Diathermy pencils--a potential vector for the transmission of prions?
Explore the source record for details and available documents.
Creutzfeldt-Jakob Syndrome↗
Biomedical subjects
N Adams
Publications and source records attributed to N Adams.
Relation of measures of sleep-disordered breathing to neuropsychological functioning.
Sleep-disordered breathing (SDB) has been associated with neuropsychological (NP) deficits. The extent to which such effects are attributable to unmeasured confounders or selection biases, or are manifest across a range of SDB is unclear. The relationship of SDB with a broad range of NP functions was examined in 100 volunteers with a spectrum of SDB and without underlying comorbidity. Factor analysis suggested that the NP tests could be summarized as four constructs: declarative memory, signal discrimination, working memory, and set shifting. These factors plus vigilance were dependent variables. Independent variables were age, the respiratory disturbance index (RDI), a sleepiness score, the arousal index, and sleep-associated hypoxemia. Factors "declarative memory" (measuring 25% of the common variance, alpha = 0.95), "signal discrimination" (10% variance, alpha = 0.70), and "working memory" (9% variance, alpha = 0.52) were each significantly, linearly predicted by hypoxemia and/or the RDI, with no evidence for significant threshold effects. SDB measures accounted for 4-6% of the variance in NP constructs. In contrast, sleepiness best predicted vigilance. Thus, adverse exposures (hypoxemia or RDI) during sleep may negatively influence NP functions in a dose-response relationship, and, other than vigilance, these effects may not be directly attributable to sleepiness.
Attention↗
Effects of ingesting a large volume of carbohydrate-electrolyte solution on rehydration during recovery and subsequent exercise capacity.
This randomized, double-blind study examined the effects of rehydration per se and rehydration plus carbohydrate (CHO) ingestion during recovery (REC) on subsequent endurance running capacity. Nine men ran at 70% VáO2max on a level treadmill for 90 min (T1) on two occasions, followed by a 4 hour REC and a further exhaustive run at the same speed (T2). During the first 3 hours of REC, subjects drank either a 6.9% CHO-electrolyte solution (CE) or a CHO- and electrolyte-free sweetened placebo (PL) every 30 min. Volumes prescribed were 200% of the fluid lost after T1, but the actual volume of fluid ingested during the REC ranged from 113-200% and 88. 5-200% of the body mass lost for the CE and PL trials (NS). However, positive fluid balance was found in both trials after REC. During T2, run time was 24.3 +/- 4.4 min longer in the CE trial (69.3 +/- 5.5 vs. 45.0 +/- 4.2 min; p <.05). Higher blood glucose concentrations were observed throughout REC in the CE trial. These results suggest that ingesting a CHO-electrolyte solution is more effective in restoring endurance capacity compared to the same large volume of placebo, even though complete rehydration was achieved in both trials.
Adult↗
Physical and other non-pharmacological interventions for fibromyalgia.
There is little empirical evidence for the effectiveness of physical and other non-pharmacological approaches to the management of fibromyalgia. Although a number of studies have been conducted into such approaches, many of these are uncontrolled, and relatively few randomized controlled trials of appropriate size and methodological rigour have been carried out. This chapter provides an overview of the evidence available under the following headings: exercise, EMG biofeedback training, electrotherapy and acupuncture, patient education and self-management programmes, multimodal treatment approaches, and other interventions. It is hard to reach firm conclusions from the literature, owing to the variety of interventions that have been evaluated and the varying methodological quality of the studies concerned. Nonetheless, in terms of specific interventions, exercise therapy has received a moderate degree of support from the literature, and has been subjected to more randomized studies than any other intervention. In contrast, there is little or no evidence available for most types of electrotherapy. In terms of overall management strategies, a multimodal programme of management, including physical, psychological and educational components and delivered in a multidisciplinary setting, has gained some support from descriptive and experimental studies, and accords with current understanding of the aetiology and clinical features of fibromyalgia. There is a clear need for further systematic evaluation of the effectiveness of non-pharmacological treatment approaches in fibromyalgia.
Acupuncture Therapy↗
Improvement of mild sleep-disordered breathing with CPAP compared with conservative therapy.
