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Biomedical subjects

M Williams

Publications and source records attributed to M Williams.

At least 379 records · Page 21Linked to original sources

Nitro-L-arginine analogues. Dose- and time-related nitric oxide synthase inhibition in brain.

BACKGROUND AND PURPOSE: The purpose of the present study was to measure cortical nitric oxide synthase (NOS) activity and determine the appropriate doses of N omega-nitro-L-arginine methyl ester (L-NAME) or N omega-nitro-L-arginine (L-NNA) for near-complete enzyme inhibition in dogs, cats, and pigs. We anticipated that NOS inhibition was dose- and time-dependent and questioned if the dose-response relationship was related to the specific drug or animal species. METHODS: Saline or L-NAME or L-NNA in escalating doses was administered to pentobarbital-anesthetized pigs, dogs, and cats. Brain temperature and arterial blood gas, hemoglobin, and blood pressure levels were maintained within the physiological range. Cortical tissue was biopsied at baseline and 30, 120, and 360 minutes after agent administration for measurement of NOS activity by isotopic assay of the conversion of [14C]arginine to [14C]citrulline. RESULTS: L-NAME produced > 70% enzyme inhibition at a dose of 20 mg/kg across the species tested. Arterial blood pressure was elevated at 30 minutes after L-NAME treatment. However, consistent decreases in brain NOS activity required a longer period of time. Near-complete inhibition was apparent in most animals by 120 minutes and persisted for 6 hours after administration. A smaller dose of L-NNA was required for > 70% enzyme inhibition in the cats and dogs (10 mg/kg). Near-complete NOS inhibition was evident in most animals at 30 minutes after L-NNA administration, which also persisted for 6 hours. In pigs, this same level of inhibition required 20 mg/kg. CONCLUSIONS: These results suggest that administration of L-NAME and L-NNA diminishes brain NOS activity in a dose- and time-dependent manner and that the duration of effect is at least 6 hours.

Amino Acid Oxidoreductases↗

High autonomic arousal and electrodermal orienting at age 15 years as protective factors against criminal behavior at age 29 years.

OBJECTIVE: Nothing is known about biological factors that protect a predisposed individual from becoming criminal. This 14-year prospective study tested the hypothesis that antisocial adolescents who desist from crime by age 29 have greater physiological arousal and orienting than antisocial adolescents who become adult criminals. METHOD: Physiological arousal and orienting were measured in 101 unselected 15-year-old male schoolchildren. Of these, 17 antisocial adolescents who desisted from adult crime (desistors) were matched on adolescent antisocial behavior and demographic variables with 17 antisocial adolescents who became criminal by age 29 (criminals), and 17 nonantisocial, noncriminal normal subjects. RESULTS: Desistors had significantly higher electrodermal and cardiovascular arousal and higher electrodermal orienting than the criminal group. CONCLUSIONS: This is the first study to report biological factors that protect against the development of criminal behavior. The findings suggest that individuals predisposed to adult crime by virtue of showing antisocial behavior in adolescence may be protected from committing crime by high levels of autonomic arousal and orienting.

Adolescent↗

Increased intracerebral cerebrospinal fluid spaces predict unemployment and negative symptoms in psychotic illness. A prospective study.

BACKGROUND: It has been suggested that the dimensions of cerebral ventricles are a risk factor for poor outcome in psychotic illness. METHOD: A cohort of 140 patients with functional psychoses of recent onset who had undergone CT scanning, were followed up for an average of 46 months and assessed on six dimensions of course and outcome of illness. RESULTS: Left and right sylvian fissure volumes and, to a lesser extent, third ventricular volume predicted negative symptoms and unemployment over the course of follow-up, the latter association being mediated by poor cognitive functioning. There was significant linear trend in risk over the distribution of sylvian fissure volumes in the cohort, and associations were especially evident in schizophrenic patients. No associations were found with global severity of illness, duration of hospital stay, homelessness, or affective symptoms. CONCLUSIONS: These findings support the notion that dimensions of the cerebral ventricles are a continuous risk factor for some measures of outcome in the functional psychoses.

