Biomedical subjects

K Millar

Publications and source records attributed to K Millar.

At least 37 records · Page 2Linked to original sources

PubMed1996

The effects of anxiety on response times to disease detection and health promotion behaviors.

It was hypothesized that increasing levels of anxiety about health issues would make response times to disease detections longer than response times to health promotion behaviors and that this effect would reverse when anxiety about health issues was decreased. In a laboratory study 82 participants recruited from undergraduates and the general community were randomly assigned to read information designed either to increase or to decrease anxiety about health. Following the anxiety manipulation participants were required to indicate their attitude about both disease detection and health promotion behaviors and response times to both types of behavior were recorded. Finally, the participants' attitudes toward all the health behaviors were measured using 9-point scales. The results supported the hypothesis.

Adolescent↗

PubMed1996

Cognitive failures after general anaesthesia for day-case surgery.

Patients are normally thought to have recovered from general anaesthesia within a few hours after day-case surgery. Previous recovery studies using objective psychometric tests showed a return to baseline values within this period. Nevertheless, patients are advised about what activities they should not undertake in the subsequent 24 h because it is feared that the residual anaesthetic effects may impair their ability. These studies did not follow patients out of hospital and their relevance to the real world is not known. Using the cognitive failures questionnaire, a standard measure of performance of everyday tasks, 54 patients were asked to report their own performance after general anaesthesia for the 3 days after discharge from hospital: 30 local anaesthetic patients were studied for comparison. The general anaesthesia group reported a highly significant greater incidence of cognitive failures after anaesthesia compared with the local anaesthesia group. This suggests that the residual effects of anaesthesia persist beyond 24 h.

Activities of Daily Living↗

PubMed1996

Patient-controlled analgesia with morphine and droperidol following caesarean section under spinal anaesthesia.

BACKGROUND: The addition of droperidol to morphine for patient-controlled analgesia reduces the incidence of nausea and vomiting, but may result in unwanted side effects. METHOD: We studied 40 women randomised to receive morphine sulphate with or without added droperidol (10mg droperidol/60 mg morphine) by patient-controlled analgesia following elective caesarean section under spinal anaesthesia. RESULTS: Median morphine demand in the 20 h after surgery was 74 mg with morphine alone, and 53 mg with added droperidol, the median consumption of which was 8.8 mg. The incidence of nausea was reduced from 80% to 38.8% (P < 0.01), and that of emesis from 55% to 16.7% (P < 0.05) by the addition of droperidol. Psychomotor function was significantly impaired to a similar degree in both groups and there was no significant difference in sedation scores or pain scores. Subjective drowsiness which resulted in withdrawal from the study occurred in two patients, both of whom were receiving droperidol, and though all patients who completed the study were satisfied with their analgesia overall, significantly more of those receiving unsupplemented morphine (11/19 compared with 4/18, P < 0.05) described it as excellent. CONCLUSION: The addition of droperidol 10 mg to morphine 60 mg for PCA following caesarean section under spinal anaesthesia reduces the incidence of nausea and emesis, but may result in drowsiness, limiting the usefulness of the technique.

Analgesia, Obstetrical↗

PubMed1996

Some common characteristics of pregnant teen who choose childbirth.

This non-experimental survey study identified some of the common characteristics of pregnant teen who choose childbirth. Respondents reported a history of physical abuse, sexual abuse, family violence, and substance abuse, as well as thoughts and attempts of suicide. These findings can assist nurses and others in developing programs to intervene with adolescents at risk for pregnancy.

Adolescent↗

PubMed1995

An in vivo model for screening peptidomimetic inhibitors of gelatinase A.

