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Biomedical subjects

N Rowland

Publications and source records attributed to N Rowland.

At least 19 recordsLinked to original sources

Lateral videofluoroscopy: a modification to aid in velopharyngeal assessment and measurement.

To overcome the difficulty of obtaining adequate videofluoroscopic images with small children because of lack of cooperation and their inability to keep their heads still and correctly rotated, a 3D View-Master was attached to the x-ray table. Its use greatly increased the ability to conduct lateral videofluoroscopies of small children by improving patient compliance, stabilizing rotation and reducing unwanted head movement, and by standardizing magnification.

Child, Preschool

Identification of alcohol-related problems in a general hospital setting: a cost-effectiveness evaluation.

Alcohol is a major cause of morbidity and mortality. The prevention of alcohol problems would result in significant savings to the NHS and society. Screening is an important step in preventing problems. This study examines the costs of screening patients for alcohol problems. Over a 21-month period doctors, nurses and a specialist worker screened medical and orthopaedic admissions to the York District Hospital. A cost-effectiveness analysis of screening data was carried out. Costs were measured by time taken to screen and the relative costs of employing different occupational groups. Effects included the screening rates of each occupational group and those identified as at risk. Results suggested a greater positive case identification rate could be achieved by employing a specialist worker, but at greater cost. The cost-effectiveness evaluation helps clarify the resource consequences of a screening programme and can be a useful aid in the decision-making process.

Alcoholism

Alcohol education for patients: some nurses need persuading.

Nurses form the largest group of health care workers and given their repeated contact with patients are in a good position to develop their health education role. Alcohol is the third major cause of morbidity and mortality and alcohol education is an important part of patient care. As part of a prospective study to assess the effects of early identification and education for those patients drinking to excess, we assessed nurses' attitudes towards screening patients for alcohol related problems, their knowledge of what constituted harmful drinking and their views on alcohol education for those at risk of harming their health. While nurses themselves were receptive to alcohol education a sizeable proportion remained unconvinced of the long term benefits of education for those who drink to excess. Alcohol researchers and health education still have some way to go in persuading health professionals of the benefits of incorporating health education into their everyday practices.

Alcoholism

Can general practitioners counsel?

It has been suggested that general practitioners are in a prime position to counsel patients presenting with psychosocial problems. While many doctors use counselling skills in their consultations few have received training in counselling and the difference between the use of counselling skills and the process of counselling is not always understood. This paper examines the differences between counselling and counselling skills and compares the role of doctors and counsellors. It is concluded that there is a need for trained counsellors to work alongside general practitioners and that this is of benefit to patients and all members of the primary care team.

Counseling

Teaching doctors to take alcohol histories: a limited success story.

Doctors often lack the knowledge and skills to identify and assess those who drink to excess and are unsure of what their preventive and educational role should be. As part of a prospective study of early identification and intervention with general hospital patients who drink to excess, we were interested to discover whether brief education about alcohol-related problems and training in the use of a quick and efficient alcohol screening questionnaire would improve doctors' alcohol history-taking and thus their identification of those at risk. The case notes of every fifth admission to orthopaedic and medical wards at the York District Hospital were studied before and after doctor education. Recorded information on both alcohol and tobacco increased over the period reviewed, reflecting perhaps doctors' growing awareness of the health-threatening aspects of these drugs. While there was no major change in doctors' alcohol history-taking, with two thirds of case notes making no mention, or only vague mention, of alcohol, there was a significant post-education increase in the number of patients for whom detailed drinking histories were recorded, but no significant changes in tobacco histories. Small but significant improvements such as these are important in view of the size of the medical problems arising from the use of alcohol.

Alcoholism

Abnormal gait sequence in locomotion after atropine treatment of catecholamine-deficient akinetic rats.

Excessive, abnormal locomotion occurs after a high dose (25-50 mg/kg) of atropine sulfate to rats already akinetic due to catecholamine deficiency from intraventricular administration of 6-hydroxydopamine. This abnormal locomotion involves an abnormal gait sequence [right (R) hindleg (H), left (L) foreleg (F), LH, RF] instead of the normal gait sequence (RH, RF, LH, LF). In such animals atropine progressively (i) decreases hindleg step size, (ii) decreases arching of the trunk, and (iii) increases foreleg step size. These factors combine to change the ratio of front/hind body support. If the body stretches too far and the hindleg step is too small, a given hindleg step supports insufficient weight to remove weight from the ipsilateral foreleg; consequently, the opposite foreleg must execute the next step, producing the abnormal gait sequence. Thus, atropine affects gait sequence indirectly; it acts on at least three variables that affect how body weight is distributed and shifted during locomotion. To maintain stability during such locomotion, gait sequence is appropriately altered.

