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Biomedical subjects

A Love

Publications and source records attributed to A Love.

At least 19 recordsLinked to original sources
PubMed2005

Randomized double-blind trial of sotalol versus lignocaine in out-of-hospital refractory cardiac arrest due to ventricular tachyarrhythmia.

AIM: We aimed to compare the efficacy of sotalol versus lignocaine for the treatment of patients with out-of-hospital ventricular fibrillation refractory to > or = 4 defibrillatory shocks. BACKGROUND: The outcome of patients in ventricular fibrillation refractory to > or = 4 defibrillatory shocks is poor. In a previous randomized trial, sotalol was superior to lignocaine for acute termination of ventricular tachycardia not causing loss of consciousness. METHODS: Patients of the Ambulance Service of New South Wales treated by paramedics with continued ventricular fibrillation despite standard resuscitation and > or = 4 defibrillatory monophasic shocks were eligible. Drug doses were sotalol 100 mg or lignocaine 100 mg, given as i.v. boluses. A further 2 min of cardiopulmonary resuscitation was given and then defibrillation was repeated twice. If this failed, half the initial dose of the trial drug was repeated and a further > or = 2 shocks were given. RESULTS: Sixty patients were randomized to sotalol and 69 randomized to lignocaine. There was no significant difference between the two groups in the clinical characteristics of the patients or in the number of shocks received. Outcomes in the sotalol and lignocaine groups were survival to hospital admission in 7 (12%) and 16 (23%), respectively (P = 0.09), and survival to hospital discharge in 2 (3%) and 5 (7%), respectively (P = 0.33). CONCLUSIONS: Sotalol is not superior to lignocaine for treatment of ventricular fibrillation refractory to multiple shocks. The overall outcome of this group of patients is poor regardless of the pharmacological intervention (lignocaine or sotalol).

Aged↗
PubMed2001

Case-control study of the health of those looked after by local authorities.

AIMS: To assess the health needs and provision of health care to school age children in local authority care. METHODS: A total of 142 children aged 5 to 16 in local authority care, and 119 controls matched by age and sex were studied. Main outcome measures were routine health care, physical, emotional, and behavioural health, health threatening and antisocial behaviour, and health promotion. RESULTS: Compared with children at home, those looked after by local authorities were significantly more likely to: experience changes in general practitioner; have incomplete immunisations; receive inadequate dental care; suffer from anxieties and difficulties in interpersonal relationships; wet the bed; smoke; use illegal drugs; and have been cautioned by police or charged with a criminal offence. They also tend to receive less health education. They were significantly more likely to have had a recent hearing or eye sight test, and reported significantly less physical ill health overall. CONCLUSIONS: The overall health care of children who have been established in care for more than six months is significantly worse than for those living in their own homes, particularly with regard to emotional and behavioural health, and health promotion. In contrast to uncontrolled observational studies we have not found evidence of problems with the physical health of these children.

Adolescent↗
PubMed2000

Carotid endarterectomy and local anaesthesia: reducing the disasters.

PURPOSE: The study was designed to assess one surgeon's operative mortality and morbidity for carotid endarterectomy using local anaesthetic (LA) compared to general anaesthetic (GA) techniques. METHOD: Data were collected prospectively from 200 patients undergoing LA carotid surgery compared with 243 patients undergoing carotid surgery using GA technique. Indication for surgical, pathology, postoperative morbidity and mortality was assessed. RESULTS: No major strokes or deaths occurred in the LA group (0/200). Significantly more major strokes and/or deaths occurred in the GA group (11/243, 4.5%; P=0.016). Significant less shunt usage was associated with LA (LA 18/200, 9% versus 94/243, 39%; P=0.001). The absence of a shunt was associated with more major events in the GA group (5/143, P=0.001. Age greater than 74 yr was associated with greater major events (4/31, P=0.002). No significant difference in the frequency of cardiovascular complications was observed (LA, 15/200 (7.5%) vs GA, 19/243(7.8%); P=0.924). CONCLUSION: Local anaesthesia enables the surgeon to assess the level of cerebral perfusion with an awake patient, gives greater assurances of cerebral protection during arterial clamping and a provides for a more relaxed and cautious endarterectomy and repair. This study demonstrates reduction in mortality and major stroke events in patients operated on with these conditions.

Aged↗
PubMed2000

Bcl-2 immunoreactive cells with immature neuronal phenotype exist in the nonepileptic adult human brain.

