PubMed Health⌕ Search

Biomedical subjects

T Thompson

Publications and source records attributed to T Thompson.

At least 73 records · Page 4Linked to original sources
PubMed1999

The Westdoc Internet Questionnaire--a survey of the use of "on-line" resources by West Lothian general practitioners.

OBJECTIVE: To investigate the extent to which a representative sample of Scottish GPs used on-line resources for medical applications and their attitudes to various aspects of the technology at a time just prior to the introduction of the Scottish Office Computers offering Internet access to the majority of Scottish practices. DESIGN: Questionnaire survey. SETTING: "Out of hours" GP emergency service cooperative. SUBJECTS: All the (106) GP principals in practice in the Scottish District of West Lothian in June 1997. Locums and Registrars were excluded. RESULTS: There was an 87% response rate. Nineteen (21%) respondents used the Internet once a month or more, 12(13%) used it to communicate with colleagues by e-mail and 4(4%) with patients. Only 8% found it useful for medical purposes though more than half thought it would be a significant part of practice in five years time. Younger GPs were more likely to use the Internet. Many users expressed concern about reliability of the information and the ease with which it could be applied. CONCLUSION: By identifying a mismatch between levels of Internet use and the perceived potential of this new technology this study points to the need for training initiatives. It also forms a benchmark against which the uptake of Internet technology by GPs can be measured in years to come.

Adult↗
PubMed1999

Hepatic transcatheter arterial chemoembolization alternating with systemic protracted continuous infusion 5-fluorouracil for gastrointestinal malignancies metastatic to liver: a phase II trial of the Puget Sound Oncology Consortium (PSOC 1104).

We assessed a regimen of alternating regional and systemic therapy in patients with gastrointestinal malignancies with liver-dominant metastases for feasibility, toxicity, response rate, response duration, patterns of progression, and progression-free and overall survival. Regional therapy comprised selective hepatic transcatheter arterial chemoembolization (TACE) using a suspension of cisplatin and particulate polyvinyl alcohol. This procedure was delivered between cycles of protracted continuous infusion 5-fluorouracil (PCI-5FU) as systemic chemotherapy. Patient eligibility criteria included: (a) having histologically documented adenocarcinoma arising from a gastrointestinal primary site with unresectable liver metastases bidimensionally measurable on computerized tomography scan; (b) age greater than 18 years; and (c) performance status 0-2 (Zubrod). PCI-5FU (250 mg/m2/day) was administered i.v. for 28 days, followed by the first TACE (TACE 1) delivered to the hepatic artery supplying the lobe with the greatest tumor burden. Restaging was performed before TACE 2 and TACE 3, which followed at monthly intervals. PCI-5FU for 21 days was sandwiched between each of the TACE treatments. After the final TACE, maintenance PCI-5FU was given for 28 days of each 35-day cycle until toxicity or progression. Between December 23, 1991, and January 19, 1995, 32 patients were registered in this trial, of whom 27 were eligible; 20 completed one or more treatment cycles and were evaluable for radiographic response. Patients with colorectal liver metastases predominated (74%). Twelve (44%) of 27 patients had failed one or more prior treatment regimens. There were no treatment-related deaths, and hematological and hepatic toxicities were generally manageable and reversible. Two patients, however, developed hepatic abscesses requiring drainage, and one patient developed an infarcted gallbladder, which necessitated cholecystectomy. There were no patients with complete responses; there were 8 (40%) with partial responses, 4 (20%) with minor responses, 2 (10%) with stable disease, and 6 (30%) who progressed on the treatment. The median duration of response for partial responders was 4.2 months (127 days; range, 56-245 days). The median reduction in carcinoembryonic antigen for responders was 87.5%. Two patients underwent subsequent resection of residual metastases; one of them is still alive at 58.4 months follow-up. The predominant site of disease progression was the liver; 25% of the patients progressed in extrahepatic sites. The median overall survival for the whole group is 14.3 months (95% confidence interval, 7.2-16.2). Actuarial overall survival for the whole group at 1 year and 2 years is 57 and 19%, respectively. Alternating systemic PCI-5FU and regional TACE (cisplatin/polyvinyl alcohol) is an active and feasible regimen with manageable toxicities in patients with metastatic gastrointestinal malignancies with liver-dominant disease and merits further investigation. The complications seen were in line with those reported at other specialized centers.