The aim of this randomized controlled trial was to assess the effects of treatment with continuous positive airway pressure versus conservative therapy (CT) on well-being, mood, and functional status in subjects with mild sleep-disordered breathing (SDB). One hundred and eleven subjects, aged 25 to 65 yr, with a respiratory disturbance index (RDI) of 5 to 30 and without subjective pathologic sleepiness, were randomized to nasal CPAP or to CT. Ninety-seven subjects were followed-up after 8 wk. Treatment response was assessed from changes between baseline and follow-up measures of mood, energy/fatigue, and functional status/general health. Of the 51 subjects randomized to CPAP, 25 (49%) experienced an improved outcome, as compared with 12 of 46 of subjects (26%) randomized to CT (p < 0.05). The odds of experiencing a treatment response in the CPAP as compared with the CT group were 2.72 (OR: 1.18 to 6.58, 95% CI). A beneficial effect of CPAP over CT was most evident among individuals without sinus problems and among subjects with hypertension or diabetes. Differential treatment responses were not related to degree of baseline sleepiness or SDB. This suggests that middle-aged snorers with relatively low levels of SDB (RDI < 30) may benefit more from nasal CPAP than from less specific therapy directed at improving breathing during sleep. CPAP therapy may be beneficial to a broader group of subjects than previously appreciated.
Activities of Daily Living↗
Health Sciences Information Tools 2000: a cooperative health sciences library/public school information literacy program for medical assistant students.
Educating diverse groups in how to access, use, and evaluate information available through information technologies is emerging as an essential responsibility for health sciences librarians in today's complex health care system. One group requiring immediate attention is medical assistants. Projections indicate that medical assistant careers will be among the fastest growing occupations in the twenty-first century. The expanding use and importance of information in all health care settings requires that this workforce be well versed in information literacy skills. But, for public school vocational education staff charged with educating entry level workers to meet this specialized demand, the expense of hiring qualified professionals and acquiring the sophisticated technology necessary to teach such skills poses a dilemma. Health Sciences Information Tools 2000, a cooperative work-study information literacy program jointly formulated by the Wayne State University's Shiffman Medical Library and the Detroit Public Schools' Crockett Career and Technical Center, demonstrates that cooperation between the health sciences library and the public school is a mutually beneficial and constructive solution. This article describes the background, goals, curriculum, personnel, costs, and evaluation methods of Tools 2000. The Shiffman-Crockett information literacy program, adaptable to a variety of library settings, is an innovative means of preparing well-trained high school vocational education students for beginning level medical assistant positions as well as further education in the health care field.
Allied Health Personnel↗
Neuropsychological function in mild sleep-disordered breathing.
Although a broad range of neuropsychological deficits has been reported in patients with severe sleep disordered breathing (SDB), little is known about the impact of mild SDB on neuropsychological performance. In this study, we compared neuropsychological test performance in two groups of carefully screened volunteers who differed clearly according to the respiratory disturbance index (RDI). Controls (n = 20) were identified on the basis of an RDI < 5; cases (n = 32) had an RDI in the range of 10-30. Cases and controls were well matched with regard to IQ, age, and sex. Cases had significantly more self-reported snorting and apneas and a higher body mass index than controls but did not differ according to sleepiness as measured by either the multiple sleep latency test or the Epworth sleepiness scale. An extensive battery of neuropsychological and performance tests was administered after an overnight sleep study. Cases performed significantly more poorly on a visual vigilance task (perceptual sensitivity, d': 2.24 +/- 0.64 vs. 2.70 +/- 0.53, p = 0.01, for cases and controls, respectively) and a test of working memory, the Wechsler adult intelligence scale-revised digits backwards test (6.12 +/- 2.20 vs. 7.55 +/- 2.22, p = 0.02), than controls. The groups did not differ in their performance on other tests of memory, information processing, and executive functioning. In summary, subjects with mild SDB may manifest a vigilance deficit in the absence of substantial sleepiness. Subjects with a mildly elevated RDI (10-30) without sleepiness do not appear to suffer appreciable deficits in more complex neuropsychological processes (e.g. executive functions).
Cognition Disorders↗
Complete nucleotide sequence of a type 4 hepatitis C virus variant, the predominant genotype in the Middle East.
