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Biomedical subjects

J L Fitzgerald

Publications and source records attributed to J L Fitzgerald.

At least 19 recordsLinked to original sources
PubMed2003

Increased prevalence of dental caries and poor oral hygiene in juvenile idiopathic arthritis.

OBJECTIVES: Recent decades have seen a trend to treat juvenile idiopathic arthritis (JIA) with increasing immunosuppression to improve the long-term outcome. Poor oral hygiene and dental decay cause significant morbidity, and patients with chronic disease (who may be further immunocompromised by treatment) are at greater risk. This study investigated patients with JIA using standard measures of oral health. METHODS: One hundred and forty-nine patients with JIA were included. The children were attending a regional paediatric rheumatology service and the adults were attending an adult rheumatology clinic. Random age- and sex-matched healthy controls were recruited from a dental teaching hospital. The structured dental examination included standard epidemiological indices of oral hygiene (gingival index, plaque index, oral cleanliness index) and dental decay [DMFT (decayed, missing or filled teeth) index]. RESULTS: JIA patients, at all ages, had increased levels of dental decay and poor oral hygiene. This increased level of decay was statistically significant in the patients aged 0-11 yr. Significant levels of untreated caries and increased levels of missing teeth were found in JIA, suggesting that patients with JIA had less restorative dental treatment, with tooth extraction often the chosen option for the treatment of dental decay. CONCLUSIONS: This is the largest study of oral health in JIA and is cross-sectional with non-diseased controls. It shows significantly increased levels of poor oral hygiene and dental decay in patients with JIA. The high levels of untreated dental decay suggest barriers to dental care. These results emphasize the role of regular dental care in the multidisciplinary management of JIA.

Adolescent↗
PubMed2002

Type and extent of enamel defects in juvenile idiopathic arthritis (JIA).

AIM: To establish whether there is an increased prevalence and extent of enamel defects associated with Juvenile Idiopathic Arthritis (JIA) in patients in the North of England. STUDY DESIGN: clinical examination of subjects and age and sex matched controls. METHODS: The labial surfaces of all erupted permanent teeth in subjects, as well as age and sex matched controls, were examined. They were classified for type and extent of defects according to the Modified DDE index. The records of 146 subjects and 142 controls were available for analysis. STATISTICS: defects were expressed as the percentage of subjects or controls with or without any defects or specific types of defect. Fisher's exact test was used to compare the prevalence of disease in the two groups with significance being accepted at the 5% level. In addition, 95% confidence intervals for the relative risk of disease in the two groups were derived. RESULTS: There was no significant difference between subjects and controls for the presence of any type of defect (p=0.48), demarcated opacities (p=0.39), diffuse opacities (p=0.71), or hypoplasias (p=0.19). There was no significant increase in severity of defects in subjects compared with controls. There was also no significant difference when comparing the group diagnosed before the age of 4 (0-3) and the group diagnosed after the age of 4 (>4) years. CONCLUSION: There was no greater overall prevalence of enamel defects or specific type of defects and no greater extent of them in subjects with JIA compared with age and sex matched controls.

Journal Article↗
PubMed1997

Confidentiality, disseminated regulation and ethico-legal liabilities in research with hidden populations of illicit drug users.

An assurance of confidentiality is at the core of trusting relationships in outreach, ethnographic research and patient/client encounters. In the past, centralized State health care services have provided assurances of confidentiality to those engaged in health-related research either through common law or by statute. However, unless specific confidentiality legislation is in place, no assurances of confidentiality can now be made to research subjects involved in either longitudinal, interview-based or ethnographic research. The consequences of this situation become more serious given the recent emergence of the use of peer and community outreach. A significant problem with the outreach model is the failure to provide adequate legal and ethical support for those in outreach roles. Additionally, unless research subjects can be granted assurances of confidentiality, they will not engage in research for fear of later prosecution. At this time when outreach models are the modus operandi, the lack of a fundamental commitment to sustain confidentiality may seriously undermine further research. This paper will draw on the experiences of some Australian qualitative research and will review some of the ethical and legal liabilities for research that arise when an assurance of confidentiality cannot be given to those participating in research.

Australia↗
PubMed1994

Sympathomimetic actions of methylenedioxymethamphetamine in rat and rabbit isolated cardiovascular tissues.

