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Biomedical subjects

G Atkinson

Publications and source records attributed to G Atkinson.

At least 37 records · Page 2Linked to original sources
PubMed2001

Selected issues in the design and analysis of sport performance research.

The aim of this review is to discuss some issues in the design and statistical analysis of sport performance research, rather than to supply an authoritative 'cookbook' of methods. In general, we try to communicate some possible solutions to the conundrum of how to maintain both internal and external validity, as well as optimize statistical power, in applied sport performance research. We start by arguing that some sport performance research has been overly concerned with physiological predictors of performance, at the expense of not providing a valid and reliable description of the exact nature of the task in question. We show how the influence of certain factors on competitive performances can be described using linear or logistic regression. We discuss the choice of analysis for factorial repeated-measures designs, which is complicated by the assumption of 'sphericity' in a univariate general linear model, and the relatively low statistical power of the multivariate approach when used with small samples. We consider a little-used and simpler technique known as 'analysis of summary statistics'. In multi-group pre- and post-test designs, a useful technique can be to pair-match individuals on their performance scores in a counterbalanced fashion before the intervention or control has been introduced. Finally, we outline how confidence intervals can help in making statements about the probability of the population difference in performance exceeding the value designated as being worthwhile or not.

Humans↗
PubMed2001

How to show that unicorn milk is a chronobiotic: the regression-to-the-mean statistical artifact.

Few chronobiologists may be aware of the regression-to-the-mean (RTM) statistical artifact, even though it may have far-reaching influences on chronobiological data. With the aid of simulated measurements of the circadian rhythm phase of body temperature and a completely bogus stimulus (unicorn milk), we explain what RTM is and provide examples relevant to chronobiology. We show how RTM may lead to erroneous conclusions regarding individual differences in phase responses to rhythm disturbances and how it may appear as though unicorn milk has phase-shifting effects and can successfully treat some circadian rhythm disorders. Guidelines are provided to ensure RTM effects are minimized in chronobiological investigations.

Biometry↗
PubMed2000

Famciclovir in chronic hepatitis B: results of a dose-finding study.

BACKGROUND/AIMS: Famciclovir, an orally available nucleoside analogue with potent in vitro activity against HBV, is being investigated for treatment of chronic hepatitis B. METHODS: A dose-finding study was conducted in patients with hepatitis B e antigen present in serum. Patients received famciclovir 125 mg, 250 mg, 500 mg three times daily (tid) or placebo for 16 weeks, followed by 8 months post-treatment observation, and 16 weeks open-label treatment. More than 90% of patients had previously received alpha-interferon or had baseline characteristics indicating a high likelihood of poor response to alpha-interferon. RESULTS: Famciclovir induced rapid, dose-dependent suppression of viral replication and reduction in alanine aminotransferase (ALT), with greatest efficacy in the 500-mg tid treatment group. HBV DNA reduction was maintained throughout the treatment period. ALT also steadily declined during the treatment period. Approximately 40% of patients with pretreatment ALT>upper limit of normal (ULN) receiving famciclovir 500 mg tid, experienced sustained normalization of ALT at the end of the 8-month follow-up. Anti-HBe seroconversion occurred more frequently in patients receiving famciclovir 500 mg tid compared with placebo (p=0.04). Famciclovir was generally well tolerated; the incidence of adverse events was comparable to placebo. Exacerbation of liver disease or serious ALT flares were not observed. CONCLUSION: Famciclovir 500 mg three times daily may offer an alternative to alpha-interferon for treatment for chronic hepatitis B. Anti-HBe seroconversion in the famciclovir 500-mg tid group suggests that 16 weeks treatment has the potential for HBV clearance. Further studies with a longer treatment duration are warranted.

2-Aminopurine↗
PubMed2000

Oral ketamine in hepatocellular carcinoma.

