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Biomedical subjects

J B Williams

Publications and source records attributed to J B Williams.

At least 73 records · Page 4Linked to original sources
PubMed1996

Gender Differences in HIV-Related Neurological Progression in a Cohort of Injecting Drug Users Followed for 3.5 Years.

We evaluated potential gender differences in the development of HIV related neurologic impairment, by matching 38 pairs of HIV positive male and female injecting drug users on their baseline age, education, disease stage and CD4 counts, and following them for 3.5 years. Adjusting for age, education, drug use, history of head injury and baseline CD4 count, more women had sensory abnormalities and symptoms than men at baseline, but the odds of having neurological impairment, particularly extrapyramidal signs and sensory abnormalities were increased over time in men but not in women. Men with ARC or AIDS had more neurological impairment than women in similar stages of illness. This study suggests further investigations of gender differences in HIV disease progression.

CD4 Lymphocyte Count↗
PubMed1996

Drug efflux as a mechanism of resistance.

A review of efflux as a mechanism of antibiotic resistance in both bacterial and eukaryotic cells is presented. This covers membrane transport, the evolution of efflux transporters, their genetic control and classification into families, and an appreciation of the widespread distribution and occurrence of these mechanisms in nature.

Anti-Bacterial Agents↗
PubMed1995

The mouse aquaporin-1 gene.

Members of the aquaporin family of molecular water transporters are expressed in diverse epithelia and in complex developmental patterns. Using a cDNA for mouse Aqp1, the structural gene was isolated and a restriction map was constructed. The 13-kb Aqp1 gene contains four exons with intronic boundaries corresponding to other known aquaporin genes. Transcription begins 67 bp 5' to the translation initiation site and 20 bp 3' from a TATAA consensus sequence. Aqp1 was localized by interspecific mouse backcross mapping to the central region of mouse chromosome 6 syntenic with human chromosome 7p14, where AQP1 had previously been localized. These studies have revealed marked structural similarities between the mouse Aqp1 and the human AQP1 genes, suggesting that further comparative studies may provide molecular insight into genetic regulatory features shared by both species.

Animals↗
PubMed1995

Health-related quality of life in primary care patients with mental disorders. Results from the PRIME-MD 1000 Study.

OBJECTIVE: To determine if different mental disorders commonly seen in primary care are uniquely associated with distinctive patterns of impairment in the components of health-related quality of life (HRQL) and how this compares with the impairment seen in common medical disorders. DESIGN: Survey. SETTING: Four primary care clinics. SUBJECTS: A total of 1000 adult patients (369 selected by convenience and 631 selected by site-specific methods to avoid sampling bias) assessed by 31 primary care physicians using PRIME-MD (Primary Care Evaluation of Mental Disorders) to make diagnoses of mood, anxiety, alcohol, somatoform, and eating disorders. MAIN OUTCOME MEASURES: The six scales of the Short-Form General Health Survey and self-reported disability days, adjusting for demographic variables as well as psychiatric and medical comorbidity. RESULTS: Mood, anxiety, somatoform, and eating disorders were associated with substantial impairment in HRQL. Impairment was also present in patients who only had subthreshold mental disorder diagnoses, such as minor depression and anxiety disorder not otherwise specified. Mental disorders, particularly mood disorders, accounted for considerably more of the impairment on all domains of HRQL than did common medical disorders. Finally, we found marked differences in the pattern of impairment among different groups of mental disorders just as others have reported unique patterns associated with different medical disorders. Whereas mood disorders had a pervasive effect on all domains of HRQL, anxiety, somatoform, and eating disorders affected only selected domains. CONCLUSIONS: Mental disorders commonly seen in primary care are not only associated with more impairment in HRQL than common medical disorders, but also have distinct patterns of impairment. Primary care directed at improving HRQL needs to focus on the recognition and treatment of common mental disorders. Outcomes studies of mental disorders in both primary care and psychiatric settings should include multidimensional measures of HRQL.

Adult↗
PubMed1995

A mammalian delayed-early response gene encodes HNP36, a novel, conserved nucleolar protein.

