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Biomedical subjects

J B Williams

Publications and source records attributed to J B Williams.

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

Validity and utility of the PRIME-MD patient health questionnaire in assessment of 3000 obstetric-gynecologic patients: the PRIME-MD Patient Health Questionnaire Obstetrics-Gynecology Study.

OBJECTIVE: This study was undertaken to determine the prevalence of mental disorders among obstetric-gynecologic patients and to assess the validity and utility of the PRIME-MD Patient Health Questionnaire (PHQ) in this population. STUDY DESIGN: A total of 3000 patients were assessed by 63 clinicians at seven obstetrics-gynecology outpatient care sites. The main outcome measures were PRIME-MD PHQ diagnoses, psychosocial stressors, independent diagnoses made by mental health professionals, functional status measures, disability days, health care use, and treatment or referral decisions. RESULTS: Current mental disorders were fairly prevalent, present in 1 in 5 obstetric-gynecologic patients. Patients with PRIME-MD PHQ diagnoses had more functional impairment, disability days, health care use, and psychosocial stressors than did patients without PRIME-MD PHQ diagnoses (P <.005 for all measures). Although most clinicians judged the PRIME-MD PHQ to be useful in management decisions, the questionnaire diagnosis of mental disorder rarely led to therapeutic intervention. CONCLUSION: The PRIME-MD PHQ is a useful instrument for the assessment of mental disorders, functional impairment, and recent psychosocial stressors in the busy obstetrics-gynecology setting.

Adolescent↗
PubMed2000

HMG-I/Y, a new c-Myc target gene and potential oncogene.

The HMG-I/Y gene encodes the HMG-I and HMG-Y proteins, which function as architectural chromatin binding proteins important in the transcriptional regulation of several genes. Although increased expression of the HMG-I/Y proteins is associated with cellular proliferation, neoplastic transformation, and several human cancers, the role of these proteins in the pathogenesis of malignancy remains unclear. To better understand the role of these proteins in cell growth and transformation, we have been studying the regulation and function of HMG-I/Y. The HMG-I/Y promoter was cloned, sequenced, and subjected to mutagenesis analysis. A c-Myc-Max consensus DNA binding site was identified as an element important in the serum stimulation of HMG-I/Y. The oncoprotein c-Myc and its protein partner Max bind to this site in vitro and activate transcription in transfection experiments. HMG-I/Y expression is stimulated by c-Myc in a Myc-estradiol receptor cell line in the presence of the protein synthesis inhibitor cycloheximide, indicating that HMG-I/Y is a direct c-Myc target gene. HMG-I/Y induction is decreased in Myc-deficient fibroblasts. HMG-I/Y protein expression is also increased in Burkitt's lymphoma cell lines, which are known to have increased c-Myc protein. Like Myc, increased expression of HMG-I protein leads to the neoplastic transformation of both Rat 1a fibroblasts and CB33 cells. In addition, Rat 1a cells overexpressing HMG-I protein form tumors in nude mice. Decreasing HMG-I/Y proteins using an antisense construct abrogates transformation in Burkitt's lymphoma cells. These findings indicate that HMG-I/Y is a c-Myc target gene involved in neoplastic transformation and a member of a new class of potential oncogenes.

Animals↗
PubMed2000

Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire.

OBJECTIVE: Bipolar spectrum disorders, which include bipolar I, bipolar II, and bipolar disorder not otherwise specified, frequently go unrecognized, undiagnosed, and untreated. This report describes the validation of a new brief self-report screening instrument for bipolar spectrum disorders called the Mood Disorder Questionnaire. METHOD: A total of 198 patients attending five outpatient clinics that primarily treat patients with mood disorders completed the Mood Disorder Questionnaire. A research professional, blind to the Mood Disorder Questionnaire results, conducted a telephone research diagnostic interview by means of the bipolar module of the Structured Clinical Interview for DSM-IV. RESULTS: A Mood Disorder Questionnaire screening score of 7 or more items yielded good sensitivity (0.73) and very good specificity (0.90). CONCLUSIONS: The Mood Disorder Questionnaire is a useful screening instrument for bipolar spectrum disorder in a psychiatric outpatient population.

