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Biomedical subjects

J L Waller

Publications and source records attributed to J L Waller.

At least 19 recordsLinked to original sources

Chronic treatment with first or second generation antipsychotics in rodents: effects on high affinity nicotinic and muscarinic acetylcholine receptors in the brain.

Several postmortem and neuroimaging studies suggest that central nicotinic and muscarinic acetylcholine receptors are important in both the pathophysiology and pharmacotherapy of schizophrenia. However, while antipsychotic drugs are routinely used in the therapeutics of schizophrenia, little is known about their effects on the densities of these receptors when they are administered for extended periods of time (a common practice in the clinical setting). In the present study in rats, the residual effects of prior chronic exposure to representative first generation antipsychotics and second generation antipsychotics on the densities of high affinity nicotinic acetylcholine receptors and muscarinic acetylcholine receptor in the brain were investigated. Test subjects were treated with the first generation antipsychotics, haloperidol (2.0 mg/kg/day) or chlorpromazine (10.0 mg/kg/day) or the second generation antipsychotics, risperidone (2.5 mg/kg/day) or olanzapine (10.0 mg/kg/day) in drinking water for periods of 90 or 180 days, given a drug-free washout period (i.e. returned to normal drinking water) for two weeks and then killed. Quantitative receptor autoradiography was subsequently performed using 16 mum sagittal slices of whole brain incubated with [3H]-epibatidine, [3H]-pirenzepine or [3H]-AFDX-384 to measure high affinity nicotinic acetylcholine receptors, M1 and M2 muscarinic acetylcholine receptors, respectively. The most notable experimental result was a moderate, but significant (P<0.01) increase in [3H]-AFDX-384 binding sites in a number of brain regions (including cortex, hippocampus, subiculum, substantia innominata, and thalamus) associated with prior exposure to olanzapine for 90, but not 180 days. Olanzapine was also associated with a significantly higher density of [3H]-pirenzepine binding sites in cortex lamina I after 90 days of prior drug exposure. These data indicate that chronic treatment with a commonly used second generation antipsychotic, olanzapine is associated with modest increases in M2 muscarinic acetylcholine receptors in memory-related brain regions that may eventually abate with longer periods of chronic drug exposure.

Animals↗

Voluntary fluid intake and core temperature responses in adolescent tennis players: sports beverage versus water.

OBJECTIVE: To examine differences in ad libitum fluid intake, comparing a 6% carbohydrate/electrolyte drink (CHO-E) and water, and associated differences in core temperature and other selected physiological and perceptual responses in adolescent athletes during tennis training in the heat. METHODS: Fourteen healthy, fit, young tennis players (nine male; five female; mean (SD) age 15.1 (1.4) years; weight 60.6 (8.3) kg; height 172.8 (8.6) cm) completed two 120 minute tennis specific training sessions on separate days (randomised, crossover design) in a warm environment (wet bulb globe temperature: CHO-E, 79.3 (2.6) degrees F; water, 79.9 (2.2) degrees F; p>0.05). RESULTS: There were no significant differences (p>0.05) between the trials with respect to fluid intake, urine volume, fluid retention, sweat loss, perceived exertion, thirst, or gastrointestinal discomfort. However, there was a difference (p<0.05) in the percentage body weight change after training (CHO-E, -0.5 (0.7)%; water, -0.9 (0.6)%). Urine specific gravity before training (CHO-E, 1.024 (0.006); water, 1.025 (0.005)) did not correlate significantly (p>0.05) with any of these measurements or with core body temperature. In examining the main effect for trial, the CHO-E trial showed a significantly lower (p<0.001) mean body temperature (irrespective of measurement time) than the water trial. However, the mean body temperature in each trial was not associated (p>0.05) with fluid intake, fluid retention, sweat loss, or percentage body weight change. CONCLUSION: Ad libitum consumption of a CHO-E drink may be more effective than water in minimising fluid deficits and mean core temperature responses during tennis and other similar training in adolescent athletes.

