Biomedical subjects

C King

Publications and source records attributed to C King.

At least 37 records · Page 2Linked to original sources

PubMed2001

Electroconvulsive therapy for minors: experiences and attitudes of child psychiatrists and psychologists.

OBJECTIVE: To estimate knowledge, experience, and attitudes towards the use of electroconvulsive treatment in minors (patients < 18 years of age), among child and adolescent psychiatrists and psychologists. METHOD: 1,600 questionnaires were mailed to a group of child and adolescent psychiatrists and psychologists. RESULT: There were 625 (39%) respondents. 329 (53.8%) of the respondents stated that they possessed minimal knowledge about the use of ECT in children and adolescents. Lack of confidence in providing a second opinion was common and reported by 75%. Compared with those with minimal knowledge, respondents with advanced knowledge reported a higher perception of safety and efficacy. The majority (70%) of the respondents regarded ECT as a treatment of last resort. CONCLUSION: Many child and adolescent psychiatrists and psychologists have very little knowledge, training, or experience in this treatment. They seem to be ill equipped to appropriately consider or advise patients and families about ECT. Clinical and research implications of these findings are discussed.

Adolescent↗

PubMed2001

Evidence that systemic gentamicin suppresses premature stop mutations in patients with cystic fibrosis.

Here we report the effects of gentamicin treatment on cystic fibrosis transmembrane regulator (CFTR) production and function in CF airway cells and patients with CF with premature stop mutations. Using immunocytochemical and functional [6-methoxy-N- (3-sulfopropyl) quinolinium (SPQ)-based] techniques, ex vivo exposure of airway cells from stop mutation CF patients led to the identification of surface-localized CFTR in a dose-dependent fashion. Next, five patients with CF with stop mutations and five CF control subjects were treated with parenteral gentamicin for 1 wk, and underwent repeated in vivo measures of CFTR function (nasal potential difference [PD] measurements and sweat chloride [Cl(-)] testing). During the treatment period, the number of nasal PD readings in the direction of Cl(-) secretion was increased approximately 3-fold in the stop mutation patient group compared with controls (p < 0.001), and four of five stop mutation patients with CF had at least one reading during gentamicin treatment with a Cl(-) secretory response of more than -5 mV (hyperpolarized). A response of this magnitude was not seen in any of the CF control subjects (p < 0.05). In an independent series of experiments designed to test the ability of repeat nasal PDs to detect wild-type CFTR function, evidence of Cl(-) secretion was seen in 88% of control (non-CF) nasal PDs, and 71% were more than -5 mV hyperpolarized. Together, these results suggest that gentamicin treatment can suppress premature stop mutations in airway cells from patients with CF, and produce small increases in CFTR Cl(-) conductance (as measured by the nasal PD) in vivo.

Adolescent↗

PubMed2001

Removal of perforated adhesive tape: dry versus solvent-assisted.

This study compared the speed of dry removal of perforated adhesive tape from skin with some of the more commonly used solvents, namely acetone, arachis (peanut) oil, paraffin oil and saline. Twenty healthy volunteers had each of the solvents used on separate adhesive tapes applied circumferentially to their arms. Time to removal was recorded and analysed using the non-parametric sign test. The findings indicate that removing the tape dry was faster than using solvents, with the exception of acetone. Additionally, the researchers had difficulty cleaning the skin following the removal of tape when solvents were used. The solvents tended to cause some disintegration of the tape adhesive, which remained attached to the volunteers' skin and was difficult to remove. The researchers' preference is for dry removal of perforated adhesive tapes.

Acetone↗

PubMed2001

Comparison of hydrocellular foam and calcium alginate in the healing and comfort of split-thickness skin-graft donor sites.

This is a comparative study of a hydrocellular foam (Allevyn, Smith and Nephew) and a calcium alginate (Kaltostat, ConvaTec) in dressing split-thickness skin-graft donor sites. The dressing materials were used in equal halves of each donor site in 20 patients undergoing skin-graft harvest. The donor sites dressed with Allevyn showed a tendency to earlier healing, but this was not confirmed statistically. However, Allevyn was found to be more comfortable than Kaltostat and this difference was statistically significant. Due to its increased patient comfort, cheaper cost and comparable time to healing with Kaltostat, the authors recommend the use of Allevyn as a dressing for split-thickness skin-graft donor sites.

Adolescent↗

PubMed2001

Long-term habituation of the speech-elicited mismatch negativity.

