Comparison of the Villalta and Ginsberg clinical scales to diagnose the post-thrombotic syndrome: correlation with patient-reported disease burden and venous valvular reflux.
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Adult↗
Biomedical subjects
L Arsenault
Publications and source records attributed to L Arsenault.
Clinical predictors of upgrading to Gleason grade 4 or 5 disease at radical prostatectomy: potential implications for patient selection for radiation and androgen suppression therapy.
PURPOSE: A survival benefit has been suggested by the Radiation Therapy Oncology Group (RTOG) for the addition of androgen suppression to external beam radiation therapy for patients with locally advanced and high-grade disease. This study was performed to identify clinical factors that predicted high-grade disease at prostatectomy (i.e., Gleason grade 4 or 5) in patients with clinically localized and low-grade disease (i.e., Gleason grades 1-3) at biopsy. These pretreatment factors may allow for the identification of patients likely to derive a survival benefit from the addition of androgen suppression to external beam radiation therapy while awaiting the results of the prospective randomized trials. METHODS AND MATERIALS: Concordance testing of both the primary and secondary biopsy and prostatectomy Gleason grades was performed in 693 patients with clinical Stage T1c, 2 prostate cancer managed with a radical prostatectomy (RP). For the subset of 420 patients with low-grade disease (i.e., Gleason grade < or =3) a logistic regression multivariable analysis was performed to evaluate the ability of the preoperative prostate-specific antigen (PSA), clinical stage, and ultrasound determined prostate gland volume to predict for upgrading to high-grade disease (i.e., Gleason grade 4 or 5). RESULTS: Forty percent of men with low-grade disease at biopsy were found to have high-grade disease at RP. Men who have at least a 50% chance of being upgraded from biopsy Gleason grade < or =3 to prostatectomy Gleason grade > or =4 disease included those with prostate gland volumes < or =75 cm3 and a PSA > 20 ng/ml or a PSA >10 and < or =20 and clinical Stage T2b,2c. For men with prostate gland volumes >75 cm3, only those with both PSA > 20 ng/ml and clinical Stage T2b,2c were at a significant risk of upgrading. CONCLUSION: Until the randomized data become available, clinical factors may be useful in identifying patients with clinically localized prostate cancer who are likely to benefit from combined androgen suppression and external beam radiation therapy.
Biopsy↗
A longitudinal evaluation of the Mississippi Scale for Combat-Related PTSD in detecting war-related stress symptomatology.
The long-term psychological effects of war-related stress were assessed 3 years after the Persian Gulf War with the Mississippi Scale for Desert Storm War Zone Personnel (M-PTSD-DS), developed from the Mississippi Scale for Combat-Related PTSD (M-PTSD: Keane, Caddell, Taylor, 1988). The M-PTSD-DS scores of 30 Marine reservists were compared with the number of DSM-III-R PTSD criteria each met at two points in time, initially at 3 months after the Gulf War and again 3 years later. Findings support the construct validity (sensitivity) of this scale in the immediate and longitudinal measurement of relatively nonpathological degrees of war-related stress in reservists not involved in direct fighting. Initial level of PTSD symptomatology upon returning from a war zone was predictive of M-PTSD-DS scores 3 years later. This scale was effective in detecting varying degrees of war-related stress in this self-selected group of reservists and warrants further study.
Adult↗
Use of the hand test in the assessment of combat-related stress.
This study investigated the effectiveness of the Hand Test in discriminating the differential symptomatology of posttraumatic stress (PTS) in Vietnam combat veterans (VCVs). Participants were 108 VCV outpatients, 85 of whom met the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) criteria for posttraumatic stress disorder (PTSD), and 23 patients that were found to meet some, but not the minimum criteria, required for a diagnosis of PTSD by the DSM-IV. The latter group of patients was classified into a subclinical PTSD, posttraumatic stress symptoms (PTSS) group. Results showed higher levels of overall psychopathology, a vulnerable capacity for coping, and a tendency for feelings of inadequacy and inferiority in the PTSD group. The PTSD group also exhibited more limited interaction with the world around them than the PTSS group, which may be indicative of withdrawal, apathy, or a lack of concern with environmental activities and goals. These findings are discussed in relation to the assessment, understanding, and treatment of PTS symptomatology and PTSD.
