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Biomedical subjects

S Moss

Publications and source records attributed to S Moss.

At least 19 recordsLinked to original sources
PubMed1997

A single serine residue confers tetrodotoxin insensitivity on the rat sensory-neuron-specific sodium channel SNS.

Sensory neurons express a sodium channel (SNS) that is highly resistant to block by tetrodotoxin (IC50 = 60 microM). SNS is 65% homologous to the cardiac sodium channel, in which a single hydrophilic residue in the SS2 segment is critical for tetrodotoxin resistance. By site-directed mutagenesis, we have substituted phenylalanine for serine at the equivalent position in SNS: this mutated (S356F) SNS channel is functionally similar to wild-type SNS when expressed in Xenopus oocytes, but is potently blocked by tetrodotoxin and saxitoxin with IC50s of 2.8 nM and 8.2 nM, respectively. These data provide clues to the rational design of selective blockers of SNS with potential as analgesic drugs.

Animals↗
PubMed1997

Haloperidol, lorazepam, or both for psychotic agitation? A multicenter, prospective, double-blind, emergency department study.

Rapid tranquilization is a routinely practiced method of calming agitated psychotic patients by use of neuroleptics, benzodiazepines, or both in combination. Although several studies have examined the efficacy of the three approaches, none have compared these treatments in a prospective, randomized, double-blind, multicenter trial. Ninety-eight psychotic, agitated, and aggressive patients (73 men and 25 women) were prospectively enrolled during an 18-month period in emergency departments in five university or general hospitals. Patients were randomly assigned to receive intramuscular injections of lorazepam (2 mg), haloperidol (5 mg), or both in combination. Patients in each treatment group received 1 to 6 injections of the same study drug within 12 hours, based on clinical need. They were evaluated hourly after the first injection until at least 12 hours after the last. Efficacy was assessed on the Agitated Behavior Scale (ABS), a modified Brief Psychiatric Rating Scale (MBPRS), Clinical Global impressions (CGI) scale, and an Alertness Scale. Effective symptom reduction was achieved in each treatment group with significant (P < .01) mean decreases from baseline at every hourly ABS evaluation. Significant (P < .05) mean differences on the ABS (hour 1) and MBPRS (hours 2 and 3) suggest that tranquilization was most rapid in patients receiving the combination treatment. Study event incidence (side effects) did not differ significantly between treatment groups, although patients receiving haloperidol alone tended to have more extrapyramidal system symptoms. The superior results produced by the combination treatment support the use of lorazepam plus haloperidol as the treatment of choice for acute psychotic agitation.

Adolescent↗
PubMed1997

Dementia in older people with intellectual disability: symptoms of physical and mental illness, and levels of adaptive behaviour.

Detailed data on health and functional ability of 101 people with intellectual disability over 50 years of age are presented. Using a combination of informant interviewing, observation and measurement of cognitive change over a 3-year period, 12 of these individuals were identified as suffering from dementia. Their data are compared to those of the non-dementia sufferers. The people suffering from dementia had a greater number of chronic physical health problems and chronic disability resulting from physical health problems. Their capacity for self-directed activity was lower. The subjects had a reduced capacity to enjoy things, and were more irritable and more prone to violence. However, the outlook is somewhat different from a strategic perspective. The population of people with intellectual disability shows considerable epidemiological changes across the lifespan because of the effects of differential survival. The interaction of these factors tends to mask the impact of dementia-related skill loss in this population.

Adaptation, Psychological↗
PubMed1997

Levels and role of cytokines in bovine leukemia virus (BLV) infection.

Bovine leukemia virus belongs to a small subfamily of exogenous retroviruses that includes the human retroviruses HTLV-1, HTLV-II and the simian virus, STLV-1. Like other retroviruses, infection with BLV results in deregulation of the host immune system at both humoral and cellular levels. An approach which might help in the elucidation of some immune impairment phenomena is the investigation of the role that cytokines play in the pathogenesis and immune response of BLV infected animals. Here we describe our findings on IL-6 and TNF. We have found that the levels of IL-6 in the sera of BLV infected cows which show persistent lymphocytosis (BLV+ PL+) were significantly higher than those of BLV infected with no lymphocytosis (BLV+ PL-) or BLV negative cows (BLV-). The same results were obtained by measuring the spontaneous production of IL-6 in peripheral blood mononuclear cells (PBMC). Furthermore, PBMC derived from BLV+PL+ cows secrete higher levels of IL-6 and TNF alpha than those derived from BLV+PL- and BLV- ones following in vitro exposure to the BLV gp51 antigen, bacterial endotoxins (LPS) and ConA. Similar results were obtained when supernatants from stimulated adherent (monocytes, macrophages) and non-adherent cells (B and T lymphocytes) were tested. When exogenous IL-6 and TNF alpha were added to BLV infected cells in vitro, the expression of viral antigens was strongly suppressed. Thus, the possibility exists that the elevated production of IL-6 and even more than that of TNF alpha play a role as contributing factors to the latency of the clinical expression in BLV infection.

