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Adlakha VK, Chandna P, Joshi JL, Thomas AM, Singh N. A Comparative Evaluation of Hydroxyapatite Crystals and Glutaraldehyde as Agents for Pulpotomy in Deciduous Molars. Int J Clin Pediatr Dent 2009; 2:13-22. [PMID: 25206093 PMCID: PMC4086550 DOI: 10.5005/jp-journals-10005-1035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Accepted: 08/05/2009] [Indexed: 11/23/2022] Open
Abstract
Purpose: To evaluate and compare clinically and radiographically
use of hydroxyapatite crystals and 2%
glutaraldehyde as a pulpotomy agent.
Method: Thirty deciduous molars were treated with pulpotomy
using hydroxyapatite crystals and 2% glutaraldehyde.
Results: Clinical and radiographic findings were observed
at three months and six months. The success rate was found
to be 100% clinically and 80.33% radiographically in the
hydroxyapatite crystals group and 100% clinically and
radiographically in the glutaraldehyde group.
Clinical significance: The results of this study revealed that
hydroxyapatite crystals is a potential pulpotomy agent for
deciduous molars.
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Abstract
The aim of the report was to highlight the rarity of occurrence of bilaterally fused mandibular primary lateral incisors and canines by virtue of the number of such cases reported in literature; to identify congenital absence of successor teeth;and to evaluate their pulpal morphologies to understand the type of fusion. Clinical observation along with an orthopantomograph and periapical radiographs were used to arrive at a diagnosis. The pulpal morphologies varied in each of the fused teeth although both were fusions of the Complete type. There was congenital absence of the permanent mandibular lateral incisors, bilaterally. It was a case of bilateral fusion of mandibular primary lateral incisors and canines of the Complete type with congenitally absent mandibular permanent lateral incisors. Only 13 such cases have been previously reported in literature.
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Ramirez AP, Thomas AM, Woerpel KA. Preparation of bicyclic 1,2,4-trioxanes from gamma,delta-unsaturated ketones. Org Lett 2009; 11:507-10. [PMID: 19132925 PMCID: PMC2657341 DOI: 10.1021/ol8022853] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Treatment of gamma,delta-unsaturated ketones with hydrogen peroxide and acid provides a rapid entry into the medicinally important 1,2,4-trioxane structure. Alkene substitution that stabilizes carbocationic intermediates proved to be important for the success of this transformation.
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Abbott AN, Guidry TV, Welsh KJ, Thomas AM, Kling MA, Hunter RL, Actor JK. 11beta-hydroxysteroid dehydrogenases are regulated during the pulmonary granulomatous response to the mycobacterial glycolipid trehalose-6,6'-dimycolate. Neuroimmunomodulation 2009; 16:147-54. [PMID: 19246936 DOI: 10.1159/000204227] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2008] [Accepted: 08/06/2008] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Tuberculosis has a staggering influence on world health, resulting in nearly 2 million deaths per year. The influence of glucocorticoids during Mycobacterium tuberculosis infection has been under investigation for decades; however, the identity of mycobacterial factors and the mechanism by which glucocorticoids are tissue specifically regulated to influence immune function during acute granuloma formation are unknown. METHODS One factor implicated in initiating immunopathology during M. tuberculosis infection is trehalose-6,6'-dimycolate (TDM), a glycolipid component of the mycobacterial cell wall. Intravenous administration of TDM causes inflammatory responses in lungs of mice similar to M. tuberculosis infection and has been used as a successful model to examine proinflammatory regulation and early events involved in the manifestation of pathology. RESULTS AND CONCLUSION IL-6, IL-1alpha and TNF-alpha mRNA and protein peaked during the initiation of granuloma formation. Pulmonary corticosterone levels were elevated when the proinflammatory response was greatest, dropping to half of that upon the establishment of granuloma pathology on day 7. It is hypothesized that once corticosterone reaches the site of inflammation, the enzymes 11beta-hydroxysteroid dehydrogenases (11betaHSDs) can influence bioavailability by interconverting corticosterone and the inert metabolite 11-dehydrocorticosterone. RT-PCR demonstrated that pulmonary 11betaHSD type 1 mRNA decreased 4-fold and 11betaHSD type 2 (11betaHSD2) mRNA expression increased 2.5-fold on day 3 after injection, suggesting that corticosterone regulation in the lung, specifically the reduction of active corticosterone by 11betaHSD2, may influence the progression of granuloma formation in response to the mycobacterial glycolipid.
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Thomas AM, Chopra S, Singh N, Simratvir M, Moghe G. Syndromes associated with labiopalatine clefting: a report of three cases. J Indian Soc Pedod Prev Dent 2008; 26:88-91. [PMID: 18603737 DOI: 10.4103/0970-4388.41625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Clefts of the lip and palate are a common craniofacial anomaly, The etiology is thought to be multifactorial, with both genetic and environmental factors playing a role. Because of the frequent manifestation of cleft lip and palate in association with some syndromes, it is essential that a detailed examination of these patients be carried out. This facilitates early formulation of preventive and treatment advice and aids in overcoming gross deformities in the early stages of development. In this paper, we review three such patients who presented with cleft lip and palate in association with a syndrome.
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Larsen RA, Bauer M, Brouwer AE, Sanchez A, Thomas AM, Rajanuwong A, Chierakul W, Peacock SJ, Day N, White NJ, Rinaldi MG, Harrison TS. In vitro-clinical correlations for amphotericin B susceptibility in AIDS-associated cryptococcal meningitis. Antimicrob Agents Chemother 2006; 51:343-5. [PMID: 17060519 PMCID: PMC1797648 DOI: 10.1128/aac.00742-06] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Reliable measures of antifungal drug susceptibility are needed. We tested the susceptibility of Cryptococcus neoformans from patients treated with amphotericin B. In vitro susceptibility employed a modified broth macrodilution method. We demonstrate a strong correlation between the quantitative measures of in vitro amphotericin B susceptibility and the quantitative response observed in patients.
