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Biomedical subjects

D Simpson

Publications and source records attributed to D Simpson.

At least 109 records · Page 6Linked to original sources
PubMed1999

Limitations of CDT and GGT in detecting relapses in patients attending an alcohol problems clinic.

Biochemical markers of alcohol consumption are useful for the detection and monitoring of problem drinking. Blood samples from 37 patients attending an alcohol treatment clinic were analysed for GGT and %CDT, and results were compared with self-reported periods of abstinence and alcohol consumption. Poor correlation was obtained between GGT and %CDT, and between these assays and self-reported alcohol use. The apparent sensitivity and specificity of GGT (57%, 63%) and %CDT (43%, 88%), were considerably lower than those reported by other workers.

Alcohol Drinking↗
PubMed1999

Neuromuscular blockers.

The use of corrosive, injectable neuromuscular blockers has been a treatment option for many years; however, the more recent advent of botulinum toxin (BTX) treatment has revived interest in localized treatments. This article reviews the use of local anesthetics, alcohol, phenol, and BTX treatment for localized muscular overactivity syndromes.

Anesthetics, Local↗
PubMed1999

How pediatric educators know what to teach: the use of teaching scripts.

OBJECTIVE: Expert clinical teachers in medicine use teaching scripts. The aim of this study was to determine whether pediatricians also use common components of teaching scripts. METHODS: Seventy-three pediatric clerkship directors identified anticipated errors and teaching points in response to two short vignettes. The content analysis of responses, which we completed, was analyzed by rank and receipt of teaching awards. RESULTS: Greater than 87% of respondents identified at least one of three anticipated learner errors and greater than 80% of respondents identified at least one of three to four teaching points. Teaching points related directly to anticipated errors in 60% of responses. Level of experience and receipt of teaching awards had no impact on response content. CONCLUSIONS: Consistent with findings on the use of teaching scripts, pediatrics' educators achieved high congruence on anticipated errors and teaching points on two teaching vignettes. These findings support the hypothesis that developing teaching expertise is associated with other script components.

Analysis of Variance↗
PubMed1999

Acquisition of surgical skills: a randomized trial of didactic, videotape, and computer-based training.

BACKGROUND: Although computer-based training (CBT) can enhance didactic instruction, few studies have assessed the efficacy of CBT for basic surgical skills training. This study compares CBT with traditional methods of basic surgical skills training. METHODS: Sixty-nine naive medical students were randomized into 3 treatment groups for basic surgical skills instruction: didactic, videotape, or CBT. All instructional material contained the same pictures, text, and audio. With use of a multiple-choice question examination and a series of performance stations, students were objectively assessed before, immediately after, and 1 month after skills instruction. Raters were blinded to treatment modality during the follow-up evaluation. RESULTS: There were no significant differences among the groups before treatment. After treatment, the didactic group scored higher on the multiple-choice question examination. In contrast, the videotape and CBT groups demonstrated statistically significant (P < .01) enhancement of technical skills compared with the didactic group. After 1 month, a calculated performance quotient revealed statistically significant (P < .01) improvement only in the CBT group. The amount of time students spent practicing their skills was not significantly different among the groups. CONCLUSIONS: CBT is as effective as, and possibly more efficient, than traditional methods of basic surgical skills training for medical students.

Adult↗
PubMed1998

Failure of cytarabine in progressive multifocal leukoencephalopathy associated with human immunodeficiency virus infection. AIDS Clinical Trials Group 243 Team.

BACKGROUND: Progressive multifocal leukoencephalopathy affects about 4 percent of patients with the acquired immunodeficiency syndrome (AIDS), and survival after the diagnosis of leukoencephalopathy averages only about three months. There have been anecdotal reports of improvement but no controlled trials of therapy with antiretroviral treatment plus intravenous or intrathecal cytarabine. METHODS: In this multicenter trial, 57 patients with human immunodeficiency virus (HIV) infection and biopsy-confirmed progressive multifocal leukoencephalopathy were randomly assigned to receive one of three treatments: antiretroviral therapy alone, antiretroviral therapy plus intravenous cytarabine, or antiretroviral therapy plus intrathecal cytarabine. After a lead-in period of 1 to 2 weeks, active treatment was given for 24 weeks. For most patients, antiretroviral therapy consisted of zidovudine plus either didanosine or stavudine. RESULTS: At the time of the last analysis, 14 patients in each treatment group had died, and there were no significant differences in survival among the three groups (P=0.85 by the log-rank test). The median survival times (11, 8, and 15 weeks, respectively) were similar to those in previous studies. Only seven patients completed the 24 weeks of treatment. Anemia and thrombocytopenia were more frequent in patients who received antiretroviral therapy in combination with intravenous cytarabine than in the other groups. CONCLUSIONS: Cytarabine administered either intravenously or intrathecally does not improve the prognosis of HIV-infected patients with progressive multifocal leukoencephalopathy who are treated with the antiretroviral agents we used, nor does high-dose antiretroviral therapy alone appear to improve survival over that reported in untreated patients.

