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S Wiggins

Publications and source records attributed to S Wiggins.

31 records · Page 2Linked to original sources
PubMed1992

Predictive testing for Huntington disease in Canada: the experience of those receiving an increased risk.

Predictive testing for Huntington disease (HD) has been offered in some parts of Canada for nearly 5 years. Candidates who were expected to have a significant likelihood for psychological problems were those who received an increased risk for developing HD. Sixty-six persons have now received such an increased risk result. In this manuscript we describe in detail the experience of 4 such persons who were chosen to illustrate recurrent and common themes which have emerged during counselling, and to highlight the strategies of coping with this information. Themes include difficulties communicating about HD, defensive postures adopted in preparing for testing, ramifications of testing for the whole family, and the impact of being at high risk on the candidates' perception of the future. One candidate has had testing postponed due to active suicidal risk. Only a few candidates have expressed regret at taking the test and no person receiving an increased risk result has made a suicide attempt or required hospitalization. After receiving results, symptoms of depression and anxiety are most common in the first 2 months, but over 1 year, candidates, in general, have less depression but live with a heightened perception of the present. The potential risk of premature diagnosis of HD in an individual with an increased risk results is highlighted. The significant ramifications of testing for the relative are shown. The importance of communication as a means of establishing a social support network, as well as the hazards of open communication, are discussed. Longitudinal evaluation will provide much needed data on the long-term effects of living at increased risk for HD.

Adult↗
PubMed1992

Predictive testing for Huntington disease in Canada: adverse effects and unexpected results in those receiving a decreased risk.

By January 1, 1991, a total of 388 persons had enrolled in the Canadian collaborative study of predictive testing for Huntington disease (HD). Of these participants, 105 persons have been given a decreased risk result. Contrary to expectations, approximately 10% of persons with a decreased risk result have had psychological difficulties coping with their new status. Here, we describe the individual responses of 6 such persons and experimental themes emerging after following these persons for up to 2 years. Individuals who are more likely to suffer an adverse reaction to a decreased risk result include those persons who have made irreversible decisions based on the belief they would develop HD or those who had unrealistic overoptimistic expectations of the positive effects of a decreased risk result. In contrast to those receiving an increased risk result, the most vulnerable time for persons receiving a decreased risk result is between 2 and 12 months after learning the outcome. The need for assessment and counselling of participants in predictive testing programs, even when there is a decreased risk result, is emphasized.

Adult↗
PubMed1992

Effect of aspirin on the contractility of aortic smooth muscle in female spontaneously hypertensive rats.

The effects of acetylsalicylic acid (ASA), on aortic smooth muscle contractility during hypertension were studied in female SHR and WKY rats. The rats were administered two intraperitoneal injections of 10 mg/kg of ASA per week for three weeks. Twenty four hours after the last injection the aortic smooth muscles were evaluated for generation of active tension in response to KCl, phenylephrine, clonidine and norepinephrine. We report that aortic rings from ASA-treated SHR animals were more responsive than rings from non-treated SHR female rats. ASA treatment of SHR animals restored the contractile response to the level shown by non-treated WKY control female rats. The response from aortic rings of ASA-treated SHR to KCl, phenylephrine and clonidine was essentially similar to the response of rings from non-ASA-treated WKY control female rats. We did not observe any decrease in the systolic blood pressure during the ASA treatment in SHR female rats. These results suggest that acetylsalicylic acid modulates aortic smooth muscle contractility either through the metabolites of arachidonic acid or through alpha-adrenoceptors.

Adrenergic alpha-Agonists↗
PubMed1991

A critical appraisal of the cardiac arrhythmia suppression trial (CAST).

The presence of ventricular ectopic activity in the post-myocardial infarction patient, especially associated with left ventricular dysfunction, has been associated with a high incidence of sudden cardiac death. To test the PVC hypothesis, that PVC suppression in asymptomatic patients with ventricular arrhythmias post-myocardial infarction might reduce sudden death rate, the cardiac arrhythmia suppression trial (CAST) was performed. In patients treated with encainide or flecainide, total mortality at 10 months was 7.7% compared to only 3% overall mortality on placebo. The increase in mortality and sudden cardiac death with these two drugs raised the question of whether PVC suppression in this group of patients should be attempted. In addition, the extrapolation of the results of this study to other patient groups has resulted in a change of our antiarrhythmic prescription habits. Criticism of the CAST study has included a low placebo mortality, which may have been secondary to entry of low-risk groups of patients, deaths in the open label titration groups not being included, and recent advances in thrombolysis and revascularization. In addition, this low placebo mortality may have been explained by the concept that drug-responsive arrhythmias may have more benign prognosis. The above results suggest that, except for the use of beta blockers, benefits of other anti-arrhythmic drug treatment in the post-infarction patient with asymptomatic benign and potentially lethal ventricular arrhythmias is questionable. Flecainide and encainide should be avoided in this group of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Arrhythmias, Cardiac↗
PubMed1989

Retinopathy of prematurity: a new epidemic?

This study provides the first empiric evidence for the existence of a new epidemic of retinopathy of prematurity-induced blindness. Data from a population-based register of handicapping conditions in the Canadian province of British Columbia, and a birth weight-specific census of live-born infants in British Columbia, were used to determine annual, population-level incidences of retinopathy of prematurity-induced blindness during 1952 to 1983. Changes in incidence since the end of the original epidemic (1954) were determined by subdividing the 29-year period (1955 to 1983) into two intervals (1955 to 1964 and 1965 to 1983). Standardized incidence ratio analyses revealed a marginally significant increase in the overall incidence of retinopathy of prematurity-induced blindness in the later as compared with the earlier period. Infants weighing 750 to 999 g at birth had a significantly increased standardized incidence ratio of 3.07 (95% confidence interval 1.26, 11.06). No increases in risk were observed in heavier or lighter weight infants. Because ascertainment and diagnostic changes do not explain the weight-specific increases in incidence, these results provide the first population-level evidence for a new epidemic.

Blindness↗
PubMed1983

An evaluation of family-centered maternity care.

The effectiveness of a family-centered maternity program in promoting a positive feeling toward the infant and in preparing the mothers for their new role was evaluated. Seventy-three married primiparous women completed measures of anxiety and depression as well as a series of questionnaires relating to their attitudes toward pregnancy, the baby, and the hospital experience. Statistical analyses revealed that the women in the family-centered maternity program, when compared with those in the traditional program, had a more positive attitude toward their babies while in the hospital. In addition, they reported having received more experience in caring for their babies and more help from the hospital personnel in preparing for the mothering role.

Adult↗
PubMedDate not supplied

The effect of season and weather on suicide rates in the elderly in British Columbia.

OBJECTIVES: The authors examined the relationship of suicide in the elderly (65 years and older) to season and weather and compared it to that in the younger population (10-64 years). METHODS: Information on suicides and on weather was obtained for British Columbia for the period 1981 to 1991. The association of suicide with season and weather was assessed using Poisson regression. RESULTS: Whereas younger suicides were associated with season, showing a spring-summer peak, elderly suicides were associated with actual weather. They increased with higher mean daily temperature for the current month (RR = 1.16, 95% CI 1.05-1.28 for each 2.5 degrees C change in mean temperature), and with lower mean daily temperature for the preceding three months (RR = 1.12, 95% CI 1.01-1.23). CONCLUSIONS: Elderly suicide rates appear to be affected by deviations of monthly mean temperature from values expected for that time of year. Increased support by service agencies at times of predicted high risk is suggested.

Adult↗