Ketamine, an NMDA antagonist, has been used in pain treatment for a number of years. Recent reports have suggested its utility in a variety of pain states including post-herpetic neuralgia [1], cancer [2], and postoperative pain [5]. While a variety of neuropsychologic side effects are observed with parenteral ketamine, in oral use these side effects have been less pronounced [2,3]. We report a patient with severe hepatic disease who developed hallucinations following a 75-mg oral dose of ketamine for treatment of severe cancer pain unresponsive to morphine.

Journal Article↗
PubMed2000

Estimates of the daily phase and amplitude of the endogenous component of the circadian rhythm of core temperature in sedentary humans living nychthemerally.

Fifteen healthy female subjects were studied for eight days while living conventionally. Subjects were free to choose the ways they spent their time within a framework of regular times of retiring and rising; in practice, much of the waking time was spent in sedentary activities. Nine of the subjects were aware of the natural light-dark cycle, this approximating to a 12:12 L:D schedule at the time of year when the study took place. Before the study, subjects were assessed for their degree of "morningness" by questionnaire; throughout the study, they wore a rectal probe, and an activity meter on their non-dominant wrist. The timing (phase) and amplitude of the circadian rectal temperature rhythm were assessed on each day by cosinor analysis as well as by a method based on visual inspection of the data. These two parameters were also assessed after the temperature data for each day had been "purified" by a number of methods. From these results it was possible to investigate the effect of purification upon the amplitude of the circadian rhythm of temperature. Also, the day-by-day variability of phase, and the relationship between morningness and phase, were compared using these methods of phase estimation, and using cross-correlation between data sets from adjacent days; in all cases, raw and purified temperature data were used. There was a significantly greater amount of daily variation in phase using purified rather than raw data sets, and this difference was present with all methods of purification as well as with all methods for estimating phase. Purification decreased the amplitude of the circadian temperature rhythm by about 30%. Finally, there was a significant correlation between the morningness score of the subjects and the phase of the circadian temperature rhythm, the phase becoming earlier with increasing morningness; when this relationship was re-examined using purified data, it became more marked. These results reflect the masking effects exerted upon raw temperature data by lifestyle. The extent to which the purification methods enable the endogenous component of a circadian rhythm - and, by implication, the output of the endogenous circadian oscillator - to be estimated in subjects living normally is addressed.

Activities of Daily Living↗
PubMed2000

Pacing strategies during a cycling time trial with simulated headwinds and tailwinds.

The aims of this study were to examine the effects of one self-selected and two enforced pacing strategies (constant and variable power output) on cycling performance during a time trial in which variable wind conditions were simulated. Seven male cyclists rode their own bicycles on a Computrainer cycle ergometer, which was programmed to simulate a 16.1 km time trial on a flat course with a 8.05 km h(-1) headwind in the first half of the race and a 8.05 km h(-1) tailwind in the second half of the race. Subjects rode an initial time trial (ITT) at a self-selected pace to the best of their ability. The mean power output from this trial was then used to calculate the pacing strategies in the subsequent two trials: Constant (C)--riders rode the whole time trial at this mean power output; and Variable (V)--riders rode the first headwind section at a power output 5% higher than the mean and then reduced the power output in the last 8.05 km so that the mean power output was the same as in the initial time trial and in trial C. Power output, heart rate and ratings of perceived exertion (RPE) were recorded every 1.61 km. Finish times, 8.05 km split times and blood lactate levels, pre- and post-exercise (to calculate delta lactate), were also recorded in each trial. In the ITT, riders chose a mean +/- SD power output of 267 +/- 56 W in the first 1.61 km which was 14% higher than the overall race mean +/- SD of 235 +/- 41 W. Power outputs then dropped to below the race mean after the first few kilometres. Mean +/- SD finish times in the C and V time trials were 1661 +/- 130 and 1659 +/- 135 s, respectively. These were significantly faster than the 1671 +/- 131 s recorded in the initial time trial (p = 0.009), even though overall mean power outputs were similar (234 - 235 W) between all trials (p = 0.26). Overall mean RPE and delta lactate were lowest in trial V (p < 0.05). Perceived exertion showed a pacing strategy by race split interaction (p < 0.0001), but it was not increased significantly during the first 8.05 km of the V condition when power outputs were 5% higher than in condition C. Heart rate showed no main effect of pacing strategy (p = 0.80) and the interaction between strategy and race split did not reach statistical significance (p = 0.07). These results suggest that in a 16.1 km time trial with equal 8.05 km headwind and tailwind sections, riders habitually set off too fast in the first few kilometres and will benefit (10 s improvement) from a constant pacing strategy and, to a slightly greater degree (12 s improvement), from a variable (5% +/- mean) pacing strategy in line with the variations in wind direction during the race. Riders should choose a constant power when external conditions are constant, but when there are hilly or variable wind sections in the race, a variable power strategy should be planned. This strategy would be best monitored with 'power-measuring devices' rather than heart rate or subjective feelings as the sensitivity of these variables to small but meaningful changes in power during a race is low.

