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Biomedical subjects

C Thompson

Publications and source records attributed to C Thompson.

At least 271 records · Page 15Linked to original sources
PubMed1992

Bridging the gap between psychiatric practice and primary care.

The recognition and treatment of psychiatric illness in general practice is a skilled and difficult task and it is estimated that about 30% of psychiatric diagnoses may be missed. Patients whose illness is recognized are more likely to recover at follow-up than those whose illness is missed, demonstrating the importance of adequate training in recognizing psychiatric illness. Many general practitioners find difficulty in using tricyclic antidepressants to treat depression. The usual dose is lower than research evidence accepts as therapeutic and side effects often result in patient refusal to take a full dose. Additionally, the tricyclics are highly toxic in overdose. Many general practitioners in the UK are wary of new treatments because of previous experience of rare side effects leading to withdrawal of some new drugs. However, prescriptions of the selective serotonin reuptake inhibitors (SSRIs) for depression are gradually increasing here and in other countries such as the USA, France and Canada, where the SSRIs as a class account for upwards of 30% of new antidepressant prescriptions. The SSRIs are well suited to general practice; they have a greater therapeutic index than tricyclics, are much safer in overdosage, and have a different range of side effects (mainly nausea) which are better tolerated by patients at therapeutic doses. Furthermore, the SSRIs generally do not require dosage escalation for most patients and evidence indicates that they are effective in the treatment of depression associated with anxiety and insomnia. The safety and efficacy of the new SSRI sertraline has been established in comparative trials versus amitriptyline, imipramine and dothiepin (Reimherr et al., 1990; Cohn et al., 1990; Fontaine, 1991; Langdon, 1991).(ABSTRACT TRUNCATED AT 250 WORDS)

1-Naphthylamine↗
PubMed1992

Colorectal cancer screening: optimal compliance with postal faecal occult blood test.

Five approaches to postal faecal occult blood test (FOBT) were compared in a population sample of 966 subjects collected from three general practitioner patient lists in Southern Sydney. The highest compliance rate (59.8%) was achieved by a method using a general practitioner letter, with no dietary restrictions with FOBT. This was also the least expensive method. Compliance rates can be affected by incorrect address information and screenees not considering themselves to be current patients. An explanation from the family doctor addressed personally to the patient with an enclosed FOBT kit can achieve high compliance rates.

Aged↗
PubMed1992

Neuropsychological and psychiatric abnormalities in myalgic encephalomyelitis: a preliminary report.

Ten patients attending one general medical hospital clinic who fulfilled operational criteria for the diagnosis of myalgic encephalomyelitis (ME) and with a history longer than three months, underwent a series of standardized neuropsychological and psychiatric tests. Nine were able to complete the tests and were individually matched with a normal control group for age, sex, educational background and premorbid intelligence. The ME subjects showed inferior performance to the controls on two tests of verbal memory. Their personality scores displayed less extraversion and less psychoticism. This is the first report of objective neuropsychological abnormalities in patients with ME, suggesting a discrete deterioration of short-term memory. The findings may also suggest a concurrent psychiatric component of the condition, but the direction of causality remains to be clarified.

Anxiety Disorders↗
PubMed1991

Prognostic significance of carcinoembryonic antigen in colorectal carcinoma. Serum levels before and after resection and before recurrence.

The use of carcinoembryonic antigen was evaluated in 425 patients with a mean follow-up of 48 months. The preoperative and postoperative carcinoembryonic antigen levels were predictive of recurrence and survival independent of the tumor stage. In a multivariate regression analysis of age, location, tumor stage, and preoperative and postoperative carcinoembryonic antigen levels, the latter three factors were significant prognostic variables with respect to the adjusted survival. Recurrent disease was found in 42% of patients, excluding patients with stage IV disease. The carcinoembryonic antigen level at recurrence was greater than 5 ng/mL in 79% of the patients and in 89% of the intra-abdominal recurrences. Carcinoembryonic antigen level at recurrence was not predictive of postrecurrence survival except in the subgroup of locoregional disease. The life span in patients with liver and lung metastases was not influenced by carcinoembryonic antigen level at recurrence. Preoperative and postoperative carcinoembryonic antigen levels can indicate a poorer prognostic group of patients with colorectal cancer who may benefit from adjuvant treatment. The carcinoembryonic antigen at recurrence can be used effectively to diagnose intra-abdominal recurrences and project survival after development of local/regional disease.

