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Biomedical subjects

J Nee

Publications and source records attributed to J Nee.

At least 19 recordsLinked to original sources
PubMed2004

Linkage analysis of psychosis in bipolar pedigrees suggests novel putative loci for bipolar disorder and shared susceptibility with schizophrenia.

The low-to-moderate resolution of linkage analysis in complex traits has underscored the need to identify disease phenotypes with presumed genetic homogeneity. Bipolar disorder (BP) accompanied by psychosis (psychotic BP) may be one such phenotype. We previously reported a genome-wide screen in a large bipolar pedigree sample. In this follow-up study, we reclassified the disease phenotype based on the presence or absence of psychotic features and subgrouped pedigrees according to familial load of psychosis. Evidence for significant linkage to psychotic BP (genome-wide P<0.05) was obtained on chromosomes 9q31 (lod=3.55) and 8p21 (lod=3.46). Several other sites were supportive of linkage, including 5q33 (lod=1.78), 6q21 (lod=1.81), 8p12 (lod=2.06), 8q24 (lod=2.01), 13q32 (lod=1.96), 15q26 (lod=1.96), 17p12 (lod=2.42), 18q21 (lod=2.4), and 20q13 (lod=1.98). For most loci, the highest lod scores, including those with genome-wide significance (at 9q31 and 8p21), occurred in the subgroup of families with the largest concentration of psychotic individuals (> or =3 in a family). Interestingly, all regions but six--5q33, 6q21, 8p21, 8q24, 13q32 and 18q21--appear to be novel; namely, they did not show notable linkage to BP in other genome scans, which did not employ psychosis for disease classification. Also of interest is possible overlap with schizophrenia, another major psychotic disorder: seven of the regions presumed linked in this study--5q, 6q, 8p, 13q, 15q, 17p, and 18q--are also implicated in schizophrenia, as are 2p13 and 10q26, which showed more modest support for linkage. Our results suggest that BP in conjunction with psychosis is a potentially useful phenotype that may: (1) expedite the detection of susceptibility loci for BP and (2) cast light on the genetic relationship between BP and schizophrenia.

Bipolar Disorder↗
PubMed1997

Endicott Work Productivity Scale (EWPS): a new measure to assess treatment effects.

The Endicott Work Productivity Scale (EWPS) is a brief self-report questionnaire designed to enable investigators to obtain a sensitive measure of work productivity. The total score is based on the degree to which behaviors and subjective feelings or attitudes that are likely to reduce productivity and efficiency in work activities characterize the subject during the week before evaluation. The total score was found to be reliable and valid within a group of depressed outpatients and a group of nonpatients in the community. The EWPS score is related to, but not redundant with, measures of overall severity of illness and severity of depression in these samples. The EWPS shows considerable promise as an easily used, brief, and sensitive measure for assessing the effects on work performance of various disorders and the efficacy of different therapeutic interventions.

Dysthymic Disorder↗
PubMed1994

An internist joins the surgery service: does comanagement make a difference?

OBJECTIVE: To determine the effect of internist comanagement of cardiothoracic surgical patients on patient outcome and resource utilization. DESIGN: Before/after comparison. SETTING: Tertiary care university-affiliated Veterans Affairs hospital. PATIENTS: 165 patients (86 before the intervention and 79 after the intervention) undergoing cardiothoracic surgery. INTERVENTIONS: All patients were seen preoperatively and at least daily through discharge by a comanaging staff internist who was a full-time member of the surgical team. MAIN OUTCOME MEASURES: Length of stay, in-hospital mortality, and laboratory and radiology utilization. RESULTS: Significant shortening of postoperative length of stay (18.1 days before and 12.1 days after, p = 0.05) and total length of stay (27.2 days before and 19.7 days after, p = 0.03) was noted. The in-hospital mortality rate for the patients undergoing surgery was 8.1% before the intervention versus 2.5% afterward (p = 0.17). There were significant reductions in the total number of x-rays (p = 0.02) and nearly significant reductions in total laboratory test utilization (p = 0.06). Referring physicians and surgeons both believed that the contribution of the internist was important. CONCLUSIONS: The addition of an internist to the cardiothoracic surgery service at a tertiary care teaching center was associated with decreased resource utilization and possible improved outcomes. Before becoming more widely adopted, this intervention deserves further exploration at other sites using stronger study designs.

Hospital Mortality↗
PubMed1993

Sodium lactate infusion in late luteal phase dysphoric disorder.

The effects of sodium lactate infusion were compared in 13 women who sought treatment for marked premenstrual dysphoric changes that met criteria for late luteal phase dysphoric disorder and 7 control women. No subject had a lifetime history of panic disorder. The rate of blindly rated panic to sodium lactate was 7 (58%) in patients and 0% in controls. Nonpanicking patients also had higher Modified Acute Panic Inventory scores than control subjects. The differences cannot be fully explained on the basis of a history of panic attacks. Further study is warranted.