Animals

Voluntary exercise, food intake, and plasma metabolites in streptozotocin-diabetic Syrian hamsters.

Diabetes mellitus was induced in Syrian hamsters by treatment with streptozotocin. The efficacy of and survival from this treatment are compared across several drug regimens, and in exercising versus sedentary hamsters. Stable diabetes, with plasma glucose levels typically below 400 mg/dl, is accompanied by a decrease of approximately 50% in voluntary wheel running in a 14L:10D cycle. Wheel running in diabetics is, however, almost completely abolished in continuous light. The diabetic hamsters are hyperphagic on chow, eating about 60% more than controls, exclusively by increasing the size of individual meals. Their intake is normalized on a high fat diet. The high fat diet greatly exacerbates the extant ketonemia in diabetics, and produces hypertriglyceridemia. Exercise has no apparent effect on plasma metabolic fuels of diabetic hamsters.

Animals

Failure of 2-deoxy-D-glucose to stimulate feeding in deermice.

Deermice (Peromyscus maniculatus) did not increase their food intake above baseline following treatment with 2-deoxy-D-glucose (2DG, 500 or 1000 mg/kg). They did eat more following food deprivation or treatment with insulin at a high dose (100 U/kg). House mice (Mus musculus) showed hyperphagia to 2DG, low dose of insulin (5 U/kg) and deprivation.

Animals

Preference for high carbohydrate over various high fat diets by diabetic rats.

Streptozotocin-diabetic male rats were hyperphagic relative to nondiabetic controls when offered only high carbohydrate (CHO) laboratory chow. Diabetics and controls ate about the same amount of high fat diets made from 67% w/w chow and 33% either coconut oil (saturated) or safflower oil (unsaturated). However, when offered a simultaneous choice of high fat diets and chow, nondiabetics and low dose (35 mg/kg) streptozotocin-diabetics showed a preference for the high fat diet: in contrast the high dose (65 mg/kg) streptozotocin diabetics developed a preference for chow. When pairs of isocaloric synthetic diets were offered, diabetics again preferred low fat/high CHO to high fat/low CHO diets, but the actual intake of fat was not constant across different diet pairs. Nondiabetics also selected away from the high fat diets in these synthetic diet pairs, even when saccharin was added to the high fat diet in an attempt to equate its sweetness with that of the paired low fat-high CHO diet. Plasma ketone levels of diabetics during obligatory high fat diet consumption were negatively correlated with their subsequent preference for the fat diet over simultaneously-offered chow. These data show that strong dietary preferences do not develop for fat in diabetics and suggest that high fat diets do not have net beneficial postingestional effects in these rats.

Animals

Effects of initial body weight on anorexia and tolerance to fenfluramine in rats.

The initial anorexia and development of tolerance to dl-fenfluramine was examined in rats with graded pretreatment body weight losses. Fenfluramine strongly attenuated food intake on the first test day in all weight groups and the magnitude of the initial anorexia did not differ between groups. The time course of anorectic tolerance was also similar in each of the groups. The results do not support a strict "set point" hypothesis according to which the tolerance to fenfluramine anorexia is an artifact of decreasing body weight and/or concurrently increasing relative food deprivation.

Animals

Stereotyped behavior and diabetes mellitus in rats: reduced behavioral effects of amphetamine and apomorphine and reduced in vivo brain binding of [3H]spiroperidol.

Rats made diabetic with streptozotocin showed decreased stereotyped behaviors following administration of amphetamine or apomorphine. Spontaneous activity in an open field was lower in diabetics than in controls, but a low dose of apomorphine produced equivalent fractional decreases in activity in both groups. In vivo accumulation of amphetamine and apomorphine was generally similar in both groups: Reduced tissue access did not appear to be responsible for the decreased behavioral effects of these agents. The in vivo accumulation of spiroperidol in several brain regions was generally less in diabetics than in controls. These data are discussed in terms of altered catecholamine biochemistry and behavior in diabetics.

Animals

Inhibition of gastric emptying by peripheral and central fenfluramine in rats: correlation with anorexia.

Rats treated acutely with i.p. fenfluramine showed a profound inhibition of emptying of a chow meal from the stomach. This inhibition was attenuated by previous chronic treatment with fenfluramine. Tolerance to the gastric slowing occurred with as few as 2-4 prior injections, a time course which closely matches tolerance to the anorectic effects of the drug. Cerebroventricular injections of fenfluramine and norfenfluramine in anorectic doses also inhibited gastric emptying.

