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Biomedical subjects

J F Wilson

Publications and source records attributed to J F Wilson.

At least 91 records · Page 5Linked to original sources
PubMed1996

Evidence for saturable incorporation of methadone into rat hair: relationships among oral dose, plasma concentration, and hair content.

Six groups of six male Wistar rats were administered methadone in their drinking water over the concentration range 0-0.25 mg/ml. Hair and trunk blood samples were collected after a 6-week period of drug administration. Immunoreactive methadone was measured by radioimmunoassay and methadone and its major metabolite, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidene (EDDP), by gas chromatography in plasma and alkali digests of hair. Plasma methadone concentration increased with increasing oral dose. The mean hair concentration of methadone increased to a maximum of 5.1 ng/mg at a drinking water concentration of 0.1 mg/ml corresponding to a plasma level of 14.0 ng/ml. No further significant rise in hair content was seen with higher drinking water concentrations despite a continuing increase in oral drug intake and in plasma methadone concentration. EDDP was not detected in plasma but was present at > 2 ng/mg in 25% of hair samples. The mean EDDP concentration in hair peaked at 3.2 ng/mg at the lowest dose level of methadone administered. The data suggest that methadone is incorporated into rat hair via a capacity-limited process that becomes saturated at plasma levels of some 14 ng/ml. Competition for uptake into hair between methadone and EDDP may occur.

Animals↗
PubMed1996

External quality assessment of Syva Emit and Abbott TDx II assays for methotrexate in serum.

The Syva Emit and Abbott TDx II kits for determination of methotrexate in serum were compared using data from 14 samples distributed by the United Kingdom National External Quality Assessment Scheme to a mean of 38 European laboratories. For methotrexate concentrations above 0.2 mumol/L, there was no significant difference in the bias or coefficient of variation of measurements between the two techniques. A significantly greater number of measurements by Syva Emit (6.9%) were rejected as outliers > 3 SD from the sample mean compared with Abbott TDx (1.3%). The lower sensitivity of the Syva Emit assay was evident in data reported for samples containing methotrexate concentrations below 0.2 mumol/L.

Antimetabolites, Antineoplastic↗
PubMed1996

An assessment of the routes of incorporation of opiates into beard hair after a single oral dose of codeine.

The time course of appearance of immunoreactive opiates was monitored in saliva, sweat, and beard hair in six healthy whites who were not opiate users after oral administration of 60 mg of codeine phosphate. The opiate concentration in saliva peaked within 30 min of drug administration and returned to near the predose level within 24 h. Ninety-one percent of the total secretion of opiates in sweat was collected by the skin-collection patch worn during the first 24 h after drug administration. Detectable material was also present in sweat patches on the following 2 days. Opiates were detected in extracts of alkali digests of beard hair in all subjects on the day after drug administration. Hair concentration peaked on day 3 after dosing and then decreased continuously until day 8. From day 8 until the end of the experiment on day 14, beard hair contained opiate concentrations significantly greater than the predose level. From comparison with cotinine pharmacokinetics, it is proposed that an early and the largest transfer of opiates into beard hair is through sweat. Transfer during hair growth is secondary and of comparable importance to a newly identified contribution of long duration that may involve transfer from storage depots within skin.

Adult↗
PubMed1996

Hills, ridges, mountains, and roads: geographical factors and access to care in rural Kentucky.

Access to health care remains an important issue facing many individuals. Barriers to health care include financial factors, characteristics of the individuals and of the health care delivery system, as well as geographical factors. Using a telephone survey of Kentucky residents, this study investigated the relationship between the road quality and county elevation and access to health care for individuals in rural and urban areas of the state. Controlling the comparison for known individual characteristics, community characteristics, and medical infrastructure characteristics, this study uncovered that worse road conditions, measured by a road "rideability" index, were associated with longer times to reach medical care. It also found an association between higher county elevations and shorter times to reach medical care.

Catchment Area, Health↗
PubMed1996

Housestaff social history knowledge. Correlation with evaluation of interpersonal skills.

It was hypothesized that internal medicine housestaff who inquire into their hospital patients' social histories would be rated by nurses and attendings as having better interpersonal skills. Thirty-seven internal medicine housestaff were asked to answer a questionnaire regarding the social history of up to three of their hospital patients. The score on these questionnaires was then compared to evaluations by nurses and attendings of housestaffs' interpersonal skills. We found that nurses' evaluations of housestaff interpersonal skills correlated with performance on the social history questionnaire, while attendings' evaluations did not. Social history inquiry by housestaff may be a marker for housestaff humanistic and interpersonal skills.

Adult↗
PubMed1996

The psychobiology of hostility: possible endogenous opioid mechanisms.

