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Biomedical subjects

S Stuart

Publications and source records attributed to S Stuart.

At least 19 recordsLinked to original sources
PubMed2002

Capillary supply of the tibialis anterior muscle in young, healthy, and moderately active men and women.

Tibialis anterior muscle biopsies from moderately active men and women (21-30 yr; n = 30) were examined to determine potential gender differences in capillarization. The fiber type proportions [type I (T1) approximately 73%] were unaffected by gender. The men (M) had significantly (P < 0.001) larger fibers than the women (W), with a greater gender effect for type II (T2) fibers (P < 0.001). The M and W had similar capillary densities (CD approximately 390 capillaries/mm2), but the capillaries-to-fiber ratio (C/F) was higher in the M (M = 2.20 +/- 0.35, W = 1.66 +/- 0.32; P < 0.01). Capillary contacts (CC) were higher in T2 than T1 for the M (P < 0.01), but not W, and M had greater CC (P < 0.001). Both fiber area per capillary (FA/C) and fiber perimeter per capillary (FP/C) indicated that T1 fibers had greater capillarization than T2 fibers (P < 0.001). There were no gender differences in T1 FA/C and T2 FA/C or T1 FP/C, but a gender difference existed for T2 FP/C (M = 60.5 +/- 10.9, W = 70.6 +/- 13.4; P < 0.01). The gender difference for C/F could be explained by fiber size; however, the physiological implications of the difference in T2 FP/C remains to be determined. In conclusion, despite gender differences for fiber size, overall, capillarization was similar between the men and women.

Adult↗
PubMed2001

Oncogenic Cushing's syndrome and nephrotic syndrome in the same patient.

The association of the nephrotic syndrome with malignancy is well established. This case report describes a patient who presented with renal cell carcinoma and went on to develop ectopic adrenocorticotropic hormone (ACTH) syndrome as well as the nephrotic syndrome. The patient's presentation was with hypokalemia refractory to conventional medical therapy. Oncogenic Cushing's syndrome and minimal change disease were diagnosed. We discuss the differentiation of Cushing's disease and Cushing's syndrome as well as oncogenic nephrotic syndrome and therapeutic options.

ACTH Syndrome, Ectopic↗
PubMed2000

Efficacy of interpersonal psychotherapy for postpartum depression.

BACKGROUND: Postpartum depression causes women great suffering and has negative consequences for their social relationships and for the development of their infants. Research is needed to evaluate the efficacy of psychotherapy for postpartum depression. METHODS: A total of 120 postpartum women meeting DSM-IV criteria for major depression were recruited from the community and randomly assigned to 12 weeks of interpersonal psychotherapy (IPT) or to a waiting list condition (WLC) control group. Subjects completed interview and self-report assessments of depressive symptoms and social adjustment every 4 weeks. RESULTS: Ninety-nine of the 120 patients completed the protocol. Hamilton Rating Scale for Depression (HRSD) scores of women receiving IPT declined from 19.4 to 8.3, a significantly greater decrease than occurred in the WLC group (19.8 to 16.8). The Beck Depression Inventory (BDI) scores of women who received IPT declined from 23.6 to 10.6 over 12 weeks, a significantly greater decrease than occurred in the WLC group (23.0 to 19.2). A significantly greater proportion of women who received IPT recovered from their depressive episode based on HRSD scores of 6 or lower (37. 5%) and BDI scores of 9 or lower (43.8%) compared with women in the WLC group (13.7% and 13.7%, respectively). Women receiving IPT also had significant improvement on the Postpartum Adjustment Questionnaire and the Social Adjustment Scale-Self-Report relative to women in the WLC group. CONCLUSIONS: These findings suggest that IPT is an efficacious treatment for postpartum depression. Interpersonal psychotherapy reduced depressive symptoms and improved social adjustment, and represents an alternative to pharmacotherapy, particularly for women who are breastfeeding.

Depression, Postpartum↗
PubMed2000

Use of the intubating laryngeal mask airway by medical and nonmedical personnel.

