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Biomedical subjects

Michael P Collins

Publications and source records attributed to Michael P Collins.

5 recordsLinked to original sources
PubMed2005

The effects of meditation and visual imagery on an immune system disorder: dermatomyositis.

OBJECTIVE: To analyze the relationship between a patient's "spontaneous recovery" from dermatomyositis and her practice of transcendental meditation and visual imagery without confounding effects of conventional therapies. DESIGN: Study of time-varying relationships between (1) measures of arm strength and skin condition (rash and pain) and (2) mind-body interventions-controlling for psychologic stress-in a patient with dermatomyositis, using regression analysis to determine half-lives of treatments and stress. SETTING: Institutional referral center. INTERVENTION: Transcendental meditation and visual imagery (no drugs). OUTCOME MEASURES: Daily measurements of arm strength and skin condition over 294 days. Events producing psychologic stress were also rated using a numerical scale. RESULTS: The patient recovered, which is a low-probability event without conventional therapy. Regression analysis of time dependence between measures of arm strength, rash, and pain and application of mind-body treatments revealed statistically significant relationships for both meditation (p values 0.02 to 0.001) and visual imagery (p values 0.02 to 0.002). Stress had a significant negative impact on skin symptoms but not arm strength. Beneficial effects of meditation had half-lives of 48-59 days for skin condition and no detectable decay for arm strength. Benefits of visual imagery were more transient (half-lives 4-18 days). The effects of stress had half-lives of only 1-3 days. CONCLUSIONS: The results demonstrate a statistically significant relationship between mind-body therapies and the patient's recovery from dermatomyositis, possibly mediated by influences on the humoral immune system. A key factor in the recovery was the slower decay rate of meditation and visual imagery compared to stress. As dermatomyositis is a humorally mediated immune microvasculopathy, the benefits of meditation and imagery in our patient comport with a growing body of evidence showing that these techniques influence immune system function.

Attitude to Health↗
PubMed2004

Non-systemic vasculitic neuropathy.

PURPOSE OF REVIEW: This article reviews the literature on non-systemic vasculitic neuropathy, with emphasis on recent advances, summarizing the clinical presentation, diagnosis, pathology, treatment, and outcome of this condition, and speculating on its nosological status vis-à-vis the systemic vasculitides. RECENT FINDINGS: A new cohort of non-systemic vasculitic neuropathy patients was recently reported. Analysis of the clinical characteristics of this cohort demonstrated a higher incidence of painful, asymmetric, overlapping deficits than in previous studies. Extended follow-up revealed a high relapse rate, low risk of systemic spread, high incidence of chronic pain, relatively good neurological outcome, and low mortality rate. Analysis of therapeutic responses showed better outcomes with combination therapy than corticosteroid monotherapy. Another recent report proposed a role for magnetic resonance angiography in the diagnosis and follow-up of non-systemic vasculitic neuropathy. Recent pathological studies implicated proinflammatory cytokines and matrix metalloproteinase-9 in the mediation of vascular and axonal damage in non-systemic vasculitic neuropathy. SUMMARY: Non-systemic vasculitic neuropathy is one of many localized vasculitides, with involvement restricted to nerves and (possibly) muscles. Inclusion and exclusion criteria differ between reported cohorts. All require a nerve biopsy diagnostic of or suspicious for vasculitis and no extra-neuromuscular involvement. Patients typically present subacutely with a painful, multifocal/asymmetric, distal-predominant neuropathy. In the absence of clinical or laboratory evidence of systemic vasculitis or a condition predisposing to such, prognosis with treatment is good. Pathological data are supportive of a primary T-cell-mediated immunopathogenesis. Some patients classified as having non-systemic vasculitic neuropathy have a systemic vasculitis presenting with neuropathy; in others, the disease is organ-specific.

Anti-Inflammatory Agents↗
PubMed2003

Impact of the thimerosal controversy on hepatitis B vaccine coverage of infants born to women of unknown hepatitis B surface antigen status in Michigan.

OBJECTIVE: Hepatitis B vaccine is recommended for all infants, and the series may be started during the delivery admission. For infants who are born either to women who are positive for hepatitis B surface antigen (HBsAg) or to women whose HBsAg status is unknown, vaccination should be started within 12 hours of birth to prevent perinatal and early childhood hepatitis B virus infection. Because of concerns about mercury exposures from vaccines that contain thimerosal, the United States Public Health Service (USPHS) and the American Academy of Pediatrics (AAP) recommended in July 1999 that the first dose of hepatitis B vaccine be deferred until 2-6 months of age but only for infants who are born to HBsAg-negative women. To assess the impact on birth-dose vaccine coverage for infants who are born to women with unknown HBsAg status, we measured coverage before and after July 1999. METHODS: A sample of Michigan infants who were born to women whose HBsAg status was either unknown or missing were identified by reviewing newborn screening cards for infants who were born during 1) March-April 1999 (before recommendation changes [T1]); 2) July 15-September 15, 1999 (immediately after recommendation changes [T2]); and 3) March-April 2000 (6 months after resumption of pre-1999 practices were recommended [T3]). We verified maternal HBsAg screening and newborn hepatitis B vaccination by reviewing infant and maternal hospital records. RESULTS: Of 1201 infants who were born to women whose HBsAg status was indicated as unknown or missing on the newborn screening card during the 3 time periods, 216 (18%) were born to women whose status was truly unknown at the time of delivery, as determined by medical record review. During T1, 53% of these 216 infants received hepatitis B vaccine before hospital discharge, compared with 7% of infants who were born during T2 and 57% of infants who were born during T3. During T1, 19% of these infants received hepatitis B vaccine within 12 hours of birth compared with 1% of infants who were born during T2 and 14% of infants who were born during T3. CONCLUSIONS: Hepatitis B vaccine birth-dose coverage for infants who were born to women whose HBsAg status was unknown at the time of delivery was already low in Michigan before the July 1999 USPHS/AAP Joint Statement but decreased significantly during the 2 months after the USPHS/AAP Joint Statement. Abrupt changes in established vaccination recommendations for lower risk children may lead to decreased coverage among higher risk children. Increases in hepatitis B vaccine coverage at birth are necessary to reduce the risk of perinatal infection for infants who are born to women with unknown HBsAg status.

Contraindications↗