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Biomedical subjects

E M Morris

Publications and source records attributed to E M Morris.

17 recordsLinked to original sources
PubMed1999

An open clinical trial of fluvoxamine treatment of psychogenic excoriation.

The purpose of this study was to examine the safety and efficacy of fluvoxamine in the treatment of psychogenic (neurotic) skin excoriation. Fourteen subjects with psychogenic excoriation were given fluvoxamine in a 12-week, open-label trial after completion of the Structured Clinical Interview for DSM-IV. All subjects met DSM-IV criteria for at least one comorbid psychiatric disorder, with mood disorder the most common. Most subjects' excoriation had features of an impulse control disorder. Both completers (N = 7) and the entire group had significant improvement on the modified Yale-Brown Obsessive Compulsive Scale but no improvement on the Hamilton Rating Scale for Depression. In the self-report data, the seven completers had significant reduction in behaviors involving the skin (e.g., scratching, picking, gouging, or squeezing) and in global assessment of symptoms. Endpoint analysis of all 14 subjects' self-report data demonstrated significant improvement in the presence of skin sensations, skin appearance and lesions, behaviors involving the skin, control over skin behavior, and global assessment. The results of this preliminary open trial suggest that fluvoxamine may be effective in reducing psychogenic excoriation, and this effect seems to be independent of mood. Controlled studies are needed to confirm these findings.

Adult↗
PubMed1998

Professional help sought for emotional problems: coping with child sexual abuse in a Dunedin community sample of women.

AIM: To investigate how often women reporting child sexual abuse obtain professional help for emotional reasons compared with non-abused women and how useful they find it. METHOD: In a follow-up survey of a random community sample of women, information on formal help for emotional problems was analysed by demographic, health status and abuse information. RESULTS: In the year prior to survey, 11.8% of women in this community sample sought professional help for emotional problems. Women in the child sexual abuse sub-sample were significantly more likely than the comparison sub-sample to have sought help (16.6% vs 7.3%) but marital status (separation) was a more significant predictor. Problematic relationships or depression were the reasons given most often for help-seeking. Therapists/counsellors and general practitioners were the health professionals most often approached. Most help-seekers thought the help useful but some child sexual abuse help-seekers did not. The child sexual abuse sub-sample were more likely to report cost as a barrier. CONCLUSIONS: Relationship difficulties and depression are the most common reasons for seeking professional help for emotional problems. Women giving a history of child sexual abuse have higher rates of formal help-seeking and are more likely than other women to report that help they receive is not useful.

Adaptation, Psychological↗
PubMed1998

Characteristics of 34 adults with psychogenic excoriation.

BACKGROUND: Psychogenic excoriation, characterized by excessive scratching or picking of the skin, is not yet recognized as a symptom of a distinct DSM-IV disorder. The purpose of this study was to provide data regarding the demographics, phenomenology, course of illness, associated psychiatric comorbidity, and family history of subjects with psychogenic excoriation. METHOD: Thirty-four consecutive subjects were recruited from an outpatient dermatology practice and by advertisement. Subjects completed the Structured Clinical Interview for DSM-IV augmented with impulse control disorder modules, the Yale-Brown Obsessive Compulsive Scale, and a semistructured interview for family history, demographic data, and clinical features. RESULTS: Most subjects were women who described a mean age at onset of 38 years and a chronic course. Subjects excoriated multiple sites, most frequently the face. The behavior caused substantial distress and dysfunction. All 34 subjects met criteria for at least 1 comorbid psychiatric disorder, with a mood disorder the most common. Family histories were notable for depressive disorders and psychoactive substance use disorders. Most subjects experienced both mounting tension before excoriation and relief after excoriation as in impulse control disorders. A minority of subjects excoriated skin as part of obsessive-compulsive disorder. Body dysmorphic disorder with preoccupation about the skin's appearance precipitated excoriation in about a third of subjects. CONCLUSION: Psychogenic excoriation is chronic, involves multiple sites, and is associated with a high rate of psychiatric comorbidity. The behavior associated with the excoriation is heterogeneous and spans a compulsive-impulsive spectrum. Most subjects in this sample described features of an impulse control disorder.

Adult↗
PubMed1997

Risk factors for adolescent pregnancy: how important is child sexual abuse? Otago Women's Health Study.