Adult↗
A polymer-based drug delivery system for the antineoplastic agent bis(maltolato)oxovanadium in mice.
Using vanadyl sulphate, sodium orthovanadate or bis(maltolato)oxovanadium (BMOV), Cruz TF, Morgan A, Min W (1995, Mol Cell Biochem 153: 161-166) have recently demonstrated the antineoplastic effects of vanadium in mice. In this study, the antineoplastic effects of BMOV against human tumour cell lines was confirmed, and this effect was shown to depend on the prolonged exposure of the cells to the drug. We have investigated a polymeric drug delivery system for the sustained delivery of BMOV as an antineoplastic agent in mice. The objective was to design and evaluate an injectable polymer-BMOV paste that would act as a drug implant for the slow but sustained release of BMOV in the mice. In vitro studies showed that the biodegradable polymer poly (Ghlr epsilon epsilon-caprolactone) (PCL) released BMOV in a sustained manner with rates of drug release increasing with increased loading of the drug in the polymer. In vivo studies showed that PCL-BMOV paste implants produced a concentration-dependent inhibition of MDAY-D2 tumour growth via systemic drug delivery. Further in vivo studies showed that 5% BMOV-loaded PCL (containing 20% methoxypolyethylene glycol) was effective in preventing tumour regrowth of resected RIF tumour masses in mice when the PCL-BMOV paste was applied to the resected site for localized drug delivery. The results confirm the potential of vanadium as an antineoplastic agent and show that the injectable PCL-BMOV formulation releases a chemotherapeutic dose of vanadium for the systemic treatment of whole tumours as well as the localized treatment of resected RIF tumours.
Animals↗
The Juvenile Arthritis Quality of Life Questionnaire--development of a new responsive index for juvenile rheumatoid arthritis and juvenile spondyloarthritides.
OBJECTIVE: To develop a disease specific measure of quality of life for application in children with juvenile rheumatoid arthritis and juvenile spondyloarthritides-the Juvenile Arthritis Quality of Life Questionnaire (JAQQ). METHODS: Patients and their parents were interviewed by a trained interviewer using a questionnaire focusing on physical function, psychosocial function, and general symptoms to determine the most appropriate items to include in the JAQQ. Respondents volunteered items and scored them for frequency of occurrence and importance. Items so generated were scored by a panel of experts for potential responsiveness and categorized into dimensions. Item number was reduced using this scoring system. The product was then pretested to confirm its construct validity and responsiveness. Thereafter, it was distributed to clinical experts to establish face and content validity. RESULTS: 91 patients, mean age 10.35 years (range 1.25-18.0), mean disease duration 3.99 years, and their parents were included in the interview process. 220 items generated were ultimately reduced to 85. Pretesting this version of the instrument in a further 30 patients showed it to have construct validity and responsiveness and led to a further reduction in items to 74, distributed in 4 dimensions: gross motor function (17 items), fine motor function (16 items), psychosocial function (22 items), and general symptoms (19 items). Face and content validity were established in 20 clinicians. Scaling was by 7 point Likert scale to enhance responsiveness. English and French versions were developed. CONCLUSION: The JAQQ measures physical and psychosocial function and an array of general symptoms. Preliminary data suggest it is valid and responsive and thus might have potential in clinical trials.
Adolescent↗
Immunity to cartilage link protein in patients with juvenile rheumatoid arthritis.
OBJECTIVE: To determine whether children with juvenile rheumatoid arthritis (JRA) express cellular immunity to cartilage link protein. METHODS: Link protein was purified from human fetal epiphyseal and bovine adult nasal cartilage. It was used in proliferation assays with the peripheral blood lymphocytes isolated from 54 children with JRA and 22 nonarthritic controls. RESULTS: Patients with JRA expressed a significantly higher prevalence of cellular proliferation to human link protein compared with the control group, independent of whether they had pauciarticular, polyarticular, or systemic disease. In the case of bovine link protein, significant differences were only noted for the polyarticular group. There was significant correlation between the immunity to bovine and to human link proteins. Furthermore, immune responses to both molecules correlated with measures of joint disease activity. CONCLUSION: These results suggest that immunity to link protein may play a role in the pathogenesis of JRA.
