Search PubMed⌕ Search

Biomedical subjects

P Reed

Publications and source records attributed to P Reed.

At least 37 records · Page 2Linked to original sources

A comparison of clinical response to electroconvulsive therapy in puerperal and non-puerperal psychoses.

BACKGROUND: There is a widespread belief that puerperal psychosis is particularly responsive to electroconvulsive therapy (ECT), but research evidence for this is lacking. METHOD: We have conducted a retrospective case-note study of clinical improvement following ECT in puerperal and non-puerperal psychosis. The main outcome measure was improvement in mental state at the end of a course of ECT, rated by a blind rater on a simple four-point scale. Additional indicators of responsiveness to ECT were improvement in mental state 4 weeks after stopping ECT, duration of in-patient stay following ECT and number of ECT received. RESULTS: Women with puerperal psychosis showed greater clinical improvement than women with non-puerperal psychosis. The results were not explained by the greater preponderance of depressive illness in the puerperal group, as the same results were also found when the analysis was confined to women with a clinical diagnosis of depressive illness. CONCLUSION: These findings are the first evidence of a particular sensitivity of ECT in puerperal psychosis. However, they are preliminary and a number of explanations are possible, including good responsiveness to treatment in general. A prospective study using standardised clinical ratings and definitions of key variables is now required. CLINICAL IMPLICATIONS: Clinicians treating severe postpartum illness should continue to regard ECT as a treatment option. LIMITATIONS OF THE STUDY: The study is limited by its reliance on retrospective examination of information recorded in case notes. Ratings of clinical improvement were not standardised.

Adult↗

Treatment of newly diagnosed AML, RAEB-t or RAEB with lisofylline or placebo in addition to chemotherapy.

To determine whether the addition of lisofylline (LSF) to idarubicin (12 mg/m2 daily x 3) + ara-C (1.5 g/m2 daily x 4) affects the rates of infection, serious infection, CR or mortality during remission induction of newly diagnosed AML, RAEB-t or RAEB, we randomized 70 patients to 3 mg/kg lisofylline or placebo every 6 h i.v., to begin 6 h before the first dose of idarubicin and to continue until recovery of neutrophil and platelet counts or for 28 days, whichever came first. Eligibility required that patients be below age 71 years, have no history of abnormal counts, or chemotherapy for a prior malignancy, and have a creatinine <1.6 mg/dl and bilirubin <3.0 mg/dl. The study was double-blinded and infections were tabulated separately and independently at MD Anderson and by a three-member outside panel of experts. Logistic regression was used to assess the relative effects of treatment arm (LSF or placebo), age, performance status, treatment site (laminar air flow room or not), and cytogenetics on rates of infection and serious infection following the first course of chemotherapy, and on CR rate. There were 84% and 87% concordance between the expert panel and MD Anderson enumerations of infection and serious infections, respectively. Both analyses found no significant (P < 0.05) differences between the rates of infection, or serious infection, in the placebo and LSF groups. CR, 60-day, and overall mortality rates were similar in the two groups, as were time to neutrophil and blood count recovery and outcome once in CR. Logistic regression analyses supported the above conclusions. Severe nausea/vomiting and mucositis were more frequent in the LSF group. Our results suggest that larger studies of LSF in newly diagnosed AML, RAEB-t, or RAEB are not warranted.

Acute Disease↗

Freedom from drug interference in new immunoassays for urinary catecholamines and metanephrines.

BACKGROUND: Determination of urinary free catecholamine and total (i. e., free plus conjugated) metanephrine excretion is considered the most clinically sensitive biochemical test for pheochromocytoma. In this study, we evaluated new immunoassay methods for the measurement of these analytes for potential drug-based interference. METHODS: Urine samples collected from patients on a variety of medications were grouped by specific drug type. The significance of any difference in the free catecholamine or total metanephrine concentrations in the different groups was assessed by one-way ANOVA. A group of patients receiving no medication was included as a control (no analytical interference). Additionally, analytical accuracy, detection limit, and precision were determined. RESULTS: No significant differences were found in the concentrations of free catecholamines or total metanephrines in urine from patients taking the medications investigated and the control group: P = 0.649 (fE), 0.221 (fNE), 0.149 (tM), and 0.170 (tNM). For free catecholamines, intraassay CVs were 4.6-18%; interassay CVs were 10-25%. For total metanephrines, intraassay CVs were 9.6-27%; interassay CVs were 5. 8-22%. Detection limits were 0.009 and 0.027 micromol/L for fE and fNE and 0.119 and 0.346 micromol/L for tM and tNM, respectively. CONCLUSIONS: None of the drugs examined in this study interfered in the measurement of free catecholamines or total metanephrines by these immunoassays. The technique is easier to use, requires less equipment, and is more accessible than HPLC. In combination, these assays are suitable as initial screening tests for pheochromocytoma.

