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Biomedical subjects

R Prince

Publications and source records attributed to R Prince.

At least 37 records · Page 2Linked to original sources
PubMed1993

The calcium controversy revisited: implications of new data.

OBJECTIVE: To review and synthesis recent literature relating to the skeletal effects of dietary calcium supplementation. DATA SOURCES: Six recent randomised controlled clinical trials are reviewed together with other relevant clinical and physiological studies. CONCLUSIONS: Recent controlled clinical trials of the effect of dietary calcium supplementation in postmenopausal women have supported the conclusion that increasing calcium intake can slow bone loss at appendicular and axial skeletal sites. Supplementation may be more effective in those with a low calcium intake or when combined with an exercise regimen in those with low bone mass, and was more effective in women further from the menopause. Calcium has its effect by reducing bone resorption. The effect of dietary calcium on bone is due to the absorbed fraction which is influenced negatively by other dietary factors such as dietary fibre and positively by the circulating concentration of the active form of vitamin D, calcitriol. To improve the efficacy of calcium supplements it will be necessary to optimise absorption. Nevertheless, in the light of these recent trials it would be reasonable to consider increasing the Australian recommended dietary intake for postmenopausal women to 1500 mg calcium per day.

Bone Density↗
PubMed1993

Importance of bone resorption in the determination of bone density in women more than 10 years past the menopause.

There is general agreement that bone density falls with age and is higher in heavy people than light people. We have studied a variety of potential correlates of vertebral, ankle, and hip bone density to evaluate other potential influences on the skeleton. We recruited 196 healthy women who were more than 10 years past the menopause and collected a diet and activity record, a 24 h urine, and a fasting blood and urine specimen. These blood and urine samples were analyzed for factors related to calcium homeostasis. We then measured bone density at lumbar vertebrae 1-4 and the hip and the ankle bone density of the nondominant leg. Correlations between vertebral, hip, and ankle bone density and other measured variables were explored using the statistical package SPSS PC. At the vertebral site, in addition to correlations with age and body mass index (BMI), a negative correlation with a measure of bone resorption, the hydroxyproline creatinine ratio (OHPCR), was noted. At the ankle site, in addition to correlation with age, BMI, and OHPCR, a positive correlation with activity and a negative correlation with serum calcitriol were noted. At the hip site, as well as age, BMI, and OHPCR, significant correlations with GFR and dietary calcium intake were noted. These data suggest that even in women 10 years past the menopause bone resorption has a significant effect on bone density, that renal function may account for some of the variance in bone density at the hip, and that activity effects are more marked at sites of greater loading, namely the ankle.

Aged↗
PubMed1992

Philadelphia positive acute leukaemia with minor breakpoint cluster rearrangement may be a stem cell disease.

The biology of Philadelphia chromosome positive (Ph+) acute lymphoblastic leukaemia (ALL) is the subject of much interest. We present a case of Ph+ ALL with a minor breakpoint cluster (mBCR) rearrangement who subsequently relapsed with Ph+ mBCR+ acute myeloid leukaemia and later with Ph+ mBCR+ acute stem cell leukaemia. This case provides further evidence that Ph+ ALL with a mBCR rearrangement may arise from a pluripotent stem cell with similar potential to that of chronic granulocytic leukaemia to undergo blastic crises with differing lineage characteristics.

Acute Disease↗
PubMed1991

GABAA receptor subtypes immunopurified from rat brain with alpha subunit-specific antibodies have unique pharmacological properties.

The unique cytoplasmic loop regions of the alpha 1, alpha 2, alpha 3, and alpha 5 subunits of the GABAA receptor were expressed in bacterial and used to produce subunit-specific polyclonal antisera. Antibodies immobilized on protein A-Sepharose were used to isolate naturally occurring alpha-specific populations of GABAA receptors from rat brain that retained the ability to bind [3H]muscimol, [3H]flunitrazepam, [3H]Ro15-1788, and [125I]iodo-clonazepam with high affinity. Pharmacological characterization of these subtypes revealed marked differences between the isolated receptor populations and was generally in agreement with the reported pharmacological profiles of GABAA receptors in cells transiently transfected with alpha 1 beta 1 gamma 2, alpha 2 beta 1 gamma 2, alpha 3 beta 1 gamma 2, and alpha 5 beta 1 gamma 2 combinations of subunits. Additional subtypes were also identified that bind [3H]muscimol but do not bind benzodiazepines with high affinity. The majority of GABAA receptor oligomers contains only a single type of alpha subunit, and we conclude that alpha 1, alpha 2, alpha 3, and alpha 5 subunits exist in vivo in combination with the beta subunit and gamma 2 subunit.

