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Biomedical subjects

J A Fleming

Publications and source records attributed to J A Fleming.

At least 19 recordsLinked to original sources
PubMed1992

Sleep disturbance, depression, and lesion site in patients with multiple sclerosis.

We examined the prevalence of sleep problems in a sample of patients with mild but clinically definite multiple sclerosis (n = 143) and sought to determine whether there was a relationship between the presence of sleep complaints and the level of depression. As magnetic resonance imaging scans were available for a subsample of the patients with multiple sclerosis (n = 117), we also wanted to determine whether there was a relationship between the site of the lesion and the presence of sleep difficulties. The prevalence of sleep difficulties was three times higher in the patients with multiple sclerosis than the control group (25.2% vs 8.2%). Moreover, the presence of sleep complaints was associated with higher levels of depression. Three lesion sites that subserve supplemental motor areas were significantly related to the presence of sleep complaints. These findings suggest that, for some patients with MS, sleep disturbance and accompanying increases in depression may be a function of the lesion site resulting in nocturnal spasms.

Adult↗
PubMed1992

Adenotonsillectomy for upper airway obstruction carries increased risk in children with a history of prematurity.

To define better the clinical presentation and perioperative outcome in children undergoing adenotonsillectomy (T&A) for relief of upper airway obstruction (UAO), we reviewed the hospital records of 60 consecutive, otherwise normal children aged 12 years or younger. Seven patients with trisomy 21, neurologic impairments, or preoperative cor-pulmonale were excluded. Intraoperative and postoperative complications were experienced by 15 (34%) and 13 (25%), respectively, of the 53 children with preoperative UAO. The most severe complications comprised pulmonary edema and prolonged postoperative oxyhemoglobin desaturation. Multivariate logistic regression analysis found a history of prematurity and/or low birth weight to be the most significant risk factors related to the occurrence of complications. Twenty-eight % of the study population had a history of prematurity and they had approximately 85% of the perioperative complications seen in children with UAO undergoing T&A. Other significant risk factors included adenoidal facies and evidence of respiratory distress at the time of surgery. It appears that T&A poses significant risk for children with UAO who were born prematurely and have evidence of abnormal facial development or respiratory distress preoperatively.

Adenoidectomy↗
PubMed1992

Use of antianxiety drugs as countermeasures in the detection of guilty knowledge.

To evaluate whether antianxiety drugs enable guilty subjects to appear innocent on polygraph tests, we compared the effects of diazepam, meprobamate, and propranolol on the outcome of a guilty knowledge test (GKT). Seventy-five undergraduate students were evenly divided among one innocent and four guilty groups. Subjects in each of the guilty groups received either one of the drugs or a placebo prior to the administration of the GKT and after viewing a videotape that depicted a burglary as seen from the perspective of the burglar. The results showed that drug status had no influence on the outcome of the GKT. Innocent subjects who coincidentally obtained high scores on a recognition memory test covering details of the mock crime tended to obtain higher guilt scores on the GKT.

Adolescent↗
PubMed1992

Cardiovascular and vasoactive hormone responses to bladder distension in spinal and normal man.

Many patients with high spinal cord injury experience exaggerated blood pressure rises in response to bladder distension. To examine the humoral mechanisms associated with these responses, ECG heart rate, blood pressure and vasoactive hormone levels were measured at baseline and during bladder distension following slow bladder filling in 23 subjects: 9 high spinal lesion patients, 7 low spinal lesion patients and 7 normal control subjects. Systolic blood pressure rose significantly during bladder distension in the high spinal lesion group by an average of 56 mm Hg (48%) and diastolic blood pressure rose by 22 mm Hg (47%), while heart rate fell by a mean of 7.4 beats per minute (15%). By contrast, neither systolic or diastolic blood pressure nor heart rate changed significantly during bladder distension in the low spinal lesion or normal control group. There were no significant changes in plasma levels of noradrenaline, renin, aldosterone, vasopressin, arginine, or atrial natriuretic peptide during bladder distension to account for the blood pressure rise in the high spinal lesion group. These findings suggest that humoral mechanisms are unlikely to play a major role in the mediation of pressor responses to bladder distension in high spinal lesion patients.