Adrenergic beta-Antagonists↗

Role of a stimulus filling an action-outcome delay in human judgments of causal effectiveness.

Experiments examined the effect of a stimulus filling a response-outcome delay on human judgments of causal effectiveness. In Experiment 1, subjects rated the effectiveness of 2 concurrently available responses. One response led to the outcome with a 75% probability, the other never led to the outcome. Ratings were higher for the former compared to the latter key, and for immediate compared to delayed outcomes. A signal presented during the delay ameliorated this deficit. Experiments 2 and 3 examined conditioned reinforcement and perceptual catalysis accounts of this effect. In both experiments, 50% of responses on each of 2 keys led to an outcome. Ratings were high, relative to an unsignaled condition, when a stimulus filled the outcome delay, and when the same stimulus followed the response but did not precede the outcome. This result is not consistent with the operation of perceptual catalysis and was shown to be the result of secondary-reinforcement-like processes rather than outcome-confusion or generalization between responses (Experiments 3, 4).

Adolescent↗

Safe house.

Explore the source record for details and available documents.

Bereavement↗

Evidence for a type 1 diabetes susceptibility locus (IDDM10) on human chromosome 10p11-q11.

A region of linkage to type 1 diabetes has been defined on human chromosome 10p11-q11 (IDDM10; P = 0.0007) using 236 UK and 76 US affected sibpairs and a 1 cM resolution microsatellite marker map. Analysis by the transmission disequilibrium test (TDT) in 1159 families with at least one diabetic child, from the UK, the US, Norway, Sardinia and Italy provided additional support for linkage at D10S193 (P = 0.006, Pc = 0.17). Notably, 5.1 cM distal to D10S193, marker D10S588 also provided positive TDT results (P = 0.009, Pc = 0.25) but the allele under analysis was also preferentially transmitted to nonaffected siblings (P = 0.0008, Pc = 0.02). This allele was positively associated in an independent UK case control study and, importantly, was neutrally transmitted in control CEPH families. These results suggest a type 1 diabetes susceptibility locus on chromosome 10p11-q11 (provisionally designated IDDM10) and demonstrate the necessity of analysis of non affected siblings in disease families, as well as analysis of control families.

Adolescent↗

Human immunodeficiency virus type 2 (HIV-2) seroprevalence and characterization of a distinct HIV-2 genetic subtype from the natural range of simian immunodeficiency virus-infected sooty mangabeys.

The extent of zoonotic infections in rural Sierra Leone, where both feral and pet sooty mangabeys harbor divergent members of the human immunodeficiency virus type 2 (HIV-2)-sooty mangabey simian immunodeficiency virus (SIVsm) family, was tested in blood samples collected from 9,309 human subjects in 1993. Using HIV-1- and HIV-2-specific enzyme immunoassays and confirmatory Western blot analysis to test for antibodies to SIVsm-related lentiviruses, we found only nine subjects (0.096%) who tested positive for HIV: seven tested positive for HIV-1 and two tested positive for HIV-2. Compared with other rural West African communities, Sierra Leone displayed the lowest seroprevalence (0.021%) of HIV-2 infection yet reported, much lower than the previously reported seroprevalence in SIVsm-infected feral and household pet sooty mangabeys. Heteroduplex analysis demonstrated that two of the newly found HIV-1 strains belonged to subtype A, the most common HIV-1 subtype in Africa, but this is the first report of subtype A in Sierra Leone. The two HIV-2-infected individuals harbored two distinct HIV-2 strains, designated 93SL1 and 93SL2. Phylogenetic analysis indicated that HIV-2 93SL1 is a member of HIV-2 subtype A, the first strain of this HIV-2 subtype found in Sierra Leone. In contrast, HIV-2 93SL2 belongs to none of the five previously characterized HIV-2 subtypes (A to E) but is a new subtype, herein designated F, having the most divergent transmembrane sequences yet reported for HIV-2. The fact that both of the two most divergent HIV-2 subtypes known, E and F, are rare and found as single occurrences in persons from Sierra Leone may be related to the fact that this small region of West Africa also contains free-living and household pet sooty mangabeys with highly divergent variants of SIVsm. This finding provides support for the hypotheses that new HIV-2 subtypes result from independent cross-species transmission of SIVsm to the human population and that these single-occurrence transmission events had not spread widely into the population by 1993.