Animals↗
PubMed1996

The association between tumour necrosis factor-alpha, interleukin-6 and microbiological findings in the synovial fluid of aborted and neonatal calves.

Tumour necrosis factor-alpha (TNF alpha) and interleukin-6 (IL-6) were detected in the intra-carpal synovial fluids collected from aborted and recently dead young calves. Five out of seven TNF-alpha positive joint fluids were bacteriologically positive and two were sterile. Only one out of 20 TNF-alpha negative joint aspirates was infected (P = 0.0014). Sixteen of the synovial fluid samples were examined for the presence of IL-6. In 12 samples IL-6 was detected, six of which were bacteriologically contaminated. Four out of the 16 samples were IL-6 negative. These findings indicated the possible association between TNF-alpha and the intra-articular inflammatory processes in young calves, which in the present study were either found in combination with or without IL-6.

Abortion, Veterinary↗
PubMed1996

Counselling for an HIV test.

Doctors may feel uncomfortable with the prospect of discussing a human immunodeficiency virus (HIV) antibody test with their patient. This is in part because they do not enquire about high risk activity as part of a medical history. With increasing medical and public awareness of both the clinical manifestations and social implications of HIV infection, it is important that all doctors receive guidance on how to deal with these issues. Counselling is not the usual term used to describe obtaining informed consent. In the general medical setting, tests for hepatitis B and syphilis are routinely carried out without specific consent even though results of these tests may have profound effects on both the patient and their sexual partners. However society and ethical considerations have made HIV testing different. HIV testing will inevitably become more widespread, and thus become a more routine part of patient investigation and management.

Confidentiality↗
PubMed1996

Validity of the schizophrenia diagnosis of the psychiatric assessment schedule for adults with developmental disability (PAS-ADD).

BACKGROUND: First rank symptoms are central to the diagnosis of schizophrenia, but their complexity makes it difficult to validly detect them in people with learning disability. This report investigates ability of PAS-ADD to detect schizophrenia, validated against expert clinical opinion. METHOD: The sample consisted of 98 patients with learning disabilities and a key informant for each sample member. Clinical opinions of the referring psychiatrists were sought using a symptom checklist. Reportage of remission, and the number of core schizophrenia symptoms identified, were used to estimate level of symptom activity at time of interview. RESULTS: The proportion of schizophrenia cases detected by PAS-ADD increases with the number of active core symptoms identified by the referrer. Where two or more core symptoms were indicated, PAS-ADD detected 71% cases. The most frequently fulfilled criterion was third-person auditory hallucinations. Six schizophrenia diagnoses disagreed with the clinician, four of which were referred as being hypomania. Overall symptom frequency detected by PAS-ADD was positively correlated with IQ. CONCLUSIONS: Results suggest there may be scope for modifying the ICD-10 diagnostic algorithm for use with learning disability, particularly in relation to the delusions and negative symptoms criteria.

Adolescent↗
PubMed1996

The health needs of adults with learning disabilities and the Health of the Nation strategy.

Studies of mortality and morbidity relating to people with learning disabilities are reviewed within the context of the five Health of the Nation Key Areas. It is concluded that the Key Areas have become increasingly relevant as a result of increased longevity and changing lifestyles. For example, both cardiovascular disease and cancers appear to be more common than before, and a high proportion of people with learning disabilities carry one or more risk factors associated with morbidity and mortality from these causes. However, there are a range of other health needs in this population which should not be overlooked by an undue focus on the five Key Areas, and these are also discussed. The efficacy of programmes seeking to limit the risk factors of obesity and poor fitness are reviewed. There is a need for further evaluation of such programmes, particularly in community settings. The literature relating to primary health care services suggests that professional training and access to services need to be improved for this group, in order to address health needs both within and without the Health of the Nation priorities.