The intubating laryngeal mask airway (ILMA) is a newly available device designed to allow for blind endotracheal intubation and treatment of patients with difficult airways. We studied the intubation success rates and speed with initial use of this device on an intubation manikin to determine whether this device might be easily used by trained and untrained personnel. Rapid and successful intubation with a device requiring limited or no training could have widespread implications for both health care providers and laypersons. The study consisted of 2 parts. In part 1, health care providers with intubation experience, health care providers without prior intubation experience, and nonmedical personnel were instructed to enter a room and intubate a manikin using the ILMA. A single page set of schematic directions was provided within the ILMA setup. The main outcomes were the intubation success rate and the time required for successful ventilation and intubation. In part 2, participants were retested after a standardized <60 second device demonstration. The 111 participants in the study included 44 emergency physicians (40%), 21 anesthesiologists (19%), and 46 other medical or nonmedical personnel (41%). On first attempted use of the device, and with no prior training, 59% of all participants successfully intubated the manikin. Attending and resident physicians had an 83% initial success rate. The median time to ventilation was 47 seconds, and the median time from ventilation until intubation was 29 seconds. Following the <60 second demonstration, 108 of 111 (97%) participants achieved success, with the median time to ventilation 18 seconds, and the median time from ventilation until intubation 17 seconds. All attending and resident physicians succeeded in intubation following the demonstration. Success rates on first attempt correlated with level of training, prior intubation experience, and prior LMA use (all P < .001). After a <60 second demonstration, medical and nonmedical personnel with and without prior intubation training can successfully use the ILMA to rapidly establish an airway in a manikin model. The ILMA should be further studied to determine if it may permit endotracheal intubation by first responders, paramedical personnel, and other medical staff with limited or no laryngoscopy skills.

Clinical Competence↗
PubMed2000

An ovine model of chronic stable heart failure.

BACKGROUND: Chronic stable large animal models of heart failure are difficult to establish. We report an ovine model of chronic stable heart failure achieved by a technique of repetitive myocardial infarctions (one of the most common causes of cardiac failure) with catheter-based techniques. METHODS AND RESULTS: Ejection fraction (EF) was assessed by echocardiography. A perfusion catheter was positioned in either the left anterior descending or circumflex artery by using standard angioplasty techniques. Myocardial infarction was induced by a Gelfoam embolism via this catheter and was confirmed by electrocardiographic (ECG) changes and new segmental abnormalities. The procedure was repeated at 2 weekly intervals until the EF was less than 40%. Target EF was achieved in 15 animals, with a mean of 3.4 embolizations (range 2 to 8). Baseline EF was 68%, with a mean final EF of 33%. This resulted in a 54% reduction in EF (range 44% to 68%) from baseline values. Two animals developed late symptomatic heart failure and died, whereas EF was stable at 3-month follow-up echocardiography in the remaining animals with no significant spontaneous improvement. CONCLUSION: Chronic stable heart failure can be established in sheep with catheter-based skills and a microembolization technique that causes repetitive myocardial infarctions.

Animals↗
PubMed1999

A novel and highly divergent homolog of human eosinophil granule major basic protein.

Eosinophils are important effector cells in defense against helminth infection and in allergic diseases. To identify novel eosinophil proteins, large scale sequencing of a cDNA library prepared from interleukin-5-stimulated umbilical cord precursor cells was performed, and the major genes expressed by maturing eosinophils were determined. This resulted in the identification of a cDNA with 64% identity to human prepro-major basic protein (hprepro-MBP). This cDNA was designated hprepro-MBP homolog (hprepro-MBPH). Interestingly, the calculated pI values for hMBPH and hMBP differed by >100-fold, with pI values of 8.7 and 11.4, respectively. Given this pronounced basicity difference, the homolog transcript's abundance (1.1%), and MBP's critical role in eosinophil biological activity, we further characterized the homolog. Reverse transcription-polymerase chain reaction detected transcription of hprepro-MBPH in bone marrow only, and this result was confirmed by analysis of a large cDNA data base (electronic Northern). hMBPH was isolated from human eosinophil granule lysates, and its identity was verified by amino acid sequencing and by mass spectrometry. Analyses of the biological activities showed that hMBPH had effects similar to hMBP in cell killing and neutrophil (superoxide anion production and interleukin-8 release) and basophil (histamine and leukotriene C4 release) stimulation assays, but usually with reduced potency. Overall, this novel homolog's unique physical properties indicated that the high net positive charge of hMBP is important but not essential for biological activity.

