Ethics of genomic patenting.
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Advisory Committees↗
Biomedical subjects
D Shapiro
Publications and source records attributed to D Shapiro.
Craniofacial injuries resulting from taxicab accidents in New York City.
Taxicab accidents are a common occurrence in New York City. This review was undertaken to characterize the nature of craniofacial injuries that result from taxicab accidents. Data were collected on 16 patients who required admission to trauma or plastic and reconstructive surgery services, after sustaining craniofacial injury as a result of a taxicab accident. Front-end deceleration collisions were the most common mechanism of injury. Fifty-six percent of the patients were thrown against the bulletproof, Plexiglas driver safety divider and sustained an injury most commonly to the anterior midface. Both bony and soft-tissue injuries were common in the entire group. Complex facial fractures were sustained by 56% of patients, with nasal-septal fractures most common, followed by naso-ethmoid-orbital, anterior frontal, anterior maxillary, and Le Fort I and II fractures. Only 1 patient in the group was wearing a seat belt and that patient was a driver. Given the high incidence of craniofacial injury, appropriate safety standards for taxicabs must be initiated, including the reevaluation of the utility of the safety divider and mandatory seat belt use for rear-seat passengers.
Accidents, Traffic↗
Blood pressure publication guidelines. Society for Psychophysical Research.
Blood pressure is one of the most commonly recorded functions in physiology and medicine, and it has become a major variable in recent psychophysiological and behavioral medicine research. Many methods have been developed for the measurement of blood pressure in clinical, laboratory, and natural settings. The broad objectives of this report are to summarize the most critical methodological issues in the measurement of blood pressure and to present principles and recommendations for the evaluation of blood pressure methods and findings in published studies.
Blood Pressure↗
The role of the right hemisphere in the physiological and cognitive components of emotional processing.
Right hemisphere specialization for emotional processing was investigated using behavioral and psychophysiological methods. Fifty undergraduates were shown slides depicting negative emotional and neutral scenes briefly lateralized to the right or left cerebral hemispheres and asked to categorize each as emotional or neutral. Pulse volume and heart rate (HR) measured physiological processing and reaction time measured cognitive processing. The largest vasoconstriction responses and HR deceleration were obtained for emotional items in the right hemisphere. However, reaction time failed to show right hemisphere superiority in perceptual/cognitive processing, demonstrating instead slowest responses to emotional stimuli presented to the right hemisphere together with evidence for left hemisphere competence. Selective right hemispheric activation in autonomic responses, combined with the lack of right hemisphere specialization in the cognitive task, suggests that the physiological response system rather than the perceptual/cognitive system is the locus of the right hemisphere superiority for emotion.
Adult↗
Who is dentally anxious? Concordance between measures of dental anxiety.
Studies of the prevalence of dental anxiety in general population samples have produced estimates which range from a low of 2.6% to a high of 20.4%. It is not clear whether these reflect real differences among populations or whether they are the result of the use of different measures and different cut-off points. We undertook a large scale mail survey of dental anxiety in a random sample of the adult population living in Metropolitan Toronto designed to assess the performance of and agreement between three measures. These were Corah's DAS, the single item used by Milgrom and colleagues in Seattle and the ten-point fear scale used by Gatchel. These measures and their published cut-off points produced prevalence estimates of 10.9%, 23.4% and 8.2% respectively. While there was a significant association between scores on pairs of measures the agreement between them was far from perfect. Kappa values ranged from 0.37 to 0.56, indicating only fair to moderate agreement beyond chance. There was evidence to indicate that the dentally anxious subjects identified by each measure differed according to certain behavioural and other characteristics. The results of the study suggest the need to revisit the issue of measurement in studies of dental anxiety.
Adolescent↗
Character and psychotherapy.
Psychoanalytic theory of psychopathology began as a theory of particular pathogenic agents in the form of repressed memories or drive-generated fantasies. It has developed in the direction of a theory of the mind's organization; that is, a theory of character pathology. A characterological understanding of psychopathology enlarges therapeutic attention beyond the patient's verbal references and toward the patient himself in the "here and now."
Character↗
Size-dependent neural integration between genetically different colonies of a marine bryozoan
Although the formation of genetic chimeras is rare in the animal kingdom, it has long been known that colonial marine invertebrates fuse under natural conditions, forming genetic chimeras. I report here an example of selective, partial fusion. When small colonies of the encrusting marine bryozoan Membranipora membranacea grow into contact, they usually become behaviorally coordinated: if one colony is disturbed, both colonies will simultaneously retract their feeding structures (lophophores). As a first step towards understanding the fitness consequences of this type of apparent fusion, I examine its mechanistic basis. Using assays of zooid behavior, electrophysiological recordings and 14C-labeled metabolites, I demonstrate that physiological integration between M. membranacea colonies is both partial and temporary. Specifically, this study demonstrates (1) that behavioral coordination is the result of neural integration between colonies, (2) that coordinated colony pairs do not exchange metabolites, and (3) that neural integration is a temporary phenomenon that is terminated as colonies grow larger. Additionally, I show that only those zooids at the middle of the intercolony border mediate neural integration. Partial physiological integration between M. membranacea colonies could be a highly specific interaction that increases the potential benefits of fusion (i.e. neural integration) while minimizing the potential costs (i.e. resource parasitism).