Gelatinase A, a matrix metalloproteinase, is frequently associated with human solid tumors, and its secretion and activation in the tumor milieu is considered important in the process of angiogenesis, invasion, and metastasis. Consequently, metalloproteinase inhibitors may be of value in the therapy of cancer as well as other disease states involving tissue remodeling and release of biologically active peptide/protein by proteolytic cleavage. Here we describe the development of a rapid screening assay for in vivo activity of peptidomimetic inhibitors of gelatinase A that involves assessment of inhibition of an enzyme-substrate reaction in a circumscribed body compartment, the mouse pleural cavity. As examples of the utility of this assay, in vivo activity of the aryl sulfonamide, sulfamyl urea, morpholino and carboxylic acid functionality at the P3' position of a series of hydroxamic acid inhibitors was examined after administration both intraperitoneally (ip) (to approximate systemic administration) and orally. For up to 2 h after ip administration, all inhibitors tested showed marked activity (> 90% inhibition) at 17 mumol/kg (approximately 10 mg/kg). This activity declined in a dose-responsive manner to insignificant levels at 0.67 mumol/kg (approximately 0.4 mg/kg). Aryl sulfonamides showed significant inhibition (> 50%) for up to 7 h after administration. A higher dosage (136 mumol/kg, approximately 80 mg/kg) was required to reveal oral activity, which was observed only with morpholino compounds (> 50% inhibition). Thus, the model described may be of value in the identification of orally active gelatinase A inhibitors.

Administration, Oral↗

PubMed1995

Influence of ivermectin on cellular and humoral immune responses of lambs.

In view of the extensive use of anthelmintics in sheep and the fact that their activity may in part depend upon the immune system, we were interested to determine if ivermectin had any influence on aspects of the sheep immune response. Ten parasite-free 6-month-old lambs were drenched with ivermectin and 1 day later were given intravenously human erythrocytes and subcutaneously ovalbumin. Ten other lambs with injected antigens were not drenched and served as controls. Both groups were bled at intervals for cells and serum. The procedure was repeated on day 28. Lymphocytes from the drenched lambs, cultured in vitro in RPMI plus 50% autologous serum collected up to 7 and 14 days after the first and second antigen injections respectively, had decreased blastogenic activity compared with lymphocytes from control lambs. Similar results were obtained with lymphocytes cultured in RPMI 1640 supplemented with 50% autologous serum plus concanavalin A (Con A) or phytohaemagglutinin (PHA). When washed, lymphocytes were cultured in RPMI 1640 supplemented with 5% foetal calf serum (FCS) or 5% FCS plus Con A or PHA, decreased blastogenesis was observed but blastogenesis depression was not as marked as that observed with autologous serum. Similar antibody responses were seen for the drenched and control groups in response to the two injections of both antigens except that after the second injection, there was a significant reduction in antibody response to ovalbumin in the ivermectin-treated lambs. There were no differences in serum complement or serum nitric oxide levels between the two groups at any stage, but insulin-like growth factor-1 levels were significantly reduced in serum of the ivermectin-treated group, 4 days after each drench. Growth hormone levels were consistently significantly higher 22 days after both drenchings. There was no difference in mean body weight increase between the groups during the experiment.

Animals↗

PubMed1995

Negative affective consequences of thinking about disease detection behaviors.

It was proposed that thinking about disease-detection behavior would lead to more negative moods than thinking about health-promotion behavior. Detection behaviors produce more negative moods because they can threaten perceptions of good health. In a laboratory study, the initial mood states of 121 participants recruited from undergraduates and the general community were measured using a neutral-words rating procedure. Then participants were randomly assigned to think about performing a disease-detection behavior or a health-promotion behavior. Subsequently, they wrote down their responses to the behavior and evaluated these as either positive, negative, or neutral. Finally, the participant's mood was remeasured using both a neutral words-rating procedure and a more traditional bipolar rating measure. Results indicated that thought about disease-detection behavior produced more negative affective responses and more negative mood change than did thought about health-promotion behavior.

Adolescent↗

PubMed1995

The effects of expectancy and alcohol on cognitive-motor performance.

Previous studies have found equivocal evidence for expectancy effects on cognitive-motor performance. The effects of expectancy and alcohol on a dual tracking and reaction-time task analogous to some driving skills, and on choice reaction-time, were studied in a balanced-placebo design (n = 90). A dose of alcohol achieving 80 mg/100 ml (high dose) had large effects on both tasks, but a low dose (40 mg/100 ml) had no significant effects. Expecting alcohol led to subjects who received the high dose performing significantly better on the primary tracking task than subjects expecting placebo (but also receiving the high alcohol dose). By contrast, on a secondary reaction-time task, subjects who had received placebo performed worse 100-130 minutes after drinking, if they had expected alcohol. All groups felt more drunk than baseline and expecting alcohol made subjects feel more able to perform, whatever drink they had received. The implications of these findings for the nature of expectancy effects on performance and the relationship between expectations and strategy are discussed.