Murine fibroblasts respond to mitogens by sequential gene expression in which immediate-early, or primary response, gene transcription factors direct expression of secondary transcripts encoded by delayed-early response (DER) genes. DER gene products include growth progression factors, but the products of several novel cDNAs are unknown. Murine and human cDNAs derived from one novel DER gene (DER12) were characterized to identify its product and to probe its role in the growth response. Both sequences encoded a hydrophobic 36 kD protein (HNP36) that was related to the yeast protein, FUN26. Anti-murine HNP36 antibodies were prepared and shown to immunoprecipitate both mammalian in vitro translation products. Immunocytochemical staining indicated localization of HNP36 to the nucleolus where its concentration increased after mitogen stimulation. Although HNP36 protein function is unknown, its identification as a nucleolar gene transcriptionally activated by growth factors implicates it as participating in the proliferative response.

3T3 Cells↗
PubMed1995

Gender differences in depression in primary care.

OBJECTIVES: To determine gender differences in the frequency and manifestation of depression in primary care. STUDY DESIGN: PRIME-MD, a new assessment tool, was tested in 1000 patients as an aid to diagnose depression in primary care patients. Answers to a self-assessment questionnaire completed by patients determined whether physicians administered the mood module in the Clinician Evaluation Guide to diagnose depression. Functional status was assessed with the Medical Outcomes Study Short Form (SF-20). RESULTS: More women than men were diagnosed as having a mood disorder (31% vs 19%; p < 0.01), and an antidepressant was newly prescribed only for women (p < 0.001). There were no gender differences in physician ratings of patients' health, but women rated their health significantly more poorly than did men. Similarly, functional impairment scores were significantly lower in women than in men. CONCLUSIONS: Women are much more likely than men to have depressive disorders, and when these disorders are diagnosed, to receive a prescription for antidepressant medication. Further research is needed to determine why women seem to suffer disproportionately from symptoms of depression and signs of functional impairment.

Antidepressive Agents↗
PubMed1995

Scanning electron microscopy of Polystoma integerrimum (Monogenea, Polystomatidae).

The tegumental surfaces of both the bladder (normal) adult and branchial (neotenic) adult of the dimorphic monogenean Polystoma integerrimum are elevated into ridges forming a honeycomb-like pattern of hexagons. In some regions, upright microvilli are located at the angles of the hexagons. The two hamuli of the adult forms are sheathed with the ornamented tegument except for the naked distal spine. Larvae with haptors at the two-sucker stage of development have a tegument with the elevated honeycomb design characteristic of the adults. Developing hamuli appear as fully sheathed, conical elevations. The 16 marginal hooklets of the larval haptor are covered by tegument, with the exception of their strongly curved spines. Genetic blueprints for normal and neotenic development, contained in the genome of all larvae hatching from the eggs of normal individuals, appear to diverge only in relation to the different rates of embryonic development of the two adult forms and the incomplete ontogeny of the neotenic adult.

Animals↗
PubMed1995

Phylogeny of the Polystomatidae (Platyhelminthes, Monogenea), with particular reference to Polystoma integerrimum.

Polystome phylogeny is examined, with emphasis on the dimorphism of the frog parasite Polystoma integerrimum, which exists in a fully differentiated and a neotenic form, and the evolutionary development of exclusively neotenic genera. Protopolystoma, which infects the aquatic toad Xenopus, has essentially the same morphology as the neotenic (branchial) adult of P. integerrimum and is interpreted as a neotenic genus; however, it inhabits the bladder of its host, the infection site of the normal adult of the dimorphic species. The sphyranurid Sphyranura, ectoparasitic on the external gills of the mud puppy Necturus, resembles the two-sucker larva of P. integerrimum in possessing a single pair of haptorial suckers in place of the 6 suckers of adult polystomes, and is probably a neotenic parasite associated with a neotenic host. The neotenic animals in general are parasites of aquatic hosts, and the uterus is lost or reduced in these genera; by contrast, uterine function is greatly enhanced among polystomes infecting amphibians best adapted to terrestrial life.