AIM: To examine the relative importance of child sexual abuse as a risk factor for adolescent pregnancy. METHOD: Postal survey and interview of a community sample of New Zealand women. RESULTS: Four preceding familial and psychosocial factors were associated with adolescent pregnancy; these included living in nonnuclear family or one in which the parents had frequent rows, being physically punished after the age of 12 and not having a confidante as a child. Whilst women who reported child sexual abuse were more likely to become pregnant under 19, this variable was confounded by these other characteristics. Only when child sexual abuse was of the most intrusive subtype, ie intercourse, did it independently predict adolescent pregnancy. Some interesting negative (nonsignificant) findings such as the type of high school attended, coeducational or single sex, were found. Material deprivation, as measured by parental socioeconomic and educational status, seemed less important in leading to adolescent pregnancy than has been reported from overseas. CONCLUSIONS: Adolescent pregnancy does not occur randomly in the community but was found in women who came from families with preexisting psychosocial problems. This suggests that preventive strategies aiming to reduce adolescent pregnancy should focus on measures which improve the general functioning of family units, in addition to providing good sexual information.

Adolescent↗
PubMed1997

Selegiline percutaneous absorption in various species and metabolism by human skin.

PURPOSE: A Selegiline Transdermal System (STS) is under development for indications which may not be optimally or safely treated with oral selegiline. Studies were conducted to evaluate the in vitro penetration and skin metabolism of selegiline in order to better understand the toxicological findings and the observed plasma levels of selegiline and its metabolites in animals and man. METHODS: In vitro penetration studies were conducted in four different species (male hairless mice, male and female rats, female dog and male Micropig) and compared to human skin. In another study, viable human skin was used to estimate the extent of metabolism of selegiline by human skin using Franz diffusion cells. RESULTS: Results indicated that female dog and male Micropig skin were reasonable animal models for 24 hour in vitro selegiline penetration through human skin. Penetration of selegiline through rat skin and hairless mouse skin was 2-fold and 3-fold higher than through human skin, respectively. Metabolism was negligible in human skin. Selegiline metabolites (L-methamphetamine and N-desmethylselegiline but not L-amphetamine) were detected at all time points but the extent of selegiline metabolism was negligible. The cumulative 24 hour in vitro selegiline permeation from a 1.83 mg/cm2 STS through human skin was 5.0 mg. This was similar to the in vivo permeation in humans as assessed by residual patch analysis. CONCLUSIONS: The similarity of dog and human skin permeation results support the use of the dog as a species for evaluating the toxicology of transdermally-administered selegiline. Selegiline is not metabolized cutaneously and hence the metabolic profile following STS administration is likely due to hepatic metabolism only.

Animals↗
PubMed1994

Effect of aerosolized recombinant human DNase on exacerbations of respiratory symptoms and on pulmonary function in patients with cystic fibrosis. The Pulmozyme Study Group.

BACKGROUND: Respiratory disease in patients with cystic fibrosis is characterized by airway obstruction caused by the accumulation of thick, purulent secretions, which results in recurrent, symptomatic exacerbations. The viscoelasticity of the secretions can be reduced in vitro by recombinant human deoxyribonuclease I (rhDNase), a bioengineered copy of the human enzyme. METHODS: We performed a randomized, double-blind, placebo-controlled study to determine the effects of once-daily and twice-daily administration of rhDNase on exacerbations of respiratory symptoms requiring parenteral antibiotics and on pulmonary function. A total of 968 adults and children with cystic fibrosis were treated for 24 weeks as outpatients. RESULTS: One or more exacerbations occurred in 27 percent of the patients given placebo, 22 percent of those treated with rhDNase once daily, and 19 percent of those treated with rhDNase twice daily. As compared with placebo, the administration of rhDNase once daily and twice daily reduced the age-adjusted risk of respiratory exacerbations by 28 percent (P = 0.04) and 37 percent (P < 0.01), respectively. The administration of rhDNase once daily and twice daily improved forced expiratory volume in one second during the study by a mean (+/- SD) of 5.8 +/- 0.7 and 5.6 +/- 0.7 percent, respectively. None of the patients had anaphylaxis. Voice alteration and laryngitis were more frequent in the rhDNase-treated patients than in those receiving placebo but were rarely severe and resolved within 21 days of onset. CONCLUSIONS: In patients with cystic fibrosis, the administration of rhDNase reduced but did not eliminate exacerbations of respiratory symptoms, resulted in slight improvement in pulmonary function, and was well tolerated.

