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Biomedical subjects

C Jackson

Publications and source records attributed to C Jackson.

At least 73 records · Page 4Linked to original sources
PubMed1997

Dopamine agonist treatment of Tourette disorder in children: results of an open-label trial of pergolide.

This exploratory study was meant to determine the effect of the dopamine (DA) agonist pergolide on Gilles de la Tourette syndrome (GTS) in children and adolescents and to ascertain correlates of pergolide response. Thirty-two outpatients, aged 7-19 years, were systemically assessed in a neuropsychiatric clinic for the presence of GTS and comorbid disorders. After a 6-week open-label, fixed-flexible dosing schedule, response to pergolide on standard GTS severity outcome measures was assessed. Overall, 75% of patients (24/32) had a > 50% drop in their tic severity rating from baseline with a mean treatment dosage of 177 +/- 61 micrograms/day. Highly significant (p = 0.0001) baseline to week 6 differences were demonstrated in all tic symptom measures. The presence of restless legs syndrome (RLS) comorbidity (59%) was highly associated with a positive response. These results suggest DA agonism as a strategy, and pergolide in particular, may be a practical form of therapy for GTS. Response predictors of patient comorbid RLS argue for its further study with regard to GTS.

Adolescent↗
PubMed1997

Effect of methotrexate and sulphasalazine on UMR 106 rat osteosarcoma cells.

Methotrexate is commonly used in the treatment of rheumatoid arthritis. An osteopathy has been described in children treated with methotrexate for leukaemia, consisting of bone pain, osteoporosis and fractures. Animals given short-term high-dose and long-term low-dose methotrexate have both reduced bone formation and increased resorption on histomorphometry. As patients with rheumatic diseases have numerous risk factors for osteoporosis, possible additional risk from low-dose methotrexate is of relevance to the rheumatologist. To investigate further the mechanism of osteoporosis in animals and man, in vitro studies were carried out on an osteoblast cell line, using concentrations found in patients with rheumatic disease. UMR 106 rat osteoblast-like osteosarcoma cells were incubated with methotrexate, and also with sulphasalazine, an anti-rheumatic drug with no known effect on bone, for comparison. A dose-dependent toxic effect of methotrexate on the cell line was observed using concentrations found in patients with rheumatic disease. This was not observed with sulphasalazine. The reduced bone formation observed in animals and man may be due to a direct effect of methotrexate on the osteoblast.

Alkaline Phosphatase↗
PubMed1997

Relative efficacy of haloperidol and pimozide in children and adolescents with Tourette's disorder.

OBJECTIVE: The authors evaluated the relative efficacy and safety of pimozide and haloperidol in the treatment of Gilles de la Tourette's syndrome in children and adolescents. METHOD: A double-blind, 24-week, placebo-controlled double crossover study of equivalent dose formulations of haloperidol and pimozide was conducted with 22 subjects, aged 7-16 years, with Tourette's disorder who were randomly assigned to first one active drug treatment and then the other. Biweekly assessment and flexible dose titration mimicked clinical practice. The primary outcome variable was total score on the Tourette Syndrome Global Scale. Final outcome was determined after 6 weeks of each treatment (placebo, pimozide, haloperidol), with a 2-week placebo baseline period and intervening 2-week placebo washout periods between treatments. RESULTS: Pimozide proved significantly different from placebo in affecting the primary outcome variable, whereas haloperidol failed to have a significant effect. Haloperidol exhibited a threefold higher frequency of serious side effects and significantly greater extrapyramidal symptoms relative to pimozide. Haloperidol-associated treatment-limiting adverse events were experienced by 41% of the patients. The therapeutic doses of pimozide and haloperidol were equivalent (mean = 3.4 mg/day, SD = 1.6, and mean = 3.5 mg/day, SD = 2.2, respectively). CONCLUSIONS: At equivalent doses, pimozide is superior to haloperidol for controlling symptoms of Tourette's disorder in children and adolescents.

