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Biomedical subjects

L Thomas

Publications and source records attributed to L Thomas.

At least 217 records · Page 12Linked to original sources
PubMed1997

A national survey of U.S. statutes on juvenile transfer: implications for policy and practice.

A survey of the statutes on juvenile transfer and decertification in the U.S. federal and 50 state jurisdictions, and the District of Columbia, was performed. Relevant information was obtained on the procedures in each jurisdiction by which a juvenile can be tried in criminal court, whether there are applicable decertification ("transfer back") procedures in jurisdictions permitting criminal court processing through automatic file or prosecutorial discretion, and the burden and allocation of proof in relevant proceedings. We also identified four criteria relevant to the mental, emotional, and developmental functioning of juveniles that are used in various jurisdictions in making transfer and decertification decisions: treatment needs and amenability, risk assessment of future criminality, the presence of mental retardation or mental illness, and certain kinds of offense characteristics. The majority of jurisdictions now allow 14-year-old juveniles to be tried in criminal court. Treatment needs/amenability and risk assessment are set forth as criteria relevant to transfer in the majority of jurisdictions as well, with the presence of mental retardation or mental illness explicitly relevant in a small number of jurisdictions. The patterns of these findings are discussed in their implications for social policy and for the forensic mental health assessment of juvenile transfer and decertification, with needed areas of research identified within each.

Adolescent↗
PubMed1997

Gestational diabetes and fetal macrosomia in a multi-ethnic population.

We set out to examine maternal and neonatal factors surrounding increased birthweight in a multi-ethnic population having an increased prevalence of diabetes mellitus. Additionally, to document the difference (if any) for such neonates in rates of obstetrical operative intervention at delivery where a specific diagnosis of maternal gestational diabetes mellitus had been made. This was an observational study of unselected mothers giving birth to a neonate of 4000 g or more. Data for this population concerning the results of antenatal screening and diagnostic testing for gestational diabetes mellitus were available as a subset of a larger independent and ongoing database. Odds ratios were used to compare group attributes subset on ethnic, diabetic screening and diabetic diagnostic status. Two ethnic groups showed an increased odds ratio for increased birthweight. A diagnosis of diabetes was associated with a twofold increase in caesarean section rate, and a significant increase in median birthweight when compared with screen positive/ diagnostic negative mothers. A total of 70.4% of mothers were overweight or obese while neonatal ponderal index showed a dependence on birthweight ( r2 = 0.17). We conclude that ethnic status is an important factor in assessing fetal size, as is maternal body mass index. A diagnosis of diabetes mellitus confers an increased risk of operative intervention at delivery. Our approach to the use of birthweight data requires re-assessment.

Journal Article↗
PubMed1997

Effect of Strongyloides stercoralis infection and eosinophilia on age at onset and prognosis of adult T-cell leukemia.

Onset of adult T-cell leukemia (ATL) usually follows a long period of viral latency. Strongyloides stercoralis infection has been considered a cofactor of leukemogenesis. Hypereosinophilia (HE) is also observed and could be associated with either the presence of parasites or the leukemic process. In non-Hodgkin's lymphoma, eosinophilia may or may not affect prognosis. To determine whether infection with S stercoralis and therefore eosinophilia has a significant effect on the development of ATL, we studied two variables in 38 patients: age at onset and median survival rate. Infected (Ss+) patients (n = 19) were younger (P = .0002) and survived longer (P = .0006) than uninfected (Ss-) patients (n = 19) (median age, 39 vs 70 years; median survival, 167 vs 30 days). Mean survival of patients with hypereosinophilia (HE+) was not significantly different from that of patients without hypereosinophilia (HE-) (P = .57). However, overall survival was longer for Ss + HE + patients than for Ss-HE-patients (P = .01; 180 vs 30 days) or Ss-HE + patients (P = .03; 180 vs 45 days). Among patients with mean survival more than 180 days, Ss + HE + patients survived longer (P = .028). Our data confirm that cofactors related to the environment, such as S stercoralis and hypereosinophilia associated with S stercoralis or human T-cell leukemia virus, type 1 (HTLV-1) might be important in HTLV-1-associated leukemogenesis and suggest that hypereosinophilia affects the prognosis of HTLV-1-associated leukemia.

Adult↗
PubMed1997

Fallopian tube and pulmonary sarcoidosis. A case report.

BACKGROUND: Female reproductive tract sarcoidosis is a rare clinical condition, especially when the fallopian tube is the site of involvement. A search of the medical literature revealed 22 cases of female genital tract sarcoidosis, with 6 cases involving the fallopian tube. CASE: Sarcoidosis of the genital tract occurred in a woman with a 16-year history of pulmonary sarcoidosis. CONCLUSION: Since various diseases, including sarcoidosis and tuberculosis, cause similar histologic changes, obtaining bacteriologic proof is mandatory, for the diagnosis can have therapeutic and public health implications.

