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Biomedical subjects

D Watson

Publications and source records attributed to D Watson.

At least 55 records · Page 3Linked to original sources
PubMed1998

Comorbidity of anxiety and unipolar mood disorders.

Research on relationships between anxiety and depression has proceeded at a rapid pace since the 1980s. The similarities and differences between these two conditions, as well as many of the important features of the comorbidity of these disorders, are well understood. The genotypic structure of anxiety and depression is also fairly well documented. Generalized anxiety and major depression share a common genetic diathesis, but the anxiety disorders themselves are genetically hetergeneous. Sophisticated phenotypic models have also emerged, with data converging on an integrative hierarchical model of mood and anxiety disorders in which each individual syndrome contains both a common and a unique component. Finally, considerable progress has been made in understanding cognitive aspects of these disorders. This work has focused on both the cognitive content of anxiety and depression and on the effects that anxiety and depression have on information processing for mood-congruent material.

Anxiety Disorders↗
PubMed1998

Factors in delays in discharge from acute-care psychiatry.

OBJECTIVE: To determine if there are any potential opportunities for patients to be discharged earlier and to determine what factors are responsible for delays in discharge. METHOD: A survey was completed by clinical staff of all patients on the wards of 12 adult psychiatry units in the Greater Vancouver Regional Hospital District (GVRD) for a 1-day period. The survey included a modified Brief Psychiatric Rating Scale (BPRS) and the Discharge Readiness Inventory (DRI). A 1-month follow-up measured discharge and nondischarge outcomes. RESULTS: Of the 327 patients surveyed, 42% were ready for discharge at the time of the assessment, and 37% of those who were ready were not discharged within 2 weeks. Delayed patients had significantly higher scores for disorientation, hallucinations, conceptual disorganization, and manifest psychopathology and significantly lower scores for Community Adjustment Potential (CAP) (P < 0.05). The most frequent reasons given for delays were ongoing medication adjustment, behaviour stabilization, and discharge planning. Patients who were delayed were more likely to need services, to need or be waitlisted for a residential placement, to be a client of the community-based mental health team that provides ongoing support to clients living in the community, to have a diagnosis of schizophrenia, and to have had no previous psychiatric hospital admission. CONCLUSION: The removal of all barriers to delays would reduce lengths of stay by 11% for this sample of patients. This would require a shift of about 42 out of 327 beds to an alternate level of care. These "earlier discharge patients" will need ongoing medication and behaviour monitoring through a variety of community services.

Adult↗
PubMed1998

Workload implications of community psychiatric nurse employment by a general practice: a pilot study.

This study examines the impact of the employment of a community psychiatric nurse (CPN), dedicated to the care of patients with chronic mental illness, on general practice workload. Although the consultation rate with general practitioners for mental health reasons was significantly lower after CPN intervention, no differences were found in the total consultation rate.

Community Mental Health Services↗
PubMed1997

Southern analysis of BT-R1, the Manduca sexta gene encoding the receptor for the Cry1Ab toxin of Bacillus thuringiensis.

Various subspecies of the gram-positive bacterium Bacillus thuringiensis are known to produce a wide array of insecticidal crystal proteins (ICPs) upon sporulation. These ICPs act primarily on the brush border of midgut epithelial cells of susceptible larvae. Recently, a protein of 210 kDa, isolated from the midgut of Manduca sexta, has been demonstrated to bind the Cry1Ab toxin produced by B. thuringiensis subsp, berliner and is therefore postulated to be involved in mediating the toxicity of Cry1Ab. The cDNA encoding the 210 kDa protein, termed BT-R1 (Bacillus thuringiensis receptor-1), was recently cloned, and shows limited homology to the cadherin superfamily of proteins. Quite naturally, there is a great deal of interest in the characterization of BT-R1, the gene encoding the 210 kDa Cry1Ab binding protein. The studies presented here involve the use of various restriction fragments prepared from the cDNA encoding BT-R1 as probes of Southern blots bearing M. sexta genomic DNA cleaved with a variety of restriction endonucleases. These Southern blot data reveal that there are two discrete regions within the M. sexta genome which encode sequences homologous to BT-R1. On the basis of the signal intensities seen on Southern blots, it appears that only one of these genes encodes BT-R1, whereas the other is a closely related homologue.

