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Biomedical subjects

T Mann

Publications and source records attributed to T Mann.

At least 19 recordsLinked to original sources
PubMed2004

Polymorphous light eruption (PLE) and a new potent antioxidant and UVA-protective formulation as prophylaxis.

BACKGROUND: Polymorphous light eruption (PLE) is the most common photodermatosis. While its etiology still remains elusive, pathogenesis seems to involve UVA-induced oxidative stress and subsequent deregulation of antioxidative immune responses. Only few and often ineffective prophylactic and therapeutic measures exist to date. METHODS: In our randomized, double-blind, placebo-controlled clinical study, we compared the efficacy of a new topical formulation, consisting of 0.25%alpha-glucosylrutin (AGR) (a natural, modified flavonoid), 1% tocopheryl acetate (vitamin E) and a broad-spectrum, highly UVA-protective sunscreen (SPF 15) in a hydrodispersion gel vehicle, to a sunscreen-only gel and vehicle. Thirty patients with a history of PLE were pretreated with either the above formulation, a similar preparation (with the same concentration for vitamin E and AGR, but a different UV filter system), placebo or a SPF 15 sunscreen-only gel, 30 min prior to daily photoprovocation with UVA irradiations of 60-100 J/cm(2) to 5 x 5 cm(2) areas on the upper arms. RESULTS: After 4 days, results revealed a statistically highly significant difference (P<0.001) between the antioxidant containing formulations and placebo, and sunscreen-only formulation, respectively, in experimentally eliciting PLE. While only one patient developed clinical signs of PLE with accompanying itch in the area treated with the new antioxidant UV-protective gel formulation, 62.1% of the placebo-treated areas and 41.3% of the sunscreen-only treated areas showed mild to moderate signs of PLE. CONCLUSION: Combining a potent antioxidant with a broad-spectrum, highly UVA-protective sunscreen is far more effective in preventing PLE than sunscreen alone or placebo and should thus be employed as the prophylaxis of choice for PLE.

Administration, Topical↗
PubMed2003

Evaluation of a brief low-cost intervention to improve antiretroviral treatment decisions.

An earlier pilot study found that US DHHS guidelines for antiretroviral treatment were not being successfully implemented (Mann et al., 2000). A brief and inexpensive intervention (visual aid checklist) was developed with the assistance of HIV-expert physicians in order to aid HIV/AIDS health care providers' and their patients' decisions about antiretroviral therapy. The visual aid checklist consisted of a two-page coloured diagram and explanation of key concepts (T-cell, viral load and resistance) and a checklist of the benefits and risks of antiretroviral therapy. Twenty adult HIV-positive subjects and eight health care providers were studied. Ten subjects were observed with their providers without the intervention being used, and then ten subjects were observed with the intervention. A pre-/post-test format was used to assess the patients' antiretroviral knowledge, patient-provider discussion of the DHHS guidelines, and provider satisfaction with the intervention. No differences in baseline HIV knowledge were found between the two groups. Results showed that patients in the intervention condition had greater knowledge of the benefits and risks of antiretroviral therapy than patients in the control condition. Providers reported that the intervention was useful in aiding and encouraging communication as well as conveying knowledge.

Adult↗
PubMed2002

Internal jugular vein patency following carotid endarterectomy.

We performed ultrasound examinations on forty-five patients with a history of carotid endarterectomy to assess the patency and position of the internal jugular vein on the side of the endarterectomy. The study was performed in a tertiary referral centre. In the 55 internal jugular veins examined (ten bilateral procedures), the veins were patent and in a normal relationship to the carotid artery. We concluded that previous carotid surgery should not be a contraindication to cannulation of the internal jugular vein.

Endarterectomy, Carotid↗
PubMed2001

Forbidden fruit: does thinking about a prohibited food lead to its consumption?

OBJECTIVE: The phenomenon of overeating the very foods that one is trying to resist is potentially consistent with both an ironic process account of overeating and a reactance account of the desire for "forbidden fruit." These two models are tested. METHOD: Participants in two studies were prohibited or not prohibited from eating a food, or they were encouraged to "choose" to avoid it. Food consumption, thoughts, and desire were assessed before and after the food was forbidden. RESULTS: Consistent with an ironic process account, participants' thoughts about the food increased, regardless of whether they were required to or chose to avoid it. Consistent with a reactance account, participants' desire for the food increased if they were required to avoid it, but not if they chose to avoid it. Participants did not, however, ultimately overeat the forbidden food. DISCUSSION: Neither increased thoughts nor enhanced desire for a food necessarily leads to overindulgence.

Adult↗
PubMed2001

Eating disorder symptoms and body image concerns in Iran: comparisons between Iranian women in Iran and in America.