Adolescent↗
PubMed1997

The early use of alcohol and tobacco: its relation to children's competence and parents' behavior.

OBJECTIVES: Use of tobacco and alcohol during childhood predicts heavy use of these substances and use of illicit drugs during adolescence. This study aims to identify developmental correlates of tobacco and alcohol use among elementary-school children. METHODS: Cross-sectional surveys were used to measure tobacco and alcohol use, multiple indicators of child competence, parenting behaviors, and parental modeling of tobacco and alcohol use in a sample of 1470 third- and fifth-grade children. Both self-report and teacher-rated assessments were obtained, which allowed collateral testing of study hypotheses. RESULTS: Children's tobacco and alcohol use was strongly related to low scores on several measures of child competence, both self-reported and teacher rated. Children's tobacco and alcohol use was also associated with less effective parenting behaviors and with parental use of tobacco and alcohol. CONCLUSIONS: Children's early experience with tobacco and alcohol is associated with weak competence development and exposure to socialization factors that promote risk taking. Interventions to prevent early use of tobacco and alcohol are needed.

Adolescent↗
PubMed1997

Does psychological testing help to predict the response to acupuncture or massage/relaxation therapy in patients presenting to a general neurology clinic with headache?

Patients with chronic headache were offered treatment by acupuncture or massage with relaxation instead of a change in their prescribed medication. They were randomly allocated to either treatment. There was a significant improvement in pain ratings with both treatment types. Specifically a greater effect was seen in migraine patients treated by massage with relaxation when compared to acupuncture. No psychological factors were found to predict response to either treatment. At the end of the study, 13% of patients were significantly more worried that there may be a more serious cause underlying their headache despite reassurance and an improvement in their headache scores.

Acupuncture Therapy↗
PubMed1997

Gingival hyperplasia: interaction between cyclosporin A and nifedipine? A case report.

Treatment with either cyclosporin A or nifedipine may induce gingival hyperplasia. A case report is presented which describes a patient medicated simultaneously with both drugs and who subsequently developed extreme hyperplasia. Could such a severe gingival pathology have resulted from an additive interaction between the two drugs?

Calcium Channel Blockers↗
PubMed1997

GPs and eye skills. A brave new world?

OBJECTIVE: To evaluate the efficacy of a brief general practitioner eye upskilling intervention to enhance GP eye skills and increase their use in clinical practice. METHOD: Seventeen GPs from a Brisbane Division of General Practice were recruited to participate in a 7 hour clinical upskilling intervention, delivered over an 8 week period. RESULTS: The proportion of GPs able to accurately recognise glaucomatous fundal damage on clinical assessments rose from 24.0 to 54.2% (standard error [SE] 3.96). The proportion able to accurately recognise diabetic fundal disease on clinical assessment rose from 30.8 to 54.1% (SE 9.2). The ability to recognise fundal disease on slide presentations rose on average from 27.1 to 67.5% (SE 10.8). Although none of the practitioners were able to perform oculokinetic perimetry at the beginning of the intervention, all were able to accurately perform it at the conclusion of the intervention. CONCLUSION: GPs are capable of rapidly upskilling in important areas of ocular assessment involving preventable blindness.

Australia↗
PubMed1997

Efficacy of antimigrainous therapy in the treatment of migraine-associated dizziness.