Adult↗
PubMed1993

Premenstrual changes: are they familial?

To investigate the potential familial component in premenstrual changes, 80 pairs of sisters were assessed with the Premenstrual Assessment Form, a retrospective measure, and the Daily Ratings Form, a prospective measure, for physical, behavioral and mood changes during the premenstrual phase of the menstrual cycle. Sisters were not found to be concordant for premenstrual changes on measures derived from either procedure, a finding contradictory to previous reports in the literature as well as to our own prior research.

Adult↗
PubMed1993

Quality of Life Enjoyment and Satisfaction Questionnaire: a new measure.

The Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) is a self-report measure designed to enable investigators to easily obtain sensitive measures of the degree of enjoyment and satisfaction experienced by subjects in various areas of daily functioning. The summary scores were found to be reliable and valid measures of these dimensions in a group of depressed outpatients. The Q-LES-Q measures were related to, but not redundant with, measures of overall severity of illness or severity of depression within this sample. These findings suggest that the Q-LES-Q measures may be sensitive to important differences among depressed patients that are not detected by the measures usually employed.

Adolescent↗
PubMed1991

Structure activity hypotheses in occupational asthma caused by low molecular weight substances.

Many substances with a low molecular weight (less than 1000 molecular weight) but of different chemical classes are recognized as causative agents of occupational asthma. Some of their major chemical properties are highlighted in relation to their putative interactions with human macromolecules. Thus, certain transition metals which form co-ordination complexes may chelate human proteins. Several organic substances have marked basic properties which are responsible for their chemical reactivity. Some of these, such as the bifunctional bases ethylene diamine, piperazine and para-phenylene diamine are known causative agents of asthma while their monofunctional counterparts, in spite of wide industrial application, are not similarly recognized causes. This suggests that the presence of multiple reactive groups is of importance in the molecular interactions with human macromolecules that eventually lead to occupational asthma. Reference is also made to other substances to exemplify hypothetical mechanisms of these interactions. Such generation of hypotheses is a prelude to quantitative studies of structure activity relationships (QSARs) where the hypotheses can be tested and revised. Structure activity hypotheses in isolation might not be adequate predictors of the risk of occupational asthma. However, if applied to novel chemical entities they might eventually prove useful in contributing to the development of policies for prospective health surveillance and in establishing priorities for epidemiological research.

Air Pollutants, Occupational↗
PubMed1990

Treatment of premenstrual dysphoria with alprazolam. A controlled study.

Thirty women who met DSM-III-R criteria for late luteal phase dysphoric disorder completed a double-blind, randomly assigned crossover treatment study comparing alprazolam with placebo. Alprazolam was found to be superior to placebo. The outcome measures included physicians' global ratings as well as patients' prospective (daily) ratings and retrospective assessments. Improved study design, which addressed methodologic flaws of most previous studies of treatment outcome of "premenstrual syndrome" may account, in part, for our ability to demonstrate significant drug/placebo differences. This includes extensive screening to eliminate women who had premenstrual exacerbations of a more persistent mental illness rather than a discrete premenstrual disorder, use of prospective ratings to confirm retrospective reports of symptom patterns, placebo washout before randomization, and use of patients as their own controls.

Adolescent↗
PubMed1990

Premenstrual depression predicts future major depressive disorder.

To assess the power of premenstrual changes as a risk factor for future major depressive disorder (MDD), we conducted a follow-up study of 36 women who had volunteered for menstrual cycle studies. Scores on the depressive subscale of the Premenstrual Assessment Form (PAF) at initial evaluation were found to be significantly correlated (r = 0.35) with the occurrence of MDD during the follow-up period. Moreover, multiple regression analysis indicated that the PAF scores had predictive value above and beyond 2 known risk factors for MDD, family history of depression and prior personal history of depression. The Premenstrual Change Index, a score derived from prospective daily self-ratings of severity of dysphoric symptoms, was also correlated with interval MDD, but did not enhance the predictive power of the PAF score. We conclude that the assessment of premenstrual depression has validity in identifying women at risk for future MDD, even when a retrospective instrument, PAF, is utilized for such assessment.

Adult↗
PubMed1989

Provocation of panic with carbon dioxide inhalation in patients with premenstrual dysphoria.

The effects of double breath inhalation of a 35% CO2 mixture in oxygen and placebo air inhalation were compared in 14 women seeking treatment for marked premenstrual dysphoric changes who did not have panic disorder and 12 control women. The first exposure to CO2 inhalation induced a panic attack reaction (severe subjective anxiety with autonomic symptoms) in 9 of 14 women with premenstrual dysphoria but none of the controls. Neither patients nor controls panicked in response to the air inhalation. Control subjects experienced mild anxiety and/or somatic symptoms after CO2 inhalation, but these did not resemble panic attacks and were clearly different from the response of the patient group.