Adolescent↗

PubMed1995

Assessment of preoperative anxiety: comparison of measures in patients awaiting surgery for breast cancer.

We have compared three measurements of anxiety to determine their equivalence in assessing anxiety before surgery. Forty-four patients awaiting breast cancer surgery completed the state scale of the state-trait anxiety inventory (STAI), the hospital anxiety and depression scale (HAD) and a 100-mm visual analogue scale (VAS). Analysis restricted to correlations between the scales gave the misleading impression that VAS scores were inconsistent with those of the HAD and STAI. However, when scores were considered in relation to normative cut-off values to categorize anxiety levels, the three scales showed good agreement. We conclude that the scales were equivalent in their assessment of anxiety before surgery, but that reference to normative data was important in establishing such equivalence and in determining the patient's state.

Adult↗

PubMed1994

Comparative biodistributions of indium-111-labelled macrocycle chimeric B72.3 antibody conjugates in tumour-bearing mice.

A novel 111In ligand (a C-functionalised derivative of 1,4,7-triazacyclononanetriacetic acid), termed 9N3, was covalently attached to chimeric B72.3, labelled with 111In and compared with 111In-labelled chimeric B72.3 diethylenetriaminepentaacetic acid (DTPA) cyclic anhydride conjugate (cDTPA) and a C-linked derivative of DTPA (CT-DTPA) in athymic mice bearing human colon carcinoma xenografts. Significant differences in biodistribution were observed between 9N3 and cDTPA conjugates especially in the tumour uptake and blood, liver, femur and colon levels at 24, 48 and 144 h. Significantly higher tumour uptake was observed for 111In-cB72.3-9N3 compared with 111In-cB72.3-cDTPA at all time points. Radiolocalisation (RI) indices increased with time for the 9N3 conjugate but remained constant for the cDTPA conjugate. The biodistribution of 111In-labelled cB72.3-CT-DTPA was similar to that of 111In-labelled cB72.3-9N3 except for elevated kidney levels. A 12N4 macrocycle (a C-functionalised derivative of 1,4,7,10-tetraazacyclododecanetetraacetic acid) was also tested for its ability to chelate 111In and its biodistribution examined. Labelled conjugates with this macrocycle were more difficult to prepare in a stable form but gave a very similar biodistribution to the 9N3 macrocycle conjugate. Macrocycle-antibody conjugates of this type offer considerable promise for tumour imaging in patients.

Amines↗

PubMed1993

Is salivary flow related to personality?

Studies conducted in the 1960s proposed that stimulated salivary flow was negatively correlated with the personality trait of introversion-extraversion such that introverted individuals were supposed to salivate more strongly to lemon-juice stimulation than were extraverts. The relationship was re-examined in the present study in light of more recent but inconsistent findings. A sample of 36 male and female volunteers showed no significant relationship between stimulated salivary flow and extraversion. Nor was flow related to State or Trait anxiety according to Spielberger's anxiety inventory, or to CNS activation as assessed by an objective electronic test. It was concluded that there was no evidence to relate stimulated salivary flow rates to personality in volunteers selected from a non-psychiatric population.

Adult↗

PubMed1993

Skin conductance responses to auditory stimuli and anticipatory responses before venepuncture in patients premedicated with diazepam or morphine.

We have measured the skin conductance response to innocuous auditory stimuli and the anticipatory response before venepuncture in 45 patients receiving diazepam, morphine or no premedication before general anaesthesia. Subjective ratings of anxiety and sedation were measured using visual analogue scales. Skin conductance was less in subjects receiving diazepam than in the other groups, and the pattern of change of skin conductance in this group indicated superior adaptation to the environment during presentation of the innocuous stimuli compared with the other groups. After warning of venepuncture there was a large increase in skin conductance in all groups. There was a significant relationship between anxiety and skin conductance in unpremedicated patients and those receiving diazepam.

