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PubMed1996

Enhanced hypnotic suggestibility following application of burst-firing magnetic fields over the right temporoparietal lobes: a replication.

The suggestibility of normal, young men and women as assessed by Spiegel's Hypnosis Induction Profile (HIP) before and after weak (1 micro Tesla), burst-firing magnetic fields were applied for 20 min over the left or over the right temporoparietal lobe or both hemispheres; a fourth group received sham treatment. Only the group that received the stimulation over the right hemisphere exhibited a marked increase in suggestibility (eta = 0.58) following the treatment. These results replicate components of several different previous experiments and suggest that attribution of symptomatic changes following exposures to weak, extremely low frequency magnetic fields, to placebo effects may not be correct. Instead, fields whose signatures contain biorelevant information may directly affect the neurocognitive processes that are associated with hypnotizability.

Adult↗
PubMed1991

The prevalence of symptoms suggestive of esophageal disorders.

A questionnaire study was conducted to assess the prevalence and severity of symptoms suggestive of esophageal disorders in a general population. The study included 407 randomly selected subjects, evenly distributed in terms of sex and age, within the age span of 20-79 years. A total of 337 subjects replied (85%). Symptoms suggestive of gastroesophageal reflux were found among 25% of the participants. Cough on swallowing was common (27%), as was globus (16%) and chest pain (13%). In addition, dysphagia was reported by 10% and vomiting by 9%. The symptoms were usually mild, and moderate to severe symptoms were reported only occasionally (1-4%). No statistical correlation was found between esophageal symptoms and age, sex, or the reported consumption of tobacco, alcohol, or non-steroidal anti-inflammatory drugs. The frequency of heartburn and/or acid regurgitation was twice as common among those with symptoms of respiratory disease as among those with no respiratory complaints. A stepwise logistic regression analysis showed that a chronic cough and/or breathing difficulties were significantly related to the presence of symptoms suggestive of gastroesophageal reflux.

Adult↗
PubMed1995

Cluster analysis of Helicobacter pylori genomic DNA fingerprints suggests gastroduodenal disease-specific associations.

BACKGROUND: Helicobacter pylori infection is now accepted as the most common cause of chronic active gastritis and peptic ulcer disease. The etiologies of many infectious diseases have been attributed to specific or clonal strains of bacterial pathogens. Polymerase chain reaction (PCR) amplification of DNA between repetitive DNA sequences, REP elements (REP-PCR), has been utilized to generate DNA fingerprints to examine similarity among strains within a bacterial species. METHODS: Genomic DNA from H. pylori isolates obtained from 70 individuals (39 duodenal ulcers and 31 simple gastritis) was PCR-amplified using consensus probes to repetitive DNA elements. The H. pylori DNA fingerprints were analyzed for similarity and correlated with disease presentation using the NTSYS-pc computer program. RESULTS: Each H. pylori strain had a distinct DNA fingerprint except for two pairs. Single-colony DNA fingerprints of H. pylori from the same patient were identical, suggesting that each patient harbors a single strain. Computer-assisted cluster analysis of the REP-PCR DNA fingerprints showed two large clusters of isolates, one associated with simple gastritis and the other with duodenal ulcer disease. CONCLUSIONS: Cluster analysis of REP-PCR DNA fingerprints of H. pylori strains suggests that duodenal ulcer isolates, as a group, are more similar to one another and different from gastritis isolates. These results suggest that disease-specific strains may exist.

Adult↗
PubMed1994

Diagnostic conundrums in substance abusers with psychiatric symptoms: variables suggestive of dual diagnosis.