A significant issue in the use of the mismatch negativity evoked potential (MMN) concerns its low signal-to-noise ratio (SNR). One can improve the noise level by increasing the number of samples included in the averaged response. However, improvement achieved in this way assumes that the signal, the MMN, remains stable for extended test times, an assumption which has not been tested. If the MMN is not stable, or exhibits habituation over the test session, then SNR would be adversely affected. MMN response magnitude was measured in 5-min intervals over the course of a test session in response to various speech syllable contrasts. Significant long-term habituation of MMN was observed for all three subject populations tested: young adults, school-age children, and guinea pigs. The time course of the habituation and the stimulus conditions under which it occurs have important implications for research and clinical applications of the MMN. Recording procedures that minimize habituation effects may be used to advantage to improve the signal-to-noise ratio of the MMN.

Adolescent↗

PubMed2001

Once daily high-dose gentamicin to prevent infection in open fractures of the tibial shaft: a preliminary investigation.

BACKGROUND: Cephalosporin and aminoglycoside antibiotics are currently recommended for infection prophylaxis in high-energy open tibial shaft fractures. We evaluated cephalosporin in conjunction with once daily high-dose gentamicin as prophylaxis against infection in Gustilo types II and III open tibial shaft fractures. METHODS: Sixteen patients were identified in whom once daily gentamicin dosing was used as part of an antibiotic prophylaxis regimen in patients with types II and III open tibial shaft fractures. Cefazolin (1 g) and gentamicin (5 mg/kg) were given before operation. Antibiotic therapy was continued for 48 hours after definitive wound closure. Monitoring for gentamicin toxicity consisted of blood urea nitrogen (BUN) and creatinine levels, gentamicin trough levels, and a daily query for signs of prodromal ototoxicity. RESULTS: Average time to fracture union was 8 months. One superficial and two deep infections were observed. No patient showed signs of nephrotoxicity or ototoxicity. CONCLUSIONS: Our investigation suggests that this dosing regimen might be safe as prophylaxis against infection in open tibial shaft fractures and that it warrants further study.

Adolescent↗

PubMed2001

Perioperative nursing data set for the adult patient having a cystoscopy.

This article gives a brief summary of a student project required in a perioperative internship program in a large medical center hospital. The Perioperative Nursing Data Set (PNDS) was used to determine activities necessary in developing a nursing care plan for patients undergoing cystoscopy. The project description and the total care plan is shared with the reader.

Adult↗

PubMed2000

REDK, a novel human regulatory erythroid kinase.

We have identified a novel regulatory erythroid kinase (REDK) that is homologous to a family of dual-specificity kinases. The yeast homolog of REDK negatively regulates cell division, suggesting a similar function for REDK, which is primarily localized in the nucleus. REDK is present in hematopoietic tissues, such as bone marrow and fetal liver, but the RNA is expressed at significant levels only in erythroid or erythropoietin (EPO)-responsive cells. Two novel forms of cDNA (long and short) for REDK have been isolated that appear to be alternative splice products and imply the presence of polypeptides with differing amino termini. The ratio of short-to-long forms of REDK increases dramatically in CD34(+) cells cultured with EPO, suggesting differing regulation and function for each form. REDK is predominantly found in nuclear, rather than cytoplasmic, protein extracts, and immunoprecipitated REDK is active in phosphorylating histones H2b, H3, myelin basic protein, and other coimmunoprecipitated proteins. Antisense REDK oligonucleotides promote erythroid colony formation by human bone marrow cells, without affecting colony-forming unit (CFU)-GM, CFU-G, or CFU-GEMM numbers. Maximal numbers of CFU-E and burst-forming unit-erythroid were increased, and CFU-E displayed increased sensitivity to suboptimal EPO concentrations. The data indicate that REDK acts as a brake to retard erythropoiesis. (Blood. 2000;95:2838-2846)

Amino Acid Sequence↗

PubMed2000

Asymmetric copper-catalyzed

The asymmetric copper-catalyzed generation and subsequent [2,3]-sigmatropic rearrangement of sulfur ylides is strongly dependent on the structure of the starting allyl sulfide. A series of alkyl and aryl substituted allyl sulfides (2a-i) were reacted with ethyl diazoacetate in the presence of copper triflate (CuOTf) and a C2-symmetric bis-oxazoline ligand (5a-c). The degree of asymmetric induction ranged from 2.8% for allyl methyl sulfide (2a) to 60% for (1S,2S,5R)-(+)-allyl menthyl sulfide (2d). The enantioselectivity of the reactions was also dependent on the electronic nature of the sulfide; allyl phenyl sulfide (2e) gave a 14% ee, whereas allyl p-methoxyphenyl sulfide (2i) produced only an 8% ee. The stereochemistry of 2d and (1R,2S,5R)-(+)-allyl menthyl sulfide (7) was assigned on the basis of NMR spectroscopic experiments.