Animals↗
PubMed1991

The comorbidity of borderline personality disorder and other DSM-III-R axis II personality disorders.

OBJECTIVE: This study examines the comorbidity of DSM-III-R borderline personality disorder and the other axis II personality disorders. The extent and direction of overlap provides a measure of the clarity of its diagnostic boundaries and descriptive validity. METHOD: In 110 outpatients without concurrent major axis I conditions, axis II diagnoses were assessed in semistructured format and all DSM-III-R personality disorder criteria were rated. Multiple diagnoses were recorded. RESULTS: Twenty-two patients (20%) met criteria for borderline personality disorder; 18 (82%) had at least one additional personality disorder diagnosis. Using measures of frequencies and intercorrelation coefficients, the authors found that overlap was extensive and not confined to any one of the three designated axis II clusters. Factor analysis revealed 1) a group containing borderline personality disorder with paranoid, histrionic, narcissistic, antisocial, and passive-aggressive personality disorders and 2) another grouping of schizoid, schizotypal, avoidant, obsessive-compulsive, and self-defeating personality disorders. CONCLUSIONS: Borderline personality disorder appears to constitute a broad, heterogeneous category with unclear boundaries that embraces a general personality disorder concept. Both further refinement of the borderline personality disorder construct and investigation into alternative models to the DSM-III-R axis II classification system are suggested.

Adolescent↗
PubMed1989

Abuse of the child and anxiety in the adult.

We report on the early development and family background of 20 patients admitted to an anxiety disorders clinic serving a disadvantaged population. Sixteen of these 20 patients had been abused or neglected. Nineteen had a diagnosis of at least one personality disorder. We discuss the relationship between the patients' backgrounds and their current disorders. It is our thesis that the traumatic background of our patients is the major factor that allows anxiety to be passed across the generations.

Adult↗
PubMed1988

The effects of dietary calcium deprivation on serum calcitriol levels in premenopausal and postmenopausal women.

The effect of the postmenopausal state on serum calcitriol levels was studied in 13 normal premenopausal women and 10 normal postmenopausal women under basal conditions and during seven days of dietary calcium deprivation. Calcitriol levels and the free calcitriol index were lower in the postmenopausal women, and this difference persisted during calcium deprivation. One of the major actions of calcitriol is to increase gut calcium absorption. Relative calcitriol deficiency, despite retained renal synthetic reserve, would in part explain the increased dietary calcium requirement to maintain calcium balance in postmenopausal women.

Adult↗
PubMed1987

Culture-bound syndromes and international disease classifications.

An important endeavor in the world psychiatric community is the development of an international classification of psychiatric disorders that will be more culture-free than either the current DSM-III or ICD-9. This classification should be clinically useful and relevant to psychiatric experience in all countries of the world. A major problem in this endeavor is the existence of the so-called culture-bound syndromes syndromes (CBS's) which reflect cultural influences on disease patterns and render them difficult to place in disease classifications which have their origins in Western cultures. Literally dozens of disorders have been labelled CBS's around the world, and considerable looseness has developed in the use of the CBS rubric. Recently it has been proposed that all illnesses (both physical and psychiatric) are in fact culture bound. In reaction to this drift towards meaninglessness, a new definition for CBS's is proposed - a collection of signs and symptoms (excluding notions of cause) which is restricted to a limited number of cultures primarily by reason of certain of their psychosocial features. In this definition, notions of etiology and illness labels are excluded because these are highly variable and change over time. On the other hand, collections of signs and symptoms (i.e., syndromes), insofar as they are reasonably complete descriptions of nature, remain constant over time and are verifiable by all investigators. Using two CBS's from the Pacific basin area - taijin-kyofu-sho and latah - as examples, the following conclusions are drawn: CBS status should not be assigned on the basis of differential distribution of illnesses because of accidents of geography or on the basis of local labels or notions of cause; epidemiological features of diseases such as global prevalence or age/sex differentials of those affected should not be used as basis of CBS status; the meaning of illness, both for individuals and for cultures, is an important area of study in its own right but such meanings should not be confused with syndrome descriptions or used as criteria for an international disease classification; a truly international classification of diseases is close to realization through relatively minor alterations in the Axis I designations and descriptions of DSM-III. Few entirely new categories would be required.

Adult↗
PubMed1987

Spontaneous rupture of the tibialis anterior tendon. A case report.

Spontaneous rupture of the tibialis anterior tendon occurred in a 65-year-old man with diabetes mellitus. Treatment with sliding tendon lengthening of the proximal portion of the tibialis anterior tendon was successful. This unusual injury occurs in diabetics older than 45 years of age, following minor trauma. The condition can be misdiagnosed as peroneal nerve deficit. Tibialis anterior tendon deficit should be included in the differential diagnosis of patients with isolated weakness of foot dorsiflexion.