Arousal↗

Mental illness: media perpetuation of stigma.

Content analysis of 83 newspaper articles from February 1991 to January 1993 was the chosen method to determine the role of newspapers in the portrayal of the mentally ill. Two emergent themes arose: the closure of a mental health hospital was viewed negatively; and the stereotypical perception of the mentally ill as violent and unpredictable was reinforced. Over the two year period of the study the shift in focus from the ideology of de-institutionalisation, funding issues, crisis and chaos in the mental health hospital eventuated in an emphasis on the negativity associated with mental illness.

Attitude to Health↗

Developing a system for automated monitoring of psychiatric outpatients: a first step to improve quality.

OBJECTIVE: To evaluate an automated system of quality monitoring for psychiatric outpatients. DESIGN: Cross-sectional study. SETTING: Large outpatient psychiatry clinic in Kaiser Permanente--Northern California. PARTICIPANTS: Approximately 1500 new psychiatric patients and 20 clinicians. INTERVENTIONS: This system gave clinicians data on new patients from validated instruments before their intake interviews, measured outcomes for the depressed and panic-disordered patients, and monitored the clinic's case-mix. MAIN OUTCOME MEASURES: Clinic case-mix: Axis II disorders (Personality Disorder Questionnaire--Revised); emotional, social and physical functioning (Health Status Questionnaire 2.0); Axis I symptoms (Symptom Checklist-90); depression and panic disorder (Health Outcomes Institute Modules). Clinician reaction to system (telephone interview). RESULTS: The study population was 62.4% female; 73.9% Caucasian; 70% employed; 15.9% had evidence of personality disorder; 63% reduced daily activities because of emotional problems; 18% had depression; 7% had panic disorder. Over 75% of clinicians used the data reports and found them helpful; criticism focused on questionnaire length, inadequate training, numerous false-positives, and insufficient administrative support. CONCLUSION: An automated patient monitoring system can be implemented; clinician involvement needs to be significant; more research is needed to establish the usefulness of standardized data and outcomes management.

Adult↗

Cholinergic channel activators: novel opportunities for the treatment of CNS disorders.

Negative connotations associated with the use of (-)-nicotine has limited medicinal chemistry research in the area of nAChRs [5]. However, recent evidence suggests that a diversity of nAChR subunits exist, that each subtype may be involved in mediating specific neurochemical/behaviors, and that these subtypes have a defined pharmacology that may be selectively targeted [1]. (+/-)-Epibatidine, GTS-21 and ABT-418 differentially interact with nAChR subtypes to elicit a diversity of behavioral effects including analgesia, neuroprotection and cognitive enhancement. These agents therefore represent important new pharmacological probes to dissect the nAChR subtype(s) mediating specific pharmacological responses to nAChR activation.

Animals↗

Managing quality.

This article explores the role of management in supporting and delivering quality nursing care. Clinical nurses and a number of different grades of other staff are usually the people who deliver direct 'hands on' care, but they are 'managed' by other people. The personal vagaries, attitudes and behaviours of managers can have an effect on the quality of care delivered by the staff whom they manage.

Humans↗

Phenotypic-genotypic correlation will assist genetic counseling in 4q35-facioscapulohumeral muscular dystrophy.

The wide range of severity in facioscapulohumeral muscular dystrophy (FSHD) complicates genetic advice, although onset age is youngest and severity is greatest in isolated cases. From 14 of 16 large FSHD families which are 4q35 linked, and from 25 of 34 isolated cases exhibiting a de novo D4F104S1 DNA fragment, we find a correlation between proband age at onset and FSHD-associated D4F104S1 fragment size (r = 0.56; P < 0.001), with the smallest fragments occurring in isolated cases. A 4q35-linked 38-kb fragment in one family supports scapulohumeral presentation without facial involvement as a milder late-onset variant of FSHD, and with apparent "unaffected" recombinants in small families, suggests that nonpenetrance is more likely with large fragment sizes. Our results, predicting a more limited range for severity within families, and suggesting > 85% of FSHD maps to 4q35, will facilitate genetic counseling. We propose that quantitative variation in a uniform mutation mechanism influences age at onset, but by deletion rather than expansion of DNA.

