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Biomedical subjects

M O'Boyle

Publications and source records attributed to M O'Boyle.

At least 19 recordsLinked to original sources
PubMed2005

Fronto-parietal activation in attention-deficit hyperactivity disorder, combined type: functional magnetic resonance imaging study.

A functional magnetic resonance imaging mental rotation paradigm was used to investigate the patterns of activation of fronto-parietal brain areas in male adolescents with attention-deficit hyperactivity disorder, combined type (ADHD-CT) compared with age-, gender-, handedness- and performance IQ-matched healthy controls. The ADHD-CT group had (a) decreased activation of the 'action-attentional' system (including Brodmann's areas (BA) 46, 39, 40) and the superior parietal (BA 7) and middle frontal (BA10) areas and (b) increased activation of the posterior midline attentional system. These different neuroactivation patterns indicate widespread frontal, striatal and parietal dysfunction in adolescents with ADHD-CT.

Adolescent↗
PubMed2001

Fractures of the proximal third of the tibial shaft treated with intramedullary nails and blocking screws.

OBJECTIVES: To describe the technique and results of using blocking screws and intramedullary nails to treat patients with fractures of the proximal third of the tibial shaft. DESIGN: Prospective. SETTING: Level I trauma centers. PATIENTS: Twelve consecutive patients treated with intramedullary nailing and blocking screws for fractures of the proximal third of the tibial shaft. INTERVENTION: Patients were treated with intramedullary nails and blocking screws. MAIN OUTCOME MEASURE: The alignment of fractures was determined using standard anteroposterior and lateral radiographs after surgery and at each follow-up examination. One patient was lost to follow-up. All other patients were followed at regular intervals until union or establishment of a nonunion. Changes in alignment and complications were noted. RESULTS: Postoperatively, all patients had less than 5 degrees of angular deformity in the planes in which blocking screws were used to control alignment. One patient had postoperative malalignment (6 degrees of valgus), but a lateral blocking screw to control valgus deformity was not used in this patient. One patient was lost to follow-up. Eleven patients were followed up to union (n = 10) or establishment of a nonunion (n = 1). Ten of eleven patients maintained their postoperative fracture alignment at their last follow-up examination (average follow-up of thirty-three weeks). One patient progressed from 6 degrees of valgus immediately after surgery to 10 degrees of valgus at union. This patient did not have a blocking screw to control valgus angulation. CONCLUSIONS: Blocking screws are effective to help obtain and maintain alignment of fractures of the proximal third of the tibial shaft treated with intramedullary nails.

Adolescent↗
PubMed2000

Randomized, placebo-controlled pilot study of divalproex sodium in the treatment of acute exacerbations of chronic schizophrenia.

Experimental and clinical data suggest that GABA-ergic drugs such as valproate may have a potential role in the treatment of schizophrenia. The authors designed a 21-day prospective, double-blind, randomized, placebo-controlled pilot study of divalproex sodium as add-on treatment to haloperidol in 12 hospitalized patients with acute exacerbations of chronic schizophrenia. All patients received haloperidol 10 mg/day for 3 days and 15 mg/day for the remaining 18 days. In addition, five patients were randomly assigned to receive divalproex augmentation and seven to receive placebo. The divalproex dose was adjusted to a target serum concentration of 75 microg/mL for 2 weeks; placebo replaced divalproex during the third and last weeks to determine any carryover effect. Psychiatric rating scales were administered at baseline and on days 7, 14, and 21. Although the placebo group improved with haloperidol treatment, the divalproex group demonstrated greater improvement. On day 21, the divalproex group had greater improvement from baseline on the Clinical Global Impression Scale (p < or = 0.04), Brief Psychiatric Rating Scale (p < or = 0.13), and Schedule for Assessment of Negative Symptoms scores (p < or = 0.007). After divalproex withdrawal on day 15, a carryover effect was observed during week 3. The authors concluded that the addition of divalproex sodium to standard antipsychotic drugs may prove effective in relieving the symptoms of acute schizophrenia. Future studies may benefit from the design of this pilot study. However, it is premature to apply this augmentation strategy in the clinical setting just yet because of the small sample size and the likely heterogeneity of the disorder.

