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Biomedical subjects

J J Strain

Publications and source records attributed to J J Strain.

At least 127 records · Page 7Linked to original sources
PubMed1995

Operationalizing a bedside pen entry notebook clinical database system in consultation-liaison psychiatry.

No current system of computerized data entry of clinical information in consultation-liaison (C-L) psychiatry has been well received or has demonstrated that it saves the consultant's time. The inability to achieve accurate, complete, systematic collection of discrete variables and data entry in the harried C-L setting is a major impediment to the advancement of the subspecialty and health services research. The hand-held Notebook computer with Windows PEN ENTRY MICROCARES capabilities has permitted one-time direct entry of data at the time of collection at the patient's bedside. Variable choice and selection enhances the completeness and accuracy of data collection. For example, ICD-9, Axis III diagnoses may be selected from a "look-up" which at the same time automatically assigns the appropriate code and diagnostic-related groups, (DRG) number. A patient narrative can be typed at the nurse's station, a chart note printed for the medical record, and the MICRO-CARES literature database perused with the printing of selected citations, abstracts, and in some cases experts' commentaries for the consultee. The consultant's documentation time is halved using the NOTEBOOK WINDOWS PEN ENTRY MICRO-CARES software, with the advantage of more accurate and complete data description than with the traditional handwritten consultation records. Consultees preferred typewritten in contrast to handwritten notes. The cost of the hardware (about $2000) is less than that of an optical scanner, and it permits report generation and archival searches at the nurses' station without returning to the C-L office for scanning. Radio frequency or ethernet download from the Notebook permits direct data transfer to th C-L office archive computer.

Attitude of Health Personnel↗
PubMed1995

Dietary fish oil supplementation alters leukocyte function and cytokine production in healthy women.

The effect of low-dose fish oil supplementation on cytokines and white cell function in women was investigated. Thirty-three healthy, nonsmoking women entered the double-blind study. For 4 weeks, 2.4 g of either fish oil (n = 16) or fish oil with vitamin E (n = 17) was added daily to the subjects' otherwise unchanged diets. Venous blood samples were taken at the onset of the trial, after the supplementation period, and again after a 9-week washout period. Plasma levels of platelet-derived growth factor and myeloperoxidase were measured using immunoassays. The intracellular peroxidase content of white blood cells was measured using a staining technique. Platelet-derived growth factor levels were significantly lowered after supplementation (P < or = .05). Intracellular peroxidase was increased (P < or = .01), and extracellular myeloperoxidase levels were lowered (P < or = .05). Taken together, these results suggest that the anti-inflammatory effect of fish oil may be due at least partly to alterations in white cell function and growth factor levels.

Adolescent↗
PubMed1995

DSM-IV field trial: testing a new proposal for somatization disorder.

OBJECTIVE: The purpose of this study was to evaluate for APA a proposed strategy to diagnose somatization disorder for possible inclusion in DSM-IV. METHOD: Five sites--Washington University, University of Kansas, University of Iowa, University of Arkansas, and Mount Sinai Medical Center in New York--participated in a collaborative field trial. Female subjects (N = 353) were recruited from several different services (psychiatry, internal medicine, and family practice) and were evaluated for the presence or absence of the disorder. This assessment was performed with a new instrument constructed by combining all the criteria for somatization disorder from the proposed criteria for DSM-IV, DSM-III, DSM-III-R, Perley-Guze, and proposed criteria for ICD-10. RESULTS: A high level of concordance was found between the proposed diagnostic strategy for DSM-IV and the current criteria (DSM-III-R), as well as the earlier criteria (Perley-Guze and DSM-III). The ICD-10 criteria agreed poorly with all other criteria sets. The level of experience of the rater (expert versus novice) with the earlier (Perley-Guze, DSM-III) and current (DSM-III-R) criteria did not influence the identification of cases by use of DSM-IV criteria. No racial effect was introduced by any of the criteria sets. CONCLUSIONS: The strategy for DSM-IV is an accurate and simpler method of diagnosing somatization disorder that does not require special expertise for proper use.

Adult↗
PubMed1994

Estimates of food and macronutrient intake in a random sample of Northern Ireland adolescents.