Journal Article↗

PubMed2000

Early carotid endarterectomy after stroke.

The authors sought to determine if patients with stroke and a high-grade carotid stenosis benefited from a delay before carotid endarterectomy. A retrospective study of 45 patients undergoing carotid endarterectomy after stroke is presented. The patients were divided into two groups: group I (early group, n = 20), composed of patients who had carotid endarterectomy less than 6 weeks after stroke, and group II (late group, n = 25), comprised of patients who had carotid endarterectomy more than 6 weeks after stroke. As assessed by cerebral angiography, 100% of patients in group I and 64% of patients in group II had carotid artery stenoses > 76% (P < 0.001). The median interval from stroke to carotid endarterectomy was 14 days in group I and 129 days in group II. There was no mortality in either group. No patients in either group demonstrated any neurological deterioration. The authors conclude that, in select patients, carotid endarterectomy may be done safely less than 6 weeks after stroke in order to avoid new events or carotid occlusion while awaiting surgery.

Aged↗

PubMed2000

Aerosolized pentamidine as pneumocystis prophylaxis after bone marrow transplantation is inferior to other regimens and is associated with decreased survival and an increased risk of other infections.

Pneumocystis carinii pneumonia (PCP) is a life-threatening but preventable infection that may occur after bone marrow transplantation (BMT). Although various prophylactic regimens have been used in this setting to prevent active infection, their efficacy, toxicity profile, and impact on outcomes are poorly described in this patient group. We undertook a retrospective cohort study in which we reviewed the records of 451 adult patients who underwent BMT for hematologic malignancies, aplastic anemia, or myelodysplasia over a 7-year period at the Brigham and Women's Hospital. Post-BMT PCP prophylaxis consisted of aerosolized pentamidine (AP) 150 mg every 2 weeks or 300 mg per month, trimethoprim/sulfamethoxazole (TMP/SMX) 160/800 mg orally b.i.d. 3 times per week, or dapsone 100 mg orally each day. Prophylaxis was continued for 1 year post-BMT in all patients when clinically feasible. One hundred twenty-one patients were unevaluable because of death or relapse <60 days after BMT (n = 89), loss to follow-up upon hospital discharge (n = 20), or other reasons (n = 12). Three eligible patients did not receive any prophylaxis and were not further evaluated. Of the 327 patients analyzed, 133 underwent autologous BMT, 4 syngeneic BMT, 159 related allogeneic BMT, and 31 unrelated allogeneic BMT. Graft-versus-host disease prophylaxis in the 190 patients receiving allogeneic BMT consisted of T-cell depletion with anti-CD5 and complement in 58 patients and cyclosporine/methotrexate or FK506 with or without steroids in 132 patients. Eight of 327 (2.4%) documented PCP cases were identified, 0 of 105 in patients receiving only TMP/SMX. Four cases occurred in patients receiving only AP (4/44, 9.1%; odds ratio [OR] relative to TMP/SMX 23.4, 95% confidence interval [CI] 1.2, 445.2); 1 in patients receiving only dapsone (1/31, 3.2%; OR not significant); 2 in patients receiving more than 1 prophylactic regimen (2/147 1.4%; OR not significant); and 1 >1 year post-BMT in a patient who was off PCP prophylaxis. Although the patients receiving only AP had a significantly lower probability of treatment-related toxicity than those receiving TMP/SMX (OR 0.19 [95% CI 0.04, 0.851), the probability of their acquiring other serious non-PCP infections was increased (OR 2.2 [95% CI 1.0, 4.6]), and the probability of their dying by 1 year post-BMT was significantly higher (OR 5.2 [95% CI 2.4, 26.6]), even when adjusted for variables such as type of BMT (autologous versus allogeneic; high versus low risk) and sex. Although AP is associated with fewer toxicities, the data show that it is inferior to TMP/SMX in preventing PCP in the post-BMT setting and is associated with an increased risk of other infections and a higher mortality at 1 year after BMT.

Administration, Inhalation↗

PubMed2000

Aggressive behavior in clinically depressed adolescents.