Acute Disease↗
PubMed2000

Self-evaluation of unintended biases and prejudices.

A scale for measuring self-assessment of factors, which might lead to unintended biases and prejudices, was tested with 39 professionals working with adolescents on probation. The scale has 10 items (e.g., "Would feel comfortable providing clinical services to [e.g., African Americans]." Each item was rated on a 3-point scale so as summated scores increase across items the probability of unintended biases and prejudices against five culturally diverse groups (African American, American Indian, Asian, Hispanic, and White) would also increase. The coefficient alpha was .87. Participants' mean unintended bias and prejudices across items were always lower toward clients from their own racial or ethnic group. For example, Hispanic and White participants tended to be more prompt to display these attitudes against African Americans, relative to African-American participants. White participants, however, reported lower scores leading to unintended biases in the case of White clients, relative to African-American and Hispanic participants. Overall, participants' mean unintended bias and prejudices against American Indian and Asian clients tended to be higher with these groups, relative to clients from the African-American, Hispanic, and White communities. Results are discussed in terms of further development of the scale in the design of cross-cultural training in various working environments with culturally diverse clients.

Adolescent↗
PubMed1999

Critical review of GABA-ergic drugs in the treatment of schizophrenia.

GABA-ergic medications may have a potential role in the treatment of schizophrenia. Laboratory evidence has generally supported the ability of gamma-aminobutyric acid (GABA) to reduce dopaminergic activity and has suggested that GABA may be effective in combating hypofrontality by acting on mesoprefrontocortical tracts in patients resistant to treatment with antipsychotic drugs. Although the results of clinical trials of several GABA-ergic compounds have been inconclusive because of methodologic limitations and drug toxicity, benzodiazepines and valproate seem to be associated with favorable treatment outcomes, especially when combined with typical antipsychotic agents. This study concludes that further investigation of the use of GABA in schizophrenia is likely to improve the understanding of the psychopathology of this illness and to expand our treatment alternatives. Also provided are suggestions to enhance the design of future studies, improve the potential for favorable treatment outcomes, and assist in predicting patients' responses to GABA-ergic medications.

Anti-Anxiety Agents↗
PubMed1999

Knowledge of laws regulating issues related to HIV and AIDS: development of the HIV/AIDS and the law scale.

42 middle-aged and older adults, ranging in age from 51 to 85 years, completed 10 items dealing with the assessment of knowledge regarding laws regulating issues related to HIV and AIDS. Participants also completed 40 items involving knowledge of risks for HIV infection. The Cronbach coefficient alpha and test-retest reliability coefficient on the HIV/AIDS and the Law Scale were .74 and .83, respectively. Over-all, the grand mean for correct answers was 46.9%, whereas the grand means for incorrect answers and "don't know" responses were 13.6% and 39.5%, suggesting substantial lack of knowledge of laws regulating issues related to HIV and AIDS. Women (50%) and younger participants (51 to 66 years old; 48.2%) showed more of this knowledge (50%) than men (43.0%) and older participants (46.2%). The sample reported a substantial amount of knowledge regarding HIV transmission assessed with factual (92.2% correct) and misconception (87.5% correct) items. The correlation between this knowledge and knowledge of laws regulating issues related to HIV and AIDS was .42 (p < .01). Research with this scale using adolescents and young adults as well as the utility of the scale in areas of clinical, legal, and policy development are discussed.

AIDS Serodiagnosis↗
PubMed1998

HIV/AIDS education survey for mental health professionals.

