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Biomedical subjects

E Bartlett

Publications and source records attributed to E Bartlett.

10 recordsLinked to original sources
PubMed2005

Chasing "chasing the dragon" with MRI: leukoencephalopathy in drug abuse.

UNLABELLED: Spongiform leukoencephalopathy is a rare complication from inhalation of heated heroin vapour, a practice called "chasing the dragon". The MRI findings are considered pathognomonic, making MRI important for diagnosis. This is especially true in busy urban emergency departments where a variety of patients may present obtunded, unable or unwilling to provide a useful history. Even though the MR pattern of "chasing" toxicity is considered pathognomonic, there are mimickers. We compare the MRI findings of two classic cases of chasing leukoencephalopathy with one case of mimickery from cocaine exposure only. All three cases had diffuse symmetrical white matter changes. MR spectroscopy (MRS) in chasing patients showed increased lactic acid and myo-inositol, decreased N-acetyl aspartate and creatine, normal to slightly decreased choline, and normal lipid peak. MRS in the cocaine exposure patient showed marked increase in lactic acid and lipids. MR perfusion in one chasing patient was normal. IN CONCLUSION: (1) All three cases have MR findings suggestive of spongiform leukoencephalopathy. MRS may help differentiate toxicity due to inhaled heroin from other non-heroin related toxicities. (2) Discordance between perfusion and spectroscopy in one chasing patient adds evidence that the disease is due to impaired energy metabolism at the cellular level. (3) MR findings of spongiform leukoencephalopathy secondary to chasing heroin can progress despite apparent abstinence of the drug and during clinical improvement, suggesting the MR changes may represent an evolving injury.

Adult↗
PubMed2004

The natural history of lower urinary tract dysfunction in men: the influence of detrusor underactivity on the outcome after transurethral resection of the prostate with a minimum 10-year urodynamic follow-up.

OBJECTIVES: To assess the long-term outcome of the efficacy of transurethral resection of the prostate (TURP) in men with detrusor underactivity (DUA), a cause of lower urinary tract symptoms (LUTS) in a significant minority of men. PATIENTS AND METHODS: Neurologically intact men with LUTS, who were investigated in our department between 1972 and 1986, diagnosed with DUA and who underwent surgical intervention, were invited for a repeat symptomatic and urodynamic assessment. Identical methods were used, allowing direct comparison of the results. RESULTS: In all, 224 men were initially diagnosed with DUA; 87 (39%) of these died in the interim and 22 followed had a TURP, with a mean follow-up since surgery of 11.3 years. There were no significantly sustained reductions in any symptoms. There was a small but significant reduction of questionable clinical significance in the bladder outlet obstruction index, but this did not translate into an improved flow rate. Comparison with 58 age-matched patients with DUA who remained untreated showed no significant advantage of surgical intervention in the long-term; on the contrary, there was more chronic retention in those who had had surgery. CONCLUSIONS: There are no long-term symptomatic or urodynamic gains from TURP in men shown to have DUA. The results of TURP in men with DUA are important, as urologists who surgically treat patients based on the symptoms and uroflowmetry alone will do so in a significant minority of men with DUA. These results strengthen the argument for a routine preoperative urodynamic assessment.

Adult↗
PubMed2000

Impaired prepulse inhibition of acoustic startle in schizophrenia.

BACKGROUND: Schizophrenics show deficits in sensorimotor gating, as measured by prepulse inhibition of acoustic startle (PPI). The goal of this investigation is to further characterize PPI and habituation deficits in schizophrenia, and to examine whether differing subgroups of schizophrenics would show comparable PPI deficits. METHODS: PPI was measured in 24 male schizophrenic subjects (9 acutely decompensated inpatients and 15 stable outpatients) and in 20 age-matched normal control subjects. Schizophrenic subjects were rated for positive and negative symptoms at the time of testing. RESULTS: Schizophrenic subjects showed deficits in prepulse inhibition and habituation as compared to normal subjects. Similar latency facilitation was produced by the prepulse in both groups. Acutely decompensated inpatients and stable outpatients did not differ in percent PPI. PPI did not correlate with severity of positive or negative symptoms. CONCLUSIONS: These results suggest that schizophrenic subjects have impaired central inhibitory mechanisms as measured by PPI, and support the hypothesis that periods of relative clinical remission are not accompanied by normalization of sensorimotor gating.

