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Biomedical subjects

J Pearson

Publications and source records attributed to J Pearson.

At least 73 records · Page 4Linked to original sources

Short-term outcome of major depression: II. Life events, family dysfunction, and friendship difficulties as predictors of persistent disorder.

OBJECTIVE: To determine whether there is a pattern of social characteristics that specifically predicts persistent major depression at 36 weeks follow-up. METHOD: Sixty-eight consecutive cases with a first-episode DSM-III-R diagnosis of major depression completed a life events and friendship difficulties interview at presentation and again at 36 weeks. RESULTS: Four factors were associated with persistent psychiatric disorder in general: lack of a maternal confiding relationship with current partner, family dysfunction and poor friendships at presentation, and severely disappointing events between presentation and follow-up. There was no association between these adverse experiences. No combination of long-term or recent life events or difficulties was, however, specifically associated with persistent depression. CONCLUSION: Nonsocial factors may need to be taken into account to specifically explain the phenotypic persistence of major depressive disorder in first-episode nonrecovered cases within a year of presentation. Psychosocial interventions with first-degree relatives and current close friendships should be considered as a part of the treatment strategy for first-episode major depression.

Adolescent↗

Germline duplication of chromosome 2p and neuroblastoma.

A child with a germline duplication of chromosome 2p, 46,XY,der(13)t(2;13)(p23;q34), who developed a fatal neuroblastoma confirmed at necropsy is reported. Fluorescent in situ hybridisation studies showed chromosome 2p (p23-pter) duplicated on chromosome 13 (q34). The clinical features of the present case shared many similarities to previous reports of trisomy 2p and there have been two cases described with neuroblastoma. Germline duplication of chromosome 2p including the N-myc proto-oncogene may have pre-disposed to the development of neuroblastoma in this case.

Chromosomes, Human, Pair 13↗

Radial cortical and trabecular bone densities of men and women standardized with the European Forearm Phantom.

We previously showed that it is possible to cross-calibrate peripheral bone densitometers using the European Spine Phantom (ESP). We have now performed a multinational study of cross-calibrated radius bone density based on normal subjects of both sexes in eight European centers. Six centers were equipped with machines made by Scanco or Stratec for determining distal radial trabecular bone density by quantitative computed tomography (QCT) and two were equipped with Lunar SP2 single photon absorptiometry (SPA) equipment for measuring midshaft cortical bone density. Subjects recruited ranged from 20 to over 80 years of age. Over one hundred and fifteen men were studied by QCT and a different cohort of 104 men were studied with SPA; the equivalent figures for women were 235 and 123. Reference ranges were derived for bone density against age for each of the four groups, and their applicability is discussed in relation to between-center differences in the results obtained. There were insignificant differences (P > 0.05 with Bonferroni correction) between centers in the values obtained by QCT in the different populations. However, there were considerably larger and highly statistically significant differences between midshaft cortical bone density values of about 10% of overall means between subjects from eastern Finland and central Belgium (P < 0.001), with higher Finnish values. Women had considerably lower radial trabecular bone density values than men at all ages, a result that differentiates the radius from the spine. This sex difference widened after menopause. These results have important implications for understanding the contribution of bone density to the differential risk of Colles' fracture in the two sexes and suggest that further work is needed to establish young normal reference ranges for radial bone density in Europe.

Absorptiometry, Photon↗

Dopamine-beta-hydroxylase and tyrosine hydroxylase immunoreactive neurons in the human brainstem.

Immunohistochemistry of dopamine-beta-hydroxylase in the human hind brain indicates that neuronal cell bodies containing the antigen form prominent populations in the nucleus tractus solitarius and nearby medial and dorsal edge of the medial vestibular nucleus. They are frequent in and around the periphery of the dorsal motor nucleus of the vagus and in an oblique band extending from that region to the ventrolateral aspect of the reticular formation, where they are most numerous at the mid medullary levels. Dopamine-beta-hydroxylase immunoreactive neurons are also closely packed in the nuclei coeruleus and subcoeruleus. Concomitant immunohistochemistry for tyrosine hydroxylase demonstrates small numbers of neuronal cell bodies that are reactive only for this antigen, and which do not contain detectable dopamine-beta-hydroxylase. Such neurons are present in the nucleus tractus solitarius, the pontine lateral parabrachial nucleus and within the core of the rostral pontine reticular formation. Some medullary and pontine axon bundles similarly stain for tyrosine hydroxylase but not for dopamine-beta-hydroxylase. These differential staining patterns suggest, among other possibilities, that in humans some neurons of the caudal brainstem are dopamine (if they contain the second step catecholamine synthesizing enzyme, aromatic L-aminoacid decarboxylase) rather than noradrenaline or adrenaline containing catecholamine neurotransmitters.

