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Biomedical subjects

R West

Publications and source records attributed to R West.

At least 19 recordsLinked to original sources
PubMed1992

Thrombocytopenia associated with administration of trimethoprim/sulfadiazine in a dog.

A diagnosis of trimethoprim/sulfadiazine-induced, immune-mediated thrombocytopenia in a dog was made, using a novel in vitro assay for thrombolytic activity. The assay quantifies thrombolytic activity by measuring the amount of platelet fragments in normal canine platelets before and after incubation with plasma from the thrombocytopenic dog. This report confirms previous reports of the development of thrombocytopenia after administration of trimethoprim/sulfadiazine, and describes a new assay that, after further validation, may be useful in the diagnosis of immune-mediated thrombocytopenia when an adequate sample of platelets cannot be obtained for quantification of platelet-associated IgG.

Animals↗
PubMed1992

Nicotine addiction: a re-analysis of the arguments.

This paper evaluates the arguments put forward by Robinson and Pritchard (R&P, this volume) that the conclusions of the US Surgeon General (USDHHS 1988) that nicotine is addictive were ill founded. R&P state that nicotine does not cause intoxication, that many smokers do not exhibit compulsive use, that nicotine is not a euphoriant, that nicotine is a weak reinforcer in other species, that non-pharmacological aspects of smoking are important and that negative affect control accounts for more of the variance in questionnaire measures of smoking motives than does habit. This paper points out that intoxication and a euphoriant effect are not normally considered to be central to dependence potential, that no addictive drug results in compulsive use in all users in all situations, that animals do reliably self-administer nicotine, that evidence concerning the apparent importance of non-pharmacological components of smoking do not diminish the importance of pharmacological aspects and that "variance accounted for" of self-report measures of smoking motivation do not bear on the issue of the importance of those motives. The paper concludes with a summary of the essence of the argument that cigarettes are addictive and that nicotine is the primary focus of that addiction.

Humans↗
PubMed1992

Function of cigarette smoking in relation to examinations.

Eighty-two college students took part in a study on motives underlying increases in cigarette smoking prior to examinations. One group was tested a month before, and a second group was tested the day before, the start of examinations. Measures were taken of current cigarette consumption, general anxiety, anxiety about forthcoming exams, the importance of sedative and stimulant smoking motives, hours spent revising and in other activities and amounts smoked during these activities. The results indicated that the students increased the hours they spent revising and there was a corresponding increase in the number of cigarettes smoked during this activity. They also reported an increase in the importance of stimulant smoking motives. Anxiety levels increased in the run up to exams but there was no increase in sedative smoking motives. The results raise the issue of whether any anxiolytic action of nicotine may be limited to acute stressors and also whether smokers' use of cigarettes to help them stay alert during revision translates into improved examination performance.

Adult↗
PubMed1992

Involvement of Arkansas hospitals in promotion of car restraint device use among young children.

Child restraint devices are a proven means of reducing automobile-related deaths and injuries among infants and toddlers. To determine the role that Arkansas hospitals play in promoting use of these devices, a survey similar to one conducted previously in Tennessee was performed of hospitals providing newborn and/or pediatric services. Hospital policies relating to discharge of patients in car restraints were more likely to pertain to newborns than to older children. Nearly all the facilities having such policies claimed that these were strictly enforced. Hospitals are encouraged to establish discharge policies and to expand educational efforts and loaner programs.

Arkansas↗
PubMed1991

Effect of buspirone on cigarette withdrawal symptoms and short-term abstinence rates in a smokers clinic.

This paper reports on a double blind trial of the effect of buspirone, 15 mg per day, on cigarette withdrawal symptoms and ability of smokers to maintain abstinence during treatment. A total of 61 smokers were randomly assigned to active or placebo conditions. They were maintained on their drug for 2 weeks prior to attempting abstinence and then for a further 4 weeks of abstinence. Subjects attended weekly group sessions of a psychological treatment programme. There was no evidence that the side effects in the active drug group were worse than those in the placebo group. Although there was no significant difference between active and placebo conditions on withdrawal symptoms, smokers in the active drug condition were more than twice as likely to maintain abstinence for the duration of the study than those in the placebo condition (47% versus 16%, chi square = 5.3, P less than 0.025). The results provide preliminary evidence for short-term efficacy of buspirone as an aid to smoking cessation at a low dose. They also provide evidence of a dissociation between withdrawal symptoms and successful abstinence.