OBJECTIVE: To assess the effects of antimigrainous therapy on migraine-associated dizziness/vertigo. We hypothesized that a medication's ability to ameliorate dizziness/vertigo in this patient population would be directly correlated with its efficacy in improving headache symptoms. STUDY DESIGN: Patient survey. SETTING: Patients were entered into the study from the University of California, San Diego (UCSD) Headache Clinic, a tertiary care referral clinic. PATIENTS: All patients presenting to the UCSD headache clinic are entered into its comprehensive database. Patients who identified dizziness or vertigo as symptoms were entered into this study and were surveyed. MAIN OUTCOME MEASURES: Patients were surveyed as to the nature of their vestibular symptoms, and the therapeutic response of these symptoms and their headaches to various antimigrainous medications. Patients were asked to rank therapeutic efficacy utilizing a numeric scale. These results were then subjected to statistical analysis (Spearman rank correlation) to identify any correlation between the efficacies of the medications in improving headache and dizziness/vertigo. RESULTS: The efficacy of the medications in treating migraine-associated dizziness was directly correlated with their ability to alleviate headaches. CONCLUSION: We conclude that antimigrainous therapy may offer specific treatment to patients suffering from the spectrum of migraine-associated vestibular disorders. This would include the entity known alternately as vestibular Meniere's disease, benign recurrent vertigo, or recurrent vestibulopathy. Given the potential benefits that may be derived from this therapy, clinicians should be sensitive to a history of migraines in patients complaining of dizziness, particularly in those complaining of recurrent episodic vertigo.

Adolescent↗
PubMed1997

Behind the bare statistics.

The findings of the Mental Health Care stress survey will come as no surprise to nurses working on the front-line. But the statistics tell only half the story.

Burnout, Professional↗
PubMed1996

A continuous striatal infusion of 6-hydroxydopamine produces a terminal axotomy and delayed behavioral effects.

Rat models of Parkinson's disease typically employ a rapid nigral injection of 6-hydroxydopamine (6-OHDA) to produce a near-complete loss of nigrostriatal dopamine neurons, and thus, model end stage disease. The present report describes the use of a continuous, low dose infusion of 6-OHDA into the striatum which produces a terminal axotomy of nigrostriatal dopamine neurons and protracted behavioral response. A solution of 6-OHDA in 0.4% ascorbate, delivered at 37 degrees C from osmotic minipumps, was stable for 8 days as determined by its retained toxicity to a dopaminergic neuroblastoma cell line. The continuous infusion of 0.2 mu g 6-OHDA per h did not affect the striatal uptake of [3H]%GABA, [3H]choline, or [3H]glutamate but reduced [3H]dopamine uptake by 55% within 1.5 days after the start of the infusion. The striatal infusion of 6-OHDA produced a dose-dependent reduction of striatal dopamine and DOPAC levels but did not alter HVA, 5-HT, or 5-HIAA. An increase in amphetamine-induced ipsiversive rotations occurred within 1.5 days after the acute striatal injection of 20 mu g or 30 mu g of 6-OHDA but required 4 days to develop with the continuous 6-OHDA infusion. The topography of the lesion mapped by [3H]mazindol binding showed that, beginning by 1.5 days, a diffuse depletion of terminals encompassed much of the striatum in the 30 mu g acute injection group, whereas in the continuously infused rats, the lesion was apparent only by 4 days and was restricted to a smaller and more completely lesioned area. Unlike acutely lesioned animals, continuously infused rats revealed no obvious loss of dopamine neurons in the pars compacta by 5 weeks after 6-OHDA. The continuous striatal infusion of 6-OHDA can produce a topographically limited terminal axotomy of dopamine neurons and a protracted behavioral impairment.

Animals↗
PubMed1996

Humidification in the upper respiratory tract: a physiological overview.

Over the last 30 years, there has been a wealth of literature investigating the principles of humidification in the upper respiratory tract. Most of the nursing literature provides subjective information, whilst the medical profession presents concrete objective data based on sound clinical research. A great deal of information does not date; the physiological principles of humidification remain unchanged. As a clinical nurse adviser with previous experience of humidification trials (Jackson & Webb 1992), I was invited by the Trust Clinical Practice Group, which is responsible for practice development issues, to design humidification guidelines for use in the Trust. Such work is necessarily based on sound knowledge of normal physiology and hazards of artificial humidification. This article contains an outline of the concept of humidity, examination of the normal mechanism of humidification, and details of consequences of over- and under-humidification. Finally, the concept of optimal humidification is discussed, and the main mechanisms of viral and bacterial contamination of the upper airways are briefly detailed.

Humans↗