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Biomedical subjects

H Bird

Publications and source records attributed to H Bird.

At least 37 records · Page 2Linked to original sources
PubMed2000

Paroxetine versus amitriptyline for treatment of depression associated with rheumatoid arthritis: a randomized, double blind, parallel group study.

OBJECTIVE: To compare the efficacy and tolerability of paroxetine (a selective serotonin reuptake inhibitor) with that of amitriptyline (a tricyclic antidepressant) in the treatment of depression in 191 patients with rheumatoid arthritis (RA). METHODS: A randomized, double blind, double dummy, parallel group study. A placebo washout period of 3-7 days was followed by an 8 week active treatment phase during which patients received either paroxetine (20-40 mg daily) or amitriptyline (75-150 mg daily). The primary efficacy variable was the change from baseline in Montgomery Asberg Depression Rating Scale score at endpoint. RESULTS: Paroxetine was as effective as amitriptyline for the treatment of depression, with similar improvements in RA associated pain and disability also seen in both groups. However, paroxetine was better tolerated than amitriptyline, with an overall frequency of adverse experiences of 56.4% and 67.7% in the 2 groups, respectively. The frequency of anticholinergic adverse experiences was much lower in the paroxetine treatment group (18.1% vs 43.8% taking amitriptyline) and paroxetine treated patients also experienced fewer severe (16.0% vs 21.9%), serious nonfatal (0% vs 4.2%), and drug related adverse experiences (12.8% vs 29.2%). CONCLUSION: Tolerability is an important consideration in this patient population, which is largely composed of elderly patients who are taking additional medications for RA. Paroxetine shows a number of advantages in the management of depression comorbid with RA.

Adolescent↗
PubMed1999

Informant-based determinants of symptom attenuation in structured child psychiatric interviews.

Informant-related determinants of item attenuation, that is, the drop-off in symptom endorsement rates at retest, were examined in an enriched community subsample of 245 parent-child pairs drawn from the National Institute of Mental Health Methods for Epidemiology of Child and Adolescent Mental Disorders Study. Youngsters and their parents were interviewed with the Diagnostic Interview Schedule for Children (Version 2.3; DISC-2.3) on two occasions with a mean test-retest interval of 12 days. Item attenuation rates were high for both informants, with adults failing to confirm 42% and children 58% of baseline responses at retest. Stepwise regressions revealed that item attenuation at DISC-P retest was higher for adult informants who were younger, and who reported on older and less impaired children. On the DISC-C, attenuation was higher for children who were less impaired, rated as doing worse in school, and who had a longer test-retest interval. These results are broadly consistent with past studies examining the determinants of attenuation and test-retest reliability and have implications for the design and use of structured diagnostic instruments.

Adolescent↗
PubMed1999

Relation of age of onset to the type and severity of child and adolescent conduct problems.

In a cross-sectional household sample of 9-through 17-year-old youths from 4 U.S. communities, youths with earlier ages of onset of conduct problems engaged in more conduct problems than youths with later ages of onset when current age and gender were controlled. Specifically, youths with earlier ages of onset were more likely to engage in several types of physical aggression, frequent lying, theft, and vandalism and were less likely to engage in only truancy. There also was an inverse relation between age of onset and level of functional impairment, mental health service use, and meeting diagnostic criteria for conduct disorder, attention-deficit hyperactivity disorder, and oppositional defiant disorder. Within the limits of cross-sectional data, these results support the hypothesis that key aspects of the heterogeneity of conduct problems among youths are related to the age of onset of conduct problems.

Adolescent↗
PubMed1999

Fluorescent detection techniques for real-time multiplex strand specific detection of Bacillus anthracis using rapid PCR.

Speed is a key area in our development of PCR assays for Bacillus anthracis. We believe that the strand specific detection of amplicons within 10 min is a realistic goal and that this will be achieved through fluorescent in-tube assays. We have used the Idaho LightCycler to study and develop candidate assays for B. anthracis. New strand specific fluorescent methods have been developed and a number of formats have been studied for speed and sensitivity. Internal controls have been developed as a method of improving our assay confidence. In this communication we will introduce the field of rapid PCR whilst discussing previous work in the areas described above, the development of our own rapid assay and a novel internal control system for B. anthracis. This work used PCR assays and hardware that are either commercially available, or have been previously described in open literature publications.

Animals↗
PubMed1997

A phase 1 study to address the safety and efficacy of granulocyte colony-stimulating factor for the mobilization of hematopoietic progenitor cells in active rheumatoid arthritis.

