Biomedical subjects
Tony Stanton
Publications and source records attributed to Tony Stanton.
Variation at the beta-1 adrenoceptor gene locus affects left ventricular mass in renal failure.
OBJECTIVES: To examine the relationship between this variation in the beta1AR gene and the effect on LV mass. BACKGROUND: Left ventricular (LV) mass is an important cardiovascular risk factor. Beta-1 adrenoceptors (betaAR) are predominately located in the heart and their variation may, therefore, affect LV mass. A known polymorphism of the betaAR changes the amino acid at position 389 from glycine to arginine within an area critical for G-protein coupling and so cell signalling. The arginine-form of the receptor has been demonstrated to have increased GTP binding. METHODS: We studied 249 patients attending a renal clinic, 37% of whom were on renal replacement therapy (RRT). Raw LV mass was calculated by echocardiography. LV mass index (LVMI) and LV mass indexed to height2.7 were derived thereafter. Individuals were genotyped for the beta1AR variation and categorised CC if both alleles encoded for arginine at position 389, GG if both alleles encoded for glycine and CG if heterozygous. RESULTS: There was a highly significant difference in raw LV mass, LV mass index and LV mass indexed to height2.7 between the GG group when compared to both the CC and CG genotypes groups (p<0.05). The strength of the relationship was maintained when patients on RRT or taking beta-blockers were excluded (p<0.05). CONCLUSIONS: These data suggest that genetic variation at this locus is of importance in defining left ventricular mass.
A boy who stops taking stimulants for "ADHD": commentaries on a Pediatrics case study.
This article presents eight commentaries on a case study published in the journal Pediatrics in 2001. The case study, introduced in Pediatrics to highlight the issue of adolescents' compliance with drug treatment in a "high-prevalence neurobehavioral condition," briefly describes an adolescent boy who announces that he no longer needs the methylphenidate he was prescribed for ADHD and had been taking for the last five years. We invited experienced professionals from the disciplines of psychiatry, psychology, counseling, education, and occupational therapy to comment on the case and make recommendations to the adolescent boy in the case study, his family, and professionals. Their commentaries highlight issues rarely discussed in the mainstream literature, including: the extent to which ADHD is erroneously portrayed and vigorously managed as a disease; the lack of validity of the ADHD construct in adolescence; the widespread use of stimulants as performance-enhancing drugs; the need to respect an adolescent's gut instinct and developing decisions; the importance of family dynamics in ADHD-like situations; the need to ease stimulant withdrawal effects; and the human rights of children prescribed psychotropic drugs.