Journal Article↗
Negative dental experiences and their relationship to dental anxiety.
Although negative dental experiences are often cited as the major factor in the development of dental anxiety, very few studies have provided data on their prevalence. The studies that are available used limited samples from which it is not possible to generalise, or confined their enquiries to painful experiences only. In this paper data are provided on negative dental experiences and their relationship to dental anxiety obtained from a large, random sample of the general population. Just over three-quarters reported what are termed as direct negative experiences; 71 per cent had had experiences that were painful, 23 per cent experiences that were frightening and 9 per cent experiences that were embarrassing. Such experiences were not confined to childhood. For 23 per cent, the first experience of this kind happened during adolescence and for 40 per cent in adulthood. The relationship between these experiences and dental anxiety was strong. Subjects reporting all three types of experience were 22.4 times at risk of being dentally anxious than subjects reporting none of them. The data suggested that the nature of these unpleasant experiences was more important than the age at which they occurred in predicting dental anxiety. One third of dentally anxious subjects reported a negative response experience in the form of feeling faint, fainting or having a panic attack while at the dentist. Further research using more appropriate methods is needed to clarify the role of dental experiences in the genesis of dental anxiety.
Adolescent↗
Concordant loss of imprinting of the human insulin-like growth factor II gene promoters in cancer.
The human insulin-like growth factor II (IGFII) gene has been shown to be imprinted for the promoters P2, P3, and P4 but not for the promoter P1 in liver and chondrocytes. Loss of imprinting of the IGFII gene has been found in a variety of human tumors including rhabdomyosarcoma and lung cancer. In this report, we determined whether loss of imprinting in tumors displays a promoter-specific pattern. We examined allelic expression of all four IGFII promoters in rhabdomyosarcoma, lung cancer, and normal skeletal muscle. We demonstrate that the imprinting of all IGFII promoters is relaxed in rhabdomyosarcoma and lung cancer. These data suggest that loss of imprinting of IGFII gene promoters may be regulated coordinately by a common mechanism in these tumors. Unexpectedly, we also found that P1, in addition to P2, P3, and P4 is monoallelically expressed in three informative adult skeletal muscle tissues. This indicates that imprinting of the IGFII promoter P1 occurs in a tissue-specific manner.
Adult↗
Ambulatory monitoring of panic patients during regular activity: a preliminary report.
Ten patients with panic disorder and 10 matched control subjects were compared as to their blood pressure and heart rate during regular daily activity. Physiological responses were monitored by ambulatory recorder, and subjective reports of mood were collected. Data were analyzed controlling for activity and stress level of the subjects. Diastolic blood pressure emerged as a possible discriminatory factor between the groups. A trend for higher heart rate occurred in the panic group. In behavioral terms, panic patients tended to avoid anxiety-provoking situations, resulting in anxiety ratings comparable to those of the control group. Thus, recorded physiological differences between the groups may reflect heightened baseline autonomic activity in panic patients.
Activities of Daily Living↗
Long-term efficacy and tolerability of simvastatin in a large cohort of elderly hypercholesterolemic patients.
The long-term efficacy and tolerability of simvastatin, a 3-hydroxy-3-methylglutaryl-co-enzyme A (HMG-CoA) reductase inhibitor, was assessed during a 24-month follow-up period in 168 elderly hypercholesterolemic patients. After completing a 4 week double blind dose ranging study with simvastatin, 47 males and 122 females over 62 years of age with type II hyperlipidemia, a total cholesterol level above 6.5 mmol/l and clinically manifest cardiovascular disease were included in this extended study. A total of 159 patients completed the 12-month follow-up period and 141 patients were monitored over the full 24 months. All patients were started on 10 mg simvastatin once daily and the dosage was increased until the target levels of low density lipoprotein (LDL) cholesterol between 2.3 mmol/l (90 mg/dl) and 3.6 mmol/l (140 mg/dl) were reached. Fifty percent of patients reached the targeted LDL cholesterol goal of < 3.6 mmol/l (140 mg/dl) during the study. At study completion, 65 patients (39%) were taking 40 mg simvastatin per day, 56 patients (33%) 20 mg, 42 patients (25%) 10 mg and 5 patients (3%) only used 5 mg per day. Sixteen patients (9%) received concomitant lipid lowering therapy. Over 2 years, the mean decrease in LDL cholesterol ranged from 36% to 38%, the median decrease in triglycerides was 12% to 19% and the mean increase in high density lipoprotein (HDL) cholesterol ranged from 9% to 10%, respectively. Seven patients discontinued simvastatin because of adverse clinical or laboratory events, but only in two (1.1%) was this considered to be drug-related. Side-effects were mild and most frequently gastrointestinal in nature. Mean changes in asparate aminotransferase (AST) were not significantly different from zero and mean changes in alanine aminotransferase (ALT) and creatine phosphokinase (CPK) showed a small increase. We conclude that simvastatin is an efficacious and well-tolerated treatment for hypercholesterolemia in elderly individuals for extended periods.