OBJECTIVE: To examine the safety and efficacy of granulocyte colony-stimulating factor (G-CSF) alone for the mobilization of peripheral blood progenitor cells in patients with resistant active rheumatoid arthritis (RA). METHODS: Five patients with resistant active RA were studied. A dose of 5 microg/kg of G-CSF (Filgrastim) was given subcutaneously each day for 5 days, and the number of stem cells mobilized into the peripheral blood was assessed by daily CD34 counts. RA disease activity was assessed by standard clinical methods. RESULTS: The absolute numbers of peripheral blood CD34+ cells peaked on day 4, with a mean value of 0.025 x 10(9)/liter (range 0.013-0.048 x 10(9)/liter). There was no significant change in disease activity during the study or in the month following therapy. CONCLUSION: Using G-CSF alone, CD34+ progenitor peripheral blood cells were mobilized in numbers suitable for leukopheresis. G-CSF therapy was well-tolerated in patients with active RA, and was not associated with a flare during treatment or in the month following treatment.

Adult↗
PubMed1997

The epidemiology of mental disorders in the adult population of Puerto Rico.

OBJECTIVES: The main objective of the manuscript is to present a review of the literature of the psychiatric epidemiological studies carried out in Puerto Rico in the last decade. BACKGROUND: Data from three major epidemiological surveys carried out in the last decade is presented which provide evidence against prior long standing observations that Puerto Ricans reported higher levels of psychiatric symptomatology as compared to other populations and ethnic groups in the United States. METHODS: The studies selected for review were the universe of population epidemiological studies carried out in Puerto Rico in the last decade. All studies used island wide probability sampling procedures to select the study population. RESULTS: Rates of psychiatric disorders in Puerto Rico were found to be significantly different from those obtained in United States communities. Exceptions were somatization disorder and symptoms which were found to be significantly more common in Puerto Rico and drug abuse/dependence which was found to be considerably less common in the island as compared to the Unites States adults in the age range of 17 to 67 years old. CONCLUSION: In spite of several indicators of social disruption in the island, the prevalence of most psychiatric disorders does not appear to be more prevalent than in other communities in the United States and other parts of the world. Risk factors for mental disorders are also similar, although sex ratios for gender linked disorders are more marked in the island.

Adolescent↗
PubMed1996

Which is the active moiety of sulfasalazine in ankylosing spondylitis? A randomized, controlled study.

OBJECTIVE: To compare the efficacy of sulfasalazine (SSZ) with its two moieties, 5-aminosalicylic acid (ASA) and sulfapyridine (SP), in patients with active ankylosing spondylitis (AS). METHODS: A 26-week randomized, observer-blinded, 2-center, controlled study of treatment with either SSZ, ASA, or SP was conducted in 90 patients with active AS. Patients were evaluated at baseline and at monthly intervals, using several clinical and laboratory measures of disease activity. A global assessment of treatment efficacy was made by both patients and observers at the end of the study period. RESULTS: There were no significant changes in any of the parameters of disease activity in the ASA treatment group. Levels of serum IgG, IgA, and IgM fell significantly during treatment with SP, but none of the other changes reached statistical significance. Plasma viscosity and IgG and IgA levels fell significantly during treatment with SSZ, as did nocturnal spinal pain and overall spinal pain. Patients and observers reported a favorable outcome after treatment with SSZ or SP significantly more often than with ASA treatment. CONCLUSION: SP appears to be the active moiety in AS, although there was a trend suggesting a better outcome in the SSZ group compared with the SP group, perhaps suggesting the importance of a common sulfonamide structure for efficacy.

Adolescent↗
PubMed1996

Synovial fluid interleukin-8 and neutrophil function in rheumatoid arthritis and seronegative polyarthritis.

The relationships between synovial fluid (SF) interleukin-8 (IL-8) and neutrophil turnover as measured by cytidine deaminase (CD), and SF metabolites were studied in 28 patients, 16 with rheumatoid arthritis (RA; median age and disease duration 62 and 14 yr, respectively) and 12 with seronegative polyarthritis (SNP; median age and disease duration 32 and 5 yr, respectively). Knee SF samples were aspirated using indwelling cannulae following a period of rest for 1 h. SF IL-8 levels (measured by an ELISA) were significantly elevated in RA compared to SNP (median 2.35 vs 0.22 ng/ml, P < 0.001), as were median levels of CD (55.8 vs 8.11 U/ml, P < 0.01), lactic acid (29.6 vs 16.6 mg/dl, P < 0.001), glucose (57.9 vs 84.5 mg/dl, P < 0.05) and the lactate to glucose ratio (0.85 vs 0.19, P < 0.001). Measures of disease activity, C-reactive protein, plasma viscosity and articular index were also elevated in RA compared to SNP (P < 0.05). SF IL-8 levels correlated strongly with CD, lactate, glucose and the lactate to glucose ratio when both disease groups were considered together (P < 0.001). These parameters also showed some association with the measures of disease activity (P < 0.05). All these associations were less marked when the individual disease groups were analysed separately. These results suggest that factors responsible for neutrophil accumulation and priming (probably IL-8) are present in SF, and these coincide with products of their activation (CD). The degree of neutrophil turnover is linked to the anaerobic metabolism of the synovial cavity.