This study examined the role of endogenous opioids in the relation between hostility and cardiovascular stress responsiveness. Forty-six men completed the Cook-Medley Hostility Scale and experienced a laboratory pain stressor once under opioid blockade and once under placebo. Hostility scores were significantly related to the magnitude of change in cardiovascular reactivity/recovery resulting from opioid blockade. Low scorers on the Cynicism subscale displayed increases in heart rate (HR) reactivity under blockade relative to placebo, with reactivity decreases noted in high scorers. Low Hostile Affect scores were similarly associated with impaired diastolic blood pressure recovery under opioid blockade. HR recovery results were somewhat different, with high scorers on Aggressive Responding and the total Cook-Medley displaying improved HR recovery under opioid blockade, with no change noted in low scorers. These data provide preliminary support for the hypothesis that low hostile individuals rely on endogenous opioids for buffering cardiovascular stress responsiveness, but high hostiles do not.

Journal Article↗
PubMed1995

Knowledge and experience with Alzheimer's disease. Relationship to resuscitation preference.

BACKGROUND: Previous studies suggest that 20% to 67% of patients would desire cardiopulmonary resuscitation (CPR) even if they had advanced Alzheimer's disease. These preferences were not affected by education about CPR. We hypothesized that CPR preferences in scenarios involving Alzheimer's disease are influenced more by knowledge of or experience with Alzheimer's disease than by knowledge of CPR and its outcomes. METHODS: We performed a random digit-dialing telephone survey of adult Kentuckians in June 1993. A total of 661 persons responded. We asked respondents whether they have had a friend or family member with Alzheimer's disease and whether they had cared for that person at home. We then assessed basic knowledge of Alzheimer's disease and CPR. We read to one half of respondents an educational paragraph describing CPR and its outcomes. Finally, we asked respondents their CPR preference if they were to develop Alzheimer's disease. RESULTS: Overall, 22% of respondents would probably or definitely want CPR if they had Alzheimer's disease. With the use of simultaneous multiple linear regression, predictors of refusing CPR in scenarios involving Alzheimer's disease included knowledge of or experience with Alzheimer's disease (P < .001), older age (P < .001), greater income (P < .004), female sex (P < .01), and nonwhite race (P < .04). Baseline knowledge of CPR did not affect CPR preferences, nor did being read the educational paragraph. CONCLUSIONS: Cardiopulmonary resuscitation preferences in scenarios involving Alzheimer's disease are strongly associated with knowledge of or experience with Alzheimer's disease more so than with knowledge of CPR. These findings suggest that in eliciting patients' CPR preferences in an advanced directive, care must be taken that patients understand the condition presented in the scenario (eg, Alzheimer's disease).

Adult↗
PubMed1995

Alveolar hydatid disease. Review of the surgical experience in 42 cases of active disease among Alaskan Eskimos.

OBJECTIVE: The authors reviewed the pathophysiology and clinical management of endemic alveolar hydatid disease in Alaskan Eskimos, incorporating recent developments in diagnosis and treatment. SUMMARY BACKGROUND DATA: Alveolar hydatid disease is a highly lethal zoonotic infection caused by the larval stage of Echinococcus multilocularis. This cestode is restricted geographically to northern climates, where foxes and small rodents represent the natural hosts. Domestic dogs also may serve as definitive hosts, and thus, transmit the parasite to humans. Human infection is characterized by the development of a cancer-like hepatic mass, which may extend to adjacent structures or metastasize to distant sites. If the infection goes untreated, mortality reaches 80%. METHODS: The medical records of all patients with alveolar hydatid disease diagnosed or treated at the Alaska Native Medical Center between 1951 and 1993 were reviewed. Forty-two cases of active disease are presented. RESULTS: Nine patients underwent resection of hepatic lesions with intent to cure, and each had a favorable result. Average post-diagnosis survival of those patients was 22 years; six still are living and free of disease. Partial resections or drainage procedures were performed in ten patients. Chemotherapy was used to augment the surgical treatment of eight patients, and four received chemotherapy alone, resulting in improved outcomes compared with historic controls. Late complications included hepatic abscess, biliary obstruction, and portal venous hypertension. CONCLUSIONS: Whereas alveolar hydatid disease rarely is encountered in other areas of North America, the biologic potential for spread of the disease may be increasing because of illegal importation of infected foxes to the Eastern seaboard. Therefore, the surgical community should maintain an awareness of the diagnosis and management of this potentially devastating parasitic infection.

Adult↗
PubMed1995

Housestaff's knowledge of their patients' social histories.

PURPOSE: To assess the extent to which house officers know the social histories of their hospital patients, and to examine the factors that influence social history knowledge. METHOD: In October-November 1992, all 31 internal medicine housestaff rotating on the hospital inpatient services at the University of Kentucky A. B. Chandler Medical Center completed questionnaires regarding the social histories of up to three of their patients. Responses were analyzed using simultaneous multiple linear regression analysis. RESULTS: Standard questions about social history were answered correctly only 29% of the time (two of seven items). The overall knowledge of patients' social histories was significantly less for supervising residents than for interns (p = .03) and, independently, for housestaff with greater patient loads (p = .04). Knowledge of a patient's social history was not related to the particular inpatient service, time the patient was admitted, or other characteristics of the patients or residents. CONCLUSION: The internal medicine residents' knowledge of their hospital patients' social histories was limited, particularly when the residents had relatively heavy patient loads or supervisory roles in patient care. The data suggest that patients' social histories may have been underemphasized during the residents' training.

