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Biomedical subjects

C Fox

Publications and source records attributed to C Fox.

At least 19 recordsLinked to original sources
PubMed1997

Development and validation of a computerized screening test for personality disorders in DSM-III-R.

The available self-report instruments designed to measure personality disorder (PD) are time-consuming to administer and/or score and can be impractical for routine clinical use. There is a need for a computerized method of personality assessment based on contemporary systems of classification. A computerized DSM-III-R-based questionnaire was developed and validated against the structured clinical interview for DSM-III-R Axis-II disorders on a sample of 60 subjects. The computerized test showed moderate validity as a diagnostic instrument (mean kappa coefficient = 0.47). With adjusted cut-off scores it was valid as a screening instrument (mean sensitivity = 0.87). Antisocial, borderline and avoidant PD scores were strongly correlated across measures and not subject to significant observer bias.

Adult↗
PubMed1996

Dopaminergic regulation of progesterone receptors: brain D5 dopamine receptors mediate induction of lordosis by D1-like agonists in rats.

To characterize the signaling pathway by which the neurotransmitter dopamine modulates progesterone receptor (PR) activation, the steroid-dependent behavior lordosis was used in estrogen-primed ovariectomized Sprague-Dawley rats with stereotaxic implanted third ventricle cannulas. Lordosis was observed in response to solicitous males in females after central administration of the D1-like agonist SKF38393 and three of its analogs (SKF77434, SKF75640, and SKF85174). In contrast, D1-like antagonist SCH23390 and D1-like/D2 repopulation inhibitor EEDQ blocked behavior inducible by the D1-like agonists. Further, antisense oligonucleotides to D5, but not D1, dopamine receptor mRNA suppressed reproductive behavior associated with D1-like stimulation. This finding provides strong evidence that dopaminergic modulation of lordosis is mediated by the novel D5 dopamine receptor. Although D1, but not D5, dopamine receptor mRNAs were detected in the ventromedial nucleus (VMN) by in situ hybridization, agonists microinjected into the VMN, but not into the arcuate nucleus or preoptic area, induced lordosis, suggesting the functional presence of D5 dopamine receptors in the VMN. Also in support, D5 receptor mRNA antisense microinjected into the VMN blocked the subsequent induction of lordosis by D1-like agonists. Finally, facilitation of sex behavior by D1-like agonists was blocked by the antiprogestin RU38486 and PR antisense oligonucleotide. Collectively, the data provide strong evidence for dopaminergic modulation of reproductive behavior through D5 dopamine receptor-mediated modulation of PR-dependent behavior in rat CNS.

Animals↗
PubMed1996

Comparison of virus burden in blood and sequential lymph node biopsy specimens from children infected with human immunodeficiency virus.

BACKGROUND: Lymph nodes serve as reservoirs for the replication of human immunodeficiency virus (HIV) type 1. Comparison of serial measurements of virus burden in lymph nodes and peripheral blood after a change in antiretroviral therapy may provide insights into pathogenic mechanisms and permit a more accurate assessment of a therapeutic response. STUDY DESIGN: Nevirapine was added to the drug regiment of eight children with HIV infection treated with the combination of zidovudine and didanosine who had increasing levels of serum p24 antigen. Lymph node biopsies were performed at entry and after 12 weeks of therapy. RESULTS: Neither CD4 counts nor p24 antigen level correlated with the degree of viremia as measured by ribonucleic acid copy numbers in plasma. Correlations were found between HIV DNA copy number in peripheral blood mononuclear cells and HIV DNA copy number in lymph nodes (p = 0.02), as well as between peripheral blood CD4 counts and lymph node architecture. The HIV signals in the lymph nodes conformed to the anatomic organization of apical light zones in the germinal centers; however, in more advanced disease stages, organized germinal centers disappeared as evidence by a decline in the extent of the follicular dendritic network. CONCLUSIONS: Lymph node biopsies in this small number of HIV-infected children revealed a progressive loss of an organized architecture, especially of the follicular dendritic network. This correlated with a progressive loss of CD4+ cells but not with other measures of disease stage, including viral load, as measured by ribonucleic acid copy numbers.

Antiviral Agents↗
PubMed1996

Health-related quality of life as an outcome for patients with heart failure.

The Agency for Health Care Policy and Research Clinical Practice Guidelines on heart failure recommends that providers assess patients' health-related quality of life (HRQOL) and recommends using HRQOL information to modify treatment and guide patient and family teaching to facilitate adaptation to heart failure. This research column reviews eight studies that measured HRQOL as an outcome for patients with medically managed heart failure.

