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Biomedical subjects

P Terry

Publications and source records attributed to P Terry.

At least 55 records · Page 3Linked to original sources
PubMed2000

Utility of on-site cytopathology assessment for bronchoscopic evaluation of lung masses and adenopathy.

STUDY OBJECTIVES: To determine the extent to which on-site cytopathology assessment improves diagnostic yield when sampling lung nodules or masses and/or hilar or mediastinal lymphadenopathy by fiberoptic bronchoscopy (FOB). DESIGN: Prospective cohort study. SETTING: Two teaching hospitals in Baltimore, MD. PATIENTS: Consecutive adult patients (>/= 18 years) undergoing FOB for evaluation of lung nodules or masses and/or hilar or mediastinal lymphadenopathy. INTERVENTION: Prospective collection of data on patient factors and details of the procedure on standardized report forms. MEASUREMENTS AND RESULTS: The primary outcome measure was a new diagnosis obtained by FOB. On-site assessment was used in 81 of 204 cases (40%), and overall diagnostic yield was 62%. Yield was greater when on-site cytopathology assessment was used, in unadjusted analysis (81% vs 50%, p < 0.001) and in a multivariate model (odds ratio, 4.5; 95% confidence interval, 2.1 to 10.0). Other significant predictors of a new diagnosis included older patient age, higher dose of narcotic used during FOB, and shorter procedure time. CONCLUSIONS: We conclude that diagnostic yield was greater when on-site cytopathology was used to assist FOB evaluation of intrathoracic adenopathy and/or lung nodules or masses. Increasing the use of on-site cytopathology assessment may improve the quality of FOB services.

Adolescent↗
PubMed1999

Lifestyle and endometrial cancer risk: a cohort study from the Swedish Twin Registry.

Case-control studies of lifestyle factors have been inconclusive in the study of endometrial cancer, and prospective data are scarce. Our aim was to examine the associations of physical activity, weight and weight change, fruit, vegetable, and alcohol consumption, socio-economic status, parity and presence of diabetes mellitus with the risk of endometrial cancer in a cohort study. In 1967, 11,659 women in the Swedish Twin Registry, born 1886-1925, answered a 107-item questionnaire, including questions about diet, physical activity and other lifestyle factors. Complete follow-up through 1992 was attained through record linkage to the Swedish Cancer and Death Registers. The relative risks for endometrial cancer were estimated in proportional hazards models that adjusted confidence limits for correlated outcomes. We observed 133 incident cases of endometrial cancer in the cohort. There was no clear pattern of risk over strata of alcohol or fruit and vegetable intake, although the data suggest an increased risk with very low fruit and vegetable intake. Increasing physical activity markedly decreased the risk of endometrial cancer (p for trend < 0.01), independently of weight and parity; the risk in the highest quartile, relative to the sedentary category, was 0.2 (95% CI 0.3-0.8). As expected, higher weight in middle age increased the risk (p for trend < 0.01), as did higher weight in early adulthood. Contrary to previous findings, weight gain did not have an effect independent of weight at enrollment. We did not find a genetic component to endometrial cancer. Our results confirm that environmental factors are the most important, especially physical activity, parity, and weight in young and middle age.

Adult↗
PubMed1999

High affinity binding of [3H]epibatidine to rat brain membranes.

Several compounds, such as epibatidine, A-85380, and their analogs, have been identified recently as nAChR ligands whose affinities lie in the low picomolar range. Accurate measurement of such high affinities is fraught with certain technical difficulties, which may account for the inconsistency of previously reported affinities of epibatidine, ranging from 4 to 60 pM. Here, we demonstrate that (+/-)-[3H]epibatidine (1-500 pM) binds to a single population of sites in rat brain with KD of 8 +/- 2 pM. This affinity was confirmed in both kinetic experiments and competition assays with (+/-)-[3H]epibatidine and (-)-[3H]cytisine, which were performed under experimental conditions developed specifically for ligands with subnanomolar affinities. Variations from these conditions decreased the observed affinities.

Alkaloids↗
PubMed1999

Asymmetric generalization between the discriminative stimulus effects of nicotine and cocaine.

