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Biomedical subjects

D H Barlow

Publications and source records attributed to D H Barlow.

At least 19 recordsLinked to original sources
PubMed1992

Platelet-activating factor levels in human follicular and amniotic fluids.

Platelet-activating factor (PAF) was estimated in extracts of human follicular and amniotic fluids using a commercially available 125I-radioimmunoassay. Levels obtained before and after purification of the extracts by thin-layer chromatography were similar and PAF could be estimated with high accuracy and reproducibility over a wide dilution range. PAF levels in fluid aspirated from mature (17 mm average diameter) follicles from in vitro fertilization patients were 1005 +/- 129 fmol/ml in successful (clinical pregnancy) cycles and 949 +/- 75 fmol/ml in unsuccessful (failure of implantation) cycles. PAF levels were also similar in follicles containing eggs and those where no egg was found, and in fluid from follicular cysts characterised by low oestradiol and progesterone levels. PAF was detected in midtrimester amniotic fluid (60 +/- 20 fmol/ml). At term, PAF was low or undetectable in amniotic fluid obtained at elective caesarean section before the onset of labour, but increased to 102 +/- 28 fmol/ml in samples obtained following spontaneous labour and vaginal delivery. The data suggest that PAF may be involved in ovulation and parturition but further studies into the mechanism of action of PAF are necessary. The good performance of the radioimmunoassay and the convenience of gamma-counting are strong advantages of this method over the available bioassays, but its expense remains a drawback.

Amniotic Fluid↗
PubMed1992

Psychometric properties of the Penn State Worry Questionnaire in a clinical anxiety disorders sample.

With the advent of DSM-III-R, the diagnostic criteria for generalized anxiety disorder (GAD) shifted in emphasis from the autonomic arousal to the cognitive component of the disorder, namely worry. The Penn State Worry Questionnaire was developed to assess the trait of worry and has proven to be a reliable and valid measure in a series of studies largely based on college student samples. The purpose of the present study was to assess the psychometric properties and utility of the PSWQ in a clinical sample of 436 anxiety disorder patients and 32 normal controls. Factor analysis indicated that the PSWQ assesses a unidimensional construct. Furthermore, the PSWQ evidenced quite favorable internal consistency using GAD patients and each of the other anxiety disorder groups and normal controls. The validity of the PSWQ was supported by an analysis indicating that the measure distinguished. GADs from each of the other anxiety disorder groups including those with obsessive-compulsive disorder. Moreover, correlations between the PSWQ and measures of anxiety, depression, and emotional control supported the convergent and discriminant validity of the measure. Collectively, the findings speak favorably to the use of the PSWQ in research examining the nature and treatment of GAD and the processes of normal and pathological worry.

Agoraphobia↗
PubMed1992

Effect of estradiol implant on noradrenergic function and mood in menopausal subjects.

The effect of the alpha 2-adrenoceptor agonist, clonidine, on plasma growth hormone (GH), plasma 3-methoxy-4-hydroxyphenylethylenegylcol (MHPG), blood pressure and sedation were studied in 16 menopausal subjects before and 6 wk after a 100-mg implant of estradiol. The specific binding of tritiated yohimbine to intact platelets also was studied. Estradiol implants increased basal GH output and reduced baseline MHPG and sedation scores. However, none of the subsequent responses to clonidine were altered. Platelet yohimbine binding also was unchanged following the implant. Both observer- and self-rating scales showed a marked reduction in anxiety and depression scores. The results suggest that estradiol may alter some indices of noradrenergic function, but that the mechanism does not involve alterations in alpha 2-adrenoceptor sensitivity.

Adult↗
PubMed1992

A controlled assessment of direct intraperitoneal insemination.

OBJECTIVE: To test the efficacy of direct intraperitoneal (IP) insemination and its effect on cell-mediated immunity. DESIGN: A prospective trial with each couple having one treatment (insemination) cycle and one control (timed intercourse) cycle performed in random order with the same ovulation stimulation in both cycles. SETTING: Secondary and tertiary referral fertility clinics; university teaching hospital. PATIENTS: Twenty-six infertile couples. Excluding pregnancy, only one couple did not complete the two cycles. INTERVENTIONS: Ovulation induction in both cycles. Intraperitoneal insemination in the insemination cycles. MAIN OUTCOME MEASURES: These were pregnancy rate (treatment versus control) and mixed lymphocyte response (MLR) sensitivity (before and after direct IP insemination treatment). RESULTS: There were four control and no treatment pregnancies. This was not a significant difference (odds ratio). Mixed lymphocyte responses in fertile subjects did not change during the menstrual cycle (Wilcoxon). There was no significant increase in MLR sensitivity to partner's cells after direct IP insemination treatment. CONCLUSIONS: This controlled study found no benefit from direct IP insemination in terms of pregnancies over control cycles. There was no evidence that direct IP insemination had increased cell-mediated immune response sensitivity to husband's cells.