Adolescent↗

Signaled Delay of Reinforcement: Effects of Postconditioning Manipulation of Context Associative Strength on Instrumental Performance

Two experiments examined the influence of postconditioning treatments of contextual cues on instrumental responding acquired with a signaled delay of reinforcement schedule. In Experiment 1, mere exposure to the conditioning context after instrumental training resulted in an attenuated response rate during an extinction test. In the second experiment, responding was decreased by exposure to the contextual cues or sessions in which signaled noncontingent reinforcements occurred. The greatest response decrement, however, occurred following unsignaled noncontingent food presentations. The results are discussed with respect to the different roles of contextual cues on operant responding.

Journal Article↗

Visual Reinforcement Signals Interfere with the Effects of Reinforcer Magnitude Manipulations

Three experiments examined the effect of reinforcement magnitude on free-operant response rates. In Experiment 1, rats that received four food pellets responded faster than rats that received one pellet on a variable ratio 30 schedule. However, when the food hopper was illuminated during reinforcer delivery, there was no difference between the rates of response produced by the two magnitudes of reward. In Experiment 2, there was no difference in response rates emitted by rats receiving either one or four pellets of food as reward on a random interval (RI) 60-s schedule. In Experiment 3, rats responding on an RI 30-s schedule did so at a lower rate with four pellets as reinforcement than with one pellet. This effect was abolished by the illumination of the food hopper during reinforcement delivery. These results indicate that the influence of magnitude is obscured by manipulations which signal the delivery of reinforcement.

Journal Article↗

The von Restorff effect in rats (Rattus norvegicus).

Two experiments examined the functional equivalence of memory in the rat (Rattus norvegicus) with memory in humans for serially presented items. Memory was assayed with an 8-arm radial maze, in which rats were allowed access to 5 arms of the maze and were then removed. Following a retention interval of 16 min, the rats were replaced in the maze and allowed to retrieve pellets from the 3 unvisited arms. The errors in reentering previously visited arms were noted. Both primacy and recency effects were found as with humans. Presenting a stimulus change after entry to 1 of the maze arms improved recall for that arm relative to when no change occurred. This effect was found using both handling and tone cues, and irrespective of whether the change consisted of presentation or nonpresentation of the cue. These results suggest that rats are subject to a von Restorff-like effect similar to that in humans.

Animals↗

Rats' memory for serially presented novel flavours: evidence for non-spatial primacy effects.

Four experiments examined the effects of serially presenting a number of novel flavours to rats on their subsequent consumption of those flavours. In Experiments 1-4, rats were orally infused with 0.5 ml of flavour over 30 sec for each of five flavours in the exposure phase of the experiment. In these studies, primacy and recency effects emerged, the size of the primacy effect being related to the length of the retention interval, which varied from zero to twenty-four hours. Thus, both primacy and recency effects can be generated using non-spatial stimuli with rats.

Animals↗

A double-blind, placebo-controlled, crossover trial of oral vitamin C in erythropoietic protoporphyria.

There is evidence that reactive oxygen species and free radicals may be involved in the pathogenesis of photosensitivity in erythropoietic protoporphyria (EPP). Considering the well-known antioxidant properties of vitamin C, we investigated whether oral supplementation with this vitamin was photoprotective in patients with EPP. Twelve patients with EPP received either oral vitamin C 1 g daily or placebo, for 4 weeks, followed by a crossover period of another 4 weeks. Nine patients were already receiving beta carotene at entry and continued this at the same dose throughout the study. Patients compared their sunlight tolerance throughout each of the treatment periods with sunlight tolerance at entry on a 10 cm visual analogue scale; at the end of the study, they were asked to choose which treatment period they felt had been associated with least photosensitivity. Eight patients stated that they were able to tolerate sunshine better during the vitamin C period, 2 during the placebo period and 2 noticed no difference between the two periods. This distribution of preferences approached but did not reach statistical significance in favour of vitamin C. Visual analogue scores improved by a median of 1.2 cm in the vitamin C period. This change too approached but did not reach statistical significance. Although these results do not reach statistical significance, it appears possible that oral vitamin C may reduce photosensitivity in some patients with EPP. A larger study is necessary to confirm this impression.

Administration, Oral↗

Genetic characterization of new West African simian immunodeficiency virus SIVsm: geographic clustering of household-derived SIV strains with human immunodeficiency virus type 2 subtypes and genetically diverse viruses from a single feral sooty mangabey troop.

