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Biomedical subjects

P Higgins

Publications and source records attributed to P Higgins.

At least 19 recordsLinked to original sources
PubMed1992

Neuroticism and the pain-mood relation in rheumatoid arthritis: insights from a prospective daily study.

For 75 consecutive days, 54 Ss with rheumatoid arthritis supplied daily reports of their mood and joint pain. After aggregating daily reports, the relation between chronic mood and chronic pain remained statistically significant when controlling for neuroticism, depression, disease activity, disability, and characteristic responses to increasing pain. Findings of a path analysis suggest that (a) individuals higher in neuroticism experience more chronic distress regardless of their responses to pain, their pain intensity, and depressive symptomatology, and (b) the relation between neuroticism and chronic pain is mediated by the propensity of high-neuroticism individuals to catastrophize their pain. Within-subject analyses that controlled for autocorrelation and linear trends in the time series revealed that 40% of the Ss experienced significantly worse moods on more painful days. Although individuals higher in neuroticism reported more intense pain and more negative mood, their daily mood was less strongly linked to their daily pain.

Adaptation, Psychological↗
PubMed1992

Clozapine-induced weight gain: prevalence and clinical relevance.

OBJECTIVE: The aim of this study was to determine the prevalence and clinical relevance of weight gain during clozapine treatment. Previous reports indicated clinically significant weight gain in 13% to 85% of patients and an average gain of 9.0 to 24.7 lb. METHOD: Twenty-one state hospital patients with treatment-resistant schizophrenia or schizoaffective disorder were weighed weekly for 12 weeks before clozapine treatment and during the first 16 weeks of treatment. Psychiatric symptoms were rated with a modified version of the Brief Psychiatric Rating Scale (BPRS). RESULTS: The mean weight gain for the entire group was 13.9 lb, or 8.9% of body weight. During the 16 weeks of clozapine treatment, 38% of the patients experienced marked weight gains and 29% had moderate weight gains. The improvements in BPRS total score and composite negative symptom score were significantly greater for the eight patients with marked weight gains than for the other 13 patients. CONCLUSIONS: Clozapine's propensity to induce weight gain may relate to the drug's efficacy and/or its unique neuropharmacologic effects. Increased attention to this phenomenon is important because of the morbidity associated with obesity.

Adult↗
PubMed1991

An embryo-specific protein of barley (Hordeum vulgare).

An immunological approach has been used to identify embryo-specific products that can be used as molecular markers of embryogenesis. Immunoadsorption of antisera to remove antigens common to embryos, meristematic cells and callus, revealed one major embryo-specific antigen, a polypeptide of 17 kDa. The antigen appeared at mid-stages of zygotic embryo formation and remained at similar levels up to six days post-germination of the seedling. The polypeptide could not be detected by protein staining, suggesting it is a non-abundant product. Appearance of the antigen could be induced by culture of zygotic embryos in vitro on abscisic acid (1 microM) or mannitol (9% mass/vol.). Cross-reactive products of near-identical molecular mass were observed in embryos of wheat, rye and oats but not distantly related cereals, nor embryos from dicotyledonous species. The timing of the appearance of the antigen was different in embryos formed from microspores during anther culture in vitro. In the cultured material, the 17-kDa polypeptide preceded the appearance of morphologically distinct embryonic structure.

Abscisic Acid↗
PubMed1991

Individual differences in the day-to-day experience of chronic pain: a prospective daily study of rheumatoid arthritis patients.

Explored the distribution and temporal patterning of daily pain reported by 47 patients with rheumatoid arthritis (RA) for 75 consecutive days. Approximately half the pain series were significantly positively skewed, trended significantly across the recording period, or both. One fourth of the sample had relatively painful "outlier" days that clustered together. Most series displayed a significant autocorrelation in pain intensity across successive days even when the series were detrended. Patients with more active disease had pain that was more intense but more predictable from day to day and reported fewer painful outlying days and briefer episodes of atypically severe pain. Patients describing themselves as more depressed on the Center for Epidemiological Stress Depression Scale also reported more intense pain across the recording period, independent of their level of disease activity and disability. Implications for daily process studies of RA pain are discussed.

Activities of Daily Living↗
PubMed1991

Role of general practitioners in care of long-term mentally ill patients.