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Krow GR, Huang Q, Lin G, Centafont RA, Thomas AM, Gandla D, Debrosse C, Carroll PJ. 5-Carboxy-2-azabicyclo[2.1.1]hexanes as Precursors of 5-Halo, Amino, Phenyl, and 2-Methoxycarbonylethyl Methanopyrrolidines. J Org Chem 2006; 71:2090-8. [PMID: 16496997 DOI: 10.1021/jo052506b] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Novel 5-X-substituted-2-azabicyclo[2.1.1]hexanes (X = 5-syn-Cl, -Br, -I, -Ph, -NHCOOR (R = Me, Bn, t-Bu), -CH2CH2COOMe and X = 5-anti-Br, -I, -Ph) were synthesized from the X = 5-syn-carboxy derivative. New 5-anti-X-2-azabicyclo[2.1.1]hexanes, X = NHCOOR (R = Me, Bn), were prepared stereoselectively from the X = 5-anti-carboxy substrate.
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Thomas AM, Corona-Morales AA, Ferraguti F, Capogna M. Sprouting of mossy fibers and presynaptic inhibition by group II metabotropic glutamate receptors in pilocarpine-treated rat hippocampal slice cultures. Neuroscience 2005; 131:303-20. [PMID: 15708475 DOI: 10.1016/j.neuroscience.2004.11.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2004] [Indexed: 11/20/2022]
Abstract
Mossy fibre sprouting (MFS) is a phenomenon observed in the epileptic hippocampus. We have studied MFS, in 7, 14 and 21 day in vitro (DIV) organotypic slice cultures, or in slice cultures treated with pilocarpine (0.5 mM) or pilocarpine and atropine (0.1 mM or 0.5 mM) for 48-72 h at 5 DIV and tested at 21 DIV. Acute application of pilocarpine directly activated hilar neurons and elicited epileptic-like discharges in CA3 pyramids and mossy cells of 5-8 DIV cultures, without causing substantial cell death, as assessed by lactate dehydrogenase measurements. Timm staining revealed increases in MFS in chronic pilocarpine-treated cultures, which was prevented by prior application of atropine. Extracellular synaptic responses were recorded in the granule cell layer and elicited by antidromic mossy fibre stimulation. The GABA(A) antagonist 6-imino-3-(4-methoxyphenyl)-1(6H)-pyridazinebutanoic acid (1 microM) induced a greater increase in the coastline bursting index in pilocarpine-treated cultures than in 21 DIV controls. However, there was no significant increase in the frequency of spontaneous or miniature synaptic events recorded in granule cells from pilocarpine-treated cultures. Granule cells were filled with biocytin and morphometric analysis revealed that the length of axon collaterals in the granule and molecular layer was longer in pilocarpine-treated cultures than in 21 DIV controls. Dual recordings between granule cells and between granule and hilar neurons showed that pilocarpine-treated cultures had a larger proportion of monosynaptic and polysynaptic connections. The group II metabotropic glutamate receptor (mGluR) agonist LY354740 (0.5 microM) suppressed excitatory but not inhibitory monosynaptic currents. LY354740 also inhibited antidromically evoked action currents in granule cells from pilocarpine- and to a lesser extent in pilocarpine and atropine-treated cultures, suggesting that group II mGluRs can reside along the axon and suppress action potential invasion. We provide direct evidence for the development of functional MFS and suggest a novel, axonal mechanism by which presynaptic group II mGluRs can inhibit selected synapses.
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Taylor RW, Schaefer AM, McDonnell MT, Petty RKH, Thomas AM, Blakely EL, Hayes CM, McFarland R, Turnbull DM. Catastrophic presentation of mitochondrial disease due to a mutation in the tRNAHis gene. Neurology 2004; 62:1420-3. [PMID: 15111688 DOI: 10.1212/01.wnl.0000120667.77372.46] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The authors describe a patient who presented with headache, seizures, and severe cerebral edema in whom they identified a novel mutation in the mitochondrial (mt-) tRNAHis gene. This G12147A transition is heteroplasmic, predicted to disrupt a highly conserved base pair, and segregates with the cytochrome c oxidase deficiency in single muscle fibers.
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60
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Krow GR, Lin G, Moore KP, Thomas AM, DeBrosse C, Ross CW, Ramjit HG. Novel Selectfluor and Deoxo-Fluor-Mediated Rearrangements. New 5(6)-Methyl and Phenyl Methanopyrrolidine Alcohols and Fluorides. Org Lett 2004; 6:1669-72. [PMID: 15128263 DOI: 10.1021/ol0494818] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Stereoselective syntheses of novel 5,6-difunctionalized-2-azabicyclo[2.1.1]hexanes containing 5-anti-fluoro or hydroxyl in one methano bridge and a variety of syn- or anti-chloro, fluoro, hydroxy, methyl, or phenyl substituents in the other methano bridge have been effected. Rearrangements of iodides to alcohols were initiated using Selectfluor. Rearrangement of alcohols to fluorides was initiated using Deoxo-Fluor. Ring opening of 2-azabicyclo[2.2.0]hex-5-ene exo-epoxide with organocopper reagents is regioselective at C(5).
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61
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Krow GR, Lin G, Herzon SB, Thomas AM, Moore KP, Huang Q, Carroll PJ. Convenient preparations of 2,4-methanopyrrolidine and 5-carboxy-2,4-methanopyrrolidines. J Org Chem 2003; 68:7562-4. [PMID: 12968923 DOI: 10.1021/jo0348672] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
An efficient four-step synthesis of N-BOC-5-syn- and 5-anti-carboxymethanopyrrolidines (12 and 13) and the conversion of 12 to N-BOC-methanopyrrolidine (2) are described.