Adenocarcinoma↗
PubMed1998

Sustained ventricular arrhythmias in patients receiving thrombolytic therapy: incidence and outcomes. The GUSTO Investigators.

BACKGROUND: Sustained ventricular tachycardia (VT) and fibrillation (VF) occur in up to 20% of patients with acute myocardial infarction (MI) and have been associated with a poor prognosis. The relationships among the type of arrhythmia (VT versus VF or both), time of VT/VF occurrence, use of thrombolytic agents, and eventual outcome are unclear. METHODS AND RESULTS: In the GUSTO-I study, we examined variables associated with the occurrence of VT/VF and its impact on mortality. Of the 40 895 patients with ventricular arrhythmia data, 4188 (10.2%) had sustained VT, VF, or both. Older age, systemic hypertension, previous MI, Killip class, anterior infarct, and depressed ejection fraction were associated with a higher risk of sustained VT and VF (P<0.001). In-hospital and 30-day mortality rates were higher among patients with sustained VT/VF than among patients without sustained ventricular arrhythmias (P<0.001). Both early (<2 days) and late (>2 days) occurrences of sustained VT and VF were associated with a higher risk of later mortality (P<0. 001). In addition, patients with both VT and VF had worse outcomes than those with either VT or VF alone (P<0.001). Among patients who survived hospitalization, no significant difference was found in 30-day mortality between the VT/VF and no VT/VF groups. However, after 1 year, the mortality rate was significantly higher in the VT alone and VT/VF groups (P<0.0001). CONCLUSIONS: Despite the use of thrombolytic therapy, both early and late occurrences of sustained VT or VF continue to have a negative impact on patient outcome; patients with both VT and VF had the worst outcome; and among patients who survived hospitalization, the 1-year mortality rate was significantly higher in those who experienced VT alone or VT and VF.

Administration, Cutaneous↗
PubMed1998

The latent variable structure of the Compulsive Behaviour Checklist in people with Prader-Willi syndrome.

The presence and severity of compulsive behaviours may be evaluated via the Compulsive Behaviour Checklist (CBC) and this instrument has been successfully employed in people with intellectual disability. However, the applicability of the overall CBC scoring system, which entails tallying the number of behavioural categories represented (i.e. five) as well as the number of individual behaviours endorsed (i.e. 25), is not known in the population with Prader-Willi syndrome (PWS). The present investigation examined the latent variable structure of the CBC in people with PWS in order to identify possible population-specific scoring and interpretation considerations. The 25 behaviour-specific items of the CBC were analysed for 75 people with PWS (44 females and 31 males) aged between 4 and 41 years (mean +/- SD = 11.4+/-9.4) via factor analysis with principal component extraction and equamax rotation. The most suitable solution was determined on the basis of multiple empirical criteria: (1) the scree test; (2) eigenvalues >1.00; (3) salient loadings >0.30; (4) the clarity of item assignment to a single latent dimension; (5) the internal consistency of the latent dimension(s) (coefficient alpha > or = 0.70); and (6) item-total correlations between 0.20 and 0.79. In addition, solutions were examined with respect to psychological theory and previous research. A 'general factor' (i.e. single latent dimension) solution which adhered to all a priori criteria was indicated. Twenty-four out of 25 items achieved salient loadings ranging from 0.46 to 0.80 on the general factor. The single item which failed to achieve salience, 'deviant grooming-skin picking', exhibited both substantial unique variance (0.997) and moderate reliability (r = 0.59, P<0.001). The internal consistency of the general factor was strong (alpha = 0.93) and all salient items were suitably correlated with the unit-weighted total score (r(item-total) = 0.41-0.77). The traditional CBC scoring system, which includes tallying the number of categories represented, would not be relevant in this PWS sample. In addition, the recommended tallying of the number of individual behaviours endorsed does not reflect the empirically indicated notion of compulsive behaviour in this special population. These findings indicate that the 24 salient items should be scored as a unit-weighted composite and that the score on the substantially unique item (skin picking) should be considered a separate measure when evaluating compulsive behaviours via the CBC in people with PWS.