"OBJECTIVE--To assess general practitioners' involvement with long term mentally ill patients and attitudes towards their care. DESIGN--Postal questionnaire survey. SETTING--General practices in South West Thames region. SUBJECTS--507 general practitioners, 369 (73%) of whom returned the questionnaire. MAIN OUTCOME MEASURES--The number of adult long term mentally ill patients whom general practitioners estimate they have on their lists and general practitioners' willingness to take responsibility for them. RESULTS--110 respondents had noticed an effect of the discharge of adult long term mentally ill patients on their practices. Most (225) respondents estimated that they had 10 or fewer such patients each on their lists. Having higher numbers was significantly associated with practising in Greater London or within three miles of a large mental hospital and having contact with a psychiatrist visiting the practice. 333 general practitioners would agree to share the care of long term mentally ill patients with the psychiatrist by taking responsibility for the patients' physical problems. Only 59 would agree to act as a key worker, 308 preferring the community psychiatric nurse to do it. Only nine had specific practice policies for looking after long term mentally ill patients and 287 agreed that such patients often come to their general practitioner's attention only when there is a crisis. CONCLUSIONS--The uneven distribution of long term mentally ill patients suggests that community psychiatric resources might be better targeted at those practices with higher numbers of such patients. Most general practitioners seem to be receptive to a shared care plan where the consultant takes responsibility for monitoring psychiatric health with the community nurse as key worker. The lack of practice policies for reviewing the care of long term mentally ill patients must limit general practitioners' ability to prevent crises developing in their care."

Attitude of Health Personnel↗
PubMed1990

A host-cell-selected variant of influenza B virus with a single nucleotide substitution in HA affecting a potential glycosylation site was attenuated in virulence for volunteers.

An influenza B virus was passaged in man (virus A) and then in human embryo trachea (C) and into embryonated eggs (D) or directly into eggs (B). Virus A, B, and C had the same (cell-like) haemagglutinin phenotype on reaction with selected monoclonal antibodies while D had an "egg-like" phenotype. The viruses were administered at a dose of 1,000 TCD50 (for MDCK cells) by intranasal inoculation to groups of 27 or 28 volunteers. Viruses A, B, and C all produced disease in six to eight volunteers, whereas D produced no illness and only four volunteers were infected. The viruses shed by the volunteers were indistinguishable from those with which they were inoculated. The haemagglutinin genes of the viruses were sequenced and changes were detected indicating amino acid substitutions at position 196-198 in the attenuated egg-grown virus D whereby a potential glycosylation site present in the other viruses was lost.

Amino Acid Sequence↗
PubMed1990

Mothers' remembrances of newborn intensive care: a predictive study.

Six months after discharge, 94 mothers described their memories of their infant's hospitalization on an NICU. Mothers of sicker infants, those who had claimed difficulties with NICU staff, and those who felt less attached to their infant more often described painful reminders of this crisis. Pleasurable reminders were reported more often by mothers who had perceived greater personal control over their infant's recovery and had construed a purpose in this crisis. Mothers described several benefits of their memories and were more likely to do so when they had perceived a purpose in their misfortune.

Adaptation, Psychological↗
PubMed1990

Umbilical artery Doppler velocimetry in pregnancies of less than 21 weeks' duration.

Most Doppler ultrasound investigations of the umbilical artery circulation have been confined to beyond 16 weeks' gestation. The purpose of this study is to explore the evolution of this circulation in human pregnancies of less than 21 weeks' gestation. We studied 169 low-risk pregnant women (125 longitudinally and 44 cross-sectionally) with a pulsed Doppler system on 357 separate occasions between 9 and 20 weeks of gestation. Systolic/diastolic (S/D) ratios were used for waveform analysis. We obtained umbilical waveforms as early as 9 weeks. Before 13 weeks, all fetuses had absent end-diastolic velocity (AEDV), then progressive development of end-diastolic velocity (EDV) appeared from 13 to 18 weeks. At 18 weeks, all fetuses had developed EDV. S/D ratios progressively declined from 13 to 20 weeks (y = 17.67 - 1.26x + 0.3x2; r2 = .95). A cross-sectional evaluation of fetal heart rate in 136 fetuses revealed a significant negative second-order polynomial relationship with gestational age between 9 and 20 weeks y = 245.84 - 10.33x + 0.27x2; r2 = .93). In 136 fetuses, 185 measurements of S/D ratios and their corresponding fetal heart rate revealed no relationship (weighted linear regression, r2 = .005). Mean fetal heart rate was significantly higher when EDV was absent (164.6 +/- 10.8 standard deviation [SD], n = 74) than when EDV was present (150.1 +/- 5.8 SD; n = 62; P = .000). Thus, upstream factors may be of little importance in the generation of umbilical artery velocity waveforms in early pregnancy. Umbilical Doppler velocimetry in the first half of pregnancy gives a functional assessment of the vascular development of the umbilical-placental circulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Flow Velocity↗
PubMed1988

Immunogenicity and pathogenicity of temperature-sensitive modified respiratory syncytial virus in adult volunteers.