Bcl-2, a cell death suppressor protein, is expressed during brain development but is largely down-regulated in the adult central nervous system. We previously reported strong expression of bcl-2 in small, "oligodendrocyte-like" cells (OLC) found in glioneuronal hamartias. These hamartias are microscopic cell rests found in temporal lobe resections from patients with intractable epilepsy and are considered a form of cerebral microdysgenesis. However, a causative relationship between these rests and seizures is not clear. We now report the identification, lineage characterization, and postnatal ontogeny of hamartia-like cell rests in temporal lobes of nonepileptic humans. Postmortem temporal lobes from 28 patients without history of neurologic disease (mean age = 53 years; range = 20 to 83 years) were studied. Microscopic cellular aggregates containing immature-appearing, bcl-2-immunoreactive cells (BIC) (identical to OLC) were observed in 23 of 28 (82%) temporal lobes from nonepileptic individuals. BIC were strongly immunoreactive for neuronal-specific class III beta tubulin, neuronal nuclear antigen, and MAP-2, but were consistently negative for neurofilament proteins and Ki67. Such cells were localized to subventricular regions of the caudal amygdala and often extended into the adjacent subcortical white matter and periamygdaloid cortex. BIC became less abundant with advancing age. These findings suggest that hamartia-like rests containing immature postmitotic neurons are normally present in the human brain and that glioneuronal hamartias may not always represent a maldevelopmental lesion associated with epilepsy.

Adult↗
PubMed1998

A comparison of two alcohol craving questionnaires.

AIM: To compare two multi-dimensional questionnaires to measure cravings and urges for alcohol: the Alcohol Craving Questionnaire (ACQ: Singleton, Henningfield and Tiffany, 1994a) and the Desires for Alcohol Questionnaire (DAQ: Clark et al., 1996). DESIGN, SETTING, AND PARTICIPANTS: Both questionnaires were administered, in a counterbalanced order, to a total of 380 recreational drinkers. In a further study, a shortened version of the DAQ was administered to a sample of 131 drinkers attending AA or a treatment centre. Exploratory factor analyses were carried out on the data and relationships between questionnaire score and other variables were assessed. FINDINGS: In recreational drinkers both instruments appeared to have a three-factor structure. The DAQ appeared superior to the ACQ in a number of respects: it produced more reliable factors; its structure accounted for a higher proportion of the variance; the factor inter-correlations were somewhat lower; in a combined analysis of both instruments most of the factors retained came from the DAQ; and the DAQ discriminated better between bing and non-binge drinkers and excessive and moderate drinkers. A similar factor structure was found for the DAQ in the alcoholic subjects with addition of a factor of "controllability". CONCLUSIONS: The results support a multifactorial account of alcohol craving, and indicate that the DAQ has some advantages over the ACQ as a research tool.

Adolescent↗
PubMed1997

Effects of alpha-tocopherol on nerve conduction velocity and regeneration following a freeze lesion in immature diabetic rats.

We investigated whether anti-oxidant treatment with alpha-tocopherol (1 g kg-1 day-1) could prevent the blunting of the normal maturational increase in motor and sensory nerve conduction velocity when diabetes is induced by streptozotocin in young rats. A further study in the same rats examined effects on myelinated fibre regeneration distance 14 days after a punctate sciatic nerve lesion by a liquid nitrogen cooled probe. In non-diabetic rats between 8 and 14 weeks of age, sciatic motor and saphenous sensory conduction velocity increased by approximately 28% (P < 0.001) and 21% (P < 0.001) respectively. Diabetes induced at 8 weeks blunted this maturational change by 65% for sciatic motor and almost completely for saphenous sensory fibres (P < 0.001). Treatment with alpha-tocopherol from diabetes induction totally prevented motor conduction velocity deficits (P < 0.001). For sensory saphenous nerve, conduction abnormalities were markedly attenuated (72%, P < 0.001) although a significant deficit remained compared to age-matched non-diabetic rats (P < 0.01). Sciatic nerve myelinated fibre regeneration distance, 14 days post lesion, was 15% reduced (P < 0.001) by untreated diabetes. However, in diabetic rats treated with alpha-tocopherol, regeneration distance was significantly improved (P < 0.001), being within the non-diabetic range. Thus, the data highlight the importance of reactive oxygen species in the aetiology of impaired nerve maturation and regeneration in experimental diabetes and indirectly support the view that anti-oxidant treatment could have a therapeutic role in patients.