OBJECTIVE: Rates of eating disorder symptoms were compared between Iranian women living in Iran and Iranian women living in America, in order to assess the impact of Western culture on eating disorders. Women in Iran are mandated by law to cover their bodies with a long veil or overcoat and they have little legal exposure to Western culture and media. METHOD: Fifty-nine female Iranian students living in Tehran and 45 female students of Iranian descent living in Los Angeles were surveyed with the Eating Disorder Examination-Questionnaire and the Figure Rating Scale. RESULTS: Few differences were found between participants in the two samples, despite ample power to detect them. Participants in Iran reported as much disordered eating as participants who had immigrated to America. DISCUSSION: Neither exposure to Western media nor acculturation to Western norms appeared to be related to symptoms of disordered eating and body image concerns in this sample.

Adolescent↗
PubMed2001

Causes of complications from cervical spine manipulation.

Cervical manipulation occasionally causes serious vertebrobasilar complications. The usual cause is vertebral artery dissection, however in some cases there has been no obvious arterial injury. The present paper reviews the mechanisms by which complications occur, particularly when the applied force is trivial or there is no injury to the vertebral arteries, and the factors that increase risk of complications. In addition, implications are drawn for use of the recently revised Australian Physiotherapy Association (APA) guidelines. In the absence of vertebral artery rupture, complications are proposed to arise from vasospasm, haemostasis, endothelial injury or turbulent flow. These mechanisms have a sound scientific basis but have yet to be demonstrated as specifically causing vertebrobasilar complications. The most important risk factors for vertebrobasilar complications appear to be prior trauma to the vertebral arteries and symptoms of vertebrobasilar ischaemia from previous manipulation. There is weak evidence that hypoplasia of the vertebral arteries also increases the risk of complications. Neither general vascular factors nor pre-existing degenerative conditions of the cervical spine increase risk of vertebrobasilar complications. The procedures described in the APA guidelines test adequacy of total cerebral perfusion during cervical movements rather than patency of the vertebral arteries or their susceptibility to injury. The guidelines may therefore indicate potential for surviving a complication from manipulation. They may also identify patients at risk of complications from minor trauma. It is recommended that the procedures described in the APA guidelines be applied prior to every manipulation, and that manipulation be avoided in the presence of any signs of vertebrobasilar insufficiency.

Humans↗
PubMed2001

Characterization of the subpellicular network, a filamentous membrane skeletal component in the parasite Toxoplasma gondii.

Electron microscopic examination of detergent-extracted Toxoplasma tachyzoites reveals the presence of a mechanically stable cytoskeletal structure associated with the pellicle of this parasite. This structure, composed of interwoven 8-10 nm filaments, is associated with the cytoplasmic face of the pellicle and surrounds the microtubule-based cytoskeleton. Two protein components of this network, TgIMC1 and TgIMC2, were identified. Both are novel proteins, but have a resemblance to mammalian filament proteins in that they are predicted to have extended, coiled-coil domains. TgIMC1 is also homologous to articulins, the major components of the membrane skeleton of algae and free-living protists. A homologue of TgIMC1 in the related malaria parasite Plasmodium falciparum was also identified suggesting the presence of structurally similar membrane skeletons in all apicomplexan parasites. We suggest that the subpellicular network, formed by TgIMC1 and 2 in Toxoplasma gondii and related parasites, plays a role in the determination of cell shape and is a source of mechanical strength.

Amino Acid Sequence↗
PubMed2001

Effect of glycoprotein IIb/IIIa receptor inhibition on angiographic complications during percutaneous coronary intervention in the ESPRIT trial.

OBJECTIVES: We sought to determine whether eptifibatide decreases the incidence of in-laboratory angiographic complications and to determine the relationship of angiographically evident complications to elevations of creatine kinase-MB (CK-MB) enzyme levels during percutaneous coronary intervention. BACKGROUND: In the Enhanced Suppression of the Platelet IIb/IIIa Receptor with Integrilin Therapy (ESPRIT) trial, eptifibatide during coronary intervention was associated with decreased ischemic complications at 48 h and 30 days. METHODS: Patients (n = 2,064) were randomized to placebo versus eptifibatide (two 180 microg/kg boluses 10 min apart and as a continuous infusion of 2 microg/kg per min) during percutaneous coronary stenting. Angiographic complications including major dissection, distal embolization, residual thrombus, abrupt closure, residual stenosis >50% and side-branch occlusion were prospectively recorded by the operator. Creatine kinase-MB levels were measured after the procedure and every 6 h thereafter. The incidence of angiographic complications and CK-MB elevation was determined for eptifibatide versus placebo groups. RESULTS: Eptifibatide-treated patients demonstrated nonsignificant trends toward fewer angiographic complications (10 vs. 12% for placebo patients, p = 0.13) and, for patients with angiographic complications, fewer subsequent CK-MB elevations (43 vs. 50% for placebo patients, p = 0.31). In patients without any angiographic complications, the incidence of CK-MB elevation >3 times the normal was 7% with placebo and 4% with eptifibatide (p = 0.003). CONCLUSIONS: Eptifibatide during nonurgent coronary stent intervention only minimally (and insignificantly) reduces the incidence of angiographic complications and subsequent CK-MB elevations in patients developing an angiographic complication. The greater effect is to reduce myocardial infarction in patients undergoing otherwise uneventful coronary stent implantation as well as in the overall study population.