Animals↗
PubMed1995

Psychiatric comorbidity, health status, and functional impairment associated with alcohol abuse and dependence in primary care patients: findings of the PRIME MD-1000 study.

The psychiatric comorbidity, health, and functioning of primary care patients with alcohol abuse and dependence (AAD) were investigated in a sample of 1,000 patients. Psychiatric symptomatology was assessed with the Primary Care Evaluation of Mental Disorders (PRIME-MD) diagnostic system. Health and functional status was assessed with the Medical Outcomes Study Short Form General Health Survey (SF-20). Results indicated that use of the PRIME-MD system brought about a 71% increase in physician recognition of AAD. AAD patients were diagnosed with substantial psychiatric comorbidity, and they reported poorer health and functioning than did patients without any psychiatric disorders. However, they reported less impairment and psychiatric comorbidity than did patients with other psychiatric disorders. Results also indicated that AAD patients' health and functioning were associated with the presence or absence of psychiatric comorbidity.

Adolescent↗
PubMed1995

Axis I psychiatric symptoms associated with HIV infection and personality disorder.

OBJECTIVE: The prevalences of personality disorders among HIV-positive and HIV-negative homosexual men were compared, and the presence of personality disorders was related to axis I psychiatric disorders, psychiatric distress, and impaired functioning. METHOD: The subjects were 162 homosexual men who either were HIV seronegative (N = 52) or were seropositive and had absent to moderate physical symptoms (N = 110). Lifetime and current histories of DSM-III-R axis I disorders, current diagnoses of DSM-III-R personality disorders, and levels of anxiety, depression, hopelessness, and adaptive functioning were assessed. RESULTS: In both the seropositive and seronegative groups, 19% of the study participants were diagnosed with personality disorders. The seropositive participants with personality disorders reported higher levels of psychiatric symptoms and poorer functioning than all participants without personality disorders, and they were over six times as likely as the seronegative participants without personality disorders to have current axis I disorders. CONCLUSIONS: These findings indicate that HIV infection and personality disorders may interactively increase the likelihood of clinically significant psychiatric symptoms.

Anxiety Disorders↗
PubMed1995

Remission of substance use disorders: gay men in the first decade of AIDS.

OBJECTIVE: Participants in a 5-year prospective study of HIV-seropositive and seronegative gay men demonstrated a significant decline in the rate (from lifetime to current) of alcohol and other DSM-III-R psychoactive substance use disorders. The goal of the current study was to identify factors associated with the cessation of problematic substance use, to observe rates of relapse over 4 years, and to describe factors associated with relapse and no relapse. METHOD: A volunteer community sample of self-identified gay men (N = 56) were administered a semi-structured interview and several self-report measures by trained mental health clinicians, twice annually over a 5-year period. RESULTS: Retrospective and prospective data revealed a significant decline in substance use and problems associated with use in the decade of the 1980s. This change occurred, for the most part, without formal treatment. Numerous motivating factors were associated with this change, which included a fear of AIDS, a change in attitudes in the gay community, changes in other risk-taking behaviours and concerns about self-image. A variety of informal methods were employed. Most notable was "avoiding situations associated with substance use." CONCLUSIONS: Changes in substance abuse/dependence occurred in the context of health concerns, caring for oneself and "cleaning up one's act." Having a concern about "self-image," avoiding situations associated with drug use and not using "drug substitution" as a method of quitting were important factors for maintaining successful change.

Adult↗
PubMed1994

Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study.