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62
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Thomas AM. In situmeasurement of moisture in soil and similar substances by `fringe' capacitance. ACTA ACUST UNITED AC 2002. [DOI: 10.1088/0950-7671/43/1/306] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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63
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64
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Scheper GC, van Wijk R, Thomas AM. Regulation of the activity of eukaryotic initiation factors in stressed cells. PROGRESS IN MOLECULAR AND SUBCELLULAR BIOLOGY 2002; 27:40-56. [PMID: 11575160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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65
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McGonigal A, Thomas AM, Petty RKH. Facioscapulohumeral muscular dystrophy and myasthenia gravis co-existing in the same patient: a case report. J Neurol 2002; 249:219-20. [PMID: 11985390 DOI: 10.1007/pl00007868] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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66
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Ougham HJ, Thomas AM, Thomas BJ, Frick GA, Armstrong GA. Both light-dependent protochlorophyllide oxidoreductase A and protochlorophyllide oxidoreductase B are down-regulated in the slender mutant of barley. JOURNAL OF EXPERIMENTAL BOTANY 2001; 52:1447-1454. [PMID: 11457904 DOI: 10.1093/jexbot/52.360.1447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The gibberellin-insensitive overgrowth mutant of barley, slender, exhibits altered expression of a number of nuclear genes in comparison with the wild type. There is a particularly marked reduction in slender seedlings of transcript encoding protochlorophyllide oxidoreductase (POR), the enzyme which catalyses the penultimate and only light-requiring step in chlorophyll biosynthesis. The expression of the two barley genes encoding light-dependent POR, PORA and PORB was investigated. Expression of both genes was found to be reduced in slender seedlings relative to the wild type, in both etiolated and light-grown leaf tissue; this was most marked in the zone of rapid cell extension. Western blot analysis showed that POR protein was also less abundant in etiolated and in light-grown slender than in the equivalent wild-type leaf tissue, although the effect was less pronounced than at the transcript level. Protochlorophyllide content in etiolated slender seedlings was reduced in comparison with wild-type seedlings, though chlorophyll content in light-grown leaf blades was unaffected. The reduction in POR expression in slender barley may reflect a novel response to the constitutive activation of gibberellin signalling in this mutant. Despite the consequences of the mutation for POR gene expression, slender seedlings develop apparently normal chloroplasts in the light, and etioplasts with well-defined prolamellar bodies when grown in continuous darkness. This suggests that the POR content of wild-type barley seedlings is well in excess of the minimum required for normal plastid development.
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68
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Savic I, Thomas AM, Ke Y, Curran J, Fried I, Engel J. In vivo measurements of glutamine + glutamate (Glx) and N-acetyl aspartate (NAA) levels in human partial epilepsy. Acta Neurol Scand 2000; 102:179-88. [PMID: 10987378 DOI: 10.1034/j.1600-0404.2000.102003179.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate whether cerebral levels of N-acetyl aspartate (NAA), and glutamine + glutamate (Glx), are interictally altered in the epileptogenic regions of patients with partial seizures. MATERIAL AND METHODS NAA, Glx, creatine (Cr), choline (Cho) and myo-inositol (mI) was measured in 28 patients with partial epilepsy and 10 healthy controls using localized 1H magnetic resonance spectroscopy. According to the multimethodological consensus, the epileptogenic region was mesial temporal in 18 and neocortical in 10 patients. RESULTS The Glx/NAA and Glx/Cr ratios in epileptogenic regions were higher, and the NAA/Cr ratios lower than in the homologous regions (P=0.013, P=0.002 and P<0.0001). Applying the 95% confidence interval of controls, 17 of the 20 mesial temporal epileptogenic regions were correctly identified by an increased Glx/NAA and 15 of 20 by a decreased NAA/Cr ratio. Among patients with neocortical epilepsy the Glx/NAA ratio was increased in 8 of the 10 epileptogenic regions, whereas the NAA/Cr ratio was decreased in three. CONCLUSION Both Glx and NAA are useful to identify the epileptogenic zone. The Glx/NAA ratios may be particularly useful to indentify neocortical epileptogenic regions.
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Thomas AM, Hickey M, Fraser IS. Disturbances of endometrial bleeding with hormone replacement therapy. Hum Reprod 2000; 15 Suppl 3:7-17. [PMID: 11041216 DOI: 10.1093/humrep/15.suppl_3.7] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Breakthrough bleeding is a common problem in postmenopausal women taking hormone replacement therapy (HRT) and is often the single most important factor deterring women from continuing to use HRT, or from starting it in the first place. The mechanisms which underlie this unscheduled bleeding are poorly understood. The benefits of HRT in terms of longevity and quality of life are becoming increasingly apparent, and a greater understanding of why this bleeding occurs and how we can prevent or treat it, will undoubtedly enable more women to reap the potential considerable benefits of long-term oestrogen and progestogen replacement. What sets postmenopausal women apart from their counterparts in the mid-reproductive years is the increased likelihood of endometrial adenocarcinoma in which unscheduled bleeding is the presenting symptom. Therefore, spontaneous postmenopausal bleeding must always be appropriately evaluated. Hence, the occurrence of unscheduled bleeding with HRT may provide a dilemma with diagnosis as well as a challenge to acceptability. Combined HRT regimens tend to be predominantly progestogenic, and there is increasing evidence to suggest that some of the vascular changes seen in women taking long-term, low-dose progestogen-only contraceptives may also occur in women taking HRT.