Estimates of food consumption and macronutrient intake were obtained from a randomly selected population sample (2%) of 1015 adolescents aged 12 and 15 years in Northern Ireland during the 1990/1991 school year. Dietary intake was assessed by diet history with photographic album to estimate portion size. Reported median energy intakes were 11.0 and 13.1 MJ/d for boys aged 12 and 15 years respectively and 9.2 and 9.1 MJ/d for girls of these ages. Protein, carbohydrate and total sugars intakes as a percentage of total energy varied little between the age and sex groups and were approximately 11, 49 and 20% respectively of daily total energy intakes. Median dietary fibre intakes were approximately 20 and 24 g/d for boys aged 12 and 15 years respectively and 18 and 19 g/d for girls of these ages. Major food sources of energy (as a percentage of total energy intakes) were bread and cereals (15-18%), cakes and biscuits (12-14%), chips and crisps (13-14%), dairy products (9-11%), meat and meat products (9-11%) and confectionery (9%). Fruit and vegetable intakes were low at about 2.5% and 1.5% respectively of total energy intakes. Median fat intakes were high at 39% of total daily energy intakes. Major food sources of fat as a percentage of total fat intakes were from the food groupings: chips and crisps (16-19%), meat and meat products (14-17%), fats and oils (14-16%), cakes and biscuits (13-16%) and dairy products (12-15%). Median intakes of saturated fatty acids were also high at approximately 15% of daily total energy intake while intakes of monounsaturated fatty acids averaged 12% of daily total energy intake. Median polyunsaturated fatty acid (PUFA) intakes were low, comprising 5.2 and 5.5% of daily total energy intake for boys aged 12 and 15 years respectively and were lower than the PUFA intakes (5.9 and 6.3% of daily total energy intake) for girls of these ages. About 1.3% for boys and 1.4% for girls of daily total energy intake was in the form of n-3 PUFA. Ca and Mg intakes were adequate for both sexes. Based on these results, some concern about the dietary habits and related health consequences in Northern Ireland adolescents appears justified.

Adolescent↗
PubMed1994

Newer aspects of micronutrients in chronic disease: copper.

Cu ions are pro-oxidants when added to biological material in vitro and excessive levels of Cu in the body, such as in Wilson's Disease (Yarze et al. 1992) promote oxidant-related pathologies. In contrast there is now substantial evidence that an optimum level of Cu is required to maintain antioxidant defence and that Cu deficiency in animals increases oxidant stress. There are abundant mechanistic relationships linking Cu deficiency and processes associated with IHD, some of which do not directly involve oxidant damage. These mechanistic relationships, however, have mostly been demonstrated in animal models and more information is urgently required concerning possible chronic mild Cu deficiencies in human populations. A major hurdle to advances in this area is the lack of indices of Cu status which are sensitive enough to detect marginal Cu deficiency in humans. The question, therefore, of whether or not there is a role for mild Cu deficiency in the onset of chronic disease processes, including IHD, remains unanswered.

Animals↗
PubMed1994

Cholesterol screening and family history of vascular disease.

Hypercholesterolaemia is a major risk factor for the development of coronary heart disease (CHD). Early detection and management of hypercholesterolaemia could retard the atherosclerotic process. Given that CHD and hypercholesterolaemia cluster within families, a screening strategy based on a family history of vascular disease has been advocated. Serum total cholesterol concentrations were measured in a random stratified sample of 1012 children aged from 12-15 years old participating in a coronary risk factor surveillance study in Northern Ireland. Information about vascular disease in close family members was obtained by means of a questionnaire. The study population was divided into two groups according to total cholesterol values: (i) normal, < 5.2 mmol/l (n = 822) and (ii) raised, > or = 5.2 mmol/l (n = 190). A family history identified 63 out of 190 individuals with hypercholesterolaemia yielding a sensitivity of 33.2% and specificity of 71.5%. Our data indicated that a strategy whereby only children from high risk families are screened for hypercholesterolaemia is ineffective. While primary prevention emphasising a healthy diet for all is essential, the role of universal screening deserves further appraisal.

Adolescent↗
PubMed1994

Effects of copper deficiency and experimental diabetes on tissue antioxidant enzyme levels in rats.