Adult↗
PubMed2000

Use of melatonin in recovery from jet-lag following an eastward flight across 10 time-zones.

Subjective, physiological and physical performance variables are affected following travel across multiple time-zones (jet-lag). The objective of the study was to examine the effects of oral melatonin in alleviating jet-lag by investigating its effects on subjects who had flown from London to Eastern Australia, 10 time-zones to the east. Melatonin (5 mg day(-1)) or placebo capsules were administered to 14 experimental (13 males and 1 female) and 17 control subjects (15 males and 2 females), respectively, in a double-blind study; the time of administration was in accord with the current consensus for maximizing its hypnotic effect. Grip strength and intra-aural temperature were measured on alternate days after arrival at the destination, at four different times of day (between the times 07:00 - 08:00 h, 12:00 - 13:00 h, 16:00 - 17:00 h and 19:00 - 20:00 h local time). In addition, for the first 6 - 7 days after arrival in Australia, subjective ratings of jet-lag on a 0 - 10 visual analogue scale and responses to a Jet-lag Questionnaire (incorporating items for tiredness. sleep, meal satisfaction and ability to concentrate) were recorded at the above times and also on retiring (at about midnight). Subjects continued normally with their work schedules between the data collection times. Subjects with complete data (13 melatonin and 13 placebo subjects), in comparison with published data, showed partial adjustment of the diurnal rhythm in intra-aural temperature after 6 days. A time-of-day effect was evident in both right and left grip strength during adjustment to Australian time; there was no difference between the group taking melatonin and that using the placebo. Right and left grip strength profiles on day 6 were adjusted either by advancing or delaying the profiles, independent of whether subjects were taking melatonin or placebo tablets. Subjects reported disturbances with most measures in the Jet-lag Questionnaire but, whereas poorer concentration and some negative effects upon sleep had disappeared after 3 - 5 days, ratings of jet-lag and tiredness had not returned to 'zero' (or normal values), respectively, by the sixth day of the study. Subjects taking melatonin showed no significant differences from the placebo group in perceived irritability, concentration, meal satisfaction, ease in getting to sleep and staying asleep, frequency of bowel motion and consistency of the faeces. These results suggest that, in subjects who, after arrival, followed a busy schedule which resulted in frequent and erratic exposure to daylight, melatonin had no benefit in alleviating jet-lag or the components of jet-lag, and it did not influence the process of phase adjustment.

Adult↗
PubMed2000

Do subjective symptoms predict our perception of jet-lag?