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Abstract
Fear of intimacy among heterosexual dating couples was examined with the Fear-of-Intimacy Scale (FIS) and the Personal Assessment of Intimacy in Relationships (PAIR). Following a 6-month interval, couples were again contacted to determine whether they continued to date. Males reported higher FIS scores than females, and FIS scores were positively correlated within couples. Also, FIS scores of males and females were significantly correlated with indices of actual and desired intimacy; however, for females, correlations of FIS scores with desired intimacy were significantly lower than correlations with actual intimacy. Females who were no longer in the dating relationship at the 6-month follow-up had higher FIS scores than those who were continuing in their dating relationship. These findings increase our understanding of fear of intimacy, especially gender differences in dating couples.
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71
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Stemberger RM, Thomas AM, Mansueto CS, Carter JG. Personal toll of trichotillomania: behavioral and interpersonal sequelae. J Anxiety Disord 2000; 14:97-104. [PMID: 10770238 DOI: 10.1016/s0887-6185(99)00028-6] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Patients suffering from trichotillomania are at risk for significant mood and interpersonal problems. Using a clinical sample, this study sought to clarify the nature and types of problems experienced by patients and to examine how these problems might be interrelated. The charts of 67 patients who sought treatment for trichotillomania were reviewed. The majority of patients reported problems with affect and interpersonal relationships. Public and social activities (e.g., haircuts, sexual activities) were avoided by a large number of patients. Self-esteem, shame, feelings of unattractiveness, depressed affect, and secretiveness were all interrelated, suggesting that these issues might best be conceptualized as a cluster that needs to be considered in the etiology, effects, and treatment of trichotillomania.
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Naqvi TZ, Shah PK, Ivey PA, Molloy MD, Thomas AM, Panicker S, Ahmed A, Cercek B, Kaul S. Evidence that high-density lipoprotein cholesterol is an independent predictor of acute platelet-dependent thrombus formation. Am J Cardiol 1999; 84:1011-7. [PMID: 10569655 DOI: 10.1016/s0002-9149(99)00489-0] [Citation(s) in RCA: 104] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Plasma total and low-density lipoprotein (LDL) cholesterol are established risk factors for atherosclerotic vascular disease and may also contribute to a prothrombotic risk via enhanced platelet reactivity. This study examines whether high-density lipoprotein (HDL) cholesterol, which is inversely correlated with coronary artery disease, is associated with a reduced thrombogenic potential. Platelet thrombus formation was evaluated by exposing porcine aortic media placed in Badimon perfusion chambers to flowing nonanticoagulated venous blood for 5 minutes at a shear rate of 1,000 s(-1). Forty-five subjects, 23 normal (LDL 104 +/- 31, HDL 50 +/- 15 mg/dl) and 22 hypercholesterolemic (LDL 181 +/- 45, HDL 41 +/- 10 mg/dl) patients without coronary artery disease were studied. Platelet aggregation and CD62 antigen expression, and assay for circulating prothrombotic factors were also performed. In univariate analysis platelet thrombus formation correlated with weight (r = 0.33, p = 0.03), diastolic blood pressure (r = 0.39, p = 0.01), HDL cholesterol (r = -0.45, p = 0.003), total/HDL cholesterol (r = 0.43, p = 0.004) and LDL/HDL (r = 0.38, p = 0.01) ratios, and platelet CD62 expression (r = 0.41, p = 0.02). In multiple regression analysis only HDL cholesterol showed significant correlation with platelet thrombus formation (p = 0.03). Platelet aggregation and circulating prothrombotic factors did not correlate with platelet thrombus formation. A comparison between normal and hypercholesterolemic subjects revealed enhanced thrombus area (0.026 +/- 0.20 vs 0.045 +/- 0.039 mm2/mm; p = 0.04), resting CD62 expression (6 +/- 7% vs 15 +/- 10% positive platelets, p = 0.02), and platelet aggregation (16.7 +/- 5.2 vs 21.7 +/- 6.7 ohms, p = 0.04) in hypercholesterolemic subjects. Our results demonstrate that HDL cholesterol is a significant independent predictor of ex vivo platelet thrombus formation.
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Abstract
Wounds with a covering of eschar require debridement before optimal wound healing can proceed. There are several different methods available but these have been derived empirically with no direct evidence of the structure or composition of the tissue they are designed to remove, or of the potential autolytic mechanisms which are the targets for some of these treatments. The aim of this study therefore was to determine the composition of chronic wound eschar and hence identify potential targets for the induction of autolytic debridement. Chronic wound eschar was removed by surgical debridement and analysed using immunohistochemistry, polyacrylamide gel electrophoresis (PAGE) and gelatin zymography. Immunohistochemistry using antibodies specific for extracellular matrix (ECM) proteins revealed a definite tissue structure, consisting of many fibrous regions and fine fibrillar elements separated by areas of tissue which were of a more irregular and amorphous nature. An antibody specific for all leucocytes revealed the presence of leucocytes in the region of tissue closest to the wound bed. The presence of this leucocyte population correlated to elevated levels of gelatinase activity as identified by gelatin zymography. PAGE analysis identified various protein species in the range 3.5-60 kDa molecular weight. These data indicate that wound debridement is likely to require multiple enzyme specificities to degrade the eschar and that these enzymes may be supplied by inflammatory leucocytes infiltrating the eschar from the wound bed. The various protein species demonstrated by PAGE may represent ECM proteins, those with lower molecular weight possibly representing the degradation products of autolytic debridement.
