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Biomedical subjects

L Hill

Publications and source records attributed to L Hill.

At least 55 records · Page 3Linked to original sources
PubMed1998

Intracranial hypotension presenting with severe encephalopathy. Case report.

A patient with severe and protracted symptoms from intracranial hypotension is described. The patient's presentation was marked by diffuse encephalopathy and profound depression of consciousness. This case report expands the presently known clinical spectrum of this uncommon and generally benign illness. The clinical and laboratory findings typically observed in the syndrome of intracranial hypotension are outlined. The pathophysiological mechanisms of the phenomenon are briefly discussed. Intracranial hypotension is a potentially severe illness with specific treatments that are distinct from the treatment of most neurological diseases. Three cardinal features--postural headache, pachymeningitis, and descent of midline cerebral structures--should prompt the diagnosis.

Adult↗
PubMed1997

The serotonin transporter gene and peer-rated neuroticism.

Polymorphisms in the serotonin transporter gene (5HTT) have been reported to be associated with neuroticism (emotionality) and with depression. A recent report of an association between 5HTT and neuroticism involved unselected samples and self-report questionnaires. We attempted to extend these findings using a selected extremes design and peer ratings. From a sample of 2085 individuals, each assessed on neuroticism by two independent peers, we selected 52 individuals from the top 5% and 54 individuals from the bottom 5%. No association was found for either a functional 44 bp insertion/deletion polymorphism in 5HTT regulatory sequence (5HTTLPR) or for a non-functional variable number tandem repeat 5HTT polymorphism.

Adolescent↗
PubMed1997

DNA by mail: an inexpensive and noninvasive method for collecting DNA samples from widely dispersed populations.

As specific genes are identified that are associated with behavior, it becomes increasingly important for behavioral geneticists to be able to incorporate these genes in their research. Rather than using blood, DNA can be extracted from cheek swabs, which makes it possible to obtain DNA inexpensively by mail from large, widely dispersed individuals. The purpose of this paper is to recommend this technique to the behavioral genetics community and to present results of our use of this technique to obtain DNA by mail for 114 2-year-olds and 116 adults.

Adult↗
PubMed1997

Emergent migration policy in a democratic South Africa.

This article sets recent debates on migration policy in South Africa against broader historical realities that have shaped patterns of population movement on the subcontinent since the end of the nineteenth century. During the course of the last century, most forms of population movement were the result of disjointed regional economic development which can be traced to two epochal events at the end of the nineteenth century: the creation of the modern African state system and the discovery of mineral wealth in Southern Africa. Although regulation of migrant labor was a fundamental feature of the colonial period, it was only after 1950, when independent states began to define specific migration priorities, that states began to restrict significantly the flow of transnational labor. From this point notions such as internally displaced person, refugee and illegal immigrant become increasingly appropriate to the study of regional migration. Particular attention is given to current debate on the definition of refugee which forms part of a broader international debate. A number of South African writers have argued that, given the structural imbalances contained in the regional economy, the term "refugee" should be redefined to included economic migrants. This position is not shared by the South African Government, and an analysis of current policy and legislation demonstrates a growing tendency to restrict the influx of undocumented migrants. This is due, in part, to the recent political transition and the institutional compromises that it produced as well as the growth of negative sentiment towards illegal immigrants at both mass and elite levels, as demonstrated by two recent research findings. The article concludes with a summation of recent trends in South African migration policy and an evaluation of the ambiguous position that South Africa occupies within Southern Africa.

Africa↗
PubMed1997

Chronic imipramine is associated with diminished hypothalamic-pituitary-adrenal axis responsivity in healthy humans.

The hypercortisolism of melancholic depression is thought to reflect hypothalamic hypersecretion of CRH and may be related to the hyperarousal associated with this syndrome. Although chronic administration of imipramine to experimental animals significantly decreases CRH messenger RNA levels in the paraventricular nucleus, it is generally thought that resolution of hypercortisolism following recovery from depression is related to the improvement in mood and decrease in anxiety that accompanies recovery rather than an intrinsic effect of imipramine. The present study was designed to explore whether chronic imipramine administration to healthy, nondepressed volunteers is associated with effects on hypothalamic-pituitary-adrenal (HPA) axis function. We studied basal and provocative measures of HPA axis function in 14 healthy volunteers before and after 6 weeks of imipramine treatment at therapeutic doses. Imipramine was associated with decreased responses in peak ACTH and cortisol to ovine CRH and in peak ACTH to arginine vasopressin (P = 0.02, P = 0.003, and P = 0.02, respectively) without changes in indices of basal HPA axis function. These data are consistent with preclinical findings and support the hypothesis that imipramine has an intrinsic effect on central components of HPA axis function, potentially related to its therapeutic effects.

Adrenocorticotropic Hormone↗
PubMed1996

Bone mineral density in women with depression.