Blood Pressure↗
PubMed1992

Smooth-pursuit eye tracking in first-episode psychotic patients and their relatives.

We wished to determine the specificity of smooth-pursuit eye tracking dysfunction to schizophrenia and the prevalences of dysfunction among functionally psychotic and normal individuals. Therefore, we investigated pursuit tracking in a large sample of psychotic patients, normal subjects, and first-degree relatives (N = 482). Patients were recruited as part of an epidemiological study of first-episode psychosis that used a broadly based referral network to identify all cases in a major metropolitan area over a 2 1/2-year period. Patients received diagnoses of schizophrenia, schizophreniform disorder, psychotic mood disorder, and paranoid or other psychotic disorder based on the third edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1980). The distribution of tracking performance was bimodal for the schizophrenic patients and their relatives, perhaps reflecting major gene action. Moreover, poor tracking ran in families. Pursuit tracking dysfunction was relatively specific to schizophrenic patients and their relatives and occurred infrequently in other psychotic patients and normal subjects.

Acute Disease↗
PubMed1990

Use of early baculovirus promoters for continuous expression and efficient processing of foreign gene products in stably transformed lepidopteran cells.

Baculoviruses are currently used as vectors for the transient high-level expression of foreign gene products in insect cells. In this study, we demonstrate that baculoviruses can also be made to continuously express a foreign gene product by using the promoter from IE1, an immediate early viral gene, to produce stably-transformed insect cells. This approach gave levels of foreign gene expression lower than those usually obtained with the lytic baculovirus expression vector system. Expression, however, was continuous and stable, and a complex human glycoprotein (tissue plasminogen activator) was processed more efficiently. We conclude that stable transformation is a feasible approach for baculovirus-mediated foreign gene expression in lepidopteran cells, particularly for products that are relatively poorly-expressed and/or processed in lytically infected cells.

Animals↗
PubMed1990

A comparison of the efficacy, safety and withdrawal effects of zopiclone and triazolam in the treatment of insomnia.

A double-blind study comparing zopiclone and triazolam, in 48 healthy, chronic insomniacs, was undertaken in two centers to compare the hypnotic and withdrawal effects of both compounds. Comparable doses of 7.5 mg zopiclone and 0.25 mg triazolam were given at bedtime for 21 nights after a 3 day wash-out period, followed by 4 placebo nights of withdrawal monitoring. During the investigation, a 17 item post-sleep questionnaire was completed daily, the Clinical Global Impression (CGI) scale weekly, and the Hamilton Anxiety Scale (HAM-A) at baseline and at the end of the study. Withdrawal effects were evaluated with a withdrawal symptom checklist and the CGI (withdrawal). Results indicated that both compounds improved sleep and were equally effective. However, a larger number of triazolam subjects withdrew from the study because of ineffectiveness or adverse side-effects. A greater number of zopiclone subjects experienced a transient modification of taste which disappeared with discontinuation of therapy. Significant deterioration in nearly all sleep parameters were noted after the first withdrawal night of triazolam; much fewer modifications of sleep parameters were observed following the discontinuation of zopiclone.

Adolescent↗
PubMed1989

Reduction of post-ECT memory complaints through brief, partial restricted environmental stimulation (REST).

1. A previous paper (Suedfeld, et al. 1987) reported on preliminary results of placing patients into a room with substantially reduced environmental stimulation (REST) immediately after recovery from ECT. 2. Comparing two depressed patients who had undergone this experience with three who had instead returned to their own hospital room (Ward), Suedfeld et al. (1987) found that the former registered much fewer complaints concerning memory loss related to ECT administration than the latter. 3. The current report extends this finding to a total of 19 patients, of whom 13 completed four testing sessions. Once again, objective tests of memory showed no significant change as a function of ECT. Both groups of patients complained of substantial memory disruption after the first ECT. By the one-week follow-up, such complaints were minimal among REST patients but showed only a slight decline among the Ward group. This was the only significant intergroup difference.

Adult↗
PubMed1989

The role of social relationships in the course of first-episode schizophrenia and affective psychosis.

