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Biomedical subjects

J Alexander

Publications and source records attributed to J Alexander.

At least 649 records · Page 36Linked to original sources
PubMedDate not supplied

Relationship between neurotic symptoms and neurotic diagnosis: a longitudinal study.

Symptoms of anxiety, panic, depression, hypochondriasis and phobias were recorded serially over a 2-year period in 78 psychiatric patients with depressive, anxiety and phobic neuroses. It was hypothesised that if there was a clear-cut relationship between symptom type and diagnosis the current classification of neurotic disorder would be supported. The results showed great temporal variability of anxiety and depressive symptoms. These symptoms were also poorly related to diagnosis. Phobic symptoms, however, were relatively consistent over time. The findings suggest that classifications of neurotic disorder based on presenting anxiety and depressive symptoms are unsatisfactory and that many patients could be classified as a single mixed disorder.

Adult↗
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Comparison of the phosphofructokinase and pyruvate kinase activities of Cryptosporidium parvum, Eimeria tenella and Toxoplasma gondii.

Oocysts of Cryptosporidium parvum were shown to contain a pyrophosphate-dependent phosphofructokinase (PPi-PFK) similar to those previously described for Eimeria tenella and Toxoplasma gondii. PPi-PFK of C. parvum displayed simple hyperbolic kinetics with respect to its substrate fructose 6-phosphate and was not affected by fructose 2,6-bisphosphate, the major allosteric activator of most ATP-PFKs. Inorganic pyrophosphatase was not detectable in any of the three parasites. T. gondii tachyzoites and C. parvum cysts both contained a pyruvate kinase (PK) specific for ADP rather than PPi/AMP. The PK of T. gondii was similar to that of E. tenella in that it displayed strong positive cooperativity with respect to its substrate phosphoenolpyruvate and was heterotropically activated by glucose 6-phosphate, fructose 6-phosphate and fructose 1,6-bisphosphate. PK of C. parvum showed no evidence of allosteric properties. The results suggest that the three coccidia are similar in depending heavily on anaerobic energy production via glycolysis but that the mechanisms for regulating glycolysis are not common to all species.

Anaerobiosis↗
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Cognitive decline due to aging among persons with Down syndrome.

This study examined decline in cognitive functions in individuals with Down syndrome (DS) over the age of 40 in comparison to participants of the same age and comparable mental handicap without Down syndrome (NonDS). Both DS (n = 32) and NonDS (n = 31) samples were divided into "younger" (40-49 years) and "older" (50-62) groups. Cognitive processes were examined by tests of general intellectual functioning (Dementia Rating Scale, Peabody Picture Vocabulary Test-Revised, and the Matrix Analogies Test-Expanded form), as well as planning, attention, simultaneous, and successive processing tests taken from Das-Naglieri Cognitive Assessment System. The older individuals with Down syndrome performed more poorly than those in the other three groups. The differences were particularly evident in tasks requiring planning and attention. The possibility of using these tests as indicators of the early signs of Alzheimer's disease is discussed.

Adult↗
PubMedDate not supplied

A prospective study of psychosocial morbidity in adult bone marrow transplant recipients.

Forty recipients of bone marrow transplantation were recruited prospectively and assessed pretransplant, at 1 month postdischarge, and at 6 months postdischarge between 1989 and 1990. Assessments included a psychiatric interview, a variety of standardized questionnaires (Hospital Anxiety and Depression Scale, Mental Attitude to Cancer Scale, Psychosocial Adjustment to Illness Scale), and a standardized diagnostic interview. The influence of factors such as depression and anxiety upon length of stay, survival, psychosocial adjustment, and negative prognostic attitudes were examined. In contrast to other studies, little influence was found for psychiatric illness on physical outcome variables, but they did affect psychosocial outcome. The implications of these findings are discussed.

Adult↗
PubMedDate not supplied

Heterocyclic aromatic amines in human urine following a fried meat meal.

