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PubMedDate not supplied

An exploratory study: the use of paroxetine for methamphetamine craving.

Methamphetamine abuse and dependence are growing problems nationally and worldwide. There are currently no effective pharmocologic treatments. Animal studies with SSRI's suggest that serotonergic modulation alters methamphetamine's behavioral effects. This exploratory study is a trial of the effects of the SSRI paroxetine versus placebo (in a double blind design) on craving and use in a population of methamphetamine users. Many subjects dropped out of the study, but those in active treatment who completed the eight week trial had a decrease in methamphetamine craving compared to the placebo treatment as measured by the OCDS modified for use in this population. Statistical analyses were not performed due to the low number of subjects. The preliminary data suggest that serotonergic agents may play a role in the effective treatment of methamphetamine abuse and dependence within the context of other effective behavioral interventions.

Adult↗

PubMed1974

Caste variation in the distribution of placental alkaline phosphatase genes among the Hindus of West Bengal.

798 placentas (Brahmin 141, Kayastha 303, Mahishya 91 and mixed low castes 263), from Calcutta hospitals, have been studied by starch gel electrophoresis for alkaline phosphatase types. The estimated gene-frequencies resemble those found else-where in caucasoid populations. Statistically significant differences (P approximately 0.02) were, however, noticed between the broadly divided upper caste group (Brahmin and Kayastha) and the lower caste group (Mahishya and mixed low castes) in respect of Plf 1 and Pls 1) gene distributions. The upper caste group has higher Plf 1 and lower Pls 1 frequencies than the lower caste group. The two broad caste groups are, however, quite uniform in Pli 1 distribution. All the six common phenotypes (S1, F1, I 1, S1F1, S1 I 1 and F1 I 1) and seven rare phenotypes (S1S2, S1S3, F1F2, F1S2, F2S1, F1S3 and I 1S2) were found.

Alkaline Phosphatase↗

PubMed2000

Neuropsychological follow-up in early-treated congenital hypothyroidism: a problem-oriented approach.

Screening programs for congenital hypothyroidism (CH) dramatically improved the neuropsychological prognosis in affected children. However, mild impairments in cognitive performances, poorer motor skills, defective language abilities, and learning problems have been reported in some studies of early-treated CH children. The occurrence of these defects makes neuropsychological follow-up mandatory. The aim of the present study was to identify those neuropsychological functions that are more frequently affected in early-treated CH children and that might require prompt rehabilitation treatment to prevent permanent defects. The study group involved 24 CH children. Levothyroxine (LT4) treatment (initial dose 8-10 microg/kg per day) was started at mean age of 28 days (range 15-45) and was then adjusted with the goal to keep thyrotropin (TSH) and free thyroid hormone levels in the normal range. Cognitive evaluation was performed at 3, 5, and 7 years of age and did not significantly differ from that of controls. Mean neurological scores were lower in children 5 years of age than in controls. Children with severe neonatal hypothyroidism (serum thyroxine [T4] < 2 microg/dL) had significantly lower neurological scores compared to less affected CH children and normal controls. The most affected functions were balance, extremity coordination, fine motricity, quality of movements, associated movements, and head movements. Language disorders were observed in half of CH children at 3 and 5 years of age, but moderately severe defects were restricted to those with severe neonatal hypothyroidism. In conclusion, a problem-oriented, simplified neuropsychological follow-up of early-treated children with CH should not systematically include the frequent repetition of time-consuming and expensive psychometric tests because individual IQ scores are in the normal range of tests in almost all CH children and can be differentiated from those of normal controls only on a population-statistic basis. Selected tests of motor proficiency are indicated at 3 and 5 years of age to detect those defects in motor skills that appear to be more specifically affected in CH children. Language performances are at particular risk in CH children, and should be always checked at 3 and 5 years of age. Children with even mild language disorders or delayed language achievements should be regularly reevaluated at 6-month intervals and, if no spontaneous improvement is observed, they should receive specific rehabilitation treatment. No further motor and language evaluation is warranted in CH children with normal tests at age 5 years.

Child↗

PubMed1988

Stability of hematologic parameters in healthy subjects. Intraindividual versus interindividual variation.