Adolescent↗
The effects of growth factors on the survival and differentiation of cultured dentate gyrus neurons.
Dentate granule cells (DGCs) are the principal cell population of the hippocampal dentate gyrus, and granule cells provide the main excitation to the hippocampus proper via their mossy fibers axons. Although it is well established that granule cells express various growth factors and growth factor receptors, the functional effects of growth factors on the normal development and response to injury of granule cells are relatively unknown. To address this question, primary cultures enriched in DGCs were prepared by microdissecting hippocampal slices from neonatal rats and growing dissociated cells in defined media with added nerve growth factor, brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3), neurotrophin-4/5 (NT4/5), ciliary neurotrophic factor, basic fibroblast growth factor (bFGF), or vehicle. The effects on cell survival and morphology were quantified by studying neuron-specific enolase-immunostained cells at various time points, plating densities, host ages, and growth factor concentrations. BDNF or bFGF significantly increased both neuronal survival and differentiation by 30-80% compared with control cultures. Maximal effects were observed at relatively longer time points (5-12 d), with younger cells (postnatal day 3-5) and at lowest plating densities. Addition of a trkB-IgG fusion protein that blocks the activity of BDNF or NT4/5 inhibited the effects of BDNF and attenuated the differentiation of cells cultured at high plating densities. Furthermore, treatment of cultures with the kinase inhibitor K252b specifically blocked the effects of BDNF, suggesting involvement of trkB (the high-affinity BDNF receptor) in BDNF-induced differentiation. These results show that growth properties of cultured neonatal DGCs are influenced by exogenously applied BDNF or bFGF in a time-, age-, and density-dependent manner. The effect of plating density suggests an endogenous expression of growth factors in these culture conditions, and this is mediated in part by endogenous BDNF acting via a tyrosine kinase receptor. Combined with previous work showing that various growth factors and their receptors are expressed by DGCs, these findings provide strong support for the hypothesis that BDNF and bFGF influence both the growth and development of DGCs in vivo.
Animals↗
Dentate granule cell layer collagen explant cultures: spontaneous axonal growth and induction by brain-derived neurotrophic factor or basic fibroblast growth factor.
The molecular mechanisms that underlie dentate granule cell axon (i.e., mossy fiber) growth during development and following seizure-induced hippocampal injury remain unknown. Part of this process may involve specific factors that support dentate granule cells during differentiation, and molecular cues that allow the appropriate growth of mossy fiber axons toward their targets. To study this process, we developed an in vitro assay system to measure the activity of putative trophic, chemoattractant and chemorepulsive factors. Two-hundred-micrometer-thick transverse hippocampal sections were prepared from neonatal rats and microdissected to isolate the middle one-third of the superior blade of the dentate granule cell layer. These were embedded in a three-dimensional collagen matrix either alone or with microdissected regions of the CA2 pyramidal cell layer. Cultures were maintained in a defined medium and grown for two to three days in a standard culture environment. Results showed that numerous processes grew primarily from the hilar side of explants into the collagen matrix, often in excess of 500 microns in length. These were determined to be axons based on: (i) morphological criteria including size and presence of growth cones, (ii) synaptophysin and growth-associated protein-43 immunoreactivity, (iii) lack of glial fibrillary acidic protein immunoreactivity and (iv) contiguity of biocytin-filled processes with neuronal soma within the explant. Treatment of cultures with brain-derived neurotrophic factor caused a significant increase in axon number and length, and this effect was partially reversed by the addition of a trkB-immunoglobulin fusion protein that blocks the activity of brain-derived neurotrophic factor and neurotrophin-4/5. Basic fibroblast growth factor also caused a marked increase in axon number and length, and caused a migration of neuron-like cells out of the explant into the collagen. These results show that cultured dentate granule cell layer explants are capable of growing mossy fibers into a neutral collagen matrix, and the growth of axons can be modified by the addition of exogenous growth factors. Furthermore, since target tissue and point sources of purified factors can easily be co-cultured with the explants, this new system provides a direct means for testing the molecular cues that influence mossy fiber growth.