Amino Acid Sequence↗
PubMed1999

Evidence of functional zinc deficiency in Parkinson's disease.

One of the primary areas of investigation in the pathophysiology of Parkinson's disease (PD) is the loss of the dopamine-producing cells in the melanized neurons of the substantia nigra, believed to be caused by oxidative stress resulting from excessive free radical activity. The cuprozinc enzyme, superoxide dismutase (SODCu2Zn2), catalyzes the dismutation of superoxide anions to hydrogen peroxide plus oxygen, and is normally found in high concentrations in the substantia nigra where it protects neurons by scavenging free radicals. Zinc supplementation has been shown to significantly increase SODCu2Zn2 in vitro. A novel oral zinc tally test (ZTT) used in the assessment of zinc status was administered to 100 PD patients and 25 controls. Patients with PD showed a significantly decreased zinc status as compared to controls (p < 0.001). Significance was also established for 3 self-reported health-related variables thought to be related to zinc status: vision problems, olfactory loss, and taste loss (p < 0.05). Relative risks for patients with PD for these variables were 1.51, 1.56, and 1.33, respectively. Zinc status as measured by the ZTT is negatively correlated with PD status. PD status is positively correlated with self-reported vision problems, and olfactory and taste loss. Further study of the role of zinc in the development and treatment of PD is warranted.

Aged↗
PubMed1999

Physical "phantasies" and family functions: overcoming the mind/body dualism in somatization.

In this article, we examine some of the ways in which family therapists have conceptualized the experience of illness of unexplained physical origin. We argue that opinions about the etiology of somatic symptoms should not be the primary focus of therapeutic work with people who share the prototypical characteristics of what has been defined as "somatization disorder." We suggest that current research in neurobiology can expand the linguistic resources of clinicians and help them avoid perpetuating unhelpful dichotomies between the mind and the body.

Aged↗
PubMed1998

Postpartum anxiety and depression: onset and comorbidity in a community sample.

A community-based sample of 107 women completed the Beck Anxiety Inventory, Beck Depression Inventory, State-Trait Anxiety Inventory, and Edinburgh Postnatal Depression Scale at 14 weeks postpartum and at 30 weeks postpartum. The point prevalence of anxiety was 8.7% at 14 weeks and 16.8% at 30 weeks postpartum. The point prevalence of depression was 23.3% at 14 weeks and 18.7% at 30 weeks postpartum. The incidence of anxiety during this time period was 10.28%, and the incidence of depression was 7.48%, indicating high incidences of both postpartum anxiety and depression later in the postpartum period. The Edinburgh Postnatal Depression Scale was found to have a strong correlation with the State Anxiety Scale of the State-Trait Anxiety Inventory (r = .73 at 14 weeks, r = .82 at 30 weeks), suggesting that the Edinburgh Postnatal Depression Scale may be a good screening instrument for anxiety as well as depression.

Adult↗
PubMed1998

Human eosinophil granule major basic protein and its novel homolog.

Human MBP is associated with an array of in vitro cytotoxic and cytostimulatory activities, mediated in part by its strong basicity. It is most prominently found in the eosinophil, but is also present in placental X cells and placental-site giant cells during pregnancy. Pathologically, its pattern of tissue deposition and its ability to induce characteristic pathophysiologic changes, such as bronchial hyperreactivity and vasopermeability, strongly suggest a role for MBP in allergic and eosinophilic diseases. The role of MBP in protection from helminthic disease is also evident. Here, we present information on a novel homolog of eosinophil granule MBP with biologic activities similar to that of MBP. However, results from experiments on eosinophil granules suggest that the quantity of the homolog present in the eosinophil granule is significantly less than that of MBP itself. Further, preliminary experiments indicate that the two proteins are not synergistic in terms of their cytotoxic and cytostimulatory biologic activities. Future experiments must determine whether the MBP homolog is deposited at sites of tissue damage and can be detected in biologic fluids at concentrations required for biologic activity.

