Search PubMed⌕ Search

Biomedical subjects

C Campbell

Publications and source records attributed to C Campbell.

At least 73 records · Page 4Linked to original sources
PubMed2000

Cognitive behaviour therapy for schizophrenia.

BACKGROUND: Although medication is the mainstay of treatment for schizophrenia, always, some sort of informal or formal talking therapy is indicated. In cognitive behavioural therapy (CBT) links are made between the person's feelings and patterns of thinking which underpin their distress. OBJECTIVES: To review the effects of cognitive behaviour therapy (CBT) for those with schizophrenia compared to standard care, specific medication and non-intervention; also to review the effects of CBT for those with schizophrenia who are concurrently receiving standard care compared to no additional intervention to standard care, specific medication, additional drug interventions to standard care and other additional psychosocial interventions to standard care. SEARCH STRATEGY: Electronic searches of Biological Abstracts (1980-1998), CINAHL (1982-1998), The Cochrane Library (Issue 2, 1998), The Cochrane Schizophrenia Group's Register of Trials (August 1998), EMBASE (1980-1998), MEDLINE (1966-1998), PsycLIT (1887-1998), SIGLE (1990-1998), and Sociofile (1980-1998) were undertaken. All references of articles selected were searched for further relevant trials. SELECTION CRITERIA: Randomised trials of cognitive behaviour therapy for people with a diagnosis of schizophrenia, possible schizophrenia or mental illnesses where specific diagnoses have not been employed. Outcomes such as death, metal state, relapse, psychological well-being and acceptability of treatment were sought. DATA COLLECTION AND ANALYSIS: Studies were reliably selected and assessed for methodological quality. Data were extracted by two reviewers working independently. Dichotomous data were analysed on an intention-to-treat basis and continuous data with 70% completion rate are presented. MAIN RESULTS: Four small trials were identified. All presented data suggested that there was a difference favouring CBT plus standard care over standard care alone in terms of reducing relapse rates (short term OR 0.31 CI 0.1-0.98; medium term OR 0.38 CI 0.17-0.83; long term OR 0.46 CI 0.26-0.83, NNT 6 CI 3-30). These findings were supported within the trials by scale-derived data. CBT, however, did not keep more people in care than a standard approach and there is no data relating to the effect of CBT on compliance with medication. One study also presented data on the effects of CBT when compared to supportive psychotherapy. No effect statistically significantly favoured either group but all were suggestive that the trial may have been underpowered to find an effect in favour of CBT. REVIEWER'S CONCLUSIONS: The results of well conducted and reported ongoing trials are eagerly awaited. Currently, for those with schizophrenia willing to receive CBT, access to this treatment approach is associated with a substantially reduced risk of relapse. However, at present CBT is a fairly scarce commodity, often provided by highly skilled and experienced therapists. Therefore, its application in day to day practice may be restricted by the availability of suitable practitioners. Similarly, the present data provides little indication of how effective CBT procedures might be when they are applied by less experienced practitioners.

Cognitive Behavioral Therapy↗
PubMed2000

Zuclopenthixol acetate in the treatment of acute schizophrenia and similar serious mental illnesses.

