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Biomedical subjects

M H Lewis

Publications and source records attributed to M H Lewis.

At least 73 records · Page 4Linked to original sources
PubMed1997

D1 dopamine receptor mediation of social and nonsocial emotional reactivity in mice: effects of housing and strain difference in motor activity.

The study examined the effects of isolation housing and the role of D1 dopamine receptors on isolation-induced social and nonsocial (acoustic startle) reactivity in mice high (C57BL/6) and low (A) in motor activity. Isolation housing had no effect on acoustic startle but increased strain-specific forms of social reactivity. The D1 agonist dihydrexidine (DHX) increased acoustic startle in isolated mice of both strains, but this effect was more pronounced in C57BL/6 mice. In this strain, DHX and the D1 agonist SKF-81297 increased locomotor forms of social reactivity (e.g., escape, jump), whereas the D1 antagonist SCH-23390 increased stationary reactivity (e.g., freezing). In A mice, DHX and SKF-81297 increased and decreased stationary reactivity, respectively, whereas SCH-23390 had no effect on these behaviors. Administration of SKF-81297 after pretreatment with SCH-23390 or the D2 antagonist sulpiride confirmed the importance of D1 receptors in mediating specific forms of social reactivity in C57BL/6 mice. These results suggest an important relationship between social reactivity and motor activity and an important, albeit strain-dependent, role for D1 receptors in mediating specific emotional behaviors.

Animals↗
PubMed1997

B lymphocyte antigen D8/17: a peripheral marker for childhood-onset obsessive-compulsive disorder and Tourette's syndrome?

OBJECTIVE: It has been hypothesized that Sydenham's chorea, a major manifestation of rheumatic fever, may provide a medical model for obsessive-compulsive disorder and associated conditions, such as Tourette's syndrome. Monoclonal antibody D8/17 identifies a B lymphocyte antigen with expanded expression in nearly all patients with rheumatic fever and is thought to be a trait marker for susceptibility to this complication of group A streptococcal infection. The authors investigated whether D8/17 expression is greater than normal in some forms of obsessive-compulsive disorder and Tourette's syndrome. METHOD: By immunofluorescence techniques, 31 patients with childhood-onset obsessive-compulsive disorder and/or Tourette's syndrome or chronic tic disorder and 21 healthy comparison subjects were evaluated for percentage of D8/17-positive B cells. None had rheumatic fever or Sydenham's chorea. Levels of antineuronal antibodies and streptococcal antibodies were also determined. RESULTS: The average percentage of B cells expressing the D8/17 antigen was significantly higher in the patients (mean = 22%, SD = 5%) than in the comparison subjects (mean = 9%, SD = 2%). When classified categorically, all patients but only one comparison subject were D8/17 positive. No difference between groups in the presence of antineuronal antibodies or high streptococcal titers was found. CONCLUSIONS: Patients with childhood-onset obsessive-compulsive disorder or Tourette's syndrome had significantly greater B cell D8/17 expression than comparison subjects despite the absence of documented Sydenham's chorea or rheumatic fever. These findings suggest that D8/17 may serve as a marker for susceptibility among some forms of childhood-onset obsessive-compulsive disorder and Tourette's syndrome, as well as rheumatic fever or Sydenham's chorea.

Adolescent↗
PubMed1997

Akathisia in adults with mental retardation: development of the Akathisia Ratings of Movement Scale (ARMS).

We developed an akathisia rating scale for use with persons who have mental retardation and screened for the occurrence of akathisia in three samples: 66 adults receiving maintenance neuroleptic treatment, 20 adults not receiving neuroleptics, and 8 adults undergoing neuroleptic dose reduction. The scale had an acceptable level of interrater reliability and validly measured group differences related to neuroleptic treatment status. Using an empirically derived cut-off-score, we estimated the prevalence rate for akathisia to be 5% in neuroleptic-free subjects, 17% in neuroleptic-maintenance subjects, and 25% in neuroleptic-reduction subjects. Akathisia, dyskinesia, and stereotypy manifested as qualitatively different movement topograhies. The occurrence of dyskinesia stereotyped movement disorder was associated significantly with an increased occurrence of akathisia.

Adolescent↗
PubMed1997

Gall stone ileus following multiple endoscopic retrograde cholangiopancreatographies.

Endoscopic retrograde cholangiopancreatography (ERCP) is used as a diagnostic and therapeutic procedure and common bile duct (CBD) stones can be removed using this technique. Early complications of ERCP are well recognized, but there is little in the literature concerning complications developing later. Gall stone ileus following ERCP has been previously reported but not with a delay of up to 2 months. This case illustrates such a delayed complication following multiple ERCPs for CBD stones.

Aged↗
PubMed1997

Visiting registrars in surgery: the trainees' viewpoint.