OBJECTIVE: To assess the validity and utility of PRIME-MD (Primary Care Evaluation of Mental Disorders), a new rapid procedure for diagnosing mental disorders by primary care physicians. DESIGN: Survey; criterion standard. SETTING: Four primary care clinics. SUBJECTS: A total of 1000 adult patients (369 selected by convenience and 631 selected by site-specific methods to avoid sampling bias) assessed by 31 primary care physicians. MAIN OUTCOME MEASURES: PRIME-MD diagnoses, independent diagnoses made by mental health professionals, functional status measures (Short-Form General Health Survey), disability days, health care utilization, and treatment/referral decisions. RESULTS: Twenty-six percent of the patients had a PRIME-MD diagnosis that met full criteria for a specific disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition. The average time required of the primary care physician to complete the PRIME-MD evaluation was 8.4 minutes. There was good agreement between PRIME-MD diagnoses and those of independent mental health professionals (for the diagnosis of any PRIME-MD disorder, kappa = 0.71; overall accuracy rate = 88%). Patients with PRIME-MD diagnoses had lower functioning, more disability days, and higher rates of health care utilization than did patients without PRIME-MD diagnoses (for all measures, P < .005). Nearly half (48%) of 287 patients with a PRIME-MD diagnosis who were somewhat or fairly well-known to their physicians had not been recognized to have that diagnosis before the PRIME-MD evaluation. A new treatment or referral was initiated for 62% of the 125 patients with a PRIME-MD diagnosis who were not already being treated. CONCLUSION: PRIME-MD appears to be a useful tool for identifying mental disorders in primary care practice and research.

Adult↗
PubMed1994

Physical symptoms in primary care. Predictors of psychiatric disorders and functional impairment.

OBJECTIVE: To examine how the type and number of physical symptoms reported by primary care patients are related to psychiatric disorders and functional impairment. DESIGN: Outpatient mental health survey. SETTING: Four primary care clinics. PATIENTS: One thousand adult clinic patients, of whom 631 were selected randomly or consecutively and 369 by convenience. MAIN OUTCOME MEASURES: Psychiatric disorders as determined by the Primary Care Evaluation of Mental Disorders procedure; the presence or absence of 15 common physical symptoms and whether symptoms were somatoform (ie, lacked an adequate physical explanation); and functional status as determined by the Medical Outcomes Study Short-form General Health Survey. RESULTS: Each of the 15 common symptoms was frequently somatoform (range, 16% to 33%). The presence of any physical symptom increased the likelihood of a diagnosis of a mood or anxiety disorder by at least twofold to three-fold, and somatoform symptoms had a particularly strong association with psychiatric disorders. The likelihood of a psychiatric disorder increased dramatically with increasing numbers of physical symptoms. The prevalence of a mood disorder in patients with 0 to 1, 2 to 3, 4 to 5, 6 to 8, and 9 or more symptoms was 2%, 12%, 23%, 44%, and 60%, respectively, and the prevalence of an anxiety disorder was 1%, 7%, 13%, 30%, and 48%, respectively. Finally, each physical symptom was associated with significant functional impairment; indeed, the number of physical symptoms was a powerful correlate of functional status. CONCLUSIONS: The number of physical symptoms is highly predictive for psychiatric disorders and functional impairment. Multiple or unexplained symptoms may signify a potentially treatable mood or anxiety disorder.

Adult↗
PubMed1994

Restraint, fear, and distress in Japanese quail genetically selected for long or short tonic immobility reactions.

Japanese quail genetically selected for long (LTI) rather than short (STI) tonic immobility reactions showed more pronounced overt fear-responses in a number of putatively frightening situations. Greater fear has also been found in Japanese quail selected, in an independent program, for exaggerated (HS, high stress) rather than reduced (LS, low stress) plasma corticosterone response to brief mechanical restraint. The present study examined tonic immobility (TI) and adrenocortical responses in male and female quail of the LTI, STI and CON (control) lines which had either remained undisturbed or had been briefly exposed to a mechanical restraint stressor similar to that used for selection of the HS and LS lines. Behavioral strategies during restraint differed across lines, i.e., struggling followed the pattern STI > CON > LTI. The LTI quail showed more pronounced TI reactions than did CON and STI birds. Mechanical restraint prolonged subsequent TI responses and markedly elevated plasma corticosterone concentrations in all lines, but there were no line x treatment interactions. The results are discussed in terms of the parallels between the four selected lines and of the likelihood that the independent selection programs may have affected the same intervening variable.

Animals↗
PubMed1994

Balloon angioplasty with intraluminal stenting as the initial treatment modality in aorto-iliac occlusive disease.