Epithelium↗
PubMed1997

[Congenital eccrine angiomatous hamartoma].

BACKGROUND: Eccrine angiomatous hamartoma is an uncommon skin disease with vascular and sudoral components: less than thirty cases have been reported in the literature. CASE REPORT: A 3.5 month-old female infant developed a painful angiomatous plaque on the abdomen which was first seen 15 days after birth. Histology showed numerous vessels and eccrine sudoral glands in the dermis. Exeresis could not be complete and was followed for 15 years. There has been a slight hyperpigmentation with localized hyperhidrosis over the plaque. This hypersudation confirms the diagnosis which could not be confirmed on the initial biopsies. DISCUSSION: This case of congenital eccrine angiomatous hamartoma could only be diagnosed late in the clinical course. This is the first case report on the abdomen, 80 p. 100 of the previous reports were on the limbs. After a 15 year follow-up, there was no progression of the hamartoma and pain regressed gradually. Without secondary development of localized hyperhidrosis, the diagnosis could not have been made. Careful comparison of pathology findings and clinical expression are essential for the diagnosis of eccrine angiomatous hamartoma.

Abdominal Muscles↗
PubMed1996

A consensus structure for omega-conotoxins with different selectivities for voltage-sensitive calcium channel subtypes: comparison of MVIIA, SVIB and SNX-202.

The omega-conotoxins are a set of structurally related peptides that have a wide range of specificities for different subtypes of the voltage-sensitive calcium channel (VSCC). To understand their VSCC subtype differentiation we studied the structure of two naturally occurring omega-conotoxins, MVIIA (specific to N-type) and SVIB (specific to P/Q-type) and a synthetic hybrid, SNX-202, which has altered specificities to both VSCC subtypes. The secondary structures of the three peptides are almost identical, consisting of a triple-stranded beta-sheet and several turns. A comparison of NMR data emphasizes the structural similarities between the peptides and highlights some minor structural differences. In the three-dimensional structures of SVIB and MVIIA these are manifested as orientational differences between two key loops. The structural rigidity of MVIIA was also examined. H alpha shifts are similar in a range of solvents, indicating that there are no solvent-induced changes in structure. The omega-conotoxins form a consensus structure despite differences in sequence and VSCC subtype specificity. This indicates that the omega-conotoxin macrosites for the N/P/Q-subfamily of VSCCs are related, with specificity for receptor targets being conferred by the positions of functional side-chains on the surface of the peptides.

Amino Acid Sequence↗
PubMed1996

A study to determine patient satisfaction with nursing care.

In this paper, the authors describe a newly constructed measure of patient satisfaction entitled the Newcastle Satisfaction with Nursing Scales (NSNS). A study using the NSNS found that patients 'most liked' the humour that nurses tried to inject into their interactions with patients, but that they were dissatisfied in general with the amount of information given to them by nurses. The sensitivity of the tool in relation to detecting differences between wards, hospitals or groups of patients is emphasised. The authors then discuss how the NSNS package can be used by others to carry out similar comparisons.

Adult↗
PubMed1996

Sertraline in the treatment of rape victims with posttraumatic stress disorder.

Posttraumatic stress disorder (PTSD) is a significant problem following rape, yet reports on the efficacy of pharmacological agents in this population are lacking. The results of an open 12-week clinical trial utilizing sertraline (mean dose 105 mg) in the treatment of adult female rape victims with chronic PTSD are presented. The five completers were, on average, 41.6 years old and 15.6 years postassault. Sertraline reduced PTSD and related symptoms in these rape victims. The mean Clinician Administered PTSD Scale (CAPS) scores decreased by 53%, with four out of five participants responding positively to treatment. These preliminary results support the need for systematic assessment of sertraline in this population.

1-Naphthylamine↗
PubMed1996

Genotypes of the vitamin-D-receptor gene and bone mineral density in Caucasoid postmenopausal females.

OBJECTIVE: To evaluate the relation of bone mineral density (BMD) to inherited polymorphisms within the gene coding for the vitamin D receptor (VDR) in postmenopausal women. METHODS: DNA samples from 163 post-menopausal women and from 112 controls were genotyped for common allelic determinants within the VDR gene as defined by the restriction enzyme sites for BsmI, ApaI, and TaqI. BMD was evaluated at the lumbar spine (L2-L4) by dual energy X-ray absorptiometry. Single restriction enzyme site polymorphisms as well as their joint genotypes were evaluated for their association with BMD in postmenopausal women. RESULTS: The three restriction site polymorphisms showed a close association indicating linkage disequilibrium (P < 0.0001). There was no relationship between any of the single restriction site polymorphisms and BMD. The distribution of the five most common joint genotypes among postmenopausal women and controls was similar. There was no relation of BMD and any of the five most common VDR genotype groups. Females more than 5 years after menopause had a significantly lower BMD than those less than 5 years after menopause (P < 0.001). This age-related decrease of BMD was also decernible within genotype groups. CONCLUSION: In our population, the postmenopausal period has a major influence on BMD, but BMD is not controlled significantly by any of the common allelic variations within the VDR gene.

