more positive attitudes in patients after this phase. CONCLUSIONS: We interpret this result as an indication of positive effects and sufficient reason to initiate similar projects in the future.

Aged↗
PubMed2006

Humor and smiling: cortical regions selective for cognitive, affective, and volitional components.

BACKGROUND: The interrelationships among humor, smiling, and grinning have fascinated philosophers for millennia and neurologists for over a century. A functional dissociation between emotional facial expressions and those under voluntary control was suggested decades ago. Recent functional imaging studies, however, have been somewhat at odds with older studies with respect to the role of the right frontal cortex in the perception of humor. METHODS: Blood oxygen level-dependent (BOLD) activity was measured in 13 subjects during the presentation of "funny" vs "nonfunny" versions of essentially the same cartoons and compared with BOLD activity associated with "merely grinning" at similar nonfunny cartoons via fMRI. RESULTS: Humor perception was correlated with BOLD activity in the left temporo-occipitoparietal junction and left prefrontal cortex and humor-associated smiling (recorded with an MR-compatible video camera) with bilateral activity in the basal temporal lobes. Unexpectedly, both conditions were also accompanied by a decrease in BOLD activity in the right orbitofrontal cortex. Voluntary "grinning" in the absence of humorous stimuli was accompanied by bilateral activity in the facial motor regions. CONCLUSIONS: These results confirm the clinically derived hypothesis of separate cortical regions responsible for the production of emotionally driven vs voluntary facial expressions. The right orbitofrontal decrease reconciles inconsistencies between clinical and functional imaging findings and may reflect a disinhibition of facial emotional expression.

Adolescent↗
PubMed2006

[Anorexia nervosa].

Anorexia nervosa differs distinctly from other psychogenic eating disorders. Well known for the past 300 years, anorexia occurs consistently and is one of the most serious illnesses to be found for a certain age group. Three-quarters of the patients are healed or improve their condition long-term; one-quarter has a chronic course frequently including somatic complications and death. Because of the long healing process as well as the extensive chronification and complication rate, an individual treatment plan should be set up at the beginning of therapy to allow for a long-term structure of the course of therapy. Depending on the severity, phase and co-morbidity, inpatient and ambulant therapies are indicated. Depending on the duration of therapy, adequate weight (BMI > 15 kg/m2), good motivation, and lack of complications, an ambulant therapy is justified. Inpatient treatment is multimodal corresponding to the multifactorial etiology of anorexia nervosa. Weight gain is an important primary goal of therapy and a prerequisite for a conflict oriented, ambulant psychotherapy to be carried on after inpatient treatment. Ambivalent psychotherapy motivation and the necessity of symptom orientation demand technical modification both for inpatient as well as ambulant psychotherapy.

Anorexia↗
PubMed2005

Sickle haemoglobin and haemoglobin Stanleyville II: possible confusion with sickle cell-haemoglobin C disease.

OBJECTIVES: To bring to the attention of East African practitioners, the characteristics of Hb Stanleyville II, its interaction with HbS, and the resemblance of the double heterozygote to sickle cell-haemoglobin C (SC) disease. DATA SOURCES: A prospective study of 100 patients with Sickle Cell (SS) disease in the steady state attending the sickle cell Clinic at Mulago Hospital, Kampala, Uganda. STUDY SELECTION: Out of 100 patients with SS disease, two were also heterozygous for an alpha chain variant identified as Hb Stanleyville II. CONCLUSIONS: In association with HbS, Hb Stanleyville II produces a hybrid haemoglobin band which on alkaline haemoglobin electrophoresis, travels in the position of HbC. Such cases may cause confusion with sickle cell-haemoglobin C (SC) disease. The index cases in both families had associated alpha thalassaemia but from this small group, no conclusions may be drawn on the haematological or clinical significance of the interaction of Hb Stanleyville II with SS disease.

Adult↗
PubMed2004

Albuminuria in Afro-Caribbeans with Type 2 diabetes mellitus: is the sickle cell trait a risk factor?