Patients with substance dependence and psychiatric symptoms often present a diagnostic conundrum because each of these problems may mutually and reciprocally complicate the other. This may challenge the ability to identify dual-diagnosis patients who have both a substance abuse disorder and a definitive symptom-based psychiatric disorder. The main purpose of this explorative study was to identify variables suggestive of dual diagnosis in the population of substance-dependent patients with psychiatric symptoms. A secondary purpose was to examine the subgroups in this population for their distinctiveness from one another. Based upon clinical experience and the literature, seven independent variables were hypothesized as suggestive of dual diagnosis. Seventy-nine patients with substance dependence and psychiatric symptoms of depression, anxiety, and/or psychosis were assessed for symptom and disorder status generating three subgroups: I) 20 patients with psychiatric symptoms not meeting thresholds for clinical significance; II) 36 patients exhibiting a psychiatric disorder (dual diagnosis); and III) 23 patients with psychiatric symptoms meeting thresholds for clinical significance but not for a disorder. Odds ratios were calculated to examine the risk for dual diagnosis using the seven independent variables. A persistent increased risk for dual diagnosis was observed in patients who were positive for the seven variables. The seven variables were combined into an overall measure of patients' risk for dual diagnosis. Mean scores were significantly different for the three groups F(2, 76) = 8.4, p < .001. This study indicates variables that may be suggestive of dual diagnosis and finds subgroup distinctiveness in this sample. Both of these findings have treatment implications.

Adult↗
PubMed1996

Pharmacological characterization of endothelin receptors in the rabbit iris sphincter muscle: suggestion for the presence of atypical receptors.

Pharmacological profiles of endothelin (ET) receptors in the isolated rabbit iris sphincter were characterized. ET isopeptides caused dose-dependent contraction of the preparation. The respective EC50 values for ET-1, ET-2 and ET-3 were 39.4, 58.0 and 84.3 nM, so that ET-1 was twice as potent as ET-3. Sarafotoxin (SRTX) -b, an ET(A)/ET(B) non-selective agonist, caused very potent contraction with an EC50 of 1.13 nM. However, selective ET(B) receptor agonists SRTX-c and IRL 1620 showed no contractile activity up to 1 microM. BQ-123, a selective ET(A) receptor antagonist, shifted the dose-response curves of ET isopeptides to the right. The pA2 value for ET-1 was 5.52 with a slope of 1.06, which is not different from unity, and the pK(B) value for ET-2 was 5.06. Interestingly, very low doses of BQ-123 antagonized responses to ET-3 and SRTX-b, with a Schild plot slope of approximately 0.7 which is significantly different from unity, suggesting receptor heterogeneity. The abscissal intercepts of the Schild plots were -9.29 for ET-3 and -8.53 for SRTX-b. FR 139317, another ET(A) receptor antagonist, also preferentially antagonized responses to ET-3. RES-701-1, a selective ET(B) receptor antagonist, did not shift dose-response curves for ET-1 and ET-3. These results suggest that ET receptors in the rabbit iris sphincter muscle cannot be classified into the ET(A), ET(B) or ET(C) receptor subtypes, so far established. When compared to the established receptor subtypes, ET receptors in this preparation were quite different from the ET(B) receptor, but apparently showed a pharmacological profile most similar to the ET(A) receptor, suggesting the presence of heterogeneous and atypical ET(A) receptors.

Animals↗
PubMed2003

Diagnostic contribution of gastric and bronchial lavage examinations in cases suggestive of pulmonary tuberculosis.

We assessed whether acid fast bacilli (AFB) determination in gastric lavage (GL) and bronchial lavage (BL) contributes to diagnosis in cases radiologically suggestive of pulmonary tuberculosis but with either negative AFB in sputum or the inability to expectorate sputum. Of 129 cases recruited for the study, 22 were excluded due to evaluation as inactive disease or non-tuberculosis disease. The remaining 107 cases were evaluated in 2 groups. Group A consisted of 49 patients that could not expectorate sputum and from whom GL was obtained. In group B, BL was performed in 58 patients that had negative sputum smear. Smear positivity was 61.2% (30/49) and culture positivity was 30.6% (15/49) in group A, 51.7% (30/58) and 81% (47/58), respectively, in group B. Thirteen cases, in whom AFB could not be detected microbiologically but who were radiologically strongly suggestive of tuberculosis, were regarded as tuberculosis according to "from treatment to diagnosis" criteria. In conclusion, detection of AFB positivity in the diagnosis of tuberculosis is important in terms of early initiation of treatment and detection of resistant bacilli. Therefore, we suggest that it would be helpful to obtain GL in cases where the patient is unable to expectorate sputum, and perform BL in cases with negative sputum smear.