Animals

Nycthemeral variation in brain monoamines of Syrian hamsters: relation to activity and energy homeostasis.

No significant time-of-day variations were found in whole brain content of various monoamines and metabolites of sedentary Syrian hamsters. In a second experiment, norepinephrine and serotonin levels in diencephalon were higher in the morning than the evening of both sedentary and voluntarily exercising hamsters. In telencephalon, levels of most transmitters were elevated in the evening, with the most dramatic rises in the metabolites 3,4-dihydroxyphenylacetic acid and 5-hydroxyindoleacetic acid. Again, in most instances, there was no difference between sedentary and exercise conditions.

Animals

Metabolic fuel homeostasis in Syrian hamsters: nycthemeral and exercise variables.

The food intake and growth of male and female golden hamsters, with and without access to running wheels, were measured under several conditions. These included different seasons, photoperiods and diets. Chow-fed males in wheels invariably had slowed weight gain and showed little hyperphagia relative to sedentary controls. One group of exercising female hamsters, fed high fat diet, grew faster than sedentary controls. The food intake of both exercising and sedentary groups was distributed evenly through the day/night cycle, but the exercising animals took smaller, more frequent meals at night. The nycthemeral variations in plasma glucose, triglycerides, free fatty acids and liver glycogen were quite small in sedentary hamsters. In exercising hamsters, however, liver glycogen was elevated in the late daytime and depleted in the mid-to-late night. In vivo lipogenesis rates in white and brown adipose and liver were elevated by day in the exercising compared to sedentary hamsters, and were lower at night in both groups. It appears that in exercising hamsters, and to a lesser extent sedentary hamsters, the day phase is one of inactivity and fuel storage, and the night phase is one of exercise and fuel mobilization.

Animals

Effects of chronic cold exposure on wheel running, food intake and fatty acid synthesis in Syrian hamsters.

Mesocricetus auratus with established wheel running in a thermoneutral environment (23 degrees C) showed an immediate suppression of running when placed in a cold room at 4 degrees C. This suppression was seen in three separate studies and lasted at least 1 month. Food intake of these hamsters rose within 48 hr in the cold, and body weight was maintained. In contrast, hamsters which had been sedentary in the 23 degrees C room showed a slower rise in food intake in the cold and sustained a chronic drop in body weight. In vivo fatty acid synthesis rates were greatly elevated in white and brown adipose tissue, but not liver, of exercise versus sedentary hamsters after 1 month in the cold, despite the relative inactivity of both groups throughout the cold exposure. Previous exercise training predisposes hamsters to efficient energy storage in the cold. The energy demand of the cold environment may be responsible for the decreased voluntary running.

Adipose Tissue

Anorexia and brain serotonin: development of tolerance to the effects of fenfluramine and quipazine in rats with serotonin-depleting lesions.

The acute and chronic effects of the "serotonergic anorectics" quipazine and dl-fenfluramine were examined in rats with substantial and specific depletions of brain 5-hydroxytryptamine (5-HT) induced by 5,7-dihydroxytryptamine (5,7-DHT). A "dessert" test which did not involve food deprivation was used to assess anorexia. Markedly increased sensitivity to the L-5-HTP-induced behavioral syndrome in 5,7-DHT-lesioned rats indicated postsynaptic 5-HT receptor supersensitivity. We found low (2 mg/kg) and intermediate (5 mg/kg) doses of fenfluramine, a putative presynaptic agent, were more effective in producing anorexia in lesion rats versus controls. A higher dose of fenfluramine (10 mg/kg) was less effective in lesion rats, suggesting that high dose and low dose fenfluramine anorexia are mediated by different mechanisms. We found quipazine, a putative 5-HT postsynaptic agonist, in a dose range of 2-10 mg/kg, to be no more effective in producing anorexia in lesion rats compared to controls. The development of tolerance to both fenfluramine and quipazine anorexia was similar for lesion and control rats showing that an intact brain 5-HT system is not necessary for tolerance. Tolerance to the "behavioral syndrome" induced by high doses of these agents developed rapidly in controls but not at all in lesion rats. This suggests that the behavioral syndrome and anorexia are independent effects of fenfluramine and quipazine. These results also challenge the popular notion that the primary anorectic action of fenfluramine is via brain serotonin.

5,7-Dihydroxytryptamine