AIMS: To determine the prevalence of albuminuria [raised albumin-creatinine ratio (ACR)] in an out-patient population of Afro-Caribbeans with Type 2 diabetes mellitus (DM) and to determine if the possession of the sickle cell trait (SCT) is a risk factor. PATIENTS AND METHODS: The ACR in a morning urine sample was determined in each of 181 Afro-Caribbeans with Type 2 DM attending the out-patient clinic at King's Diabetes Centre of King's College Hospital, London. The subjects were genotyped for the SCT, Haemoglobin AS (HbAS). RESULTS: Although a raised ACR was demonstrated more frequently in those with the SCT than in those without, with an odds ratio of 1.19, this was not statistically significant (P = 0.68). CONCLUSIONS: In this study the possession of the SCT does not appear to play a significant role in the development of albuminuria. However, a larger study is needed to clarify its role as a risk factor for development of albuminuria in Afro-Caribbeans with Type 2 DM.

Adult↗
PubMed2003

[Tick-borne encephalitis (FSME)--how great is the danger really?].

Tick-borne encephalitis is a neurotropic viral disease transmitted by ticks, and occasionally by the drinking of milk. Its incidence in Central and Eastern Europe has increased sharply, supposedly due--among other things--to climate warming and changes in leisure activities. The probability of contracting the disease following viral infection is about 30%. Some 70% of victims manifest a biphasic course with two fever peaks. Some 10% will have lasting, sometimes severe, neurological deficits, and 1 to 2% will die. The diagnosis is based on confirmed exposure to ticks in a high-risk area, a tick bite within the previous three weeks, clinical symptomatology, infected CSF, and FSME-specific IgM and IgG antibodies in the serum. Causal treatment is not possible, but the disease can be effectively avoided by prophylactic (anti-exposure) measures and vaccination. The vaccines currently available in Germany are highly effective and well tolerated, and a vaccine for children became available in 2002. Medical counselling of travellers should give consideration to vaccination against the condition--in particular for destinations in the south east or east of Europe.

Child↗
PubMed2003

Haemoglobin Etobicoke, an incidental finding in an Irish diabetic.

It is well recognized that haemoglobin variants can be detected during the measurement of HbA1c by high-performance liquid chromatography (HPLC). A number of variants have been reported as compromising the quantification of HbA1c, a marker used in the assessment of glycaemic control in diabetes. We describe a case of haemoglobin Etobicoke, a rare alpha chain variant detected in an Irish diabetic during HbA1c analysis. Its identity was confirmed using a series of investigations. These included haemoglobin electrophoresis at alkaline and acid pH, isoelectric focusing and globin chain electrophoresis. Ultimately mass spectrometry isolated the mutation at position alpha 84 (F5). Haemoglobin Etobicoke, first described in Canada in 1969 has not previously been detected on HbA1c analysis. In the presence of this rare variant, HbA1c, a standard method using HPLC to assess glycaemic control in diabetes is unreliable and alternatives such as fructosamine need to be considered. HbA1c measured by automated HPLC will effectively screen populations where haemoglobin variants were not previously known. Precise identity of these variants when they are detected is crucial to the reliable interpretation of HbA1c analyses.

Blood Protein Electrophoresis↗
PubMed2002

Heart-rate variability (HRV) in the ECG trace of routine EEGs: fast monitoring for the anticholinergic effects of clozapine and olanzapine?