An automated complete blood count with white blood cell differential was performed yearly on successive groups of healthy second-year medical students from 1979 through 1987. For three classes (1984-1987), the counts were repeated on the same people nine months later. These data demonstrated that the mean value of all hematologic parameters was quite stable over nine years. This allowed for an estimation of the upper limit for the combined effects of drift in accuracy, precision, and biologic stability. The stability was achievable despite an evolution in technology and quality assurance methods over that period. A comparison of intraindividual versus interindividual variation demonstrated that a normal range based on population statistics may be less sensitive than a normal range established for a person during routine health maintenance, especially for the platelet count.

Adult↗

PubMed1998

A new approach to the problem of multiple comparisons in the genetic dissection of complex traits.

Saturated genetic marker maps are being used to map individual genes affecting quantitative traits. Controlling the "experimentwise" type-I error severely lowers power to detect segregating loci. For preliminary genome scans, we propose controlling the "false discovery rate," that is, the expected proportion of true null hypotheses within the class of rejected null hypotheses. Examples are given based on a granddaughter design analysis of dairy cattle and simulated backcross populations. By controlling the false discovery rate, power to detect true effects is not dependent on the number of tests performed. If no detectable genes are segregating, controlling the false discovery rate is equivalent to controlling the experimentwise error rate. If quantitative loci are segregating in the population, statistical power is increased as compared to control of the experimentwise type-I error. The difference between the two criteria increases with the increase in the number of false null hypotheses. The false discovery rate can be controlled at the same level whether the complete genome or only part of it has been analyzed. Additional levels of contrasts, such as multiple traits or pedigrees, can be handled without the necessity of a proportional decrease in the critical test probability.

Animals↗

PubMed2001

Modeling linkage disequilibrium between a polymorphic marker locus and a locus affecting complex dichotomous traits in natural populations.

Linkage disequilibrium is an important topic in evolutionary and population genetics. An issue yet to be settled is the theory required to extend the linkage disequilibrium analysis to complex traits. In this study, we present theoretical analysis and methods for detecting or estimating linkage disequilibrium (LD) between a polymorphic marker locus and any one of the loci affecting a complex dichotomous trait on the basis of samples randomly or selectively collected from natural populations. Statistical properties of these methods were investigated and their powers were compared analytically or by use of Monte Carlo simulations. The results show that the disequilibrium may be detected with a power of 80% by using phenotypic records and marker genotype when both the trait and marker variants are common (30%) and the LD is relatively high (40-100% of the theoretical maximum). The maximum-likelihood approach provides accurate estimates of the model parameters as well as detection of linkage disequilibrium. The likelihood method is preferred for its higher power and reliability in parameter estimation. The approaches developed in this article are also compared to those for analyzing a continuously distributed quantitative trait. It is shown that a larger sample size is required for the dichotomous trait model to obtain the same level of power in detecting linkage disequilibrium as the continuous trait analysis. Potential use of these estimates in mapping the trait locus is also discussed.

Alleles↗

PubMed1994

Outmigrant ascertainment for bias assessment in environmental epidemiology.

BACKGROUND: In the summer of 1985, the McGill Epidemiology Rapid Response Unit undertook a study comparing two areas exposed to emissions of 'sour gas' refineries to an unexposed area. One operational objective of the project was the identification and survey of all the people who had lived in the study area but had since moved (outmigrants). METHODS: We estimated the number of outmigrants (people who had ever lived in the area during the period 1957 to 1985) to be 3363 by using information obtained from our cross-sectional survey and from population statistics for the area of interest. Ten different methods combined lead to the identification of approximately 87% of all the outmigrants who left the study area during that period. We used vital statistics to identify the outmigrants who had died and mailed questionnaires to obtain the necessary information from the others. RESULTS: We confirmed the vital status of approximately 46% of them (1532/3363). The results from the outmigrant survey showed that they were younger than area residents, that they experienced lower rates of heart disease and hypertension and that they had moved for health reasons in only 1.3% of the cases. These findings were similar across comparison areas. CONCLUSION: We concluded that there was no effect due to migration bias on the cross-sectional study results. This evidence considerably strengthened the conclusions regarding the effects of exposure, a benefit that largely justified the cost of identifying and surveying the outmigrants.