Animals↗
PubMed1996

Nerve function and regeneration in diabetic and galactosaemic rats: antioxidant and metal chelator effects.

Immature rats were made diabetic with streptozotocin or were fed a 40% galactose diet to stimulate the polyol pathway. Separate diabetic and galactosaemic groups were treated with butylated hydroxytoluene or trientine. After 4 weeks the sciatic nerve was freeze-lesioned. Two weeks later, the degree of myelinated fibre regeneration was assessed electrophysiologically and nerve conduction velocity was measured in the contralateral leg. Similar sciatic motor and saphenous sensory nerve conduction velocity deficits of approximately 18% and 19%, respectively, compared to age-matched control rats were found in both models. They were partially prevented by treatment (approximately 68% for butylated hydroxytoluene and 63% for trientine). There were 12% and 10% deficits in nerve regeneration distance with diabetes and galactosaemia respectively, which were markedly attenuated (approximately 80%) by both treatments. The data emphasise the importance of elevated, free radical activity for the aetiology of neural/neurovascular deficits in experimental diabetes and galactosaemia.

Animals↗
PubMed1996

Effects of the sulphydryl donor N-acetyl-L-cysteine on nerve conduction, perfusion, maturation and regeneration following freeze damage in diabetic rats.

Peripheral nerve conduction velocity deficits in diabetic rats depend on decreased nerve perfusion, which may be related to increased free radical activity and impaired endogenous protection by the glutathione redox cycle. We studied the effect of treatment with the glutathione precursor N-acetyl-L-cysteine on nerve conduction, blood flow, maturation and regeneration. Two months of diabetes in mature rats caused 20% and 48% deficits in sciatic motor conduction velocity and endoneurial blood flow, respectively, which were largely corrected by N-acetyl-L-cysteine treatment during the second month. In young nondiabetic rats, sciatic motor conduction velocity increased by 31% over 6 weeks. Diabetes halved the conduction velocity maturation rate, however N-acetyl-L-cysteine treatment allowed a normal pattern of development. After 1 month of treated or untreated diabetes, the sciatic nerve was lesioned by a liquid nitrogen-cooled probe. Myelinated fibre regeneration distance, determined electrophysiologically, was reduced by 12.2% with diabetes; this was prevented by N-acetyl-L-cysteine treatment. Thus, the data stress the importance of free radical-mediated changes in the aetiology of experimental diabetic neuropathy.

Acetylcysteine↗
PubMed1995

Impaired myelinated fiber regeneration following freeze-injury in rats with streptozotocin-induced diabetes: involvement of the polyol pathway.

This study examined the effects of streptozotocin-induced diabetes mellitus and aldose reductase inhibitor (ZD5522) treatment on myelinated fiber regeneration in rats. After 2 months of diabetes, with or without ZD5522 treatment (10 mg.kg-1.day-1) from induction, sciatic nerve degeneration was initiated by a punctate lesion using a liquid N2 cooled probe. Regeneration was studied over a subsequent 14-day period using in vitro electrophysiological techniques. There was a 21.4% (P < 0.001) deficit in the maximum fiber regeneration distance in diabetic rats, 14 days postlesion. This was partially (64.9%, P < 0.01) prevented by aldose reductase inhibitor treatment, the resultant regeneration distance being not significantly different from that of age-matched nondiabetic control rats. The regeneration rate, assessed from data collected 4, 9 and 14 days postlesion, was 23.7% (P < 0.001) reduced by diabetes and ZD5522 treatment provided 73.1% protection (P < 0.01). We conclude that polyol pathway activity is involved in impaired regeneration in experimental diabetes, potential pathophysiological mechanisms involving a reduction in neurotrophic support and impaired endoneurial blood supply.

Acetanilides↗
PubMed1995

Effects of natural free radical scavengers on peripheral nerve and neurovascular function in diabetic rats.