Adolescent↗

Chronic exposure to typical or atypical antipsychotics in rodents: temporal effects on central alpha7 nicotinic acetylcholine receptors.

A decrease in alpha7 nicotinic acetylcholine receptors in the hippocampus has been hypothesized to contribute to alterations in auditory gating and other behavioral impairments in schizophrenia. However, while both typical and atypical neuroleptics are routinely used in the therapeutics of schizophrenia, little is known about their effects on auditory gating or alpha7 nicotinic acetylcholine receptor expression particularly when they are administered for extended periods of time (which is common in the clinical setting). In the present study in normal rats, the residual effects of prior chronic treatment (90 or 180 days) with representative typical and atypical neuroleptics (oral haloperidol, 2.0 mg/kg/day; chlorpromazine, 10.0 mg/kg/day, risperidone, 2.5 mg/kg/day; or olanzapine, 10.0 mg/kg/day) on prepulse inhibition of the auditory gating response were investigated. The densities of alpha7 nicotinic acetylcholine receptors were subsequently measured using [125I]-alpha-bungarotoxin autoradiography. The results indicated that none of the compounds significantly altered the startle amplitude or prepulse inhibition response either during drug treatment (day 60) or after 90 or 180 days of treatment (i.e. during a drug free washout). However, prior exposure to chlorpromazine, risperidone and olanzapine for 90 days resulted in modest but significant (P<0.01) decreases in [125I]-alpha-bungarotoxin binding sites in some brain regions (e.g. posterior cortical amygdala). After 180 days of treatment, decreases in [(125I]-alpha-bungarotoxin binding ranging from approximately 12% (lateral dentate gyrus) up to 24% (e.g. CA1 hippocampal region) were evident in the risperidone group in 13 of the 36 regions analyzed while decreases associated with the other neuroleptics agents were still present, but not statistically significant. These data indicate that the commonly used atypical neuroleptic, risperidone is associated with time dependent and persistent negative effects on an important biological substrate of memory (i.e. the alpha7 nicotinic receptor), but that the magnitude of the deficits was not sufficient to impair auditory gating.

Acoustic Stimulation↗

Comparison of galantamine and donepezil for effects on nerve growth factor, cholinergic markers, and memory performance in aged rats.

This study was designed to determine 1) whether repeated exposures to the acetylcholinesterase inhibitors (AChEIs) galantamine (GAL) or donepezil (DON) resulted in positive effects on nerve growth factor (NGF) and its receptors, cholinergic proteins, and cognitive function in the aged rat, and 2) whether GAL had any advantages over DON given its allosteric potentiating ligand (APL) activity at nicotinic acetylcholine receptors. Behavioral tests (i.e., water maze and light/dark box) were conducted in aged Fisher 344 rats during 15 days of repeated (subcutaneous) exposure to either GAL (3.0 or 6.0 mg/kg/day) or DON (0.375 or 0.75 mg/kg/day). Forty-eight hours after the last drug injection, cholinergic receptors were measured by [(125)I]-(+/-)-exo-2-(2-iodo-5-pyridyl)-7-azabicyclo[2.2.1]heptane ([(125)I]IPH; epibatidine analog), (125)I-alpha-bungarotoxin ((125)I-BTX), [(3)H]pirenzepine ([(3)H]PRZ), and [(3)H]-5,11-dihydro-11-[((2-(2-((dipropylamino)methyl)-1-piperidinyl)ethyl)amino)carbonyl]-6H-pyrido(2,3-b)(1,4)-benzodiazepin-6-one methanesulfonate ([(3)H]AFDX-384, or [(3)H]AFX) autoradiography. Immunochemical methods were used to measure NGF, high (TrkA and phospho-TrkA)- and low (p75 neurotrophin receptor)-affinity NGF receptors, choline acetyltransferase (ChAT), and the vesicular acetylcholine transporter (VAChT) in memory-related brain regions. Depending on dose, both GAL and DON enhanced spatial learning (without affecting anxiety levels) and increased [(125)I]IPH, [(3)H]PRZ, and [(3)H]AFX (but decreased (125)I-BTX) binding in some cortical and hippocampal brain regions. Neither AChEI was associated with marked changes in NGF, NGF receptors, or VAChT, although DON did moderately increase ChAT in the basal forebrain and hippocampus. The results suggest that repeated exposures to either GAL or DON results in positive (and sustained) behavioral and cholinergic effects in the aged mammalian brain but that the APL activity of GAL may not afford any advantage over acetylcholinesterase inhibition alone.

