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Biomedical subjects

H Healy

Publications and source records attributed to H Healy.

16 recordsLinked to original sources
PubMed2002

Functional effects of agents differentially selective to noradrenergic or serotonergic systems.

BACKGROUND: The diversity of pharmacological actions of antidepressants suggests that they may bring about their clinical effects by different functional means. METHODS: Twenty healthy volunteers were randomized in a cross-over design to receive 2 weeks of a clinical dose of both reboxetine and sertraline. Baseline assessments of personality were made using the Cloninger Tridimensional Personality Questionnaire and the Karolinska Scales of Personality. Daily and weekly ratings of mood (POMS and PANAS) and quality of life (SASS) were undertaken. RESULTS: Reboxetine and sertraline differed in their effects on the SASS as well as on measures of mood. Reboxetine appeared more likely to be energy enhancing; the effects of sertraline were more difficult to quantify. Personality factors, such as harm avoidance predicted the preference of subjects for these effects and the effect of being on a preferred drug had a significant impact on SASS, and ratings of moods as well as on self-assessments of personality. CONCLUSIONS: The differences reported here are consistent with the original thinking that led to the development of the SSRIs. The findings point to the need for further research on possible differential functional effects of psychotropic agents selective to different brain systems. The findings also have implications for clinical practice, in particular for maintenance treatment with antidepressants.

Adrenergic Uptake Inhibitors↗
PubMed2002

Mood, eating behaviour and attention.

BACKGROUND: Obesity is a growing health problem, but most people find dieting unsuccessful. Three studies examine possible reasons for the difficulty and the extent to which dieting-related reductions in cognitive function are associated with mood and well-being. METHOD: In Study One, 49 female dieters were compared with a control group of 31 matched non-dieters on measures of well-being, mood, eating behaviour (Dutch Eating Behaviour Questionnaire), and attention. Study Two examined two measures of restraint to examine why previous studies find high restrainers are prone to react to emotion. Study Three experimentally manipulated mood using music and the standard Velten Induction Procedure to examine attention in restrainers and emotional eaters. RESULTS: Dieting was found to be associated with deficits in sustained attention. This finding was further supported by the demonstration of a significant impairment in performance following a negative mood induction in high emotional eaters whereas high restrainers were relatively unaffected by the mood challenge. CONCLUSIONS: We suggest that different aspects of eating behaviour have dissociable effects on cognitive-affective function. Trait tendencies to restrained eating are associated with attentional deficits, but are not further affected by mood disruption. It is the long-term tendency to eat when emotional that combines with current emotional state to trigger cognitive deficits.

Adult↗
PubMed2001

The recurrent neurotrophic buttock ulcer in the meningomyelocele paraplegic: a sensate flap solution.

A large percentage of meningomyelocele paraplegic patients have a distal zone of sensation-bearing skin on their thighs. This sensate skin can be used as a fasciocutaneous flap to resurface a recidivistic ulcer after excision. In this study, because the transposition distance was significant, the flap length-width ratio was greater than normal and, therefore, required a 3-week elevation delay. This also permitted appraisal of the sensate flap after the first stage. The wound-healing was excellent after both stages. This reconstructive procedure was completed in four patients, with an average follow-up period of 13 years. These patients remain chronic sitters in administrative jobs and have been pressure sore-free after flap repair.

Adolescent↗
PubMed2000

Review: Biology and relevance of C-reactive protein in cardiovascular and renal disease.

C-reactive protein (CRP) is a member of the pentraxin family of proteins, which are characterised by a cyclic pentameric structure and radial symmetry. The five identical 24-kDa protomers consist of 206 amino acids, and are noncovalently linked. CRP binds to a range of substances such as phosphocholine, fibronectin, chromatin, histones, and ribonucleoprotein in a calcium-dependent manner. It is a ligand for specific receptors on phagocytic leukocytes, mediates activation reactions on monocytes and macrophages, and activates complement. Plasma CRP is the classical acute-phase protein, increasing 1,000-fold in response to infection, ischemia, trauma, burns, and inflammatory conditions. A growing number of studies suggest that CRP is an independent risk factor for atherosclerotic vascular disease. Plasma CRP concentrations in the highest quartile are associated, depending on the subject group, with 1.5- to 7-fold increases in relative risk. In the high-risk endstage renal failure population, a raised CRP is associated with up to 5.5-fold increased relative risk of CVD and 4.6-fold increased relative risk of death. This review examines the relationships between CRP, cardiovascular disease, and mortality, with special reference to renal disease.

