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Biomedical subjects

M Adams

Publications and source records attributed to M Adams.

At least 253 records · Page 14Linked to original sources
PubMed1991

Life events, depression, and perceived problem solving alternatives in adolescents.

The association between negative life events and depression may be mediated by adolescents' sense of competency in solving problems. This study investigated (a) the relationship between troublesome life events and level of depression and (b) the association between level of depression and adolescents' perceived problem solving alternatives, in 135 tenth graders. The specific life events of "unemployment of a family member", "starting at a new school", and "breaking up with a boy/girlfriend", were associated with higher levels of depression. In addition, higher levels of depression were associated most consistently with the perceived alternatives of getting intoxicated and of isolating oneself in response to a variety of problems. Further research is needed to clarify both the extent to which depression influences adolescents' responses to negative life events and leads to poorer problem solving choices, and the degree to which negative life events and the lack of constructive problem solving alternatives increase the risk of depression.

Adaptation, Psychological↗
PubMed1991

Graphical analysis of single-case time series data.

This article outlines the major principles for constructing good graphs and visual displays. Several methods for exploring time series data with graphical techniques are given: these include procedures for summarizing the central tendency of data, plotting linear and non-linear trend, and displaying variability and change in variability over time. We emphasize the need to explore single-case data thoroughly in order to highlight various components. Graphical analysis should be conducted in tandem with statistical analysis.

Data Display↗
PubMed1991

Anticoagulants, iliopsoas hematoma and femoral nerve compression.

A case of bilateral compression femoral neuropathy due to iliopsoas muscle hematomas during anticoagulant therapy is described. Diagnosis was confirmed with computed tomographic scan. The right hematoma was larger than the left and caused a more severe femoral neuropathy. The hematoma on the right side was surgically evacuated, and the left-sided one was treated conservatively. The patient had a complete recovery.

Anticoagulants↗
PubMed1991

Cardiovascular risks: among Black and White rural-urban low income women.

The purpose of this descriptive comparative pilot study was to determine if there are rural-urban and racial differences in the prevalence of four modifiable risk factors (blood pressure, serum cholesterol, diabetes and smoking) for cardiovascular disease among low income Black and White women. Of the 163 low income women who participated in the study, it was found that Black women had a significantly higher prevalence of elevated blood pressure and serum cholesterol levels than White women. The observed rates for smoking and diabetes were highest among rural White women. Implications for health education and continued research are presented.

Adult↗
PubMed1990

Aerosolized pentamidine for prophylaxis against Pneumocystis carinii pneumonia. The San Francisco community prophylaxis trial.

BACKGROUND AND METHODS: Pneumocystis carinii pneumonia (PCP) is the most frequent life-threatening opportunistic infection associated with human immunodeficiency virus (HIV) infection. To assess the possible value of aerosolized-pentamidine prophylaxis in different doses, a controlled clinical trial was begun in 1987 with 408 subjects at 12 treatment centers. The participants were randomly assigned to receive 30 mg of pentamidine every two weeks, 150 mg every two weeks, or 300 mg every four weeks. RESULTS: Eighteen months after randomization, the subjects in the 300-mg arm had had 8 confirmed episodes of PCP while receiving treatment, as compared with 22 in the 30-mg arm (P = 0.0008). The 150-mg arm had intermediate results but ones not significantly different from those of the 300-mg arm. Participants with previous episodes of PCP and CD4-cell counts less than 200 per cubic millimeter were at the highest risk for PCP. CONCLUSIONS: Aerosolized pentamidine was effective for prophylaxis against PCP in patients infected with HIV, according to the dose and schedule of administration. It and zidovudine were well tolerated together and had independent prophylactic benefits.

Adult↗
PubMed1990

A cohort study of summary reports of controlled trials.

Substantial numbers of clinical trials continue to be reported only in summary reports that present insufficient methodological details to permit informed judgments about the likely validity of the conclusions. Using a cohort of 176 controlled trials reported in summary form, we tested the hypotheses that they would be more likely to be followed by full reports if, on the basis of the information provided in the summary report, (1) the trial was judged to be methodologically sound, (2) the results favored the test treatment, and (3) the sample size was relatively large. The results of univariate and multivariate analyses provided support for only the third of these hypotheses. Investigators, as well as those who fund and sanction the conduct of clinical research, should make greater efforts to ensure that clinical trials are reported properly.

Clinical Trials as Topic↗
PubMed1990

OC125 immunoscintigraphy in ovarian carcinoma: a comparison with alternative methods of assessment.