Acetylcholinesterase↗

Differential effects of chronic haloperidol and olanzapine exposure on brain cholinergic markers and spatial learning in rats.

RATIONALE: In psychiatric patients, haloperidol (HAL) induces a number of adverse extrapyramidal and cognitive symptoms, which appear to be less problematic with olanzapine (OLZ). In animals, HAL may initiate a number of harmful effects on central nervous system neurons, including damage to cholinergic pathways - an effect that could be especially deleterious to those experiencing memory dysfunction. The identification of the neurobiological substrates of such effects in animal models may help to improve the algorithms used for proper drug selection especially for long-term neuroleptic use. OBJECTIVES: The aim of this study was to compare the effects of chronic (45-day and 90-day), continuous oral exposure to HAL with OLZ for effects on cognitive performance and cholinergic markers in rats. METHODS: After chronic neuroleptic exposure (and a 4-day washout) spatial memory performance was measured in a water maze task, and choline acetyltransferase (ChAT) immunoreactivity was assessed with immunofluorescence staining. RESULTS: In water maze experiments, HAL and OLZ (relative to vehicle) administered for 90 days (but not 45 days) significantly impaired learning performance (i.e., higher mean latencies across several trials to reach a hidden platform). HAL administered for 90 days was associated with impairment across a greater number of trials than OLZ and it also impaired probe trial performance, as indicated by a reduced number of crossings over the previous platform area (when compared with OLZ or vehicle). Both 45 days and 90 days of HAL treatment reduced ChAT staining in the cortex and hippocampus when compared with OLZ or vehicle. CONCLUSIONS: The results in the rat suggest that OLZ (relative to HAL) may be more desirable as an antipsychotic for patients suffering from memory dysfunction especially for those in which cholinergic deficits may already be present.

Animals↗

Plasma membrane disruption in orthodontic tooth movement in rats.

Sublethal plasma membrane disruption (PMD) is an established mechanism for signaling in several cell types, including endothelial cells and skeletal muscle. We used a rat model of orthodontic tooth movement to test the hypothesis that periodontal ligament (PDL) cells communicate stretch to changes in bone cell activity in part via PMD. To produce PMD, we used a 50-g load from a spring activated in the buccal direction against the maxillary first molars for 5 min. Uptake of endogenous serum albumin was used as a PMD marker. Immunohistochemistry demonstrates albumin in PDL cells surrounding moved first molar tips. Image analysis shows significantly more albumin in cells of the buccal side (tension) of the moved teeth compared with those of the lingual, distal, and mesial sides, and those of the unmoved control. Albumin localization within cells of the PDL, after only 5 min of mechanical loading, suggests that PMD could promote uptake or release of signaling molecules.

Analysis of Variance↗

Provider feedback improves adherence with AHCPR Smoking Cessation Guideline.

