PubMed Health⌕ Search

Biomedical subjects

S R Clark

Publications and source records attributed to S R Clark.

At least 19 recordsLinked to original sources
PubMed1994

Assessing depression in fibromyalgia patients.

PURPOSE: This study investigated the relationships among four methods of detecting depression in patients with fibromyalgia. METHODS: Data were obtained from 100 women (mean age 43 years) who had been diagnosed with fibromyalgia. Instruments included a computerized Diagnostic Interview Schedule (C-DIS), Beck Depression Inventory (BDI), an adjusted "disease-free" BDI (BDI-A), and Minnesota Multiphasic Personality Inventory depression subscale (MMPI-D). Chance-corrected concordance, sensitivity, specificity, and accuracy among the four methods were calculated. RESULTS: The C-DIS detected 22% and BDI-A 29% with current major depression. The BDI and MMPI-D yielded higher estimates of 55% of the 44%, respectively. Agreement on the diagnosis among the four methods was significantly greater than chance. When compared with the C-DIS, the BDI was the most sensitive instrument and the BDI-A most specific.

Adult↗
PubMed1992

Low levels of somatomedin C in patients with the fibromyalgia syndrome. A possible link between sleep and muscle pain.

OBJECTIVE: Fibromyalgia is a common syndrome of musculoskeletal pain and fatigue. Lacking distinctive tissue or laboratory correlations, it has often been considered a form of "psychogenic rheumatism." In the present study, the notion that the stage-4 sleep anomaly typically seen in the fibromyalgia syndrome may disrupt growth hormone secretion was tested. Because growth hormone has a very short half-life, serum levels of somatomedin C were measured; somatomedin C is the major mediator of growth hormone's anabolic actions and is a prerequisite for normal muscle homeostasis. METHODS: Serum levels of somatomedin C were measured in 70 female fibromyalgia patients and 55 healthy controls, using a peptide-specific radioimmunoassay. RESULTS: Significantly lower levels of somatomedin C were observed in the fibromyalgia patients compared with controls (mean +/- SD 124.7 +/- 47 ng/ml versus 175.2 +/- 60 ng/ml; P = 0.000001). These results could not be explained by concomitant therapy or by weight, and in a subset of 21 patients in whom this was investigated, there was no correlation with various indices of disease activity. CONCLUSION: These findings indicate that there is a distinctive disruption of the growth hormone-somatomedin C neuroendocrine axis in a majority of fibromyalgia patients. It is hypothesized that this abnormality may explain the link between disturbed sleep and predisposition to muscle pain.

Adult↗
PubMed1992

A comparison of pain perceptions in women with fibromyalgia and rheumatoid arthritis: relationship to depression and pain extent.

Two studies were conducted to characterize the pain of fibromyalgia syndrome (FMS); to compare it to rheumatoid arthritis (RA) pain; and to examine the relationships between depression, pain extent, and pain description. Two methods of administering the McGill Pain Questionnaire (MPQ) were used. When the MPQ was administered in the standard manner, FMS pain could not be distinguished from RA pain. When participants were allowed to select as many words from an adapted MPQ as they wished, significant differences in word choice emerged. Depression and pain extent were major predictors of group differences in the evaluation of pain. However, depression scores contributed only 50% of the explanation for the differences in pain extent, with group membership contributing the other 50%. These findings suggest that the character and extent of pain in FMS are at least partially due to peripheral sensory components and not simply centrally controlled pain amplification secondary to depression.

Adult↗
PubMed1992

Perforated ulcers related to smoking "crack" cocaine.

This article describes four patients with perforated gastroduodenal ulcers related to smoking "crack" cocaine. All patients came to the hospital with acute abdominal pain; only one patient had a history of ulcer disease. Only one patient had an elevated white blood cell count, and two patients had depressed white blood cell counts. In three patients, the x ray showed that pneumoperitoneum was present. Upon surgical exploration of the abdomen, all patients were found to have extensive peritoneal contamination. Operative repair consisted of omental patching with or without primary closure of the perforation. A history of cocaine smoking should be sought in patients with unexplained abdominal pain or pneumoperitoneum. In patients with acute abdominal pain and a history of smoking cocaine, a perforated gastroduodenal ulcer may be present, despite normal or low white blood cell counts and the lack of pneumoperitoneum on x-ray examination.

Adult↗
PubMed1991

Symptoms of Raynaud's syndrome in patients with fibromyalgia. A study utilizing the Nielsen test, digital photoplethysmography, and measurements of platelet alpha 2-adrenergic receptors.