Animals↗
Rorschach measures of posttraumatic stress in Persian Gulf War veterans: a three-year follow-up study.
The long-term psychological effects of war-related stress were assessed with the Rorschach 3 years after the Persian Gulf War. Rorschach data are presented for 30 U.S. Marine reservists at a 3-year follow-up who reported experiencing symptoms of posttraumatic stress (PTS) initially after Operation Desert Storm (ODS), and for 25 Marine reservist controls who did not participate in ODS. Results showed significant differences over time between the initial evaluation data and follow-up, and between initial evaluation and the control group on selected Rorschach variables associated with coping ability and PTS. Scores associated with acute distress, capacity for coping and control, and feeling overwhelmed all were found to significantly decrease over time. These findings are discussed in relation to the assessment and understanding of PTS symptomatology over time.
Adaptation, Psychological↗
Use of the Mississippi scale for combat-related PTSD in detecting war-related, non-combat stress symptomatology.
This study investigated the effectiveness of the Mississippi Scale for Desert Storm War Zone Personnel (M-PTSD-DS), developed from the Mississippi Scale for Combat Related PTSD (M-PTSD; Keane, Caddell, & Taylor, 1988), in the measurement of varying degrees of war-related post-traumatic stress (PTS) symptomatology of non-combat Persian Gulf War veterans. Thirty Marines were administered the M-PTSD-DS after 3 months of active duty in Operation Desert Storm. The M-PTSD-DS scores of the Marines were related significantly to the number of PTS symptoms reported by the Marines. This scale appears to be quite effective in detecting varying degrees of war-related stress in non-combatants.
Adult↗
Rorschach measures of posttraumatic stress in Persian Gulf War veterans.
The effectiveness of the Rorschach in detecting acute posttraumatic stress (PTS) in Persian Gulf War veterans was investigated. Subjects were 30 U.S. Marine Reservists who reported experiencing symptoms of PTS after 3 months of active duty in Operation Desert Storm. Subjects were administered the Rorschach and MMPI-2 soon after their return from the Persian Gulf War. Results showed acute distress, a vulnerable capacity for coping and control, and a tendency to be overwhelmed by internal and external stimulation. Selected Rorschach variables were significantly related in a conceptually valid manner to MMPI-2 scales associated with defensiveness, coping ability, and PTS. These findings are discussed in relation to the assessment, understanding, and treatment of PTS symptomatology and posttraumatic stress disorder.
Adaptation, Psychological↗
The relationship between vigilance deficits and traffic injuries involving children.
OBJECTIVE: This study was designed to determine whether there is an increased frequency of deficits in impulse control, vigilance, or both, among child bicyclists or pedestrians who have been injured in traffic accidents, as assessed using objective measures and parent and teacher reports. RESEARCH DESIGN: This was a case-control study, in which cases were children injured as pedestrians or bicyclists (excluding those with severe head injuries) and controls were those injured as passengers or in some other manner in which the child's behavior was unlikely to be a factor. SETTING: Children ages 5 to 15 years presenting to the emergency room of the Montreal Children's Hospital. PARTICIPANTS: For each of 286 cases, two controls were selected, making a total of 848 subjects. Among the cases, 172 were injured as pedestrians and 114 as bicyclists. MEASURES: Children were assessed using the Continuous Performance Task and the Delayed Response Test, both parts of a computerized test battery. Parents and teachers completed the Conners Abbreviated Symptom Questionnaire to assess hyperactivity. RESULTS: Cases and controls were similar on most sociodemographic and clinical measures but showed statistically significant differences in mean scores on the Continuous Performance Task measures of omissions and commissions, pointing to differences in vigilance, and on the Delayed Response Test measures of impulsivity. Mean Conners scale scores of both parent and teacher were significantly higher for cases than controls, and those of parents were higher than those of teachers. CONCLUSIONS: Among children whose behavior may have been a factor in the occurrence of an injury, there is subjective evidence of increased hyperactivity and objective evidence of deficits in vigilance and attention when compared with closely matched controls. These findings have important implications for prevention.
Accidents, Traffic↗
Demyelination in a transgenic mouse: a model for multiple sclerosis.