C-Reactive Protein↗
PubMed2000

Are metalloproteins and acute phase reactants associated with cardiovascular disease in end-stage renal failure?

End-stage renal failure (ESRF) is associated with a higher risk of cardiovascular disease (CVD) than predicted by the major risk factors. We investigate the hypothesis that metalloproteins such as transferrin and ceruloplasmin and the inflammatory response are associated with CVD risk in this population. In this cross-sectional study of 81 subjects stable on haemodialysis (HD), 43 with CVD and/or peripheral vascular disease (PAD) were compared to 38 subjects without clinical evidence of CVD/PAD. Serum concentrations of metalloproteins and acute phase reactants were compared by univariate analysis and logistic regression modelling. Body mass index, gender ratios, prevalence of diabetes, iron status, and homocysteine concentrations did not differ significantly between the groups. Those with CVD were older (P< 0.001) and had been on dialysis for longer (P = 0.004). CVD subjects had significantly higher concentrations of ceruloplasmin (325 vs 284 mg/L, P = 0.011), copper (18.2 vs 15.7 micromol/L, P = 0.002), and C-reactive protein (CRP) (median 9.0 vs 3.8 mg/L, P = 0.002). Transferrin iron binding capacity tended to be higher in the CVD group (P = 0.088). CVD risk for subjects with serum concentrations in the upper tertile was increased 9.4-fold (CI 2.8-31.0) for copper, 4.2-fold (CI 1.5-12.2) for ceruloplasmin, 3.9-fold (CI 1.3-12.1) for transferrin iron binding capacity, and 2.3-fold (CI 0.9-6.1) for CRP. In multivariate logistic regression models, age (P = 0.001) and time on dialysis (P = 0.002) were the strongest risk factors for CVD. After adjustment for age and time on dialysis, transferrin iron binding capacity (P = 0.013) and copper (P = 0.019) continued to be associated with CVD risk but ceruloplasmin (P = 0.065) and CRP (P = 0.634) were not. Total cholesterol was associated with a lower risk of CVD (ie protective), presumably due to cholesterol-lowering therapy in high-risk patients. In conclusion, copper and transferrin iron binding capacity may be associated with CVD risk in HD subjects.

Acute-Phase Proteins↗
PubMed2000

Microvascular complications in cystic fibrosis-related diabetes mellitus: a case report.

CONTEXT, The prevalence of cystic fibrosis-related diabetes mellitus is increasing and is associated with increased survival from cystic fibrosis. CASE REPORT, This study describes a case of the premature onset of disabling and widespread microvascular complications resulting from cystic fibrosis-related diabetes mellitus. Previously asymptomatic retinopathy was diagnosed on recognition of diabetic nephropathy. CONCLUSIONS, The treatment of pulmonary exacerbations has become more complex due to the nephrotoxic potential of intravenous aminoglycoside drugs which are frequently used to control chronic Pseudomonas infection in cystic fibrosis.

Adult↗
PubMed1999

Comparison of low-molecular-weight heparin (enoxaparin sodium) and standard unfractionated heparin for haemodialysis anticoagulation.