BACKGROUND: People with schizophrenia or other psychotic illnesses may have delusions or hallucinations that may lead them to be aggressive or violent to themselves or others. Medication that is used in this context require the properties of rapid onset of effect (tranquillisation or at least initial sedation in order to quell aggressive or disorganised behaviour, but also antipsychotic effect), low frequency of administration and low levels of side effects, such as cardiological or neurological side effects, or pain at the injection site. Zuclopenthixol is the cis(Z)-isomer of clopenthixol, a neuroleptic of the thioxanthene group, used for treating people with psychotic symptoms. There is one oral preparation and two depot forms: zuclopenthixol acetate and zuclopenthixol decanoate. The acetate version does not stay in the body for very long (a single dose persists for only 72 hours) and is said to have these properties. OBJECTIVES: To estimate the effectiveness of zuclopenthixol acetate for the acute treatment of serious mental illnesses in comparison to other neuroleptic drugs. SEARCH STRATEGY: Searches of the Cochrane Schizophrenia Group's Register of Trials, The Cochrane Library, MEDLINE, abstracts of congresses and trial reference lists were performed. Appeals for unpublished data to the research community and to the Medical Information Department of Lundbeck Limited were also made. Attempts were made to contact relevant authors. SELECTION CRITERIA: Two reviewers independently assessed citations or papers and selected all randomised trials that included people with serious mental illnesses and compared zuclopenthixol acetate with other drug regimes. DATA COLLECTION AND ANALYSIS: Data were extracted independently by two reviewers. Attempts were made to contact authors for additional or missing information. Odds-ratios (OR) and 95% confidence intervals (CI) were estimated for binary data. Where possible, OR were pooled using Peto method and intention-to-treat analysis undertaken. Mean differences were used for continuous variables. MAIN RESULTS: Pooled data shows no difference for the outcome 'no important improvement' in psychotic symptoms at the end of the follow-up period (OR 0.84 CI 0. 34-2.05). Sedation was evaluated using different instruments. Only one study presented data which suggested an earlier and more intense sedation in zuclopenthixol acetate users at 4 hours (OR 0.18 CI 0. 04-0.93). Use of additional antipsychotic medication was not avoided in the zuclopentixol acetate group (OR 2.18, CI 0.64-7.42) and data on total number of administrations was not obtainable. Side effect data were poorly reported but there is no evidence of a consistent difference between zuclopenthixol acetate and other 'standard drugs' for either the pattern of side effects or the wish to leave the study early. Hospital and service outcomes, number of aggressive incidents, satisfaction with care and economic outcomes were not addressed by any study. REVIEWER'S CONCLUSIONS: Recommendations on the use of zuclopenthixol acetate for the management of psychiatric emergencies in preference to 'standard' treatment have to be viewed with caution. Most trials present important methodological flaws and findings are poorly reported. This review did not find any suggestion that zuclopenthixol acetate is more effective in controlling aggressive/disorganised behaviour, acute psychotic symptoms, or preventing side effects. There were no data directly related to tranquillisation, but it may produce more earlier and intense sedation than oral haloperidol. Well conducted randomized controlled trials are needed to confirm claims related to the use of zuclopenthixol acetate in emergency psychiatry.

Acute Disease↗
PubMed2000

Particle-mediated gene transfer to rat neurons in primary culture.

Gene transfer into neuronal cells provides an important approach to study their function. Particle-mediated gene delivery was used to transfect rat dorsal root ganglion (DRG) and hippocampal neurons in primary culture with the genes for the enhanced blue and green fluorescent proteins (EBFP and EGFP) under control of the cytomegalovirus promoter. Quantitative analysis of marker protein fluorescence detected expression at 3 h that continued to increase for 48 h. For DRG neurons the optimal expression efficiency of 8+/-2% was obtained 24 h following transfection. In contrast, approximately 2+/-1% of hippocampal neurons in culture expressed EGFP at 3 h which subsequently declined. Co-transfection of DRG cultures with two plasmids produced reliable expression of both genes. Transfected DRG neurons exhibited normal electrophysiological properties, and resting and stimulated intracellular Ca2+ concentrations were unchanged. After transfection, 44% of hippocampal neurons remained in functional synaptic networks as indicated by glutamatergic Ca2+ spiking activity. Particle-mediated gene delivery provided a straightforward, reproducible and efficient method for transfection of neurons in primary culture. Transfected cells were easily identified by EGFP fluorescence, enabling subsequent physiological analysis. Biolistic particle bombardment was well tolerated by peripheral neurons, although caution was required when this method was applied to CNS cultures.

Animals↗
PubMed2000

Selling sex in the time of AIDS: the psycho-social context of condom use by sex workers on a Southern African mine.

This paper provides a detailed account of the social organisation of commercial sex work in a squatter camp in a South African gold mining community. On the basis of in-depth interviews with 21 women, living in conditions of poverty and violence, the paper examines factors which might serve to help or hinder a newly implemented community-based peer education and condom distribution project aimed at vulnerable single women. Attention is given to the way in which the routine organisation of sex workers' everyday working and living conditions, as well as the strategies they use to construct positive social identities despite working in the most stigmatised of professions, serve to undermine their confidence in their ability to insist on condom use in sexual encounters with reluctant clients. However, even amongst this disadvantaged group of women, the interviews suggest that the tendency to speak of women's 'powerlessness' (as is the case in many studies of African women in the context of the HIV epidemic) is unduly simplistic and fails to take account of the range of coping strategies and social support networks that women have constructed to deal with their day to day life challenges. These strategies and networks could serve as potentially strong resources for community-based sexual health promotion programmes.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Early and long-term results of heart transplantation after previous cardiac surgery.

