Treating hyperkinetic disorders in childhood.
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Biomedical subjects
Publications and source records attributed to E Taylor.
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To determine the incidence of and risk factors for human T-lymphotropic virus, type II (HTLV-II) seroconversion among injecting drug users (IDUs), specimens from IDUs recruited into the ALIVE Study in 1988/1989 were assayed at baseline for antibody to HTLV with use of enzyme immunoassay and Western blot. Participants were monitored semiannually with venipuncture and interviews. In 1992, the most recent sera of HTLV-negative participants were tested for HTLV with use of enzyme immunoassay and confirmed and typed by Western blot. For positive cases, assays were then performed for all intervening visits to determine the calendar time of seroconversion. Incidence rates were estimated using person-time. Risk factor analysis used a nested case-control design, with up to seven controls per case matched by time of study entry and duration of follow-up. At baseline, 251 HTLV-positive, 22 indeterminate, and 2,574 HTLV-seronegative IDUs were identified. Follow-up of the seronegative IDUs identified 38 seroconverters (all HTLV-II) over 5,813.6 person-years, for a rate of 0.7/100 person-years. Median lag time for seroconversion was 6.8 months. Factors associated with HTLV-II seroconversion included a specific needle-sharing practice called "backloading" within the previous 6 months [odds ratio (OR) = 6.52; 95% confidence interval (CI) = 1.94-21.95] and a baseline history of receiving money for sex (OR = 3.36; 95% CI = 1.32-8.57). Of those with more than one sex partner in the past 6 months, women were more likely than men to seroconvert (OR = 5.77; 95% CI = 1.33-25.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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In 1991, the costs for schizophrenia, which has a lifetime prevalence of 1.5% among adult Americans, totaled $65 billion. Costs were broken down into their direct and indirect components. Direct costs, which totaled $19 billion dollars, consisted of treatment-related expenditures such as those for inpatients and outpatients, as well as nontreatment-related expenditures such as those for the criminal justice system used by individuals with schizophrenia. The direct costs were fairly similar to those of other recent estimates of the cost of schizophrenia. Indirect costs, which were $46 billion dollars, included the lost productivity of both wage earners ($24 billion) and homemakers ($4.5 billion), individuals who were in institutions ($4.5 billion) or who had committed suicide ($7 billion), and caregivers who took care of schizophrenic family members ($7 billion). Our method for calculating the indirect costs was slightly different than methods used in prior studies, which may account for our estimates being higher. The method for determining each expenditure is provided, and the implications of these staggering costs are discussed.
We used a paradigm involving monozygotic (MZ) twin pairs discordant for schizophrenia (n = 20) and concordant for schizophrenia (n = 8), as well as normal MZ twin pairs (n = 7) in order to study cognitive measures of genetic risk in schizophrenia. A comparison between the unaffected twins from the discordant sample and the normal twins indicated subtle attenuations in some aspects of memory and executive functioning in the unaffected group and thus provided evidence for cognitive markers of a genetic component in schizophrenia. A comparison of the affected twins from the discordant pairs and the concordant twins yielded virtually no differences, suggesting that a distinction between familial and sporadic cases is not valid in this sample. Large differences between unaffected and affected members of discordant pairs on a wide variety of variables, including IQ, attention, memory, and executive function, highlighted the magnitude of disease-specific factors.
Injection drug users are at high risk for hepatitis C virus (HCV) infection. In Baltimore, Maryland, the prevalence of anti-HCV is greater among injection drug users who are black, human immunodeficiency virus (HIV) infected, have injected longer, have injected more frequently, and have injected cocaine than among other injection drug users. HCV infection occurs quickly after the initiation of injecting illicit drugs, with 78% of study participants anti-HCV positive after 2 years of injecting. The prevalence of anti-HCV among injection drug users does not appear to be related to socioeconomic factors or sexual practices. Some injection drug users remain free of anti-HCV even after years of injecting and serologic evidence of other bloodborne pathogens. Some of these injection drug users have HCV infection, demonstrated by HCV RNA in their sera. However, the basis for viral persistence in the absence of anti-HCV and for the absence of HCV infection in long-term drug users is not known. Further studies are indicated to determine the mechanism or mechanisms for the absence of anti-HCV in persons exposed to the virus, because the biologic basis for this condition may elucidate the elements missing in the immune response of the majority of HCV-exposed persons who acquire persistent infection. In addition, interventions to prevent HCV infections should be applied in populations at risk for injection drug use early or before drug use begins.
Lactating goats were given relaxin (50 micrograms) by close-arterial infusion into one mammary gland. The increase in intramammary pressure and in mammary blood flow elicited by exogenous oxytocin i.v. was attenuated by relaxin in goats during pregnancy and early lactation but not in a group studied during the oestrous cycle. Intramammary pressure in both mammary glands was affected at the dose of relaxin used. It is concluded that a change in responsiveness of the mammary myoepithelium to oxytocin is one possible effect of relaxin, acting directly or indirectly, circulating systemically during pregnancy and produced locally by the mammary gland at the onset of and during lactation.