A total of 6804 mental health professionals, e.g., licensed and certified psychologists, licensed professional counselors, in Arkansas, Louisiana, New Mexico, Oklahoma, and Texas were mailed a questionnaire regarding HIV/AIDS topics professionals might recommend for educational programs. Participants were asked to rate how strongly they would recommend each topic. The return rate was 31% (2121). The percentage of participants who did not recommend the topics was low (0.7%-10.9%). Most topics were either recommended (6.5%-50.2%) or strongly recommended (29.0%-92.8%). Topics with ratings of 80% of participants endorsing the strongly recommended rating included psychological crises associated with learning one is HIV positive, psychosocial issues, and counseling dying clients regarding grief, loss, and legal issues. The results are discussed in terms of continuing to develop educational programs targeting mental health professionals.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Comorbidity of gender dysphoria and other major psychiatric diagnoses.

Previous studies suggest that many transsexuals evidence an Axis I diagnosis according to the DSM-IV classification (e.g., psychoses, major affective disorder). The current study examined retrospectively the comorbidity between gender dysphoria and major psychopathology, evaluating the charts of 435 gender dysphoric individuals (318 male and 117 female). All had undergone an extensive evaluation, addressing such areas as hormonal/surgical treatment, and histories of substance abuse, mental illness, genital mutilation, and suicide attempts. In addition, a subgroup of 137 individuals completed the MMPI. Findings revealed over two thirds were undergoing hormone reassignment, suggesting a commitment to the real-life cross-gender process. One quarter had had problems with substance abuse prior to entering treatment, but less than 10% evidenced problems associated with mental illness, genital mutilation, or suicide attempts. Those completing the MMPI (93 female and 44 male) demonstrated profiles that were notably free of psychopathology (e.g., Axis I or Axis II criteria). The one scale where significant differences were observed was the Mf scale, and this held true only for the male-to-female group. Psychological profiles as measured by the MMPI were more "normal" in the desired sex than the anatomic sex. Results support the view that transsexualism is usually an isolated diagnosis and not part of any general psychopathological disorder.

Adult↗
PubMed1997

Students' perception of a difficult case in psychotherapy.

Paniagua, et al. suggested that the definition of a "difficult" case in psychotherapy implies a relational definition involving the characteristics of the patient, the case, and the therapist. This study concerned this hypothesis with 44 graduate students in social work who received the Difficult Case Questionnaire representing examples of variables across each domain, e.g., motivation of the client, nature of the disorder, generic factors, and orientation of the therapist. The results were compared with the 1993 findings reported by Paniagua, et al., for a group of professionals in mental health practice. As in the earlier study, the present sample also agreed that, although all such domains are important in the formulation of that definition, their importance is not equal. Whereas professionals rated patient's, case's, and therapist's characteristics as the most important order of domains in that definition, students in this study agreed on the order of therapist's, patient's, and case's characteristics.

Adult↗
PubMed1996

In search of effective programs to address students' emotional distress and behavioral problems part III: student assessment of school-based support groups.

Emotional distress and behavioral problems are common in high schools. This report describes the efficacy of an in-school program based on participation in volunteer-facilitated peer support groups in addressing these problems. Two hundred and fifty students who experienced such problems participated in weekly 50-minute peer support groups led by adult nonmental health professional volunteers. The students anonymously evaluated their progress and program acceptability using an instrument developed specifically to evaluate the group experience. Analysis of the evaluation of the 131 respondents documented the reliability of a proposed Self-Assessment Questionnaire which showed that participation led to improvement in school, interpersonal, and internal domains. The program was highly accepted and showed other signs of success: half of the alcohol and substance users reduced their intake, and 60% of those who considered dropping out of school continued their education. The results provide preliminary evidence that peer support groups show promise as an economical and well-accepted method for early recognition and management of emotional and behavioral problems in high schools. For some adolescents, these groups may be the only acceptable or available therapeutic modality.

Adolescent↗
PubMed1995

Training health professionals in the recognition and treatment of depression.

A total of 423 health professionals, including physicians, psychologists, counselors, social workers, and nurses, attended a two-day program to increase awareness, recognition, and treatment of depression. In a preprogram opinion survey, nurses and social workers reported less perceived ability to recognize mood disorders compared with physicians and psychologists. In a group of 274 respondents who took a 20-item test of their knowledge about depression before and after attending the program, scores for all professions increased after the program and pretest differences in scores between professions decreased. The results suggest that training was successful in increasing knowledge about depression among a diverse group of health professionals.