Twenty-nine female patients with fibromyalgia were questioned about symptoms of cold intolerance and Raynaud's syndrome; objective documentation of cold-induced vasospasm was obtained by a Nielsen test. Twelve patients (41%) had abnormal Nielsen test results, and 11 patients (38%) had elevated levels of platelet alpha 2-adrenergic receptors. There was a positive correlation between the percentage of change in finger systolic pressure on cooling (Nielsen test) and the number of alpha 2-adrenergic receptors. There was poor correlation between Raynaud's syndrome symptoms and an abnormal Nielsen test result. Digital photoplethysmography showed a normal waveform in 2 of 3 patients. We hypothesize that a subgroup of patients with fibromyalgia syndrome have an up-regulation of alpha 2-adrenergic receptors as a cause of their exaggerated reaction to cold.

Adult↗
PubMed1991

Fibrin glue sealing of pancreatic injuries, resections, and anastomoses.

Fibrin glue made with highly concentrated human fibrinogen and clotting factors was evaluated as a means of preventing pancreatic fistulas in 15 patients operated on for traumatic and nontraumatic conditions. Fibrin glue was applied directly to penetrating pancreatic injuries, pancreatic suture and staple lines in patients treated by partial resection, and pancreaticointestinal anastomoses. Postoperatively, no patient developed pancreatic fistulas, pancreatic abscesses, or pseudocysts. Fibrin glue sealing of pancreatic injuries, resections, and anastomoses may aid in preventing fistulas after pancreatic surgery. Additional potential uses include the sealing of pancreatic biopsy sites and occlusion of the pancreatic duct in pancreatic transplantation.

Anastomosis, Surgical↗
PubMed1991

The fibromyalgia impact questionnaire: development and validation.

An instrument has been developed to assess the current health status of women with the fibromyalgia syndrome. The Fibromyalgia Impact Questionnaire (FIQ) is a brief 10-item, self-administered instrument that measures physical functioning, work status, depression, anxiety, sleep, pain, stiffness, fatigue, and well being. We describe its development and validation. This initial assessment indicates that the FIQ has sufficient evidence of reliability and validity to warrant further testing in both research and clinical situations.

Adult↗
PubMed1991

Spraying of aerosolized fibrin glue in the treatment of nonsuturable hemorrhage.

In the present report, the authors describe the use of aerosolized fibrin glue (FG) to achieve hemostasis in patients with nonsuturable hemorrhage. The multicomponent FG was sprayed on bleeding tissues with a dual chamber spray head that allowed simultaneous application and mixing of fibrinogen and thrombin on the tissue surface. Sterile propellant gas was passed through tubing to the spray head and independently controlled, allowing for drying of the tissue surface immediately before FG application. This technique was found to be effective in achieving hemostasis of parenchymal organs, retroperitoneal surfaces, and skin graft donor sites. Additional potential applications of this technique include the control of hemorrhage from mediastinal and pleural surfaces.

Aerosols↗
PubMed1990

Techniques of splenic preservation using fibrin glue.

Fibrin glue (FG) was used to achieve hemostasis of 16 splenic injuries in 14 patients. The etiologies of injury included five gunshot wounds, two stab wounds, four iatrogenic injuries, and five patients with blunt splenic trauma. The intraoperative blood loss averaged 1.8 +/- 2.4 (SD) liters and patients were transfused 3 +/- 2 units of blood perioperatively. The amount of FG required to achieve splenic hemostasis averaged 11 +/- 8 ml and varied directly with the grade of injury. One patient with a splenic hilar vascular injury (Grade V) underwent splenectomy following failure to achieve complete hemostasis despite the use of 25 ml of FG. All other splenic injuries were successfully managed using less than 25 ml of FG. Postoperative computerized tomographic (CT) scanning, performed in ten patients, was negative for rebleeding or abscess formation. The overall splenic salvage rate was 86%. FG was effective in achieving hemostasis of both superficial and deep splenic injuries. Its use as an adjunct in trauma surgery should result in increased splenic salvage rates compared with that obtained using conventional surgical techniques.

Adult↗
PubMed1989

Aerobic fitness in patients with fibrositis. A controlled study of respiratory gas exchange and 133xenon clearance from exercising muscle.