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Abstract
The goal of the present study was to investigate the clinical profile of patients with primary headache syndromes who also suffer from mood disorders. Four-hundred-and-seventy headache outpatients (170M, 300F) and 150 age- and sex-matched healthy subjects were screened using a specific questionnaire that included the Hamilton rating scales for anxiety and depression. The average scores of the Hamilton rating scales for anxiety and depression were significantly higher in headache sufferers (17.4 and 14.2, respectively) than in healthy people (6.8 and 5.7, respectively). The frequency of headache attacks, the history of headaches, and gender (women more than men) were correlated with the score of the Hamilton rating scale for both anxiety and depression. Sixteen headache patients (3.4%) achieved the DSM-IV criteria for major depression or dysthymia versus one among headache-free subjects (0.6%; OR 5.2). Patients suffering from drug-overuse and migraine with aura showed the higher odds ratios (35 and 17, respectively). These results suggest that those headache patients with long history and high frequency of headaches, or patients suffering from migraine with aura and drug-overuse might benefit from psychiatric evaluation.
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Thomas AM, Cohen G, Cook-Deegan RM, O'Sullivan J, Post SG, Roses AD, Schaffner KF, Green RM. Alzheimer testing at Silver Years. Camb Q Healthc Ethics 1998; 7:294-307. [PMID: 9663350 DOI: 10.1017/s096318019870310x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Early last year, the GenEthics Consortium (GEC)
of the Washington Metropolitan Area convened at George
Washington University to consider a complex case about
genetic testing for Alzheimer disease (AD). The GEC consists
of scientists, bioethicists, lawyers, genetic counselors,
and consumers from a variety of institutions and affiliations.
Four of the 8 co-authors of this paper delivered presentations
on the case. Supplemented by additional ethical and legal
observations, these presentations form the basis for the
following discussion.
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Tenholder MF, Greene LM, Thomas AM. The role of radiology in pulmonary infectious disease. Curr Opin Pulm Med 1998; 4:142-7. [PMID: 9675516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This review of recently published papers focuses on the recent tious disease. Despite advances in thoracic imaging, the chest roentgenogram combined with the clinical history remain the cornerstone in the diagnosis, staging, and follow-up of pulmonary infectious disease. Examination of all prior films to document preexistent anatomic pulmonary or cardiac disease and to establish the progression or regression of the pulmonary infiltrate is essential prior to proceeding with more costly imaging.
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MESH Headings
- Diagnosis, Differential
- Humans
- Lung/diagnostic imaging
- Lung Diseases, Fungal/diagnosis
- Lung Diseases, Fungal/diagnostic imaging
- Pneumonia, Bacterial/diagnosis
- Pneumonia, Bacterial/diagnostic imaging
- Pneumonia, Viral/diagnosis
- Pneumonia, Viral/diagnostic imaging
- Radiography
- Respiratory Tract Infections/diagnostic imaging
- Sensitivity and Specificity
- Technology, Radiologic
- Tuberculosis, Pulmonary/diagnosis
- Tuberculosis, Pulmonary/diagnostic imaging
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Diamond DM, Bauer M, Daniel BE, Leal MA, Johnson D, Williams BK, Thomas AM, Ding JC, Najvar L, Graybill JR, Larsen RA. Amphotericin B colloidal dispersion combined with flucytosine with or without fluconazole for treatment of murine cryptococcal meningitis. Antimicrob Agents Chemother 1998; 42:528-33. [PMID: 9517927 PMCID: PMC105493 DOI: 10.1128/aac.42.3.528] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Studies with animals and in vitro studies have demonstrated that flucytosine plus amphotericin B or fluconazole has significantly improved mycologic activity against meningitis caused by Cryptococcus neoformans compared to the activity of amphotericin B or fluconazole used alone. However, few doses have been tested in combination. This study evaluated the antifungal efficacy of amphotericin B colloidal dispersion (ABCD) combined with flucytosine with and without fluconazole in a murine model of cryptococcal meningitis. The following dosages were tested: ABCD at 0 to 12.5 mg/kg of body weight given intravenously 3 days/week, flucytosine at 0 to 110 mg/kg/day, and fluconazole at 0 to 50 mg/kg/day. Meningitis was established in male BALB/c mice by intracerebral injection of C. neoformans. Treatment with flucytosine with or without fluconazole dissolved in the sole source of drinking water was started on day 2; animals were sacrificed at 16 days, and the numbers of fungal colonies in the brain were quantified. A survival rate of 100% was achieved with ABCD plus flucytosine without fluconazole; however, the addition of fluconazole was required to prevent weight loss (P < 0.00001) and to achieve the maximum antifungal effect (P < 0.00001). The only region of dose combinations for which the 99% confidence intervals were less than 100 CFU/g of brain was defined by ABCD at 5.0 to 7.5 mg/kg combined with flucytosine at 20 to 60 mg/kg/day and fluconazole at 30 to 40 mg/kg/day. The triple combination of ABCD plus flucytosine and fluconazole was necessary to achieve the greatest antifungal activity.
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Green RM, Thomas AM. DNA: five distinguishing features for policy analysis. HARVARD JOURNAL OF LAW & TECHNOLOGY 1998; 11:571-91. [PMID: 12731549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
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Kelly AM, Shaw NJ, Thomas AM, Pynsent PB, Baker DJ. Growth of Pakistani children in relation to the 1990 growth standards. Arch Dis Child 1997; 77:401-5. [PMID: 9487961 PMCID: PMC1717391 DOI: 10.1136/adc.77.5.401] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This study was designed to compare the growth of Pakistani schoolchildren in the UK with the 1990 UK growth standards. Measurements of height, weight, and sitting height were performed on 785 Pakistani schoolchildren aged 5-14 years with the mean values for each age and sex being plotted on the UK growth standards. The results were expressed as SD scores relative to the 1990 reference data. The mean height for the boys was only 0.2 SD scores below the mean for the new growth standards with the mean height for the girls being 0.4 SD scores below the mean. The mean values for weight and body mass index were 0.3 and 0.5 SD scores less than the mean for boys and girls respectively. This study demonstrates that the growth of Pakistani schoolchildren in the UK is comparable to the 1990 UK growth standards with only minor differences. It is not safe to assume that short stature or low body weight in a Pakistani child is due to his or her ethnic background.