Aging↗
PubMed1996

Respondent and informant accounts of psychiatric symptoms in a sample of patients with learning disability.

This paper investigates differences in the nature and frequency of psychiatric symptoms reported by patients with learning disability and key informants. The study involved psychiatric assessment of 100 patients with learning disabilities and key informants using the Psychiatric Assessment Schedule for Adults with a Developmental Disability (PAS-ADD), a semi-structured psychiatric interview developed specifically for people who have a learning disability. There was considerable disagreement between respondent and informant interviews: only 40.7% of cases were detected by both interviews. Respondents were more likely to report on autonomic symptoms and certain psychotic phenomena. Other anxiety and depression symptoms were more frequently reported by informants. The results indicate that it is crucial for sensitive case detection to complete both interviews where possible. If the respondent cannot be interviewed, panic disorder or phobias may be particularly difficult to detect.

Adolescent↗
PubMed1995

A comparison of the study populations in the Diabetes Control and Complications Trial and the Wisconsin Epidemiologic Study of Diabetic Retinopathy.

BACKGROUND: We compared the Diabetes Control and Complications Trial (DCCT) cohort with patients who had insulin-dependent diabetes mellitus (IDDM) in the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) to determine whether the DCCT cohort was similar to the patients with IDDM in the general population and whether the DCCT results are generalizable to a nonresearch population. METHODS: Demographic and clinical characteristics were compared between the DCCT study cohort and the WESDR cohort of patients with IDDM with age at onset of diabetes at younger than 30 years and followed up from 1980 to 1986. The DCCT eligibility criteria were applied to the WESDR cohort, and patients were identified who fulfilled the major criteria of the DCCT primary prevention and secondary intervention cohorts. Conventionally treated subjects in the DCCT primary prevention and secondary intervention cohorts were compared with their respective WESDR groups with regard to clinical characteristics, progression of retinopathy, and development of gross proteinuria. RESULTS: Comparison of the DCCT primary prevention and secondary intervention cohorts at baseline with the respective WESDR groups revealed an older age and an older age at diagnosis, a lower hemoglobin A1c (HbA1c) level, and more frequent injections and monitoring in the DCCT cohorts, but there were few other substantive differences. The progression of retinopathy and the association with baseline HbA1c level were similar for the conventionally treated DCCT and WESDR cohorts, except for a lower rate of progression in the DCCT secondary intervention cohort compared with that of the WESDR cohort, perhaps because of the lower HbA1c level. CONCLUSIONS: At baseline, patients in the DCCT cohort were generally similar to patients with IDDM in the population-based WESDR cohort, except for differences in the levels of HbA1c that diminished over time as the HbA1c levels in the WESDR cohort decreased. The demographic similarities between the DCCT and WESDR cohorts, the similar rates of progression of retinopathy in conventionally treated patients, and the similar associations between the HbA1c levels and progression of retinopathy in the DCCT and WESDR cohorts support the validity of generalizing the DCCT results to patients with IDDM in the general population.

Adolescent↗
PubMed1995

The applicability of the Kaufman Assessment Battery for Children (K-ABC) with older adults (50+ years) with moderate, severe and profound intellectual impairment.

To define the intellectual characteristics of a population of older people (50+ years) with severe intellectual impairment who were the focus of a wider demographic study, participants were assessed on the Kaufman Assessment Battery for Children (K-ABC). Test material was modified to make it age-appropriate and culturally suitable. Of the 122 people in the population [chronological age (CA) = 63.5 years; range 50-90 years], 61 were successfully tested on the K-ABC (CA = 60.9 years; range 51-81 years). Factor analysis closely replicated the factorial structure demonstrated for younger children. Separate Sequential and Simultaneous Mental Processing factors were identified, with subtests from the Achievement Scale loading on these factors and not constituting a separate factor. Application of hierarchical cluster analysis confirmed the factor structures. Inferences in relation to cognitive development from a Piagetian perspective are drawn, and the utility of information on mental processing for educational intervention with older persons with severe intellectual impairment is noted.

Achievement↗
PubMed1995

Dysphagia in an HIV-positive man.

An HIV-positive man whose dysphagia was due to non-Hodgkin's lymphoma. The differential diagnosis of this symptom in the context of HIV infection is summarised in box 3.

Adult↗