The discriminative stimulus effects of nicotine and cocaine were studied, alone and in combination, in rats. Two sets of rats were trained to press one lever when injected intraperitoneally (i.p.) with either nicotine (0.1 mg/kg = 0.6 micromol/kg, Set 1) or cocaine (8.9 mg/kg base = 29.4 micromol/kg, Set 2), and another lever when injected with saline. Rats learned to discriminate drug from saline, and maintained discriminative control throughout the study (at > 85% drug-appropriate responding). In accordance with most previous findings, cocaine only partially substituted for nicotine (maximum = 41% nicotine-lever responding). The nicotinic agonist, nornicotine, produced dose-related, near-full substitution for nicotine (maximum = 76% nicotine-lever responding), whereas the peripherally acting nicotinic agonist, methylcarbamylcholine, did not substitute for nicotine. The muscarinic receptor agonist pilocarpine also failed to substitute for nicotine. However, in the cocaine-trained rats, nicotine substituted fully for cocaine in a dose-dependent manner, demonstrating that cross-generalization between the two drugs is not symmetrical. Finally, administration of each drug as a pre-treatment to the other yielded inconsistent increases in each drug's discriminative stimulus effects. The results are congruent with the view that the discriminative stimulus effects of nicotine and cocaine share common features, but the asymmetric pattern of cross-generalization and the interactions revealed in the combination tests also suggest that there are important differences between them.

Animals↗
PubMed1998

Protective effect of fruits and vegetables on stomach cancer in a cohort of Swedish twins.

Observational studies, primarily of a case-control design, have shown an inverse association of fruit and vegetable consumption with the risk of stomach cancer, a finding tentatively attributed to anti-oxidant vitamins. Ensuing randomized-intervention trials of these vitamins, however, have been mostly negative. Therefore, the seemingly protective effect of fruit and vegetables in case-control studies is suspected to be influenced by the information bias inherent in the retrospective assessment of exposure, particularly since pre-conceptions about the wholesome effects of these foods are common among the public. Our aim was to examine the association of fruit and vegetable intake with the risk of stomach cancer in a prospective cohort study. Fruit and vegetable consumption was assessed in 1967 in 11,546 individuals in the Swedish Twin Registry, along with a wide range of potentially confounding factors. Complete follow-up through 1992 was attained through record linkage to the National Cancer and Death Registers. The relative risk of stomach cancer was estimated in proportional hazards models, with confidence intervals (CIs) adjusted for correlated outcomes. The risk of stomach cancer was inversely related to fruit and vegetable consumption. Controlling for potentially confounding factors, the relative risk among subjects with the lowest compared to those with the highest intake was 5.5 (95% CI 1.7-18.3) with a statistically significant dose-risk trend (p < 0.05). Our results indicate that information bias is not likely to explain the discrepancy between the results of observational studies and of randomized-intervention trials.

Aged↗
PubMed1998

The dopamine D4 receptor antagonist L-745,870: effects in rats discriminating cocaine from saline.

The contribution of dopamine D4 receptors to the discriminative stimulus effects of cocaine was evaluated by testing the selective dopamine D4 receptor antagonist, L-745,870 (3-([4-(4-chlororphenyl) piperazin-1-yl] methyl)-1 H-pyrrolo[2,3-b] pyridine), alone and in combination with cocaine, in rats trained to discriminate cocaine (10 mg/kg) from saline. The antagonist (1-10 mg/kg) failed to engender cocaine-appropriate responding when injected alone, and failed to modify the cocaine dose-response curve when injected as a pre-treatment; however, it reduced response rates dose-dependently. Conversely, the dopamine 'D1-like' receptor antagonist, SCH 39166 ((-)-trans-6,7,7a,8,9, 13b-hexahydro-3-chloro-2hydroxy-N-methyl-5H-benzo[d]napth o-¿2,1-b¿azepine, produced surmountable antagonism. Results suggest that dopamine D4 receptors play a negligible role in cocaine's discriminative stimulus effects, and further support a critical involvement of dopamine D1-like receptors.

Animals↗
PubMed1998

Amphetamine-induced conditioned activity and sensitization: the role of habituation to the test context and the involvement of Pavlovian processes.

Behaviours associated with drug action can sometimes be elicited, in the absence of drug, by exposure to stimuli that were present during drug administration. Such a finding is usually interpreted as a conditioned drug effect. Often, however, the outcome could arise if drug administration in a particular environment retarded behavioural habituation to that environment. To test the 'habituation hypothesis' of conditioned drug effects, mice received 10 daily injections of d-amphetamine ('paired' group) or saline ('unpaired') in test boxes, and the converse injections in the colony room. Another group received saline in both environments. The apparatus and procedures yielded minimal habituation of behaviours (ambulation and rearing) over sessions. Only the paired group demonstrated behavioural sensitization, indicating environment-specific sensitization. The paired group also showed more ambulation and rearing than the others on the critical test of conditioning (saline injection in test box); moreover, their conditioning test scores were higher than those of the other groups on their first exposure to the test boxes, contradicting the habituation hypothesis. Further supporting the involvement of Pavlovian conditioning, levels of ambulation and rearing measured for 10 min before each injection increased in the paired group, relative to the unpaired groups, over successive pairing sessions. Tests controlling for differential handling/injection experience produced results consistent with those previously obtained. Together, the findings are incompatible with the habituation hypothesis, and further support the role of Pavlovian conditioning.

