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Biomedical subjects

M J Garvey

Publications and source records attributed to M J Garvey.

At least 19 recordsLinked to original sources
PubMed2000

Relationship of N-acetyl-beta- glucosaminidase levels to seriousness of suicide attempts.

We hypothesized that levels of N-acetyl-beta-glucosaminidase (NAG) would differ between patients making serious versus nonserious suicide attempts. The levels of NAG from 11 patients hospitalized for serious suicide attempts were compared to 5 patients whose suicide attempts were not rated serious. There was a significant difference in the mean NAG levels of the serious suicide attempters and the nonserious attempters (23 versus 52; p = 0.01). NAG may be a marker for a biological variable that is associated with the seriousness of a suicide attempt.

Acetylglucosaminidase↗
PubMed1999

How to select counsel and participate in your own defense. The defendant's perspective.

The successful defense of a medical malpractice case is a team effort between the defendant doctor and his or her attorney. However, the most common complaint voiced by physicians is the failure, real or perceived, of the selected attorney to keep them involved in the preparation of the case and its progress. To ameliorate this situation, the author explains how to participate in one's defense in a helpful and meaningful fashion.

Humans↗
PubMed1998

An association of NAG levels and a mutation of the CCK gene in panic disorder patients.

Levels of the enzyme N-acetyl-beta-glucosaminidase (NAG) and a mutation of cholecystokinin (CCK) gene appear to be independently associated with panic disorder. We explored whether there was an association of NAG levels and a CCK mutation identified in a group of panic disorder patients. NAG was measured in 12 panic disorder patients who had a mutation of the CCK gene and 17 who did not. Urine for NAG was collected at baseline and after 3 and 6 weeks of treatment. NAG levels were lower at all three times in the patients that did not have the CCK mutation. The difference between the two groups was significant at week 6 (P < 0.02), and showed a trend toward a difference at baseline (P < 0.15).

Acetylglucosaminidase↗
PubMed1997

Association of N-acetyl-beta-glucosaminidase levels with seriousness of suicide attempts.

We hypothesized that levels of N-acetyl-beta-glucosaminidase (NAG) would differ between patients making serious versus nonserious suicide attempts. The levels of NAG from 7 patients hospitalized for serious suicide attempts were compared to 3 patients whose suicide attempts were not rated serious. There was a significant difference in the mean NAG levels of the serious suicide attempters and the nonserious attempters, 25 versus 61; p = .036. Implications of this finding are discussed.

Acetylglucosaminidase↗
PubMed1997

Closure of a bronchopleural fistula using decalcified human spongiosa and a fibrin sealant.

Bronchopleural fistulas associated with empyema can occur as a life-threatening sequelae after pulmonary resection, most frequently occurring after pneumonectomy. With the use of the flexible bronchoscope, the bronchopleural fistula of a 62-year-old critically ill woman was permanently sealed with a fibrin sealant and a small section of demineralized human spongiosa. Closure of bronchopleural fistulas with the application of fibrin sealant plus human spongiosa may offer a valuable addition to the armament of therapeutic alternatives.

Adenocarcinoma↗
PubMed1997

Cognitive impairment in the euthymic phase of chronic unipolar depression.

Cognitive functioning in the nonsymptomatic phase and the long-term cognitive outcome of patients with mood disorders are both heuristic and important clinical issues in the study of mood disorders. Literature findings are inconsistent because of design confounds. We tried to address these issues while controlling for several confounds including age, education, gender differences in neurobehavioral functioning, and diagnosis. Nonsymptomatic patients with a history of chronic unipolar depression and bipolar affective disorder and healthy male individuals were administered neuropsychological tests to assess attention, visual-motor tracking, executive abilities, and immediate verbal memory. Subjects had comparable depression scores at the time of testing. Disease duration was 7.5 years (SD 5.1) for unipolar and 11 years (SD 7.3) for bipolar patients. Unipolar patients were more impaired than healthy normal comparison subjects on measures of visual-motor sequencing (Trail Making Test A, p < .05), executive function (Trail Making Test B, Stroop Test Color/Word Trial, p < .05), and immediate memory and attention (CERAD 1st trial, WAIS Digit Symbol subtest, p < .05). Differences between bipolar patients and normal comparison subjects did not reach significance in any of the selected measures. Male patients with a history of chronic unipolar disorder are at risk for cognitive impairment in the nonsymptomatic phase of their disease. Cognitive disturbance is the type seen with prefrontal dysfunction and may be assessed with standard neuropsychological assessments.