Adolescent↗
PubMed2000

Flexibility in basal metabolic rate and evaporative water loss among hoopoe larks exposed to different environmental temperatures.

The 'energy demand' hypothesis for short-term adjustments in basal metabolic rate (BMR) posits that birds adjust the size of their internal organs relative to food intake, a correlate of energy demand. We tested this hypothesis on hoopoe larks (Alaemon alaudipes), inhabitants of the Arabian desert, by acclimating birds for 3 weeks at 15 degrees C and at 36 degrees C, then measuring their BMR and total evaporative water loss (TEWL). Thereafter, we determined the dry masses of their brain, heart, liver, kidney, stomach, intestine and muscles of the pectoral region. Although mean body mass did not differ initially between the two groups, after 3 weeks, birds in the 15 degrees C group had gained mass (44.1+/-6.5 g), whereas larks in the 36 degrees C group had maintained a constant mass (36.6+/-3.6 g; means +/- s.d., N=6). Birds in the 15 degrees C group had a mean BMR of 46.8+/-6.9 kJ day(-1), whereas birds in the 36 degrees C group had a BMR of 32.9+/-6.3 kJ day(-1), values that were significantly different when we controlled for differences in body mass. When measured at 35 degrees C, larks in the cold-exposure group had a TEWL of 3.55+/-0.60 g H(2)O day(-)(1), whereas TEWL for birds in the 36 degrees C group averaged 2.23+/-0.28 g H(2)O day(-1), a difference of 59.2%. Mass-independent TEWL differed significantly between groups. Larks in the 15 degrees C group had a significantly larger liver, kidney and intestine than larks in the 36 degrees C group. The total increase in organ mass contributed 14.3% towards the total mass increment in the cold exposure group. Increased food intake among larks in the cold group apparently resulted in enlargement of some of the internal organs, and the increase in mass of these organs required a higher rate of oxygen uptake to support them. As oxygen demands increased, larks apparently lost more evaporative water, but the relationship between increases in BMR and TEWL remains unresolved.

Acclimatization↗
PubMed2000

Difficulties in interpersonal relationships associated with personality disorders and axis I disorders: a community-based longitudinal investigation.

A longitudinal study was conducted to investigate the association between Axis I and Axis II psychiatric disorders, interpersonal relationships, and global functioning among men in the community. Structured clinical interviews assessing Axis I and Axis II psychiatric disorders, global assessments of functioning, and questionnaires assessing social support, social conflict, and loneliness were administered to a community sample of 95 HIV+ and 45 HIV- men. The questionnaires were readministered 1 year later. Results indicated that (a) Personality disorders (PDs) and unipolar depressive disorders were associated with loneliness, social conflict, and low levels of social support after HIV status was controlled statistically; (b) PDs were associated with interpersonal and global impairment after HIV status and co-occurring Axis I disorders were controlled statistically; (c) Axis I disorders were associated with global impairment, but were not associated with interpersonal difficulties after HIV status and PDs were controlled statistically; (d) PDs, but not Axis I disorders, predicted increases in social conflict and global impairment after HIV status was controlled statistically; (e) PDs continued to predict increases in global impairment after both Axis I disorders and HIV status were controlled statistically; and (f) HIV+ men reported more loneliness, less social support, and had a higher prevalence of substance use disorders than HIV- men. The present findings are of particular interest because they suggest that PDs are associated with loneliness, social conflict, and a lack of social support among men in the community, whether or not Axis I disorders are present.

Adult↗
PubMed1999

Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire.