Adult↗
PubMed1989

Characteristics of women seeking treatment for premenstrual syndrome.

Controversy has developed about the existence of a relatively discrete condition of severe premenstrual dysphoric changes in the absence of underlying mental disorder (late luteal phase dysphoric disorder). With careful screening and evaluation, women with this disorder can be identified. In this study, women who sought treatment for premenstrual syndrome were divided into two groups: individuals who experienced mood and behavior changes and impaired social functioning that were limited to the premenstrual period (n = 86), and women with persistent mental disorders who experienced exacerbation or complication of symptoms during the premenstrual period (n = 54). These groups were compared with a control group of women who had no significant premenstrual changes and no current mental disorder (n = 61). Most of the differences between subjects seeking treatment and controls that were not attributable to premenstrual changes were accounted for by the women with persistent mental disorders.

Adolescent↗
PubMed1989

Treatment of premenstrual depression with nortriptyline: a pilot study.

There are no reports on treatment of premenstrual syndrome with antidepressants, although depression is a common symptom of the syndrome. Eleven women who met DSM-III-R criteria for late luteal phase dysphoric disorder were treated with nortriptyline in an open pilot study after they failed to respond to placebo or another medication. Eight of 11 patients had a good therapeutic response. The efficacy of antidepressants in the treatment of premenstrual depression needs confirmation with double-blind studies.

Adult↗
PubMed1986

Diagnosis of schizophrenia. Prediction of short-term outcome.

Seven systems for the diagnosis of schizophrenia were compared in their ability to predict short-term outcome at follow-up: with each other, with selected specific symptoms, and with a simple additive composite symptom score. None of the systems nor the symptoms predicted strongly, but DSM-III and Schneiderian First Rank Symptoms and the composite score performed somewhat better than the other predictors.

Female↗
PubMed1986

Premenstrual changes and changes in gonadal hormones.

Changes in plasma levels of estradiol and progesterone and their temporal relationship with changes in mood and behavior were studied along the menstrual cycle in 17 normal women with a wide range of severity and types of premenstrual changes (PMC). Emphasizing changes in hormonal levels over time as well as their rates of change, selective clinical features of premenstrual changes were found to be positively associated with peak levels of progesterone, its rate of decrease over time, and the ratio between the rates of decrease-over-time of progesterone and estradiol levels. A time-lag of 4-7 days between changes in plasma levels of progesterone and changes in clinical features was also found. Rate of change of estradiol was somewhat associated with clinical PMC. It is suggested that the association between gonadal hormones, other biological changes, and mood should be further studied as a diversified, dynamic, time-related process.

Adult↗
PubMed1983

Interaction of external H+ with the Na+-H+ exchanger in renal microvillus membrane vesicles.

We examined the effects of external H+ on the kinetics of Na+-H+ exchange in microvillus membrane vesicles isolated from the rabbit renal cortex. The initial rate of Na+ influx into vesicles with internal pH 6.0 was optimal at external pH 8.5 and was progressively inhibited as external pH was reduced to 6.0. A plot of 1/V versus [H+]o was linear and yielded apparent KH = 35 nM (apparent pK 7.5). In vesicles with internal pH 6.0 studied at external pH 7.5 or 6.6, apparent KNa was 13 or 54 mM, Ki for inhibition of Na+ influx by external Li+ was 1.2 or 5.2 mM, Ki for inhibition by external NH4+ was 11 or 50 mM, and Ki for inhibition by external amiloride was 7 or 25 microM, respectively. These findings were consistent with competition between each cation and H+ at a site with apparent pK 7.3-7.5. Lastly, stimulation of 22Na efflux by external Na+ (i.e. Na+-Na+ exchange) was inhibited as external pH was reduced from 7.5 to 6.0, also consistent with competition between external H+ and external Na+. Thus, in contrast with internal H+, which interacts at both transport and activator sites, external H+ interacts with the renal microvillus membrane Na+-H+ exchanger at a single site, namely the external transport site, where H+, Na+, Li+, NH4+, and amiloride all compete for binding.

Amiloride↗
PubMed1983

Premenstrual depressive changes. Value of differentiation.

Premenstrual depressive changes and differential correlates of specific subtypes of premenstrual dysphoria vary. Our data support two basic assumptions: (1) Premenstrual changes should be studied as diversified subtypes rather than as a single premenstrual tension syndrome; such an approach might lead to a better understanding of the pathophysiology of specific types of premenstrual changes. (2) Some specific subtypes of premenstrual changes of a depressive nature resemble some subtypes of affective disorder and, hence, may serve as a model for the study of these disorders.

Adult↗