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80
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Thomas AM, Turner RE, Tenholder MF. Esophageal pressure measurements in cardiopulmonary exercise testing. Chest 1997; 112:829-32. [PMID: 9315820 DOI: 10.1378/chest.112.3.829] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
STUDY OBJECTIVES We sought to determine the adaptability and effectiveness of a new esophageal balloon technique to measure changes in esophageal pressure (Pes) as a reflection of pleural pressure with progressive incremental exercise testing in normal subjects. DESIGN An 8F (0.9 cm) esophageal balloon catheter (Smart Cath; Allied Health Products; Riverside, Calif), a CP-100 pulmonary monitor (BiCore Monitoring Systems PC-100; Irvine, Calif), and a flow transducer (Var flex; Allied Health Products; Riverside, Calif) were connected to a breathing valve (model 2700; Hans-Rudolph Inc; Kansas City, Mo). This apparatus was then used to measure Pes during a graded cardiopulmonary exercise test (CPX) to symptom limitation. SETTING University-affiliated Veterans Affairs Hospital. PARTICIPANTS Eight nonsmoking volunteers with normal results of pulmonary function tests. INTERVENTIONS Plots of deltaPes against pressure time product (PTP), minute ventilation (VE), and oxygen consumption (VO2) were obtained. Pes at baseline, anaerobic threshold (AT), and maximum oxygen consumption (VO2max) were obtained by comparing the Pes measurements from the computer printout to the corresponding breath-by-breath measurements on the CPX. MEASUREMENTS AND RESULTS The flow transducer (Varflex) connection added only 20 mL of dead space to the standard mouthpiece apparatus. The mean maximum work performance was 203+/-32 W. The mean VO2max was 29+/-9 mL/kg/min. The Pes at AT was 16+/-3 cm H2O. The Pes at maximal exercise was 42+/-16 cm H2O. CONCLUSION The small esophageal balloon was well tolerated by all subjects. Plots of deltaPes vs PTP, VE, and VO2 demonstrated a linear correlation. This apparatus could be added to the standard CPX to assess the contribution of the diaphragm and respiratory muscles in patients with dyspnea.
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81
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Thomas AM, Peterson L, Goldstein D. Problem solving and diabetes regimen adherence by children and adolescents with IDDM in social pressure situations: a reflection of normal development. J Pediatr Psychol 1997; 22:541-61. [PMID: 9302851 DOI: 10.1093/jpepsy/22.4.541] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Investigated problem-solving ability and reported regimen adherence among children, early adolescents, and middle adolescents with IDDM in response to hypothetical social situations where a choice between diabetes regimen adherence and peer desires must be made. Sixty-seven 8- to 17-year-olds with IDDM from two distinct U.S. geographical areas participated. Results indicated that compared to children with IDDM, adolescents with IDDM had better problem-solving abilities in response to social pressure situations, possibly reflecting their greater cognitive maturity. However, adolescents were also more likely to choose behaviors that are less regimen adherent. Differences in levels of problem-solving ability and adherence between the two regional subsamples were also found. Similar developmental patterns were found in both groups, showing the robust nature of the observed age-related trend of decreasing adherence in social situations despite increasing problem-solving abilities. Findings were interpreted in the context of normal adolescent development. Results are conceptually important for those interested in the transaction between peer and social influences and adherence for children and adolescents with IDDM, as well as other health behaviors.
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Ding JC, Bauer M, Diamond DM, Leal MA, Johnson D, Williams BK, Thomas AM, Najvar L, Graybill JR, Larsen RA. Effect of severity of meningitis on fungicidal activity of flucytosine combined with fluconazole in a murine model of cryptococcal meningitis. Antimicrob Agents Chemother 1997; 41:1589-93. [PMID: 9210691 PMCID: PMC163965 DOI: 10.1128/aac.41.7.1589] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
We studied the effect of the severity of meningitis on the response to therapy with fluconazole and flucytosine in a murine model of cryptococcal meningitis. Meningitis was established by intracerebral injection of Cryptococcus neoformans. The severity of meningitis was varied by delaying the onset of treatment from 3 to 7 days. Animals were sacrificed after 14 days of treatment, and the numbers of C. neoformans per gram of brain tissue were quantified. The range of effective dose combinations of fluconazole and flucytosine became progressively reduced as the severity of meningitis increased. The magnitude of treatment effect, as measured by the numbers of CFU/gram of brain tissue, was also reduced with increasing severity of meningitis. In this model, as the severity of meningitis increases, higher doses of fluconazole are required to achieve equivalent levels of activity. The combination of fluconazole and flucytosine appears to have the most-potent antifungal effects. This is most readily observed in animals with more-severe meningitis.
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84
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Mansueto CS, Stemberger RM, Thomas AM, Golomb RG. Trichotillomania: a comprehensive behavioral model. Clin Psychol Rev 1997; 17:567-77. [PMID: 9260041 DOI: 10.1016/s0272-7358(97)00028-7] [Citation(s) in RCA: 103] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
As our knowledge of chronic hair pulling as neither rare nor benign has increased, so has the need for a comprehensive framework to guide our conceptualization of this disorder for both research and clinical work. Such a model is presented which incorporates (a) the varied antecedents that both cue the impulse to pull and facilitate pulling, (b) the wide array of behaviors involved in the actual pulling, and (c) the full range of consequences of pulling. The cyclical nature of pulling episodes is highlighted.