Acoustic Stimulation↗

PubMed1993

Efficacy of therapeutic suggestions presented during anaesthesia: re-analysis of conflicting results.

Re-analysis has been made of two clinical studies which used similar methodologies but found different effects of so-called therapeutic suggestions presented to anaesthetized patients undergoing abdominal hysterectomy. The re-analysis suggested that when data from the two studies were examined jointly, it was uncertain if positive suggestions had a reliable influence upon the recovery measure of "days to discharge". The supposed positive effect reported in one of the studies may arise from a rather different distribution of data in the control group. It is proposed that the effect may be attributable to chance bias in allocation of patients to the control group, or to some other chance anomaly in the composition of the group as a result of relatively small sample size. The importance of sample size is discussed in relation to detection of effects when only a few patients may be in a state susceptible to intra-anaesthetic suggestions. The importance of presenting data distributions in addition to summary statistics is also emphasized.

Anesthesia, General↗

PubMed1993

Personality traits as predictors of anxiety prior to caesarean section under regional anaesthesia.

One hundred and fifteen patients scheduled for elective Caesarean section under regional anaesthesia were questioned to determine their personality profiles and anxiety state. Positive correlations were found between neuroticism and anxiety scores (p < 0.05). Patients with tendencies towards both neuroticism and introversion had higher pre-operative anxiety scores than other personality types (p = 0.015). In general, previous experience did not reduce pre-operative anxiety and personality appeared to be a better predictor of anxiety prior to Caesarean section under regional anaesthesia. Some personality types might benefit from additional support to improve their ability to cope with this stressful event.

Adult↗

PubMed1993

Implicit learning during enflurane anaesthesia in spontaneously breathing patients?

Forty-one patients breathing spontaneously during enflurane anesthesia were presented (via headphones) either with statements about common facts of some years ago, or new verbal associations, i.e. names of fictitious people. Postoperatively, there were no differences between the two groups in the responses to questions about the common facts or attribution of fame to the fictitious people. This finding suggests that unconscious learning and activation may not occur during enflurane anaesthesia without neuromuscular block.

Adult↗

PubMed1993

Behavioural problems associated with the chronic fatigue syndrome.

Disturbances of memory, concentration and motor function are often reported by patients with the chronic fatigue syndrome (CFS). The present study objectively evaluated these behavioural problems using a computerized test battery measuring memory, attention and motor skills. Fifty-seven CFS patients were compared with 19 matched controls and all subjects completed the performance test battery and filled in questionnaires measuring psychopathology and mood. The patients reported significantly higher levels of depression, anxiety, physical symptoms and cognitive failures than the controls. Similarly, they reported more negative affect at the time of testing. The patients were slower on psychomotor tasks, showed increased visual sensitivity and impaired attention. Digit span and free recall were not impaired but retrieval from semantic memory and logical reasoning were slower. None of the performance differences between patients and controls could be attributed to differences in psychopathology. These results agree with recent findings from other laboratories, and it is now time to consider the nature of the neurological dysfunction underlying these effects.

Adult↗

PubMed1993

Clinical note on the use of denial in patients undergoing surgery for breast cancer.

44 patients awaiting surgery for breast cancer completed the Hospital Anxiety and Depression Scale. Thirteen patients had anxiety scores within the normal range, and five of them even scored extremely low in anxiety. These five and possibly all 13 patients were probably using denial as a defense against the stress of major surgery.

Adaptation, Psychological↗

PubMed1993

Effect of different therapeutic suggestions presented during anaesthesia on post-operative course.

A double-blind, randomized study was conducted to examine the effect of different types of therapeutic suggestions, administered during general anaesthesia, on post-operative course. Eighty-two patients undergoing cholecystectomy were intra-operatively exposed to either affirmative and non-affirmative suggestions, affirmative or non-affirmative suggestions separately, or some irrelevant text. Patients who had received both affirmative and non-affirmative suggestions spent less time in hospital than patients in the other three groups. No significant differences were demonstrated for subjective well-being measured on the third and sixth days.

Anesthesia, General↗