Animals↗
PubMed1998

Quality assessment through patient self-report of symptoms prefiberoptic and postfiberoptic bronchoscopy.

STUDY OBJECTIVE: To apply the principles of quality improvement to measure the frequency and severity of symptoms that result from fiberoptic bronchoscopy (FOB), and to identify opportunities to improve FOB practice by identifying factors about patients and the process of care that predict these symptoms. DESIGN: Concurrent longitudinal cohort study. PATIENTS: Four hundred ninety-three adult patients who underwent FOB. MEASUREMENTS AND RESULTS: Patients completed questionnaires just prior to FOB and again at 48 h postprocedure. Patients were asked to rate the severity of nose pain, throat pain, swallowing pain, and chest pain, and the frequency of coughing, hemoptysis, phlegm, shortness of breath, wheezing, difficulty swallowing, fever, and chills. Symptom severity was reported on a four-point ordinal scale. FINDINGS: Significant worsening was found for nose pain, throat pain, swallowing pain, and hemoptysis. Shorter patients experienced more throat pain and hemoptysis, and longer procedure time predicted nose pain and hemoptysis. CONCLUSIONS: Bronchoscopy causes nose pain, throat pain, swallowing pain, and hemoptysis to a larger extent than previously has been recognized. There are opportunities to improve the patient experience with bronchoscopy by using smaller bronchoscopes in shorter patients, shortening the procedure length, and reanesthetizing the nares in longer procedures.

Adult↗
PubMed1997

Dopaminergic mediation of the discriminative stimulus effects of bupropion in rats.

Bupropion is a novel, non-tricyclic antidepressant with a primary pharmacological action of monoamine uptake inhibition. The drug resembles a psychostimulant in terms of its neurochemical and behavioural profiles in vivo, but it does not reliably produce stimulant-like effects in humans at clinically prescribed doses. Bupropion binds with modest selectivity to the dopamine transporter, but its behavioural effects have often been attributed to its inhibition of norepinephrine uptake. This experiment examines monoaminergic involvement in the discriminative stimulus effects of bupropion. Rats were trained to press one lever when injected i.p. with bupropion (17.0 mg/kg), and another lever when injected with saline. In substitution tests, dose-response curves were obtained for several monoamine uptake inhibitors. Nine of ten dopamine uptake blockers fully substituted for bupropion; the exception, indatraline (LU 19-005), partially substituted (71% bupropion-appropriate responding). Serotonin and norepinephrine uptake blockers (zimelidine and nisoxetine, respectively) produced negligible or limited substitution, and the anti-muscarinic dopamine uptake blocker benztropine produced limited partial substitution. A series of dopamine D1-like and D2-like receptor agonists were also tested: only the D2-like agonist RU 24213 fully substituted; three other D2-like agonists and four D1-like agonists partially substituted (50% < drug responding < 80%). Antagonism of the discriminative effects of bupropion was obtained with a D1- and a D2-like dopamine antagonist. The results demonstrate strong similarities with those obtained using other dopamine uptake inhibitors as training drugs, and support the view that the behavioural effects of bupropion are primarily mediated by dopaminergic mechanisms.

Animals↗
PubMed1997

Conditioned grooming induced by the dopamine D1-like receptor agonist SKF 38393 in rats.

Stimulation of dopamine D1-like receptors reliably increases grooming in rats and mice. The study examined whether the grooming response elicited by the prototypical D1-like agonist SKF 38393 (8 mg/kg s.c.) could be conditioned to the specific environment in which it occurred. Rats in one group (Paired) received SKF 38393 and rats in another group (Unpaired) received saline in observation boxes outside of their housing room; the rats were then scored for duration and frequency of grooming bouts over 25 min. The ordering of injections was reversed the next day in the rats, housing room. The procedure was repeated twice, with at least one intervening drug-free day, to give three conditioning trials. The D1-like agonist significantly increased grooming on each of the three conditioning trials, without obvious tolerance or sensitization, and the effect tended to persist for the duration of each trial. On the test trial for conditioned grooming, mean grooming duration was significantly greater in the Paired than the Unpaired group, suggesting that SKF 38393-induced grooming had been conditioned to the test environment. This is the first time that drug-elicited grooming has been conditioned to environmental cues.

2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-ben↗
PubMed1997

Dopamine 'D2-like' receptor agonists in combination with cocaine: absence of interactive effects on locomotor activity.