Male weanling rats were fed diets containing either adequate (6.2 mg/kg) or deficient (0.82 mg/kg) quantities of copper for 35 days. Six rats from each group (n = 12) were then injected with streptozotocin to induce diabetes. Rats were killed after a further 16 days and tissues removed for the analysis of the copper level and antioxidant enzyme activities. Diabetes resulted in increased cardiac catalase, glutathione S-transferase (GST), copper-zinc superoxide dismutase and manganese superoxide dismutase activities. Renal catalase levels were decreased in diabetes, while glucose-6-phosphate dehydrogenase activity (G6PDH) was increased. Diabetes significantly decreased the activities of hepatic GST and G6PDH. The combination of diabetes and copper deficiency resulted in increased levels of hepatic GST, glutathione peroxidase and glutathione reductase. Hepatic and renal tissue copper levels were also increased in diabetes, apparently improving copper status in the copper-deficient rats. Alterations of antioxidant enzyme activities in diabetes were suggestive of increased oxidant stress, especially in cardiac tissue.

Analysis of Variance↗
PubMed1994

SCID diagnosis of panic disorder in psychogenic seizure patients.

The authors administered the Structured Clinic Interview for DSM-III-R (SCID) to 20 outpatients with nonepileptic seizures documented by video-EEG. Fourteen (70%) had one or more non-somatoform DSM-III-R diagnoses. All 14 met criteria for panic disorder. Comorbid mood, psychotic, substance abuse, and eating disorders were also noted. Meticulous use of the SCID, with extensive follow-up, may have resulted in enhanced detection of panic disorder in patients who do not spontaneously report panic symptoms. Panic attacks may play a more important role in nonepileptic seizures than has been generally recognized, especially in outpatients with a chronic course of illness.

Adult↗
PubMed1994

Human milk contains granulocyte colony stimulating factor.

Human milk provides the neonate with a variety of balanced nutrients and contains biologically active molecules such as hormones and growth factors. We have utilized a sensitive enzyme immunoassay to detect the granulocyte stimulator, granulocyte colony-stimulating factor (G-CSF) in human milk samples. The 12 milk samples tested contained G-CSF ranging from 45 to 1551 pg/ml.

Adult↗
PubMed1994

Putative role of dietary trace elements in coronary heart disease and cancer.

Relatively little attention has been given to the role of dietary trace elements in oxidative processes or in the aetiologies of chronic disease processes. Iron and copper are pro-oxidants in vitro, but there is now compelling evidence that adequate body copper status is required to maintain antioxidant defences in vivo. Epidemiological evidence linking measures of high iron nutritional status with both coronary heart disease (CHD) and cancer is accumulating, although there are few mechanisms implicating iron in these disease processes apart from acting as a pro-oxidant. In contrast, low copper nutritional status may produce pro-oxidant effects and experimental evidence, especially from animal models of CHD, suggests that copper has an involvement in disease mechanisms which is much wider than simply an involvement in maintaining oxidant/antioxidant balance. Zinc is considered to have antioxidant effects in vivo but the role of zinc as an antioxidant, or in CHD and cancer processes, is presently unclear. Although selenium has for some time been recognised as an antioxidant nutrient, epidemiological data gathered to date linking this trace element with either CHD or cancer are inconsistent.

Coronary Disease↗
PubMed1994

Iron status, blood lipids and endogenous antioxidants in response to dietary iron levels in male and female rats.

The effect of dietary iron levels on iron status, blood lipids and endogenous antioxidants was investigated in male and female rats. Diets low in iron (15 mg/kg Fe; LFe) or high in iron (400 mg/kg Fe; HFe) were given to groups of male (n = 6) and female (n = 6) weanling rats for six weeks. In a second experiment the same dietary iron levels were fed to groups (n = 12) of males and females for seven months, during which colon tumours were induced. Indices of iron status, blood lipid levels and antioxidant enzyme activities were measured in both experiments. In the first experiment, indices of iron status were significantly higher in HFe rats and in females compared with males. Cholesterol and triglycerides were significantly higher in HFe rats and cholesterol was significantly higher in males. Plasma albumin and bilirubin levels and plasma caeruloplasmin activity were significantly higher in female rats. The second experiment confirmed the higher indices of iron status in HFe rats and in female rats, and also showed that plasma cholesterol levels were significantly higher in HFe rats. There were no consistent, significant differences over both experiments in activities of the antioxidant enzymes measured. Results show that higher dietary iron levels are associated with higher cholesterol levels in male and female rats. However cholesterol was found to be higher in male rats while iron status was higher in female rats. This indicates that factors other than iron status are responsible for the differences in cholesterol in male and female rats.