CONTEXT: The Primary Care Evaluation of Mental Disorders (PRIME-MD) was developed as a screening instrument but its administration time has limited its clinical usefulness. OBJECTIVE: To determine if the self-administered PRIME-MD Patient Health Questionnaire (PHQ) has validity and utility for diagnosing mental disorders in primary care comparable to the original clinician-administered PRIME-MD. DESIGN: Criterion standard study undertaken between May 1997 and November 1998. SETTING: Eight primary care clinics in the United States. PARTICIPANTS: Of a total of 3000 adult patients (selected by site-specific methods to avoid sampling bias) assessed by 62 primary care physicians (21 general internal medicine, 41 family practice), 585 patients had an interview with a mental health professional within 48 hours of completing the PHQ. MAIN OUTCOME MEASURES: Patient Health Questionnaire diagnoses compared with independent diagnoses made by mental health professionals; functional status measures; disability days; health care use; and treatment/referral decisions. RESULTS: A total of 825 (28%) of the 3000 individuals and 170 (29%) of the 585 had a PHQ diagnosis. There was good agreement between PHQ diagnoses and those of independent mental health professionals (for the diagnosis of any 1 or more PHQ disorder, kappa = 0.65; overall accuracy, 85%; sensitivity, 75%; specificity, 90%), similar to the original PRIME-MD. Patients with PHQ diagnoses had more functional impairment, disability days, and health care use than did patients without PHQ diagnoses (for all group main effects, P<.001). The average time required of the physician to review the PHQ was far less than to administer the original PRIME-MD (<3 minutes for 85% vs 16% of the cases). Although 80% of the physicians reported that routine use of the PHQ would be useful, new management actions were initiated or planned for only 117 (32%) of the 363 patients with 1 or more PHQ diagnoses not previously recognized. CONCLUSION: Our study suggests that the PHQ has diagnostic validity comparable to the original clinician-administered PRIME-MD, and is more efficient to use.

Adult↗
PubMed1999

Summer mood in winter depressives: validation of a structured interview.

Two structured interviews, the Hypomania Interview Guide (Including Hyperthymia), for Seasonal Affective Disorder (HIGH-SAD) and its successor, the Hypomania Interview Guide (Including Hyperthymia), Retrospective Assessment Version (HIGH-R), were validated for the assessment of nondepressed spring/summer mood states in patients with DSM-III-R or DSM-IV diagnoses of Recurrent Bipolar disorder (I, II or NOS) or Recurrent Major Depressive Disorder (MDD; unipolar), both with Seasonal Pattern, and in normal control subjects (HIGH-SAD only). The instruments retrospectively rate the frequency and severity of DSM diagnostic criterion features as well as several non-DSM features. Both instruments had high internal consistency. Normal controls had lower total scores than unipolar patients, who had lower scores than bipolar patients. Total score classified 85-91% of patients with seasonal affective disorder (SAD) into the correct unipolar or bipolar group. For boundary mood cases, small subsets of features provided better classification accuracy. Based on total score, MDD patients were divided into three subgroups: euthymes (normal mood), hyperthymes (slightly elevated mood), and high-hyperthymes (scores overlapping with hypomania). With the exception of sharpened thinking, DSM items dominated patient classifications. Distinct clusters of "positive" (pleasant, agreeable) or "negative" (impairing) features described the mood states. The HIGH-R and HIGH-SAD are useful for discriminating and classifying hypomania and mania in bipolar patients, and euthymia and hyperthymia in unipolar patients.

Adolescent↗
PubMed1999

Measuring the biodegradability of nonylphenol ether carboxylates, octylphenol ether carboxylates, and nonylphenol.

We examined the biodegradability of several metabolites of C8- and C9-alkylphenol ethoxylates, including nonylphenoxyacetic acid (NPEC1), nonylphenoxyethoxyacetic acid (NPEC2), octylphenoxyacetic acid (OPEC1), octylphenoxyethoxyacetic acid (OPEC2), and nonylphenol (NP). Using OECD method 301B (modified Sturm method), OPEC1 and OPEC2 are readily biodegradable: both compounds exceeded 60% of theoretical CO2 formation (ThCO2) by day 28, and required less than 10 days to go from 10% to 60% ThCO2. Also using method 301B, NPEC1 and NPEC2 exceeded 60% ThCO2 at day 28, but did not meet the 10 day window. Using OECD method 301F, the manometric respirometry method that measures oxygen consumption, approximately 62% of NP was biodegraded in 28 days, but required more than 10 days to go from 10% to 60% biodegradation. While the validity of the "10-day window" is currently being debated within OECD, the data show that the common metabolites of C8- and C9-APEs are rapidly degraded in the test systems used, which strongly suggests that they would not accumulate or persist in the environment.