Acoustic Stimulation↗
PubMed1997

A monosynaptic GABAergic input from the inferior colliculus to the medial geniculate body in rat.

The goal was to investigate possible monosynaptic GABAergic projections from the inferior colliculus (IC) to thalamocortical neurons of the medial geniculate body (MGB) in the rat. Although there is little evidence for such a projection in other sensory thalamic nuclei, a GABAergic, ascending auditory projection was reported recently in the cat. In the present study, immunohistochemical and tract-tracing methods were used to identify neurons in the IC that contain GABA and project to the MGB. GABA-positive projection neurons were most numerous in the central nucleus and less so in the dorsal and lateral cortex. They were rare in the lateral tegmental system and brachium of the IC. The dorsal nucleus of the lateral lemniscus also contained GABA-positive projection neurons. In brain slices, stimulation of the brachium produced monosynaptic inhibitory postsynaptic potentials in morphologically identified thalamocortical relay neurons. The inhibitory potentials cannot originate locally, because they persisted when ionotropic glutamatergic transmission was blocked. Typically, brachium stimulation elicited a GABAA-mediated inhibitory potential followed by an excitatory potential and a longer latency GABAB-mediated inhibitory potential. We conclude that the GABA-containing neurons of the IC make short-latency, monosynaptic inputs to the thalamocortical projection neurons in the MGB. Such inputs may distinguish the main auditory pathway from indirect or tegmental auditory pathways as well as from other sensory systems. Monosynaptic inhibitory inputs to the medial geniculate may be important for the regulation of firing patterns in thalamocortical neurons.

Animals↗
PubMed1997

Selective sensitization to the psychosis-inducing effects of cocaine: a possible marker for addiction relapse vulnerability?

Patients in inpatient rehabilitation for uncomplicated cocaine dependence were asked whether, compared with the time of their first regular use, they could now identify changes in the effects of similar doses of cocaine. We asked about a spectrum of cocaine effects "then" and "now" and whether the same amount of drug caused effects to occur to about the same degree, less intensely (tolerance), or more intensely (sensitization). Nearly half our sample developed predominantly paranoid psychoses in the context of cocaine use. Sensitization was consistently linked only to psychosis-related cocaine effects. It has been proposed that mesolimbic dopaminergic sensitization might contribute to addiction severity. A preliminary followup of patients who were sensitized or nonsensitized to psychosis development suggests that rehospitalization for treatment of addiction may be more frequent in the sensitized group.

Adult↗
PubMedDate not supplied

Reconstitution of rabbit sarcoplasmic reticulum calcium ATPase in a series of phosphatidylcholines containing a saturated and an unsaturated chain: suggestion of an optimal lipid environment.

The calcium-dependent ATPase from sarcoplasmic reticulum of rabbit has been purified and reconstituted in dispersions containing pure phosphatidylcholines. Each phosphatidylcholine (PC) had palmitate (16:0) at the sn-1 position of glycerol and stearate (18:0), oleate (18:1), linoleate (18:2), arachidonate (20:4), or docosahexaenoate (22:6) at the sn-2 position. The activities and activation energies of the enzyme indicated that the best enzyme function occurred when 16:0-18:1 PC or 16:0-18:2 PC was the lipid in which the ATPase was embedded. Circular dichroism measurements made as a function of temperature suggested that the protein in 16:0-18:0 and 16:0-18:1 PC behaved most like sarcoplasmic reticulum or purified ATPase. The results suggest that there may be an optimal lipid environment for the ATPase which is provided by 16:0-18:1 PC and 16:0-18:2 PC, the two most common lipids of the sarcoplasmic reticulum.

Animals↗