Aged↗
PubMed1991

A double-blind crossover study of oral xamoterol in postural hypotension due to diabetic autonomic neuropathy.

Recent reports have suggested that xamoterol, a beta 1 adrenoceptor partial agonist with 43% intrinsic sympathomimetic activity improves symptomatic postural hypotension in patients with primary autonomic failure. To evaluate the use of xamoterol in eleven insulin dependent patients with diabetes mellitus who had postural hypotension (over 20 mmHg systolic blood pressure) secondary to autonomic neuropathy, we performed a double-blind, randomized, placebo controlled crossover study with xamoterol (200 mg bd orally) for 1 month. Treatment with xamoterol raised supine systolic blood pressure by 11 mmHg but a reduced standing systolic blood pressure by 11 mmHg with an increase in the standing-supine systolic blood pressure difference. No significant differences were observed in symptom score, HbA1 or plasma glucose. We conclude that oral xamoterol raises supine systolic blood pressure but paradoxically lowers standing systolic blood pressure further in insulin dependent diabetes mellitus. Xamoterol is unlikely to be of value in the management of postural hypotension in diabetic patients with autonomic neuropathy.

Adrenergic beta-Agonists↗
PubMed1991

Psychological and behavioral benefits of a stress/type A behavior reduction program for healthy middle-aged army officers.

Twenty army officers who participated in a stress/type A behavior reduction program and a comparison group of 17 officer nonparticipants volunteered to undergo a battery of psychological and behavioral tests before and after the program. Following the program, participants displayed a significantly greater reduction in average daily caloric intake and levels of perceived stress, anxiety, hostility, depression, psychological distress, and type A behavior as compared to the officers who did not participate in it. Given the fact that most of these psychological and behavioral factors have been found in previous studies to be related to an increased risk for coronary artery disease, it seems that the changes reported by the participants in the program are potentially healthful.

Adaptation, Psychological↗
PubMed1991

Effect of polymyxin B on experimental shock from meningococcal and Escherichia coli endotoxins.

Meningococcemia is the most frequent cause of septic shock in healthy children. To determine whether polymyxin B (PMB) might improve mortality from meningococcal shock, its protective activity was evaluated in rabbits challenged with an LD90 of meningococcal lipooligosaccharide (LOS) and compared with an LD80 of Escherichia coli O111:B4 lipopolysaccharide (LPS). PMB (5 mg/kg) administered intravenously 30 min before meningococcal LOS challenge had no significant effect on heart rate, mean arterial pressure, serum bicarbonate, serum tumor necrosis factor (TNF) levels, or survival relative to controls. However, PMB premixed with LOS in vitro increased serum bicarbonate levels (P less than .05) and improved 24-h survival (P less than .05). In contrast, PMB given before E. coli LPS challenge increased serum bicarbonate levels, decreased TNF levels, and improved 24-h survival (all, P less than .05). In vitro studies confirmed that PMB at 10 micrograms/ml neutralized E. coli LPS but not meningococcal LOS activity. Thus, pretreatment with PMB apparently protects rabbits against shock induced by E. coli LPS but not by meningococcal LOS.

Animals↗
PubMed1991

Preliminary evaluation of "Clearview Chlamydia" for the rapid detection of chlamydial antigen in cervical secretions.

Clearview Chlamydia (Unipath) is a rapid monoclonal antibody based latex immunodiffusion test for detecting chlamydial antigen in endocervical specimens. The assay does not require specialised equipment or extensive training and takes less than 30 minutes from sample to results. The clinical performance of Clearview Chlamydia was evaluated with 478 paired endocervical swabs from patients attending a genitourinary medicine clinic. In the first part of the study, 221 non-randomised specimens were tested by cell culture (1st swab) and Clearview (2nd swab) whereas in the second part of the study 257 randomised swabs were examined by Clearview, cell culture and immunofluorescence. The overall prevalence of chlamydial infection was 8.8% and the sensitivity, specificity, positive and negative predictive values for Clearview were 85.7%, 99.1%, 90% and 98.6%. The test requires further evaluation to establish its role in the management and control of chlamydial infection.

Antigens, Bacterial↗
PubMed1991

Activated oxygen species do not mediate hypercapnia-induced cerebral vasodilation in newborn pigs.