Adult↗
PubMed2004

Diagnostic and prognostic value of cardiac troponin I assays in patients admitted with symptoms suggestive of acute coronary syndrome.

CONTEXT: Increasing numbers of patients are presenting to emergency departments with symptoms suggestive of an acute myocardial infarction. OBJECTIVE: To demonstrate the comparative performance of the Ortho Vitros Troponin I and Beckman Access AccuTnI assays used to detect myocardial infarction and to develop risk stratification schemes for all-cause death in patients who presented with myocardial ischemia symptoms that were suggestive of acute coronary syndrome (ACS). DESIGN: The prospective enrollment of patients with ACS and the measurement of serial plasma samples by 2 commercial cardiac troponin I (cTnI) assays. SETTING: A metropolitan medical center that admitted patients with ACS during a 2-month period. PATIENTS: The study population consisted of 200 consecutively admitted patients who presented with symptoms that were suggestive of ACS. RESULTS: Correlation scatterplots showed no significant bias between cTnI assays based on 659 specimens across the dynamic range of each assay. Only minor differences in slopes and intercepts were observed between assays when correlations were based across selected concentration ranges. The receiver operating characteristic curve areas for the detection of myocardial infarction were not significantly different (Ortho,.991; Beckman,.995). At the 99th percentile (Beckman, 0.04 microg/L; Ortho, 0.08 microg/L), each assay demonstrated 100% sensitivity with 78% and 80% specificity, respectively. Kaplan-Meier survival curves and the log-rank test were used to compare time-to-event data. Patients with increased baseline cTnI values had higher odds ratios of death than did those with normal concentrations. For Ortho, the 99th percentile cutoff was 5.9, and the 10% coefficient of variation cutoff was 10.3; for Beckman, the 99th percentile cutoff was 31.4, and the 10% coefficient of variation cutoff was 15.3. CONCLUSIONS: Comparable diagnostic and risk stratification abilities were demonstrated in patients with ACS by the Ortho Vitros and Beckman Access cTnI assays, with no significant analytic bias between cTnI assays.

Academic Medical Centers↗
PubMed1990

Acceptance of pharmacists' suggestions by prescribers: a literature review.

Acceptance of pharmacists' suggestions by prescribers is a necessary component of the evaluation of clinical pharmacy services that is often overlooked. A literature search was performed to review the information on this topic. Acceptance was defined as a measure of a prescriber's compliance with a pharmacist's recommendation regarding drug therapy. In order for the pharmacist to impact upon the quality of patient care or drug costs, the prescriber must accept the suggestions. A total of 23 studies was found that addressed the topic. The average rate of acceptance was 85.5%. Factors affecting acceptance included time, communication, solicited versus unsolicited recommendations, type of prescriber, and type of pharmacist. Factors leading to non-acceptance included lack of physician awareness of pharmacokinetic parameters, quality of suggestions, prescribers' exercise of caution with respect to patient safety and well-being, and negative attitude toward clinical pharmacy. More research needs to be done in order to evaluate the importance of these factors.

Attitude of Health Personnel↗
PubMed1999

Characteristics of sequences around individual nucleotide substitutions in IgVH genes suggest different GC and AT mutators.