Adolescent↗

PubMed1999

SCOP: a Structural Classification of Proteins database.

The Structural Classification of Proteins (SCOP) database provides a detailed and comprehensive description of the relationships of all known proteins structures. The classification is on hierarchical levels: the first two levels, family and superfamily, describe near and far evolutionary relationships; the third, fold, describes geometrical relationships. The distinction between evolutionary relationships and those that arise from the physics and chemistry of proteins is a feature that is unique to this database, so far. The database can be used as a source of data to calibrate sequence search algorithms and for the generation of population statistics on protein structures. The database and its associated files are freely accessible from a number of WWW sites mirrored from URL http://scop. mrc-lmb.cam.ac.uk/scop/

Algorithms↗

PubMed1992

Septal rupture after myocardial infarction: is very early surgery really worthwhile?

Despite numerous publications, mostly with small patient populations, the management of post-infarct septal rupture is still not well defined. Although urgent surgery appears to be the therapy of choice it is still unclear whether surgery very early after septal rupture in patients with severe haemodynamic compromise salvages a significant number of patients. In this paper we present the data from a large population of consecutive patients with post-infarct septal rupture from one cardiac centre. From 1980 through 1989, 108 patients with post-infarct septal rupture were seen at this Regional centre of whom 81 had operative repair; 43 (53%) of these survived the early postoperative period. Of 32 patients with cardiogenic shock who had surgery, early operative mortality in those operated on within 48 h of rupture was 90% (18/20) compared with 33% (4/12) in those operated on later (P less than 0.001). All survivors with pre-operative shock had intra-aortic balloon counter-pulsation before operation. Concomitant coronary artery bypass grafting was not associated with improved survival in our patients. Three patients survived long-term without operation. Analysis of population statistics suggest that approximately 270 patients with post-infarction septal rupture were not transferred from peripheral hospitals to the Regional Cardiothoracic Centre for assessment during this decade.

Aged↗

PubMed2000

Abuse of older persons: an overview.

As demographics in the United States indicate that by 2050 older persons will constitute one-fourth of the population, statistics indicating abuse of older persons will also increase. As a serious social problem, nurses will need to assess and intervene with families where this type of family violence occurs. The types of abuse of older persons include physical, psychological, sexual, and financial abuse; neglect, self-neglect; and other types such as violation of rights, denial of privacy, and denial of participation in decision making. This article examines types of abuse, who is at risk, identifying characteristics of abusers, and nursing assessment and nursing interventions related to abuse of older persons.

Aged↗

PubMed2004

40 mg pantoprazole and 40 mg esomeprazole are equivalent in the healing of esophageal lesions and relief from gastroesophageal reflux disease-related symptoms.

BACKGROUND: Proton pump inhibitors are regarded as the most effective class of acid suppressive medication for gastroesophageal reflux disease treatment. There is considerable interest regarding the dose equivalence between various proton pump inhibitors. GOALS: To compare the efficacy of pantoprazole and esomeprazole with regard to healing and relief from gastroesophageal reflux disease-related symptoms. STUDY: Multicenter, randomized, double-blind study. Patients with gastroesophageal reflux disease grades B/C (Los Angeles classification) received 40 mg pantoprazole daily (n = 113) or 40 mg esomeprazole daily (n = 114). Healing (endoscopy) and relief from gastroesophageal reflux disease-related symptoms (direct questioning) were assessed at first and final visit (after 4, 6, 8, or 10 weeks of treatment). RESULTS: Overall healing in both treatment groups was 88% of patients (intention-to-treat population), 95% (pantoprazole), and 90% (esomeprazole) (per-protocol population); statistically, this indicates "at least equivalence" between treatments. Overall relief from gastroesophageal reflux disease-related symptoms was similar for pantoprazole (55%) and esomeprazole (51%, per-protoco). No correlation between healing and symptom relief was seen. The majority of reported adverse events were assessed as "not related" to the study drug. Pantoprazole and esomeprazole have comparably good safety and tolerability. CONCLUSION: In patients with gastroesophageal reflux disease, 40 mg pantoprazole daily and 40 mg esomeprazole daily are equally effective for healing of esophageal lesions and relieving gastroesophageal reflux disease-related symptoms.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMed2003

How to measure the phase diffusion dynamics in the micromaser.

