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Biomedical subjects

W Fisher

Publications and source records attributed to W Fisher.

At least 55 records · Page 3Linked to original sources
PubMed1991

A faded bedtime with response cost protocol for treatment of multiple sleep problems in children.

The sleep-wake cycles of 4 developmentally delayed individuals with longstanding severe sleep disturbances were regulated using a faded bedtime procedure with response cost. Bedtimes were systematically delayed for each individual, thus increasing the probability of short latency to sleep onset. The response cost component, consisting of removing the individual from bed for 1 hour, was implemented when an individual did not experience short latency to sleep onset. A fading procedure was then applied successfully to advance the bedtimes and to gradually increase durations of sleep. Specifically, all 4 individuals had decreased amounts of nighttime sleep that increased following treatment. Two of the 4 individuals showed excessive daytime sleep that decreased following treatment. Three of the 4 individuals experienced decreases in night wakings following treatment. Both environmental and biological manipulations of the sleep-wake cycle are hypothesized as mechanisms of treatment. The relative advantages of this procedure over other procedures for the treatment of pediatric sleep disorders are discussed, as are directions for future research.

Adolescent↗
PubMed1991

Prevalence of psychoactive drug use among North Dakota group home residents.

To determine the prevalence of psychoactive medication usage among persons with mental retardation residing in community settings in the state of North Dakota, we sent a questionnaire to all group homes serving persons with developmental disabilities. The return rate was 97%. Psychoactive medications were used by 37% of residents represented. Results were discussed in relation to previous studies that have primarily involved institutionalized populations.

Adolescent↗
PubMed1990

Aberrant sleep patterns in children with the Rett syndrome.

Previous studies on the characteristics of disturbed sleep/wake patterns in children with the Rett syndrome have yielded inconsistent findings. In the current study, momentary time sampling procedures were used to measure the sleep/wake patterns of 20 girls with classical Rett syndrome. These patients had significantly more total sleep than age peers (M = 110.1; Zm = 2.58; p = .01), significantly less nighttime sleep (M = 80.8; Zm = -7.53; p less than .0001), and significantly more daytime sleep (M = 24.5; Zm = 8.71; p less than .0001). Night sleep was negatively correlated with age (r = -.59; p less than .01); day sleep was positively correlated with age (r = .54; p = .01). These girls also displayed night wakings on 20.9% of nights, delayed sleep onset on 67.8% of nights and early wakings on 24.5% of nights. These data clearly demonstrate that children with the Rett syndrome have markedly impaired sleep/wake patterns and suggests that the sleep dysfunction may worsen over time.

Adolescent↗
PubMed1990

Asperger's syndrome: to be or not to be?

It has been questioned whether Asperger's syndrome (AS) is in fact a specific (high functioning) subgroup of autism, rather than a distinct entity. Thirteen AS patients were compared with 13 autistic patients and 13 developmentally disordered controls. While there was symptom overlap between AS and autism, patients could be separated into one or other group. However, current criteria are based on symptoms, and it is argued that studies of genetics and treatment response are needed to elucidate the relationship between these developmental disorders.

Adolescent↗
PubMed1990

Children with self-injurious behavior.

Self-injurious behavior is a serious problem that is not uncommon among individuals with mental retardation. Medical and developmental characteristics of 97 children, adolescents, and young adults (age range 11 months to 21 years, 11 months) assessed and treated for self-injurious behavior in a specialized, interdisciplinary inpatient unit between 1980 and 1988 were reviewed. This population differed from those reported in previous studies in that it was of school age and predominantly community based. Severe or profound mental retardation was present in 82.5% of our patients. The causative diagnoses associated with self-injurious behavior were similar to those of severe mental retardation alone. Associated disabilities represented at greater than expected frequencies included pervasive developmental disorders, visual impairment, and a history of infantile spasms. Most patients (81.4%) engaged in more than one type of self-injurious behavior. The most common topographies were head banging, biting, head hitting, body hitting, and scratching. Physical injury was documented in 77% of cases; the injuries most frequently reported were excoriations, scars/callus formation, hematomas, and local infection. As community placement of handicapped individuals continues to increase, pediatricians will be called upon to monitor patients who engage in self-injurious behavior.

Adolescent↗
PubMed1989

Assessing independent and interactive effects of behavioral and pharmacologic interventions for a client with dual diagnoses.