Hepatitis C virus (HCV) type 4 is the predominant genotype found throughout the Middle East and parts of Africa, often in association with high population prevalence as in Egypt. To investigate more fully its evolutionary relationship with other genotypes of HCV, and to study its overall genome organization, we have determined the entire sequence encompassing the coding region of the genotype 4a isolate ED43, obtained from an HCV-infected individual from Egypt. The sequence of ED43 contained a single open reading frame encoding a polyprotein of 3008 amino acids (aa), smaller than that reported for other HCV genotypes which vary from 3010 aa to 3037 aa. The nucleotide and amino acid sequences were compared with the full-length sequences already reported for genotypes 1a, 1b, 1c, 2a, 2b, 2c, 3a, 3b and those of isolates JKO49 and JKO46 described as types 10a and 11a. The differences in length of the polyprotein originated in variable regions in the E2 and NS5A genes. The complete sequence of ED43 confirmed the classification of type 4 as a separate major genotype.
Amino Acid Sequence↗
Antigenic variation of core, NS3, and NS5 proteins among genotypes of hepatitis C virus.
Assays that detect antibody to hepatitis C virus (HCV) are used to screen blood donors and patients with hepatitis. Current enzyme-linked immunosorbent assay (ELISA)-based methods are invariably based upon antigens from expressed recombinant proteins or oligopeptides from HCV type 1. Some HCV antigens used in screening assays are coded by regions of the HCV genome that show extensive variability; therefore, HCV type 1-based assays may be less effective for the detection of antibody elicited by infection with other genotypes. In this study, we have measured antibody reactivity of sera from 110 hepatitis C patients infected with type 1b, 3a, or 4a to genotype-specific and cross-reactive epitopes present in recombinant proteins from HCV genotypes 1b (core, NS3, and NS5), 3a (NS3, NS5), and 4a (core, NS3), corresponding to those used in current third-generation screening ELISAs. By comparing the serological reactivities of sera to type-homologous and type-heterologous antigens, we detected a significant type-specific component to the reactivity to NS3 (61 to 77% of the total reactivity) and NS5 (60% of the total reactivity). Furthermore, despite the similarities in the amino acid sequences of the core antigens of type 1b and type 4a, we also found significantly greater reactivity to type-homologous antigens, with approximately 25% of reactivity being type specific. These findings are consistent with previous findings of fivefold weaker reactivity of sera from HCV type 2- and HCV type 3-infected blood donors in the currently used third-generation ELISAs and suggest that these assays are suboptimal for screening populations in which the predominant genotype is not type 1.
Amino Acid Sequence↗
Relationship between sleepiness and general health status.
One commonly used instrument for evaluating general health and functional status is the medical outcomes survey short form 36 (MOS). Scores obtained from this instrument are known to vary with chronic diseases and depression. However, the degree to which these health dimensions may be influenced by sleep quality or sleepiness is not well understood. A cross-sectional study was performed on the association between general health status, as determined by the MOS, with sleepiness, assessed using a standardized questionnaire [the Epworth sleepiness scale (ESS)] and the multiple sleep latency test (MSLT). One hundred twenty-nine subjects (68 women), aged 25-65 years, without severe chronic medical or psychiatric illnesses, underwent an overnight sleep study, followed by an MSLT (consisting of a series of four attempts at napping at 2-hour intervals), and completed the MOS and the ESS. The mean MSLT score was 11 +/- 2 minutes, (range 2-20) and the mean ESS score was 10 +/- 5 (range 0-24). Scores for the MOS dimensions "general health perceptions", "energy/fatigue", and "role limitations due to emotional problems" were correlated significantly with ESS scores (r = -0.30, -0.41, and -0.30, respectively; p values were all < 0.001). The MSLT was also significantly correlated with "energy/fatigue" (r = -0.19; p < 0.05). After considering the effects of chronic illness and/or body mass index in a multiple hierarchical regression analysis, sleepiness, as assessed by the ESS score, explained 8% of the variance in general health perceptions, 17% of the variance in energy/fatigue, 6% of the variance in the summary measure of well-being, and 3% of the variance in the summary measure of functional status. The variation of MOS scores with sleepiness, unrelated to age or chronic disease, suggests that measures of general health status may be broadly influenced by sleepiness and sleep quality. These data suggest that 1) sleepiness has an important impact on general health and functional status, specifically influencing self-perceptions regarding energy/fatigue; 2) a more specific assessment of sleepiness in general health evaluations may help explain some of the observed variability in these measures across subjects; and 3) general health measures may be useful in the evaluations of patients with sleep disorders.