Bipolar Disorder↗
PubMed1996

Preliminary confirmation of the proposed link between reward-dependence traits and norepinephrine.

The tridimensional theory of personality posits that traits belonging to a personality spectrum called 'reward dependence' are determined in part by the neurotransmitter norepinephrine (NE). We hypothesized that urinary levels of the NE metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG) would be significantly correlated to the reward dependence score on the Tridimensional Personality Questionnaire (TPQ). Twenty-seven never psychiatrically ill subjects collected urine for MHPG measurements and completed the TPQ. There was a significant correlation between the reward dependence score and the level of MHPG. MHPG levels was not associated with the other two personality dimensions, novelty seeking and harm avoidance. This preliminary study supports the hypothesis that reward-dependence traits are in part determined by NE.

Adult↗
PubMed1996

Urinary levels of 3-methoxy-4-hydroxyphenylglycol predict symptom severity in selected patients with unipolar depression.

There are preliminary biological data that support the validity of subtyping depressed patients by family history into depressive spectrum disease (DSD) and non-DSD groups. We hypothesized that a relatively homogeneous group of depressed patients might show an association between symptom severity and the norepinephrine metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG). Twenty-four patients with non-DSD depression showed a relationship between urinary levels of MHPG and the severity of several depressive symptoms. There were no associations between MHPG and symptom severity for 38 DSD patients. This study provides additional support for the validity of family history approaches to subtyping depression. The data also suggest that norepinephrine may be involved in some way in the pathogenesis of symptoms in non-DSD depression.

Adult↗
PubMed1996

Low levels of MHPG in depressive spectrum patients.

There is some preliminary laboratory support for the proposed classification of depressed patients into depressive spectrum disease (DSD) and non-DSD. This study explores whether there is a difference in the levels of the norepinephrine metabolite, MHPG, in DSD and non-DSD patients. MHPG levels from 38 DSD patients were compared with 24 non-DSD patients. After controlling for the influence of age and gender on MHPG, the DSD patients had MHPG levels that were lower than non-DSD patients; 1655 +/- 90 mg/day vs. 1965 +/- 174 mg/day, respectively; P = 0.05. This study provides additional laboratory support for the DSD subtype. Possible implications of this finding are discussed.

Adult↗
PubMed1996

Association of levels of N-acetyl-beta-glucosaminidase with severity of psychiatric symptoms in panic disorder.

Urinary levels of N-acetyl-beta-glucosaminidase (NAG) were measured in 58 patients with panic disorder. NAG levels were found to be significantly related to the severity of 23 of 72 mood states, measured by the Profile of Mood States, which were grouped in three categories: hostility or irritability, sadness, and panic. A similar result was found in a previous study of bipolar patients. NAG levels were also related to scores on the Hamilton Rating Scale for Anxiety and the Sheehan Patient-Rated Anxiety Scale. It is speculated that NAG could be a marker for serotonin.

Acetylglucosaminidase↗
PubMed1996

Do low levels of MHPG in depressive spectrum patients normalize after successful treatment?

Patients with depressive spectrum disorder (DSD) have low levels of the norepinephrine metabolite, MHPG. This study examines what happens to the low levels of MHPG following improvement of depressive symptoms. Sixteen depressed patients with a family history consistent with DSD showed no change in MHPG after 6 weeks of treatment. This was true for both treatment responders and nonresponders. The lack of change in low levels of MHPG suggests that reduced norepinephrine turnover is a biological trait of DSD patients. Implications of this finding are discussed.

Adult↗
PubMed1996

Diazepam versus alprazolam for the treatment of panic disorder.