Increased generation of reactive oxygen species, coupled with impaired endogenous scavenging mechanisms, plays a prominent role in the aetiology of neurovascular abnormalities in experimental diabetes mellitus. We examined the efficacy of the natural anti-oxidants vitamins C, E and beta-carotene in preventing nerve conduction and nutritive blood flow deficits in streptozotocin-diabetic rats. One month of diabetes caused a 19.1% reduction in sciatic motor conduction velocity (p < 0.001). This was approximately prevented 80-90% by high-dose (1000 mg.kg-1.day-1) vitamin E and beta-carotene treatments (p < 0.001). Vitamin C had lesser effects; the maximum protection found for motor conduction velocity was 36% using a dose of 150 mg.kg-1.day-1 (p < 0.001). High dose (500 mg.kg-1.day-1 (p < 0.001). High dose (500 mg.kg-1.day-1) vitamin C had a lesser effect on conduction than intermediate doses. Joint vitamin C and lower dose (500 mg.kg-1.day-1) vitamin E treatment had a predominantly additive preventive effect against nerve dysfunction. Resistance to hypoxic conduction failure for sciatic nerve in vitro was markedly increased by diabetes and this remained relatively unaffected by treatment. Sciatic nutritive endoneurial blood flow, measured using microelectrode polarography and hydrogen clearance, was reduced 46.1% by 1 month of diabetes (p < 0.001). This was prevented to the extent of 87%, 36% and 98% by vitamins E, C and beta-carotene, respectively (p < 0.01). These data emphasize the role of oxidative stress in the development of early neurovascular changes in experimental diabetes and show that naturally available scavengers have a neuroprotective action.

Action Potentials↗
PubMed1995

Nerve function and regeneration in diabetic rats: effects of ZD-7155, an AT1 receptor antagonist.

Effects of the angiotensin II AT1 receptor antagonist ZD-7155 on nerve function, blood flow, capillarization, oxygenation, and regenerative capacity after injury were studied in streptozocin-diabetic rats. Deficits in saphenous sensory and sciatic motor conduction velocity measured after 1 or 2 mo of diabetes in anesthetized rats were prevented and corrected by ZD-7155. Sciatic resistance to hypoxic conduction failure, which was increased by 71% by 2 mo of diabetes, was attenuated by 39% with ZD-7155. Endoneurial capillary density, which was unaffected by diabetes, was increased by 34% with 2 mo of ZD-7155 treatment. Sciatic nutritive endoneurial blood flow, which was reduced by 45% by 2 mo of diabetes, remained in the nondiabetic range with ZD-7155. Mean endoneurial O2 tension was reduced 38% by diabetes, which was attenuated by ZD-7155. Punctate freeze damage of sciatic nerve caused complete fiber degeneration. Fourteen days postlesion, there was a 26% deficit in myelinated fiber regeneration distance after 2 mo of diabetes, which was prevented by ZD-7155 treatment from diabetes induction. Thus alterations in the renin-angiotensin system contribute to the neurovascular etiology of nerve dysfunction in experimental diabetes.

Angiotensin Receptor Antagonists↗
PubMed1995

AquaLite bioluminescence assay of thyrotropin in serum evaluated.

We studied a new commercially available thyrotropin (TSH) assay, the AquaLite Bioluminescence TSH-Immunoassay (SeaLite Inc.). This assay has a detection limit of 0.005 mIU/L and a functional sensitivity of 0.017 mIU/L and meets the requirements of a third-generation TSH assay. Using this assay, we measured serum TSH in 153 euthyroid individuals and in the following patients: 32 primary hypothyroids; 38 primary hyperthyroids; 35 with thyroid cancer receiving suppressive therapy with levothyroxine (L-T4); 33 receiving replacement L-T4 aimed at reaching and maintaining a euthyroid status; 23 with subclinical hyperthyroidism; and 52 hospitalized for nonthyroidal illnesses (NTI). The AquaLite TSH assay perfectly discriminated hypothyroid and untreated hyperthyroid patients from euthyroid subjects and clearly discriminated between overtly and mildly hyperthyroid patients. Intermethod comparisons showed that the AquaLite and the Nichols assays were more effective than the ACS-180 and the TOSOH assays in discriminating among hyperthyroid patients, including patients over-treated with L-T4.

Adult↗
PubMed1992

Effects of aminoguanidine on peripheral nerve function and polyol pathway metabolites in streptozotocin-diabetic rats.

The effect of 2 months aminoguanidine treatment on nerve conduction abnormalities was studied in streptozotocin-diabetic rats. Treatment with aminoguanidine from the induction of diabetes mellitus prevented a 22% decrease in sciatic motor nerve conduction velocity (p less than 0.001), and a 10% deficit in sensory saphenous conduction velocity (p less than 0.01). There was a 49% increase in resistance of sciatic nerve to hypoxic conduction failure in vitro. This was not significantly affected by aminoguanidine treatment. Sciatic nerve polyol pathway metabolites, sorbitol and fructose, were elevated 10-fold by diabetes (p less than 0.001). Myo-inositol levels were 18% decreased by diabetes. Aminoguanidine treatment had no significant effect on sorbitol, fructose or myo-inositol levels. Aminoguanidine has been identified as both an inhibitor of the formation of advanced glycation end products, and an aldose reductase inhibitor. The data suggest that beneficial actions on nerve function do not depend on the latter property. They support the notion that advanced glycation end products contribute to the aetiology of early diabetic neuropathy, possibly acting via a vascular mechanism, and that aminoguanidine treatment may have therapeutic applications.