It has been proposed that human immunodeficiency virus type 2 (HIV-2) originated from simian immunodeficiency viruses (SIVs) that are natural infections of sooty mangabeys (Cercocebus torquatus atys). To test this hypothesis, SIVs from eight sooty mangabeys, including six new viruses from West Africa, were genetically characterized. gag and env sequences showed that while the viruses of all eight sooty mangabeys belonged to the SIVsm/HIV-2 family, each was widely divergent from SIVs found earlier in captive monkeys at American primate centers. In two SIVs from sooty mangabeys discovered about 100 miles (ca. 161 Km) from each other in rural West Africa, the amino acids of a conserved gag p17-p26 region differed by 19.3%, a divergence greater than that in four of five clades of HIV-2 and in SIVs found in other African monkey species. Analysis of gag region sequences showed that feral mangabeys in one small troop harbored four distinct SIVs. Three of the newly found viruses were genetically divergent, showing as much genetic distance from each other as from the entire SIVsm/HIV-2 family. Sequencing and heteroduplex analysis of one feral animal-derived SIV showed a mosaic genome containing an env gene that was homologous with other feral SIVsm env genes in the troop but having a gag gene from another, distinct SIV. Surprisingly a gag phylogenetic tree based on nucleotide sequences showed that the African relatives closest to all three household-derived SIVs were HIV-2 subtypes D and E from humans in the same West African areas. In one case, the SIV/HIV-2 cluster was from the same village. The findings support the hypothesis that each HIV-2 subtype in West Africans originated from widely divergent SIVsm strains, transmitted by independent cross-species events in the same geographic locations.

Amino Acid Sequence↗

Hypertrichosis as the presenting feature of porphyria cutanea tarda.

We report a case of porphyria cutanea tarda in which the only cutaneous abnormality and initial presenting complaint was hypertrichosis. The patient had a history of excessive alcohol consumption. Alcohol avoidance and treatment with low-dose hydroxychloroquine resulted in resolution of the hypertrichosis and normalization of biochemical abnormalities.

Alcohol Drinking↗

Isolation and characterization of the first simian immunodeficiency virus from a feral sooty mangabey (Cercocebus atys) in West Africa.

The lineage of HIV-2-like viruses was studied in feral sooty mangabeys (SMs) by serological and genetic methods. Four feral sooty mangabeys were positive for simian immunodeficiency virus (SIV) antibodies and a new isolate, SIVsmSL92a, was obtained. Genetic analysis of gag genes showed that SIVsmSL92a was highly diverse and a distinct sequence subtype within the SIV sm/HIV-2 family. The results showed that SIVsm is the most diverse group of SIVs found thus far in a single monkey species.

Africa, Western↗

Enhanced latent inhibition following compound pre-exposure.

The influence of non-reinforced exposure to compound stimuli on subsequent appetitive classical conditioning was examined in five experiments with rats as the subjects. Non-reinforced exposure to a visual stimulus retarded subsequent acquisition of conditioned responding relative to a non-pre-exposed condition (latent inhibition). If the target stimulus was pre-exposed in compound with a second (non-target) stimulus, then latent inhibition was abolished. Exposure to the non-target stimulus prior to compound exposure had varying effects on subsequent conditioning to the target: 40 exposures to the non-target stimulus resulted in latent inhibition to the target stimulus that was comparable in magnitude to that observed when the target stimulus was exposed in isolation; 120 exposures to the non-target stimulus enhanced latent inhibition to the target stimulus.

Animals↗

Prognostic value of residual normal metaphases in acute myelogenous leukemia patients presenting with abnormal karyotype.

Two hundred and forty-four untreated acute myelogenous leukemia (AML) patients with unfavorable karyotypes and 109 others with favorable aneuploid karyotypes were used to evaluate the prognostic significance of having both normal and abnormal metaphases (AN) vs only abnormal metaphases (AA) at AML presentation. The AA and AN groups were similar with respect to known prognostic variables. Among patients with unfavorable karyotypes (-5, 5q-, -7, 7q-, and +8), the AN group had a significantly higher complete remission (CR) rate (46 vs 31%, P = 0.02), and a longer CR duration (P = 0.02) and survival (P = 0.026) than the AA group. The number of patients with other unfavorable karyotypes, such as t(11q23), were too small to evaluate properly. Among those with favorable karyotypes (inv(16) and t(8;21)), on the other hand, both the AN and AA group had similar CR rate, CR duration, and survival. Similarly, in patients with t(15;17), CR duration of the AN and AA groups were similar. These data suggest that, among patients with abnormal karyotypes, residual normal metaphases are associated with a higher CR rate, CR duration and survival, only in patients with unfavourable karyotypes, but not in those with favorable karyotypes.

Adult↗