BACKGROUND: This study evaluated the effect of primary care providers' adherence with the AHCPR Smoking Cessation Guideline after receiving a multicomponent intervention. METHODS: A quasi-experimental study with one intervention and one control team was conducted in a southeastern Veterans Affairs Medical Center primary care setting. During phase I, chart reviews were conducted to measure baseline provider adherence and documentation of the four A's (ask, advise, assist, arrange). In phase II, the intervention team received a single educational session on the AHCPR Guideline, four A's, and tobacco dependence treatment. This was followed by chart reviews of patients seen 4 to 8 weeks after the educational intervention to measure provider adherence and documentation of the four A's. During phase III, the intervention team received individual and team feedback from the chart reviews in phases I and II and booster education on the AHCPR Guideline. Chart reviews were conducted from patient visits 4 to 8 weeks after the feedback and booster education to determine provider adherence and documentation of the four A's. RESULTS: A nested repeated measures two-factor analysis of variance was performed for each of the following outcomes: ask, advise, assist, and arrange. Data analyses revealed that both the control and the intervention teams had 100% compliance in asking the patient about smoking status. There was a prestudy implementation of the vital sign stamp that included smoking status in this setting. Education on tobacco dependence and the AHCPR Guideline had no significant impact on provider performance with the advisement, assistance, and arrangement of follow-up. However, significant improvements occurred in the intervention team in the advisement (P = 0.05), assistance (P = 0.001), and arrangement of follow-up (P = 0.001) phase after individual and team feedback was provided. This research supports the fact that feedback impacts individuals and team performances and facilitated positive system changes to improve provider adherence with the AHCPR recommendations in treating tobacco dependence.

Feedback↗

A longitudinal study of adolescent mental health service use.

This study examines longitudinal mental health service use patterns of a school-based sample of adolescents. Based on the Center for Epidemiologic Studies Depression Scale scores, a stratified sample of middle-school students was interviewed using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children: cycle one (n = 579; mean age 12.83) and cycle two (n = 490; mean age 18.65). Service use also was assessed by mailed questionnaire: cycle three (n = 330; mean age 20.60). Service use decreased over time. Whites and males received significantly more treatment in the first cycle. In the second cycle, service use by race and gender was equal; in the third cycle, females received more treatment. Those with a psychiatric diagnosis (first cycle, 54%; second cycle, 33%) received treatment in the prior year. Under-treatment of youth with psychiatric diagnoses is a significant problem, with differences in service use by race and gender over time.

Adolescent↗

The NF-kappaB inhibitor diethyldithiocarbamate (DDTC) increases brain cell death in a transient middle cerebral artery occlusion model of ischemia.

A transient ischemic middle cerebral artery occlusion model of stroke was used to examine the role of the transcription factor NF-kappaB in cell death as measured by DNA fragmentation and infarction volume. The left middle cerebral artery was occluded for either 30 min or 2 h in rats. One set of animals was pretreated with diethyldithiocarbamate (DDTC), an inhibitor of NF-kappaB, 30 min prior to reperfusion. The animals were reperfused and allowed to survive for 2 or 7 days. DNA fragmentation was assayed by in situ end labeling in the stroke core and penumbral regions. Specific cortical and subcortical regions were measured using quantitative image analysis. DNA fragmentation was seen only on the ischemic side of the brains in all cases. Overall, the DDTC-treated groups showed significantly increased DNA fragmentation within the ischemic side compared to the saline control groups. DDTC treatment also caused an increase in stroke volume based on triphenyl tetrazolium chloride staining. Electrophoretic mobility shift assays showed NF-kappaB activation peaking 15 min following reperfusion and that this activation was blocked by the DDTC treatment. This study suggests that the use of NF-kappaB inhibitors to block cell death following stroke needs to be carefully examined because global inhibitors may not promote neuronal survival.

Animals↗

Urinary excretion of vasoactive factors are correlated to sodium excretion.

BACKGROUND: The relationship between urinary vasoactive factors and sodium excretion has not been adequately addressed in humans. PROCEDURE: Excretion rates of sodium, nitrates/nitrites (NOx), cGMP, and endothelin-1 (ET-1) were measured before and after ingestion of a mixed electrolyte solution (8 oz Gatorade) while undergoing a routine cardiovascular evaluation in a sample of 51 normotensive young adults. RESULTS: Significant correlations were detected for changes in excretion between all four variables, r ranged from 0.50 to 0.86 (P < .001). Correlations were higher in African Americans than white Americans. CONCLUSIONS: The association of renal ET-1 and NO activity with sodium excretion supports the hypothesis that these factors play a role in the physiologic response to acute changes in sodium intake, particularly in African Americans.