Drug monitoring in psychiatry usually serves psychoactive drug plasma concentration measurement. Anticholinergic properties offer a faster approach to monitoring pharmacodynamic intraindividual effects of the drug by measuring their effects on heart rate variability (HRV), which is sympathetically and parasympathetically controlled via cholinergic synapses. The plasma concentrations of the atypical antipsychotics clozapine and olanzapine correlated with parameters of HRV in 59 patients suffering from schizophrenia or schizoaffective disorder. HRV during 4 minutes at rest was extracted from the ECG trace of a routine digital EEG registration in addition to blood sampling for plasma concentration measurement (HPLC method). We calculated sympathetically and parasympathetically controlled heart frequency bands (low, medium and high frequency) and other HRV parameters, coefficient of variation (CV), and root mean square of successive differences (RMSSD). All HRV parameters were significantly more impaired in clozapine patients (n = 33, mean clozapine plasma concentration 331 +/- 294 ng/ml) than in olanzapine patients (n = 26, mean olanzapine plasma concentration 42 +/- 32 ng/ml) and demonstrated 1.7 - 4.8 times the cardiac anticholinergic properties of clozapine in vivo. 14 out of 14 patients with a CV beyond 3.2 % had clozapine plasma concentrations below the proposed optimal therapeutic concentration of 350 ng/ml. All HRV parameters were inversely and significantly correlated with the clozapine plasma concentrations (such as lgCV: r = - 0.73, p < 0.001) and, to a lesser extent, with the olanzapine plasma concentrations (lgCV r = - 0.44, p < 0.05). These results underline the potential clinical value of HRV parameter extraction from routine ECGs in predicting plasma concentrations and objective individual neurocardiac effects of drugs with anticholinergic properties.

Adolescent↗
PubMed2001

Are emotions contagious? Evoked emotions while viewing emotionally expressive faces: quality, quantity, time course and gender differences.

In human interactions, frequently one individual becomes 'infected' with emotions displayed by his or her partner. We tested the predictions by Hatfield et al. (1992) (Primitive emotional contagion. Review of Personal and Social Psychology 14, 151-177) that the automatic, mostly unconscious component of this process, called 'primitive emotional contagion', is repeatable and fast, that stronger facial expressions of the sender evoke stronger emotions in the viewer and that women are more susceptible to emotional contagion than men. We presented photos from the Pictures of Facial Affect (Ekman and Friesen, 1976). (Pictures of Facial Affect. Consulting Psychologists Press, Palo Alto) on a PC varying the affective content (happy and sad), the expressive strength and the duration of presentation. After each photo, subjects rated the strength of experienced happiness, sadness, anger, disgust, surprise, fear and pleasure. Feelings of happiness or sadness were significantly, specifically and repeatedly evoked in the viewer - even with presentations lasting only 500 ms. Stronger expressions evoked more emotion. The gender of the viewer had weak effects. We hypothesize that this fast and repeatable reaction is likely to have a 'prewired' neural basis. We propose that the induction of emotional processes within a subject by the perception of emotionally expressive faces is a powerful instrument in the detection of emotional states in others and as the basis for one's own reactions. Detailed knowledge of emotional reactions to faces is also valuable as a basis for psychiatric studies of disorders in affect and/or communication and in studies using functional imaging (fMRI or PET) where faces are increasingly used as stimuli.

Adult↗
PubMed2001

Transcranial magnetic stimulation: no effect on mood with single pulse during learned helplessness.

1. Transcranial Magnetic Stimulation (TMS) is suggested to be an effective tool in the treatment of depression. However, the methodology most suitable for clinical application remains unclear. 2. The effect of TMS was tested in a double-blind and placebo-controlled setting on 18 healthy subjects. At the same time an established learned helplessness paradigm was applied to induce dysphoria, which consisted of unsolvable anagrams. 3. Sixty 0.5 Hz stimuli were administered at an intensity of 130% of the subject's motor threshold after the subjects were exposed to the learned helplessness situation. Using a vertically positioned coil, the stimuli were applied to the right or to the left frontal cortex, or on the occipital cortex as a placebo condition. 4. Although dysphoria was successfully induced by unsolvable anagrams, TMS on either of the two frontal locations did not influence mood. This lack of effect may be due to the stimulation characteristics employed here (low TMS intensity, and low frequency). On the other hand, the findings may reflect the neurobiological difference between experimentally induced sad mood and clinical depression.

Adult↗
PubMed2000

Video camera and light system for application in magnetic resonance scanners.