Adolescent↗
PubMed1990

A prospective study of genital infections in a family-planning clinic. 1. Microbiological findings and their association with vaginal symptoms.

A prospective study of genital infection was conducted in four inner-city family-planning clinics. Fifteen per cent of routine attenders had symptoms and signs of vaginal infection and many more women attended primarily because of symptoms. Among the women with both signs and symptoms, 70% had positive laboratory findings, Trichomonas vaginalis, Candida albicans and bacterial vaginosis being equally prevalent. Measurement of vaginal pH in the clinic was the single most useful clinical finding for directing empirical therapy. Among patients with a discharge confirmed on examination and an abnormally high pH, 72% had either T. vaginalis or bacterial vaginosis. Neisseria gonorrhoeae was isolated from 4% of women with, and 1% of those without, symptoms. We believe that it is worthwhile to investigate patients presenting to family-planning clinics with vaginal symptoms. No single specimen was found ideal for all pathogens, a cervical swab is better for gonococci and also for T. vaginalis but a vaginal swab is needed for candida and bacterial vaginosis.

Bacterial Infections↗
PubMed1990

A prospective study of genital infections in a family-planning clinic. 2. Chlamydia infection--the identification of a high-risk group.

During a study of genital infection in inner-city family-planning patients we examined 452 women for Chlamydia trachomatis. The prevalence of infection was 7.3%. There was no significant difference between patients attending because of genital symptoms and those who were attending for routine family-planning advice. Infection was found to be correlated with five main demographic parameters; age less than 25, no stable partnership, hormonal contraception, nulliparity and West Indian Ethnic origin. Using these parameters a simple scoring system was devised which allowed a high-risk population to be defined in whom screening would be economically justified.

Adult↗
PubMed1990

Pharmacokinetics and erythropoietic response to human recombinant erythropoietin in healthy men.

To assess the safety, pharmacokinetics, and erythropoietic responses to human recombinant erythropoietin (epoetin beta), single intravenous doses (10, 50, 150, and 500 IU/kg) were administered at monthly intervals to 16 healthy subjects in a two-panel, placebo-controlled, double-blind ascending-dose trial. A 1000 IU/kg dose was subsequently administered in an open manner. Epoetin concentrations were determined in serum and urine by radioimmunoassay. Reticulocyte, hemoglobin, and hematocrit values were serially measured after each dose. Mean epoetin apparent half-lives ranged from 4.42 to 11.02 hours. The apparent volume of distribution was between 40 and 90 ml/kg, consistent with plasma water, and the apparent clearance values ranged from 4 to 15 ml/kg/hr, with both parameters having the highest values at the 10 IU/kg dose level. Clearance tended to decrease as a function of dose. Maximum reticulocyte counts were dose-dependent and occurred 3 to 4 days after the epoetin dose. Epoetin was well tolerated, and no antibodies were detected.

Adult↗
PubMedDate not supplied

The use of bone marrow in the study of postmortem redistribution of nortriptyline.

Thirty-two New Zealand Albino rabbits (1.5-2.0 kg) were dosed on a daily basis with 20 mg/kg nortriptyline (NT) prior to feeding for a period of five days. On the fifth day of dosing, the animals were sacrificed approximately 1.5 h after the final dose. A comparison was made of nortriptyline concentrations in the blood and bone marrow at the time of sacrifice, and between bone marrow collected at the time of sacrifice and bone marrow collected at 2, 4, 6, 12, 24, 36, and 48 h after sacrifice. The results indicate that a linear relationship exists between blood and bone marrow NT concentrations, with an average marrow-to-blood ratio of 29.98 +/- 3.91 and a correlation coefficient of 0.956. Additionally, there was no significant difference (p > 0.05) observed between NT concentrations in bone marrow at the time of sacrifice and its concentration up to 24 h after sacrifice. The results indicate that bone marrow may be used to predict blood concentrations of NT up to 24 h after death when a suitable blood sample is not available.

Animals↗