OBJECTIVE: To investigate the prevalence and characteristics of aggressive behavior in adolescent inpatients and outpatients with major depressive disorder (MDD). Differences between males and females in prevalence and type of aggression, and level of parent-child agreement in report of aggression, were analyzed. METHOD: Participants were 74 adolescents with MDD, aged 13 to 17 years. The Structured Clinical Interview for DSM-IV Axis I Disorders was used to identify MDD. Adolescents' aggressive behavior was assessed using an adapted version of the Brown-Goodwin Assessment for Lifetime History of Aggression; the Measure of Aggression, Violence, and Rage in Children; and the Buss-Durkee Hostility Inventory-Adapted Version. RESULTS: Results indicate high levels of aggressive behavior in adolescents with MDD. Amount and type of aggression did not differ by gender. Results indicate poor correspondence between parent and adolescent reports of aggression, which was most marked for females. CONCLUSIONS: Aggressive behaviors are highly prevalent in depressed youths, with similar types and levels evident in males and females. Parents tend to under-report and may not be cognizant of aggressive behavior that occurs outside the home, particularly for females.

Adolescent↗

PubMed2000

Exposure of black youths to cigarette advertising in magazines.

OBJECTIVE: To estimate the potential exposure of black adolescents to brand specific advertising in magazines. DESIGN: A probit regression analysis was conducted of pooled 1990 and 1994 data on brand specific advertising in 36 popular US magazines to examine the relationship between the presence or absence of advertising in each magazine for each of 12 cigarette brands, and the proportion of each magazine's youth (ages 12-17 years) readers who were black. MAIN OUTCOME MEASURES: The presence or absence of advertising in each magazine in 1990 and 1994, for each of 12 cigarette brands. RESULTS: After controlling for total magazine readership and the percentage of young adult, Hispanic, and female readers, black youth cigarette brands (those whose market share among black youths exceeded their overall market share) were more likely than other brands to advertise in magazines with a higher percentage of black youth readers. Holding all other variables constant at their sample means, the probability of a non-black youth brand advertising in a magazine decreased over the observed range of percentage black youth readership from 0.65 (95% confidence interval (CI) 0.55 to 0.75) for magazines with 5% black youth readers to 0.33 (95% CI 0.00 to 0.69) for magazines with 91% black youth readers. In contrast, the probability of a black youth brand advertising in a magazine increased from 0.40 (95% CI 0.17 to 0.62) at 5% black youth readership to 1.00 (95% CI 0.97 to 1.00) at 91% black youth readership. CONCLUSIONS: Black youths are more likely than white youths to be exposed to magazine advertising by cigarette brands popular among black adolescents.

Adolescent↗

PubMed2000

Detection of indinavir crystals in urine: dependence on method of analysis.

OBJECTIVES: To determine the frequency of crystalluria in patients treated with the human immunodeficiency virus protease inhibitor indinavir and to compare methods of detecting crystalluria. METHODS: A total of 308 freshly voided urine specimens from 168 patients treated with indinavir were evaluated by manual microscopy of sediment and microscopy with an automated workstation and by dipstick analysis. RESULTS: Crystals were detected in 22%, 31%, or 32% of specimens using, respectively, an automated workstation, manual microscopy, or both methods. Proteinuria or hemoglobinuria occurred significantly more often in specimens with (28%) than without (18%) crystals. Frequency of crystalluria was unrelated to specific gravity, but it increased at higher pH. Crystals were detected in 21% of specimens with pH less than 6 and 42% of specimens with pH of 6 or higher. CONCLUSIONS: Crystalluria occurs in more than 30% of urine specimens from patients treated with indinavir, but detection rates vary substantially with method of analysis. Manual microscopy detected crystalluria 41% more often than did an automated workstation.

Crystallization↗

PubMed2000

The glucuronidation of morphine by dog liver microsomes: identification of morphine-6-O-glucuronide.

Canines are used extensively in the pharmaceutical industry for the preclinical screening of novel therapeutics, yet comparatively little is known about the phase 2 metabolism in this species. In humans, morphine is known to undergo extensive metabolism by glucuronidation, and the UDP-glucuronosyltransferase isoform, which catalyzes the formation of morphine-3-O-glucuronide and morphine-6-O-glucuronide is UGT2B7. This study was designed to investigate the glucuronidation of morphine using dog liver microsomes. Liver microsomes from beagle dogs catalyzed the glucuronidation of morphine-3(and 6)-O-glucuronide at rates 4 to 10 times that of rhesus monkey and human liver microsomes. The K(m) of morphine using beagle dog liver microsomes was approximately 270 microM, which is similar to that found for expressed human UGT2B7. The V(max) for morphine, using dog liver microsomes, was 27 nmol/min/mg of protein. Flunitrazepam inhibited the glucuronidation of morphine in dog liver microsomes, and the K(i) was 40 microM, which is similar to human UGT2B7 for other substrates. The effects of detergents were also investigated with dog liver microsomes, and Brij 35 and Brij 58 were found to be the best detergents to use for maximal activation of the dog liver morphine UGT. These studies suggest that dog has a UGT2B isoform similar to human UGT2B7.

