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Biomedical subjects

S Newman

Publications and source records attributed to S Newman.

At least 37 records · Page 2Linked to original sources
PubMed2000

The psychology of rheumatic diseases.

Most chronic rheumatological disorders require major psychological adaptation, and levels of psychological distress among those with rheumatological disease have been found to be higher than in the general population. Research suggests that the relationship between disease severity, disablement and psychological well-being is not simple. This chapter highlights the complex nature of this relationship and will indicate, in particular, how psychological factors can impact on patients' perceptions of their symptoms and physical functioning. Psychological concepts that may mediate between the disease and its consequences are also discussed. A range of psychosocial interventions have been developed for individuals with rheumatological disorders. Most have related to rheumatoid arthritis, and although their primary focus has usually been on alleviating pain and improving physical functioning, this chapter examines their impact on psychological well-being. It also discusses a number of methodological issues that need to be addressed in this area of work.

Adaptation, Psychological↗
PubMed2000

Patients' satisfaction with osteopathic and GP management of low back pain in the same surgery.

Chronic low back patients reported their satisfaction with the treatment they received for back pain from GPs and osteopaths practising in the same surgery. Although levels of satisfaction were high for all treatments, patients reported significantly higher scores for satisfaction with the osteopathic treatment. The difference was stronger for aspects of care/communication and competence, and weaker for satisfaction with efficacy. These findings are discussed in reference to patients' expectations, novelty, time spent with patients, number of visits, and patients' age.

Adult↗
PubMed2000

Comparison of microembolism detected by transcranial Doppler and neuropsychological sequelae of carotid surgery and percutaneous transluminal angioplasty.

BACKGROUND AND PURPOSE: Percutaneous transluminal angioplasty (PTA) is currently being assessed for the treatment of carotid stenosis. In comparison with carotid endarterectomy (CEA), there is evidence of an increased risk of cerebral microembolism during the procedure. We have sought evidence of any neuropsychological sequelae of carotid PTA and compared it with CEA to demonstrate the relative safety of the 2 treatment options. METHODS: The neuropsychological outcomes after CEA and PTA were compared in 2 matched groups of patients with severe symptomatic carotid stenosis, 96% of whom had been randomized in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS), at a single center. Transcranial Doppler insonation of the middle cerebral artery was used to measure cerebral reactivity in response to carbon dioxide inhalation before treatment and then to detect microembolization of the ipsilateral cerebral hemisphere and measure changes in blood flow velocity during the procedures. The performance on a neuropsychological test battery administered before, 6 weeks after, and 6 months after the procedure was compared in 20 patients undergoing PTA and 26 having CEA. RESULTS: At 6 weeks, 5 patients in each group showed a similar decline in neuropsychological performance; global measures showed no significant difference between the 2 procedures, despite a significantly higher incidence of microemboli during PTA. Both groups showed a marked reduction in anxiety after treatment. CONCLUSIONS: The findings provide some reassurance that PTA is not associated with greater cerebral complications than CEA, despite the higher embolic load recorded by transcranial Doppler ultrasonography during angioplasty.

Aged↗
PubMed2000

Technical note: Constrained optimization of breed composition in composite populations to balance net merit and risk.

We developed a method to derive optimum composite genotypes when the proportion of a specific breed (or combination of breeds) in the composite is constrained to a desired level. The method allows development of composites that balance net merit according to available parameters and reflects the production system and(or) risk preference, particularly when traits in the breeding objective do not represent all traits important for production. The method can also be used to evaluate the cost of constraining breed use. For example, when the true optimal composite is difficult to obtain in the time frame available to the producer, the predicted merit of the composite with breed proportion restricted to those that are obtainable in practice can be compared with the predicted merit of the true optimum composite. In a case study the method is used to optimize a tropical composite using Brahman, Charolais, and Belmont Red breeds. The proportion of Charolais is to be constrained to 50%. Using growth parameters from a tropical crossbreeding experiment, the unconstrained optimum composite was 32.5% Brahman, 11.1% Belmont Red, and 56.3% Charolais. When the proportion of Charolais in the composite was constrained to 50%, optimum proportions of Brahman and Belmont Red were 33.9% and 16.1% respectively. In the case study net merit (annualized profit per cow exposed, $), as defined by the growth parameters, was .2% less than that of the unconstrained optimum composite.

Animal Husbandry↗
PubMed1999

11-cis retinol dehydrogenase mutations as a major cause of the congenital night-blindness disorder known as fundus albipunctatus.