We propose a realistic scheme for measuring the micromaser linewidth by monitoring the phase diffusion dynamics of the cavity field. Our strategy consists of exciting an initial coherent state with the same photon number distribution as the micromaser steady-state field, singling out a purely diffusive process in the system dynamics. After the injection of a counterfield, measurements of the population statistics of a probe atom allow us to derive the micromaser linewidth in all ranges of the relevant parameters, establishing experimentally the distinctive features of the micromaser spectrum due to the discreteness of the electromagnetic field.

Journal Article↗

PubMed2005

A survey of total quality management in Iran.

PURPOSE: The objective of this research is to investigate the success of TQM and barriers to its successful implementation in health care services organizations in Isfahan province, Iran, 2004. DESIGN/METHODOLOGY/APPROACH: This descriptive and cross-sectional research was done via two questionnaires (TQM success and its barriers). The statistical population of this research consists of all managers of health care services organizations who implemented TQM in their organizations (90 managers). FINDINGS: TQM success in Isfahan health care organizations was high. In correlation analyses between the success of TQM and its principles, success, process management and focus on employees had a positive and the greatest effect and focus on material resources and on suppliers had a lower effect. In correlation analysis between the barriers to TQM and the problem dimensions, human resource, strategic and structural problems were the most important obstacles and barriers to TQM successful implementation respectively. RESEARCH LIMITATIONS/IMPLICATIONS: Although conducted in Iran, it is anticipated that the findings may well have relevance on a broader scale. ORIGINALITY/VALUE: By replicating this study in different countries and contexts the results could be very fruitful for developing a model of TQM that can be implemented easily, effectively, efficiently and successfully in a cross-cultural context.

Cross-Sectional Studies↗

PubMed1998

Intermittent therapy for melasma in Asian patients with combined topical agents (retinoic acid, hydroquinone and hydrocortisone): clinical and histological studies.

Melasma is a common problem in Asians, but treatments have not been satisfactory. In the present study, we evaluated the efficacy of a new formula containing 0.1% tretinoin, 5% hydroquinone, and 1% hydrocortisone (RHQ) in Korean patients with melasma. Twenty-five Korean females with therapy recalcitrant melasma applied RHQ on their faces for 4 months and were evaluated before and 4 weeks after treatment clinically and histologically. They were also evaluated clinically 4 months after treatment. To minimize unavoidable side effects (erythema or peeling), we applied RHQ twice a week instead of the usual daily application. However, we obtained clinical and histological results comparable to other reports from white populations. Statistically significant depigmentation in clinical and histological studies and increased subepidermal collagen synthesis were observed in this study. These effects were seen as early as 4 weeks after treatment with RHQ. We used mMASI scoring, a modified version of the original MASI, to quantify the effects of RHQ more objectively and easily.

Administration, Topical↗

PubMed2006

Obstructive sleep apnoea syndrome: a nurse-led domiciliary service.

AIM: This paper reports a successful transformation of clinical practice from inpatient diagnosis and initiation of treatment for obstructive sleep apnoea syndrome to a nurse-led domiciliary model increasing patient access and choice. BACKGROUND: Obstructive sleep apnoea syndrome is common, affecting globally 2-4% of the adult population. It is characterized by periodic complete or partial collapse of the upper airway, leading to hypoxaemia and sleep fragmentation, resulting in daytime sleepiness and impaired quality of life. It can be treated successfully with nocturnal continuous positive airway pressure. Strategies for diagnosis and initiation of treatment have traditionally been inpatient-based, but limited facilities and increasing demand in many countries have necessitated alternative strategies. METHODS: As an extension to our current inpatient provision, we have established nurse-led domiciliary investigation and treatment. Patients meeting predefined criteria undergo a limited sleep study followed by therapy initiation at home. Confirmation of investigation findings, evaluation of treatment, education and long-term review are carried out in nurse-led clinics. RESULTS: We evaluated outcome in the first 150 patients managed in this way between August 2002 and December 2003. In our highly selected patient group, 79% of those who undertook a trial of treatment continued at 3 months, with average compliance >5 hours per night, a figure which compares favourably with our overall patient population. Statistically significant sustained improvement in sleepiness was seen. Independent predictors of long-term acceptability of continuous positive airway pressure were disease severity and magnitude of improvement in sleepiness. CONCLUSION: A nurse-led service for domiciliary diagnosis, treatment initiation and on-going management of selected patients with obstructive sleep apnoea syndrome is feasible and cost-effective, with outcomes comparable with conventional inpatient services. This approach is applicable in most countries where increasing demand for investigations greatly exceeds the availability of traditional facilities.

