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Biomedical subjects

P Moses

Publications and source records attributed to P Moses.

18 recordsLinked to original sources

Procedure-related abdominal discomfort in patients undergoing colorectal cancer screening: a comparison of colonoscopy and flexible sigmoidoscopy.

OBJECTIVES: The aims of this study were to determine if there was a difference in procedure-related abdominal discomfort or willingness to return for subsequent screening examinations between patients undergoing colonoscopy and those undergoing flexible sigmoidoscopy. METHODS: Two groups were compared: patients referred for screening flexible sigmoidoscopy and patients referred for screening colonoscopy. All patients were asymptomatic for colorectal cancer. Four university-based gastroenterologists performed all procedures. Patients received conscious sedation for colonoscopy but not for flexible sigmoidoscopy. A research nurse blinded to the procedure performed and the study purpose administered a standardized telephone questionnaire assessing and quantifying peri-procedural discomfort. RESULTS: A cohort of 466 patients underwent screening examinations, and 87% were contacted subsequent to their examination. Procedure-related discomfort, postprocedural discomfort, or discomfort at either of these two times ("peri-procedural discomfort") occurred in 28% (68/243), 14% (34/243), and 36% (88/243) of patients undergoing colonoscopy, respectively. Procedure-related discomfort, postprocedural discomfort, or discomfort at either of these two times occurred in 58% (94/162), 16% (26/162), and 62% (100/162) of patients undergoing flexible sigmoidoscopy, respectively. Peri-procedural discomfort was significantly more common in patients undergoing flexible sigmoidoscopy than with colonoscopy (p < 0.0005). Patients undergoing screening colonoscopy were more willing to undergo the procedure again than those undergoing screening flexible sigmoidoscopy (p < 0.0005). CONCLUSIONS: Patients undergoing screening colonoscopy with conscious sedation are less likely to experience peri-procedural discomfort than those undergoing screening flexible sigmoidoscopy. Although most patients are willing to undergo subsequent screening examinations, patients undergoing screening colonoscopy are significantly more willing to undergo a subsequent examination than those undergoing screening flexible sigmoidoscopy.

Abdominal Pain↗

Unusual brain growth patterns in early life in patients with autistic disorder: an MRI study.

OBJECTIVE: To quantify developmental abnormalities in cerebral and cerebellar volume in autism. METHODS: The authors studied 60 autistic and 52 normal boys (age, 2 to 16 years) using MRI. Thirty autistic boys were diagnosed and scanned when 5 years or older. The other 30 were scanned when 2 through 4 years of age and then diagnosed with autism at least 2.5 years later, at an age when the diagnosis of autism is more reliable. RESULTS: Neonatal head circumferences from clinical records were available for 14 of 15 autistic 2- to 5-year-olds and, on average, were normal (35.1 +/- 1.3 cm versus clinical norms: 34.6 +/- 1.6 cm), indicative of normal overall brain volume at birth; one measure was above the 95th percentile. By ages 2 to 4 years, 90% of autistic boys had a brain volume larger than normal average, and 37% met criteria for developmental macrencephaly. Autistic 2- to 3-year-olds had more cerebral (18%) and cerebellar (39%) white matter, and more cerebral cortical gray matter (12%) than normal, whereas older autistic children and adolescents did not have such enlarged gray and white matter volumes. In the cerebellum, autistic boys had less gray matter, smaller ratio of gray to white matter, and smaller vermis lobules VI-VII than normal controls. CONCLUSIONS: Abnormal regulation of brain growth in autism results in early overgrowth followed by abnormally slowed growth. Hyperplasia was present in cerebral gray matter and cerebral and cerebellar white matter in early life in patients with autism.

Adolescent↗

The effectiveness of activating electrical devices using alpha wave synchronisation contingent with eye closure.