Adult↗
PubMed1995

Time course of appearance of cotinine in human beard hair after a single dose of nicotine.

The time course of appearance of cotinine in saliva and in daily collections of beard clippings was monitored by gas chromatography with mass spectrometry in six volunteers who were nonsmokers following a single 30-min buccal administration of nicotine as a chewing gum. Salivary cotinine concentrations reached a plateau after 1.5 h and were nondetectable (< 0.3 ng/ml) 24 h after drug administration. Cotinine was detected in extracts of sodium hydroxide digests of beard hair in all subjects on the third day after drug administration. Mean concentrations in beard peaked on day 5, and cotinine was not detected (< 0.03 ng/mg) after day 7. The data indicate the main route for cotinine incorporation into beard is during hair growth. Transfer into beard from sweat is of little importance. A role for transfer via sebum is equivocal.

Adult↗
PubMed1995

Comparison of dihydroergotamine with metoclopramide versus meperidine with promethazine in the treatment of acute migraine.

Migraineurs often seek office-based treatment for acute headache. To compare the efficacy and side effect profile, we entered 27 migraineurs into a prospective, randomized, double-blind study where each patient received either 75 mg meperidine with 25 mg promethazine IM or .5 mg dihydroergotamine with 10 mg metoclopramide IV. After 1 hour, pain relief was similar in the two groups, but side effects were significantly greater in the meperidine with promethazine regimen group. The dihydroergotamine with metoclopramide regimen is effective, and has minimal side effects, making it an attractive method for office-based treatment of acute migraine.

Acute Disease↗
PubMed1995

Kentuckians' attitudes toward children with epilepsy.

We explored Kentuckians' attitudes toward children with epilepsy. Questions compared respondents' attitudes about children with epilepsy, asthma, hyperactivity, and AIDS. Random digit dialing led to 617 completed interviews. The key questions asked concerned (a) how a pupil with each illness would alter the classroom environment, and (b) how the condition would affect the child's quality of life (QOL) at age 21 years. Respondents used a 0-10 rating scale (0 = worst, 5 = normal, 10 = best). A dichotomous variable divided respondents into those who rated below and those who rated at or above the norm: 24% predicted a deterioration of the classroom environment with the addition of a pupil with epilepsy (similar to AIDS at 26%); 41% predicted a lessened QOL at age 21 years (a worse rating than either asthma or hyperactivity). We created summary indexes, using difference scores between epilepsy ratings and ratings for the other conditions: Relative Educational Distance (RED) and Relative Quality of Life Distance (RQLD) measures. On the RED index, rural and Appalachian respondents showed the greatest prejudice toward pupils with epilepsy. Conversely, we noted the greatest prejudice in RQLD among urban residents (the best educated group). Our data do not support contentions that prejudices against persons with epilepsy are disappearing.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Tennis racket shock mitigation experiments.

Measured in this study was the effectiveness of two types of retrofits in mitigating shocks in tennis rackets with ideally high grip fixity. The retrofits were a cushioned grip tape and a string implant device. Three types of rackets were investigated: wood, graphite composite, and metal. For low speed ball impact, neither retrofit changed significantly the magnitude and distribution of e, the coefficient of restitution on the racket heads. For moderate ball speeds impacting the rackets along the vertical centerline, three dynamic racket responses were measured: the free vibration damping based on racket head acceleration, the root-mean-square (rms) grip reaction force, and the fast Fourier transform (FFT) of the grip force. These latter experiments showed that the string implant device had a negligible effect on the three dynamic measures of racket response. However, the cushioned grip tape increased racket damping by up to 100 percent, reduced the rms grip force by about 20 percent, and reduced the magnitude of the FFT of this force by about 40 percent.

Biomechanical Phenomena↗
PubMed1995

Peritonsillar abscess: an unlikely cause of necrotizing fasciitis.

Cervical necrotizing fasciitis is a devastating polymicrobial soft tissue infection characterized by gas formation and extensive necrosis of subcutaneous fat and fascia with extension to skin and muscle. Involvement of the head and neck is rare and is typically dental in origin. Despite broad-spectrum antibiotics, mortality rates for this disease remain high. We report a successfully treated case of necrotizing fasciitis arising from a peritonsillar abscess. Review of the literature reveals only 6 other cases, with 3 successful outcomes. Early diagnosis, broad-spectrum antibiotics, and aggressive surgical debridement are the cornerstones of therapy. The pathophysiology is typically a mixed aerobic and anaerobic infection. Supportive treatment options such as hyperbaric oxygen therapy and high-calorie supplemental nutrition may be of benefit. A comprehensive literature review of craniocervical necrotizing fasciitis is presented. Factors associated with poor outcomes include diabetes mellitus, mediastinitis, cardiovascular disease, and peritonsillar abscess.

Aged↗