A total of 39 subjects were studied after a flight from the UK to either Sydney or Brisbane (10 time-zones to the east). Subjects varied widely in their age, their athletic ability, whether or not they were taking melatonin, and in their objectives when in Australia. For the first 6 days after arrival, subjects scored their jet-lag five times per day and other subjective variables up to five times per day, using visual analogue scales. For jet-lag, the scale was labelled 0 = no jet-lag to 10 = very bad jet-lag; the extremes of the other scales were labelled - 5 and + 5, indicating marked changes compared with normal, and the centrepoint was labelled 0 indicating 'normal'. Mean daily values for jet-lag and fatigue were initially high (+ 3.65 +/- 0.35 and + 1.55 +/- 0.22 on day 1, respectively) and fell progressively on subsequent days, but were still raised significantly (p < 0.05) on day 5 (fatigue) or day 6 (jet-lag). In addition, times of waking were earlier on all days. By contrast, falls in concentration and motivation, and rises in irritability and nocturnal wakings, had recovered by day 4 or earlier, and bowel activity was less frequent, with harder stools, on days 1 and 2 only. Also, on day 1, there was a decrease in the ease of getting to sleep (- 1.33 +/- 0.55), but this changed to an increase from day 2 onwards (for example, + 0.75 +/- 0.25 on day 6). Stepwise regression analysis was used to investigate predictors of jet-lag. The severity of jet-lag at all the times that were measured was strongly predicted by fatigue ratings made at the same time. Its severity at 08:00 h was predicted by an earlier time of waking, by feeling less alert 30 min after waking and, marginally, by the number of waking episodes. Jet-lag at 12:00 and 16:00 h was strongly predicted by a fall of concentration at these times; jet-lag at mealtimes (12:00, 16:00 and 20:00 h) was predicted by the amount of feeling bloated. Such results complicate an exact interpretation that can be placed on an assessment of a global term such as jet-lag, particularly if the assessment is made only once per day.

Adult↗
PubMed2000

A comparison of the immediate effects of moderate exercise in the late morning and late afternoon on core temperature and cutaneous thermoregulatory mechanisms.

Twelve healthy male subjects each undertook two bouts of moderate exercise (70% VO2max for 30 minutes) in the morning (08:00) and late afternoon (18:00) at least 4 days apart. Measurements were made of heart rate, core (rectal) temperature, sternum skin temperature, and forearm skin blood flow during baseline conditions, during the bout of exercise, and throughout a 30-minute recovery period. Comparisons were made of the changes of heart rate, temperature, and skin blood flow produced by the exercise at the two times of day. Student t tests indicated that baseline values for core temperature (37.15 degrees C +/- 0.06 degrees C vs. 36.77 degrees C +/- 0.06 degrees C) and sternum temperature (33.60 degrees C +/- 0.29 degrees C vs. 32.70 degrees C + 0.38 degrees C) were significantly (p < .05) higher in the late afternoon than the early morning. Two-way analysis of variance (ANOVA) indicated that the increases in core and sternum temperatures during exercise were significantly less (p = .0039 and .0421, respectively) during the afternoon bout of exercise compared with the morning, even though the work loads, as determined by changes in heart rate, were not significantly different (p = .798) at the two times of testing. There were also tendencies for resting forearm skin blood flow to be higher in the afternoon than in the morning and for exercise to produce a more rapid rise in this variable in the afternoon. The possible mechanisms producing these responses to exercise are discussed in terms of those that are responsible for the normal circadian rhythm of core temperature. It is concluded that the body's ability to remove a heat load is less in the early morning, when the circadian system is in a "heat gain" mode, than in the late afternoon, when heat gain and "heat loss" modes are balanced more evenly.

Adult↗
PubMed2000

A comparison of some different methods for purifying core temperature data from humans.