Adult↗
Seminatural housing increases subsequent ethanol intake in male Maudsley Reactive rats.
OBJECTIVE: Previous studies of ethanol (EtOH) intake under spontaneous choice conditions in Maudsley Reactive (MR) rats have demonstrated marked variability in EtOH preference. The present study investigated whether the social housing environment during the juvenile and early adult period would influence subsequent EtOH intake in male MR rats. METHODS: Rats were assigned to isolation, group housing in typical laboratory cages, or to a seminatural enclosure setting (1 x 2 m) at approximately 42 days of age and were maintained there for 16 weeks. Rats were then singly housed and exposed to a 2-bottle choice of 10% (v/v) EtOH versus tap water for 8 weeks. RESULTS: MRs housed in the seminatural setting drank some three times the level of EtOH consumed by isolate or group housed rats with regard to both preference ratio and intake of pure EtOH relative to body weight. CONCLUSIONS: A number of factors are hypothesized to account for the increased consumption of EtOH in rats housed in the seminatural setting, including differences in social dynamics across settings, and switching from a large physical space to a smaller isolated space. The results demonstrate that environmental factors can significantly modify the tendency to drink excessive amounts of EtOH in an inbred strain showing some preference for EtOH.
Alcohol Drinking↗
Biphasic responses in synergistic interactions.
Synergistic reactions, as exemplified by the methylenedioxyphenyl (benzodioxole) insecticide synergists, are one of the more studied interactions between toxicants. This group of chemicals includes, in addition to synergists such as piperonyl butoxide, carcinogens such as safrole and isosafrole and many compounds occurring naturally in foods, such as myristicin and piperine. These compounds may function as cytochrome P450 substrates, inhibitors and/or inducers. The biphasic curve in cytochrome P450 activities following a single dose is the result of an initial inhibitory phase followed by a phase of induction, with an eventual return to baseline levels. Both inhibition and induction may be isozyme-specific and different isozymes may be involved in the two activities of the same chemical. Details of these activities are presented and their significance is discussed.
Animals↗
Estimating premorbid intelligence in African-American and white elderly veterans using the American version of the National Adult Reading Test.
Knowledge of earlier intellectual functioning can be very helpful in the diagnosis of neurocognitive disorders. The National Adult Reading Test (Nelson, 1982), based on the observation that reading irregularly spelled words remains intact in mild dementia, may be useful for this purpose. A version for speakers of American English (AMNART) was recently published (Grober & Sliwinski, 1991). The present study evaluated the validity of the AMNART with demented and nondemented African-American and White elderly veterans. The average differences between African-American and White participants on the AMNART and WAIS-R were similar. The differences between demented and nondemented patients were greater on the WAIS-R than on the AMNART, as expected. Paradoxically, the AMNART appears to over-estimate IQ among nondemented individuals with lower WAIS-R scores, but underestimate IQ among more impaired demented patients. Using Grober and Sliwinski's (1991) 10-point discrepancy rule between AMNART and WAIS-R VIQ scores, 70% of demented and nondemented veterans were successfully classified. No discontinuation rule for the AMNART could be established because word difficulty order varies across samples.
Black or African American↗
Maternal influences on cardiovascular pathophysiology.