Adolescent↗
PubMed1998

Streptococcal emm types associated with T-agglutination types and the use of conserved emm gene restriction fragment patterns for subtyping group A streptococci.

The T-agglutination types were determined for a diverse collection of 1531 group A streptococci for which the 5' M protein gene (emm) sequences had been analysed. The majority of the T-agglutination types correlated with previously seen M/emm/T-type associations; however, several new associations were found. Analysis of a subset of this collection -- which included 1157 clinical isolates with multiply encountered emm types -- found that emm amplicon restriction profiles of isolates sharing identical T types and opacity factor phenotypes are useful for detecting groups of isolates with identical emm genes. Many emm genes of known 5' sequence display a highly conserved restriction pattern amongst clinical isolates widely separated both geographically and temporally.

Agglutination↗
PubMed1998

Variation in human plasma cholinesterase activity during low-dose cocaine administration.

BACKGROUND: Cocaine is metabolized by a number of enzymes, the activity of one of which, plasma cholinesterase has been associated with dinical manifestations of toxicity. Patients with life-threatening complications of cocaine intoxication have lower plasma cholinesterase activity than less toxic controls. In addition, relatively healthy cocaine users have lower plasma cholinesterase activity than noncocaine using controls. Thus, low plasma cholinesterase activity could be a contributing factor to cocaine toxicity, a consequence of cocaine use, or a confounding variable. The following study was designed to further assess the relationship between cocaine use and plasma cholinesterase activity. METHODS: We studied fluctuations in plasma cholinesterase activity in nine subjects enrolled in an inpatient study of the behavioral pharmacology of smoked cocaine. Subjects used at least 2 g of cocaine weekly for at least 1 year prior to enrollment. The subjects were admitted to the research unit where they remained drug-free for 2 days. They then received smoked cocaine for 4 days (up to 405 mg over 5 hours daily) and were then drug-free again for 2 days. Plasma cholinesterase activity was measured at 9 AM and 4 PM each day. RESULTS: Baseline plasma cholinesterase ranged from 265 to 930 U/L (normal > 450 U/L). The mean plasma cholinesterase increased 112+/-100 U/L from day 1 to day 8 (p = 0.025). There was no daily change in plasma cholinesterase levels from 9 AM to 4 PM (15+/-165 U/L, p > 0.6), and there was no difference in the daily change between high- and low-dose cocaine days (-3+/-137 U/L vs 28+/-165 U/L, p = 0.52). CONCLUSION: These preliminary data suggest that plasma cholinesterase levels do not change over a 7-hour period as a result of cocaine administration, but may increase during a period of inpatient study. Such an increase could potentially influence the pharmacokinetics or effects of cocaine studied in an inpatient setting and may give insight into the etiology of the observed low-plasma cholinesterase activity in cocaine users.

Adult↗
PubMed1998

Acute respiratory distress syndrome. Patient position and motion strategies.

A review of the literature since 1974 indicates that, although there is no consensus as to the mechanism, positioning strategies in patients with ARDS improve PaO2 and may diminish lung parenchymal damage. The effect of these maneuvers on patient outcomes is uncertain. There is no uniform algorithm for the application of these techniques; however, there is sufficient evidence cited in the referenced articles to support the use and early application of the techniques to improve oxygenation.

Animals↗
PubMed1997

Do oats belong in a gluten-free diet?

Celiac disease is an intolerance to protein fractions in wheat, rye, barley, and possibly oats. When these grains are consumed by a person with celiac disease, they damage the mucosa of the small intestine, which eventually leads to malabsorption of nutrients. Patients are therefore advised to remove these grains from their diet, with lifelong adherence generally suggested. Although many dietitians and physicians consider this dietary prescription to be standard protocol, it is actually quite controversial. Whether oats can safely be consumed by persons with celiac disease has been debated since the gluten-free diet was first advocated more than 40 years ago. Historically, there have been several reasons for this debate, including the difficulty in identifying the precise amino acid sequence in gliadin that is responsible for toxicity; the differences in cereal chemistry between wheat and oats; and the lack of well-designed studies to assess the toxicity of oats. A growing body of evidence now suggests that moderate amounts of oats may be safely consumed by most adults with celiac disease. If further research continues to find no adverse effects from oat consumption, a consensus may emerge on the place of oats in the gluten-free diet. In the meantime, individual dietary prescriptions, routinely assessed for appropriateness using histologic and/or serologic studies, may be warranted to prevent unnecessary dietary restrictiveness and undesirable medical complications.