Nine healthy females were studied about the time of the spring equinox while living in student accommodations and aware of the passage of solar time. After 7 control days, during which a conventional lifestyle was lived under a 24h "constant routine," the subjects lived 17 x 27h "days" (9h sleep in the dark and 18h wake using domestic lighting, if required). Throughout the experiment, recordings of wrist activity and rectal (core) temperature were taken. The raw temperature data were assessed for phase and amplitude by cosinor analysis and another method, "crossover times," which does not assume that the data set is sinusoidal. Two different purification methods were used in attempts to remove the masking effects of sleep and activity from the core temperature record and so to measure more closely the endogenous component of this rhythm; these two methods were "purification by categories" and "purification by intercepts." The former method assumes that the endogenous component is a sinusoid, and that the masking effects can be estimated by putting activity into a number of bands or categories. The latter method assumes that a temperature that would correspond to complete inactivity can be estimated from measured temperatures by linear regression of these on activity and extrapolation to a temperature at zero activity. Three indices were calculated to assess the extent to which exogenous effects had been removed from the temperature data by these purification methods. These indices were the daily variation of phase about its median value; the ratio of this variation to the daily deviation of phase about midactivity; and the relationship between amplitude and the square of the deviation of phase from midactivity. In all cases, the index would decrease in size as the contribution of the exogenous component to a data set fell. The purification by categories approach was successful in proportion to the number of activity categories that was used, and as few as four categories produced a data set with significantly less masking than raw data. The method purification by intercepts was less successful unless the raw data had been "corrected" to reflect the direct effects of sleep that were independent of activity (a method to achieve this being produced). Use of this purification method with the corrected data then gave results that showed least exogenous influences. Both this method and the purification by categories method with 16 categories of activity gave evidence that the exogenous component no longer made a significant contribution to the purified data set. The results were not significantly influenced by assessing amplitude and phase of the circadian rhythm from crossover times rather than cosinor analysis. The relative merits of the different methods, as well as of other published methods, are compared briefly; it is concluded that several purification methods, of differing degrees of sophistication and ease of application to raw data, are of value in field studies and other circumstances in which constant routines are not possible or are ethically undesirable. It is also concluded that such methods are often somewhat limited insofar as they are based on pragmatic or biological, rather than mathematical, considerations, and so it is desirable to attempt to develop models based equally on mathematics and biology.

Body Temperature↗
PubMed2000

Some factors influencing the sensitivity of body temperature to activity in neonates.

In adult humans, core temperature is influenced by activity; the sensitivity of core temperature to such effects shows a phase dependence and is also influenced by the environment and whether the individual is asleep or awake. We have investigated if similar effects are evident in neonates, in whom thermoregulation and the circadian rhythm of core temperature are not fully developed. Eleven full-term, healthy babies were studied singly (light 07:00-19:00) at 2 days of age and again 4 weeks after birth; between these times, they were tended routinely on a communal ward. On study days, 10-minute recordings were made of rectal and skin (abdominal) temperature, heart rate (HR), and behavioral state. Sensitivities of the temperatures to activity ("arousal") were assessed throughout the 24h by measuring the gradient of (temperature/HR). Sensitivities measured at 01:00, 05:00, 09:00, 13:00, 17:00, and 21:00 were used as dependent variables in stepwise regression and linear regression analyses, with "subjects," "light versus dark," "behavioral state," and "difference between time of measurement and the acrophase of the endogenous component of the temperature rhythm" (ignoring sign) as possible predictors. (Acrophases of the temperature rhythms had been estimated from 24h data purified using the behavioral state record.) Light versus dark acted as a significant predictor of the sensitivity of rectal temperature to arousal on day 2 and week 4, the sensitivity increasing in the light, and there was limited evidence for behavioral state acting as a predictor on day 2. Neither factor was a significant predictor when the sensitivity of the babies' skin temperatures to arousal was investigated. There was also some evidence that the difference between the time of measurement and the temperature acrophase acted as a predictor of sensitivity to arousal in both rectal (day 2) and skin (week 4) temperature, with larger differences decreasing the sensitivity. These results indicate that there are masking effects on body temperature due to arousal in neonates, the size of which depends on both internal and external factors. However, this sensitivity of temperature to arousal shows differences from the sensitivity of temperature to physical activity in both adult humans and adult mice. One possible explanation of this result is that temperature regulation and the circadian system are not fully developed in humans at this age.