Animals↗
PubMed1997

Oxygen transport patterns in patients with sepsis syndrome or septic shock: influence of treatment and relationship to outcome.

OBJECTIVE: To investigate the relationship between oxygen transport patterns and outcome in patients with sepsis syndrome or septic shock managed according to two different treatment regimens. DESIGN: Retrospective study of a subgroup of patients with sepsis syndrome or septic shock taken from a randomized, prospective, controlled trial. SETTING: General intensive care units in a teaching and a district general hospital. PATIENTS: Seventy-eight patients classified according to predetermined criteria as having sepsis syndrome or septic shock were drawn retrospectively from a larger study group of 109 consecutive patients considered to be at risk for developing multiple organ failure. INTERVENTIONS: All patients received volume expansion to an optimal pulmonary artery occlusion pressure. If the therapeutic goals (cardiac index of > 4.5 L/min/m2, oxygen delivery [DO2] of > 600 mL/min/m2, and oxygen consumption [VO2] of > 170 mL/min/m2) were not achieved with fluids alone, patients were randomized to either a control group or a treatment group. In the treatment group, dobutamine (5 to 200 micrograms/kg/min) was administered to increase cardiac index and DO2 until all three goals were simultaneously achieved. In the control group, dobutamine was administered only if the cardiac index was < 2.8 L/min/m2. In both groups, norepinephrine was infused to maintain mean arterial pressure at 80 mm Hg. MEASUREMENTS AND MAIN RESULTS: Hemodynamic, oxygen transport, and lactate measurements were made at the time of admission to the study, at the time of optimal volume administration, at 1, 2, 4, 8, 12, 16, 20, and 24 hrs, then every 6 hrs for the next 24 hrs, and at least every 8 hrs thereafter. The time at which all therapeutic goals were first achieved simultaneously or the time of maximal DO2 was identified and termed "tmax." Survivors from both the control and treatment groups significantly (p < .001) increased cardiac index and DO2 in response to maximal resuscitation, and despite an associated decrease in oxygen extraction (p < .01), there was a significant (p < .01) increase in VO2. In nonsurvivors from both groups, despite significant increases in cardiac index (p < .05) and DO2 (p < .01) at tmax, oxygen extraction decreased (p < .01) and VO2 remained unchanged. DO2 and VO2 were significantly lower (p < .05) at tmax in nonsurvivors than in survivors from both groups. Persistently high lactate concentrations were characteristic of nonsurvivors. CONCLUSIONS: Survivors of sepsis syndrome or septic shock are characterized by an ability to increase both DO2 and VO2. In contrast, nonsurvivors typically have reduced cardiac reserve, they fail to increase VO2 following resuscitation, and when delivery is enhanced with aggressive inotropic support, oxygen extraction falls. These patterns of response were similar in both treatment and control groups, although the magnitude of the changes was exaggerated in the treatment group. These observations may help to explain the findings by some investigators that treatment aimed at achieving survivor values of cardiac index, DO2, and VO2 fails to improve outcome when instituted following admission to intensive care.

Adrenergic alpha-Agonists↗
PubMed1996

Recombinant human growth hormone, insulin-like growth factor 1, and combination therapy in AIDS-associated wasting. A randomized, double-blind, placebo-controlled trial.

