Head size and cognitive ability in nondemented older adults are related.
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Aged↗
Biomedical subjects
J P Newman
Publications and source records attributed to J P Newman.
Response perseveration in psychopathic women.
Recent attempts to validate the Psychopathy Checklist-Revised (PCL-R) as a measure of psychopathy in female offenders have been limited by a failure to examine laboratory correlates of the syndrome. We assessed 112 incarcerated women by using the PCL-R and examined their performance on a card perseveration task that has been used to demonstrate response perseveration in psychopathic men. Contrary to prediction, psychopathic women did not perseverate responding when the PCL-R was used either dimensionally or categorically. The authors discuss the implications of the results for the PCL-R and for female psychopathy more generally.
Adult↗
Adenosine produces changes in cerebral hemodynamics and metabolism as assessed by near-infrared spectroscopy in late-gestation fetal sheep in utero.
Rises in fetal adenosine during hypoxia may have a metabolic inhibitory role that helps the fetus adapt to periods of low arterial partial pressure of oxygen (P(a)O(2)). We examined the fetal cerebral hemodynamic and metabolic responses to exogenous adenosine infusion and compared this with previous studies. Six fetal sheep at ca. 125 d gestation were instrumented under general anesthesia with catheters, flow probes, and near-infrared optodes and allowed to recover. After 3 d, adenosine was infused at a level known to reproduce fetal levels during hypoxia. Fetal hemodynamics and cerebral near-infrared spectroscopic (NIRS) variables were monitored and paired blood samples taken for oxygen delivery and consumption calculation. Fetal heart rate, mean arterial pressure, and carotid flow showed no change during adenosine infusion. Cerebral oxyhemoglobin (HbO(2)), deoxyhemoglobin (Hb), and blood volume rose, suggesting venous pooling in the brain. Cerebral cytochrome oxidase (CcO) became more oxidized, indicating reduction in electron flow down the mitochondrial electron transfer chain and, thus, a fall in metabolic rate. Blood sample analysis revealed that there was no change in oxygen delivery to the head but that cerebral oxygen consumption fell during adenosine infusion. These data indicate that fetal cerebral metabolism fell during infusion of adenosine at a level known to reproduce fetal plasma concentrations during hypoxia.
Adenosine↗
Review of closed dressings after laser resurfacing.
BACKGROUND: Laser skin resurfacing has become an accepted technique for the treatment of facial rhytides and associated solar skin damage. Achieving a successful result is directly related to proper postoperative wound care during the reepithelialization process. There are open and closed approaches to the treatment of the post-laser resurfacing patient with distinct advantages and disadvantages. OBJECTIVE: To review the most commonly used closed dressings after facial laser skin resurfacing and compare their advantages and disadvantages. To compare clinical findings with a group of patients treated exclusively with an open technique. METHODS: Review of composite foams, polymer film, polymer mesh, and hydrogel products and prospective observations of clinical outcomes of patients treated with each dressing category after facial laser skin resurfacing. We perform a retrospective chart review of a group of patients treated exclusively with an open technique comparing crust formation, comfort, and pruritus with the prospective group of patients treated with closed dressings. RESULTS: The closed dressings available today each have unique structural configurations and adhesive properties intended to maintain an occlusive wound environment. Patient acceptance of these dressings was favorable, with improved comfort compared to the open dressing group. Complications of bacterial infections and contact dermatitis were not observed when closed dressings were used with a protocol for dressing changes performed at 48 hours. Rates of reepithelialization did not vary according to dressing category. Crust formation and postoperative pruritus occurred less frequently when closed occlusive dressings were worn by patients. CONCLUSIONS: When used properly, these dressings improve patient comfort, simplify their postoperative wound care, and do not increase the risk of infection or contact dermatitis. Overall satisfaction was highest with perforated mesh and polymer dressings for full-face wounds.
Adult↗
Left-hemisphere activation and deficient response modulation in psychopaths.