Adult↗
PubMed1995

Crossover analysis in a British family suggests that Coffin-Lowry syndrome maps to a 3.4-cM interval in Xp22.

Coffin-Lowry syndrome (CLS; MIM 303600) in an uncommon X-linked disorder causing mental retardation and skeletal abnormalities. Most recently it was mapped to a 5.6-centimorgan (cM) region of Xp22, flanked distally by AFM291wf5 and proximally by DXS1052 [Biancalana et al., 1994: Genomics 22:617-625]. We present information which supports this localization and further narrows the region to approximately 3.4 cM. A recombination in a carrier from a British family mean that DXS365 is the closest proximal flanking marker identified to date for the region thought to contain the CLS gene. This information reduces the region of interest by approximately 2.2 cM, a significant decrease in terms of the scale of effort which will be required to isolate and analyze candidate genes.

Adolescent↗
PubMed1995

Family psychiatric screening instruments for epidemiologic studies: pilot testing and validation.

Family history, a risk factor for psychiatric disorders, is infrequently assessed in epidemiologic studies due to time and cost constraints. We designed a brief computer-scorable instrument, the Family History Screen for Epidemiologic Studies (FHE), which collects a pedigree and screens for 15 DSM-III diagnoses in an informant and in his family members. The FHE was administered to one informant in 77 families in which we had collected pedigrees, interviewed 77 informants and 239 relatives using the Lifetime Anxiety version of the schedule for Affective Disorders and Schizophrenia or the Epidemiologic version of the Schedule for Affective Disorders and Schizophrenia for School-Aged Children, and performed best-estimate diagnoses. We evaluated the accuracy with which the FHE predicted best-estimate diagnoses. For adults reporting on themselves, the FHE demonstrated high levels of sensitivity and specificity for depression (67.4, 75.0) and panic (92.5, 89.2), and low sensitivity and high specificity for substance abuse (33.3, 93.6). For informants reporting on adult relatives, sensitivity was low and specificity was high for depression (35.2, 84.9), panic (20.0, 91.7), and substance abuse (42.1, 93.4). For informants reporting on children, perhaps due to lower prevalence, sensitivity and specificity were poor. The FHE is a good screen for psychiatric disorders in adult informants, but it is not useful for family history. It may be useful in primary care medical settings as a screen for psychiatric history.

Adolescent↗
PubMed1995

Bone alkaline phosphatase in rheumatic diseases.

A double monoclonal immunoradiometric assay specific for bone alkaline phosphatase (BAP) was used to determine whether the raised total alkaline phosphatase (TAP) often found in patients with active rheumatoid arthritis (RA) and ankylosing spondylitis (AS) is derived from bone or liver. Fifty-eight patients with RA were compared to 14 with AS and 14 with non-inflammatory rheumatic diseases (NI). None had clinical liver disease and only one had a slightly elevated aspartate transaminase activity. Elevated BAP concentrations were found in seven patients (5 RA, 1 AS, 1 NI), only two of whom also had abnormal TAP. Abnormal TAP activities were found in only three patients (all RA). BAP did not correlate with disease activity in RA or AS. In contrast, TAP correlated with disease activity (assessed by plasma viscosity) in RA (P < 0.002) and gamma-glutamyl transferase (GGT) also correlated with plasma viscosity in RA (P < 0.01). Both TAP and BAP were significantly correlated with GGT in RA (P < 0.001 and P < 0.02, respectively). These findings are discussed, together with possible reasons for the conflicting nature of some of the observations.

Adult↗
PubMed1994

The topical NSAID felbinac versus oral NSAIDS: a critical review.

Musculoskeletal disorders such as soft tissue injuries have traditionally been treated with oral NSAIDs, despite the significant side-effects associated with their clinical use. However, four separate multicentre, double-blind, double-dummy clinical trials have shown that the efficacy of the topical NSAID, felbinac, is equivalent to that of the oral NSAID, ibuprofen, in the treatment of soft tissue injuries, and to that of oral ibuprofen or fenbufen in mild to moderate osteoarthritis. In general practice the incidence of side-effects with felbinac is low, while oral NSAIDs have been associated with significant problems, particularly in the gastrointestinal system. Consequently, the cost of treating side-effects is reduced with felbinac treatment compared with oral NSAIDs, making it a logical treatment alternative from an economic view point as well as for reasons of efficacy and safety.