Adult↗
PubMed2000

Typical error versus limits of agreement.

We have shown that the SEM (typical error) and LOA are very similar when defined at the same level of abstraction. The calculation of these sample statistics does not depend on sample size, but the precision of their estimate for the population parameter does. Only the latter concept involves the t-statistic. They do differ in the type of measurement error that is described (true score error versus test-retest error) and the coverage probability of the reference interval (0.6 versus 0.95). Bland and Altman and Atdinson and Nevill have promoted the citation of either the SEM or the LOA to help researchers in their discussion of the impact of error to real uses of the measurement tol. What is vital in this discussion is the researcher having a thorough understanding of the underlying theory behind the measurement error statistic(s) that is/are employed, especially the definition of error and the coverage probability that is selected. Such issues have been built into the title of the 95% LOA statistic, and are also an inherent part of SEM. Whilst the concept of typical error appears to be easy to understand and teach, this is only because the underlying theory and definition of what the statistic actually represents is not communicated. Only if all researchers adopt one single statistic (e.g. typical error) for measurement error is it remotely possible to push underlying theory into the background, since there would be a baseline of comparison for all. Because this scenario is highly unlikely, it is important that any measurement error statistic is well defined and understood by researchers.

Confidence Intervals↗
PubMed2000

Adenovirus mediated cytosine deaminase gene transduction and 5-fluorocytosine therapy sensitizes mouse prostate cancer cells to irradiation.

PURPOSE: We assess the ability of adenovirus mediated expression of the Escherichia coli cytosine deaminase gene in conjunction with the prodrug 5-fluorocytosine to result in radiation sensitization in the mouse prostate cancer cell line RM-1 in vitro. MATERIALS AND METHODS: To document cytotoxicity of gene therapy, RM-1 cells were exposed to escalating doses of adenovirus mediated cytosine deaminase and a fixed dose of 5-fluorocytosine or phosphate buffered saline. Viable cells as determined by exclusion of trypan blue were counted the following day. Cytosine deaminase expressing RM-1 cells were then irradiated as single cell suspensions at various doses of radiation in a cesium source (4.4 Gy. per minute) and randomized to receive 5-fluorocytosine therapy at different times in relation to the external radiation therapy. End points were determined in a clonogenic assay by counting colonies with greater than 50 cells 7 days after replating. RESULTS: Use of adenovirus mediated cytosine deaminase plus 5-fluorocytosine demonstrated viral dose dependent killing of RM-1 cells to a maximum of 85%, while either therapy alone was nontoxic. Neither adenovirus mediated cytosine deaminase infection nor 5-fluorocytosine alone influenced external radiation therapy killing. However, after controlling for death due to gene therapy alone, the combination of adenovirus mediated cytosine deaminase plus 5-fluorocytosine and external radiation therapy resulted in synergistic activity to approximately 2 logs of cell kill at low doses of radiation (p = 0.001). While altering the chronology of prodrug exposure in relation to external radiation therapy maintained synergy in all scenarios tested, starting 5-fluorocytosine 24 hours before external radiation therapy resulted in the most profound killing (p = 0.04), which indicates the importance of maintaining prodrug therapy during external radiation therapy. CONCLUSIONS: The combination of adenovirus mediated cytosine deaminase plus 5-fluorocytosine and radiation therapy resulted in radiation sensitization with clinically relevant doses of radiation suggesting a potential usefulness of this treatment in patients with prostate cancer.

Adenoviridae↗
PubMed1999

Prodrug activation gene therapy and external beam irradiation in the treatment of prostate cancer.