Adult↗
PubMed1995

Renal ultrasonography as a tool for detecting dynamic changes in blood pressure.

Renal ultrasonography has been used to assess renal blood flow under pathological conditions. We attempted to determine if sonographically derived renal resistive index measurements would be affected by subtle changes in flow as a consequence of transiently induced mild increases in blood pressure in persons with normal renal functioning. Nine subjects free of structural renal disease were studied with duplex Doppler ultrasonography. Main renal artery resistive indices were determined under resting baseline conditions and in response to graded infusions of phenylephrine sufficient to increase blood pressure by approximately 13/5 mm Hg. Change in blood pressure correlated with the change in main renal artery resistive index (r = 0.254, P < 0.05). Thus, the resistive index varies in association with transient increases in blood pressure and may reflect concurrent alterations in distal resistance under physiologic conditions.

Blood Pressure↗
PubMed1993

The role of a research seminar for child psychiatry residents.

A major problem confronting the field of child and adolescent psychiatry is the development of teaching strategies to stimulate research activities and an appreciation of research. A teaching approach is described which emphasizes major research concepts using a programmed instruction method and illustrating these concepts with clinical cases. Fourteen child psychiatry residents participated in the seminar during a 3-year period. Overall, trainees' evaluation of the seminar was positive, and they demonstrated a high level of understanding across major research topics. In addition, the seminar may have contributed to an increased preference for academic careers by graduating residents.

Adolescent↗
PubMed1992

Glucocorticoid receptor binding in three different cell types in major depressive disorder: lack of evidence of receptor binding defect.

1. In order to further understand the apparent glucocorticoid resistance in major depressive disorder, circadian variation in cortisol concentration, dexamethasone suppression and glucocorticoid receptor binding in mononuclear leukocytes, polymorphonuclear leukocytes and cultured skin fibroblasts were measured in rigidly defined major depressive disorder patients and non-depressed psychiatric controls. 2. Mononuclear leukocytes binding to glucocorticoid correlated significantly with polymorphonuclear leukocytes binding to glucocorticoid, but both determinations failed to differentiate major depressive disorder and control subjects. 3. Initial and post-dexamethasone in vitro fibroblast binding to glucocorticoid was not different between major depressive disorder and non-depressed control subjects. 4. The phenomenon of glucocorticoid resistance in major depressive disorder remains unexplained.

Adult↗
PubMed1990

A comparison of two interviews for DSM-III-R personality disorders.

The study examined agreement between personality disorder diagnoses obtained using two structured interviews and the effect of depression on the diagnoses obtained. Twenty subjects were interviewed while depressed, using the Personality Disorder Examination and the Structured Clinical Interview for DSM-III-R Personality Disorder; both interviews are designed to yield DSM-III-R personality disorder diagnoses. Eighteen subjects were reinterviewed later, 17 after recovery. Diagnostic agreement between the two instruments for any disorder was fair (kappa = 0.38). Kappas for the personality disorder clusters ranged from 0.08 to 0.83. Kappas for individual personality disorders ranged from 0.18 for paranoid disorder to 0.62 for borderline disorder. While the depressive state did not consistently affect categorical diagnoses, dimensional scores tended to be higher when patients were depressed. A dimensional profile, in which scores on each disorder are generated for subjects, may be more reliable than categorical diagnoses derived from the same instrument.

Adult↗
PubMed1990

Cognitive complaints in elderly depressed and pseudodemented patients.

The cognitive complaints of 11 patients with depressive pseudodementia were compared with those of 22 patients with depression alone. Pseudodemented subjects were defined as depressed inpatients showing reversible cognitive impairment as measured by the Mini-Mental State Examination (MMSE); subjects with depression alone had no such impairment. For each group, cognitive complaints were highly correlated with depressive symptoms and were not related to MMSE scores. The pseudodemented group had significantly higher cognitive complaint scores, complaining more of difficulties with concentration and recent memory. Groups did not differ significantly in complaints of difficulties with remote memory.

Aged↗