The membrane bound, tumour associated antigen CA125 is recognized by the monoclonal antibody OC125 and may be detected in tumour tissue and serum in over 80% of patients with epithelial ovarian carcinomas. A total of 13 immunoscintigrams using 111 MBq 131I-OC125 have been performed in 11 patients. The results have been compared with clinical examination, CT and ultrasound scans, surgical findings and serum CA125 concentrations. Macroscopic disease was present at the time of scanning in 11 patients (less than 2 cm, eight patients, greater than 2 cm, three patients). Clinical examination and ultrasound were positive in three, CT scanning in four, immunoscintography in seven and serum CA125 in eight patients. This pilot study suggest that serum CA125 estimation is the most sensitive indicator of disease activity. However, immunoscintigraphy using this agent may localize residual disease when clinical examination and other radiological investigations fail.

Antibodies, Monoclonal↗
PubMed1990

Results of a randomized, double-blind comparative study of ondansetron and metoclopramide in the prevention of nausea and vomiting following high-dose upper abdominal irradiation.

Ondansetron is a 5-hydroxytryptamine 3-receptor antagonist which has shown activity in the prevention of cytotoxic-induced emesis. Preliminary non-randomized studies also indicated efficacy in preventing sickness following radiotherapy. The present study was therefore undertaken to compare the efficacy and safety of ondansetron (8 mg tds orally) and metoclopramide (10 mg tds orally) in preventing sickness after single-exposure radiotherapy treatments of 8-10 Gy to the upper abdomen. Of 82 evaluable patients 38 received ondansetron and 44 metoclopramide. On the first day after irradiation vomiting or retching was prevented in all but one of the patients on ondansetron whereas metoclopramide achieved complete control of these symptoms in only 46% of subjects (P less than 0.001). Similarly nausea was significantly better controlled by ondansetron in the first 24 hours after treatment (P = 0.001). Complete or major control of vomiting or retching was maintained for 92%-100% of patients on ondansetron during the five days of the study period. In the metoclopramide group the proportion of patients with equivalent control improved from 70% on day 1 to 95 on day 5. Both drugs were well-tolerated.

Abdomen↗
PubMed1990

Thrombin activity induced by balloon angioplasty of the coronary artery in Macaca fascicularis (cynomolgus monkey).

In this paper we address the question of whether balloon angioplasty induces thrombin action. In the studies reported here we measured fibrinopeptide A levels in a group of atherosclerotic monkeys undergoing coronary angioplasty. A blood collection catheter was introduced into the inferior vena cava through a femoral vein, and the angioplasty catheter introduced via the femoral artery. Heparin was administered immediately after insertion of the arterial catheter. Serial blood samples were collected for 20 min before angioplasty and for 10 min after angioplasty. Baseline levels of FpA were high, presumably in response to the trauma of introducing the catheters. After heparin administration the FpA concentration declined with a half-time of 1.1 min. In response to balloon inflation there was a clear increase in the concentration of FpA, despite the presence of a therapeutic concentration of heparin. The magnitude of the FpA rise was markedly different between animals, but was evident in the aggregate data after subtraction of background levels of FpA. By integration of the plasma FpA concentration curve, the amount of fibrinogen converted to fibrin in response to angioplasty was calculated to be approximately 0.4 mg/animal. We conclude that angioplasty induces significant activation of the coagulation system.

Angioplasty, Balloon, Coronary↗
PubMed1990

The effects of music therapy on a group of profoundly mentally handicapped adults.

An investigation of the effects of music therapy on profoundly mentally handicapped adults is reported. The therapy was directed at achieving specific objectives for individuals and the study compared the efficacy of music therapy and play activities in achieving these objectives. Four subjects out of the 12 included in the therapy groups were studied intensively. All subjects received both treatments in a reversal design with 20 weekly sessions of each treatment. Videotapes of the treatment sessions were analysed using a time-sampling method to record the occurrence of behaviour indicating the achievement of the individual treatment objectives. Staff behaviour in the treatment sessions was also observed to investigate the role of staff attention in mediating the treatment effects. The observations of staff behaviour showed that, overall, there was less individual attention given during music therapy than in play sessions, that there was a much greater role differentiation among the staff present in the music therapy groups and that individual clients in the groups received markedly unequal amounts of staff attention. For all four subjects studied in detail, some differences in behaviour were shown between the treatments and most, but not all, of these differences indicated greater effectiveness of music therapy. For one subject showing higher performance in play sessions than in music therapy, this could be attributed to a higher level of staff attention for this subject. The differences in favour of music therapy could not be accounted for in this way. It is concluded that music therapy is a useful treatment approach with profoundly handicapped people.

Adult↗
PubMed1990

Genetic relatedness of Legionella longbeachae isolates from human and environmental sources in Australia.