Aged↗

Adrenal secretion during major depression in 8- to 16-year-olds, I. Altered diurnal rhythms in salivary cortisol and dehydroepiandrosterone (DHEA) at presentation.

The association between basal cortisol, dehydroepiandrosterone (DHEA), its sulphate (DHEAS) and major depression was investigated in 8- to 16-year-olds. Eighty-two subjects with major depression, 25 non-depressed psychiatric cases and 40 community controls were systematically assessed for current mental state and hormone levels at 08.00, 12.00 and 20.00 h, assayed from salivary samples collected over a 48 h period. The average mean of the two time points was compared between the three groups. Evening cortisol hypersecretion and morning DHEA hyposecretion were significantly, and independently, associated with major depression. High evening cortisol (> 0.594 ng/mL) and low morning DHEA (< 0.200 ng/mL) identified subgroups of depressives with different types of adrenal hormone dysregulation. The association between high evening cortisol or low morning DHEA and MDD was not affected by either age or gender.

Adolescent↗

Adrenal secretion and major depression in 8- to 16-year-olds, II. Influence of co-morbidity at presentation.

The association between high evening cortisol and low morning DHEA and the pattern of co-morbid diagnoses in 82 cases of major depressive disorder in 8- to 16-year-olds has been analysed. There was a significant association between the presence of high evening cortisol and co-morbid dysthymia. This was independent of age or sex. No positive association was found between the presence of low morning DHEA and any co-morbid diagnosis. However, co-morbid panic or phobic disorder was significantly associated with the absence of this endocrine abnormality. These findings suggest that specific endocrine disturbances may be associated with different patterns of co-morbidity during an episode of major depression in this age group.

Adolescent↗

Renal dysplasia in a Rhodesian ridgeback dog.

A six-month-old Rhodesian ridgeback dog was presented for evaluation of facial swelling. Chronic renal failure was clinically diagnosed based on urinalysis, biochemical changes and ultrasonography. The facial swelling was due to fibrous osteodystrophy, which was evident on survey radiographs of the skull. On post mortem examination, chronic renal failure as a result of renal dysplasia was confirmed. This is the first reported case of renal dysplasia in this breed of dog.

Animals↗

Lymphangiomatosis of the pelvic limb in a Maltese dog.

A case of lymphangiomatosis is described affecting the right pelvic limb of an 18-month-old, female Maltese dog. A progressive swelling around the stifle had developed subsequent to a routine tibial crest transposition. The swollen area eventually progressed to involve the entire limb circumferentially, to end abruptly in the mid-metatarsal region. The skin of the affected area was deep red in colour, devoid of hair, and had numerous large, thin-walled vesicles that were easily ruptured and from which a serosanguineous fluid exuded. The swelling pitted on digital pressure and showed fluctuant mobility. The microscopic appearance of biopsied and post mortem material mimicked that of lymphangioma. However, the signalment, clinical presentation and histological features are consistent with a diagnosis of the recently reported variant of human lymphangiomatosis, lymphangiomatosis of the limb.

Animals↗

Hidden impact of paramedic interventions.

OBJECTIVE: To examine current patterns of deployment and use of emergency ambulance crews in Nottinghamshire, with particular reference to crew status (technician or paramedic), case mix, interventions performed, and operational times. METHODS: A retrospective survey of routinely collected computerised ambulance service despatch data, and patient treatment forms for 242 randomly selected emergency callouts in Nottinghamshire, during September 1994. Data were collected on patient demography, broad diagnostic group, crew status and operational times, and paramedic interventions performed. RESULTS: 170 of 242 callouts (70%) involved a paramedic crew; extended skills were used on 31 of these occasions (18%), predominantly for medical emergencies. Paramedic crews recorded significantly longer on-scene times (median time: 14.0 v 11.5 min, P = 0.04). An examination of the difference between paramedics who performed interventions and those who did not revealed that "intervening" paramedics recorded significantly longer onscene times (median time: 23 v 12 min, P < 0.001), turnaround times (median time: 28 v 18 min, P < 0.001), and total out-of-service times (median time 73 v 51 min, P < 0.001). CONCLUSIONS: The additional time taken by paramedics at the scene of an emergency incident relates to their performance of an intervention, rather than time spent assessing the patient to decide whether stabilisation or immediate evacuation would be most appropriate. Paramedic interventions were most often performed for medical emergencies. The performance of paramedic interventions also extended turnaround times and total out-of-service times.

Allied Health Personnel↗

Information for patients with cancer. Does personalization make a difference? Pilot study results and randomised trial in progress.

Although there are a number of groups working on the provision of personalized patient information there has been little evaluation. We have developed and piloted a method of giving patients on-line access to their own medical records with associated explanations. We are comparing, in a randomised trial, personalized with general computer based information for patients undergoing radiotherapy for cancer. We present results from the pilot study and the evaluation methods to be employed.