Adult↗
PubMed1992

Response to hyperventilation and inhalation of 5.5% carbon dioxide-enriched air across the DSM-III-R anxiety disorders.

Anxiety disorder patients (n = 198; under criteria of the Diagnostic and Statistical Manual of Mental Disorders; rev. 3rd ed.; American Psychiatric Association, 1987) and nonanxious control subjects (n = 25) underwent challenges of 90 s of voluntary hyperventilation and 15 min of 5.5% carbon dioxide in air. Panic disorder subjects showed a greater subjective response to both challenges than did subjects with other anxiety disorders, who in turn responded more than did control subjects. Furthermore, subjects with panic disorder as an additional diagnosis tended to report more subjective response than did anxiety disorder subjects without panic disorder. The best prechallenge predictor of response to each procedure was a measure of fear of physical symptoms. The findings support previous results that have pointed to a greater fear or anxiety-inducing effect of these challenge procedures in panic disorder patients, as compared with other subjects.

Adult↗
PubMed1992

Comparison of bulimics, obese binge eaters, social phobics, and individuals with panic disorder on comorbidity across DSM-III-R anxiety disorders.

Eighty-two women, presenting as normal-weight bulimics, obese binge eaters, social phobics, and individuals with panic disorder, were compared on anxiety, depression, and substance abuse. All were administered the Anxiety Disorder Interview Schedule-Revised and completed the Michigan Alcohol Screening Test, Drug Abuse Screening Test, and Self-Consciousness Scale. A striking proportion of eating disorder subjects were comorbid for one or more anxiety disorders, the most frequent diagnoses being generalized anxiety disorder and social phobia. The results suggest that the place of anxiety in bulimia nervosa goes beyond that discussed within the context of the anxiety reduction model. Conflicting comorbidity findings among this and prior investigations are noted, however, and discussed in terms of the issue of differential diagnosis between eating and anxiety disorders.

Anxiety Disorders↗
PubMed1992

Comorbidity among anxiety disorders: implications for treatment and DSM-IV.

Research on comorbidity among psychological disorders is relatively new. Yet, comorbidity data have fundamental significance for classification and treatment. This significance is particularly apparent in the anxiety disorders, which, prior to DSM-III-R, were subsumed under disorders considered more significant (e.g., psychotic and depressive disorders). After considering definitional, methodological, and theoretical issues of comorbidity, data on comorbidity among the anxiety disorders are reviewed as well as data on comorbidity of anxiety disorders with the depressive, personality, and substance use disorders. Treatment implications are presented with preliminary data on the effects of psychosocial treatment of panic disorder on co-morbid generalized anxiety disorder. Implications of comorbidity for research on the nature of psychopathology and the ultimate integration of dimensional and categorical features in our nosology are considered.

Anxiety Disorders↗
PubMed1992

Hormone replacement therapy and other menopause associated conditions.

In Britain a large majority of the women who use Hormone Replacement Therapy (HRT) use it in order to alleviate symptoms thought to relate to the menopause. These include vasomotor instability, 'minor' psychological disturbance and sexual difficulties. Other HRT effects gained by the women include effects on maintenance of collagen, as in the skin, and on oestrogen sensitive tissues related to the lower urinary tract.

Climacteric↗
PubMed1992

A randomized prospective study to assess the effect of the use of home urinary luteinizing hormone detection on the efficiency of donor insemination.

A study was carried out to establish whether the use of home urinary luteinizing hormone (LH) detection to predict ovulation could decrease the number of clinic visits required for the management of a donor insemination (DI) cycle, and thus optimize use of clinic resources without adversely affecting pregnancy rates. This was a randomized prospective study carried out at a donor insemination clinic in Oxford, England. Fifty-six patients participated in the trial; 27 used home urinary ovulation detection for a total of 111 cycles and 29 had a total of 123 DI cycles managed by routine clinical methods. There was a significant reduction in the number of visits per cycle (P less than 0.001) if home kits for detection of ovulation were used. There was no significant difference in the monthly fecundity or cumulative conception rates. We conclude that the use of home urinary LH detection in donor insemination can reduce patient attendance at the clinic and optimize the use of medical resources without adversely affecting pregnancy rates.

Female↗
PubMed1992

Isolation and purification of human endometrial stromal and glandular cells using immunomagnetic microspheres.