Activities of Daily Living↗
PubMed1996

Ring chromosome 22 and mood disorders.

The case of a 21-year-old man with severe developmental disabilities, ring chromosome 22 and rapid-cycling bipolar illness is presented. This is the first reported occurrence of mood disorder in a person with ring chromosome 22. Previously published case reports describing behavioural problems associated with this chromosome disorder suggest that severe hyperactivity is typical and that affected individuals may have an excited mood state. These symptoms are consistent with atypical bipolar disorder and raise the possibility that ring chromosome 22 increases the risk for atypical bipolar disorder.

Adult↗
PubMed1996

Perinatal tuberculosis and its public health impact: a case report.

Tuberculosis was initially unrecognized in a pregnant 26-year-old woman from Mexico. The diagnosis was first considered in this mother 24 days postpartum, when her newborn was admitted in shock with congenital tuberculosis. Had a high index of suspicion for tuberculosis been present during the early course of the patient's care or had she been tested on a routine basis because she was a member of a high-risk group, the continued exposure of 7 family members and the acute exposure of 293 healthcare workers and newborns in three tertiary-care centers could have been minimized or avoided entirely. We wish to emphasize the often elusive features of this diagnostic setting and the public health consequences of delayed recognition resulting in a massive recall effort. Unfortunately, only two thirds of the exposed infants were successfully recalled and skin tested. We identified one skin test conversion in a health-care worker.

Adult↗
PubMed1995

Studies in subjects with long-term nonprogressive human immunodeficiency virus infection.

BACKGROUND: In a small percentage of persons infected with human immunodeficiency virus type 1 (HIV-1), there is no progression of disease and CD4+ T-cell counts remain stable for many years. Studies of the histopathological, virologic, and immunologic characteristics of these persons may provide insight into the pathogenic mechanisms that lead to HIV disease and the protective mechanisms that prevent progression to overt disease. METHODS AND RESULTS: We studied 15 subjects with long-term nonprogressive HIV infection and 18 subjects with progressive HIV disease. Nonprogressive infection was defined as seven or more years of documented HIV infection, with more than 600 CD4+ T cells per cubic millimeter, no antiretroviral therapy, and no HIV-related disease. Lymph nodes from the subjects with nonprogressive infection had significantly fewer of the hyperplastic features, and none of the involuted features, characteristic of nodes from subjects with progressive disease. Plasma levels of HIV-1 RNA and the viral burden in peripheral-blood mononuclear cells were both significantly lower in the subjects with nonprogressive infection than in those with progressive disease (P = 0.003 and P = 0.015, respectively). HIV could not be isolated from the plasma of the former, who also had significantly higher titers of neutralizing antibodies than the latter. There was viral replication, however, in the subjects with nonprogressive infection, and virus was consistently cultured from mononuclear cells from the lymph nodes. In the lymph nodes virus "trapping" varied with the degree of formation of germinal centers, and few cells expressing virus were found by in situ hybridization. HIV-specific cytotoxic activity was detected in all seven subjects with nonprogressive infection who were tested. CONCLUSIONS: In persons who remain free of disease for many years despite HIV infection the viral load is low, but viral replication persists. Lymph-node architecture and immune function appear to remain intact.

Adult↗
PubMed1995

The insulin-dependent patient: perceptions and preferences.

Although patients realize that insulin is the missing hormone which keeps them alive and well, they do not regard it as a cure for diabetes because it may cause hypoglycaemia, it does not completely abolish the risk of long-term side-effects, and it does not permit a life-style equivalent to their prediabetic state. Clearly, though, insulin can improve quality of life and significantly reduce the risk of complications. Patients' perceptions of their illness and the available treatment have been explored by several means: letters written to a diabetes specialist nurse by children with diabetes, group discussion at a Young Adult Clinic and responses to questions at the annual Youth Diabetes Conference. Improvements in patient care will stem from physicians' awareness of patients' perceptions and from developments in insulin therapy.

Adolescent↗
PubMed1995

Relationships between physical activity, insulin levels and lipids in non-diabetic low income residents of Mexico City: the Mexico City Diabetes Study.