Adolescent↗

Characterization of [3H]ABT-418: a novel cholinergic channel ligand.

ABT-418 [(S)-3-methyl-5-(1-methyl-2-pyrrolidinyl)isoxazole] is a potent and selective agonist at neuronal nicotinic acetylcholine receptors (nAChRs) with cognitive enhancing and anxiolytic activities. [3H]ABT-418 was found to bind with high affinity (KD = 2.85 +/- 0.14 nM) to membranes prepared from rat brain. Binding of [3H]ABT-418 was characterized by rapid association (T1/2 = 1.4 +/- 0.3 min) and dissociation (T1/2 = 2.9 +/- 0.4 min) half-times. The pharmacology of [3H]ABT-418 binding was consistent with an interaction with the putative alpha 4 beta 2 nAChR subtype. The nAChR agonists, (-)-nicotine, (-)-cytisine and (+/-)-epibatidine, displayed a high affinity (Ki = 0.8 +/- 0.1, 0.2 +/- 0.1 and 0.05 +/- 0.01 nM, respectively) for [3H]ABT-418 binding sites, whereas among nAChR antagonists examined, only dihydro-beta-erythroidine competed with high affinity (Ki = 32 +/- 1.5 nM). Although autoradiography studies indicate that the binding distribution of [3H]ABT-418 and (-)-[3H]cytisine are largely identical, there are some brain regions including the striatum, olivary pretectal nucleus and the superior colliculus, in which [3H]ABT-418 demonstrates significantly (P < .05) less binding. The data in the present study demonstrate that [3H]ABT-418 binds with high affinity to a population of binding sites in the rat brain that have the pharmacological characteristics of neuronal nAChRs. [3H]ABT-418 may, therefore, serve as a useful radioligand to further probe the observed differences in pharmacological properties between ABT-418 and other nicotinic agonists in vivo.

Alkaloids↗

MR of cerebral aspergillosis in patients who have had bone marrow transplantation.

PURPOSE: To assess the CT and MR appearance of cerebral aspergillosis in patients who have undergone bone marrow transplantation. METHODS: The imaging and clinical data of five patients with cerebral aspergillosis were reviewed retrospectively and compared with autopsy findings. RESULTS: Lesions are often located in the basal ganglia and demonstrate an intermediate signal intensity within surrounding high-signal areas on long-repetition-time MR scans. The lesions were multiple in four of the five patients and more numerous on MR images than on CT scans. The lesions (which demonstrate no parenchymal enhancement) are consistent with acute infarcts as confirmed at autopsy. In the large lesions, there is early intravascular and meningeal enhancement, as expected in acute infarcts involving an appreciable portion of the territory of a cerebral artery. CONCLUSION: The diagnosis of early cerebral infarction in a patient considered at risk for invasive aspergillosis, even without overt pulmonary disease, is an indication to institute aggressive antifungal therapy.

Adult↗

Challenging nursing myths and traditions.

This paper was presented to the World Conference of Operating Room Nurses XI held in Hamburg. Steeped in tradition as nursing is, some observably comical traditions, myths and behaviours have been dragged into a century where they clearly don't belong. Rather like the Flintstones, an exploration of some of these aberrations provides nurses with an opportunity to laugh at themselves and benefit from it. To carry the Flintstones analogy a little further, Fred and Wilma, Barney and Betty, seem to have all the modern luxuries of life - TV, microwave and hi-fi; however these are made of stone and have very implausible operating mechanisms. What have we got in nursing and what implausible mechanisms are we perpetuating in carrying out day-to-day activities?

Attitude of Health Personnel↗

Angular cheilitis: a case for the oral physician?

It has been suggested that in the future the role of the dental practitioner increasingly will be that of the oral physician. This case report describes the difficulties encountered by a general dental practitioner while investigating and treating a patient with angular cheilitis.