BACKGROUND: Low-molecular-weight heparin (LMWH) has been suggested as providing safe, efficient, convenient and possibly more cost-effective anticoagulation for haemodialysis (HD) than unfractionated heparin, with fewer side-effects and possible benefits on uraemic dyslipidaemia. METHODS: In this prospective, randomized, cross-over study we compared the safety, clinical efficacy and cost effectiveness of Clexane (enoxaparin sodium; Rhône-Poulenc Rorer) with unfractionated heparin in 36 chronic HD patients. They were randomly assigned to either Clexane (1 mg/kg body weight, equivalent to 100 IU) or standard heparin, and followed prospectively for 12 weeks (36 dialyses) before crossing over to the alternate therapy for a further 12 weeks. Heparin anticoagulation was monitored using activated coagulation times. RESULTS: Dialysis with Clexane resulted in less frequent minor fibrin/clot formation in the dialyser and lines than with heparin (P<0.001), but was accompanied by increased frequency of minor haemorrhage between dialyses (P<0.001). Clexane dose reduction (to a mean of 0.69 mg/kg) eliminated excess minor haemorrhage without increasing clotting frequencies. Mean vascular compression times were similar in both groups. Over 24 weeks, no changes in standard serum lipid profiles were observed. CONCLUSIONS: This study suggests that a single-dose protocol of Clexane is an effective and very convenient alternative to sodium heparin, but currently direct costs are about 16% more. We recommend an initial dose of 0.70 mg/kg.

Adult↗
PubMed1999

Promoting independence for teens and young adults with physical disabilities.

The transition to adult roles and responsibilities poses unique challenges for young people with physical disabilities. The Independence Programme (TIP) assists youths to meet these challenges. TIP is client-centred and addresses each participant's occupational performance problems. Participants live in a student residence located near shops, restaurants and other businesses for 20 consecutive days during TIP. This paper describes TIP and results from the evaluation of one summer's programme. Ten youths with physical disabilities, such as cerebral palsy, participated. The programme was evaluated using interviews with each participant at the beginning and end of the programme, and at a four month follow-up with the Canadian Occupational Performance Measure (COPM) (Law et al., 1994a). Participants made clinically important changes in performance and satisfaction of their identified occupations. They rated this programme as the best experience of the summer. Participants valued the opportunities to learn about and access environmental supports, to assume greater independence, and to develop connectedness with peers.

Activities of Daily Living↗
PubMed1998

The clinical pharmacologic profile of reboxetine: does it involve the putative neurobiological substrates of wellbeing?

Following a review of the clinical trials of reboxetine, a new nonadrenegic reuptake inhibitor antidepressant, this paper presents a heuristic theoretical framework to better understand selective antidepressant action. For over three decades, the dominant views of antidepressant action have seen these agents active across all constitutional types and regardless of social setting. An increasing number of studies using quality of life methods are at odds with this view. This paper summarizes several of these studies, along with two studies of the effects of reboxetine on the quality of life, which reveal differential effects of selective agents that demand alternative explanations to the conventional monoamine theories. The authors submit that any revisions in our understanding of what is happening will have to pay attention to temperamental inputs that antedate affective episodes and to the sense of wellbeing and level of residual symptoms patients have on treatment after the acute phase of their illness has remitted. Obviously much more research needs to be done in this area. This invited paper sketches out, in very general terms, some provocative possibilities of how future understanding of antidepressants, temperament and their neurobiologic substrates could lead to better matching of specific antidepressants to specific temperament types.

Adolescent↗
PubMed1998

Providing information to carers of people admitted to psychiatric hospital.

Relatives have an increasingly important role in providing care in the community to people with mental health problems, yet numerous studies have highlighted a lack of support from health care professionals. GERARD LEAVEY and colleagues describe a study to investigate the information provided to relatives of patients in one trust, and suggest solutions to the ethical and professional dilemmas raised.

Adult↗
PubMed1997

Oxidation of low density lipoprotein in hemodialysis patients: effect of dialysis and comparison with matched controls.

End stage renal failure is associated with lipoprotein abnormalities and a high prevalence of premature atherosclerosis. Oxidative modification of low density lipoprotein (LDL) may be promoted by hemodialysis increasing its atherogenicity. The oxidative status of LDL was therefore examined in female subjects before and after routine hemodialysis (HD; n = 10) and compared with women of similar age without significant renal disease (n = 19). There were no significant differences between the groups in the LDL fatty acid composition, or in the content of reactive amino acid groups (lysine) before or after exposure to Cu2+. The kinetics of LDL oxidation by Cu2+ showed no significant differences between the groups with respect to the lag time, the level of conjugated dienes before and after oxidation, or the maximal rate of oxidation during the propagation phase. No acute effects of HD were demonstrated. The present study provides no evidence that circulating LDL isolated from HD patients is more extensively modified or more susceptible to oxidation in vitro than gender-matched controls without renal failure.