Aged↗
The cardiovascular response to postural change as a function of race.
Little is known about racial differences in cardiovascular responses to postural change. The immediate and delayed change from sitting to standing was studied in 207 healthy young Asian, black, and white men and women by means of a noninvasive blood pressure tracking system. Whereas Asians and whites had decreased mean arterial pressure (MAP) 32-41 s after standing, blacks had an increase. During the delayed response (3 min after standing), compared to Asians and whites, blacks had greater increases in diastolic blood pressure and MAP. Their heart rate increase was also greater than Asians. For systolic blood pressure and pulse pressure there were Race x Family History interactions for the immediate response to orthostasis and Race x Gender interactions for the delayed response. Blacks generally displayed different cardiovascular patterns from the other two racial groups, possibly reflecting increased peripheral resistance and altered baroreceptor function.
Adolescent↗
Effects of anger/hostility, defensiveness, gender, and family history of hypertension on cardiovascular reactivity.
In this study, we examined the combined effects of anger/hostility and defensiveness on reactivity to three stressors (math, handgrip, cold pressor) and how these effects are moderated by gender and family history of hypertension. The subjects were 209 college students. Low compared with high Spielberger anger-out scores were associated with greater diastolic blood pressure (DBP) reactivity in low- but not high-defensive women with a negative family history. High compared with low hostility scores were associated with greater heart rate reactivity in low-defensive men with an opposite effect in high-defensive men. Gender, family history, and defensiveness each affected differential DBP reactivity to the three tasks. Combined study of biological factors and coping styles can improve our understanding of cardiovascular reactivity and disease.
Adolescent↗
Insurance coverage for experimental technologies.
As the number and cost of new technologies grow, it is increasingly important that we develop sound policies for payment for those technologies while their clinical impacts are being defined. Such policies need to balance social interests in promotion of innovation, early access to promising technology, patient safety, control of health care costs, and return on investment. We present a rationale, policy options, and a proposal for insurance coverage of experimental technology.
Decision Making, Organizational↗
Requirement for transcription factor IRF-1 in NO synthase induction in macrophages.
Production of nitric oxide (NO) by macrophages is important for the killing of intracellular infectious agents. Interferon (IFN)-gamma and lipopolysaccharide stimulate NO production by transcriptionally up-regulating the inducible NO synthase (iNOS). Macrophages from mice with a targeted disruption of the IFN regulatory factor-1 (IRF-1) gene (IRF-1-/- mice) produced little or no NO and synthesized barely detectable iNOS messenger RNA in response to stimulation. Two adjacent IRF-1 response elements were identified in the iNOS promoter. Infection with Mycobacterium bovis (BCG) was more severe in IRF-1-/- mice than in wild-type mice. Thus, IRF-1 is essential for iNOS activation in murine macrophages.
Amino Acid Oxidoreductases↗
Autogenic-feedback training: a potential treatment for orthostatic intolerance in aerospace crews.
Postflight orthostatic intolerance has been identified as a serious biomedical problem associated with long-duration exposure to microgravity in space. High priority has been given to the development of countermeasures for this disorder that are both effective and practical. A considerable body of clinical research has demonstrated that people can be taught to increase their own blood pressure voluntarily, and that this is an effective treatment for chronic orthostatic intolerance in paralyzed patients. The current pilot study was designed to examine the feasibility of adding training in control of blood pressure to an existing preflight training program designed to facilitate astronaut adaptation to microgravity. Using an operant conditioning procedure, autogenic-feedback training (AFT), three men and two women participated in four to nine training (15-30-minute) sessions. At the end of training, the average increase in systolic and diastolic pressure, as well as mean arterial pressures, that the subjects made ranged between 20 and 50 mm Hg under both supine and 45 degrees head-up tilt conditions. These findings indicate that AFT may be a useful alternative treatment or supplement to existing approaches for preventing postflight orthostatic intolerance. Furthermore, the use of operant conditioning methods for training cardiovascular responses may contribute to the general understanding of the mechanisms of orthostatic intolerance.
Adult↗
Effects of carbohydrate and protein meals on cardiovascular levels and reactivity.
This study examined the effects of standard laboratory stressors on cardiovascular measures before and after the consumption of a modest meal. A mental arithmetic task and a reaction time task were administered before and 2 h after a carbohydrate or a protein meal. A noncaloric placebo meal and a fasting condition were included as control treatments. The caloric meals, in particular the carbohydrate meal, induced an increase in cardiac output, ventricular contractility, and systolic blood pressure. Total peripheral resistance and diastolic blood pressure dropped. Although postprandial adjustments were substantial, stress reactivity patterns generally were not perturbed by the meals. Only heart rate reactivity was stronger after eating the carbohydrate meal. It is concluded that subjects' meal consumption prior to their participation in a psychophysiological experiment needs to be taken into account.
Adolescent↗
Mycobacterium bovis infection of mice lacking receptors for interferon-gamma or for transcription factor IRF-1.
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Animals↗