Biodegradation, Environmental↗
PubMed1999

Early diagnosis and treatment of laryngeal injuries from prolonged intubation in adults.

Prolonged endotracheal intubation can cause injuries to 1 or more regions of the larynx, making safe extubation impossible and leading to tracheostomy in many patients. Unfortunately, a considerable number of these patients do not benefit from early laryngeal evaluation, which may reveal potentially treatable soft, obstructive tissue before it undergoes irreversible fibrosis. Between July 1992 and December 1995, we performed immediate direct telelaryngoscopy on 142 adults who required tracheostomy because of failed extubation. When present, obstructive tissue was removed with microsurgical techniques. One hundred twenty-nine (90%) patients were decannulated within 3 weeks. The 2 main reasons for failure of early decannulation were intractable granulation (in patients with insulin-dependent diabetes) and coexisting tracheal stenosis. Immediate telelaryngoscopy is recommended in all patients who require tracheostomy because of failed extubation. Flexible laryngoscopy is not adequate for thorough assessment of laryngeal damage from prolonged intubation.

Adult↗
PubMed1999

LH responses to chicken luteinizing hormone-releasing hormone I and II in laying, incubating, and out of lay turkey hens.

An experiment was conducted to assess the relative in vivo and in vitro activities of chicken LH-RH-I and -II in laying, incubating and out-of-lay turkey hens. The highest plasma concentrations of LH were measured in laying turkey hens, whereas hypophyseal concentrations were highest in incubating hens (I) and lowest in the laying hens at the end of the laying period (EL). Hypophyseal and plasma concentrations of LH decreased with aging in laying hens (L) and the greater decrease occurred in the hypophyses. An in vitro hypophyseal acute challenge with 2-min pulses of cLHRH I or II (10(-7) M) using a perifusion technique resulted in an increase in the release of LH in out-of-lay (OL) and incubating (I) hens, but not in laying (L) hens. Although both peptides elicited comparable responses in I hens, cLHRH II was more effective in OL hens. This difference was attributable to a greater amplitude of the response, whose duration was unchanged. Hypophyseal desensitization to a subsequent stimulation was observed in OL hens when the interval between stimulations was 30 min, but this did not occur at 60- or 120-min intervals. In vivo, the injection of cLHRH I or II, at doses of 10(-8) and 10(-10) M/kg B.W. stimulated increases in the plasma concentrations of LH, which were initiated within 1 min of injection in OL and I hens but from 5 to 20 min postinjection in L hens. The responses were dose-related and greater immediate responses were measured with cLHRH I than with cLHRH II. Also, after the injection of cLHRH II at the 10(-8) M/kg B.W. dose, the shape of the LH response consisted of an initial increase, followed by a more sustained phase during which LH concentrations were either stable (I hens) or continued to increase (L and OL hens) from 20 to 60 min after injection. In contrast, the injection of cLHRH I at doses of 10(-8) or 10(-10) M/kg or cLHRH II at a dose of 10(-10) M/kg in I and OL hens, produced a peak of LH concentrations in plasma within 5 min and thereafter declined gradually. The difference in the in vivo responses to LHRH I and II could not be attributed to a greater potency of cLHRH II, but to a more prolonged action. In summary, the responses to both forms of chicken LH-RH varies markedly with the stage of the reproductive cycle (L, I, and OL) and differs between the in vivo and in vitro situations. Although cLHRH II may be more active than cLHRH I, controversy still surrounds its precise physiological role.