Adult↗
PubMed1997

Concomitant intraarterial cisplatin, intravenous 5-flourouracil, and split-course radiation therapy for locally advanced unresectable pancreatic adenocarcinoma: a phase II study of the Puget Sound Oncology Consortium (PSOC-703).

A Gastrointestinal Tumor Study Group (GITSG) protocol showed a survival benefit for patients with locally advanced unresectable pancreatic adenocarcinoma when treated with split-course radiation therapy and bolus intravenous (i.v.) 5-fluorouracil (5-FU) as compared with survival achieved with radiation alone. In an attempt to improve these results, a phase II trial using intraarterial (i.a.) cisplatin, systemic-infusional 5-FU, and concomitant split-course radiation therapy was conducted. Sixteen previously untreated patients with unresectable pancreatic adenocarcinoma (5 with American Joint Committee on Cancer [AJCC] stage I-II, 11 with stage III) disease were treated with i.a. cisplatin 100 mg/m2 by selective celiac arteriography followed by i.v. infusional 5-FU 1,000 mg/m2/day for 4 days, and concomitant split-course external beam photon radiation therapy at 2.0 Gy for 10 days in a 12-day period. After a planned 14-day interval, the identical chemoradiation treatment was repeated; finally, after a second 2-week interval, a third cycle of chemotherapy with a final 10 Gy radiation was administered. All 16 patients were evaluable for response; there were two partial responses (PR: 12%) and five minor responses (31%). Median follow-up period was 77 months. Median time to progression was 6 months (range 1-12 months), and median survival was 9 months (range 4-94 months). Nausea/vomiting was the major toxicity. There were no treatment-related fatalities. This regimen of concomitant i.a. cisplatin, i.v. infusional 5-FU, and split-course external beam photon radiation is well tolerated but has minimal activity in the treatment of locally advanced unresectable pancreatic adenocarcinoma. Future combined-modality protocols for this disease should explore alternative chemoradiation schemes.

Adenocarcinoma↗
PubMed1997

Self-injurious behaviour and body site preference.

Self-injury by people with intellectual disabilities is a highly problematic and damaging behaviour with profound implications for quality of life. To date, very little detailed descriptive information has been available on the distribution and location of body sites that are injured. This study presents preliminary information on the locations of the self-injury body sites of 29 school-age individuals with developmental and intellectual disabilities who self-injured daily. Teaching staff in school-based special education programmes independently recorded the body locations of where their student's self-injured. Approximately 80% of the reported self-injury was directed disproportionately toward the head and hands. Three-quarters of head-directed self-injury was located on the front of the head, and 83% of hand-directed self-injury was located on the back of the hands. Furthermore, 32% of the body sites toward which self-injury was directed were located on stimulation-produced analgesia body sites. The implications of these findings are discussed in relation to the opioid hypothesis of self-injurious behaviour, and with regard to future research investigating functional diagnostic strategies considering both social and biological variables.

Acupuncture Therapy↗
PubMed1997

Cross-reactions of reagents from streptococcal grouping kits with Streptococcus porcinus.

Streptococcus porcinus is usually associated with swine. Because we have received several isolates from human sources that had cross-reacted with commercial group B streptococcal reagents, we examined several commercial kits to determine the extent of this cross-reaction. Fifteen reference and 15 clinical strains of S. porcinus were tested for cross-reactions with group B streptococcal reagents from 12 different commercial kits. Cross-reactions were detected with all group B reagents, but the number of cross-reactions varied with each kit. We recommend that manufacturers of reagents designed to identify group B streptococci by serologic methods test their reagents for cross-reactions with selected S. porcinus cultures or antigens.