Increases in alpha wave amplitude occur with eye closure (EC) and decreases occur when the eyes are opened (EO). The research reports in this paper emphasise effectiveness of people using these alpha wave changes to activate electrical devices. Effectiveness was measured in terms of time taken and errors made when selecting the correct device. Ten non-disabled subjects significantly decreased the time taken and errors made to activate correctly a device using a six-option environmental control system (ECS) in the laboratory. In addition, a severely disabled person was shown to use the ECS successfully to control her television in her home environment. This research demonstrates that alpha wave manipulation contingent with EC and EO can be the basis for a reliable and quick switching system for controlling electrical devices. Applications to disability are discussed.

Adult↗

Regional size reduction in the human corpus callosum following pre- and perinatal brain injury.

This morphometric study examined two aspects of corpus callosum development: pediatric cortico-callosal topography and developmental neuroplasticity subsequent to perinatal brain injury. In vivo magnetic resonance imaging was used to quantify the total midsagittal cross-sectional area and five anterioposterior subregions of the callosum in 10 children with focal lesions and 86 healthy volunteer control subjects. Nine of the ten children with early injury showed a reduction in the total area of the callosum relative to matched controls. The area of the total callosum cross-section was inversely proportional to the size of lesion. All patients displayed region-specific size reduction. This regional thinning bore a topographical relationship to the lesion sites. Reduction in anterior subregions 1, 2 and 3 was respectively associated with lesions in the anterior inferior frontal area, the middle and superior frontal region, and the precentral area. Attenuation of subregion 4 corresponded to anterior parietal lesions, and thinning of subregion 5 occurred with posterior parietal injury. This cortical-callosal pattern coincides with adult and nonhuman primate mappings. Callosal thinning despite the early onset of the lesions suggests limits to developmental neuroplasticity.

Adolescent↗

Hemispheric asymmetries in global and local processing: evidence from fMRI.

Functional magnetic resonance imaging (fMRI) was used to explore the brain substrate associated with global and local processing of visuospatial patterns. Systematic differences in activation, consistent with differences observed in reaction time data collected under conditions of visual hemifield presentation, were found in occipitotemporal regions of the right and left hemispheres. Within the right hemisphere, area of activation and fractional signal changes were greater under conditions of global processing than under local processing conditions. In the left hemisphere, activation to global and local input was high and comparable.

Adult↗

EEG-based system for rapid on-off switching without prior learning.

Details are reported of an EEG-based system that permits a person rapidly and reliably to switch on and off electrical devices without prior learning. The system detects and utilises increases in the amplitude of the alpha component of the EEG spectrum that occur when people close their eyes for more than 1 s. In addition to conventional signal-processing elements, the system incorporates a module for suppressing switching at the output of the system when predetermined noise threshold levels (such as those due to sources of EMG) are exceeded. This work indicates that a majority, perhaps in excess of 90%, of the adult population can demonstrate the control necessary to operate an electrical device or appliance using this system. It is indicated that multi-level switching and quasi-continuous control options are feasible with further development of the system. This work has implications for the design of a system that could be used, for example, to assist the infirm or severely physically disabled to effect greater control over their environment.

Adult↗

Evaluation of an ELISA for the diagnosis of brucellosis.

Brucela serology using ELISA and standard agglutination test was performed on 23 patients with prolonged fever where the test was requested, on 26 randomly chosen patients with prolonged fever where it was not requested and on 17 controls. ELISA was positive in 39.1, 26.9 and 0 per cent respectively in these groups. Brucellosis may often be unsuspected because of its varied clinical manifestations and may be a more important cause of fever than previously considered. Our data reaffirm that ELISA is superior to the standard agglutination test for the diagnosis of brucellosis.

Agglutination Tests↗

A new projective test: the Caine-Marteau-Dympna Test (CMD).