PURPOSE: Patients with fundus albipunctatus uniformly experience difficulty with vision at night. Their retinas are spotted with characteristic light yellow flecks of unknown composition that typically spare the macula. A defect in the transport or utilization of visual cycle retinoids is thought to underlie this recessive disorder with variable clinical expression. To elucidate the molecular defect we considered the genes for interphotoreceptor retinoid-binding protein (RBP3) and 11-cis retinol dehydrogenase (RDH5) as candidates for this disease. METHODS: We examined two unrelated families with fundus albipunctatus. The diagnosis was determined clinically and RBP3 and RDH5 were analyzed by molecular screening methods and direct genomic sequencing. RESULTS: Each family had two affected members with typical fundus albipunctatus. The affected members were siblings born to unaffected parents who were seventh cousins in the first family and unrelated in the second family. The probands from both families were clinically similar except for the fundus dots that were more extensive in the second family to the point of involving the parafoveal region. In the initial phase of genetic screening RBP3 defects were ruled-out as the cause of the disease in both families. In contrast, RDH5 mutations were found in the affected siblings in both families. The proband in one had a homozygotic Gly238Trp missense mutation (GGG -> TGG) involving exon 4 and in the other carried compound heterozygotic changes Arg280His (CGC -> CAC) and Ala294Pro (GCC -> CCC) in exon 5. The disease phenotype was only manifested in family members with two abnormal RDH5 alleles consistent with autosomal recessive inheritance in both pedigrees. CONCLUSIONS: These findings strongly implicate defects of RDH5 as the cause of fundus albipunctatus and point to a heterogeneity of RDH5 mutations in this form of congenital stationary night blindness with variable expressivity.

Adult↗
PubMed1999

Deposition of fenoterol from pressurized metered dose inhalers containing hydrofluoroalkanes.

The imaging technique of gamma scintigraphy has been used to quantify the total amount of drug deposited in the lungs and the pattern of regional lung deposition, for formulations of Berodual (Boehringer Ingelheim GmbH) delivered from pressurized metered dose inhalers formulated with chlorofluorocarbons, and with hydrofluoroalkane-134a or -227. Data were expressed as the mass of fenoterol deposited in the lungs from the Berodual formulations. All the formulations tested gave a whole lung deposition less than 20% of the metered (exvalve) dose. The mass of fenoterol deposited in the lungs for a solution formulation containing hydrofluoroalkane-134a was inversely proportional to the actuator nozzle diameter. The data suggest that the total and regional lung deposition of hydrofluoroalkane-based pressurized aerosol formulations is highly product-specific and that changes in bioavailability can be brought about by varying both the constituents of the formulation and the design of the actuator.

Female↗
PubMed1999

The effects of respite care on informal carers' well-being: a systematic review.

PURPOSE: The provision of respite care is a common method employed to reduce the burden on those who care for individuals with a chronic illness or disability. The aim of the present review was to examine research on respite provision with a view to establishing what effect it has on carers. METHOD: A literature search was conducted for studies examining the effect of respite provision on carers, 'Psyclit', 'Medline' and Social Science Citation Index computerized databases were utilized, followed by a search of the reference sections of relevant studies. RESULTS: The search yielded 29 studies, from which there was little evidence that respite intervention has either a consistent or enduring beneficial effect on carers' well-being. This may be due in part to the fact that the majority of the work conducted has been methodologically poor. Also significant, however, might be that the findings suggest respite care often fails to facilitate the maintenance of socially supportive relationships, which may moderate strain after respite has ended. CONCLUSIONS: A more 'carer-centred' approach is required in both the provision and evaluation of respite care intervention. This approach would address the experiences of both caregiver and care-recipient during the respite period.

Caregivers↗
PubMed1999

A chromosome 4p haplotype segregating with Parkinson's disease and postural tremor.

We investigated a large family with levodopa-responsive, Lewy body parkinsonism in which the disease segregates as an apparent autosomal dominant trait. After performing a genome screen, we identified a chromosome 4p haplotype that segregates with the disease. However, this haplotype also occurs in individuals in the pedigree who do not have clinical Lewy body parkinsonism but rather suffer from postural tremor, consistent with essential tremor. These data demonstrate a new locus for Lewy body parkinsonism and suggest that in some circumstances postural tremor can be an alternative phenotype of the samepathogenic mutation as Lewy body parkinsonism.

Chromosome Mapping↗
PubMed1999

The effect of dietary supplementation with 1,25-dihydroxycholecalciferol or vitamin C on the characteristics of the tibia of older laying hens.

