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Biomedical subjects

K Bryant

Publications and source records attributed to K Bryant.

12 recordsLinked to original sources
PubMed1992

Inpatient and outpatient cocaine abusers: clinical comparisons at intake and one-year follow-up.

Given controversy about the comparative utility of inpatient and outpatient treatment for substance abusers, we compared samples of cocaine-abusing inpatients (n = 149) and outpatients (n = 149) regarding a range of clinical characteristics both at entrance into treatment and one year following this initial assessment. We wished to assess (a) whether inpatient treatment appeared justified on the basis of more severe clinical problems in this group of patients and (b) the comparative one-year outcome of patients treated in the two conditions. Regarding the presenting clinical picture, inpatients had more severe ratings in numerous areas, with heavier drug use, social impairment, and psychopathology. At one-year follow-up, the direction of clinical ratings had reversed in the two groups, with inpatients showing lower problem severity in several areas, particularly cocaine use and psychopathology. Thus, results of this nonrandomized study of inpatient and outpatient treatment suggest that decisions to hospitalize were made on a rational basis and that inpatient treatment had better long-term efficacy.

Adult↗
PubMed1992

Reporting alcohol-impaired drivers: results from a national survey of emergency physicians.

STUDY OBJECTIVE: The purpose of this exploratory study was to learn of physicians' opinions on mandatory reporting of alcohol-impaired drivers they encounter in the course of their clinical work to the police or authorities from the Division of Motor Vehicles. DESIGN AND PARTICIPANTS: Two thousand four hundred sixty-four physicians randomly selected from the American College of Emergency Physicians were sent an anonymous, one-time only, self-administered questionnaire seeking demographic information and assessing attitudes toward mandatory reporting and alcohol treatment. MEASUREMENTS AND MAIN RESULTS: One thousand fifty-five physicians returned the survey. Seventy-eight percent of respondents agreed with mandatory reporting. More than half expressed strong agreement. Through canonical discriminant analysis we are able to identify the complex factors influencing attitude toward mandatory reporting. CONCLUSION: Although our preliminary results must be interpreted with caution, it appears that with the appropriate legal safeguards, physicians are supportive of mandatory reporting of the alcohol-impaired driver encountered in the course of clinical work.

Adult↗
PubMed1992

beta-Amyloid peptides destabilize calcium homeostasis and render human cortical neurons vulnerable to excitotoxicity.

In Alzheimer's disease (AD), abnormal accumulations of beta-amyloid are present in the brain and degenerating neurons exhibit cytoskeletal aberrations (neurofibrillary tangles). Roles for beta-amyloid in the neuronal degeneration of AD have been suggested based on recent data obtained in rodent studies demonstrating neurotoxic actions of beta-amyloid. However, the cellular mechanism of action of beta-amyloid is unknown, and there is no direct information concerning the biological activity of beta-amyloid in human neurons. We now report on experiments in human cerebral cortical cell cultures that tested the hypothesis that beta-amyloid can destabilize neuronal calcium regulation and render neurons more vulnerable to environmental stimuli that elevate intracellular calcium levels. Synthetic beta-amyloid peptides (beta APs) corresponding to amino acids 1-38 or 25-35 of the beta-amyloid protein enhanced glutamate neurotoxicity in cortical cultures, while a peptide with a scrambled sequence was without effect. beta APs alone had no effect on neuronal survival during a 4 d exposure period. beta APs enhanced both kainate and NMDA neurotoxicity, indicating that the effect was not specific for a particular subtype of glutamate receptor. The effects of beta APs on excitatory amino acid (EAA)-induced neuronal degeneration were concentration dependent and required prolonged (days) exposures. The beta APs also rendered neurons more vulnerable to calcium ionophore neurotoxicity, indicating that beta APs compromised the ability of the neurons to reduce intracellular calcium levels to normal limits. Direct measurements of intracellular calcium levels demonstrated that beta APs elevated rest levels of calcium and enhanced calcium responses to EAAs and calcium ionophore. The neurotoxicity caused by EAAs and potentiated by beta APs was dependent upon calcium influx since it did not occur in calcium-deficient culture medium. Finally, the beta APs made neurons more vulnerable to neurofibrillary tangle-like antigenic changes induced by EAAs or calcium ionophore (i.e., increased staining with tau and ubiquitin antibodies). Taken together, these data suggest that beta-amyloid destabilizes neuronal calcium homeostasis and thereby renders neurons more vulnerable to environmental insults.