OBJECTIVES: Gene therapy may represent a new avenue for the development of multimodal treatment for men with locally advanced prostate cancer. This study explores the potential benefits of combining adenovirus-mediated (ADV) herpes simplex virus thymidine kinase gene (HSV-tk) transduction and ganciclovir (GCV) therapy with external beam radiation therapy (XRT) to enhance the therapeutic efficacy of each treatment alone. METHODS: ADV/HSV-tk-transduced mouse prostate cancer cells, RM-1, were irradiated as single-cell suspensions at escalating doses in a cesium source (4.4 Gy/min). HSV-tk-expressing cells were randomized to receive varying doses and varying chronologies of GCV therapy in relation to XRT to fully evaluate potential cooperative activities. End points were determined in a clonogenic assay by counting colonies with greater than 50 cells 7 days after replating. The potential role of apoptosis as a mediator of enhanced cell killing was addressed by a TUNEL assay 12 and 24 hours after therapy. RESULTS: Neither ADV infection nor GCV alone affected XRT killing. However, the combination of ADV/HSV-tk+GCV plus XRT maintained the 1 log of cell kill from gene therapy alone through escalating doses of radiation. Radiation sensitization was noted at higher doses of radiation (8.8 Gy or more). Although decreasing the GCV dose had a profound negative influence on HSV-tk+GCV-mediated killing, combination therapy continued to maintain the degree of HSV-tk+GCV killing through escalating doses of XRT in an additive fashion but did not result in radiosensitization. Changing the chronology of GCV exposure in relation to XRT did not significantly alter the additive activities of combination therapy. Studies of apoptosis noted a doubling of apoptotic activity with HSV-tk+GCV compared with HSV-tk+PBS with or without XRT. However, there was no significant change in apoptotic activity in combination therapy over HSV-tk+GCV alone within the 24-hour period after GCV exposure. CONCLUSIONS: The combination of ADV/HSV-tk+GCV and XRT appears to result in at least additive, and with higher doses of radiation, synergistic killing activities, indicating a potential usefulness of this treatment strategy for patients with prostate cancer.

Animals↗
PubMed1999

Effect of sleep loss on core temperature when movement is controlled.

Nine subjects were studied for 16 days in an isolation unit where they lived on normal time, working at a decision-making, computer-driven task during the daytime. Interspersed among these control days were three occasions when sleep was curtailed. Rectal temperature and activity (non-dominant wrist) were measured throughout. Any effects of sleep loss on core temperature and activity were assessed by comparing these variables on control days with values during the daytime immediately following sleep loss, and during the next (recovery) day. During the daytime following sleep loss, activity showed no significant changes. By contrast, core temperature was significantly lower, particularly after the night of complete sleep loss. On recovery days also, activity was not significantly changed from control days but core temperatures during work were significantly lower than on control days if there had been no sleep the previous night. These results indicate that the effects of sleep loss on core temperature can persist for at least 24 h, and that they occur in the absence of parallel changes in activity.

Adult↗
PubMed1999

Assessment of therapeutic response of oropharyngeal and esophageal candidiasis in AIDS with use of a new clinical scoring system: studies with D0870.

We developed and compared five scoring systems designed to quantitate therapeutic response in cases of oropharyngeal candidiasis. We utilized prospectively collected data on 114 patients treated with several doses of the azole D0870. Patients were infected with fluconazole-susceptible (n = 49) or -resistant organisms (MIC, > or = 16 mg/mL; n = 61). Patients with fluconazole resistance had lower CD4+ cell counts at baseline; more symptoms (P = .0006); a higher frequency of dysgeusia (P = .004), dysphagia (P = .006), and throat pain (P = .0034); and greater oral coverage by plaques of Candida. There was no difference between the two groups in terms of colony-forming units, and any change did not correlate with response to therapy. Resolution of dysphagia (P < .01) and oral pain (P < .01) correlated well with response to therapy, unlike retrosternal pain and throat pain, which were also less frequent. Xerostomia, a "furry" taste, and dysgeusia were frequent nonspecific symptoms. Scoring system C, weighting resolution of a symptom higher than absence of a symptom at baseline, yielded the best correlation with global outcome (r = 0.86) and allows the quantitation of incomplete but clinically beneficial responses to therapy.

AIDS-Related Opportunistic Infections↗