The direct observation and simultaneous recording of subject behavior, e.g. facial movements, during MR imaging is necessary for a variety of functional imaging studies involving phenomena such as emotions, humor, mood, etc. Such observation is also valuable for the monitoring of very ill or young patients. We describe a color video camera and light system which works within the functioning scanner. The camera acquires high resolution video sequences during conventional T(1)-weighted and functional T(2)*-weighted imaging. When fixed to the head coil artefacts during the MRI-acquisition were insignificant. The video allows observation of the face detailed enough to permit FACS scoring of facial expressions. We therefore propose that it can be applied for a wide variety of studies needing visual feedback of subject behavior.

Artifacts↗
PubMed2000

A sampling approach to biases in conditional probability judgments: beyond base rate neglect and statistical format.

Conditional probability judgments of rare events are often inflated. Early accounts assumed a general deficit in using statistical base rates. More recent approaches predict improvement when problems are presented in frequency format or refer to natural categories. The present theory focuses on sampling processes. Experiment 1 showed that a seeming advantage of frequency over probability formats is due to a confounded factor, the need to mentally transform stimulus samples. An information search paradigm was used in Experiment 2. When sampling by the predictor, the probability to be estimated, p(criterion/predictor), was conserved in the samples and judgments were quite accurate. However, when sampling by the criterion, the low base-rate event was strongly overrepresented, accounting for the entire bias. Judgments were quite sensitive to the sampled data, but failed to take sampling constraints into account, as shown in Experiments 3 and 4.

Adult↗
PubMed1999

Reversal of metabolic block in glycolysis by enzyme replacement in triosephosphate isomerase-deficient cells.

Inherited deficiency of the housekeeping enzyme triosephosphate isomerase (TPI) is the most severe clinical disorder of glycolysis. Homozygotes manifest congenital hemolytic anemia and progressive neuromuscular impairment, which in most cases pursues an inexorable course with fatal outcome in early childhood. No effective therapy is available. Hitherto specific enzyme replacement has not been attempted in disorders of glycolysis. Primary skeletal muscle myoblasts and Epstein-Barr virus (EBV)-transformed lymphoblastoid cell lines generated from homozygous TPI-deficient patients were cultured in the presence of exogenous enzyme or cocultured with human K562 erythroleukemia cells as an exogenous source of TPI. Uptake of active enzyme by TPI-deficient cells resulted in reversal of intracellular substrate accumulation, with a reduction in dihydroxyacetone phosphate (DHAP) concentration to levels seen in TPI-competent cells. Evidence of successful metabolic correction of TPI deficiency in vitro establishes the feasibility of enzyme replacement therapy, and has important implications for the potential role of allogeneic bone marrow transplantation and gene therapy as a means of sustained delivery of functional enzyme in vivo.

Adolescent↗
PubMed1998

Measuring the impact of conjugate vaccines on invasive Haemophilus influenzae type b infection in Western Australia.

Haemophilus influenzae type b (Hib) causes serious infections in 26-59 per 100,000 non-Aboriginal Australian children under five years of age. Aboriginal children suffer much higher rates of infection (> or = 150 per 100,000), and at an earlier age, and have a greater risk of death and disability due to Hib infection. In 1992 and 1993, four conjugate Hib vaccines were introduced in Australia, and a nationally funded program of infant vaccination was begun in July 1993. This study aimed at evaluating the effectiveness of Hib vaccination in Aboriginal and non-Aboriginal children in Western Australia using a population-based active surveillance system for non-Aboriginal children and a case control study for Aboriginal children. The incidence of invasive Hib disease in non-Aboriginal children fell from 30.9 per 100,000 before vaccination was available to 6.3 per 100,000 in the second year after its introduction. The vaccine efficacy was estimated to be 80 per cent for Aboriginal children (odds ratio 0.20, 95 per cent CI 0.01-2.76) and, after adjustment for confounders, 75 per cent (odds ratio 0.25, CI 0.02-3.66). Based on the adjusted value (75 per cent), and using a Bayesian approach, we estimate that the posterior probability was 0.55 that the true vaccine efficacy is greater than 70 per cent, and 0.69 that the efficacy is greater than 50 per cent. We conclude that Hib vaccination is effective in preventing invasive Hib disease in Aboriginal and non-Aboriginal children in Australia.

Bacteremia↗