Adult↗
PubMed1991

Effect of cigarettes on memory search and subjective ratings.

The effects of smoking a nicotine versus a nonnicotine cigarette on performance on Sternberg's memory search task and subjective ratings were examined. Testing sessions were undertaken both before and after a period of 24 hours' abstinence in occasional and regular smokers. Memory search rate was significantly faster after the nicotine cigarette than the nonnicotine cigarette. No significant difference in search rate was found between the results from occasional and regular smokers, and between the effect of a cigarette before and after the period of abstinence. The regular smokers inhaled more smoke from the nicotine and nonnicotine cigarettes than did the occasional smokers, but the amount of smoke inhaled from the test cigarettes did not change significantly from pre- to postabstinence. The nicotine cigarette produced stronger dizziness, tremor and palpitations than the nonnicotine cigarette, the more so after abstinence than before in the regular smokers. The results indicate that smoking a cigarette can produce subjective effects and performance improvements in regular and occasional smokers during the course of normal smoking, and that some subjective effects can be greater after abstinence.

Adult↗
PubMed1991

Assessing the functional status during an asthma attack with Dartmouth COOP charts. Validity with respect to the change in asthma.

The functional status of patients was determined during an acute attack of asthma requiring medical intervention. Patients were recruited during two months from general practice: all 28 patients consulting for an acute asthma attack were invited to take part: four refused or were withdrawn from follow up. Matched control patients with asthma, not suffering from an acute attack were selected from the practice file. Patients were investigated directly after the initial intervention and exactly 14 days later: respiratory symptoms, peak expiratory flow rates and functional status were recorded. In all cases the intervention resulted in the relief of symptoms and a return of peak expiratory flow to the normal predicted range for age, sex and height. After the 14 days, patients had no longer evidence of an exacerbation of their asthma. During the attack, there were indications of reduced physical and psychological functions, and reduced daily and social activities. A difference was found in the functional profile of asthmatics with an asthma attack and asthmatics without an asthma attack. After 14 days, the functional status of all the dimensions had improved. There was no evident correlation to the change in functional status and peak expiratory flow rates. An asthma attack hampers the patient in his daily functioning--not only physically, but also in social functioning and feelings. There are indications that the recuperation in terms of functioning takes longer than the symptoms to disappear or the peak expiratory flow to return to normal.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗
PubMed1991

The focus and conduct of clinical trials.

This paper discusses some issues regarding how putative stop-smoking treatments should be evaluated. Preliminary evaluations of treatments have used withdrawal symptoms as a surrogate for abstinence in an attempt to decide those treatments on which to carry out expensive full-scale clinical trials. However, withdrawal symptom severity has not been shown to relate to long-term abstinence in any prospective studies. Until a better understanding of the relationship between withdrawal symptoms and abstinence is obtained withdrawal symptoms cannot be considered an appropriate surrogate for abstinence. Research is needed into what pattern of short-term abstinence provides the best predictor of long-term abstinence. Evidence from carbon monoxide validation of short-term abstinence raises doubts about whether minor lapses back to smoking are likely to lead to full blown relapse. Further research into the use of expired-air CO in validation of claims of abstinence is required. Finally, the traditional clinical trials format is not well suited to evaluation of treatment programmes with a large behavioural component. An alternative based on the principles underlying biological evolution is proposed.

Clinical Trials as Topic↗
PubMed1991

Private health insurance and medical care utilization: evidence from the Medicare population.

This paper examines the impact of supplemental health insurance policy ownership on the use of health care services by the elderly. It employs a data base consisting of Medicare claims data from over 2,000 beneficiaries in six states, actual copies of their supplemental insurance policies, and detailed survey information. The results show that policy ownership has a substantial, positive impact on service usage and costs, particularly for beneficiaries in fair or poor health. The greatest impact was found for policies that provide first-dollar coverage.

Aged↗
PubMed1990

Incidence of hip fracture in Saskatchewan, Canada, 1976-1985.

The authors ascertained the incidence of hip fracture in Saskatchewan, Canada, residents aged 65 years or older for the 10 years 1976-1985 from computerized hospital discharge records and compared it with rates for several other populations in Northern Europe and the United States. In Saskatchewan, the average annual incidence was 5.5 per 1,000 person-years. The incidence in women was twice that in men, the incidence in urban areas was 27% greater than that in nonurban areas, and there was no secular trend of increasing rates. The incidence of hip fracture in Saskatchewan was lower than that for populations in Scandinavia and the United States but was comparable to rates in English populations. Further study is needed to elucidate the genetic, environmental, and behavioral factors responsible for this variation.