In a search for suitable biomarkers for human dietary exposure to heterocyclic aromatic amines (HAAs), we have investigated the concentrations of three common fried food mutagens in food and urine after consumption of a fried meat meal. In this connection we developed a method for the determination of HAAs and have investigated the common fried red meat HAAs 2-amino-1-methyl-6-phenylimidazo[4,5-beta]pyridine (PhIP), 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx) and 2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline (DiMeIQx). Eight volunteers participated in the study, each consuming a meal of fried minced beef patties (295 g), boiled potatoes, and a green salad. Urine was collected for two 12-hr periods prior to and following the meal. HAAs were determined in cooked meat and in untreated and acid hydrolysed urine by a series of liquid/liquid extractions, followed by Blue cotton adsorption and finally by a novel derivatized technique for gas chromatography-mass spectrometry (GC-MS). The primary amino groups were derivatized by acylation with heptafluorobutyric acid anhydride, and the resulting amide methylated using diazomethane. Phenolic hydroxyl groups were also methylated by this procedure, making it possible to detect hydroxylated HAAs, possible metabolites or constituents of the fried meat. 4'-Hydroxy-PhIP ¿2-amino-1-methyl-6-(4-hydroxyphenyl)imidazo[4,5-beta]pyridine¿ (4'-OH-PhIP) was indeed found in meat as well as in urine. The contents of PhIP, MeIQx and DiMeIQx in meat were 4.0 +/- 2.6, 3.5 +/- 0.9 and 0.3 +/- 0.1 ng g-1 (mean +/- SD, n = 4), from which the mean amounts ingested were calculated to be 1180, 1030 and 90 ng, respectively. Total amounts of HAAs in the 0-24-hr post-meal untreated urine (and percent of ingested dose) were 6-23 ng PhIP (0.5-2%) and 10-63 ng MeIQx (1-6%). In hydrolysed urine, the levels of HAAs were higher, totalling 24-100 ng PhIP (2-8.5%) and 133-329 ng of MeIQx (13-32%). DiMeIQx was below detection limit in all urine samples. Judged from our study, there were rather large inter-individual variations in the amounts of excreted HAAs, possibly caused by variations in the activities of enzymes taking part in HAA metabolism.

Adult↗
PubMedDate not supplied

Low-level carbon-monoxide poisoning: inability of neuropsychological testing to identify patients who benefit from hyperbaric oxygen therapy.

INTRODUCTION: Although major sequelae of carbon-monoxide (CO) poisoning and its treatment with hyperbaric oxygen (HBO) are well-documented, a syndrome of low-level CO poisoning has received relatively little attention. Subtle symptoms of poor concentration, language difficulty, problems with calculations, and memory loss were noted after an acute exposure of 131 dormitory residents to low levels of CO. The CO Neuropsychological Screening Battery (CONSB), a series of tests reported by others as useful to identify victims of CO poisoning, was performed on a subset of 46 victims. It was hypothesized that their test scores would improve after treatment with HBO. METHODS: Testing was performed both before and after HBO on 35 CO-exposed victims. A control group of 20 students residing on the same college campus, but not involved with the CO incident, also were tested on two separate occasions to assess the ability of the test to identify selectively victims of low-level CO poisoning, as well as to evaluate its validity when administered serially. RESULTS: Both CO-exposed and control subjects demonstrated significant performance improvement when completing the testing for the second time. In addition, the baseline test scores were not significantly different for either the CO-exposed or the control groups. Nonetheless, all CO-exposed victims reported immediate subjective improvement of their symptoms after HBO therapy. CONCLUSION: These observations and a review of the literature suggest that there might exist a syndrome of subtle neurological disturbances in victims of low-level CO poisoning. Whether this is permanent or might regress spontaneously over time is unknown. As a diagnostic adjunct, the CONSB does not appear to be as useful in low-level CO poisoning.

Acute Disease↗
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Differential inhibition by erythro-9-[3-(2-hydroxynonyl)]adenine of flagella-like and cilia-like movement of Leishmania promastigotes.

Erythro-9-[3-(2-hydroxynonyl)]adenine (EHNA) inhibits axonemal dynein ATPase activity and hence the beating of sea urchin and mammalian flagella. We have found that EHNA has an unusual effect on the flagella of Leishmania promastigotes in that it alters both the waveform and polarity of the beat. We report here results which suggest that in Leishmania promastigotes there are either distinct EHNA-sensitive dyneins or different conformational states of a single dynein involved in the cilia-like and flagella-like waveforms and in the propagation of flagellar waves from tip-to-base and from base-to-tip.

Adenine↗
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Regional and institutional variation in burn care.