OBJECTIVES: The aim of this study was to evaluate the preoperative management and long-term survival of patients undergoing heart transplantation as a redo-operation and compare the results with those obtained in patients undergoing transplantation as their first cardiac surgical procedure. METHODS: Between 1990 and 1997, 49 heart transplantation procedures were performed in patients who had undergone previous cardiac surgery (group A). This subgroup of patients was compared to 109 control patients who underwent cardiac transplantation as the primary cardiac procedure (group B). Patient groups were analysed regarding their preoperative, intra-operative, and postoperative variables in addition to survival. RESULTS: Pre-operative events were comparable in both groups but the duration of the operation was longer for group A (311+/-68 min) compared to group B (202+/-34 min); P=0.02. Post-operative exploration for bleeding was 6/49 patients in group A compared to 2/107 patients in group B (P=0.02). Post-operative blood loss and intensive care stay were greater for group A (1302+/-360 ml and 6.1+/-3.1 days, respectively) compared to group B (763+/-126 ml and 4.1+/-1.9 days, respectively); P=0.02. There was no difference in hospital mortality (group A 12.5%, group B 13 % P=0.9) and the 5-year survival rates were 68 and 71% for group A and B, respectively (P=0.9). CONCLUSIONS: Heart transplantation after previous open cardiac surgery is entirely justified in terms of outcome and graft function even in time of profound organ scarcity. Long-term events in these recipients are similar to patients in whom transplantation is the primary procedure.

Adult↗
PubMed2000

RAD51 is required for propagation of the germinal nucleus in Tetrahymena thermophila.

RAD51, the eukaryote homolog of the Escherichia coli recA recombinase, participates in homologous recombination during mitosis, meiosis, and in the repair of double-stranded DNA breaks. The Tetrahymena thermophila RAD51 gene was recently cloned, and the in vitro activities and induction of Rad51p following DNA damage were shown to be similar to that of RAD51 from other species. This study describes the pattern of Tetrahymena RAD51 expression during both the cell cycle and conjugation. Tetrahymena RAD51 mRNA abundance is elevated during macronuclear S phase during vegetative cell growth and with both meiotic prophase and new macronuclear development during conjugation. Gene disruption of the macronuclear RAD51 locus leads to severe abnormalities during both vegetative growth and conjugation. rad51 nulls divide slowly and incur rapid deterioration of their micronuclear chromosomes. Conjugation of two rad51 nulls leads to an arrest early during prezygotic development (meiosis I). We discuss the potential usefulness of the ciliates' characteristic nuclear duality for further analyses of the potentially unique roles of Tetrahymena RAD51.

Animals↗
PubMed2000

Prevention of childhood lead poisoning.

Although past national public health efforts have reduced lead exposure significantly, lead poisoning remains the most common environmental health problem affecting American children. Currently, lead exposure occurs predominantly through ingestion of lead-contaminated household dust and soil in older housing containing lead-based paint; exposure can be increased with housing deterioration or renovation. Environmental prevention efforts focus on improvement in risk assessment, development of housing-based standards for lead-based paint hazards, and safe and cost-effective lead hazard remediation techniques. Educational efforts address parental awareness of lead exposure pathways, hygiene, and housekeeping measures to prevent ingestion of dust and soil. Blood lead screening is recommended either universally at ages 1 and 2 years or in a targeted manner where local health departments can document a low prevalence of elevated blood lead levels. Nutritional interventions involve provision of regular meals containing adequate amounts of calcium and iron and supplementation for iron deficiency. Lead chelation should complement environmental, nutritional, and educational interventions, when indicated. Collaboration of multiple federal agencies in a new strategy to eliminate childhood lead poisoning should further prevention efforts.

Chelation Therapy↗
PubMed2000

A comparison of local anaesthetics for venepuncture.

AIM: To compare the effectiveness of EMLA cream and Ametop gel in providing analgesia for venous cannulation. METHODS: Single blind study in 120 children. RESULTS: Both anaesthetic agents produced adequate analgesia. However, Ametop gel was more effective, with a statistically significant difference in the pain scores of the two groups (p < 0.05).

Adolescent↗
PubMed2000

Fluid collections detected by ultrasound following uncomplicated colorectal surgery.

The aim of the study was to assess the incidence and site of intraperitoneal fluid collections following uncomplicated colorectal surgery and to identify factors relating to the presence of such collections. 38 patients (22 males) with a mean age of 67 years (range 38-85 years) undergoing uncomplicated colorectal procedures were studied prospectively. Patients underwent abdominal and pelvic ultrasound on Day 3 and Day 7 following surgery. The number, site and volume of collections were recorded. Ultrasound-detected fluid collections were present in 26% on Day 3 and 25% on Day 7 following laparotomy. The presence of a collection was not related to the amount of residual volume after peritoneal lavage with normal saline prior to operative closure, to intraoperative blood loss or to the presence of drains. The right upper quadrant was the commonest site of intraperitoneal collections. In the absence of additional clinical signs, the presence of such collections is not an indication for intervention.