OBJECTIVE: To increase lean body mass and improve health status in patients with wasting associated with the acquired immunodeficiency syndrome (AIDS) by treatment with recombinant human growth hormone (rhGH), recombinant human insulin-like growth factor 1 (rhIGF-1), or both. DESIGN: Randomized, double-blind, placebo-controlled clinical trial. SETTING: University of New Mexico Clinical Research Center and University of Texas Southwestern Medical Center. PATIENTS: 60 patients with AIDS and wasting as defined by the Centers for Disease Control and Prevention. Patients were divided into four groups of 15 patients each. INTERVENTION: Group 1 received 1.4 mg of rhGH once daily plus placebo twice daily; group 2 received 5 mg of rhIGF-1 twice daily plus placebo once daily; group 3 received 5 mg of rhIGF-1 twice daily plus 1.4 mg of rhGH once daily; and group 4 received placebo three times daily. MEASUREMENTS: Body weight, body composition, muscle strength, protein catabolism, quality of life, and immune status were assessed at baseline, and changes in these variables were measured at 6 and 12 weeks. RESULTS: At 6 weeks, lean body mass had increased and total fat mass had decreased in the groups receiving rhGH, rhIGF-1, or both. Group 3 had the greatest changes in lean body mass (mean +/- SE, 3.2 +/- 0.59 kg; P < 0.001); only in this group were changes in body mass maintained at 12 weeks. Only patients in group 1 had improvement in muscular strength of the knees and upper body (P = 0.04) and quality of life (P = 0.01). Immunologic function did not improve in any group. CONCLUSIONS: Growth factor therapy had significantly increased lean body mass and decreased fat mass by 6 weeks, but these improvements persisted for 12 weeks only in group 3. Growth factor therapy at the dosages used in this study is not recommended because the magnitude of weight gain was modest and improvements in quality-of-life measures varied.

Adult↗
PubMed1996

An assessment of cognitive function and mood in chronic fatigue syndrome.

Data were gathered regarding the associates of chronic fatigue syndrome (CFS) with: (1) speed of cognitive processing, (2) motor speed, (3) ability to sustain attention, and (4) mood. Patients were given a brief neuropsychological test battery before and after double-blind treatment with terfenadine or placebo and completed a daily mood rating scale (Positive and Negative Affect Schedule) during the study. CFS patients exhibited slower cognitive processing and motor speed and lower positive affect, as compared to data reported from previous studies of healthy subjects and other patient groups; however, CFS patients did not exhibit deficits in sustained attention in comparison to other groups. The CFS patients' ability to attend to verbal versus figural stimuli and mood ratings were different from those reported in studies of patients with depression. Because of methodological limitations, these findings are preliminary, but they encourage further assessment of cognitive dysfunction and mood in CFS.

Adult↗
PubMed1996

Interaction of ETS-1 and ERGB/FLI-1 proteins with DNA is modulated by spacing between multiple binding sites as well as phosphorylation.

ETS is a family of transcription factors that contain a highly conserved ETS DNA binding domain. Various members of the ETS family are expressed in cells of hematopoietic lineage. ETS-1, ETS-2 and ERGB/FLI-1 are expressed at high levels in T-lymphocytes. HIV-1 infects T-cells and it has been shown that its LTR contains binding sites for various transcription factors. In this study we show that the HIV-1 core enhancer is directly regulated by ERGB/FLI-1 protein positively, as well as, negatively, depending upon the presence or absence of accessory factors in different cell types. In addition, we show that the ETS-1 transactivation activity is enhanced upon dephosphorylation of the Calmodulin-dependent Protein Kinase II phosphorylation site located in exon VII. Finally, we demonstrate that the spacing between the two EBS cores in palindromic or direct repeat sites play a crucial role in binding of ETS proteins to DNA.

Animals↗
PubMed1996

Automated feature extraction for the classification of human in vivo 13C NMR spectra using statistical pattern recognition and wavelets.

If magnetic resonance spectroscopy (MRS) is to become a useful tool in clinical medicine, it will be necessary to find reliable methods for analyzing and classifying MRS data. Automated methods are desirable because they can remove user bias and can deal with large amounts of data, allowing the use of all the available information. In this study, techniques for automatically extracting features for the classification of MRS in vivo data are investigated. Among the techniques used were wavelets, principal component analysis, and linear discriminant function analysis. These techniques were tested on a set of 75 in vivo 13C spectra of human adipose tissue from subjects from three different dietary groups (vegan, vegetarian, and omnivore). It was found that it was possible to assign automatically 94% of the vegans and omnivores to their correct dietary groups, without the need for explicit identification or measurement of peaks.

Adipose Tissue↗
PubMed1996

Parabolic bursting revisited.