Aerobic fitness was evaluated in 25 women with fibrositis, by having them exercise to volitional exhaustion on an electronically braked cycle ergometer. Compared with published standards, greater than 80% of the fibrositis patients were not physically fit, as assessed by maximal oxygen uptake. Compared with matched sedentary controls, fibrositis patients accurately perceived their level of exertion in relation to oxygen consumption and attained a similar level of lactic acidosis, as assessed by their respiratory quotient and ventilatory threshold. Exercising muscle blood flow was estimated by 133xenon clearance in a subgroup of 16 fibrositis patients and compared with that in 16 matched sedentary controls; the fibrositis patients exhibited reduced 133xenon clearance. These results indicate a need to include aerobic fitness as a matched variable in future controlled studies of fibrositis and suggest that the "detraining phenomenon" may be of relevance to the etiopathogenesis of the disease.

Adult↗
PubMed1989

Rectal prolapse caused by blunt abdominal trauma.

We describe a case of incarcerated rectal prolapse caused by blunt abdominal trauma. Emergency treatment consisted of manual reduction with the patient under general anesthesia, proctosigmoidoscopy, and peritoneal lavage. Subsequent definitive surgical therapy was then performed after bowel preparation and consisted of anterior resection of the sigmoid colon with posterior (sacral) rectopexy.

Abdominal Injuries↗
PubMed1989

Mass fatality aircraft disaster processing.

On Dec. 12, 1985, a contract transport carrying 248 U.S. Army personnel crashed on takeoff at Gander, Nfld., Canada, killing all the passengers as well as the crew of eight. This was the worst aircraft accident in U.S. military history and, at the time was the fifth worst accident in aviation history. Cooperation between the governments of Canada and the United States allowed for the transport of all human remains to the U.S. Air Force mortuary facility at Dover AFB, DE, where they were processed, identified, and ultimately returned to their families for burial. Under ideal circumstances, any medical examiner's office or mortuary facility would be overwhelmed by a mass disaster of this magnitude. Before the arrival of the first shipment of bodies, a concerted planning effort was undertaken and the facility arranged so that remains would pass in a logical sequence through a series of 10 "work stations." This report details the process and outlines the logistics of the operations.

Accidents, Aviation↗
PubMed1988

A comparison of cyclobenzaprine and placebo in the management of fibrositis. A double-blind controlled study.

The efficacy of cyclobenzaprine (Flexeril), as compared with placebo, was tested in a 12-week, double-blind, controlled trial of 120 patients with fibrositis. Of the patients who received placebo, 52% dropped out due to lack of efficacy of the drug, compared with 16% of patients taking cyclobenzaprine. The dropout rate due to adverse reactions was similar in the 2 groups. Patients taking cyclobenzaprine experienced a significant decrease in the severity of pain and a significant increase in the quality of sleep. There was a trend toward improvement in the symptoms of fatigue, but morning stiffness was not alleviated. These improvements in symptoms were associated with a significant reduction in the total number of tender points and in muscle tightness. Our findings indicate that cyclobenzaprine is a useful adjunct in treating patients with the fibrositis syndrome.

Adult↗
PubMed1988

Electromyographic biofeedback for treatment of tinnitus.

Electromyographic (EMG) feedback procedures were utilized in treating two adult patients with idiopathic subjective tinnitus. The relationship between behavioral severity ratings of tinnitus and EMG activity at the frontalis muscle was investigated using a single-subject, double-reversal experimental design. Biofeedback procedures were effective in modifying EMG activity levels, but changes in EMG levels were not related systematically to behavioral ratings of tinnitus. It was concluded that the physiologic effects of EMG biofeedback procedures may not be the active ingredient in such treatment procedures.

Biofeedback, Psychology↗
PubMed1987

Morphological and metastatic murine melanoma variants: motility, adhesiveness, cell surface and in vivo properties.

The behaviour in vivo of tight and loose variants of murine melanoma cells is further characterized. In vitro clonal morphology is reproduced on a variety of substrates. Results suggest that repeated selection of loose cells can co-select for cells with high metastatic and colonization potentials. Measurement of cell motility shows that 1G3 (loose) cells are more motile than 1G8 (tight) which are restricted to movements within clonal boundaries. Studies of adhesive properties show that loose cells are more easily detached from the substrate with trypsin or EDTA and that both cell lines attach more quickly to monolayers of loose cells than to tight ones. No gross differences are found either in attachment rates to plastic and ECM or in aggregation and disaggregation rates. Analysis of the cell surface has not revealed any differences between 1G8 and 1G3 in the sialylation of terminal galactose and N-acetylgalactosamine residues or in neuraminidase releasable sialic acid. The binding patterns of iodinated lectins to SDS-PAGE separated proteins are similar for both lines except for one 85/90 KD protein which is more abundant in 1G3 than 1G8 cells after neuraminidase treatment. The results show enhanced differences in metastatic potential of tight and loose clones after selective cloning and that there may be important differences in motility and cell-substrate interactions.

Animals↗