The genetic relatedness of Legionella longbeachae isolated in Australia since 1987 was investigated by restriction fragment length polymorphism (RFLP) analysis and allozyme electrophoresis. Three radiolabeled probes were used in Southern hybridizations for the RFLP studies. They were Escherichia coli 16S and 23S rRNA and cloned fragments of L. longbeachae selected empirically from genomal banks in lambda and a cosmid. The legionellae included in the study comprised 11 Legionella longbeachae serogroup 1 organisms isolated from humans, 28 L. longbeachae serogroup 1 isolates from environmental sources, and 3 L. longbeachae serogroup 2 environmental isolates. These were compared with the American Type Culture Collection reference strains of both serogroups and some other related Legionella species. Results of allozyme and RFLP analysis showed that all the isolates from humans and all but three of the environmental L. longbeachae serogroup 1 isolates were closely related. They were also closely related to L. longbeachae serogroup 1 ATCC 33462. There was wider variation among the three L. longbeachae serogroup 2 environmental isolates. One of these was closely related to L. longbeachae serogroup 2 ATCC 33484. RFLP studies with the rRNA probe provided the most discrimination among isolates but did not distinguish between the two serogroups.

Australia↗
PubMed1990

Lack of effect of lovastatin therapy on the parameters of whole-body cholesterol metabolism.

UNLABELLED: The effects of lovastatin therapy on the parameters of body cholesterol metabolism were explored in nine hypercholesterolemic patients. Long-term cholesterol turnover studies were performed before therapy, and were repeated after 15 mo of lovastatin therapy (40 mg/d) while continuing on therapy. The major question addressed was whether a reduction in plasma cholesterol level with lovastatin would be associated with a reduction in the whole-body production rate of cholesterol or with the sizes of exchangeable body cholesterol pools as determined by the three-pool model of cholesterol turnover. The mean plasma cholesterol level decreased 19.4% (from 294 to 237 mg/dl), and low-density lipoprotein cholesterol decreased 23.8% (from 210 to 159 mg/dl) with lovastatin therapy. Changes in high-density lipoprotein cholesterol level were not significant. The cholesterol production rate did not change significantly with therapy (1.09 +/- 0.10 [mean +/- S.D.] vs. 1.17 +/- 0.09 g/d). By comparison, colestipol and niacin treatment in three other subjects more than doubled the cholesterol production rate (1.14 +/- 0.28 vs. 2.42 +/- 0.34 g/d). Thus, hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibition by lovastatin at the therapeutic dose used here did not change the steady-state rate of whole-body cholesterol synthesis. Despite the changes in plasma cholesterol levels, no significant changes were seen in the values of M1, of M3 or of Mtot, the sizes of the pools of rapidly, of slowly, and of total body exchangeable cholesterol. CONCLUSION: lovastatin therapy to lower plasma cholesterol does not lead to corresponding reductions in body cholesterol pools or to a reduction in the rate of whole-body cholesterol synthesis. In the new steady state that exists during long-term lovastatin therapy, along with increased expression of the genes for HMG-CoA reductase and the LDL receptor, the body compensates for the effects of the drug so that cholesterol production rate and tissue pool sizes are not changed from pretreatment values.

Adult↗
PubMed1990

Hemodynamic response to pumpless extracorporeal membrane oxygenation.

Respiratory support by means of arteriovenous extracorporeal membrane oxygenation driven by systemic arterial pressure, in contrast to pump-driven venoarterial extracorporeal membrane oxygenation, is attractive because of its simplicity and lack of trauma to formed blood elements. Although arteriovenous extracorporeal membrane oxygenation has been shown to improve arterial blood gases, useful levels of arteriovenous extracorporeal membrane oxygenation shunt flow may exert detrimental effects on systemic and pulmonary hemodynamics. Therefore the hemodynamic consequences of arteriovenous extracorporeal membrane oxygenation were studied in 11 dogs that were anesthetized, heparinized, and their lungs mechanically ventilated (FIO2 = 0.21) before and after induction of oleic acid pulmonary edema. The data indicate that arteriovenous extracorporeal membrane oxygenation shunt flows adequate to improve arterial blood gases resulted in significant changes in peripheral vascular resistance (-46%; p less than 0.05), systemic arterial blood pressure (-20%; p less than 0.05), and cardiac output (+110%; p less than 0.05). Dopamine infusion (5 micrograms/kg/min) proved to be more effective than volume expansion (15 ml/kg) in maintaining cardiac output, arterial blood pressure, and arterial blood gases. We conclude that pumpless arteriovenous extracorporeal membrane oxygenation, at flow rates adequate for respiratory support, can adversely alter systemic hemodynamics. However, these effects can be beneficially modulated by a moderate dose of inotropic medication.

Animals↗
PubMed1989

Giardia intestinalis: electrophoretic evidence for a species complex.

The technique of allozyme electrophoresis was applied to 29 Australasian stocks and 48 clones of Giardia intestinalis from humans as a means of increasing the number of genetic markers currently available for identification and classification. Fifty different enzymes were examined and of these 26 loci were found to be suitable for use as genetic markers. The data indicate the presence of four discrete genetic groups within the sample of G. intestinalis examined. The groups had fixed genetic differences at 23-69% of loci established. The evidence suggests that G. intestinalis is a species complex. The results have important implications for the systematics of human isolates of Giardia, as well as for studies on the epidemiology and demography of giardiasis in Australia and elsewhere.

Animals↗