BACKGROUND: Depression is associated with alterations in behavior and neuroendocrine systems that are risk factors for decreased bone mineral density. This study was undertaken to determine whether women with past or current major depression have demonstrable decreases in bone density. METHODS: We measured bone mineral density at the hip, spine, and radius in 24 women with past or current major depression and 24 normal women matched for age, body-mass index, menopausal status, and race, using dual-energy x-ray absorptiometry. We also evaluated cortisol and growth hormone secretion, bone metabolism, and vitamin D-receptor alleles. RESULTS: As compared with the normal women, the mean (+/-SD) bone density in the women with past or current depression was 6.5 percent lower at the spine (1.00+/-0.15 vs. 1.07+/-0.09 g per square centimeter, P=0.02), 13.6 percent lower at the femoral neck (0.76+/-0.11 vs. 0.88+/-0.11 g per square centimeter, P<0.001), 13.6 percent lower at Ward's triangle (0.70+/-0.14 vs. 0.81+/-0.13 g per square centimeter, P<0.001), and 10.8 percent lower at the trochanter (0.66+/-0.11 vs. 0.74+/-0.08 g per square centimeter, P<0.001). In addition, women with past or current depression had higher urinary cortisol excretion (71+/-29 vs. 51+/-19 micrograms per day [196+/-80 vs. 141+/-52 nmol per day], P=0.006), lower serum osteocalcin concentration (P=0.04), and lower urinary excretion of deoxypyridinoline (P=0.02). CONCLUSIONS: Past or current depression in women is associated with decreased bone mineral density.

Absorptiometry, Photon↗
PubMed1996

Naloxone-induced pituitary-adrenal activation does not differ in patients with depression, obsessive compulsive disorder, and healthy controls.

Adrenocorticotropic hormone (ACTH) and cortisol secretion have been shown to be abnormal in approximately half of depressed patients. Information from pituitary and adrenal studies suggests that the locus of this dysregulation is at or above the level of the hypothalamus; however, direct evidence from provocative studies of the hypothalamic corticotropin releasing hormone (CRH) neuron does not exist. The current study was designed to stimulate hypothalamic CRH release using the opiate antagonist naloxone in patients with depression and elevated urinary-free cortisols as well as healthy and psychiatric controls. All subjects received naloxone and placebo on separate days in a double-blinded, randomized fashion at a dose determined previously to reliably induce significant increases in ACTH and cortisol secretion. No significant differences were noted among groups. We conclude that although naloxone is an effective central stimulant of the hypothalamic CRH neuron, stimulation of the hypothalamic CRH neuron with naloxone does not provide evidence of dysregulation of the HPA axis in depression.

Adrenocorticotropic Hormone↗
PubMed1996

Expandable versus conventional esophageal prostheses: easier insertion may not preclude subsequent stent-related problems.

BACKGROUND: Although expandable esophageal endoprostheses may be easier to insert and are associated with fewer procedure-related perforations, data comparing clinical results with these stents to those obtained with conventional prostheses are sparse. METHODS: We reviewed the records of all patients undergoing esophageal stent placement at our institution between October 1983 and July 1995 to define relative risks, clinical results, and need for reintervention prior to death, contrasting conventional to a variety of expandable esophageal endoprostheses. RESULTS: Over the period of review, 47 patients had conventional prostheses (CP) and 38 had expandable prostheses (EP) placed. Fifteen of 44 patients with CP and 14 of 38 with EP for malignancy also had esophago-airway fistulas. Insertion complications, prestent and poststent dysphagia scores, and complete fistula occlusion rates were comparable. Subacute complications were higher in the patients receiving EP (80%) than in those receiving CP (60%), possibly related to the prospective accumulation of data in patients receiving EP. Survival data were virtually identical and approximated 3 months for either group. CONCLUSIONS: Although both CP and EP improve dysphagia and occlude tracheoesophageal fistulae, patients ill enough to require a prosthesis do poorly regardless of prosthesis design. Moreover, although EP may be easier to insert than CP, stent- and patient-related problems persist and may require additional intervention.

Aged↗
PubMed1996

Violence to staff in a general hospital setting.

The problem of aggression to staff in a general hospital was examined from the perspective of Poyner & Warne's (1986) model of workplace violence. A total of 396 staff (39% response rate) provided information on their experience of violence in the past year and a subsample were additionally interviewed about their current levels of mental health (GHQ). Some 72 staff (21% of respondents had been physically assaulted and 90% of these assaulted staff worked beyond the accident and emergency department, e.g. in medical wards. Nurses were physically assaulted, threatened and verbally abused at higher rates than other professionals. Employee factors (younger age, shorter National Health Service experience and attendance at violence training) were significantly associated with assault (P < 0.05). Postoperative confusion, receiving treatment and delayed treatment were common precursors of aggression. Mental health was significantly worse amongst staff exposed to threats (P < 0.01). This exploratory study establishes that violence is a problem across a number of general hospital departments and occupations and we argue that effective training should be made more available for staff at risk of assault.

Adult↗
PubMed1994

Do response options influence self-reports of alcohol use?

The influence of response options on self-reported frequency of alcohol use was evaluated in an experimental study of 350 students at a west coast university. Respondents were asked about their frequency of alcohol use in the last 7 days, 30 days, 90 days, and 180 days with three methodological factors randomized: 1) how quantitative the response options were; 2) order of presentation of close-ended response options; and 3) relative placement of alcohol use items in the questionnaire. Results indicate that the quantitativeness of response options and the location of items within the questionnaire have minimal effects on the average frequency of alcohol use and number of inconsistent responses over a wide range of time frames. However, presenting higher frequency response options prior to lower frequency response options increased self-reported frequency of having consumed 2 or more drinks in the last 30 days and frequency of alcohol use over the last 180 days.

Adolescent↗