Botulinum toxin type B in the treatment of cervical dystonia: a pilot study.
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Adult↗
Biomedical subjects
M Hayward
Publications and source records attributed to M Hayward.
Stress and alcohol: the moderating effect of chronic stress on the acute stress--intoxication relationship.
OBJECTIVE: The present study evaluated whether chronic stress levels moderated the impact of laboratory stressors on subjective and behavioral responses to alcohol. METHOD: Healthy volunteers (N = 60; 30 male) completed measures of background stress levels (e.g., major life events). In addition, subjects were exposed to two laboratory stressors (i.e., cold pressor or film stressor task) or a control condition after consuming a 0.7 g/kg dose of alcohol. RESULTS: Regression analyses showed that the combination of high background stress levels and exposure to a lab stressor reduced two measures of perceived intoxication (i.e., Sensation Scale, Visual Analog Intoxication Scale). CONCLUSIONS: These data are consistent with a biobehavioral model of alcohol use where acute and chronic stressors are associated with a diminished response to alcohol. The possible mechanisms that may underlie this sobering effect include stress-related cognitive deficits and situation specific tolerance associated with high chronic stress levels.
Adult↗
Parkinsonism induced by solvent abuse.
We report the first description of a patient with parkinsonism induced by solvent abuse. Our patient developed parkinsonism acutely, following heavy abuse of lacquer thinner. Her clinical deficits were indistinguishable from idiopathic parkinsonism (Parkinson's disease) and she responded to levodopa. Parkinsonism has persisted for more than 3 months. Brain computed tomography was normal. Positron emission tomographic studies showed normal fluorodopa uptake and reduced raclopride binding, indicating an unusual disturbance of striatal dopaminergic function. This patient suggests that organic solvents may cause parkinsonism in susceptible individuals.
Administration, Inhalation↗
Key factors in improving surgical resources.
The health care environment across the country is undergoing unprecedented uncertainty and change, so it is imperative that hospital leaders develop processes that enhance their organization's ability to adapt to new realities and directions. The key factors in maximizing the utilization of resources to meet community demand involve corporate changes and active support from medical, nursing, professional and support staff. This article describes the methods adopted by one community hospital to improve the utilization of surgical resources, with particular emphasis on the process developed for allocating Operating Room time to support corporate priorities.
Appointments and Schedules↗
Effect of stress on perceived intoxication and the blood alcohol curve in men and women.
To determine the influence of stress on intoxication and blood alcohol concentration (BAC) 60 healthy male and female volunteers were exposed to a cold pressor test, distressing film, or control condition after consuming a moderate dose of alcohol. Two measures of perceived intoxication suggested a sobering effect of acute stressors. In addition, Ss viewing the distressing film showed longer latency to peak BAC than Ss in the control condition. As BAC began to fall, the cold pressor test initially increased rate of alcohol elimination. These stress-induced changes in intoxication and the BAC curve support a biobehavioral model in which stress may increase alcohol use partly because it attenuates alcohol's psychopharmacological impact.
Adult↗
Normal CAG repeat length in the Huntington's disease gene in senile chorea.
There is a widely held belief that most patients presenting with senile chorea have late-onset Huntington's disease (HD) with an unknown family history. We measured CAG trinucleotide repeat expansion in the HD gene in four patients with a clinical presentation of senile chorea and found that CAG repetition lengths were normal. These findings support senile chorea as being a distinct clinical entity that is nosologically separate from late-onset HD.
Aged↗
Continuous c-fos expression precedes programmed cell death in vivo.
The development of a multicellular organism involves a delicate balance among the processes of proliferation, differentiation and death. Naturally occurring cell death aids tissue remodelling, eliminates supernumerary cell populations and provides structural elements such as hair and skin. In the nervous system, selective cell death contributes to the formation and organization of the spinal cord and sympathetic ganglia, retina and corpus callosum. But cell death also occurs in several neuropathological conditions, such as amyelotrophic lateral sclerosis and Alzheimer's disease. Therefore an elucidation of the mechanisms responsible for cell death is critical for an appreciation of both normal development and neuropathological disorders. Using a fos-lacZ transgenic mouse, we provide evidence showing that the continuous expression of Fos, beginning hours or days before the morphological demise of the cell, appears to be a hallmark of terminal differentiation and a harbinger of death.
3T3 Cells↗
Transdermal nicotine patches with low-intensity support to aid smoking cessation in outpatients in a general hospital. A placebo-controlled trial.