Somatic hypermutation affects Ig genes during T-dependent B cell responses and is characterized by a high frequency of single base substitutions. Hypermutation is not a completely random process; a study of mutations in different systems has revealed the presence of sequence motifs that target mutation. In a recent analysis of the sequences surrounding individual mutated bases in out-of-frame human IgVH genes, we found that the target motifs around mutated G's and C's are reverse complements of each other. This finding suggests that hypermutation acts on both strands of DNA, which contradicts evidence of a strand-dependent mechanism as suggested by an observed bias in A and T mutations and the involvement of transcriptional machinery. We have now extended our database of out-of-frame genes and determined the sequence motifs flanking mutated A and T nucleotides. In addition, we have analyzed the flanking sequences for different types of nucleotide substitutions separately. Our results confirm the relationship between the motifs for G and C mutations and show that the motifs surrounding mutated A's and T's are weaker and do not have the same relationship. Taken together with our observation of A/T strand bias in out-of-frame genes, this observation suggests that there is a semitargeted G/C mutator that is strand-independent and a separate A/T mutator that is strand-dependent and is less reliant on the local target sequence.

Adenine↗
PubMed2000

Differential expression of VEGF isoforms and VEGF(164)-specific receptor neuropilin-1 in the mouse uterus suggests a role for VEGF(164) in vascular permeability and angiogenesis during implantation.

The mechanism(s) by which localized vascular permeability and angiogenesis occur at the sites of implantation is not clearly understood. Vascular endothelial growth factor (VEGF) is a key regulator of vasculogenesis during embryogenesis and angiogenesis in adult tissues. VEGF is also a vascular permeability factor. VEGF acts via two tyrosine kinase family receptors: VEGFR1 (Flt-1) and VEGFR2 (KDR/Flk-1). Recent evidence suggests that neuropilin-1 (NRP1), a receptor involved in neuronal cell guidance, is expressed in endothelial cells, binds to VEGF(165) and enhances the binding of VEGF(165) to VEGFR2. We examined the spatiotemporal expression of vegf isoforms, nrp1 and vegfr2 as well as their interactions in the periimplantation mouse uterus. We observed that vegf(164) is the predominant isoform in the mouse uterus. vegf(164) mRNA accumulation primarily occurred in epithelial cells on days 1 and 2 of pregnancy. On days 3 and 4, the subepithelial stroma in addition to epithelial cells exhibited accumulation of this mRNA. After the initial attachment reaction on day 5, luminal epithelial and stromal cells immediately surrounding the blastocyst exhibited distinct accumulation of vegf(164) mRNA. On days 6-8, the accumulation of this mRNA occurred in both mesometrial and antimesometrial decidual cells. These results suggest that VEGF(164) is available in mediating vascular changes and angiogenesis in the uterus during implantation and decidualization. This is consistent with coordinate expression of vegfr2, and nrp1, a VEGF(164)-specific receptor, in uterine endothelial cells. Their expression was low during the first 2 days of pregnancy followed by increases thereafter. With the initiation and progression of implantation (days 5-8), these genes were distinctly expressed in endothelial cells of the decidualizing stroma. Expression was more intense on days 6-8 at the mesometrial pole, the presumptive site of heightened angiogenesis and placentation. However, the expression was absent in the avascular primary decidual zone immediately surrounding the implanting embryo. Crosslinking experiments showed that (125)I-VEGF(165) binds to both NRP1 and VEGFR2 present in decidual endothelial cells. These results suggest that VEGF(164), NRP1 and VEGFR2 play a role in VEGF-induced vascular permeability and angiogenesis in the uterus required for implantation. genesis 26:213-224, 2000.

Animals↗
PubMed2000

New features of connectivity in piriform cortex visualized by intracellular injection of pyramidal cells suggest that "primary" olfactory cortex functions like "association" cortex in other sensory systems.