Adult↗

PubMed1987

Effect of screening for cystic fibrosis on the influence of genetic counseling.

We studied the influence of genetic counseling for cystic fibrosis on family planning, using neonatal screening, family size at time of diagnosis, and maternal age as possible determinants for reproductive behaviour. The expected number of children born to mothers of equal age and parity in the same period was approximated on the basis of population statistics. These numbers were compared to the numbers of children born in the study group after a CF diagnosis and information on the 25% recurrence risk were given. A 50.8% reduction in childbirth was found in the study group, although 77% of families had decided against further high-risk pregnancies. No statistically significant influence of neonatal screening could be demonstrated, but this may be due to the small number of families involved.

Adult↗

PubMed1997

Trends in the health burden due to urinary tract infection in children in Australia.

OBJECTIVE: To estimate the health burden of urinary tract infection in children less than 15 years of age in Australia and to ascertain whether any significant change has occurred during the past decade. METHODOLOGY: The number of children less than 15 years of age who were admitted in New South Wales for urinary tract infection between 1981 and 1994 was ascertained from the Department of Health, and age and sex specific incidence rates were calculated using Australian Bureau of Statistics population data. Costs for inpatient care were calculated using the cost weights from Australia National Disease Related Groups Version 3 for urinary tract infection (DRG 577). The frequency of the four most commonly requested renal tract imaging procedures in children following urinary tract infection and which qualified for Medicare reimbursement were obtained from the Health Insurance Commission for 1984-1994: micturating cystourethrography, intravenous urography, renal ultrasonography, and nuclear medicine renal studies. RESULTS: There were 1203 children who were admitted with urinary tract infection in New South Wales in 1994, at an estimated cost of $A1.6 million. Since 1981, the age standardized annual incidence of urinary tract infection requiring hospitalization has increased from 0.5 to 0.9 per 1000 children, largely because of an increase in the number of young children admitted (from 0.6 to 2.0 per 1000 children less than 5 years of age). In 1994, 46,230 non-inpatient renal imaging procedures were undertaken in children under 15 years of age at a cost of $A5.3 million. CONCLUSIONS: Urinary tract infection is an important and increasing health problem for Australian children, particularly for preschool children. Whether this represents a true increase in the incidence of urinary tract infection or improved diagnosis and more intensive management is not possible to establish with this study design. Prospective population based studies are required to assess more completely the frequency with which urinary tract infection occurs in children and any changes that may be occurring.

Adolescent↗

PubMed1989

Effects of synthetic salmon calcitonin on C cells of the thyroid.

The effects of long-term administration of synthetic salmon calcitonin (TZ-CT) on thyroid C cells of rats were evaluated immunohistochemically and electron microscopically. Low dose (0.075, 0.75 and 7.5 IU/kg/day) administration caused no significant changes in the C cell population, whereas high doses (30 and 120 IU/kg/day) caused C cell suppression. The area ratio of C cells to total cells in the thyroid was measured on sections immunoperoxidase stained for calcitonin. The average C cell ratio was compared among the experimental groups. This morphometric analysis of the high-dose and control groups confirmed the differences in C cell populations statistically (30 IU/kg vs. control, p less than or equal to 0.05; 120 IU/kg vs. control, p less than or equal to 0.05). The suppressive effect of TZ-CT on C cells was reversible after cessation of administration for one month. Electron microscopic examination on the C cells in the high-dose groups revealed no particular ultrastructural differences. These results may suggest a negative feedback mechanism on C cells by exogenous CT.

Animals↗