Psychopathic offenders have difficulty processing contextual or secondary cues once they have initiated goal-directed behavior or allocated attention to a primary task. To test the hypothesis that this deficit in response modulation is specific to conditions in which psychopaths' left-hemisphere resources are engaged, we administered a serial recall task to 21 incarcerated psychopaths and 21 control subjects. Subjects were instructed to memorize eight words that were presented one at a time, each in one of the four corners of the visual display. Subjects' primary task was to recall the words in serial order. Then, without forewarning, they were asked to recall the words' locations. As predicted, psychopaths performed as well as control subjects in recalling words from the left and right spatial fields, but recalled significantly fewer locations from the right spatial field. Thus, psychopaths' deficient response modulation was specific to conditions in which their left-hemisphere resources were actively engaged.
Adult↗
Hemodynamic and metabolic responses to moderate asphyxia in brain and skeletal muscle of late-gestation fetal sheep.
The purpose of this study was to investigate metabolic and hemodynamic responses in two fetal tissues, hindlimb muscle and brain, to an episode of acute moderate asphyxia. Near-infrared spectroscopy was used to measure changes in total hemoglobin concentration ([tHb]) and the redox state of cytochrome oxidase (COX) simultaneously in the brain and hindlimb of near-term unanesthetized fetal sheep in utero. Oxygen delivery (DO(2)) to, and consumption (VO(2)) by, each tissue was derived from the arteriovenous difference in oxygen content and blood flow, measured by implanted flow probes. One hour of moderate asphyxia (n = 11), caused by occlusion of the maternal common internal iliac artery, led to a significant fall in DO(2) to both tissues and to a significant drop in VO(2) by the head. This was associated with an initial fall in redox state COX in the leg but an increase in the brain. [tHb], and therefore blood volume, fell in the leg and increased in the brain. These data suggest the presence of a fetal metabolic response to hypoxia, which, in the brain, occurs rapidly and could be neuroprotective.
Acid-Base Equilibrium↗
Generality of Psychopathy Checklist-Revised factors over prisoners and substance-dependent patients.
The Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991) is an often-used device for assessment of adult antisociality. This research examined generalizability by replicating the 2-factor model for a sample of 326 male prisoners and assessing its congruence and relative reliability and specificity among 620 substance-dependent patients. Generality was assessed also across addiction subtypes (opioid, cocaine, and alcohol), age, gender, and ethnicity. The 2-factor model was found inappropriate for the substance-dependent samples, whereas a unidimensional model represented by the PCL-R total score was found generalizable across prison and substance-dependent samples.
Adolescent↗
Are all psychopathic individuals low-anxious?
Theorists commonly assume that true or primary psychopathic individuals experience little anxiety or neurotic conflict. This study examined the relationship between psychopathy and anxiety in 104 Caucasian and 113 African American incarcerated men using the Psychopathy Checklist--Revised (PCL-R; R. D. Hare, 1991) and multiple self-report measures to tap diverse interpretations of the anxiety construct (i.e., neuroticism, traditional definitions of anxiety, and fear). Analyses involving zero-order, semipartial, and point-biserial correlations indicate that PCL-R psychopathy and the anxiety construct are essentially independent. These findings suggest that either (a) the traditional belief that all psychopathic individuals are low-anxious is incorrect or (b) the PCL-R is not an adequate measure of primary psychopathy.
Adult↗
Testing Damasio's somatic marker hypothesis with psychopathic individuals: risk takers or risk averse?
Damasio and colleagues (A. R. Damasio, 1994; A. R. Damasio, D. Tranel, & H. Damasio, 1990) have theorized about a possible relationship between somatic markers and the behavior of psychopathic individuals (Ps), but, to date, there are no published data regarding the proposed relationship. The authors assessed 86 Caucasian and 71 African American male offenders using R. D. Hare's (1991) Psychopathy Checklist--Revised and used a modified version of Bechara and colleagues' (A. Bechara, A. R. Damasio, H. Damasio, & S. W. Anderson, 1994; A. Bechara, H. Damasio, D. Tranel, & A. R. Damasio, 1997) gambling task to test the hypothesis that Ps would, consistent with the somatic marker hypothesis, fail to become risk averse. Results indicated that level of anxiety, but not psychopathy, was predictive of response choices. Several limitations and implications of the study are noted.