Single temperature-sensitive (ts) mutants of a subgroup A strain of respiratory syncytial (RS) virus whose multiplication is restricted at 39 degrees C in MRC-6 cells and double ts mutants that are restricted at 38 degrees C, were obtained following mutagenesis using 5-fluorouracil and acridine-like compounds. Isolation and propagation of the parental RSS-2 strain of RS virus and its derived ts mutants were carried out entirely in MRC-5 human diploid cells. The immunogenicity and disease-producing ability of four of these mutants and the parental unmodified strain have been assessed by intranasal administration into groups of about 20 adult volunteers. The results of these trials indicate that the capacity of the parental RSS-2 strain to produce upper respiratory tract infection in adults was not diminished by limited propagation in MRC-5 cells. The mutants on the other hand were impaired in this respect to varying extents. The double mutant tslB in particular has characteristics that suggest that it may be suitable for further development as a live RS virus vaccine. It retained near normal immunogenicity and replicative ability in the upper respiratory tract, while exhibiting greatly reduced disease-producing potential.

Adult↗
PubMed1988

Effects of interferon alpha on performance in man: a preliminary report.

The effects of three doses of interferon alpha (1.5 Mu, 0.5 Mu and 0.1 Mu) on performance were studied. The injection of 1.5 Mu IFN produced symptoms and performance changes which closely resembled those found in volunteers with influenza. Specifically, volunteers were slower at responding when they were uncertain when a target stimulus would appear, but were not impaired on a pursuit tracking task or syntactic reasoning task. The results suggest that interferon-induced changes in CNS function provide a plausible explanation for the selective effects of influenza on performance.

Adult↗
PubMed1988

Diurnal variation in the symptoms of colds and influenza.

The present research examined diurnal variation in the severity of symptoms of experimentally-induced colds and influenza. Nasal secretion was greatest in the morning, decreased over the day, and then showed a slight increase in the late evening. Colds did not change the average temperature, nor did they alter the temperature rhythm. Similar, negative results were found with alertness ratings. Influenza B illnesses produced an increase in nasal secretion and systemic effects. The average temperature increased during this illness and subjects reported that they felt more drowsy. Diurnal variation in the severity of local and central symptoms was observed, with nasal secretion and the temperature increase being greatest in the early morning. These results have important implications for the assessment and treatment of the illnesses.

Adult↗
PubMed1987

Upper respiratory tract viral infection and mucociliary clearance.

Twenty-six normal volunteers were exposed to rhinovirus or influenza B virus. Measurement of nasal mucociliary clearance, ciliary beat frequency, percent of epithelium ciliated, ciliary ultrastructure and nasal transmucosal potential difference were made before exposure, during viral incubation and at the time of expected overt infection. Ten volunteers failed to become infected, six were subclinically infected and nine were infected with symptoms. There were no significant differences between the results in volunteer groups during the incubation period or between uninfected and subclinical groups at the time of expected symptoms. Six of nine symptomatic infected volunteers had prolonged nasal clearance, and six of the seven biopsied had less than 50% of their epithelium ciliated. However, there was no significant reduction in ciliary beat frequency nor increase in ultrastructural ciliary abnormalities within this group of symptomatic volunteers. Of the two symptomatic infected (influenza B) volunteers tested, both showed significantly reduced transmucosal potential difference.

Adult↗
PubMed1986

An evaluated programme of rheumatology training for general practitioners.

The management of painful, upper-limb disorders by 34 general practitioners (GPs) was examined 3 months before and 3 months after personal instruction of GPs by a consultant rheumatologist. Tuition was conducted either in GP surgeries or a hospital out-patient department. Following instruction there were significant increases in the application of appropriate treatments (p less than 0.0005) and of local corticosteroid injections by GPs (p less than 0.005), fewer requests for investigations and less-frequent hospital referrals for consultant rheumatology opinions. Hospital out-patient instruction was associated with a significant reduction of patients' time off work (p less than 0.005) and, in general, differences of management appeared to be more pronounced amongst those GPs instructed in the hospital than in GP surgeries. The study showed that personal instruction of GPs by a consultant rheumatologist may result in modifications of practice, at least in the short term. The evidence indicates that such alterations of GP management may significantly reduce patient morbidity.

Arm↗