Adult↗

Immunophenotypic classification of canine malignant lymphoma on formalin-mixed paraffin wax-embedded tissue by means of CD3 and CD79a cell markers.

Canine malignant lymphoma (CML) is a common lymphoid tumour. Identification of the immunophenotype is of prognostic importance: T-cell lymphomas have a worse prognosis than B-cell lymphomas. Until recently, identification of T- or B-cell lymphomas was undertaken by means of flow cytometry or fluorescent immunocytochemistry on frozen sections. Whilst valid in the research field, these methods are impractical for routine diagnostic histopathology in CML. Commercially available CD3 antibody has been successfully employed in T-cell identification in dogs in formalin-fixed paraffin wax-embedded tissue sections, but the lack of a B-cell marker has been a hindrance until the recent introduction of a commercially available pan-B cell marker, CD79a (DAKO M7051), suitable for diagnostic application upon formalin-fixed paraffin wax-embedded material. Antibody markers to CD3 and CD79a show cross-reactivity across species lines for B cells and T cells respectively. In this group of five selected canine cases, two were identified as B-cell and the other three as T-cell lymphoma, by means of CD3 and CD79a. To the best of our knowledge application of CD79a in cases of CML has not been reported.

Animals↗

Origin and molecular changes associated with emergence of a highly pathogenic H5N2 influenza virus in Mexico.

In October of 1993, there was decreased egg production and increased mortality among Mexican chickens, in association with serologic evidence of an H5N2 influenza virus. First isolated from chickens in May of 1994, after spreading widely in the country, the virus caused only a mild respiratory syndrome in specific pathogen-free chickens. Because eradication of the virus by destruction of infected birds posed major obstacles to the poultry industry in Mexico, we were able to conduct a "field experiment" to determine the fate of an avirulent virus after repeated cycles of replication in millions of chickens. By the end of 1994, the virus had mutated to contain a highly cleavable hemagglutinin (HA), but remained only mildly pathogenic in chickens. Within months, however, it had become lethal in poultry. Nucleotide sequence analysis of the HA cleavage site of the original avirulent strain revealed R-E-T-R, typical of avirulent viruses and unlike the K-K-K-R sequence characterizing viruses responsible for the 1983 outbreak in poultry in the United States. Both mildly and highly pathogenic isolates contained insertions and a substitution of basic residues in the HA connecting peptide, R-K-R-K-T-R, which made the HA highly cleavable in trypsin-free chicken embryo fibroblasts. Phylogenetic analysis of the HA of H5 avian influenza viruses, including the Mexican isolates, indicated that the epidemic virus had originated from the introduction of a single virus of the North American lineage into Mexican chickens. This sequence of events demonstrates, apparently for the first time, the stepwise acquisition of virulence by an avian influenza virus in nature.

Amino Acid Sequence↗

Dual X-ray absorptiometry of the proximal femur: normal European values standardized with the European Spine Phantom.

Measurements of the proximal femur by dual X-ray absorptiometry (DXA) are assuming increasing importance in clinical and epidemiological studies. However, different DXA manufacturers have adopted varying approaches to measuring the femoral neck and trochanter regions with the result that there is as yet no agreement on normal ranges and how to cross-calibrate between different machines. In this Concerted Action (of the EU's 2nd Framework Programme), 12 clinical centers in eight countries recruited a total of 855 female and 517 male Caucasian subjects who were judged to be free of conditions known to cause secondary osteoporosis and who had not been treated with drugs known to affect bone mass. The DXA machines used were made by Hologic, Lunar, and Norland. Each machine was cross-calibrated with the European Spine Phantom prototype designed by Kalender. All femoral neck and trochanter results were expressed as standardized values and were first examined for possible bias due to between-brand differences in choice of areas for measurement. On average, trochanter areas were similar between brands but Norland chose a narrower neck region for analysis. Bone mineral density (BMA or BMD g/cm2) was log-normally distributed for all groups at the femoral neck but normally distributed at the trochanter in men and postmenopausal women. There were substantial between-center differences after cross-calibration in age-adjusted mean values at both sites and also in the rates of apparent bone loss with age and the amounts of scatter within populations about mean age-adjusted values. With the proviso that locally derived normal ranges would allow more accurate comparisons for clinical purposes, European normal ranges were derived for both neck and trochanter. Data obtained with the three individual brands of machine fitted these overall ranges well. Bone loss was apparent in premenopausal women at the femoral neck but not the trochanter. Postmenopausal women's data was somewhat better fitted by reference to years since menopause than to chronological age. This work provides a basis for conducting future epidemiological and clinical studies with more than one brand of machine as long as each individual subject, if measured consecutively, is measured on the same machine throughout.

Absorptiometry, Photon↗