Angioplasty, Balloon, Coronary↗
PubMed2001

Ethnic differences in eating disorder symptoms among college students: the confounding role of body mass index.

Eating disorders are among the most common psychopathologies on college campuses. Research on ethnic differences in eating disorder symptoms and prevalence has resulted in conflicting conclusions. Some studies find that particular ethnic groups have a higher prevalence of a symptom; others find that members of that ethnic group have a lower prevalence of the same symptom. The authors explored the role of body mass index (BMI), one potential confound. They used a reliable measure of eating disorder symptoms to assess differences between Hispanic, Asian, and non-Hispanic White college women from two separate samples. After controlling for BMI, ethnic differences in eating disorder symptoms of concern about weight and shape disappeared, but differences in restrained eating remained. Inconsistent findings in the ethnic-difference literature on eating disorders may result from systematic group differences in BMI. Implications for college health programs, counseling, and case finding are discussed.

Adolescent↗
PubMed2001

Effects of future writing and optimism on health behaviors in HIV-infected women.

Optimists (people who have positive expectations about the future) have been shown to perform more health-promoting behaviors than pessimists. This study attempts to alter individuals' levels of optimism, and thereby their health behaviors, by having them write about a positive future. HIV-infected women (N = 40) on combination therapies were randomly assigned to write about a positive future or assigned to a no-writing control group. Among participants who were low in optimism, the writing intervention led to increased optimism, a trend toward increased self-reported adherence to medications, and decreased distress from medication side effects, compared to controls who did not write. Participants who were high in optimism showed the opposite effects after writing about the future. Results suggest that a future-oriented writing intervention may be apromising technique to increase medication adherence and decrease symptom distress in pessimistic individuals.

Adolescent↗
PubMed2001

A street intercept survey to assess HIV-testing attitudes and behaviors.

Nationally, it has been estimated that 44% of adults in the United States have been tested for HIV, with substantial individual and community-level variations in HIV-testing attitudes and behaviors. HIV-testing behaviors and intentions and attitudes toward HIV testing, particularly toward home tests, were assessed among 385 adults recruited in a street intercept survey from a gay-identified agency, a substance-abuse treatment program, and inner-city community venues (a shopping mall and community center). Across these Los Angeles sites, the proportion of persons reported being tested for HIV in their lifetime (77%) was higher than the national estimate. Gay-identified agency (88%) and substance-abuse treatment program participants (99%) were more likely to have been tested than were the community participants (67%). Participants from a gay-identified agency were more likely to have had an anonymous test (51%) than were those from a substance-abuse treatment program (25%) or community sites (24%). Attitudes toward HIV testing, including mail-in home-test kits and instant home tests, were very positive. Most participants were willing to pay about $20 for a home-test kit. Participants from the community sites (82%) and the substance-abuse treatment program participants (87%) endorsed notification of HIV status to health departments and sexual partners more than did participants from the gay identified agency (48%). The street intercept survey appears to be a quick and feasible method to assess HIV testing in urban areas.

Adolescent↗
PubMed2001

Newborn hearing screens may give a false sense of security.

Certain risk factors result in a higher incidence of delayed-onset hearing loss. Ten subjects who passed auditory brainstem response birth screenings and later returned with bilateral sensorineural hearing loss are examined in this report. Although not all subjects in this report had respiratory distress, this study reveals a high correlation between mechanical ventilation and delayed-onset hearing loss.

Attitude to Health↗
PubMed2000

Transradial coronary stenting: comparison with femoral access closed with an arterial suture device.

The purpose of this study was to determine if closure of the femoral artery access site using a percutaneous arterial suture device (Perclose, Menlo Park, CA) in patients undergoing coronary stenting can result in the same benefits as seen with radial artery access. A total of 218 consecutive patients underwent coronary stenting (109 femoral, 109 radial) by investigators experienced with each technique. The two groups were matched in terms of sex, age, clinical presentation (50% acute), number of vessels and lesions stented, and lesion morphology. The relative costs of the femoral and radial procedures were examined using a decision analytic model and sensitivity analysis. The suture device was not used in 20/109 patients (18%) for anatomic reasons and failed to obtain hemostasis in 9/89 patients (10%). One radial patient had an occluded radial artery postprocedure, but this was recanalized at follow-up a month later. Primary success, procedural complications, postprocedure length of stay, and the percentage of patients discharged the same day were the same in both groups. Because of the added time to deploy Perclose, total procedure time was significantly longer in the femoral group (57 +/- 22 min femoral vs. 44 +/- 22 min radial, P < 0.01). Access site complications occurred only in the femoral group. More patients were ambulatory the same day of the procedure in the radial group (95% radial vs. 56% femoral, P < 0.01). The cost of the radial approach was substantially less than the femoral approach because of lower supply costs and fewer access complications. The transradial approach is a dominant strategy for coronary stenting, offering better outcomes at lower cost. Cathet. Cardiovasc. Intervent. 49:150-156, 2000.