In newborn pigs, vasodilation in response to hypercapnia is dependent on prostaglandin (PG) H synthase. We investigated the contribution of activated oxygen by-products to hypercapnia-induced PGH synthase-dependent dilation of pial arteries and arterioles in anesthetized newborn pigs. Activated oxygen species were generated on the cerebral surface using xanthine oxidase and hypoxanthine. Catalase, H2O2, and iron or N-(2-mercaptopropionyl)-glycine (MPG) were used to separate effects of superoxide anion and hydroxyl radical. All the activated oxygen species tested caused vasodilation of both arteries and arterioles. Vasodilation to all activated oxygen species was largely reversible with only the hydroxyl radical encouraging combination of xanthine oxidase, hypoxanthine, H2O2, and FeCl3, causing significant dilation 20 min after removal of treatment. Cotreatment with MPG blocked this residual dilation. Neither pretreatment with the extracellular superoxide anion radical scavenger, superoxide dismutase (SOD), the intracellular superoxide anion radical scavenger, Tiron, the H2O2 scavenger, catalase, nor hydroxyl radical scavengers, dimethyl sulfoxide (DMSO) and MPG, altered vasodilation of pial arteries or arterioles in response to hypercapnia. Furthermore, the increase in cerebral prostanoid synthesis in response to hypercapnia was not affected by pretreatment with SOD, Tiron, catalase, DMSO, or MPG. We conclude that the progressively reduced forms of oxygen that would be produced during PGH synthase metabolism of arachidonic acid can dilate pial arteries and arterioles of newborn pigs. However, these activated oxygen species are not responsible for the vasodilation to hypercapnia in the newborn pig, suggesting that eicosanoids cause the dilation.

Animals↗
PubMed1990

Glutathione S-transferase. Novel vaccine against Fasciola hepatica infection in sheep.

The potential of GST as a vaccine candidate against liver fluke infection in ruminants was studied by vaccinating sheep (n = 9) with GST purified from adult worms of Fasciola hepatica and challenging with 500 F. hepatica metacercariae. The immunization induced a high antibody response to GST in contrast to the poor or undetectable response to this Ag observed in naturally infected sheep. Throughout the trial, the progress of the fluke infection was monitored by measuring RBC hemoglobin levels, the extent of liver damage and the fecal egg output in the sheep. This analysis indicated that a subpopulation (n = 4) of the GST vaccinated animals exhibited no anemia, reduced liver damage and a lower mean fecal egg count relative to the infected control group suggesting a lower fluke burden in these animals. Worm burdens in the livers of the GST vaccine group (107 +/- 22) were 57% lower than in the infected control group (250 +/- 25). The subpopulation of the GST vaccine group demonstrated a 78% reduction in mean worm burdens relative to the control group. These results show that GST of adult F. hepatica is a novel Ag that can significantly protect sheep against liver fluke infection. The results suggest that the immune response to GST is directed to the juvenile worm reducing the number of worms that can establish in the liver of the vaccinated animals.

Animals↗
PubMed1990

Impaired antibody response to Haemophilus influenzae type b polysaccharide and low IgG2 and IgG4 concentrations in Apache children.

BACKGROUND AND METHODS: Because Native American children are at much higher risk for invasive Haemophilus influenzae type b infection than white children, we compared the antibody responses to H. influenzae type b polysaccharide vaccine in healthy Apache and white children. RESULTS: The concentrations of H. influenzae type b antibody after immunization with polysaccharide vaccine were approximately 10-fold lower in 24-month-old Apache children than in whites of a similar age (P less than 0.01). The decreased response involved H. influenzae type b antibodies of the IgG, IgM, and IgA classes. Concentrations of IgG antibody to tetanus toxoid did not differ significantly, and IgG antibodies to diphtheria toxoid were only twofold lower (P = 0.028). Although total IgG, IgM, and IgA levels were higher in two-year-old Apaches than in whites (all P less than 0.001), IgG2 and IgG4 subclasses were lower (both P less than 0.001). Among the Apaches, individual immunoglobulin levels and allotypes were not significantly correlated with their antibody responses to H. influenzae type b polysaccharide. CONCLUSIONS: Apache children have significant impairment of their antibody response to H. influenzae type b polysaccharide and little or no impairment of their antibody responses to protein toxoids. This immunodeficiency may explain the high incidence of H. influenzae type b infection in this population.

Antibodies, Bacterial↗