Adult↗
Open channel block and open channel destabilization: contrasting effects of phenol, TEA+ and local anaesthetics on Kv1.1 K+ channels.
(1) Voltage-gated K+ channels are inhibited by a variety of clinical and experimental drugs. (2) Complex changes in channel gating suggest mechanisms in which drug affinity depends on channel state. (3) Here, we use the effects of external TEA+, two local anaesthetics (lidocaine and bupivacaine), and phenol on rat brain Kv1.1 K+ channels expressed in Xenopus oocytes to illustrate three mechanisms. (4) The open state has the highest affinity in the local anaesthetic model but the lowest in the phenol model, and while local anaesthetics simply block the open channel, phenol can produce a conducting but destabilized open state. (5) All states have equal affinity for external TEA+.
Anesthetics, Local↗
Closed dressings after laser skin resurfacing.
OBJECTIVE: To evaluate the safety, efficacy, and patient acceptance of closed dressings after full facial resurfacing with the carbon dioxide laser. DESIGN: Prospective cohort of men and women undergoing full facial carbon dioxide laser resurfacing. SETTING: Ambulatory surgical center at a university hospital. PATIENTS: Forty consecutive patients randomized to 1 of 4 dressing groups. INTERVENTIONS: All patients underwent full facial resurfacing with a carbon dioxide laser system. One of 5 closed dressings (single- or 3-layer composite foam, plastic mesh, hydrogel, or polymer film) was placed immediately after the procedure. Closed dressings were changed on postoperative day 2 and removed on postoperative day 4. OUTCOME MEASURES: Objective postoperative criteria of erythema, scarring, reepithelialization, and surface irregularities were recorded and photodocumented. Comparisons were made among the closed dressing groups as well as with a group of historical control subjects treated with open dressings. The ease of application, office time for preparation and application, and cost of the individual dressings were collected. Patient characteristics of overall acceptance, comfort, and ease of maintenance were recorded with a visual analog scale. RESULTS: There were no complications of scarring, surface irregularities, or contact dermatitis from the application or maintenance of the closed dressings. There were no significant differences in the number of days of postoperative erythema or in the rate of facial reepithelialization among the groups. Most patients preferred not to continue with the closed dressings past 2 days. Positive features from the use of closed dressings included reduction in crust formation, decreased pruritus, decreased erythema, and decreased postoperative pain, compared with historical controls. Negative features included time in preparation and application of the dressings. Costs ranged from $9.79 to $50 per dressing change. CONCLUSIONS: Closed dressings are safe and offer benefits noted during the first 4 postoperative days. Patients can be expected to maintain a closed dressing for at least 24 hours but no longer than 4 days. The positive features of closed dressings and patient acceptance outweigh the cost and office time involved with their application and maintenance.
Adult↗
Management of the clinically positive neck in organ preservation for advanced head and neck cancer.
BACKGROUND: To investigate clinicopathologic predictive criteria for the optimal management of neck metastases in patients with advanced head and neck cancers treated with combined chemoradiotherapy. METHODS: Prospective study, 48 patients. Mean length follow-up, 23 months. RESULTS: Neck stage predicted neck response to chemoradiotherapy; N3 necks showed more partial responses (P = 0.04), and N1 necks showed more complete responses (P = 0.12). Primary tumor site strongly predicted the pathologic response found on neck dissection in patients with a clinical partial response (cPR) following chemoradiotherapy. There was no difference in survival between patients with a clinical complete response (cCR) after chemoradiotherapy, and patients with a pathologic complete response (pCR) after neck dissection (P = 0.20); however, when grouped together, these patients survived longer than did patients with a pPR at neck dissection (P = 0.06). CONCLUSIONS: Clinical response to induction chemotherapy is a poor predictor of ultimate neck control. Induction chemotherapy followed by chemoradiotherapy, and planned neck dissection for patients with persistent cervical lymphadenopathy, provides good regional control.