Animals↗
PubMed1997

Elevated plasma gamma-aminobutyric acid (GABA) levels in individuals with either Prader-Willi syndrome or Angelman syndrome.

Plasma gamma-aminobutyric acid (GABA) levels were measured in 14 subjects with Prader-Willi syndrome, 9 subjects with Angelman syndrome, and matched control subjects. Mean levels in both patient groups were 2 to 3 times higher than in nonretarded moderately obese or retarded nonobese control subjects. Levels in each patient group differed significantly from both control groups. Neither the two patient groups nor the two control groups differed. GABA levels seemed unrelated to genetic status (chromosome 15 deletion or disomy). These preliminary findings of elevated plasma GABA levels possibly represent a compensatory increase in presynaptic GABA release in response to hyposensitivity of a subset of GABA receptors and could produce increased postsynaptic activation of other normal GABA receptor subtypes, resulting in complex alterations of GABAergic function throughout the brain.

Adolescent↗
PubMed1997

Transfer of social attributions in stimulus equivalence classes by preschool children.

The transfer of social attributions within stimulus-equivalence classes comprised of photographs of children was examined. Five children (mean age: 4 yr., 2 mo.) were taught conditional discriminations sufficient for the emergence of two 3-member equivalence classes (A1-B1-C1 and A2-B2-C2). Social attributions were established by using two photographs to identify fictional children who could facilitate (B1) or prevent (B2) the participant's reinforcement on a computer game. Transfer of attribution was assessed by asking the participants questions regarding predicted social behaviors by children in all six photographs. One set of questions pertained explicitly to the response-options of the computer game; a second set referred to other prosocial and antisocial behaviors. Three children chose photographs in response to questions consistent with their experience with members B1 and B2 of the shared equivalence class when the questions pertained to the computer game. One subject also selected photographs in response to questions about predicted prosocial and antisocial behavior which reflected her experience with the B1 and B2 photographs.

Association Learning↗
PubMed1997

Food- and nonfood-related differential outcomes in equivalence learning by adults with Prader-Willi syndrome.

Adults with Prader-Willi syndrome learned the conditional relations necessary for the formation of two equivalence classes under four conditions: (a) nondifferential, nonedible outcomes; (b) nondifferential, edible outcomes; (c) differential, nonedible outcomes; and (d) differential, edible outcomes. Tests for transitive relations revealed superior performance when the two differential outcomes procedures, in which a distinct reinforcer was associated with each stimulus set, were used during teaching. Performance on test trials following nondifferential outcomes training was better when edible outcomes were used during teaching for 4 of the 5 participants. An enhancement of performance on the derived relations separated by two or three nodal stimuli was seen when a differential outcomes procedure was used to teach the baseline conditional relations.

Adult↗
PubMed1997

Isolation and identification of major urinary metabolites of rifabutin in rats and humans.

The antimycobacterial drug rifabutin is extensively metabolized in humans and laboratory animals. About 40% of the dose is excreted in urine as unchanged drug, and lipophilic (extractable with 1-chlorobutane) and polar metabolites. Polar metabolites accounted for 59.1 +/- 2.5% and 88.8 +/- 4.4% of radioactivity in urine collected over 96 hr after intravenous administration of 25 and 1 mg/kg of [14C]rifabutin to Sprague-Dawley rats, respectively. After 48 hr, all urinary radioactivity consisted of polar metabolites. The most abundant polar metabolite, identified by electrospray ionization-MS, collision-induced dissociation-MS, and comparison of HPLC retention times with the synthetic standard, was N-isobutyl-4-hydroxy-piperidine. Lipophilic metabolites accounted for <20% of urinary radioactivity. Major lipophilic metabolites, 25-O-deacetyl-rifabutin, 27-O-demethyl-rifabutin, 31-hydroxy-rifabutin, 32-hydroxy-rifabutin, and 20-hydroxy-rifabutin were isolated from both human and rat urine by HPLC and identified by electrospray ionization-MS, collision-induced dissociation-MS, and NMR spectrometry. In addition, two metabolites formed by the oxidation of the N-isobutyl-piperidyl group of rifabutin were found in the urine of rats, but not humans.

Adolescent↗