Associational connections of pyramidal cells in rat posterior piriform cortex were studied by direct visualization of axons stained by intracellular injection in vivo. The results revealed that individual cells have widespread axonal arbors that extend over nearly the full length of the cerebral hemisphere. Within piriform cortex these arbors are highly distributed with no regularly arranged patchy concentrations like those associated with the columnar organization in other primary sensory areas (i.e., where periodically arranged sets of cells have common response properties, inputs, and outputs). A lack of columnar organization was also indicated by a marked disparity in the intrinsic projection patterns of neighboring injected cells. Analysis of axonal branching patterns, bouton distributions, and dendritic arbors suggested that each pyramidal cell makes a small number of synaptic contacts on a large number (>1000) of other cells in piriform cortex at disparate locations. Axons from individual pyramidal cells also arborize extensively within many neighboring cortical areas, most of which send strong projections back to piriform cortex. These include areas involved in high-order functions in prefrontal, amygdaloid, entorhinal, and perirhinal cortex, to which there are few projections from other primary sensory areas. Our results suggest that piriform cortex performs correlative functions analogous to those in association areas of neocortex rather than those typical of primary sensory areas with which it has been traditionally classed. Findings from other studies suggest that the olfactory bulb subserves functions performed by primary areas in other sensory systems.

Animals↗
PubMed1999

Medicare program; suggestion program on methods to improve Medicare efficiency. Health Care Financing Administration (HCFA), HHS. Final rule with comment period.

This final rule with comment period establishes a program to encourage individuals to submit suggestions that could improve the efficiency of the Medicare program. The rule implements section 203(c) of the Health Insurance Portability and Accountability Act of 1996. The intent of this rule is to encourage suggestions and to award, if we deem appropriate, monetary payments to individuals for suggestions that improve efficiency and produce monetary savings to the Medicare program.

Cost Savings↗
PubMed2000

How often do high school guidance counselors suggest practical nursing as a career option?

The Centre for Nursing Studies provides practical nursing education in Newfoundland and Labrador. Because applications to the program from direct high school students were consistently low, in 1999 the Centre for Nursing Studies surveyed the provincial high school guidance counselors to determine their perceived knowledge level of the roles and responsibilities of Licensed Practical Nurses and the practical nursing program, the number of times they suggested practical nursing to students and characteristics they believed to be necessary for a practical nurse. There were 168 questionnaires distributed. Fifty (30%) returned questionnaires were analyzed. The results demonstrated that the majority of guidance counselors (66%) receive between 1 to 5 requests for information regarding practical nursing annually. Forty-eight percent suggest practical nursing as a career option 1 to 5 times annually, while an additional 22% suggest it 6 to 10 times. Some of the characteristics identified, by the guidance counselors, to be necessary for practical nurses include good people skills, empathy, hard working, good communication skills, a desire to help others and an interest in health care.

Career Choice↗
PubMed2003

Developmental expression of Smad1-7 suggests critical function of TGF-beta/BMP signaling in regulating epithelial-mesenchymal interaction during tooth morphogenesis.

Members of the transforming growth factor-beta family (e.g. TGF-beta, BMP and activin) are critical regulators of tooth morphogenesis. The basic TGF-beta signaling engine consists of a receptor complex that activates Smads and a Smad-containing complex that controls transcription of the downstream target genes. Little is known about the expression of endogenous Smads during tooth morphogenesis. Using a cRNA probe or antibody which specifically recognizes the expression of each Smad molecule, we provide a comprehensive endogenous Smad expression analysis during tooth morphogenesis. BMP signaling is transmitted through Smad1 and 5 which are first expressed within the dental lamina and later expand into condensed dental mesenchyme at the bud stage. As tooth development advances into the cap and bell stage, BMP signaling Smads are strongly localized within the inner enamel epithelium (IEE) and cranial neural crest derived dental mesenchyme (DM), indicating their critical role in regulating epithelial-mesenchyme interaction during tooth morphogenesis. Smad2 and 3 are responsible for transmitting TGF-beta/activin signaling and show unique expression patterns during tooth morphogenesis. They are localized within the nuclei of both IEE and DM, suggesting that TGF-beta-activated Smads are critical for regulating tooth development. Smad4, the common Smad, is expressed in both dental epithelium and mesenchyme throughout all stages of tooth morphogenesis. The expression of inhibitory Smads (Smad6 and 7) largely overlaps with receptor regulated Smads, indicating that negative feedback on BMP/TGF-beta signaling is critical throughout all stages of tooth morphogenesis. Our results suggest that both receptor-regulated and inhibitory Smads are important regulators of tooth morphogenesis. The selective activation of Smad, as indicated by nucleartranslocation, may suggest selective activation of different members of the TGF-beta superfamily during tooth development.