The aim of this study was to investigate the actions of methylenedioxymethamphetamine (MDMA) in several isolated cardiovascular tissues. In spontaneously beating rat atria, concentration-dependent positive chronotropic responses to MDMA and amphetamine were blocked by the neuronal-uptake inhibitor desipramine (1 microM) and the beta-adrenoceptor antagonist propranolol (1 microM). In atria incubated with [3H]noradrenaline to label transmitter stores, 10 microM MDMA and 1 microM amphetamine increased the resting outflow of radioactivity, while 1 microM desipramine had no effect on resting outflow. The MDMA- and amphetamine-induced release of radioactivity were blocked by 1 microM desipramine. MDMA, amphetamine and desipramine each enhanced the electrical stimulation-induced (2 Hz, 30-s train) release of radioactivity; the enhancing effects of MDMA and amphetamine were blocked by 1 microM desipramine. In rat isolated perfused hearts, MDMA (1 and 10 microM) increased heart rate by a similar amount to the increase caused by noradrenaline (10 and 50 nM). MDMA also induced dysrhythmias in 7 out of 11 rat isolated perfused heart preparations. In rabbit isolated perfused and superfused ear arteries preloaded with [3H]noradrenaline, MDMA increased the resting release of radioactivity by 230 +/- 18% (n = 6) of control resting release; the increase was accompanied by a rise in perfusion pressure of 17 +/- 7 mmHg (n = 6). MDMA also facilitated the vasoconstrictor responses to noradrenaline (3-9 ng) and perivascular nerve stimulation (1-5 Hz, 10-s train). MDMA-induced vasoconstriction and the facilitation of vasoconstrictor responses to noradrenaline and electrical stimulation were blocked by 1 microM desipramine.(ABSTRACT TRUNCATED AT 250 WORDS)

Amphetamine↗
PubMed1993

Interactions of methylenedioxymethamphetamine with monoamine transmitter release mechanisms in rat brain slices.

This study investigates the effects of methylenedioxymethamphetamine (MDMA) and amphetamine on monoamine release from rat superfused brain slices in both the presence and absence of vesicular stores of transmitter. MDMA caused the release of radioactivity from slices incubated with [3H]5-hydroxytryptamine, [3H]noradrenaline or [3H]dopamine with EC50 values of 1.9 mumol/l (95% confidence limits 1.5-2.3 mumol/l), 4.5 mumol/l (2.3-8.7 mumol/l), and greater than 30 mumol/l, respectively. In contrast, amphetamine (0.1-300 mumol/l) was more effective in releasing radioactivity from slices incubated with [3H]dopamine than [3H]noradrenaline or [3H]5-hydroxytryptamine. When Ca2+ was excluded from the superfusion fluid, the MDMA-induced release of radioactivity from slices incubated with [3H]dopamine was unaltered, but that from slices incubated with [3H]noradrenaline or [3H]5-hydroxytryptamine was enhanced. MDMA (10 mumol/l) facilitated the stimulation-induced (5 Hz, 1 min) outflow of radioactivity from slices incubated with [3H]noradrenaline or [3H]5-hydroxytryptamine to 7.5-fold and 2.1-fold of control values, respectively, but had no effect on that from slices incubated with [3H]dopamine. Amphetamine (1 mumol/l) increased the stimulation-induced outflow from slices incubated with [3H]noradrenaline, but not that from slices incubated with [3H]5-hydroxytryptamine or [3H]dopamine. Inhibition of monoamine oxidase by a 30-min incubation with pargyline (100 mumol/l) enhanced the releasing action of MDMA on all three monoamines. Pargyline (100 mumol/l) also enhanced the facilitation caused by MDMA, of the stimulation-induced outflow of radioactivity from slices incubated with [3H]noradrenaline, [3H]5-hydroxytryptamine or [3H]dopamine. In some experiments, slices were obtained from reserpinised rats (2.5 mg/kg s.c. 24 h prior) and pre-exposed for 30 min to the monoamine oxidase inhibitor parglyine (100 mumol/l). Under these conditions, electrical stimulation evoked a small residual stimulation-induced outflow of radioactivity from slices incubated with [3H]noradrenaline, and failed to evoke an outflow of radioactivity from slices incubated with [3H]5-hydroxytryptamine or [3H]dopamine. However, a Ca(2+)-dependent stimulation-induced outflow of radioactivity was evoked in the presence of either MDMA (10 mumol/l) or amphetamine (1 mumol/l) from slices incubated with either [3H]dopamine or [3H]noradrenaline, but not from slices incubated with [3H]5-hydroxytryptamine. The stimulation-induced outflow of radioactivity from slices incubated with [3H]noradrenaline was enhanced in the presence of desipramine (1 mumol/l), however this enhancement was less than that caused by 10 mumol/l MDMA or 1 mumol/l amphetamine. The Ca(2+)-dependent response to electrical stimulation in the presence of MDMA from slices incubated with [3H]noradrenaline was greatly reduced when rats were pretreated with a higher dose of reserpine (10 mg/kg s.c.).(ABSTRACT TRUNCATED AT 400 WORDS)