PURPOSE: We retrospectively evaluated balloon angioplasty with intraluminal stenting to define applicability, early results, cost, and length of stay. METHODS: Seventy-three patients underwent 94 aorto-iliac angioplasties with intraluminal stents from October 1991 through July 1993. All had disabling claudication or rest ischemia. RESULTS: Mean follow-up was 10.2 months and was 90.4% complete. Ninety percent of procedures were immediately successful. There were no deaths within 30 days of surgery. Complications occurred in 13%. The ankle:brachial indices improved in all groups. Functional class improved in all groups. In class 4, limb salvage or a benefit on level of amputation was universal. Length of stay ranged 33% to 82% less than when aorto-iliac or aortofemoral bypass were undertaken (diagnosis-related group 39.25). Hospital charges for stent procedures ranged 25% to 66% less than for aorto-iliac or aortofemoral bypass (diagnosis-related group 39.25). CONCLUSION: The procedure is widely applicable, with an apparent initial advantage in mortality, morbidity, charges, and length of stay. Durability is unproven.

Adult↗
PubMed1994

Relationships between broodiness expression laying persistency and concentrations of hormones during the first productive period in turkey hens (Meleagris gallopavo).

The changes in egg production, in broodiness index and in plasma concentrations of LH, prolactin, oestradiol and progesterone were monitored throughout the first period of laying in turkey hens. The hens were subsequently classified according to their ability to express broodiness (33%) and their laying persistency; 25% were out-of-lay by the end of the experiment. A high percentage (67%) of the hens that went out-of-lay had previously been identified as broody. Altogether, a significant (p < 0.05) physiological stage effect was found when comparing prolactin, oestradiol and progesterone data obtained from short and long laying persistency hens and this stage effect was also significant for oestradiol and progesterone data obtained from broody and non-broody hens. Otherwise, plasma LH concentrations decreased slightly but significantly throughout the laying year in all hens but no significant differences between physiological states were observed, although the decrease was more pronounced in the hens that went out-of-lay. Plasma progesterone concentrations remained stable throughout in laying hens but decreased significantly in broody and/or out-of-lay hens. Plasma prolactin concentrations were maximal between the 5th and 12th week of egg production and the levels observed in laying hens that did not become broody or had a long laying persistency were twice those measured in broody and/or out-of-lay hens. In the meantime, plasma oestradiol concentrations were lower and stable in laying hens, whereas they were higher during the first half of the productive period in broody and short laying persistency hens. These results suggest that, under our experimental conditions, the hormonal profiles of prolactin and oestradiol for a given hen during the first 10 weeks of the laying cycle may provide predictive information for future changes in its physiological status. The inverse relationship that was observed here between high early plasma concentrations of oestradiol and laying persistency is original. In addition, the relationship between the ability to express broodiness and high and low early plasma concentrations of oestradiol and prolactin, respectively, in hens submitted to preventive broody treatment has not been reported previously. Furthermore, it seems clear that high initial concentrations in prolactin, far from exerting any deleterious effects on egg production are closely associated with a longer persistency of egg laying.

Animals↗
PubMed1994

Psychological distress and natural killer cells in gay men with and without HIV infection.

OBJECTIVE: The variability of the decline in immune function among those infected by HIV raises the possibility that psychological factors might help to explain the differences. Since studies of other populations have shown natural killer (NK) cells to be affected by psychiatric conditions, the authors examined this relationship in the context of HIV infection, expecting to find fewer NK cells to be associated with greater psychological distress. METHOD: Forty-six HIV-negative and 74 HIV-positive gay men who were participating in a longitudinal study had NK cells enumerations performed (by staining for CD56) 36 months after entry into the study. Comparisons were made between HIV-negative, HIV-positive asymptomatic, and HIV-positive symptomatic men by using a variety of clinician-rated and self-report measures of psychological function and absolute NK cell number. RESULTS: HIV-negative men had more NK cells than the groups of HIV-positive men. The groups' measures of psychological distress did not differ in any clinically meaningful ways. In general, the presence of DSM-III-R diagnoses and the measures of distress did not relate to NK cell number. CONCLUSIONS: NK cell number is not related to measures of psychological distress in these gay men with and without HIV infection.

Adult↗