Animals↗

PubMed2000

Serial laparoscopic biopsies of liver and spleen from Schistosoma-infected baboons (Papio spp.).

PURPOSE: To obtain large, serial biopsy samples from the liver and spleen by using laparoscopy. Large samples were needed for measurement of inflammatory mediators during various stages of schistosomiasis. METHODS: Each of the seven female baboons (Papio sp.) underwent as many as three laparoscopies, for a total of 19 laparoscopic procedures. This process permitted sampling of the liver, spleen, and mesenteric lymph nodes before and at 6 and 9 weeks after infection with Schistosoma mansoni. All surgery was performed through three trocar sites. Postoperative care included preemptive analgesia. After surgery, we monitored the animals' appetite and measured the core body temperature and activity by using implanted radiofrequency transmitters. RESULTS: We obtained samples of the liver and splenic biopsies during all 19 laparoscopic procedures. The mean weight of the liver biopsies was 3.7 g and that of the spleen samples was 5.3 g. We encountered small adhesions during 5 of the 12 reoperations. Eating and activity rapidly returned after surgery. CONCLUSIONS: Laparoscopy permitted collection of large, serial biopsies with apparently limited stress to the animals. Laparoscopy can be used for biopsies in studies to characterize disease response, confirm normal organ histology prior to drug toxicity studies, determine target-organ drug concentrations in pharmacokinetic studies, and measure drug residues. This refinement likely will reduce required animal numbers by decreasing the effect of surgery compared to that of the experimental conditions, enhance animal well-being, and permit repeated measurements in an animal that serves as its own control.

Analgesics, Opioid↗

PubMed2000

Abuse during and before pregnancy: prevalence and cultural correlates.

This study examined the prevalence of abuse during pregnancy and the influence of cultural norms and acculturation on abuse in 1,004 Mexican American, Puerto Rican, Cuban American, Central American, African American and Anglo American women. Women were recruited from consecutive delivery logs in general community hospitals in Florida and Massachusetts. The Index of Spouse Abuse and the Abuse Assessment Screen ascertained history of adult physical, sexual, and emotional abuse, abuse during pregnancy, and childhood sexual abuse. An Interview Protocol assessed cultural attitudes, acculturation, and demographic information. Hispanic American women, as a whole, did not differ significantly from Anglo American women in their prevalence of abuse during pregnancy, after controlling for sociodemographic variables. However, Cuban American and Central American partners were significantly less likely to abuse their pregnant partners than were other groups even after adjustment. Women who spoke only Spanish (less acculturated) were less likely to report physical abuse from their partners both before and during pregnancy. Cultural norms, such as a partner's belief in wife/mother role supremacy and cultural group acceptability of men hitting women, were significantly positively related to both physical and emotional abuse. Other risk factors for abuse were the abuser not being the biological father of the baby, low income and little education, and being unmarried.

Acculturation↗

PubMed1999

Hebbian modification of a hippocampal population pattern in the rat.

1. The study of the physiological role of long-term potentiation (LTP) is often hampered by the challenge of finding a physiological event that can be used to assess synaptic strength. We explored the possibility of utilising a naturally occurring event, the hippocampal sharp wave (SPW), for the assessment of synaptic strength and the induction of LTP in vivo. 2. We used two methods in which hippocampal cells were either recorded intracellularly or extracellularly in vivo. In both cases, a linear association between the magnitude of the SPW and cellular responsiveness was observed. 3. LTP was induced by depolarising cells during SPWs by either direct intracellular current injection or extracellular microstimulation adjacent to the cell body. Both of these approaches led to an increase in the slope of the linear association between SPWs and cellular responsiveness. 4. This change was achieved without a rise in overall cell excitability, implying that the synapses providing input to CA1 cells during sharp waves had undergone potentiation. 5. Our findings show that the Hebbian pairing of cellular activation with spontaneous, naturally occurring synaptic events is capable of inducing LTP.

Animals↗