Aged↗
PubMed1996

The specificity of autobiographical memory and imageability of the future.

Three studies examined whether the specificity with which people retrieve episodes from their past determines the specificity with which they imagine the future. In the first study, suicidal patients and nondepressed controls generated autobiographical events and possible future events in response to cues. Suicidal subjects' memory and future responses were more generic, and specificity level for the past and the future was significantly correlated for both groups. In the second and third studies, the effect of experimental manipulation of retrieval style was examined by instructing subjects to retrieve specific events or summaries of events from their past (Experiment 2) or by giving high- or low-imageable words to cue memories (Experiment 3). Results showed that induction of a generic retrieval style reduced the specificity of images of the future. It is suggested that the association between memory retrieval and future imaging arises because the intermediate descriptions used in searching autobiographical memory are also used to generate images of possible events in the future.

Adolescent↗
PubMed1995

Efficient infection from cDNA clones of cucumber mosaic cucumovirus RNAs in a new plasmid vector.

Full-length cucumber mosaic cucumovirus (CMV) cDNAs were cloned into a new plasmid vector containing a modified plant virus promoter designed to transcribe the inserted sequence from its first nucleotide. cDNA copies of CMV strain Q (Q-CMV) genomic RNAs 1, 2 and 3 cloned into this vector were infectious when inoculated together, producing symptoms indistinguishable from those caused by wildtype Q-CMV infection. The infectivity of the clones could be substantially increased by excision of the viral insert together with the transcriptional promoter and terminator prior to inoculation. A diagnostic but silent mutation was introduced into the RNA 2 cDNA and found to be stably maintained in viral infection, allowing distinction of the recombinant virus from native contaminants. The infectious cDNA clones supported the replication of CMV satellite RNA when co-inoculated with biologically active Q-CMV satellite RNA transcripts. Using the infectious cDNAs described, it was found that a newly-identified overlapping gene (2b) encoded by Q-CMV RNA 2 was not essential for either systemic viral infection of Nicotiana glutinosa or replication of the satellite RNAs.

Base Sequence↗
PubMedDate not supplied

Evaluation of a novel vitamin E coated cellulosic membrane hollow fiber dialyzer.

Adverse physiologic effects accompany hemodialysis. Biocompatible dialyzer membranes may both limit oxidative stress and decrease beta2-microglobulin production, thereby reducing patient morbidity. We compared standard solute clearance, lipid, and antioxidant effects of a novel cellulosic membrane dialyzer modified with covalently bonded vitamin E (Excebrane Clirans E15, Terumo Australia) with standard cellulosic and polysulphone membrane dialyzers. Stable adult hemodialysis patients taking no lipid lowering or antioxidant therapy (n = 17; 9 male, 8 female) were recruited into a 10 week, prospective, unblinded study. Measurements were made at baseline on their usual dialyzer and after 2, 4, and 10 weeks of Excebrane use. Excebrane demonstrated good in vivo clearance of standard solutes relative to surface area. Predialysis beta2-microglobulin levels were unchanged with time and were significantly lower postdialysis than with cellulose acetate (p < 0.05). Oxidized low density lipoprotein levels as measured by nitrotyrosine residues were high predialysis, but tended to decrease with both membranes (p > 0.05). Total antioxidant status fell during dialysis (p < 0.0005), but plasma vitamin A and E concentrations increased (p = 0.007 and p = 0.02, respectively). Baseline vitamin A levels were high in all patients and, along with vitamin E, total antioxidant status and lipid profiles did not change over time with Excebrane use. Excebrane is an efficient, biocompatible membrane with no deleterious effects on beta2-microglobulin or lipids. More long-term study is merited.

Adult↗