Aged↗
PubMed1990

Alcohol consumption, problem drinking and anti-social behaviour in a sample of college students.

A total of 125 male and 145 female students completed a written questionnaire (response rate 68%) on their consumption levels and patterns, problem drinking and vandalism and assaults associated with drinking, Prevalence of heavy drinking was broadly similar to that found in other college student samples in the UK with 25.6% of male students and 14.5% of female students drinking more than their safe limits of 35 and 21 units per week respectively. Six percent of male and one percent of female students exceeded the problem drinking threshold on the MAST. Twenty percent of the male students and 6% of the females admitted having caused at least some damage to property after having been drinking in the past 12 months. Four percent of males and 5% of females admitted 'minor' assaults. Fifty percent of males and 36% of females had witnessed damage to property and 19% of males and 10% of females had experienced some kind of assault. Vandalism and assaults were positively and independently associated with higher levels of consumption, reasons for drinking and patterns of drinking; in particular morning drinking appeared to play a role. Taking amount of drinking into account, males were more likely to commit acts of vandalism but females were more likely to commit assaults. The results reveal that alcohol-related, anti-social behaviour among students is a significant problem and that, while heavy drinking per se plays a role, other factors are also important.

Adult↗
PubMed1990

Oral tobacco: prevalence, health risks, dependence potential and public policy.

This paper discusses public health policy with regard to oral tobacco use. It notes that in the UK, oral tobacco use is extremely rare. Concern that it might become prevalent among schoolchildren has proved unfounded. Smokeless tobacco almost certainly carries health risks but these risks are probably less than from smoking. What little evidence exists suggests that smokeless tobacco may be less dependence-inducing than cigarettes. In the light of this, the UK Government's decision to ban oral tobacco products is hard to reconcile with their continuing to permit the sale and advertising of cigarettes. A cynic would view the Government's ban as a 'no cost' measure to placate the public health lobby and ease the pressure for more restrictions on cigarette promotion. The inconsistency in the Government's approach to Skoal Bandits and cigarettes may be used as a focus for pressure to change in the laws governing promotion of cigarettes.

Health Policy↗
PubMed1990

Molecular definition of a region of chromosome 21 that causes features of the Down syndrome phenotype.

Down syndrome (DS) is a major cause of mental retardation and heart disease. Although it is usually caused by the presence of an extra chromosome 21, a subset of the diagnostic features may be caused by the presence of only band 21q22. We now present evidence that significantly narrows the chromosomal region responsible for several of the phenotypic features of DS. We report a molecular and cytogenetic analysis of a three-generation family containing four individuals with clinical DS as manifested by the characteristic facial appearance, endocardial cushion defect, mental retardation, and probably dermatoglyphic changes. Autoradiograms of quantitative Southern blots of DNAs from two affected sisters, their carrier father, and a normal control were analyzed after hybridization with two to six unique DNA sequences regionally mapped on chromosome 21. These include cDNA probes for the genes for CuZn-superoxide dismutase (SOD1) mapping in 21q22.1 and for the amyloid precursor protein (APP) mapping in 21q11.2-21.05, in addition to six probes for single-copy sequences: D21S46 in 21q11.2-21.05, D21S47 and SF57 in 21q22.1-22.3, and D21S39, D21S42, and D21S43 in 21q22.3. All sequences located in 21q22.3 were present in three copies in the affected individuals, whereas those located proximal to this region were present in only two copies. In the carrier father, all DNA sequences were present in only two copies. Cytogenetic analysis of affected individuals employing R and G banding of prometaphase preparations combined with in situ hybridization revealed a translocation of the region from very distal 21q22.1 to 21qter to chromosome 4q. Except for a possible phenotypic contribution from the deletion of chromosome band 4q35, these data provide a molecular definition of the minimal region of chromosome 21 which, when duplicated, generates the facial features, heart defect, a component of the mental retardation, and probably several of the dermatoglyphic changes of DS. This region may include parts of bands 21q22.2 and 21q22.3, but it must exclude the genes S0D1 and APP and most of band 21q22.1, specifically the region defined by S0D1, SF57 and D21S47.

Adult↗