Administration, Oral↗
PubMed1993

Correspondence between statistically derived behavior problem syndromes and child psychiatric diagnoses in a community sample.

The correspondence between Diagnostic and Statistical Manual (3rd ed.) (DSM-III) diagnoses and statistically derived syndromes was examined within a community sample of children and adolescents in Puerto Rico. Specifically, the extent to which behavior dimensions, derived from the Child Behavior Checklist and the Youth Self-Report, corresponded to psychiatric diagnoses, derived from parent and child versions of the Diagnostic Interview Schedule for Children, was examined. The alternative approaches for assessing psychopathology in children and adolescents were compared against external validators. The results indicated a meaningful convergence between DSM-III diagnoses and statistical syndromes; however, a one-to-one correspondence did not emerge. Little evidence was found for "diagnostic thresholds." There was no evidence of the superiority of either the statistically derived syndromes or the DSM-III diagnoses. The incorporation of a measure of impairment improved the validity of both approaches. Adding parental reports to the self-reports of adolescents yielded little gain in the validity of either the statistical or diagnostic approach. The implications for the definition and assessment of child and adolescent disorders are discussed.

Adolescent↗
PubMed1991

Children of alcoholic parents in the community.

The relationship between parental alcoholism and risk for maladjustment in the offspring was investigated in a community sample. Children of parents who met criteria for DIS/DSM-III alcohol abuse or dependence and children of parents who met criteria for ten other diagnoses were compared to children of "normal" parents. The data were obtained from the merging of the data banks of two major psychiatric epidemiology studies of the adult (17-64) and child (4-16) population of Puerto Rico. Results indicated that parental alcoholism in addition to creating an adverse family environment had an effect on the relative risk for maladjustment in the offspring (as measured by scores on the Child Behavior Checklist). Although previous studies have reported higher levels of externalizing behaviors in children of alcoholics, an increased risk for internalizing symptoms was observed in the children studied. Similar findings were obtained for the children of parents with other psychiatric disorders suggesting that the effects of parental alcoholism in children ages 4 to 16 may not be different from the consequences of parental mental illness per se.

Adolescent↗
PubMed1990

The internal consistency and concurrent validity of a Spanish translation of the Child Behavior Checklist.

The Child Behavior Checklist's applicability to a Hispanic sample was assessed by an examination of the instrument's internal consistency and concurrent validity. The CBCL and TRF were administered to a community sample representative of children of Puerto Rico aged 4 to 16. Cronbach's alpha was used to assess the internal consistency of empirically derived scales. The relation of CBCL and TRF scores to clinical diagnosis, adaptive functioning, and need for services served as indicators of the concurrent validity of the instrument's Spanish version. The results indicate that the total behavior problem scores on the instruments are good continuous measures of maladjustment for children in Puerto Rico. A child with high values on the scales has a high probability of being classified as a case by a psychiatrist. High levels of internal consistency were found in most subscales. Only scales comprising low prevalence problems showed poor internal consistency.

Adolescent↗
PubMed1990

Association of osteoarthritis with homozygosity for a 5.8 kb Taq I fragment of the alpha 1-antichymotrypsin gene.

The genes coding for the protease inhibitors alpha 1-antitrypsin (A1AT) and alpha 1-antichymotrypsin (A1ACT) were analysed by Southern blot in patients with rheumatoid arthritis, psoriatic arthritis, psoriasis without arthritis, polymyalgia rheumatica and generalized osteoarthritis. The probe/restriction enzyme combinations used were the 4.6 kb 5' fragment of the A1AT gene with the Sst I enzyme, the 6.5 kb 3' fragment of the same gene with Taq I and the 3.4 kb fragment of A1ACT with Taq I. The frequency of homozygous genotype for the 5.8 kb A1ACT band was increased in osteoarthritis (62.8% versus 36.8%, P = 0.01, relative risk = 2.9, aetiological fraction = 0.41). No other disease association was found with any marker. This suggests that the A1ACT gene may influence susceptibility to generalized osteoarthritis.

Alleles↗
PubMed1990

Spiritism in Puerto Rico. Results of an island-wide community study.

Using data from the first community-based, epidemiological survey of Puerto Rico, this paper examines the current prevalence of use of spiritist healers by Puerto Ricans, the role of spiritism in the provision of mental health services, and the association between spiritism and psychiatric disorders and symptoms. Those who visit spiritists were found to be more likely to work outside the home, to have a low family income, to have sought help for emotional problems from mental health professionals, and to have mild symptoms of depression.

Adolescent↗