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85
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O'Leary CP, Veitch J, Durward WF, Thomas AM, Rees JH, Willison HJ. Acute oropharyngeal palsy is associated with antibodies to GQ1b and GT1a gangliosides. J Neurol Neurosurg Psychiatry 1996; 61:649-51. [PMID: 8971119 PMCID: PMC486666 DOI: 10.1136/jnnp.61.6.649] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Three patients with acute oropharyngeal palsy had high titre anti-GQ1b and anti-GT1a IgG antibodies. No patients had ophthalmoplegia or ptosis. In all patients limb ataxia or areflexia were present without notable limb weakness. These patients describe an oropharyngeal variant of Guillain-Barré syndrome in terms of anti-GQ1b antibody reactivity and show that high titre anti-GQ1b antibodies, serologically indistinguishable from those found in Miller Fisher syndrome, can occur in a clinical setting without ophthalmoplegia. The anti-GQ1b and anti-GT1a antibody assays may be helpful tests when considering the differential diagnosis of acute oropharyngeal palsy.
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86
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Griffith JF, Peh WC, Evans NS, Smallman LA, Wong RW, Thomas AM. Multiple rice body formation in chronic subacromial/subdeltoid bursitis: MR appearances. Clin Radiol 1996; 51:511-4. [PMID: 8689829 DOI: 10.1016/s0009-9260(96)80193-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Multiple rice body formation is an unusual complication of chronic bursitis. Clinically and macroscopically, it can resemble synovial osteochondromatosis. Radiographic and MR appearances, however, may allow an accurate pre-operative diagnosis. The imaging features of two middle-aged women with multiple subacromial/subdeltoid bursa rice bodies are described.
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87
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Johnston SG, Thomas AM. Divorce versus intact parental marriage and perceived risk and dyadic trust in present heterosexual relationships. Psychol Rep 1996; 78:387-90. [PMID: 9148291 DOI: 10.2466/pr0.1996.78.2.387] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The relationship between parental divorce and intimate relationships in late adolescence was estimated for 60 undergraduates (17 men, 43 women). Subjects from divorced families were assessed to address whether they perceived their present heterosexual relationship to be risky and if they were less trusting of their partners than were subjects from intact families. Divorce appears to be transmitted through generations in a family. Dyadic Trust and Perceived Risk were investigated as two learned components passed down within families, thereby contributing to a cycle of divorce. A correlation was found between parents' marital status and children's trust in their dating partners. An inverse relationship was indicated; when ratings of trust are low, ratings of perceived risk are high. A possible order of this relationship was discussed, i.e., low dyadic trust preceded perceived risk. One implication of these findings was that children of divorced parents may benefit from being shown how failures in relationships may result from negative expectations.
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88
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Jamieson DR, Mann C, O'Reilly B, Thomas AM. Ear clicks in palatal tremor caused by activity of the levator veli palatini. Neurology 1996; 46:1168-9. [PMID: 8780116 DOI: 10.1212/wnl.46.4.1168] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
We describe a patient who developed palatal tremor and presented with ear clicks that appeared to originate from activity of the levator veli palatini and not the tensor veli palatini. This was treated with botulinum toxin. We discuss the motor innervation of the palate in the context of our case, our findings in terms of classification, and how the lower cranial nerve nuclei are involved in the etiology of palatal tremor.
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89
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De Lord DA, Thomas AM, Salisbury J, Pitt PI. A case of chronic Escherichia coli osteomyelitis of the clavicle. BRITISH JOURNAL OF RHEUMATOLOGY 1996; 35:192-4. [PMID: 8612036 DOI: 10.1093/rheumatology/35.2.192-a] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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90
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Thomas AM, Mansell L. Health care reorganization in Alberta: nurses working successfully in a program structure. AARN NEWS LETTER 1995; 51:7-8. [PMID: 7495180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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91
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Marks DS, Thomas AM, Thompson AG, Mills S. Surgical management of haemangioendothelioma of the spine. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 1995; 4:186-90. [PMID: 7552654 DOI: 10.1007/bf00298244] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Four patients with haemangioendothelioma of the spine which was treated surgically are presented. Two were male and two female, mean age 30 years (range 5-60). All tumours were sited in the thoracic spine between T5 and T10; three were primary and one metastatic from a hepatic haemangioendothelioma. Each patient had a significant neurological deficit at presentation; three were paraplegic. A diagnosis of vertebral neoplastic disease was suggested on plain radiographs, and in three cases this was supported by computed tomography or magnetic resonance imaging. Two patients underwent anterior decompression and posterior instrumented stabilisation, one anterior decompression alone and one posterior decompression followed by tumour vessel embolisation and then anterior decompression. Intra-operative blood loss was a significant feature despite the use of hypotensive anaesthetic techniques and local haemostatic agents. Three of the tumours were tested for Factor VIII (a tumour for vascular tumours), and all proved positive. In these, sufficient histological material was available to grade the tumours according to the classification of Campanacci et al. [1]. All were grade II. Three patients recovered completely from paraglegia; one had residual mild spasticity which required the use of a walking aid. The mean improvement in Frankel grade was 2.5 (range 1-4). In two the tumour recurred outside the spine within 18 months; one had subsequently died. The presentation, investigation and results of surgery for haemangioendothelioma of the spine are presented. Particular attention is drawn to the neurological status at presentation, the effect of pre-operative tumour embolisation and the dramatic recovery that can be achieved in these patients following surgery.