Absorptiometry, Photon↗
PubMed1996

Vigabatrin and behaviour disorders: a retrospective survey.

Vigabatrin is an anticonvulsant drug with a relatively favourable side-effect profile. However, in clinical trials behaviour disorders have been reported, including agitation, depression and psychoses. In this study, 136 cases of behavioural problems that had been reported to the manufacturers, or the authors, were followed up. Satisfactory clinical information could be obtained on 81 patients. Of these, 50 cases met the criteria for either a psychosis (n = 28) or depression (n = 22). These were compared with a group of Queen Square patients, with epilepsy and psychosis, who had never taken vigabatrin (n = 21) and another group, who received vigabatrin without experiencing any behavioural problems (n = 28). The main results from this study suggest that: (1) Psychosis as a treatment emergent effect of vigabatrin is seen in patients with more severe epilepsy, compared with those patients who never develop psychopathology, and those developing an affective disorder. The psychosis is related to a right-sided EEG focus, and suppression of seizures (64% became seizure free). (2) Depression as a treatment emergent effect of vigabatrin is associated with a past history of depressive illness. There was little or no change in seizure frequency is this group. Some suggestions for managing patients who may develop these behaviour disorders are given.

Anticonvulsants↗
PubMed1996

Apoptosis is the mode of keratinocyte death in cutaneous graft-versus-host disease.

BACKGROUND: Satellite cell necrosis is a histopathologic hallmark of cutaneous graft-versus-host disease (GVHD) after allogeneic bone marrow transplantation. Although this interaction of lymphocytes with keratinocytes has features of immune cytolytic destruction, the details of the process are not known. OBJECTIVE: Our purpose was to investigate whether apoptosis is involved in the process of GVHD. METHODS: We used TdT-mediated dUTP-biotin nick end labeling (TUNEL) technique with biotinylated nucleotides. Formalin-fixed, paraffin-embedded sections from skin biopsy specimens of patients with GVHD and normal skin were studied. RESULTS: Labeling of scattered individual keratinocytes in the epidermis and adnexal epithelium undergoing cytolytic degeneration and a proportion of the adjacent lymphocytes was noted in all specimens of GVHD. CONCLUSION: The positive staining of keratinocytes by the TUNEL method indicates that cell destruction in cutaneous GVHD involves apoptosis.

Adolescent↗
PubMed1996

Conservation treatment in subareolar breast cancers.

The results of centromammary conservation in 37 patients with 20 mm-median-size breast cancer, located in the subareolar area (SAA), with an infiltration of the nipple-areolar-complex (NAC) in 12 patients and a retraction in 24, are reported. Breast conservative surgery was initially performed in 30 patients; five patients were first treated with chemotherapy; two patients received initial tamoxifen. Surgery comprised tumorectomy plus axillary dissection, with complete resection of the NAC (20 patients), or partial resection (nine patients), or without resection (eight patients). Post-operatively, all patients received 50 Gy external radiotherapy, with an additional external electron boost in 13 patients; 14 patients received adjuvant tamoxifen and two patients adjuvant chemotherapy. With a median follow-up of 49 months, one patient experienced a local failure and four a metastatic failure; 5-year overall actuarial survival and disease-free survival rates were 97%, and 75%. Cosmetic results were excellent in three patients, good in 25, and poor in seven. Breast conservation appears a satisfying treatment in small breast cancer located in SAA.

Adult↗
PubMed1996

The effects of vigabatrin on attention, concentration and mood: an investigation in healthy volunteers.

Ten healthy volunteers (six males; four females) completed this double-blind, crossover design study of vigabatrin vs placebo. Subjects were tested on four occasions; at the baselines of the placebo and the vigabatrin phase, and two weeks thereafter. At time of testing, the dose of vigabatrin was 2 g daily. Changes in cognition were assessed using the Sternberg, the PASAT, the Stroop, and Critical Fusion Flicker tests. Mood was assessed with the Mood Adjective Check List, the Beck Depression Inventory, and the Irritability, Depression and Anxiety scales. We found one drug, and one placebo, related significant difference on a measure of cognition.

Adult↗