The Markers and Predictors of Psychosis study at the University of British Columbia addresses the role of psychosocial factors, such as social relationships, in predicting the short-term course of first-episode schizophrenia. Before their first episode of illness, schizophrenic subjects had fewer and less satisfactory social relationships than subjects with affective psychosis and a matched, normal comparison group. Nonfamily social resources were positively associated with good prognosis for both psychotic groups. While involvement with family members also predicted good prognosis among subjects with affective psychosis, family involvement had a negative association with outcome among schizophrenic subjects.

Adolescent↗
PubMed1988

Causes of death in DSM-III schizophrenics and other psychotics (atypical group). A comparison with the general population.

Causes of death were determined in a cohort of DSM-III schizophrenics and in a group of "other" psychotics (with schizoaffective disorder, schizophreniform disorder, and atypical psychoses), and comparisons were made with the general population. Five causes of death were considered in this analysis: (1) infections, (2) neoplasms, (3) cardiovascular, (4) unnatural, and (5) other. Suicide occurred in excess among other psychotics compared with schizophrenics and with the general population.

Adolescent↗
PubMed1988

Selection of controls for family studies. Biases and implications.

The use of hospital-based controls as a means of comparison for family studies has raised a number of questions concerning the degree to which the control group represents the general population. Of primary interest is whether the control group should be completely free of disease-associated symptoms. To test the effect of the selection of psychiatric symptom-free controls, we examined the control group from our long-term follow-up and family study of major psychoses. Morbidity risks for psychiatric disorder among relatives of surgical controls were estimated, both for an unscreened proband group of 361 patients and for a screened group of 318 from which the relatives of controls with significant "psychiatric history" had been eliminated. The largest difference occurred with affective disorders, which were more frequent among the relatives of unscreened controls than among the relatives of the screened controls. Our results suggest that gathering data on both screened and unscreened control groups will yield more generalizable results than either alone.

Adult↗
PubMed1988

Refining the diagnosis of schizophreniform disorder.

Schizophreniform disorder, a potentially useful construct, is difficult to operationalize either for clinical or research purposes. According to DSM-III-R, schizophreniform disorder is descriptively identical to schizophrenia, differing only in duration of symptoms. This study suggests several features that, at initial examination, differentiate schizophreniform disorder from schizophrenia, such as higher DSM-III axis V ratings, lack of flattened affect, and better rapport with the examiner. The data suggest that when defined according to appropriate clinical criteria, schizophreniform disorder can be distinguished from either schizophrenia or affective disorder.

Adolescent↗
PubMed1988

Ventricular and sulcal size at the onset of psychosis.

To determine whether abnormalities in brain morphology are present at the onset of illness, patients with schizophrenia, schizophreniform and bipolar disorders, and major depression who were experiencing their first episodes of psychosis were compared with normal and medical control subjects. The schizophrenic patients had larger third ventricles but not larger lateral ventricles or cortical sulci than the normal subjects. The other psychotic patients did not differ from the normal group on these measures. A different pattern of results emerged when the medical patients were used for comparison, indicating that the choice of control group can influence the findings of computerized tomography studies.

Adolescent↗
PubMed1988

A sleep laboratory evaluation of the long-term efficacy of zopiclone.

Six patients between the ages of 25 and 59, with chronic, primary insomnia received the new, non-benzodiazepine, hypnotic zopiclone continuously for 17 weeks after a drug free interval of 12 nights. To qualify for the study, sleep efficiency, determined by a sleep study on two, consecutive, placebo-controlled nights, had to be less than 75%. Patients evaluated their sleep by questionnaire and had sleep studies completed throughout active treatment. Zopiclone (7.5 mg) increased sleep efficiency by decreasing sleep latency, wakefulness after sleep onset and increasing total sleep time. Sleep architecture was minimally affected by zopiclone treatment; no significant changes in delta or REM sleep were observed. The commonest side effect was a bitter or metallic taste. No significant changes in biological functioning were noted throughout the study period. These findings indicate that zopiclone is a safe and effective hypnotic medication which maintains its effectiveness with protracted use.

Adult↗