BACKGROUND: Alprazolam has proven efficacy as a treatment for panic disorder, but the place of other benzodiazepines is less well established. METHOD: To compare the efficacy and tolerability of diazepam and alprazolam for the disorder, a placebo-controlled, double-blind trial was undertaken in two sites. Two hundred forty-one subjects with panic disorder or agoraphobia with panic attacks were randomly assigned to flexible doses of diazepam, alprazolam, or placebo for 8 weeks. RESULTS: At the end of the trial, over 60% of subjects taking either diazepam or alprazolam were at least moderately improved compared with less than 30% of those taking placebo. On all measures of efficacy, subjects taking diazepam and alprazolam showed an equally favorable response. Despite some sedation early in the trial, both drugs were tolerated well. More severely ill subjects responded less well to either benzodiazepine. CONCLUSION: The results indicate that diazepam is an effective alternative to alprazolam for the treatment of panic disorder.

Adult↗
PubMed1995

Relationship of generalized anxiety symptoms to urinary 5-hydroxyindoleacetic acid and vanillylmandelic acid.

Urinary levels of the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) and the norepinephrine metabolite vanillylmandelic acid (VMA) were measured in 45 patients with generalized anxiety disorder. Multiple regression analysis demonstrated that the severity of several anxiety symptoms was predicted by levels of 5-HIAA and VMA. These data are consistent with the proposal that serotonin and norepinephrine may be involved in the pathophysiology of anxiety.

Adult↗
PubMed1995

The association of urinary 5-hydroxyindoleacetic acid and vanillylmandelic acid in patients with generalized anxiety.

There is evidence that serotonin and norepinephrine are in some way involved in the pathophysiology of anxiety disorders. Urinary levels of the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) and the norepinephrine metabolite vanillylmandelic acid (VMA) were measured in 46 patients with generalized anxiety disorder. There was a significant association between urinary levels of 5-HIAA and VMA: r = 0.79; p = 0.0001. Possible implications of this finding are discussed.

Anxiety Disorders↗
PubMed1995

The association of the serotonin metabolite, 5-HIAA, to the lysosomal enzyme N-acetyl-beta-glucosaminidase.

Twenty-one medication-free patients with generalized anxiety disorder (GAD) collected urine samples for 5-hydroxyindoleacetic acid (5-HIAA) and N-acetyl-beta-glucosaminidase (NAG). Nine patients with no comorbid psychiatric diagnosis showed a significant association between 5-HIAA and NAG, r = -0.683, p = 0.04. The possibility that NAG could be a marker for serotonin metabolism is discussed.

Acetylglucosaminidase↗
PubMed1995

Topical fumagillin in the treatment of microsporidial keratoconjunctivitis in AIDS.

OBJECTIVE: To report microsporidial keratoconjunctivitis in a patient infected with HIV who was treated with topical fumagillin. CASE SUMMARY: A 37-year-old white man who was experiencing redness, pain, irritation, decreased vision, and a foreign body sensation occurring in both eyes was referred to the ophthalmology clinic. The patient had a medical history significant for AIDS, Pneumocystis carinii pneumonia, and Cytomegalovirus retinitis. Conjunctival smears were taken and stained positive for the presence of Microsporidia. The patient was diagnosed with bilateral microsporidial keratoconjunctivitis and fumagillin therapy was initiated. After 5 days of therapy, the patient reported significant improvements characterized by a decrease in blurred vision with only slight blurring in the left eye, decrease in headache, and decreased foreign body sensation. The patient continued topical fumagillin therapy for more than 14 months, with only slight blurring in the left eye and no apparent ocular toxicity as a result of fumagillin therapy. DISCUSSION: Although rare in occurrence, increasing numbers of documented microsporidial infections are being reported in the medical literature, particularly in individuals who are seropositive for HIV. Clinicians need to be cognizant of microsporidial keratoconjunctivitis as another opportunistic infection in this patient population. CONCLUSIONS: Although a curative agent has yet to be discovered, fumagillin represents a safe, effective, low-cost, topical agent for the treatment of microsporidial keratoconjunctivitis.

AIDS-Related Opportunistic Infections↗