A transgenic mouse containing 70 copies (ND4) of the transgene encoding DM20, a myelin proteolipid protein, appeared clinically normal up to 3 months of age. By 8-10 months, it showed tremors, unsteady gait, and died shortly thereafter. We concluded that the clinical symptoms correlated with demyelination based on the following criteria: 1) at 10 months of age only 17% of the amount of myelin obtained from normal mice was isolated from the ND4 mice; 2) astrogliosis, a prominent feature of demyelinating disease was minimal at 3 months of age but prominent by 10 months; 3) at the electron microscopic level disrupted myelin was seen at 8 months of age in the ND4 mice and ingested myelin debris was found in astrocytes; 4) lymphocytic infiltration in association with endothelial cells was observed routinely in the ND4 mice; 5) sections through optic nerves showed denuded and thinly myelinated axons in the 8 month old ND4 mice. Although the mechanism by which demyelination takes place is not fully understood, measurements of the amounts of PLP suggest it is down-regulated by the large amount of DM20. Since DM20 is a major proteolipid in the young but a minor one in the adult, the persistence of high levels in the adult results in improperly assembled myelin which is prone to disruption. Therefore demyelination in the ND4 mouse appears to result from the persistence of immature myelin into the adult.
Animals↗
Level of agreement between parents and children in rating dysfunction in juvenile rheumatoid arthritis and juvenile spondyloarthritides.
OBJECTIVE: To determine the level of agreement between parents and children in rating dysfunction in juvenile rheumatoid arthritis (JRA) and juvenile spondyloarthritides. METHODS: We conducted separate interviews (parents and patients) of children > or = 9 years of age with JRA and spondyloarthritis attending our clinic. A questionnaire consisting of 100 probes (57 physical activities, 26 psychosocial issues and 17 general symptoms) was used. Probes were scored by respondents on a 6-point scale for their frequency of occurrence (all probes) and importance to the patient (physical activities, only), giving a total of 157 scores. Forty patients were included. Level of agreement between patients and parents was determined by weighted kappa (kappa). RESULTS: Mean kappa for all scores was 0.60; gross motor 0.51, fine motor 0.64, psychosocial 0.56 and general symptoms 0.64. One hundred and forty scores (89%) showed at least moderate agreement. CONCLUSIONS: Our data confirm that there is good parent-child agreement on the level of dysfunction of children > or = 9 years of age with JRA and spondyloarthritis. This level of agreement extends over a wide range of general symptoms and includes physical and psychosocial function. Thus both the parent and the child are reliable informants on the impact of chronic arthritis on the quality of life of affected children and either can be used for this type of assessment.
Adolescent↗
[Influence of follow-up education of mothers about too early introduction of solid food to infants].
We developed a program intended to modify maternal attitudes towards feeding in order to delay the introduction of solids to infants until they are 2 months of age. The program was provided by nurses using an individualized, educational approach. To evaluate its efficacy, a randomized trial design was used. The results in the 2 groups were comparable. The educational trial's lack of success when compared to others and the reasons for this are discussed.
Female↗
The epidemiology of road accidents in childhood.
We report the incidence of traffic injuries to children in Montreal: 33.4 per 10,000, 57 per cent pedestrians, 24.5 per cent passengers, and 18.4 per cent bicyclists. Nearly 20 per cent were hospitalized and 1.2 per cent died. One-third had MAIS scores of 2 or more with the highest rate of severe injuries found among pedestrians. Pedestrian and bicycle (but not passenger) injuries in low income areas were four to nine times greater than those in more affluent areas.
Accidents, Traffic↗
Selected postoperative complications of cranial surgery.
Selected postoperative complications following a craniotomy are discussed in relation to assessment and nursing care. Clinical differentiation between structural and metabolic postoperative complications is emphasized. The signs, symptoms, diagnostic aids and nursing implications related to each of these two major classifications of complications are presented. The specific postoperative complications discussed include: cerebral edema, intracranial bleeding, hydrocephalus, cerebral infarction, tension pneumocephalus, hypoxia, water and electrolyte imbalances, hypoglycemia, endocrine disturbances, hyperthermia, and seizures.
Brain Edema↗