Seventy-two-week-old Leghorn hens were fed a conventional corn-soybean meal diet, or comparable diets either devoid of all supplemental vitamins, or with additions of 5 microg/kg 1,25-dihydroxycholecalciferol [1,25(OH)2D3], or 100 ppm vitamin C. The diets were fed for up to 30 d, with periodic observation on bone characteristics of selected birds. With a vitamin-deficient diet it took 30 d to realize significant reductions (P < 0.05) in bone breaking strength and these birds had less bone ash as early as 15 d (P < 0.05), although bone calcium content was not affected. Adding 1,25(OH)2D3 to the diet caused an increase in bone breaking strength after 15 d (P < 0.05) in the vitamin-deficient birds, although no difference was seen after 30 d. This increase in bone strength was associated with increase in bone cross-sectional area. Vitamin C generally had little effect on bone characteristics of the bird. These results suggest that there is little bone remodeling of older laying hens in response to short-term feeding of 1,25(OH)2D3 or vitamin C.

Animals↗
PubMed1999

The effect of feed deprivation and subsequent refeeding on the bone characteristics of aged hens.

In an attempt to improve skeletal integrity of older caged laying hens, birds were held without feed for 4 to 8 d and then refed. Feed deprivation caused an immediate loss in breaking force of the tibia (P < 0.05). Although bone strength increased during subsequent refeeding, values did not return to prefast levels (P < 0.05). Feed withdrawal did cause a reduction in modulus of elasticity of the tibia (P < 0.05), which is a potential benefit for bones that are more resilient to damage; this characteristic was maintained through 30 d of feeding. Histological examination of the tibia hinted at some bone remodelling during refeeding following withdrawal, although the magnitude of these changes was of limited biological significance. These data suggest that simple feed withdrawal for 4 or 8 d is insufficient to bring about a meaningful improvement in skeletal integrity of the older caged laying hen.

Aging↗
PubMed1999

Fluorescent labels influence phagocytosis of Bordetella pertussis by human neutrophils.

To explore the role of neutrophil phagocytosis in host defense against Bordetella pertussis, bacteria were labeled extrinsically with fluorescein isothiocyanate (FITC) or genetically with green fluorescent protein (GFP) and incubated with adherent human neutrophils in the presence or absence of heat-inactivated human immune serum. In the absence of antibodies, FITC-labeled bacteria were located primarily on the surface of the neutrophils with few bacteria ingested. However, after opsonization, about seven times more bacteria were located intracellularly, indicating that antibodies promoted phagocytosis. In contrast, bacteria labeled intrinsically with GFP were not efficiently phagocytosed even in the presence of opsonizing antibodies, suggesting that FITC interfered with a bacterial defense. Because FITC covalently modifies proteins and could affect their function, we tested the effect of FITC on adenylate cyclase toxin activity, an important extracellular virulence factor. FITC-labeled bacteria had fivefold-less adenylate cyclase toxin activity than did unlabeled wild-type bacteria or GFP-expressing bacteria, suggesting that FITC compromised adenylate cyclase toxin activity. These data demonstrated that at least one extracellular virulence factor was affected by FITC labeling and that GFP is a more appropriate label for B. pertussis.

Adenylyl Cyclases↗
PubMed1998

Cortical myoclonus in levodopa-responsive parkinsonism.

We observed myoclonic movements of the fingers and wrists in two patients with a levodopa-responsive parkinsonian syndrome most consistent with Parkinson's disease. These patients were studied with electrophysiological techniques. Brief (<50 ms) myoclonic electromyographic discharges showed a time-locked relationship to a focal premovement electroencephalographic potential. Somatosensory-evoked potentials were not enlarged and long-latency reflexes were not grossly exaggerated. This pattern of electrophysiological findings can be distinguished from those previously found in other parkinsonian syndromes. These results provide evidence for a cortical origin of the myoclonus seen in these patients.

Aged↗
PubMed1998

Olfactory function in restless legs syndrome.

Restless leg syndrome (RLS) is usually idiopathic but may occur in patients with Parkinson's disease (PD). Both respond to dopaminergic medications. Whether these disorders share a common pathophysiology is unclear. Because PD is associated with a loss of olfactory function, we compared the olfactory function of patients with RLS with control and PD patients. Using the University of Pennsylvania Smell Identification Test (UPSIT), olfactory function was found to be normal in patients with idiopathic RLS and significantly reduced in patients with PD. This suggests that the pathophysiology of RLS differs from PD, and that RLS likely is not a "forme fruste" or a preclinical sign of PD.