The Caine-Marteau-Dympna (CMD) Test, a new thematic apperception projective test, has acceptable inter-rater reliability. Validity was demonstrated by its ability to differentiate psychiatric in-patients from out-patients and non-patients, and by the relationships found between ratings derived from the test protocols and various questionnaires. These latter provide measures associated with either an inner or outer orientation towards the world. This has implications for many different areas of life, including occupational preference and adjustment, psychiatric symptom formation, psychological treatment expectancies and therapeutic outcome. Thus, the inner oriented individual, who is likely to be responsive to interpretative psychotherapy, tends to produce CMD responses displaying individualistic, abstract themes; a concern with intrapsychic conflict, deficiencies in social interaction and lack of structure; and internal control.

Adult↗

Biotransformation of terodiline I. Identification of metabolites in dog urine by mass spectrometry.

Nine metabolites of terodiline (N-tert-butyl-4,4-diphenyl-2-butylamine) have been identified in dog urine by various chromatographic techniques and mass spectrometry. The main metabolic pathway is aromatic hydroxylation, leading to the quantitatively most important metabolite, N-tert-butyl-4-(4-hydroxyphenyl)-4-phenyl-2-butylamine, and to two dihydroxylated metabolites, one mono substituted in both rings (N-tert-butyl-4,4'-bis(4-hydroxyphenyl)-2-butylamine), and one disubstituted in one ring (N-tert-butyl-4-(3,4-dihydroxyphenyl)-4-phenyl-2-butylamine). The latter is further metabolized by methylation, forming N-tert-butyl-4-(4-hydroxy-3-methoxyphenyl)-4-phenyl-2-butylamine, the second most abundant metabolite. Still another metabolite is formed by hydroxylation in the tert-butyl group to N-(2-hydroxymethyl-2-propyl)-4,4-diphenyl-2-butylamine. A very minor dihydroxylated metabolite results from oxidation both in an aromatic ring and in the tert-butyl group, giving N-(2-hydroxymethyl-2-propyl)-4-(4-hydroxyphenyl)-4-phenyl-2-butylamine. Oxidation of the carbon adjacent to the nitrogen and subsequent deamination gives the two ketones 4-(4-hydroxyphenyl)-4-phenyl-2-butanone and 4-(4-hydroxy-3-methoxyphenyl)-4-phenyl-2-butanone. Reduction of the carbonyl function in the former yields the corresponding alcohol, 4-(4-hydroxyphenyl)-4-phenyl-2-butanol. Some unchanged terodiline is also present. All metabolites formed by functionalization appear to be extensively conjugated, presumably with glucuronic acid.

Animals↗

Latex agglutination: an appropriate technology for the diagnosis of bacterial meningitis in developing countries.

We evaluated prospectively the utility of a latex agglutination technique for the diagnosis of Haemophilus influenzae type b meningitis in a paediatric ward in India. Eight of 44 children had H. influenzae grown from cerebrospinal fluid. These proven cases plus four additional cases of H. influenzae meningitis were detected by the latex agglutination test. There were no cross reactions with other organisms. The high degree of sensitivity and specificity, combined with the speed and simplicity of this technique make it an appropriate method for developing countries.

Child↗

Specificity of guinea pig liver transglutaminase for amine substrates.

The amine specificity of guinea pig liver transglutaminase, a model enzyme for endo-gamma-glutamine:epsilon-lysin transferases, was explored with the aid of synthetic substrates of high apparent affinities. As exemplified by dansyl- (5-dimethylamino-1-naphthalenesulfonyl), (2,4-dinitrobenzenesulfonyl)-, and (2,4,6-triisopropylbenzenesulfonyl)-cadaverines--each of which showed affinities of approximately 4 x 10(7) M-1--the best amine substrates carried a large hydrophobic substituent attached to an alkylamine side chain of about 7.2 A in length. Altogether, our results point to the importance of a hydrophobic binding region in the enzyme from where the alkyl side chain reaches into a narrow crevice toward the active center and positions the primary amine of the substrate for attacking the carbonyl group of the acyl enzyme intermediate.

Amines↗