Elevated blood pressure (BP) is of special clinical significance because of its association with pathophysiologies such as heart disease, renal failure, and stroke. We described the development of a protocol for use with hypertensive rats in which prepubertal exposure to a high salt (8% NaCl) diet results in a pathophysiological syndrome including rapid increase in BP, failure to maintain normal weight gain, renal damage, cerebrovascular lesions, and early mortality. These phenomena are described for the inbred spontaneously hypertensive rat (SHR), and for reciprocal F1 hybrids of a cross between SHR and the Dahl salt-sensitive (SS/Jr) inbred strain. The study with reciprocal F1s revealed striking effects of maternal environment on pathophysiological response to a high salt diet. F1s nurtured by SHR mothers weighed less at 35 days of age, and after exposure to the high salt diet suffered more rapid BP increases, greater incidence of stroke, body weight loss, and mortality, than F1s nurtured by SS/Jr dams. These results suggest that maternal mediation of the nutritional status of the animal may play an important role in determining susceptibility to elevated BP and subsequent pathophysiology associated with exposure to a high salt diet. The implication of these findings for human hypertension is briefly discussed.
Animals↗
Relation of aphemia and agraphia.
A 49-year-old right-handed man presented with a severe impairment of motor speech output aphemia. Initially, he could make grunting sounds, but was otherwise mute. There was no disturbance of comprehension, and he preferred to communicate by writing. Writing was agrammatic with lexical errors and mispellings which improved with the speech disturbance. The writing abnormalities of aphemics emphasize the aphasic nature of this speech abnormality.
Agraphia↗
Carl Paxson Sherwin, American pioneer in drug metabolism.
Explore the source record for details and available documents.
Biochemistry↗
Genetic and maternal influences in rat models of spontaneous and salt-induced hypertension.
Genetic and maternal influences on hypertension were studied by comparing the SHR and SS/Jr inbred rat strains and their reciprocal F1 hybrids under identical conditions. When raised on a low salt (LS) diet (0.3% NaCl), SHR rats had higher systolic blood pressure (SBP) than SS/Jr rats by 9 weeks of age. Direct recordings from freely moving rats at 18-24 weeks confirmed this difference. Placement on a high salt (HS) diet (8% NaCl) at 5 weeks of age significantly increased SBP within 3 weeks in all groups, although the degree of increment was significantly smaller in SHR females. Inbred strains had higher SBP than their F1 hybrids when measured indirectly and directly from arterial cannulae. After exposure to HS diet, F1 females reared by SHR dams exhibited larger increments in SBP, greater weight loss, and greater debilitation and associated mortality than F1 females reared by SS/Jr dams. Differences between inbred strains and F1s maintained on LS diet were consistent with dominance for low BP, and differential genetic control of hypertension in each inbred strain. F1 differences demonstrated that maternal factors affected body weight in weanlings, pressor response to HS diet, and associated debilitation.
Animals↗
Ethanol preference in the Harrington derivation of the Maudsley Reactive and Non-Reactive strains.
Ethanol intake was explored in the Harrington derivation of the Maudsley Reactive and Maudsley Non-Reactive rat strains (MR/Har and MNRA/Har). When 5% and 10% ethanol solutions were presented as the sole source of fluid (1-bottle test), MR/Har rats, respectively, ingested 15% more, or 9% less, than their baseline water intake, whereas MNRAs ingested 6% less, or 42% less than their baseline intake. However, because MNRA/Har rats drank significantly more water than MR/Har's under ad libitum conditions (MNRA/Har, 46.6 +/- 1.83 ml; MR/Har 32.45 +/- 1.64 ml/24 hr), males and females of the two strains ingested a similar amount of ethanol in the 1-bottle test (5% ethanol, 4-7; 10% ethanol, 6-12 g/kg body weight/24 hr). In 2-bottle free-choice tests administered after an extended period of forced ethanol consumption, MR/Har male and female rats exhibited a strong ethanol preference (X = 80%) and consumed a larger amount of ethanol (MR/Har, 7-13; MNRA/Har, 6-9 g/kg body weight/24 hr) than MNRA/Har's. Across all conditions, females of both strains ingested a greater relative amount of ethanol than males. The strain difference in ethanol preference was found to be independent of prior exposure to ethanol because it was also found when 2-bottle free-choice tests were carried out in naive animals (Experiment 2). The pattern of development of ethanol preference in individual animals was characterized by abrupt onset, after variable periods of exposure to the 2-bottle choice test, and maintenance of strong ethanol preference thereafter. The extensive behavioral and biological definition of the Maudsley strains is a valuable asset in attempting to elucidate the biobehavioral correlates of ethanol preference.
Alcohol Drinking↗