Adolescent↗

Sickle cell telemedicine and standard clinical encounters: a comparison of patient satisfaction.

OBJECTIVES: To determine patient satisfaction with telemedicine encounters among adults with sickle cell disease and compare their scores with SCD patients who have standard medical encounters (as controls). METHODS: Adults patients were recruited from a list of participants in sickle cell telemedicine clinics and prospectively at the time of clinic encounter. Patients were assigned to telemedicine or standard encounter groups. Demographic and pertinent clinical data were obtained for all subjects, and the Client Satisfaction Questionnaire (CSQ-8) was administered. Patients were also asked for open-ended comments regarding their satisfaction with the service. Their responses were recorded verbatim. RESULTS: Patients with telemedicine (n = 60) and standard encounters (n = 60) were comparable in gender, genotype, education, employment, and mean number of sickle cell disease-related complications. Patients in the telemedicine group were younger (p< 0.005), more likely to have Medicaid insurance (p = 0.009), and more likely be taking hydroxyurea (p = 0.003) than patients in the control encounter group. Mean CSQ scores for the telemedicine group were high (total: 28.82+/-3.06), and there was no difference for any item between encounter groups (p = 0.389). Patients in the standard encounter group were more likely to provide positive open-ended comments regarding the encounter (95% vs. 70%; p = 0.001). Negative comments were generally in the area of confidentiality. CONCLUSIONS: While some patients expressed concern about confidentiality with telemedicine, the benefits of improved access and continuity of care were recognized, and overall satisfaction with telemedicine was high. These findings support the use of telemedicine as an acceptable health care delivery option for rural, underserved populations with sickle cell disease.

Adult↗

Assessment of self-reported anger expression in youth.

Internal consistency, temporal stability, and principal components structures of two self-report anger expression scales used in pediatric health research were examined in 415 youth (216 White, 199 Black; 191 boys, 224 girls; mean age 14.7 years). Participants completed the Anger Expression Scale (AXS) and the Pediatric Anger Expression Scale (PAES) on two occasions separated by approximately 1 year. Psychometric properties of the two scales were examined and compared with those reported by the scale authors. For both the AXS and the PAES, estimates of internal consistency (Cronbach s alpha) were acceptable and comparable to values reported by scale authors. Temporal stability of both scales was significant over 1 year. Principal components structures for both scales were similar to those reported by scale authors. Results were generally consistent for age groupings (<13, 13 years), ethnicity, and gender. It is concluded that further research using the AXS and PAES is warranted. The stability of anger expression over time and the assessment of anger suppression is discussed.

Adolescent↗

Prevalence of PTSD in a community sample of older adolescents.

OBJECTIVE: To examine prevalence and correlates of trauma and posttraumatic stress disorder (PTSD) symptoms and diagnosis in older adolescents aged 16 through 22 years. METHOD: The second cycle of a longitudinal epidemiological study in the Southeast included a semistructured interview assessing PTSD symptomatology administered to 490 adolescents. RESULTS: Approximately 3% of female subjects and 1% of male subjects satisfied the DSM-IV criteria for PTSD. Females reported more traumatic events than males, and black subjects reported more events than white subjects. Being female (odds ratio = 12.32), experiencing rape or child sexual abuse (odds ratio = 49.37), and witnessing an accident or medical emergency (odds ratio = 85.02) were associated with increased risk of PTSD. CONCLUSIONS: While relatively few adolescents satisfy the criteria for PTSD, most subjects who experienced a traumatic event reported some PTSD symptoms. Specific types of traumatic events were associated with occurrence of PTSD.

Adolescent↗

Incidence and predictors of suicidal behaviors in a longitudinal sample of young adolescents.