Animals↗
PubMed1989

Chiropractic chronic low back pain sufferers and self-report assessment methods. Part I. A reliability study of the Visual Analogue Scale, the Pain Drawing and the McGill Pain Questionnaire.

Comprehensive assessment of the problems of low back pain sufferers requires that (in addition to objective measures and clinicians' judgments) an examination of subjective perception of their difficulties should also be made. Subjective measurement has, in the past, presented several problems to researchers. However, in recent years, several new methods of exploring individual reactions to pain and disability have been developed. These assessment measures have, in the main, been carefully explored with severe chronic, acutely ill and surgical patients, but they have not been shown to be appropriate for use with mild chronic low back pain sufferers. This study examines the reliability of several widely used self-report measures. In general, the measures were shown to have acceptable levels of reliability for use with this population, although recommendations for caution in the use of the pain drawing is urged.

Back Pain↗
PubMed1989

Chiropractic chronic low back pain sufferers and self-report assessment methods. Part II. A reliability study of the Middlesex Hospital Questionnaire and the VAS Disability Scales Questionnaire.

The subjective complaints of 41 chronic low back pain sufferers attending a chiropractic clinic were assessed twice prior to therapy with a widely used psychological self-report assessment tool, the Middlesex Hospital Questionnaire (MHQ) and a newly developed VAS Disability Scales Questionnaire (DISQ), both of which investigate various aspects of certain basic positions and activities. Reliability was generally acceptable with these two questionnaires. Subjects participating in the study were commonly found to score within the normal range on the MHQ, indicating that psychological disturbance was not a major feature of their presentation. However, mild mood disturbance was commonly reported, and a more sensitive tool may need to be developed for this type of mildly affected chronic low back pain sufferers. The DISQ generally indicated subjects were mildly to moderately affected by their low back trouble and that sitting and leisure activities were the most pain provoking. Recommendations for further development of the disability scale are made.

Back Pain↗
PubMed1988

Teller acuity cards versus clinical judgment in the diagnosis of amblyopia with strabismus.

Teller acuity card testing, which is a form of the preferential-looking procedure, is a popular way of assessing visual acuity in preverbal patients. The authors suspected that the clinical judgment of a pediatric ophthalmologist is superior to the Teller acuity cards in diagnosing amblyopia when strabismus is present. Acuity card and fixation preference measurements on each eye were compared at the same clinical visit in a group of 108 strabismic patients. The authors found that the acuity cards could be used to detect amblyopia. However, the pediatric ophthalmologist was more sensitive in diagnosing amblyopia than the Teller acuity cards in the presence of strabismus.

Amblyopia↗
PubMed1986

Interaction of cyclosporin A with human lipoproteins.

The ultracentrifugal fractionation of human serum after previous incubation with cyclosporin A showed that, in healthy fasting individuals, 8% of cyclosporin A was found in the very low density lipoproteins (VLDL), 31% in the low density lipoproteins (LDL), 46% in the high density lipoproteins (HDL) and 15% in the non-lipoprotein protein fraction. In non-fasted, healthy and in non-fasted, lipaemic individuals, 7 and 6% of cyclosporin A was found in chylomicrons, 9 and 13% in VLDL, 28 and 30% in LDL, 39 and 37% in HDL, and 12 and 13% in the non-lipoprotein protein fraction, respectively. In patients receiving cyclosporin A the distribution varied from 12 to 19% in VLDL, 21 to 28% in LDL, 33 to 43% in HDL, and 13 to 20% in non-lipoprotein proteins. The interaction between cyclosporin A and isolated normal human lipoproteins was also studied by ultrafiltration. All lipoproteins exhibited a non-saturable, low affinity, high capacity uptake for cyclosporin A. Analysis of the uptake by phospholipid vesicles showed a similar uptake, suggesting that cyclosporin A dissolves in the lipophilic portion of the lipoprotein molecule rather than being associated with specific binding sites.

Cyclosporins↗