Adult↗

Emergency treatment provided by an FHSA-run clinic and the effect of the October 1990 GDS contract on its use.

A retrospective study was carried out comparing the numbers of patients attending a clinic, run by the Nottinghamshire family health services authority, for emergency dental treatment, before and after the October 1990 dental contract. In 18 months prior to October 1990, 1010 patients were treated at the emergency clinic. Of these 60.4% regularly attended a dentist. During the 18-month period after October 1990, 567 patients were treated, a reduction of 44% overall. Of these 46.9% were regular attenders.

Dental Care↗

Alternative pathways for phosphatidylcholine synthesis in olive (Olea europaea L.) callus cultures.

Olive (Olea europaea L.) callus cultures were incubated with [2-14C]ethanolamine and [Me-14C]choline in order to study phospholipid synthesis. Radioactivity from [Me-14C]choline was shown to be incorporated into the phosphatidylcholine via the CDP-base pathway. [2-14C]Ethanolamine was primarily incorporated into phosphatidylethanolamine, but significant radio-activity was also detected in phosphatidylcholine, indicating the operation of a methylation route. Incubation with [2-14C]ethanolamine indicated that phosphatidylcholine and phosphatidylethanolamine incorporated radiolabel over a similar time course. This led us to investigate the possibility that phosphatidylcholine was being synthesized by a methylation pathway distinct from the direct methylation of phosphatidylethanolamine. There was extensive incorporation of [2-14C]ethanolamine into different components of the aqueous phase of the incubations, within which phospho-base derivatives of ethanolamine were prominent. These intermediates were identified and provided evidence for the operation of an alternative methylation pathway via phosphodimethylethanolamine for the biosynthesis of phosphatidylcholine in olives.

Carbon Radioisotopes↗

Distribution of NHS funds between fundholding and non-fundholding practices.

OBJECTIVES: To estimate the amount spent on specific hospital care by health agencies in 1993-4 and compare it with the resources allocated to patients registered with fundholding practices for the same type of care. To investigate whether fundholding practices and health agencies pay different amounts for inpatient care. DESIGN: Examination of hospital episode statistics, 1991 census data, and family health services authority and health agency records. SETTING: Health agencies and fundholding practices in the former North West Thames Regional Health Authority. MAIN OUTCOME MEASURES: Amount per capita allocated to inpatient and outpatient care for patients registered with fundholding and non-fundholding practices. Average specialty cost per finished consultant episode for health agencies and fundholding practices. RESULTS: The ratio of per capita funding for patients in non-fundholding practices to those in fundholding practices ranged from 59% to 87% for inpatient and day case care and from 36% to 106% for outpatient care. Average specialty costs per episode were similar for fundholding practices and health agencies. CONCLUSIONS: Fundholding practices seem to have been funded more generously than non-fundholding practices in North West Thames.

Budgets↗

The reliability of selected pain provocation tests for sacroiliac joint pathology.

OBJECTIVE: To assess the inter-rater reliability of seven pain provocation tests for pain of sacroiliac origin in low back pain patients. SUMMARY OF BACKGROUND DATA: Previous studies on the reliability of such tests have produced inconclusive and conflicting results. METHODS: Fifty-one patients with low back pain, with or without radiation into the lower limb, were assessed by one examiner and another drawn from a pool of five. Percent agreement and the Kappa statistic were used to evaluate the reliability of the seven tests. RESULTS: Percent agreement and the Kappa statistic ranged in value from 78% and 0.52 (P < 0.001) to 94% and 0.88 (P < 0.001), respectively, when results for all examiner pairs were pooled. However, two tests demonstrated only marginal reliability when performed by one pair of assessors that examined 43% of the patients. CONCLUSIONS: Five of seven tests employed in this study were reliable, the other two were potentially reliable. These tests may be used to detect a sacroiliac source of low back pain, although sensitivity and specificity studies are needed to determine their diagnostic power.

Adult↗