Behavior analytic methods were applied to the assessment and treatment of the problem behaviors of an 8-year-old male classified as having moderate mental retardation and atypical psychosis. Functional assessment procedures demonstrated that verbal behaviors diagnosed as hallucinatory were affected by environmental contingencies. Next, a multi-element/multiple baseline design was used to evaluate the independent and interactive effects of contingency management and pharmacologic interventions on three dependent variables: (1) psychotic speech; (2) aggressive-disruptive behavior; and (3) appropriate speech. Results indicated that contingency management without haloperidol was the most effective treatment for all inappropriate and appropriate behaviors. These results are important in that behavior analytic methods were shown to have utility for: (1) assessing the functional relationship between environmental contingencies and behaviors related to differential diagnosis; and (2) evaluating the independent and interactive effects of behavioral and pharmacologic treatments.

Autistic Disorder↗
PubMed1989

Regulation of methionine synthesis in Escherichia coli: effect of the MetR protein on the expression of the metE and metR genes.

A plasmid (pRSE562) containing the metE and metR genes of Escherichia coli was used to study the expression of these genes and the role of the MetR protein in regulating metE expression. DNA sequence analysis of the 236-base-pair region separating these genes showed the presence of seven putative met boxes. When this plasmid was used to transform either wild-type E. coli, metE mutant, or metR mutant, MetE enzyme activity increased 5- to 7-fold over wild-type levels. The metR gene was subcloned from pRSE562, and this plasmid, pMRIII, relieved the methionine auxotrophy of a metR mutant after transformation. The metR gene was also cloned into a vector containing the lambda PL promoter, and the MetR protein was overexpressed and purified to near homogeneity. This protein, when added to an in vitro DNA-dependent protein synthesis system in which the MetE and/or MetR proteins were synthesized, caused a large increase in the expression of the metE gene but a decrease in the expression of the metR gene. The in vitro expression of both genes was inhibited by the MetJ protein and S-adenosylmethionine in the presence or absence of MetR protein. These results provide evidence that the product of the metR gene is a trans-activator of the expression of the metE gene and that the expression of the metR gene is under autogenous regulation and is repressed by the MetJ protein.

5-Methyltetrahydrofolate-Homocysteine S-Methyltran↗
PubMed1989

Pervasive disintegrative disorder: are Rett syndrome and Heller dementia infantilis subtypes?

Children with developmental regression and emerging symptoms of autism have been given a variety of classifications. The authors compare two boys with Heller dementia with six girls with Rett syndrome. They all differed from children with classic autism in that they had normal prenatal and perinatal periods, followed by marked developmental regression, after which they acquired few or no skills. The boys differed from the girls in terms of estimated prevalence, age at onset, stereotypic breathing patterns, midline hand stereotypies, hand and gait apraxia and speech development. It is suggested that these children should be distinguished from those with classic autism, and should be classified as 'pervasive disintegrative disorder, Heller type' and 'pervasive disintegrative disorder, Rett type'.

Adolescent↗
PubMed1989

Don't abandon FAS.

Explore the source record for details and available documents.

Activities of Daily Living↗
PubMed1988

Markers for improvement in children with pervasive developmental disorders.

In a series of prevalence and follow-up studies on North Dakota's 59 children with pervasive developmental disorders, the patient characteristics of hyperlexia, Tourette disorder (TD), and the absence of seizures were found to be associated with improved outcome or higher IQ. We entered these and 17 other characteristics into a regression model using forward, step-wise inclusion to identify the smallest set of predictor variables which were significantly associated with the dependent variables of IQ, and receptive and expressive language. Of the 20 predictor variables used in the regression analysis, the same four variables met inclusion criteria for each of the dependent variables. These predictor variables were: hyperlexia, a known aetiology, TD and age. The relevance of these findings is discussed.

Child Development Disorders, Pervasive↗
PubMed1988

Childhood Onset Pervasive Developmental Disorder.

Two male children meeting criteria for Childhood Onset Pervasive Developmental Disorder (COPDD) are described. The current DSM-III category of COPDD may have value in separating these children from others with PDD. The authors suggest that these two children, and other children described in the literature as having dementia infantalis and/or disintegrative psychosis, have a distintegrative disorder resulting in muteness, profound mental retardation and severe autistic symptomatology. The term "pervasive disintegrative disorder" may be appropriate for such children and specific diagnostic criteria are suggested. The disorder appears to be extremely rare, with a prevalence estimate of 0.11 per 10,000.

