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Biomedical subjects

J Misiaszek

Publications and source records attributed to J Misiaszek.

13 recordsLinked to original sources

Role of gamma-aminobutyric acid in antipanic drug efficacy.

All effective pharmacologic agents used to treat panic disorder augment gamma-aminobutyric acid (GABA) transmission. Anxiolytics and antidepressants that lack GABA activity are not effective in panic disorder. To test the hypothesis that GABA activity is a component of antipanic drug efficacy, the authors treated nine medication-free panic disorder subjects with oral baclofen (30 mg/day for 4 weeks) in a double-blind, placebo-controlled crossover trial. Baclofen, a selective GABA agonist, was significantly more effective than placebo in reducing the number of panic attacks and scores on the Hamilton anxiety scale, Zung scale, and Katz-R nervousness subscale. The authors discuss possible mechanisms of antipanic drug efficacy.

Anxiety Disorders↗

Poor job quality and the decline of public psychiatry.

The alarming drop in the number of public-sector psychiatrists in recent years has caused great concern and has prompted efforts to attract young, talented psychiatrists to the public mental health system. To investigate their belief that poor job quality is an important contributor to the decline, the authors asked ten young public psychiatrists to rate their overall level of job satisfaction, to identify what they liked and disliked about their positions, and to speculate about what could be done to attract or retain public psychiatrists. Based on the psychiatrists' responses and a review of the relevant literature, the authors conclude that the public mental health field can better attract psychiatrists by facilitating their autonomy, promoting a medical model of mental illness, integrating public and private psychiatry, and improving benefits and salaries.

Career Choice↗

Transition from residency training to academia.

Anxious and depressive reactions during transitions from psychiatry residency to career settings have been reported. The authors describe difficulties encountered in their transition from psychiatry residency to academic psychiatry within the same program. Four stages of transition are described: Termination--a time of separation and grief over losses; Adjustment--a time of ambivalence and uncertainty; Identity Formation--a time of increased productivity and comfort; Consolidation--a time of accomplishment and compatibility of life goals. Women may additionally encounter gender-specific problems in entering a predominantly male profession. The development of supportive relationships within and outside work settings are viewed as the best methods of coping with transitional stress.

Adaptation, Psychological↗

Functional electrical stimulation using microstimulators to correct foot drop: a case study.

This paper presents a case study that tested the feasibility and efficacy of using injectable microstimulators (BIONs) in a functional electrical stimulation (FES) device to correct foot drop. Compared with surface stimulation of the common peroneal nerve, stimulation with BIONs provides more selective activation of specific muscles. For example, stimulation of the tibialis anterior (TA) and extensor digitorum longus (EDL) muscles with BIONs produces ankle flexion without excessive inversion or eversion of the foot (i.e., balanced flexion). Efficacy was assessed using a 3-dimensional motion analysis of the ankle and foot trajectories during walking with and without stimulation. Without stimulation, the toe on the affected leg drags across the ground. BION stimulation of the TA muscle and deep peroneal nerve (which innervates TA and EDL) elevates the foot such that the toe clears the ground by 3 cm, which is equivalent to the toe clearance in the less affected leg. The physiological cost index (PCI) measured effort during walking. The PCI equals the change in heart rate (from rest to activity) divided by the walking speed; units are beats per metre. The PCI is high without stimulation (2.29 +/- 0.37, mean +/- SD) and greatly reduced with surface (1.29 +/- 0.10) and BIONic stimulation (1.46 +/- 0.24). Also, walking speed increased from 9.4 +/- 0.4 m/min without stimulation to 19.6 +/- 2.0 m/min with surface and 17.8 +/- 0.7 m/min with BIONic stimulation. These results suggest that FES delivered by a BION is an alternative to surface stimulation and provides selective control of muscle activation.

Adult↗