Animals↗
PubMed1998

The cooccurrence of DSM-III-R personality disorders.

The distinction between personality disorder diagnoses is often unclear because of the frequent cooccurrence of one or more of the diagnoses. To date, studies using sample sizes large enough to evaluate the rates of cooccurrence in the less prevalent personality disorders have not been conducted. The Structured Interview for Diagnosis of Personality-Revised, a semistructured instrument designed to yield reliable personality disorder diagnoses, was used to evaluate 1116 subjects for the presence of DSM-III-R personality disorder diagnoses. Cooccurrence rates and odds ratios were calculated for each pair of diagnoses. There was a high degree of cooccurrence between the cluster A personality disorders, between the cluster C personality disorders, and between narcissistic, borderline, and histrionic disorders. In addition, there was also a high frequency of avoidant personality disorders within the cluster A personality disorder diagnoses. Possible explanations for the high degree of cooccurrence and the potential implications for the DSM-IV personality disorder diagnoses are discussed.

Adult↗
PubMed1998

Mental disorders associated with childbearing: report of the Biennial Meeting of the Marcé Society.

This article presents highlights from an international conference focused on mental disorders in association with childbearing. Findings from related research on diagnosis, classification, epidemiology, child outcome, prevention, and treatment are summarized. A need is seen for more research on prevention of childbearing disorders, on the effectiveness of interventions in reducing maternal and child morbidity, on the development of new psychosocial interventions, and on the assessment of the efficacy and safety of somatic treatments in pregnant and lactating women. Mental disorders associated with childbearing are a significant public health problem. Antenatal and postpartum mental disorders are not only associated with morbidity and mortality in affected women, but also with increased morbidity in their children. Despite their prevalence, they are often not recognized by primary care providers, and are hence undertreated. Moreover, physicians are reluctant to treat women with medication during pregnancy and the postpartum for fear of adverse effects on the fetus and the breastfeeding newborn. Little information is available to inform clinicians about the relative risks and benefits of pharmacological treatments. Psychosocial interventions for mental disorders associated with childbearing have not been widely investigated, leaving few options for treatment. The Biennial Meeting of the Marcé Society was convened in Iowa City, Iowa, from June 24 to June 28, 1998. The meeting was jointly sponsored by the University of Iowa Department of Psychology, the Colleges of Medicine and Nursing, Postpartum Support International, and by the National Institute of Mental Health, Division of Mental Disorders, Behavioral Research, and AIDS. The Marcé Society is a multi-disciplinary organization that aims to improve the understanding, prevention, and treatment of mental illnesses related to childbearing. International and U.S. participants met to present new research on the epidemiology, identification, and treatments for childbearing women with mental disorders. Highlights of the meeting are summarized below.

Depression, Postpartum↗
PubMed1997

Cognitive therapy with inpatients.

Psychotherapeutic interventions often play a major role in the treatment of patients who are hospitalized for depression. Much of the "therapeutic milieu" of the inpatient unit includes patient participation in group psychotherapy and in one-on-one psychotherapy with staff members. These interventions are designed not only to be primary treatments for depression, but are also used to enhance patients' compliance with pharmacotherapy. Cognitive therapy (CT) has been adapted for use with inpatients and has been used as an organizing theory for the hospital milieu in several inpatient units. Research on inpatient CT suggests that it is a beneficial treatment that enhances continuity of care after discharge from the hospital. This paper describes the general principles of inpatient CT, and discusses the various types of inpatient cognitive therapy units (CTUs) that have been developed. The benefits of such programs are described, and research regarding the effectiveness of inpatient CT is discussed.

Antidepressive Agents↗
PubMed1996

Treatment of depression following myocardial infarction with interpersonal psychotherapy.

A case history involving the treatment of a depressed patient who had suffered a recent myocardial infarction is described. The patient was successfully treated using a short, time-limited course of interpersonal psychotherapy for depression. The implications of postinfarction depression are discussed, as are the implications of the successful nonpharmacologic treatment.

Adaptation, Psychological↗