Aged↗
PubMed1998

Sebaceous carcinoma. Tumor progression through mutational inactivation of p53.

BACKGROUND: Sebaceous carcinoma may masquerade for years as an inflammatory condition. In many cases, this may be because of the presence of longstanding intraepithelial disease (e.g., dysplasia or carcinoma in situ), which eventually progresses to invasive carcinoma recognized through tumefaction and a worsening clinical presentation. The mechanism for this tumor progression is unknown. In the Far East, human papilloma virus (HPV) has been suggested to play a role in the development of sebaceous carcinoma by inactivating tumor suppressor gene p53. Here, the authors explore the molecular basis of the progression of ocular sebaceous carcinoma. METHODS: Cases of sebaceous carcinoma seen at the University of Virginia, Department of Ophthalmology, during the period from 1989 to 1996 were analyzed for HPV infection by in situ hybridization and polymerase chain reaction. The expression of p53, p21WAF-1, Bcl-2, and epithelial membrane antigen was examined by immunohistochemistry. In one of the cases, frozen tumor was available, allowing exons 5 through 9 of the p53 gene to be sequenced. RESULTS: Seven cases were identified, all of which were from women. All were negative for HPV. In cases in which disease was restricted to dysplasia (carcinoma in situ), p53 but not p21WAF-1 was negative. In contrast, cases that contained a component of invasive or metastatic carcinoma showed striking hyperexpression of nuclear p53 in all of the malignant cells. In one of these cases, a G:C-->T:A transversion was found in the p53 gene. This mutation, characteristic of bulky carcinogens, substituted phenylalanine for cysteine 277, a residue that participates in hydrogen bonding to the p53 DNA binding consensus sequence. CONCLUSIONS: Mutational inactivation of p53 may be involved in the progression of sebaceous carcinoma.

Adult↗
PubMed1998

Cerebral functional changes following cardiac surgery: Neuropsychological and EEG assessment.

OBJECTIVE: Some form of organic and functional cerebral deficit may occur in up to one third of patients following cardiopulmonary bypass surgery. This study was designed to assess cerebral functional deficit in cardiac surgical patients. METHODS: Neuropsychological and quantitative electroencephalographic (EEG) changes were assessed in 62 first time coronary artery bypass graft surgery patients before surgery and within 1 week and 2 months after surgery. Patients underwent surgery with a standard Hammersmith Hospital anaesthesia and hypothermic cardiopulmonary bypass (28 degrees C), using either bubble (Harvey 1700, n = 28) or membrane (Cobe CML, n = 34) oxygenators with arterial line filters (Pall 40 microm). Neuropsychological performance was assessed using a well established battery of ten tests. Four EEG relative power frequency bands; delta (1-3.5 Hz), theta (4-7.5 Hz), alpha (8-11.5 Hz), and beta (12-23 Hz), were determined using Fast Fourier Transformation (FFT). RESULTS: Neuropsychological and EEG deficits were found in 48% of patients 1 week after surgery and in 34% 2 months after surgery. Post-operative deficits were not associated with duration of perfusion, type of oxygenator used in surgery or patient age. Neuropsychological and EEG deficits were associated 2 months after surgery, but not 1 week after surgery. Post-operative EEG deficit was associated with pre-operative deficit. CONCLUSIONS: Cerebral functional deficit was found following CABG surgery using quantitative EEG and neuropsychological assessments. Patients who had neuropsychological deficit were also more likely to show EEG deficit. EEG deficit before and after surgery suggests vulnerability of patients with already compromised cerebral function to the effects of CPB procedure.

Adult↗
PubMed1998

Effect of housing birds in cages or an aviary system on bone characteristics.

Sixty-nine-week-old brown egg layers were either maintained in cages or moved to a litter-floored aviary system. After 10 or 20 d, birds were selected at random from within each environment, and their tibiae removed. After drying, bones were measured and then subject to various physical measurements of strength and elasticity. Bone ash and bone calcium content were also measured. Birds maintained in an aviary initially had stronger bones as measured by force (P < 0.05). After 20 d in an aviary, birds had stronger bones, as assessed by force, than their contemporaries maintained in cages. This same relationship was seen in measures of bone stress (P < 0.05). After 20 d in the aviary system, previously caged birds had bone ash values that were intermediate between birds held only in cages or the aviary (P > 0.05). Bone calcium content was not influenced by the bird's environment. It appears that the skeleton of caged birds can be affected by providing them with an environment that allows opportunity for increased static and dynamic loading of the bones.

Animals↗