Aged↗
PubMed2000

Don't mind if I do: disinhibited eating under cognitive load.

Past research has shown that strong emotional or motivational states can cause normally restrained eaters to overeat. In this article it is argued that simple cognitive load can also disinhibit eating by restrained eaters. Two studies examined this disinhibition effect. In Study 1, restrained and unrestrained eaters were given the opportunity to consume high-calorie food while performing either a high cognitive-load or low cognitive-load task. Restrained eaters consumed more food when under high cognitive load than when under low cognitive load; unrestrained eaters showed the opposite pattern. Study 2 replicated the disinhibition effect and ruled out stress, diminished awareness of food consumption, and ironic rebound as probable mediators. Results suggest that cognitive load may disinhibit consumption by preventing restrained eaters from monitoring the dietary consequences of their eating behavior. Implications for theories of self-regulation are discussed.

Adaptation, Psychological↗
PubMed2000

The microneme protein MIC3 of Toxoplasma gondii is a secretory adhesin that binds to both the surface of the host cells and the surface of the parasite.

Assay of the adhesion of cultured cells on Toxoplasma gondii tachyzoite protein Western blots identified a major adhesive protein, that migrated at 90 kDa in non-reducing gels. This band comigrated with the previously described microneme protein MIC3. Cellular binding on Western blots was abolished by MIC3-specific monoclonal and polyclonal antibodies. The MIC3 protein affinity purified from tachyzoite lysates bound to the surface of putative host cells. In addition, T. gondii tachyzoites also bound to immobilized MIC3. Immunofluorescence analysis of T. gondii tachyzoite invasion showed that MIC3 was exocytosed and relocalized to the surface of the parasite during invasion. The cDNA encoding MIC3 and the corresponding gene have been cloned, allowing the determination of the complete coding sequence. The MIC3 sequence has been confirmed by affinity purification of the native protein and N-terminal sequencing. The deduced protein sequence contains five partially overlapping EGF-like domains and a chitin binding-like domain, which can be involved in protein-protein or protein-carbohydrate interactions. Taken together, these results suggest that MIC3 is a new microneme adhesin of T. gondii.

Adhesins, Bacterial↗
PubMed2000

The implementation of the DHHS guidelines for the use of antiretroviral agents in HIV-infected adults: a pilot study.

The objective of this study was to assess whether United States DHHS guidelines for treatment with antiretroviral therapies are being implemented by health care providers when discussing treatment options with newly diagnosed HIV patients. Health care providers were observed interacting with HIV patients while making decisions about treatment. Observers assessed whether providers and patients discussed the five benefits and six risks of initiating antiretroviral therapy, as recommended in the DHHS Guidelines. Preliminary results indicate that the DHHS Guidelines are not being implemented in the way they were intended. The risks and benefits of antiretroviral therapy were infrequently discussed. No more than four of the 11 risk/benefit items were discussed with any patient, and four of the six risk items were never mentioned to any patient. Potential reasons why the guidelines are not being implemented are discussed.

Adult↗
PubMed2000

Barriers to antiretroviral medication adherence in HIV-infected women.

Little is known about the barriers which women living with HIV/AIDS encounter that impede their adherence to antiretroviral medication regimens. Yet in order to design effective interventions to improve women's adherence, it is first imperative to identify the factors that contribute to their non-adherence. The purpose of this study was to explore, from HIV-infected women's own perspectives, the barriers they faced in adhering to combination antiretroviral therapies. Twenty HIV-infected women were asked to keep a personal journal for a period of one month. In the journals, women wrote about what their lives were like while taking antiretroviral medications. Line-by-line open coding was done to identify major ideas and themes within the journal entries. Results showed that women faced six main barriers to adherence, those related to: (1) medication regimens, (2) side effects, (3) social relationships, (4) medication beliefs, (5) daily schedules, and (6) body weight. The findings underscore the difficult nature of the antiretroviral regimens and illuminate the daily obstacles women face in adhering to therapy. Interventions that target women's unique barriers are needed to improve adherence to antiretroviral medication regimens.

Acquired Immunodeficiency Syndrome↗