3,4-Methylenedioxyamphetamine↗
PubMed1993

Lived fictions: moving from pharmacology to ethnography.

While positivist science dominates the drug and alcohol research sector, alternative constructivist paradigms of inquiry into drug and alcohol use are also present. The passage of individual researchers through paradigm shifts is often difficult, and rarely documented. Different paradigms of inquiry produce different types of information. The use of the psychoactive drug methylenedioxymethamphetamine (MDMA or "Ecstasy") is discussed in light of a multidisciplinary investigation into the pharmacology and use of MDMA. The role of the author in interpreting data from both positivist and constructivist paradigms is highlighted by documenting a researchers' changes in epistemology whilst undertaking multidisciplinary research. It is concluded that multidisciplinary research into drug and alcohol use could benefit from evaluation of the processes that frame how information from both research paradigms is interpreted and integrated.

Journal Article↗
PubMed1993

Alcohol availability, drinking contexts and drinking problems: the Iowa experience.

Before/after survey data were used to investigate the effects that a wine and spirits privatization-induced increase in alcohol availability might have had on drinking contexts and, in turn, what effect any context changes might have had on specific drinking-related troubles. State surveys representing the aged 18+ noninstitutionalized population of Iowa were conducted in 1985, prior to the wine privatization; in 1986, after the wine privatization but before the spirits privatization; and in 1989, after both wine and spirits sales had been privatized. Despite substantial increases in the number of off-premise outlets for bottled wine and spirits following their privatizations, there was little or no change in the frequency of drinking in several different contexts or in the specific kinds of drinking-related problems studied.

Accidents, Traffic↗
PubMed1993

Privatization, price and cross-border liquor purchases.

Self-report survey data were used to investigate the effects of liquor sales privatization on cross-border liquor purchases. A state survey sample representing the Iowa age 18+ noninstitutionalized population was interviewed in April 1989, some 25 months after retail spirits sales were privatized. Despite a privatization induced 6.1% increase in retail liquor prices, there was little, if any, change in the self-reported amount of liquor purchased outside the state of Iowa.

Adolescent↗
PubMed1992

Consequences of increasing alcohol availability: the Iowa experience revisited.

Before/after survey data were used to investigate the effect that a sudden and dramatic wine and spirits availability increase in Iowa might have had on heavy and problem drinker rates. Three state surveys representing the age 18+ non-institutionalized population of Iowa were conducted in 1985, 1986 and 1989. Neither previous sales analyses nor this survey data analysis support the Distribution of Consumption Prevention Model prediction that increased wine and spirits availability would produce significant and lasting consumption increases and, in turn, heavy drinker and problem drinker prevalence rate increases.

Adolescent↗
PubMed1992

Elderly vs. younger problem drinker 'treatment' and recovery experiences.

To address the question of whether or not elderly problem drinkers experience any treatment contact discrimination or recovery rate disadvantages, the programme utilization and recovery rate experiences of a representative sample of older and younger persons arrested for drinking and driving (OWI) in Iowa were compared. Subjects were interviewed by phone or mail shortly after their OWI arrest and then again approximately 12 months later. Younger persons (18-54 years old) were compared with elderly persons (55 and over and 65 and over). The elderly subjects were also dichotomized as early onset (at least one problem drinking indicator occurred prior to age 55) or late onset (all problem drinking indicators occurred at age 55 or later). The elderly were as likely as, or more likely than, their younger counterparts to make a treatment contact, to remain in treatment and to recover.

Adolescent↗
PubMed1992

Alcohol availability and consumption: Iowa sales data revisited.

Recent changes in Iowa liquor control laws ended the 51-year-old state alcohol monopoly distribution system and turned the sales of bottled wine and spirits over to the private sector. The resulting increase in the availability of these beverages provided a unique opportunity to study the relationship between increased wine and spirits availability and changes in their consumption. Time series analyses of monthly sales (apparent consumption) trends showed that the increased availability had no lasting impact on consumption.