Aged↗
PubMed1986

Report: conference on key issues in post-graduate psychiatric education in Canada.

At a national conference in 1985, the Royal College guidelines for post-graduate training in psychiatry in Canada were reviewed. The topics considered included geriatrics, consultation-liaison, chronic care, out-patient, and psychotherapy training, as well as pre-licensure requirements and examinations. The recommendations will be used by the Royal College in reformulating its requirements for psychiatric residency programs.

Canada↗
PubMed1985

Milieu complications of the psychiatric inpatient treatment of the AIDS patient.

The authors anticipate that an increasing number of AIDS victims will be admitted to psychiatric inpatient units. The turmoil caused by the first AIDS patient admitted to the authors' psychiatric unit is described. The authors then discuss staff difficulties from the perspective of the forces unique to this inpatient unit and from the perspective of the group defenses that such a patient mobilizes in any setting. Recommendations are made for a flexible yet authoritarian leadership style when coordinating care for a patient who provokes so much staff anxiety.

Acquired Immunodeficiency Syndrome↗
PubMed1985

The concept of culture-bound syndromes: anorexia nervosa and brain-fag.

The concept culture-bound syndrome' (CBS) is elusive. In this paper an attempt has been made to tie the concept down more firmly by proposing a strict definition, examining the appropriateness of this definition in determining the CBS status of two new syndromes (anorexia nervosa and brain-fag) and analysing the usefulness or not of the basic CBS concept. A CBS is defined as a collection of signs and symptoms of disease (not including notions of cause as recently proposed in the anthropological literature) which is restricted to a limited number of cultures by reason of certain of their psychosocial features. Anorexia nervosa appears to fit the definition but further empirical evidence is required to assure that the illness is restricted to Western cultures or cultures strongly influenced by them. The question of the CBS status of brain-fag demonstrates the need to clearly differentiate such disease features as symptom clusters, labels for those clusters, and notions of etiology. Failure to keep such features distinct has led to considerable controversy, but if the proposed definition is strictly adhered to, brain-fag does qualify for the CBS designation. As regards the usefulness of the CBS concept, it is proposed that the question hinges upon whether CBS's signal a difference that makes a difference. It is demonstrated that the CBS concept is useful for medical anthropologists or transcultural psychiatrists who are concerned about relationships between symptom patterns and cultural processes. It is also useful to epidemiologists who, for example, may be interested in estimating the prevalence of depression; it is important to know that they must count some cases of CBS's along with cases of depression with a more typically Western symptomatology. The concept may be redundant for psychopharmacologists who find that they successfully treat many different culture bound syndromes with the same drugs.

Adolescent↗
PubMed1983

Separated and divorced women compared with married controls. Selected life satisfaction, stress and health indices from a community survey.

A stratified sample of 31 French-Canadian and 33 English-Canadian separated or divorced (S/D) mothers and matched married controls were identified by telephone in four high-income census tracts of Montreal. The 128 women were home-interviewed by questionnaire which included extensive sections on health, stress and life satisfaction. It was predicted that modern S/D women with children would be better off as regards satisfaction, stress and health than pre-women's liberation era women, and that they would be as well or better off than the married controls. These hypotheses were supported only in part. The S/D were significantly worse off than the married in four areas (general life satisfaction, sexual satisfaction, self-esteem and use of professional therapists) and on almost all other health-stress measures, there were trends favouring the married. There were no significant differences or no trends favouring the S/D. Nonetheless, the S/D did appear to be considerably better off when compared with the picture of the S/D in the earlier literature. The greater frequency of depressions and greater use of therapists by the English-Canadian women was thought to reflect their weaker network of supportive relatives as well as the impact of recent political changes in Quebec.

Anxiety, Separation↗
PubMed1982

Life stress, denial and outcome in ischemic heart disease patients.

Goldberg's 20-item General Health Questionnaire was administered to 320 male ischemic heart disease patients prior to discharge from hospital. The relationship between GHQ scores and rehospitalization/death rates for the subsequent year was examined. Surprisingly, a curvilinear relationship emerged with both low and high scorers having better outcomes than patients scoring in the middle ranges. This relationship held regardless of physical risk factors reflecting severity of disease, and demographic factors failed to explain the curve. It was suggested that denial and compliance accounted for the good outcomes of the low and high scorers respectively, whereas the medium scoring patients were neither adequate deniers nor sufficiently enthusiastic about entering the sick role.

Adult↗