Adult brown trout (300­600 g) were acclimated for 2 weeks to an artificial soft water (Ca2+, 50 µmol l-1) and maintained at either 5 °C (October to March) or 15 °C (May to August). Following insertion of a cannula into the dorsal aorta under MS-222 anaesthesia and a recovery period of 2 days, the fish were exposed to a 4 day episode of sub-lethal copper levels at pH 5 or kept at control conditions of pH 7 without copper. The copper concentrations had been predetermined by toxicity testing and were approximately 0.47 µmol l-1 at 5 °C and 0.08 µmol l-1 at 15 °C. At 5 °C, a group of fish was also exposed to approximately 0.08 µmol l-1 copper at pH 5. Plasma total ammonia (Tamm) concentration was significantly elevated by exposure to copper and pH 5. In resting trout exposed to the appropriate sub-lethal copper concentration at pH 5, Tamm was six and 7.5 times greater at 5 and 15 °C, respectively, than those of control trout at the respective temperatures. Although unconfirmed, an elevation of ammonia production alone seems unlikely to account for such substantial increases. From previous studies, there is little evidence of impairment of respiratory gas exchange in trout exposed to these copper concentrations and yet, in the acidic test waters, the gradient of NH3 partial pressure between fish and water was 5.5­6 times greater than that under control conditions. Swimming performance determined by the critical swimming speed (Ucrit) was reduced by copper and acid exposure, and a significant relationship existed between Ucrit and the plasma ammonia concentration of exercised trout. Ammonium ions influence several key enzymes involved in energy metabolism, and elevated ammonia levels might, therefore, reduce the capacity of muscle to exercise. Alternatively, ammonia may have affected the nervous coordination of exercise either centrally or by disrupting peripheral motor innervation.
Freshwater crayfish, Austropotamobius pallipes, caught in the winter when water temperature was 5 °C, were acclimated in the laboratory to 5 °C for 1 week and to 1 and 12 °C for 1 month before haemolymph and tissue samples were taken for acid­base analysis. In vivo, haemolymph (extracellular) pH increased by 0.14 units between 5 and 1 °C but remained unchanged between 5 and 12 °C, giving an overall deltapHe/deltat value of -0.009 pH units °C-1 and an [H+] value of +3.3 nmol l-1. Haemolymph withdrawn from crayfish acclimated to 1 °C and warmed anaerobically in vitro to 12 °C had a deltapHe/deltat value of -0.010 pH units °C-1. This was depressed compared with the values of -0.015 and -0.016 pH units °C-1 obtained from haemolymph withdrawn from crayfish held at 5 and 12 °C, respectively, but changes in H+ concentration were similar in all three groups. There was little change in intracellular pH with rise in temperature in either claw muscle (deltapHi/deltat=-0.003 pH units °C-1) or hepatopancreas (deltapHi/deltat=-0.006 pH units °C-1). In the heart, deltapHi/deltat paralleled that in the haemolymph (-0.010 pH units °C-1), but the largest change was found in the abdominal muscle (-0.025 pH units °C-1). In all tissues apart from claw muscle, there was a metabolic acidosis, with an increase in metabolic acid load as temperature rose from 1 to 12 °C. The depressed in vivo deltapHe/deltat value and the differences in deltapHi/deltat between the tissues were attributed to active regulation of pHi, possibly to control enzyme function in the intracellular compartments. Tissues that are functionally important in the winter months, such as abdominal muscle, followed alphastat regulation, whereas tissues that are less active in the winter, such as claw muscle and hepatopancreas, maintained pHi irrespective of temperature, resulting in a relatively acidotic pHi, which may serve to depress the activity of metabolic enzymes.
In this study, we investigated temporal integration of disparity information for crossed and uncrossed stereopsis. Across three experiments, exposure duration thresholds were measured for stereoscopic stimuli created from dynamic random-dot stereograms. In Experiment 1, an investigation of disparity detection showed that detection thresholds were equal for the crossed and uncrossed directions. In Experiment 2, an examination of duration limits for depth perception showed that critical durations were lower, and depth more veridical, for crossed depth than for uncrossed depth. In Experiment 3, an investigation of depth discrimination revealed that discrimination thresholds were lower for crossed depth than for uncrossed depth. These results suggest that crossed and uncrossed mechanisms differ in terms of their temporal integration properties at processing levels involving the computation and discrimination of depth.
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A total of 215 cholecystectomies were performed at Kern Medical Center over a 20-month period from 10/92 to 5/94 and were retrospectively reviewed. Twenty-four males and 191 females ranged in age from 15-70 years. Of the total 215 cholecystectomies, 119 were performed electively and were separated into two groups. Group 1 (79) consisted of patients awaiting state authorization for cholecystectomy. Group 2 (40) consisted of patients who did not require state authorization. Date of diagnosis was defined as the date when the positive gallbladder ultrasound was completed which, in context with the clinical presentation, confirmed the need for cholecystectomy. The average number of days between diagnosis and cholecystectomy differed significantly between Group 1 and 2 (116 vs 23 respectively, P < .01). The average number of preoperative emergency room (ER) visits differed significantly between Group 1 and 2 (1.48 vs 0.76 respectively, P < .01). The average number of preoperative surgery clinic visits also differed between the two groups (2.88 vs 1.96 in Group 1 and 2 respectively, P < .01). Patients with symptomatic cholelithiasis requiring state approval for cholecystectomy had to wait longer for their operation, and preoperatively visited the ER and outpatient surgery clinic more often. Delay increases patient discomfort and adds additional strain to an already overcrowded ER and clinic. Finally, the economic impact is most likely significant as lost work hours, and additional ER and clinic visits cost taxpayers money.
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