Adult↗
PubMed2000

The role of patients' ability to pay, gender, and smoking history on public attitudes toward cardiac transplant allocation: an experimental investigation.

This study assessed public attitudes toward organ allocation through vignettes that were varied by patient's ability to pay (insured or uninsured), gender, and smoking history (current, former, or never). Participants were 681 adults contacted at a state driver's license office who read a vignette about a heart transplant candidate and subsequently rated their likelihood and priority of offering transplantation. Results revealed main effects for patient smoking history exclusively. Post hoc analyses for likelihood of offering transplantation revealed that participants gave higher ratings for never smokers than current smokers. For priority of transplantation, analyses revealed higher ratings for never smokers than for both former smokers and current smokers. Results suggest that public opinion about organ allocation may include the consideration of smoking history but not ability to pay or gender.

Adolescent↗
PubMed1999

Mammalian mitochondrial extracts possess DNA end-binding activity.

Mammalian mitochondrial protein extracts possess DNA end-binding (DEB) activity. Protein binding to a 394 bp double-stranded DNA molecule was measured using an electrophoretic mobility shift assay. Mitochondrial DEB activity was highly specific for linear DNA. Inclusion of a vast excess of non-radioactive circular DNA did not disrupt binding to radioactive f394. In contrast, binding was abolished by the inclusion of linear competitor DNA. In mammals, nuclear DEB activity is due to Ku, a hetero-dimer composed of the Ku70 and Ku86 proteins. To determine whether mitochondrial DEB activity was also due to Ku, protein extracts were prepared from the Chinese hamster XR-V15B cell line, which lacks this protein. As anticipated, nuclear extracts prepared from these cells lacked DEB activity. In contrast, mitochondrial extracts prepared from these cells had wild-type levels of DEB activity, demonstrating that this latter activity is not a consequence of nuclear contamination. Although the nuclear and mitochondrial DEB activities are independent of each other, they are nevertheless closely related, since mitochondrial DEB activity was 'supershifted' by both anti-Ku70 and anti-Ku86 antisera. The nuclear DEB protein Ku plays an essential role in nuclear DNA double-strand break repair. The DEB activity described herein may therefore play a similar role in mitochondrial DNA repair.

Animals↗
PubMed1999

Developmental basis of retinal-specific induction of cancer by RB mutation.

Understanding why children with RB mutations specifically develop retinoblastoma will contribute to the understanding of the fundamental principles of cancer. Only a subset of developing retinal cells are at risk for developing cancer when RB is mutant because rod photoreceptor and bipolar cells never normally express RB. Retinoblastomas are observed to arise commonly in the inner nuclear layer, where they can show features attributed to outer nuclear layer cells (photoreceptors). The best-studied function of RB is control of the cell cycle, and the usual tissue consequence of loss of RB is apoptosis. Perhaps the specificity of RB mutation for retinal cancer resides in the dependency of this tissue on programmed cell death to achieve a precise architecture of individual types of interconnecting neurons. The additional mutations that are present in all retinoblastoma, such as the i(6p) marker chromosome, may interrupt signals that normally would induce apoptosis when RB is absent. A combination of loss of cell cycle control and loss of signals that delete extra cells would result in retinoblastoma.

Animals↗
PubMed1999

Double strand break rejoining by mammalian mitochondrial extracts.

DNA end-joining was measured by incubating linearized plasmid DNA with mitochondrial protein extracts. A spectrum of end-joined molecules ranging from re-circularized monomer to dimer and higher molecular weight forms was observed. The DNA end-joining reaction required ATP and Mg2+, and was inhibited by sodium chloride. Both cohesive- and blunt-ended DNA molecules were end-joined, although the former were more efficient substrates. Molecular analysis of rejoined molecules revealed that >95% of the linearized DNA were precisely end-joined. The few imprecisely end-joined molecules recovered, sustained deletions that spanned direct repeat sequences. The deletions observed are strikingly similar to those present in mitochondrial genomes of patients with Kearns-Sayre or Pearson syndromes, certain ophthalmic myopathies and the aged. These results suggest that mammalian mitochondria possess a DNA double strand break repair activity similar to that seen in the nucleus, and that this repair pathway may play a role in the generation of mitochondrial DNA deletions associated with a number of human pathologies.

Animals↗
PubMed1999

Violence prevention in the primary care setting: a program for pediatric residents.