This study examined interactions between cocaine and drugs that act as direct agonists at subtypes of "D2-like" dopamine receptors. The drugs 7-OH-DPAT, quinpirole and RU24213 were studied alone and in combination with cocaine for their effects on locomotor activity in non-habituated mice. Locomotor activity was measured by photobeam crossings over 140 min. At the doses given (7-OH-DPAT: 0.006-6.4 mg/kg; quinpirole: 0.001-1 mg/kg; RU24213: 0.008-8 mg/kg) all three direct agonists dose-dependently reduced locomotor activity throughout the test, whereas cocaine (0.6-20 mg/kg) produced dose-related hyperactivity. Next, for each direct agonist, a series of doses was selected (up to threshold behaviourally-active doses) as pretreatments to a sub-maximally stimulant dose of cocaine (15 mg/kg). 7-OH-DPAT and quinpirole did not modulate the effects of cocaine; RU24213 produced, at best, a very modest attenuation of the effects of cocaine. Finally, a series of cocaine doses (below stimulant threshold) was given before a single dose of each direct agonist (the lowest dose to reduce activity significantly). Cocaine did not reliably alter the hypoactivity produced by any of the D2-like agonists. By demonstrating negligible interactions between cocaine and D2-like agonists, the results fail to demonstrate any necessary involvement of D2-like receptors in one of the behavioural effects of cocaine.

Animals↗
PubMed1996

A prospective study of folate and vitamin B6 and risk of myocardial infarction in US physicians.

OBJECTIVE: To assess prospectively the risk of myocardial infarction (MI) associated with decreased plasma levels of folate and pyridoxal phosphate (PLP, a form of vitamin B6) in relation to elevated levels of total homocysteine (tHcy). DESIGN: Nested case-control study using prospectively collected blood samples. SETTING: Participants in the Physicians' Health Study. SUBJECTS: 14,916 male physicians, aged 40-84 years, with no prior MI or stroke provided plasma samples at baseline and were followed for 7.5 years. Samples from 333 men who subsequently developed MI, and their paired controls matched by age and smoking, were analyzed for folate and PLP levels. MEASURES OF OUTCOME: Acute MI or death due to coronary disease. RESULTS: In a model controlling for diabetes, angina, hypertension, Quetelet's index, and total/high-density lipoprotein cholesterol, men with the lowest 20% of folate levels (< 2.0 ng/mL) had a relative risk of 1.4 (95% confidence interval 0.9-2.3) compared with those in the top 80%. For the lowest 20% of vitamin B6 values, the relative risk was 1.5 (95% CI: 1.0-2.2). When we included both folate and B6 in a model with cardiovascular risk factors, the relative risk of MI for low as compared to high levels of folate was 1.3 (95% CI: 0.8-2.1) and for PLP, 1.3 (95% CI: 0.9-2.1). Adding tHcy to this model did not add significant predictive value (chi sq = 2.0, p > 0.05), except in the first half of the follow-up interval when men with the top 5% of tHcy values had an almost three-fold increase in risk of MI. CONCLUSIONS: Although not statistically significant, these prospective data are compatible with the hypothesis that low dietary intake of folate and/or vitamin B6 contribute to risk of MI.

Adult↗
PubMed1996

A comparison of bladder and ovarian function two years following hysterectomy or endometrial ablation.

OBJECTIVE: To test the hypothesis that at two years bladder and ovarian function function are no different following either simple hysterectomy or endometrial ablation (transcervical resection/laser ablation). DESIGN: Randomised controlled trial comparing hysterectomy with endometrial ablation. Two years after trial entry bladder and ovarian function were evaluated subjectively by means of questionnaires and objectively by means of cystometry and estimation of serum follicle stimulating hormone respectively. SETTING: Aberdeen Royal Infirmary. PARTICIPANTS: Tow hundred and four women with dysfunctional uterine bleeding who, when recruited to the initial study two years previously, were aged less than 50 years, weighed less than 100 kg, and who would otherwise have undergone hysterectomy. RESULTS: Of the 204 women originally recruited, 101 re-attended the clinic and underwent cystometry and follicle stimulating hormone estimation. These, together with a further 59 women, completed postal questionnaires (79% of original cohort). Rates of stress incontinence (44% vs 44%, 95% CI of difference -16% to +15%), urge incontinence (21% vs 19% 95% CI of difference -11% to +14%), and hot flushes (30% vs 44%, 95% CI of difference -25% to +7%) were similar in the hysterectomy and endometrial ablation groups, respectively. Cystometry revealed 14 (31%) cases of bladder dysfunction after hysterectomy and 17 (35%) after hysteroscopic surgery (95% CI of difference -23% to +15%). Serum follicle stimulating hormone levels > 40 IU/L [corrected] were found in three (6%) women following hysterectomy and five (10%) of women after endometrial ablation. CONCLUSION: This study suggests that in comparison with endometrial ablation, simple hysterectomy for dysfunctional uterine bleeding does not compromise bladder or ovarian function, at least at two years after the operation. Due to lack of power the estimates of any differences are imprecise, and clinically significant effects cannot be ruled out.

Adult↗