Many excitable membrane systems display bursting oscillations, in which the membrane potential switches periodically between an active phase of rapid spiking and a silent phase of slow, quasi steady-state behavior. A burster is called parabolic when the spike frequency is lower both at the beginning and end of the active phase. We show that classes of voltage-gated conductance equations can be reduced to the mathematical mechanism previously analyzed by Ermentrout and Kopell in [7]. The reduction uses a series of coordinate changes and shows that the mechanism in [7] applies more generally than previously believed. The key hypothesis for the more general theory is that a certain slow periodic orbit must stay close to a curve of degenerate homoclinic points for the fast system, at least during the active phase. We do not require that the slow system have a periodic orbit when the voltage is held constant.

Animals↗
PubMed1996

The long-term stability and predictive validity of trait measures of affect.

This study examined the long-term temporal stability and predictive utility of trait Positive Affect and Negative Affect scales. Participants were assessed initially as undergraduates: They rated how they felt generally (general sample) or during the past year (year sample). They were retested on a general affect measure and on scales assessing current depression and anxiety approximately 6 (general sample) or 7 (year sample) years later. By this time, all of them had graduated from college and most were working full-time. Negative Affect scores declined significantly over the study. Nevertheless, the Negative and Positive Affect scales both displayed a significant, moderate level of stability. Moreover, initial scores on both scales correlated significantly with measures of current symptoms that were completed several years later. Thus, trait affect scales were substantially stable--and maintained significant predictive power--even across extended time spans.

Adult↗
PubMed1996

The clinical course and management of thoracic empyema.

We report a prospective multi-centre study of the clinical course and hospital management of thoracic empyema in 119 patients (mean age 54.8). The commonest presenting symptom was malaise (75%), 55% were febrile; 31% were previously well with no predisposing condition. Initial treatments were antibiotics alone (5), needle aspirations (46), intercostal tube drainage (61), rib resection (3) and decortication (4). Overall, intercostal drainage was used in 77 patients (16 failed aspirations), surgical rib resection in 24 (1 failed aspirations, 20 failed drainage), and surgical decortication in 28 (6 failed aspirations, 17 failed drainage). Only 4 patients received intrapleural fibrinolytic agents. Aspiration and drainage were likely to fail if the empyema was > 40% of the hemithorax. Median time from treatment start to discharge was: aspirations, 26 days; drainage, 23 days; resection 11 days; decortication, 12 days. Overall 21 patients died (12 with empyema as the major cause); two had been surgically treated. Mortality correlated with age, diabetes, heart failure, and low serum albumin at admission. Infecting organisms, identified in 109 patients (92%) included anaerobes (37), Str. melleri (36), and Str. pneumoniae (28). Six months after discharge, all but six survivors had regained their previous health.

Adolescent↗
PubMed1996

Met-enkephalin and catecholamine release during feline intestinal ischemia-reperfusion.

Release of met-enkephalin-like immunoreactivity (MLI) into the circulation was investigated during feline intestinal ischemia-reperfusion in relation to the mass of ischemic tissue and in correlation to the sympathoadrenergic, response as gauged by plasma norepinephrine (NE) and epinephrine (E) levels. Chloralose anesthetized cats were randomized to a control group (C, n = 7), 20 cm segmental (S, n = 7), or complete intestinal ischemia (l, n = 7) for 90 min followed by reperfusion for 180 min. MLI and NE/E concentrations were assayed by radioimmunoassay and chromatography, respectively. Severe mucosal lesions and cardiovascular decompensation were observed in l animals in association with increased MLI and NE levels in femoral venous and portal venous plasma, whereas no such responses were observed in the S or C groups. MLI and NE concentrations were consistently higher in portal venous than in femoral venous plasma in 1 animals and correlations between MLI and NE levels were found during reperfusion in the portal, but not the systemic, circulation. Concentrations of E remained unchanged in all groups and did not correlate to MLI release. We conclude that: 1) intestinal MLI release and sympathetic activation occur only when the ischemic insult is sufficient to cause circulatory collapse, characteristic of an "on-off" rather than a "dose-response" pattern; and 2) intestinal MLI and NE release at reperfusion are correlated whereas MLI and E release do not appear to be related events.

Animals↗