OBJECTIVE: To measure the effect of a violence prevention program on pediatric residents' violence prevention guidance during well-child visits. DESIGN: Prospective study of an educational intervention. SETTING: Inner-city tertiary care hospital and satellite site. PARTICIPANTS: Pediatric residents. INTERVENTIONS: A 2(1/2)-hour violence prevention program, consisting of an introductory talk, role playing, a printed resident guide, and supplemental reading materials. MAIN OUTCOME MEASURES: Parent or guardian report of violence prevention guidance offered during the well-child visit, using a postvisit survey. RESULTS: Three hundred eight patient encounters were included in the survey: 93 prior to the program, 106 just afterward, and 109 after 6 months. Before the program, guns or violence was discussed at 9.7% of visits; this increased to 19.1% of visits after the program (odds ratio, 2.20; 95% confidence interval, 1.02-4.74). The improvement was sustained 6 months after the program. More than 80% of residents felt the program increased their fund of knowledge and taught them skills, and 93% stated that they would use these skills in the future. CONCLUSION: This one-time educational intervention significantly increased the amount of violence prevention guidance provided by pediatric residents to their patients and families. The effect was sustained after 6 months. Residents regarded the program as a successful method of providing the skills and knowledge needed to address the issue of interpersonal violence in their primary care encounters.

Adult↗
PubMed1999

Zonal allocation for thoracic organs in the united kingdom: Has it been successful? A single-center view.

OBJECTIVES: The purpose of this study was to analyze the impact of the zonal allocation system for thoracic organs on the outcome of our transplant activity. METHODS: We analyzed the results of thoracic transplants performed between 1987 and 1998. The transplants were divided into 3 groups: local donors retrieved by our team (171 hearts and 61 lungs; DL group); distant donors retrieved by our team (58 hearts and 35 lungs; DD group); and distant donors retrieved by other teams (51 hearts and 41 lungs; DX group). RESULTS: No significant differences were observed among the groups in early postoperative events for either heart or lung transplantation. Heart transplants: Cardiac index was 2.6 +/- 0.4 L/m(2) for the DL group, 2.7 +/- 0.6 L/m(2) for the DD group, and 2.5 +/- 0.7 L/m(2) for the DX group (P =.4). The 30-day mortalities were 9.1%, 9.1%, and 8.3% ( P =.5) and the 1-year survivals 83%, 80%, and 82% ( P =.4) for the DL, DD, and DX groups, respectively. Lung transplants: Alveolar-arterial oxygen gradient was 358 +/- 19 mm Hg for the DL group, 345 +/- 17 mm Hg for the DD group, and 329 +/- 21 mm Hg for the DX group (P =.07). The 30-day mortalities were 9.9%, 10.5%, and 12.8% (P =.2) and the 1-year survivals 79%, 75%, and 77% (P =.3) for the DL, DD, and DX groups, respectively. CONCLUSION: Zonal allocation for thoracic organs has been successfully applied to our program. Using donor organs retrieved by other teams, we have achieved equivalent outcomes for both heart and lung transplantation.

Actuarial Analysis↗
PubMed1999

Bicaval and standard techniques in orthotopic heart transplantation: medium-term experience in cardiac performance and survival.

OBJECTIVE: The aim of this study was to compare the medium-term results of right heart pressures, tricuspid valve dysfunction, overall cardiac performance, and survival between the bicaval and standard techniques. METHOD: Between 1991 and 1997, 201 heart transplantations were performed in our center. Right heart catheterization was performed up to 12 months after transplantation. Echocardiography was used to assess left ventricular and tricuspid valve function. RESULT: The standard technique was used in 105 cases, and the bicaval technique was used in 96 cases. There was no difference in the age, preoperative parameters, pulmonary hemodynamics, or ischemic time between the 2 groups. Right atrial pressure (4.3 +/- 4.0 mm Hg for the bicaval vs 10.9 +/- 4.8 mm Hg for standard technique) and mean pulmonary artery pressure (17.5 +/- 5.3 mm Hg and 22.5 +/- 5.2 mm Hg, respectively) were lower for the bicaval recipients up to 12 months after the operation (P =.001 and. 01, respectively). Left ventricular ejection fraction was higher for the recipients of the bicaval technique up to the most recent measurement (P =.005). The prevalence of moderate or severe tricuspid regurgitation was higher in the recipients of the standard technique up to the most recent measurement (28% vs 7%; P =.02). The actuarial survival at 1, 3, and 5 years was 74%, 70%, and 62% for the recipients of the standard technique versus 87%, 82%, and 81% for the recipients of the bicaval technique (P <.03, <.04, and <.02, respectively). CONCLUSION: The bicaval technique maintains good left ventricular function, lower incidence and severity of tricuspid valve dysfunction, and improved survival compared with the standard technique.

Actuarial Analysis↗