Age Factors↗
PubMed1988

A comparison of breastfeeding rates among children with pervasive developmental disorder, and controls.

The breastfeeding rates for 50 children with pervasive developmental disorder (PDD) from North Dakota's roster of PDD patients were compared with the national average and with the rates for a control group matched for age, sex, and IQ. In addition, the breastfeeding rates for the normal siblings of the PDD and control groups were compared with the national average to help determine whether the lower breastfeeding rate among PDD patients was a function of parenting practices. The breastfeeding rates for the PDD and control groups were not significantly different from each other, but both were significantly lower than the national average. The breastfeeding rate for the normal siblings of PDD children was almost identical to the national average, but the rate for the siblings of the matched control group was significantly lower than the national average. These results are discussed in terms of hypotheses regarding the early parent-child interactions and characteristics in the families of PDD children.

Autistic Disorder↗
PubMed1987

Expression of leukocyte adherence-related glycoproteins during differentiation of HL-60 promyelocytic leukemia cells.

We used the HL-60 human promyelocytic leukemia cell line to analyze the surface expression of a family of adherence-related leukocyte surface antigens during myeloid differentiation. These antigens are composed of discrete alpha subunits, designated alpha L, alpha M, and alpha X, that are each noncovalently associated with a common beta subunit. Monoclonal antibodies directed against the individual subunits served as markers in both indirect immunofluorescence studies and immunoprecipitations from HL-60 cells differentiated preferentially towards mature granulocytes (DMSO, retinoic acid) or monocyte/macrophages (PMA, vitamin D3). In undifferentiated HL-60 cells, the alpha L and alpha X subunits were constitutively expressed, whereas the alpha M subunit was not. Differentiation of HL-60 cells along the granulocytic pathway with DMSO resulted in a marked increase in alpha M and minimal increases in alpha L and alpha X. The phenotypic expression of these antigens on DMSO-treated HL-60 cells closely resembled that on normal circulating PMN. Differentiation along the monocyte/macrophage pathway when using PMA or vitamin D3 resulted in major increases in alpha L and alpha X expression, as well as alpha M. These changes resulted in a surface phenotype characteristic of that present on human monocyte-derived macrophages. Triggering of undifferentiated HL-60 cells with PMA caused no increase in subunit expression, whereas stimulation of DMSO-differentiated HL-60 cells with PMA produced more than a 1.5-fold enhancement of both the alpha M and alpha X subunits, and stimulation of human PMN with PMA increased the surface expression of alpha M more than fourfold and alpha X subunit twofold. Stimulation with PMA produced no change in expression of the alpha L subunit in any of the three cell populations. These results indicate that the alpha subunits of this glycoprotein family can be selectively regulated during in vitro differentiation of a human promyelocytic leukemia cell line. Second, DMSO-differentiated HL-60 cells and human PMN possessed an intracellular pool of alpha M and alpha X, but not alpha L, that could be translocated to the surface. Thus, despite structural and functional relationships among the alpha subunits in this glycoprotein family, they undergo disparate surface expression and intracellular regulation during differentiation.

Antigens, Surface↗
PubMed1987

Does the use of phenobarbital as an anticonvulsant permanently exacerbate hyperactivity?

Data is presented on 12 patients in whom phenobarbital, when used as an anticonvulsant medication, either precipitated hyperactivity or permanently exacerbated existing hyperactivity. Discontinuation of the medication resulted in a decrease in hyperactivity in all patients. None of the patients returned to a pre-drug level of activity. The effect of phenobarbital on the reticular system is discussed. It is important for clinicians to carefully consider the potential side-effects of the use of phenobarbital in children in whom overactivity is a problem. Ascertaining whether hyperactivity has been caused or exacerbated by exposure to phenobarbital may be important in the differential diagnosis of hyperactivity.

Diagnosis, Differential↗
PubMed1987

Lithium carbonate in the treatment of two patients with infantile autism and atypical bipolar symptomatology.

Two patients with infantile autism by DSM-III criteria and with atypical bipolar symptomatology were treated with lithium carbonate. Both children demonstrated a significant response with levels above 1.0mEq/liter. Factors that may be useful in discovering patients with autism who may respond to lithium treatment include a family history of bipolar illness; extreme hyperactivity not responsive to a stimulant; a definite cyclic component to symptomatic behaviors; sustained laughter, irritability, or giddiness that is not stereotypic; and/or the presence of many or all of the symptom criteria for bipolar disorder.

Autistic Disorder↗