Overseas Doctors have been coming for higher surgical training to the UK for many years. Little is known about the reasons they choose to come here, what their expectations are and if the training they receive fulfils these expectations and prepares them for a career back home. The aim of this study was to address these questions and to see what changes could be suggested to make training more meaningful to visiting registrars. Questionnaires were sent to 26 trainees who were part of the 3 year surgical registrar rotation in Wales from 1992. 23 completed questionnaires were available for analysis as the others were not traceable. 83% came to the UK to obtain the FRCS and train in a specific aspect of general surgery (74%). The period of training was felt to be inadequate by 79% of trainees. 65% felt that of the total period of training, less than 75% was useful. On return to their own countries 96% were to be either solely or largely responsible for patients in their care. In conclusion, if surgical training is to remain meaningful to visiting trainees, changes would have to be made to the Calman system to enable them to continue to do the FRCS and avenues made available for them to train in their stated areas of interest with adequate supervision, regular assessment and certification.

Attitude of Health Personnel↗
PubMed1996

Growth differences associated with compulsive and stereotyped behavior disorders in adults with mental retardation.

We have recently observed that compulsive behaviors in mentally retarded patients appear to be quite prevalent, can be reliably assessed, and have a high rate of co-occurrence with stereotyped and self-injurious behaviors in this population. As abnormal growth rate has been observed in obsessive-compulsive disorder (OCD) patients, we examined physical stature in adults with mental retardation who display repetitive movement disorders. Identification of cases with stereotypic movement disorder, and cases with compulsive behaviors was done using a symptom checklist and direct observation. Subjects with repetitive movement disorders were smaller in stature than control subjects, with gender differences observed across repetitive behavior disorders. Specifically, female subjects with compulsive behavior disorder, but not stereotypic movement disorder, were significantly shorter and weighted significantly less than same sex-matched controls. Conversely, male subjects with stereotypic movement disorder, but not compulsive disorder, were significantly shorter and weighed significantly less than same sex controls. These findings may point to a neuroendocrine abnormality associated with repetitive movement disorders.

Adolescent↗
PubMed1996

Clomipramine treatment for self-injurious behavior of individuals with mental retardation: a double-blind comparison with placebo.

The efficacy of the serotonin (5-HT) uptake inhibitor clomipramine in the treatment of self-injurious behavior (SIB) was tested in individuals with severe and profound mental retardation. Six of the 8 subjects who completed a double-blind, placebo-controlled crossover trial exhibited a clinically significant improvement (50% or greater reduction from placebo) in the frequency of SIB. Clomipramine treatment was also associated with improvement in SIB intensity, frequency of stereotypy and compulsions, teacher ratings of stereotypy and social withdrawal, and frequency of staff intervention required for problem behaviors. Adverse effects (seizure and tachycardia/agitation) occurred in 2 of the 8 subjects. These results represent the first controlled trial of a 5-HT uptake inhibitor in the treatment of SIB in mental retardation.

Adult↗
PubMed1996

Self-restraint and self-injury: occurrence and motivational significance.

The occurrence of self-restraint was examined in a sample of 99 adults with severe or profound mental retardation who exhibited self-injury. Results showed that 46% of the sample exhibited self-restraint. A significantly higher occurrence of compulsive behaviors was found for subjects who engaged in self-injury and self-restraint when compared to self-injury subjects without self-restraint. To determine the motivational significance of self-restraint, we assessed the response to brief interruption of this behavior. Subjects who engaged in self-restraint responded more negatively to response interruption than did control subjects. These preliminary findings support the hypothesis that self-injury may be related to a compulsive behavior disorder in some individuals who self-restrain.

Adolescent↗
PubMed1996

Dyskinetic movement disorder among adults with mental retardation: phenomenology and co-occurrence with stereotypy.

We screened for the occurrence of dyskinetic and stereotypic movement disorders using item-independent screening protocols to determine whether these forms of movement disorder can be distinguished among adults with mental retardation. Stereotypies and dyskinesias were reliably distinguished in terms of topography. Tardive dyskinesia occurred in 18.2% of a cohort of individuals receiving chronic neuroleptic treatment. Stereotypic movement disorder was associated with increased dyskinesia scores and increased prevalence of tardive dyskinesia. Increased dyskinesia scores were also found for subjects exhibiting stereotypy who had been free of neuroleptic treatment for 3 years. Results indicate that dyskinesia and stereotypy are discriminable movement disorders and provide preliminary support for the hypothesis that they may be related by common mechanisms.

Adolescent↗
PubMed1996

The senior SHO rotation in Wales--a basis for BST training.

Between 1969-1992 there was a successful surgical registrar rotation in South Wales (1). This was a three-year rotation comprising two years general surgery, six months trauma and orthopaedics and six months surgical specialty. The rotation was aimed at those doctors who had completed senior house officer (SHO) posts in accident and emergency, 6-12 months general surgery and had already obtained the primary FRCS. However, with the recent recommendations of the Calman Report concerning general surgical training (2) changes to this rotation have become necessary, namely to reduce the number of surgical registrars in order to achieve a balance in numbers entering higher surgical training and to shorten the period of training to seven years with two years Basic Surgical Training (BST) and five years Higher Surgical Training (HST). A modified rotation was therefore designed and implemented in South Wales since July 1992. The previous registrar rotation was shortened to two years instead of three ensuring the pre-requirements for entry into HST and eligibility to sit the second part FRCS. The aim of this study was to assess whether the new senior SHO/BST rotation in South Wales is providing adequate training for our surgical trainees to enter into HST. We present our data as a potential basis for setting up a formal BST rotation.

Attitude of Health Personnel↗