Adult↗
Passive avoidance in psychopathic offenders: a replication and extension.
A passive avoidance task was administered to 97 Caucasian and 110 African American offenders to (a) replicate prior research demonstrating poor passive avoidance in psychopathic individuals (Ps) with low anxiety, (b) compare the effects of anxiety, neuroticism, and fear in identifying subgroups of Ps and controls who differ in passive avoidance, and (c) reevaluate the generalizability of this finding to African American offenders. Replicating past research with Caucasian offenders, low-anxious Ps committed significantly more passive avoidance errors than low-anxious controls. Although this difference was also found in Ps and controls with low neuroticism scores, the comparison involving low-fear offenders failed to reach significance. As in past research, comparable comparisons involving African American offenders were not statistically significant.
Adult↗
Advantages and disadvantages of computer imaging in cosmetic surgery.
BACKGROUND: Despite the growing popularity of computer imaging systems, it is not clear whether the medical and legal advantages of using such a system outweigh the disadvantages. OBJECTIVE: The purpose of this report is to evaluate these aspects, and provide some protective guidelines in the use of computer imaging in cosmetic surgery. METHODS: The positive and negative aspects of computer imaging from a medical and legal perspective are reviewed. Also, specific issues are examined by a legal panel. RESULTS: The greatest advantages are potential problem patient exclusion, and enhanced physician-patient communication. Disadvantages include cost, user learning curve, and potential liability. CONCLUSION: Careful use of computer imaging should actually reduce one's liability when all aspects are considered. Recommendations for such use and specific legal issues are discussed.
Communication↗
Transcalvarial suture fixation for endoscopic brow and forehead lifts.
OBJECTIVE: To evaluate the safety and effectiveness of transcalvarial suture fixation during endoscopic repair of brow ptosis. DESIGN: Case series. SETTINGS: A private ambulatory surgicenter and a Veterans Affairs Hospital. PARTICIPANTS: Fifty patients with brow ptosis with minimum follow-up of 12 months. RESULTS: Patients had improvement in brow position in all cases. There were no adverse effects of performing cortical tunnels and suture fixation. CONCLUSION: Transcalvarial suture fixation can be performed safely with good to excellent results and avoids the need for screw or plate fixation.
Endoscopy↗
Distortion of the auriculocephalic angle following rhytidectomy. Recognition and prevention.
Distortion of ear protrusion after rhytidectomy results in an aesthetically unfavorable appearance. We have seen cases in which the auriculocephalic angle has widened postoperatively, producing a noticeable deformity. Herein, we report 3 cases that resulted in abnormal postsurgical ear protrusion. We also discuss prevention through the use of conchal setback sutures.
Adult↗
The impact of motivationally neutral cues on psychopathic individuals: assessing the generality of the response modulation hypothesis.
Psychopathic individuals' lack of responsiveness to punishment cues and poor self-regulation have been attributed to fearlessness (D. T. Lykken, 1957, 1982, 1995). Alternatively, deficient response modulation (RM) may hinder the psychopathic individual's processing of peripheral information and self-regulation when they are engaged in goal-directed behavior (C. M. Patterson & J. P. Newman, 1993). Although more specific than the fearlessness hypothesis in some respects, the RM hypothesis makes the more general prediction that psychopathic individuals will have difficulty processing motivationally neutral as well as fear-related stimuli. The authors assessed this prediction by using psychopathic and nonpsychopathic male inmates subdivided by level of anxiety/negative affectivity (NA). As predicted by the RM hypothesis, peripheral presentation of motivationally neutral cues produced significantly less interference in low-NA psychopathic individuals than in low-NA controls.
Adult↗