The epidemiologic data supporting an association between physical activity and lipoprotein profile is controversial. We hypothesized that physical activity is positively associated with triglyceride levels and negatively associated with high density lipoprotein (HDL) cholesterol levels, and that these associations are mediated by insulin activity. We tested these hypotheses in 819 male and 1159 female healthy non-diabetic Mexicans, aged 35-64 years, residing in Mexico City. Physical activity was assessed using a modified Stanford 7-day Physical Activity Recall. Serum glucose and insulin were evaluated in the fasting state and 2 h following a glucose challenge. Crude analysis indicated that physical activity was not associated with HDL cholesterol in males, but was associated with HDL cholesterol in females (r = 0.06; p = 0.025). Physical activity was not associated with triglyceride concentration in males or females. Multivariate results showed that the positive association between HDL cholesterol and physical activity in women remained after controlling for age, estrogen status, body mass index, and smoking. Furthermore, there was a significant interaction between physical activity, HDL cholesterol and an index of insulin sensitivity. Women with higher levels of insulin sensitivity had higher levels of HDL cholesterol. However, among women at lower levels of insulin sensitivity, those with greater physical activity were significantly more likely to have higher HDL cholesterol values.

Adult↗
PubMed1994

A comparison of six different plating media used in the isolation of Salmonella.

Seventeen Canadian Federal, Provincial and Public Health Laboratories took part in different phases of a comparative/collaborative study that evaluated rapid methods to the standard Health Protection Branch (HPB) method for the detection of Salmonella. A variety of commercial media were tested, including Brilliant Green Sulpha Agar, Bismuth Sulphite Agar, Hektoen Enteric Agar, Xylose Lysine Deoxycholate Agar, EF-18 Agar and Rambach Agar. Each laboratory compared up to six of these different plating media. Plating of 123 salmonellae cultures and 28 artificially-inoculated foods showed the recovery of Salmonella spp. on the six plating media to be within one log. Therefore, quantitative testing of the media showed them to be comparable in the recovery of salmonellae. Qualitative testing of the six media during the comparative/collaborative study of various methods showed that EF-18 Agar recovered the greatest number of isolates. Hektoen Enteric Agar ranked second, with the other agars being comparable in their recovery of Salmonella spp. Problems with the various media are summarized. Based on our results and those of other researchers, it is recommended that Bismuth Sulphite Agar be compulsory and that at least one other agar be used for newly developed cultural procedures.

Bacteriological Techniques↗
PubMed1994

Modification of forearm resistance vessels by exercise training in young men.

The aim of this study was to determine whether a 4-wk handgrip training program would elicit changes in endothelium-dependent and endothelium-independent vasodilatation in resistance vessels of the human forearm. Minimum vascular resistance after a 10-min ischemic stimulus, an index of peak vasodilator capacity, was also determined. Forearm blood flow response to the endothelium-dependent vasodilator methacholine chloride did not change over the 4-wk-intervention period either in the group undertaking training (n = 11) or in control subjects (n = 6). Similarly, the response to sodium nitroprusside was not influenced by the handgrip training program. Peak vasodilator capacity of the trained forearms significantly increased, whereas no change was evident in the untrained limbs. These results suggest that 4 wk of forearm exercise training enhances peak vasodilator capacity of the vasculature without influencing stimulated activity of the nitric oxide dilator system.

Adult↗
PubMed1994

Community-based asthma care: trial of a "credit card" asthma self-management plan.

Although asthma self-management plans are widely recommended as essential in the long-term treatment of adult asthma, there have been few studies examining their use. Our objective was to assess the effect of a "credit card" adult asthma self-management plan in a community experiencing major health problems from asthma, by means of a before and after intervention trial of the efficacy of the "credit card" plan, when introduced through community-based asthma clinics. The participants were 69 Maori people with asthma. The "credit card" plan consisted of written guidelines for the self-management of asthma, based on self-assessment of asthma severity, printed on a plastic card. On one side, management guidelines were based on the interpretation of peak expiratory flow rate (PEFR) recordings, whilst the reverse side was based on symptoms. The outcome measures used were before and after comparison of markers of asthma morbidity and requirement for acute medical treatment; and a structured questionnaire assessing the acceptability and use of the credit card plan. Following the introduction of the plan, the mean PEFR increased from 347 to 389 l.min-1, the percentage of nights woken fell from 30.4 to 16.9%, and the number of days "out of action" fell from 3.8 to 1.7%. The requirements for acute medical treatment also fell during the intervention period. Most participants commented favourably on the content and usefulness of the plan. In the situation of worsening asthma, 28% of subjects found the peak flow side of the card most helpful, 7% the symptoms side, and 48% found both sides equally helpful.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