Amino Acid Sequence↗
PubMed1989

Older women's perceptions of female counselors: the influence of therapist age and problem intimacy.

Elderly women (N = 96, Mn age = 69.6) who served as pseudoclients in an analogue study were more positive toward all counselors when vignettes dealt with less intimate rather than more intimate problems. Older counselors were preferred when less intimate concerns were discussed whereas younger counselors were preferred for more intimate problems. Perceived differences in helper expertness, attractiveness, and trustworthiness were also influenced by perceptions of the individuality of counselors. These findings have significance for the delivery of mental health services to older persons.

Age Factors↗
PubMed1979

Surgical management of the hypodynamic palate.

The most successful surgical correction of velopharyngeal insufficiency (VPI) has been achieved in those patients in whom residual dynamic function of the soft palate/nasopharyngeal sphincter mechanism exists. In spite of the obvious need for rehabilitation, surgical reconstruction has often been advised against in those cases where the palate was hypodynamic or adynamic. We have developed a surgical procedure for these patients by utilizing a modification of Hogan's lateral port control pharyngeal flap method. We present the surgical considerations along with the initial application and results in four patients with hypodynamic palates of differing origins. We think that this technique extends surgical correction of VPI to the previously neglected group of patients in whom this condition is the result of a hypodynamic palate.

Adolescent↗
PubMed1975

Early childhood development of four boys with 47, XXY karyotype.

In an epidemiological study, infants identified at birth as having sex chromosome anomalies are enrolled in a voluntary, long term evaluations program. Case histories are presented of the first four boys in the series to have a 47,XXY karyotype. They have been followed from birth for 6 to 9 years, with physical and psychological evaluations. Parents were informed in general terms of the child's genetic defect, and were offered continuing support and encouragement throughout the study. Close cooperation with the families was maintained. So far, the development of all these children has fallen clearly within the normal range and a reasonable healthy dpattern has been secured. Minor deviations in motor, speech and emotional development suggest a common underlying pattern, but four cases are too few on which to establish a relationship between karyotype and phenotype. The data suggest that the symptomatology reported in selected children with a 47,XXY karyotype may be strongly dependent on factors other than the chromosomal constitution, and that an appropriate familial and environmental situation may minimize elevated risks due to the marked genetic defect.

Adolescent↗
PubMed1975

A developmental study of girls with trisomy X.

Development of 11 girls (ages 2-10 years) with 47,XXX karyotype identified in a newborn survey is compared with eight girls having a mosaic sex chromatin pattern and with the normal siblings of each group. Delay in early motor development and speech, a mild intellectual deficit, and disturbance in interpersonal relationships occurred in one-third of the index cases, a higher frequency than in the comparison groups. two-thirds were considered normal and adequately adjusted. No consistent phenotype was found.

Age Factors↗
PubMedDate not supplied

Lack of Alzheimer pathology after beta-amyloid protein injections in rat brain.

In order to establish a direct relationship between beta-amyloid protein (beta AP) and in vivo neurotoxicity, we made intraparenchymal injections and Alzet pump infusions of beta AP into the hippocampus and cortex of adult rats. We tested a number of synthetic beta AP peptides (beta AP 1-40, 1-38, and 25-35) and peptide controls (scrambled and reversed 1-40, and scrambled and reversed 25-35) over a wide range of concentrations and in a variety of vehicles. The rats were sacrificed from 2-35 days following the implant, and the brains examined by standard immunohistochemical and histological methods used to evaluate the pathologies associated with Alzheimer's disease. We report the lack of Alzheimer related pathology and no significant morphological differences between the beta AP peptide and the peptide and vehicle control injections. These observations indicate that the simple intraparenchymal injection of beta AP in the rat brain is not an appropriate model of Alzheimer-related neurotoxicity.

Alzheimer Disease↗