OBJECTIVE: To assess whether transdermal nicotine patches combined with low-intensity support can help outpatients in a general hospital stop smoking. DESIGN: Randomized, double-blind, placebo-controlled trial with 12 weeks of follow-up. SETTING: Department of Thoracic Medicine in an inner-city public general hospital, London, England. SUBJECTS: Two hundred forty-eight outpatients in a general hospital, who smoked at least 10 cigarettes per day (the majority were being treated for smoking-related diseases), referred by clinicians at the hospital. INTERVENTION: Brief advice to stop smoking and daily application of transdermal nicotine patches (delivering 15 mg over 16 hours) or placebo, with follow-up appointments at 1, 3, 6, and 12 weeks, with a doubling of the dosage for continuing smokers at week 1. MAIN OUTCOME MEASURE: Sustained abstinence from tobacco from week 3 to week 12 validated with measurement of expired-air carbon monoxide concentration at weeks 3, 6, and 12. RESULTS: Twenty-nine (23.4%) of 124 subjects assigned to the nicotine group were validated as having abstained from smoking at both weeks 3 and 6, compared with 16 (12.9%) of 124 subjects receiving placebo (P = .008). At week 12, 22 (17.7%) of the subjects in the nicotine group were validated as having abstained at all three points as were 15 (12.1%) of the subjects in the placebo group (P = .058). CONCLUSION: Transdermal nicotine patches combined with low-intensity support are effective in helping outpatients in a general hospital stop smoking but do not prevent relapse after 6 weeks.
Administration, Cutaneous↗
A prototype erodible mask delivery system for the excimer laser.
PURPOSE: The authors developed an erodible mask delivery system for the argon-fluoride 193-nm excimer laser, which offers the possibility of correcting hyperopia and astigmatism as well as myopia. METHOD: Masks were made of polymethylmethacrylate on a quartz window, with intended corrections for myopia and hyperopia of 2.5 and 5 diopters (D). Ablations using the mask and control ablations using an expanding diaphragm were performed in 30 eyes of 15 pigmented rabbits with an Excimed UV200 laser (Summit Technology, Inc, Waltham, MA). The rabbits were followed for 134 days with regular biomicroscopy and retinoscopic examination by two observers. RESULTS: Ablations with the mask to correct myopia were successful and produced stable corrections, although the higher-power mask produced undercorrections. Hyperopic masks produced paradoxic myopic corrections, possibly due to the lack of a transition zone at the edge of the mask. Corneas ablated with the mask had less sub-epithelial haze than those ablated with the diaphragm at all examinations. Results of histopathologic examination showed epithelial hyperplasia over the ablation zone in all eyes. Dichlorotriazinyl aminofluorescein collagen staining showed subepithelial new collagen in all eyes, but there was no relation between the depth of ablation at any point on the cornea and the amount of new collagen deposited there. CONCLUSIONS: Myopic ablations are feasible with the erodible mask, although additional calibration is needed. Hyperopic ablations were unsuccessful with the current design. Corneas ablated with the mask may be clearer than corneas ablated with the diaphragm, possibly due to a smoother ablated surface. Regression of effect after laser ablation in the rabbit model is likely due more to epithelial hyperplasia than to stromal remodeling.
Animals↗
Improved care of patients with diabetes through telecommunications.
This project tested the importance of enhanced information transfer of home monitoring results to health care providers. The study tested whether computer-assisted communication of medical information between the chronic care patient and the physician can result in health care benefit. The information tools were constructed/adapted as a test of this hypothesis for diabetes mellitus. Patients connected a glucometer to an intelligent modem weekly for six to nine months. Graphical and mathematical tools extracted and emphasized the information content of the home monitoring data arriving at the central site. Data smoothing, trend analysis, and calculation of quality control statistics were incorporated into a graphical time series oriented report that was used by the health care provider during an outpatient visit. The integrated home monitoring system was tested on 20 patients with diabetes in a double cross-over design over a 15-month period. A significant improvement in serum glucose control as measured by glycated hemoglobin was shown in the study group, but not in the control group.
Algorithms↗
Tc HMPAO-labelled white cell scintigraphy in Cröhn's disease of the small bowel.
99mTechnetium-hexamethyl propylene amine oxime (99mTc HMPAO) white cell scintigraphy is increasingly used in the investigation of inflammatory bowel disease. It is now an accepted technique in the assessment of patients with colitis, although its role in small bowel is less clear. A retrospective study was performed on patients with jejunal and ileal Cröhn's disease to assess the sensitivity, reliability and usefulness of this technique in small bowel disease. Tc HMPAO scintigraphy was compared with barium studies, clinical outcome and, where available, subsequent histology. Good correlation between this technique and barium studies was found in 14 out of 18 patients and additional information was provided in two patients. A single false positive scan highlights the importance of early scanning in avoiding errors of interpretation due to the normal hepatobiliary excretion of activity that occurs with this pharmaceutical.
Adult↗
Improved diabetic prognosis following telecommunication and graphical processing of diabetic data.
The thesis that an integrated telecommunications/reporting system would affect diabetic prognosis was tested. Over fifteen months a double crossover study compared traditional diaries versus graphical display of telecommunicated blood glucose data. Significant drops in glycohemoglobin were observed in both groups during the telecommunications period, while no significant drops were observed in the groups while diaries were employed.
Blood Glucose Self-Monitoring↗
Joint venture arrangement for RN to BSN. A model of synergy between academia and service.
The joint venture between or among educational and practice institutions is fast becoming the norm in nursing education and practice. Authors Bargagliotti, Jones, Trygstad, Hayward, Crow, and Bower, describe one such program enabling RNs to pursue the BSN degree.
Advertising↗
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↗
Evaluation of intense renal parenchymal activity ("hot kidneys") on bone scintigraphy.