Animals↗
PubMed1999

Jet lag: clinical features, validation of a new syndrome-specific scale, and lack of response to melatonin in a randomized, double-blind trial.

OBJECTIVE: The goals of this study were to validate a new rating scale for measuring severity of jet lag and to compare the efficacy of contrasting melatonin regimens to alleviate jet lag. METHOD: This was a randomized, double-blind trial of placebo and three alternative regimens of melatonin (5.0 mg at bedtime, 0.5 mg at bedtime, and 0.5 mg taken on a shifting schedule) for jet lag. The subjects were 257 Norwegian physicians who had visited New York for 5 days. Jet lag ratings were made on the day of travel from New York back to Oslo (6 hours eastward) and for the next 6 days in Norway. The main outcome measures were scale and item scores from a new, syndrome-specific instrument, the Columbia Jet Lag Scale, that identifies prominent daytime symptoms of jet lag distress. RESULTS: There was a marked increase in total jet lag score in all four treatment groups on the first day at home, followed by progressive improvement over the next 5 days. However, there were no significant group differences or group-by-time interactions. In addition, there was no group effect for sleep onset, time of awakening, hours slept, or hours napping. Ratings on a summary jet lag item were highly correlated with total jet lag scores (from a low of r = 0.54 on the day of travel to a high of r = 0.80 on day 3). The internal consistency of the total jet lag score was high on each day of the study. CONCLUSIONS: The use of melatonin for preventing jet lag needs further study.

Aerospace Medicine↗
PubMed1999

Consensus criteria for traumatic grief. A preliminary empirical test.

BACKGROUND: Studies suggest that symptoms of traumatic grief constitute a distinct syndrome worthy of diagnosis. AIMS: A consensus conference aimed to develop and test a criteria set for traumatic grief. METHOD: The expert panel proposed consensus criteria for traumatic grief. Receiver operator characteristic (ROC) analyses tested the performance of the proposed criteria on 306 widowed respondents at seven months post loss. RESULTS: ROC analyses indicated that three of four separation distress symptoms (e.g. yearning, searching, loneliness) had to be endorsed as at least 'sometimes true' and four of the final eight traumatic distress symptoms (e.g. numbness, disbelief, distrust, anger, sense of futility about the future) had to be endorsed as at least 'mostly true' to yield a sensitivity of 0.93 and a specificity of 0.93 for a diagnosis of traumatic grief. CONCLUSIONS: Preliminary analyses suggest the consensus criteria for traumatic grief have satisfactory operating characteristics, and point to directions for further refinement of the criteria set.

Grief↗
PubMed1999

Motion artifact seen on slot-scanning direct digital mammography.

OBJECTIVE: Our goal was to determine the appearance of motion artifact when imaging an anthropomorphic breast phantom using a digital slot-scanning system compared with a screen-film system. MATERIALS AND METHODS: Digital and screen-film images were obtained during both brief and continuous manually induced motion of an anthropomorphic phantom in four directions. Continuous motion was further characterized using a syringe pump to induce motion artifact. RESULTS: On screen-film images, brief motion caused degradation of the entire image, simulating a double exposure. Conversely, on digital images using a slot-scanning system, brief motion caused degradation of only a small portion of the image. Continuous motion resulted in smearing of phantom details with both systems, although the smearing was more strongly influenced by the direction of motion when the slot-scanning system was used. With the slot-scanning system, motion in the direction of the detector sweep resulted in elongated distortion, whereas motion in the opposite direction resulted in foreshortening; diagonal smearing was seen with perpendicular phantom motion. The magnitude of distortion for continuous motion at a set velocity was substantially less with the slot-scanning system. CONCLUSION: Motion artifact with a slot-scanning direct digital mammography unit differs significantly from that seen with a conventional screen-film unit and, despite a relatively long overall exposure, may prove to be less of a problem than with conventional units because any given part of an object is exposed only briefly.

Artifacts↗