In reviewing the literature on burn therapy and observing clinical burn care, we noted differences among institutions and individual experts in several areas. To study variation in burn care, we surveyed the 140 burn centers listed by the American Burn Association to determine how burn care is currently administered in the United States and Canada. Responses were obtained from 83 hospitals (60%). The survey addressed resuscitation, operative and nonoperative wound care, medications, antimicrobial agents, and pain control. The major influence on care appeared to be the experience of the director (considered "very influential" in 85%) compared with the literature ("very influential" in 12%) and habit/what works for us ("very influential" in 48%). The Parkland formula was used "always" or "often" by 78%, and the Brooke formula "never" by 81% of respondents. Lactated Ringer's solution was the most popular initial fluid, and most (78%) respondents changed fluids after 24 hours. However, the fluids used in the second 24 hours varied equally among several choices. The use of colloids also varied without a set pattern. Furosemide (Lasix) and nonsteroidal antiinflammatory drugs were used "rarely" or "never" by 67% of centers in the acute stage. H2 blockers were used for gastritis prophylaxis "always" or "often" in 60% (vs 53% for antacids and 20% for sucralfate [Carafate]). Tube feedings were started on day 1 after burn injury "always" by less than 30% of centers. Total parenteral nutrition was not commonly used. Most centers use of silver sulfadiazine on the body and hands, but facial topical antimicrobial therapy varied.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗
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Genetic analysis of Leishmania mexicana infection in mice: single gene (Scl-2) controlled predisposition to cutaneous lesion development.

Subcutaneous inoculation of Leishmania mexicana amastigotes into the shaven rumps of DBA/2 mice results in a unique 'no lesion growth' phenotype not observed in other mouse strains. Statistical analysis (Kolmogorov-Smirnov and log likelihood tests) of lesion diameters in F1, F2 and backcross progeny from (C57BL/6 x DBA/2) matings indicate that segregation between lesion growth and no lesion growth phenotypes comes under single gene control. The gene has been designated Scl-2 for susceptibility to cutaneous leishmaniasis locus 2. Preliminary mapping studies using 12 of the 26 BXD recombinant inbred mouse strains suggest a location for Scl-2 near Xmmv-8 on a region of mouse chromosome 4 showing homology with human 9p. The identification and mapping of this murine resistance gene could provide an important tool for genetic analysis of susceptibility and resistance to cutaneous leishmaniasis in man.

Animals↗
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The impact of regulation on the administrative structure of hospitals: toward an analytic framework.

The dramatic and recent regulatory changes in the hospital industry (e.g., TEFRA , DRG-based reimbursement) have given added impetus to the analytic framework developed here. Regulation will play an increasingly important role in the future of hospitals, affecting not only fiscal operations, but organizational and administrative arrangements as well. The conceptual framework developed in this article will be refined and augmented through empirical research. Healthcare executives will then have a stronger basis for adapting organizationally to changes in their regulatory environments, thereby increasing the effectiveness and survival of their institutions.

Facility Regulation and Control↗
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Chronology of a hyperbaric oxygen treatment center.

A visit to a Texas hyperbaric medical facility convinced the administrators of a southern California hospital to support a proposal for a multiplace hyperbaric oxygen treatment center at their facility.

California↗
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Primary care for children with brain injury.

Children who have sustained a brain injury should receive specialized, coordinated, family-centered care from their primary care providers. By knowing more about the etiology, assessment, associated conditions, and prevention of pediatric TBI, medical providers can better address the multiple needs of the child and family as they cope with new challenges. The management of pediatric brain injury can be complex and time consuming, but we must all be responsive to the needs of these children and their families to ensure their good health, their welfare, and their happiness.

Accident Prevention↗
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North Carolina's TBI project ACCESS. Assuring coordinated care, education, and support for survivors of pediatric brain injury.

Over the past three years, families, school staff, and healthcare personnel in our state have benefited from an innovative service delivery system designed to demonstrate that we can improve the lives of children with TBI. Project ACCESS has used hospital-based pediatric brain injury Community Transition Coordinators to identify, coordinate care, educate, support, and generally improve the lives of thousands of children with TBI. The project also uncovered a host of barriers that adversely affect the future of many of North Carolina's most vulnerable children. We hope that this article helps delineate the challenges faced by our state's healthcare and educational systems, and contributes to the adoption of a statewide model system of care for children with brain injury.

Adolescent↗