AIDS-Related Opportunistic Infections↗
PubMed1998

A cysteine endopeptidase with a C-terminal KDEL motif isolated from castor bean endosperm is a marker enzyme for the ricinosome, a putative lytic compartment.

A papain-type cysteine endopeptidase with a molecular mass of 35 kDa for the mature enzyme, was purified from germinating castor bean (Ricinus communis L.) endosperm by virtue of its capacity to process the glyoxysomal malate dehydrogenase precursor protein to the mature subunit in vitro (C. Gietl et al., 1997, Plant Physiol 113: 863-871). The cDNA clones from endosperm of germinating seedlings and from developing seeds were isolated and sequence analysis revealed that a very similar or identical peptidase is synthesised in both tissues. Sequencing established a presequence for co-translational targeting into the endoplasmic reticulum, an N-terminal propeptide and a C-terminal KDEL motif for the castor bean cysteine endopeptidase precursor. The 45-kDa pro-enzyme stably present in isolated organelles was enzymatically active. Immunocytochemistry with antibodies raised against the purified cysteine endopeptidase revealed highly specific labelling of ricinosomes, organelles which co-purify with glyoxysomes from germinating Ricinus endosperm. The cysteine endopeptidase from castor bean endosperm, which represents a senescing tissue, is homologous to cysteine endopeptidases from other senescing tissues such as the cotyledons of germinating mung bean (Vigna mungo) and vetch (Vicia sativa), the seed pods of maturing French bean (Phaseolus vulgaris) and the flowers of daylily (Hemerocallis sp.).

Base Sequence↗
PubMed1998

Ontogenesis of lateralized rotational behavior in hamsters: a time series study.

This is a longitudinal study of the postnatal development of lateralized rotational behavior. Hamsters (n = 75) were tested for spontaneous rotational behavior in cylindrical arenas, from P2 (P1 = day of birth) to P60. A daily laterality index was calculated for each animal, of which the averages and standard deviations were used to follow the animals' lateralized behavior. A strong variability between and within animals appeared throughout development, with a tendency to the right side in most animals, which declined after the first postnatal week. No oscillatory cycles were identified. To study patterns of development, the series were divided into four periods and the animals were separated into five groups. The laterality indexes of all four periods were significantly different between the groups. A total of 79% of the animals showed consistent behavior along development: either a preference to one side (20% left, 26% right), or no preference at all (33%). The remaining animals changed preference during development. Only a few animals remained strongly lateralized throughout the 60 days, most of them showing a slight, non-significant preference after P10. Results suggest an ontogenetic decrease in lateralization of this behavior that could in part be explained by the maturation of an interhemispheric regulatory system.

Aging↗
PubMed1998

HIV rounds at Cornell: selected neurologic complications of HIV disease.

Neurological disorders are among the most frequent and devastating complications of HIV infection and AIDS. As patients survive longer with the availability of highly active anti-retrovital therapy, it is likely that the frequency of some of these disorders will increase, since patients will survive long enough to develop them. The central and peripheral nervous system may be affected by numerous primary and secondary complications. These neurological disorders include HIV dementia, primary CNS lymphoma, toxoplasmosis, progressive multifocal leukoencephalopathy, vacuolar myelopathy, peripheral neuropathies, and myopathy. In this review we discuss current thoughts on clinical features, pathogenesis, diagnostic evaluation, treatment and clinical trials in several of these HIV-associated neurologic disorders.

AIDS Dementia Complex↗
PubMed1998

Possible toxicity of herbal remedies.

Herbal remedies are rapidly gaining popularity throughout the world as a result of dissatisfaction with conventional medicines. It is a widely held belief that herbal preparations are "natural" and are therefore intrinsically harmless. However, their effects can be very powerful and potentially lethal if used incorrectly and their use as a substitute for conventional medicines may be ineffective. Toxic effects have been attributed to several factors including hepatotoxicity of main constituents, contamination of preparations by heavy metals or microorganisms, and adverse reactions due to age, and genetic and concomitant disease characteristics of the user.

Drugs, Chinese Herbal↗
PubMed1998

Buchu--South Africa's amazing herbal remedy.

Buchu leaves and oil of buchu were used by the indigenous people of South Africa for hundreds of years. The medicinal use of buchu was taken up by the early Dutch settlers and later introduced into the pharmaceutical industry in the UK. Buchu preparations are now used as a diuretic and for a wide range of conditions including stomach aches, rheumatism, bladder and kidney infections and coughs and colds.

Humans↗