Isolation of pure preparations of the different cell populations of human endometrium is a prerequisite for studies of in-vitro function. Sieving of dispersed endometrial cells, followed by adsorption onto immunomagnetic microspheres coated with antibody to Thy-1 was used to separate glandular and stromal cells. The purity of these cell populations was checked with antibodies to cytokeratin and Thy-1. The stromal cells were 98% pure and 90% viable, gland cells were 82% pure with 76% viability. The purified cells were able to proliferate in vitro as shown by thymidine incorporation.

Antigens, Surface↗
PubMed1992

Suicidal ideation and suicide attempts among patients with panic disorder: a survey of two outpatient clinics.

OBJECTIVE: Recent epidemiologic studies found that 20% of subjects with the diagnosis of panic disorder had attempted suicide. This study sought to determine the prevalence of suicidal ideation and suicide attempts among patients with panic disorder and whether the presence of comorbid borderline personality disorder influenced the prevalence of suicidal thoughts and behavior. METHOD: At two outpatient clinics, experienced clinicians conducted retrospective reviews of data from the intake interviews and charts of 59 patients with panic disorder and comorbid borderline personality disorder and 234 patients with panic disorder with or without axis II disorders other than borderline personality disorder. RESULTS: Suicide attempts were reported by 2% of the patients with panic disorder, compared to 25% of the patients with both panic disorder and borderline personality disorder. In addition, 2% of the patients with panic disorder, compared to 27% of the patients with panic disorder and borderline personality disorder, reported suicidal ideation that was judged to be of clinical significance. CONCLUSIONS: The rate of suicidal ideation and suicide attempts for psychiatric outpatients with panic disorder was discrepant with the findings of the earlier studies. The increased suicide risk in this group of patients was associated with borderline personality disorder, increased substance abuse, and affective instability. While 61% of the panic disorder patients and 78% of the patients with both panic disorder and borderline personality disorder reported thinking about death, this must be distinguished from actual suicidal ideation and clinical risk of suicide.

Adult↗
PubMed1992

Cognitive-behavioral approaches to panic disorder and social phobia.

In the past several years, substantial progress has been made in developing relatively efficient and seemingly effective brief psychosocial treatments for anxiety disorders. Knowledge has advanced along both biological and psychological fronts, although the greater effort has been put into understanding the neurobiological basis of anxiety disorders and developing appropriate, effective pharmacological treatment. Nevertheless, psychological knowledge has also advanced, and a more recent trend is to integrate psychological and biological advances at the level of psychopathology and treatment. The author highlights recent developments in understanding the psychological basis of two anxiety disorders: panic disorder and social phobia. He then describes psychosocial treatment protocols for these disorders that have been developed at the Center for Stress and Anxiety Disorders at the State University of New York at Albany, and reviews data on their effectiveness.

Cognitive Behavioral Therapy↗
PubMed1991

Study of general practice consultations and menopausal problems. Oxford General Practitioners Menopause Study Group.

OBJECTIVE: To investigate the nature of work related to the menopause in general practice. DESIGN: Questionnaire study over six months among general practitioners after each consultation with a woman aged 40-69 at which issues related to the climacteric had been discussed. SETTING: 9 General practices in the Oxford area. SUBJECTS: 416 Women who had 572 consultations. MAIN OUTCOME MEASURES: Age, menopausal state, and first or subsequent consultation. Symptoms were classified together with the treatment and the outcome of the consultation. RESULTS: The consultation rate varied greatly between practices, the overall rate being 4.4%. There were many premenopausal women and women in their 60s presenting; women with hysterectomies presented more often--36% (37/103) of women with hysterectomies had more than one consultation compared with 26% (38/144) for premenopausal women and 24% (38/155) for postmenopausal women. 409 women had symptoms and 218 were prescribed oestrogen treatment. 156 of the consultations involved discussion and advice only. Only four women were referred to a local specialist clinic. CONCLUSION: There is a low overall use of hormone replacement therapy in the general postmenopausal population despite the recent media coverage of its benefits in the prevention of osteoporosis and subsequent fractures.

Adult↗
PubMed1991

An approach to preimplantation diagnosis of beta-thalassaemia.

Using the polymerase chain reaction (PCR), it was possible to amplify a single copy fragment of the beta-globin gene from 2-32 human embryonic cells obtained from arrested preimplantation embryos. For the detection of beta-thalassaemia mutations, allele specific priming of the PCR using nested primers was employed using approximately 10 pg of DNA from individuals known to carry these mutations. This approach was successful in detecting the presence or absence of five Asian Indian beta-thalassaemia mutations that were selected for this study. In spite of meticulous precautions against contamination, false-positive amplification was observed, a problem that will have to be overcome before this approach can be used in clinical practice.

Base Sequence↗