Animals↗
PubMed2003

[Effectiveness of standardized direct suggestions in dental hypnosis].

The frequency of occurrence of amnesia, analgesia and time distortion during hypnotic dental treatments (n = 60) was investigated on high dental anxiety patients. Hypnosis with and without standardised direct suggestions related to amnesia, analgesia and time distortion were compared. Treatment of alert patients without direct suggestions (n = 10) were also used for comparison. Amnesia and time distortion was higher (p < or = 0.05) with the use of suggestions under hypnotic conditions, but analgesia was not significantly different. Alert appearance of the events were in all cases less (p < or = 0.01) than under hypnotic conditions.

Adult↗
PubMed2005

Male adolescents' reasons for participating in physical activity, barriers to participation, and suggestions for increasing participation.

This study explored male adolescents' reasons for participating in moderate and vigorous physical activity, perceived barriers to moderate and vigorous physical activity, and suggestions as to what can be done to increase participation in physical activity. A total of 26 male 15- and 16-year-old adolescents participated in focus group sessions, which were audiotaped and transcribed verbatim; qualitative software facilitated data analysis. A constant comparison approach was used to inductively develop themes. It was found that participants engaged in physical activity for both intrinsic and extrinsic reasons. Their perceived barriers to physical activity included both internal factors (individual characteristics, lower priority for physical activity, and involvement in technology-related activities) and external factors (the influence of peers and family, lack of time, and inaccessibility and cost of facilities). Participants suggested that physical activity be promoted more in the community and that an environment more supportive of physical activity be developed. Results suggest that a variety of strategies should be used to help male adolescents maintain or increase participation in moderate and vigorous physical activity.

Adolescent↗
PubMed2005

Public opinion and organ donation suggestions for overcoming barriers.

Getting organs for transplantation depends on people's decision; thus, public opinion is essential to finding a solution to this problem. Efforts to improve organ shortage focus on: 1) Living, unrelated donation, 2) increasing marginal donors and 3) proposing economic support for donors. Paradoxically, no initiative has been suggested to modify public opinion towards cadaver donors. Several reasons explain the resistance to donating cadaver organs: Lack of awareness, religious uncertainties, distrust of medicine, hostility to new ideas, and misinformation. Education should be used to reshape public opinion about the use of organs for transplantation. Society should accept that "using" body parts is moral and offers a source of health for everybody. The concept that using cadaver organs implies sharing a source of health might be a social agreement between all members of Society. Suggestions for improving organ shortage include: 1) Society should understand that during one's life one may be just as easily a potential organ receiver as one is an organ donor. 2) Cadaver organs are an irreplaceable source of health. 3) As self-interest is one obstacle to donating cadaver organs, the "concept that allowing the use of our organs after death represents a chance of sharing health for everybody" may be useful for a change of attitude. Even though a poll among transplant professionals supported this suggestion, an international public survey should be carried out to evaluate people's reaction to this message.

Clinical Competence↗
PubMed2005

Root caries in periodontally treated patients in relation to their compliance with suggested periodontal maintenance intervals.

The purpose of this study is to investigate the correlation between the degree of patient compliance with the suggested periodontal maintenance treatment intervals and the new root caries development 5 years after the completion of the active periodontal treatment. The percentage of root surfaces with new root caries was low for both the erratic and the complete compliance patient groups. Erratic compliance with the suggested maintenance intervals 5 years after the active periodontal treatment leads to greater root caries prevalence, greater percentages of patients and root surfaces with new root caries, greater root caries prevalence for smokers, and greater percentages of new defects in root surfaces with further clinical attachment loss and plaque retention. The prevention of root caries development is based on the daily plaque removal and the high patient compliance with the therapist's suggestions for periodontal maintenance intervals.

Adult↗