The bone scintigrams of 600 patients performed over a 12-month period were reviewed. Thirty-six demonstrated abnormalities of the urinary tract of which six cases of intense renal parenchymal activity ("hot kidneys") were found. Two cases were related to treatment with the new antineoplastic agent mitoxantrone. In one patient it was related to treatment with calcitonin. Neither of these associations has been previously reported. Recognized causes of hypercalcemia and recent radiotherapy were present in two patients. No cause could be found in the final patient.
Adult↗
Identification of MARPP-58, a morphine- and cyclic AMP-regulated phosphoprotein of 58 kDa, as tyrosine hydroxylase: evidence for regulation of its expression by chronic morphine in the rat locus coeruleus.
Previously, we have identified a number of morphine- and cyclic AMP-regulated phosphoproteins (MARPPs) in the rat locus coeruleus (LC) and other brain regions. We now show that one of these phosphoproteins, a 58 kDa protein designated MARPP-58, is tyrosine hydroxylase. First, MARPP-58 comigrates with immunolabeled, immunoprecipitated, and purified tyrosine hydroxylase on 1- and 2-dimensional electrophoresis. Second, MARPP-58, immunoprecipitated tyrosine hydroxylase, and purified tyrosine hydroxylase yield identical 1-dimensional phosphopeptide maps. Third, MARPP-58 exhibits a regional and subcellular distribution in brain consistent with tyrosine hydroxylase. Identification of MARPP-58 as tyrosine hydroxylase made it possible to determine whether increases in MARPP-58 phosphorylation induced by chronic morphine in the LC reported previously are associated with alterations in enzyme activity and expression in this brain region. We show that chronic treatment of rats with morphine increases levels of tyrosine hydroxylase activity, immunoreactivity, and mRNA in the LC. Induction of the enzyme by chronic morphine was blocked by concomitant treatment of rats with the opiate receptor antagonist naltrexone, indicating that morphine produces this effect through the activation of opiate receptors. Consistent with previous observations that the chronic morphine-induced change in MARPP-58 phosphorylation is specific to the LC, changes observed in enzyme activity, immunoreactivity, and mRNA were not observed in a number of other brain regions studied. The results indicate that chronic morphine regulates the expression of tyrosine hydroxylase specifically in the LC and suggest that such regulation reflects long-term adaptations of LC neurons to chronic morphine at the level of gene expression.
Animals↗
Corticosterone differentially regulates the expression of Gs alpha and Gi alpha messenger RNA and protein in rat cerebral cortex.
The possibility that glucocorticoids regulate specific guanine nucleotide binding regulatory proteins (G proteins) was investigated in rat cerebral cortex. Corticosterone was administered to normal and bilaterally adrenalectomized rats, and hormone regulation of individual G-protein subunits was investigated in cerebral cortex in three ways: (i) immunoblot analysis of subunit protein, (ii) hybridization blot analysis of subunit mRNA, and (iii) ADP-ribosylation analysis of stimulatory G protein (Gs alpha) subunits. Chronic (7 days) corticosterone administration to normal rats increased levels of Gs alpha immunoreactivity, mRNA, and ADP-ribosylation but decreased levels of inhibitory G protein (Gi alpha) mRNA and tended to decrease levels of Gi alpha immunoreactivity. In contrast, levels of Go alpha and G beta immunoreactivity and mRNA were not influenced by corticosterone treatment. In adrenalectomized rats, corticosterone treatment produced a 25-50% increase in the levels of Gs alpha immunoreactivity, mRNA, and ADP-ribosylation, whereas the hormone produced a 20-35% decrease in the levels of Gi alpha immunoreactivity and mRNA. Adrenalectomy, without corticosterone replacement, produced the opposite effects on Gs alpha and Gi alpha compared to sham-operated controls, indicating that these G proteins are regulated by this class of steroid hormone under physiological conditions in vivo. The results indicate that specific G-protein subunits--namely, Gs alpha and Gi alpha--are under the coordinated control of glucocorticoids in rat brain and demonstrate that G proteins are physiological targets of glucocorticoids in vivo. Possible roles played by these G-protein responses in mediating the effects of glucocorticoids on brain function are discussed.
Adenosine Diphosphate Ribose↗
Microinjections of growth hormone-releasing factor into the medial preoptic area/suprachiasmatic nucleus region of the hypothalamus stimulate food intake in rats.
The role of the suprachiasmatic nucleus/medial preoptic area region of the hypothalamus in the expression of rat hypothalamic growth hormone-releasing factor-induced feeding in the rat was examined. Rats were tested for their 90-min food intake following microinjections of growth hormone-releasing factor (0.0, 0.01, 0.1 or 1.0 pmol) aimed at the suprachiasmatic nucleus/medial preoptic area region. It was found that growth hormone-releasing factor dose-dependently stimulated food intake with the 1.0 pmol dose being the most effective, increasing food intake by approximately 200%. Injections outside the suprachiasmatic nucleus/medial preoptic area region were ineffective. These data are taken to suggest that the suprachiasmatic nucleus/medial preoptic area region of the hypothalamus is important for the central stimulatory effects of growth hormone-releasing factor on feeding.
Animals↗