Adult↗
PubMed1992

Elderly versus younger problem drinker profiles: do they indicate a need for special programs for the elderly?

To address the question, "Do elderly problem drinkers differ from younger ones and therefore might they need special treatment programs?", the descriptive profiles of a representative sample of older and younger persons arrested for drinking and driving in Iowa were compared. Subjects were interviewed by telephone or mail using a structured, clinical interview schedule that was designed to obtain a comprehensive self-report picture of the role of alcohol in their lives. Younger persons (18-54 years old) were compared with two overlapping elderly age groups (55 and over and 65 and over). The elderly subjects were also dichotomized as "early onset" (at least one problem-drinking indicator occurred prior to age 55) and "late onset" (all problem drinking indicators occurred at age 55 or later). Although there were several statistically significant (p < or = .01) differences between the elderly and younger problem drinkers, there was a much, or more, heterogeneity within the elderly groups as there were differences between the elderly and their younger counterparts. Also, the descriptive profile of these at-large elderly problem drinkers differed, depending on whether their alcohol abuse was early- or late-onset.

Adolescent↗
PubMed1991

Chronic cocaine treatment does not alter rat striatal D2 autoreceptor sensitivity to pergolide.

Rat superfused striatal slices, preloaded with [3H]dopamine, were electrically stimulated and the stimulation-induced outflow of radioactivity was taken as an index of dopamine release. In the presence of 10 microM nomifensine, exposure of striatal slices to unlabelled dopamine (0.3 microM) for 6 min prior to stimulation, significantly reduced stimulation-induced outflow. In contrast, a 21-min exposure to dopamine did not significantly alter stimulation-induced outflow. These results suggest that D2 receptors modulating dopamine release in the rat striatum may be rapidly desensitized in vitro. Rats were pretreated for 14 days with cocaine HCl (10 mg/kg/day i.p.) or saline. A progressive enhancement of locomotor activity in cocaine-treated rats over the pretreatment period compared to that in saline-treated rats indicated a behavioural sensitization to cocaine. The inhibitory effect of pergolide (1, 10 and 100 nM) on stimulation-induced outflow from striatal slices obtained from cocaine-pretreated rats was not different from that in slices obtained from saline-pretreated rats. Therefore no evidence was obtained for either a desensitization or a supersensitivity of striatal D2 autoreceptors by chronic cocaine administration.

Animals↗
PubMed1990

Effects of methylenedioxymethamphetamine on the release of monoamines from rat brain slices.

The effects of 3,4-methylenedioxymethamphetamine (MDMA) on monoamine release were investigated in superfused slices of rat striatum and hippocampus. MDMA (10 microM) increased the resting release of radioactivity from slices incubated in [3H]dopamine, [3H]5-hydroxytryptamine or [3H]noradrenaline. These effects of MDMA (10 microM) were blocked by the neuronal uptake inhibitors, cocaine (10 microM), fluoxetine (1 microM) and desmethylimipramine (1 microM), respectively. MDMA (10 microM) enhanced the stimulation-induced efflux of radioactivity from slices incubated in [3H]noradrenaline but not from slices incubated in [3H]5-hydroxytryptamine or [3H]dopamine. These results demonstrate for the first time a direct noradrenaline-releasing action of MDMA and differential effects of MDMA on the stimulation-induced release of noradrenaline, dopamine and 5-hydroxytryptamine from rat superfused brain slices.

3,4-Methylenedioxyamphetamine↗
PubMed1990

Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study.

A sample of 761 subjects 70 years and over was drawn from general-practice records of a rural township. Each subject was assessed and followed for 1 year to determine the incidence of and factors related to falls. The fall rate (number of falls per 100 person-years) increased from 47 for those aged 70-74 years to 121 for those 80 years and over. There was no sex difference in fall rate but men were more likely than women to fall outside and at greater levels of activity. Twenty per cent of falls were associated with trips and slips but we found no evidence that inspection of homes and installation of safety features would have decreased the fall rate. Ten per cent of falls resulted in significant injury. Men who fell had an increased subsequent risk of death compared with those who did not fall (relative risk 3.2, 95% CI 1.7-6.0). Subsequent mortality was increased among women who fell but not to significant levels (relative risk 1.6, 95% CI 0.9-2.7).

Accidental Falls↗