Animals↗
PubMed1993

A technique for the tensile testing of demineralised bone.

The purpose of this study was to devise a method for the tensile testing of the organic component of demineralised bone. It was hoped that the method could be applied to determine whether an observed reduction in the strength of bone in copper-deficient rats could be attributed to a reduction in the cross-linking of collagen. Tensile testing of a fully demineralised specimen proved impossible to perform because of the difficulty in gripping the material, which tended to slide out of its holding clamps. The technique devised involved the demineralisation of only the diaphysis of the bone, leaving the bone ends intact. This enabled the bone to be gripped firmly at both ends in an Instron tensile testing machine. Elongation under loading of the demineralised diaphysis was measured by the Instron and a video recording was made of the elongation of the central portion. The strain was found to be uniform. Tensile strength was found to correlate with copper levels in the liver (r = 0.54, p < 0.05), although no significant differences were found between the strength, the stiffness, or the strain to failure for bone from the copper-deficient animals and bone from the normal controls. The test method itself should be useful in other studies in which the tensile properties of the organic phase of bone need to be measured.

Animals↗
PubMed1993

An optical scan/statistical package for clinical data management in C-L psychiatry.

This paper explores aspects of the need for clinical database management systems that permit ongoing service management, measurement of the quality and appropriateness of care, databased administration of consultation liaison (C-L) services, teaching/educational observations, and research. It describes an OPTICAL SCAN databased management system that permits flexible form generation, desktop publishing, and linking of observations in multiple files. This enhanced MICRO-CARES software system--Medical Application Platform (MAP)--permits direct transfer of the data to ASCII and SAS format for mainframe manipulation of the clinical information. The director of a C-L service may now develop his or her own forms, incorporate structured instruments, or develop "branch chains" of essential data to add to the core data set without the effort and expense to reprint forms or consult with commercial vendors.

Computer Systems↗
PubMed1993

Identification of alcoholism and depression in a geriatric medicine outpatient clinic.

OBJECTIVE: To examine the utility of brief screening instruments for alcoholism and depression in the frail elderly medical outpatient. DESIGN: Cross-sectional examination. SETTING: Coffey Geriatric Outpatient Clinic, The Mount Sinai School of Medicine, New York City. SUBJECTS: Convenience sample of 84 consenting male and female outpatients over 62 years of age. MEASUREMENTS: The Michigan Alcohol Screening Test (MAST), CAGE questionnaire, and the Geriatric Depression Scale (GDS). RESULTS: Four subjects (5%) scored positive for alcoholism on the MAST, all of whom had been previously identified by the geriatric clinic staff. In contrast, the CAGE only identified 1 (1.4%) alcoholic subject. Thirty-two percent of subjects scored positive for depression on the GDS, yet only one-third of these depressed patients had been previously identified by the geriatric team as depressed. Among the depressed outpatients, 19% were labeled anxious and received anxiolytics from the geriatric medical staff. CONCLUSIONS: Whereas brief alcohol screening instruments to detect alcoholism did not augment the geriatrician's clinical assessment, screening for depression with the GDS may be an important adjunct to the identification of depression in geriatric medical patients.

Aged↗
PubMed1993

Impaired mechanical strength of bone in experimental copper deficiency.

Copper, through its role as cofactor for lysyl oxidase, is essential for intra- and inter-molecular cross-links in collagen. Copper deficiency, in man and in animals, is associated with bone fragility ascribed to defective cross-links. To assess bone strength in copper-deficient animals, we designed a sensitive torsion-testing apparatus according to biomechanical considerations. Femora from 7 copper-deficient rats and from their pair-fed controls were tested in torsional loading until fracture. Significant decreases in the maximal sustained torque (t = 2.93, p < 0.05), in the ultimate angular deformation (t = 2.52, p < 0.05) and in the toughness (t = 2.88, p < 0.05) were demonstrated. In a complementary study, it was shown that the ash weight and the calcium content of the femora from the copper-deficient animals did not differ from those of the controls. It was likely, therefore, that the impaired mechanical strength was related to defects in the collagen component of bone.

Animals↗