OBJECTIVE: This analysis examines 1-year transition probabilities and baseline predictors for suicidal behaviors in young adolescents. METHOD: Adolescents from a two-stage, community-based longitudinal study were classified into suicidal behavior categories (attempt, plan, ideation, and none) for baseline and follow-up years. Transition probabilities for movement among categories were calculated, and polytomous logistic regression analysis was used to examine predictors of suicidal behaviors. RESULTS: Among those with no suicidal behaviors at baseline, 1-year incidence rates were 1.3% for attempts and 1.7% each for plans and ideation. Increasing family cohesion was protective for suicide attempts (odds ratio [OR] = 0.9). Female subjects were more likely than males to report plans (OR = 8.9) and ideation (OR = 4.1). Increasing impulsivity (OR = 2.3), prior suicidal behavior (OR = 10.6), and undesirable life events (OR = 1.1) were significant predictors of plans. CONCLUSIONS: While there are a number of predictors of suicidal behaviors, the false-positive rate is high. Focusing on proximal risk factors, particularly stressors in adolescent development, may overlook the fundamental role of underlying mental disorder and familial factors--both biological and environmental. Suicide and suicidal behaviors are the result of a constellation of adverse factors requiring a range of interventions for prevention.

Adolescent↗

Incidence of major depressive disorder and dysthymia in young adolescents.

OBJECTIVE: An epidemiological study conducted between 1987 and 1989 in a single school district in the southeastern United States investigated the incidence, transition probabilities, and risk factors for major depressive disorder (MDD) and dysthymia in adolescents aged 11 to 16 years. METHOD: Diagnoses were based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children, which was administered to 247 mother-adolescent pairs at 12-month intervals. RESULTS: One-year MDD and dysthymia incidences were 3.3% (n = 11) and 3.4% (n = 9), respectively. Transition probabilities demonstrated movement from disorder to no disorder over time. Family cohesion (odds ratio = 0.95) was the only significant predictor of incident MDD. No factors were significant for dysthymia. While baseline MDD was a significant risk factor for depression at follow-up, 80% of subjects with baseline MDD did not meet the criteria for diagnosis at follow-up. CONCLUSION: Findings suggest perceived family support or cohesion may be more important to adolescent mental health than family structure.

Adolescent↗

Incidence of obsessive-compulsive disorder in a community sample of young adolescents.

OBJECTIVE: To investigate the incidence, transition probabilities, and risk factors for obsessive-compulsive disorder (OCD) and subclinical OCD in adolescents. METHOD: A two-stage epidemiological study originally designed to investigate depression was conducted between 1987 and 1989 in the southeastern United States. For the screening, a self-report depressive symptom questionnaire was administered to a community sample of 3,283 adolescents. In the diagnostic stage, the Schedule for Affective Disorders and Schizophrenia for School-Age Children was administered to 488 mother-child pairs. Baseline screening and diagnostic data from the first year the subject completed an interview and follow-up diagnostic data from subsequent years were used. RESULTS: The 1-year incidence rates of OCD and subclinical OCD were found to be 0.7% and 8.4%, respectively. Transition probabilities demonstrated a pattern of moving from more severe to less severe categories. Of those with baseline OCD, 17% had the diagnosis of OCD at follow-up; 62% moved to the referent group. Of those with baseline subclinical OCD, 1.5% had OCD at follow-up and 75% moved to the referent group. Black race (odds ratio [OR] = 23.38), age (OR = 4.02), desirable life events (OR = 0.78), undesirable life events (OR = 1.21), and socioeconomic status (OR not estimable) were significant predictors of incident OCD. Age (OR = 2.30), desirable life events (OR = 0.92), and undesirable life events (OR = 1.13) were significantly associated with incident subclinical OCD. CONCLUSION: An initial diagnosis of subclinical OCD was not significantly predictive of a diagnosis of OCD at 1-year follow-up. The overall morbidity remained higher at follow-up in the baseline OCD group than in the baseline subclinical OCD group. The baseline subclinical OCD group was more dysfunctional at follow-up than was the baseline referent group. Further research concerning differences in symptomatology and impairment between OCD and subclinical OCD is warranted.

Adolescent↗