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Thomas AM. Health care reorganization in Alberta: what is really going on and why is it taking so long? AARN NEWS LETTER 1995; 51:12, 17. [PMID: 7668073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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93
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Thomas AM, Forehand R, Neighbors B. Change in maternal depressive mood: unique contributions to adolescent functioning over time. ADOLESCENCE 1995; 30:43-52. [PMID: 7625263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
There is substantial evidence of the relationship between maternal depressive mood and problematic child functioning. The vast majority of studies in this area concentrate on cross-sectional designs and depressive mood at one point in time. In contrast to the existing literature, the goal of this study was to investigate the relation of change in maternal depressed mood across time and adolescent functioning, including the possible moderating effects of gender of the adolescent and the marital status of parents. Regression analyses indicated that increased depressed mood across one year predicted teacher report of higher levels of externalizing and internalizing problems and lower levels of social competence, above that which could be predicted from the initial assessment of depressed mood. With one exception, neither gender nor parental marital status qualified the findings. The results suggest that static levels of maternal depressive mood are not sufficient for forecasting adolescent functioning. Future research needs also to consider change in such mood.
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Banz K, Schwicker D, Thomas AM. Economic evaluation of immunoprophylaxis in children with recurrent ear, nose and throat infections. PHARMACOECONOMICS 1994; 6:464-477. [PMID: 10155274 DOI: 10.2165/00019053-199406050-00008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This study compares the costs of immunoprophylaxis versus no immunoprophylaxis in children with recurrent ear, nose and throat (ENT) infections (otitis media and rhinopharyngitis) using ribosomal immunotherapy ('Ribomunyl'). The per-patient cost of ribosomal immunotherapy (FF297) is offset by direct savings garnered through the prevention of many acute infectious episodes. The net 6-month per-patient savings associated with immunoprophylaxis range from FF272 to FF1704, depending on the indication and the type of treatment-cost estimate. Saved healthcare resources include physician consultations and visits, laboratory tests, medicotechnical services (audiometric tests) and antibiotic therapy. Sensitivity analysis of efficacy and treatment-cost estimates enabled threshold ranges of incremental efficacy to be identified. Cost-equivalence between the 2 treatment options was found to exist when the incremental efficacy of immunoprophylaxis lay between 7.4 and 17.5% (recurrent otitis media), and between 8.9 and 26.1% (recurrent rhinopharyngitis). Thus, even when clearly lower incremental efficacy rates than those reported in controlled clinical trials (approximately 40 to 60%) are assumed, ribosomal immunotherapy can still be expected to be cost effective. An analysis of the perspectives of the various payers in the French healthcare system demonstrated that net savings occurred for all payers involved. However, social security insurance would gain most from an immunoprophylaxis programme. Based on the evidence presented here for France, physicians and payers should give increased attention to this treatment option.
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Thomas AM, Chandra S, Chandra S, Pandey RK. Elimination of infection in pulpectomized deciduous teeth: a short-term study using iodoform paste. J Endod 1994; 20:233-5. [PMID: 7931014 DOI: 10.1016/s0099-2399(06)80284-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This study was conducted to retain the pulp-involved deciduous teeth in dental arches and were restored to function by elimination of infection in pulpectomized deciduous teeth using iodoform paste. Clinically the teeth were evaluated for pain, mobility, and presence or absence of sinus for 3 months. We concluded that the iodoform paste is a suitable root canal filling material for single-visit pulp canal treatment in chronic pulp-infected deciduous teeth.
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De Silva RN, Willison HJ, Doyle D, Weir AI, Hadley DM, Thomas AM. Nerve root hypertrophy in chronic inflammatory demyelinating polyneuropathy. Muscle Nerve 1994; 17:168-70. [PMID: 8114785 DOI: 10.1002/mus.880170206] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A patient with chronic inflammatory demyelinating polyneuropathy (CIDP) and central demyelinating disease is described in whom striking nodular filling defects on multiple lumbar-sacral nerve roots, mimicking neurofibromata, were observed at myelography and magnetic resonance imaging. We suggest that these lesions are secondary to recurrent segmental demyelination and remyelination and that the differential diagnosis of this radiological feature should include CIDP.
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97
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Thomas AM. Strategic planning: a practical approach. Nurs Manag (Harrow) 1993; 24:34-5, 38. [PMID: 8429972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Strategic planning identifies a department's environmental factors while establishing its purpose, mission, philosophy and goals and developing a long-range plan and objectives. This hospital's practical approach mirrors the nursing process related to assessment, diagnosis and planning, implementation and evaluation.
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98
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Thomas AM, Forehand R. The role of paternal variables in divorced and married families: predictability of adolescent adjustment. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 1993; 63:126-135. [PMID: 8427303 DOI: 10.1037/h0079390] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The predictability of adolescent adjustment, based on teacher reports, in divorced and married families was examined in relationship to four variables: paternal mood, spouse-ex-spouse relationship, father-adolescent relationship, and parental visitation. Analyses indicated that the father-adolescent relationship was predictive of adolescent functioning in divorced families, and the spousal relationship and paternal mood were similarly predictive in married families.
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Logue MB, Thomas AM, Barbee JG, Hoehn-Saric R, Maddock RJ, Schwab J, Smith RD, Sullivan M, Beitman BD. Generalized anxiety disorder patients seek evaluation for cardiological symptoms at the same frequency as patients with panic disorder. J Psychiatr Res 1993; 27:55-9. [PMID: 8515389 DOI: 10.1016/0022-3956(93)90049-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Although panic disorder (PD) and generalized anxiety disorder (GAD) have similar somatic symptoms, panic attacks with chest pain and/or palpitations may seem more likely to be mistaken for heart attacks because of their acute onset. One would therefore expect that PD patients are more likely than GAD patients to seek cardiological consultations. In a survey of 146 PD and 154 GAD patients entering a multi-site drug trial, we found virtually identical rates of such consults. Approximately 50% of each patient group sought medical evaluation for cardiac symptoms. Furthermore, 40% of each group had standard treadmill evaluations and 33% reported having an echocardiogram. This study suggests that future epidemiological studies in cardiology populations should include probes for generalized anxiety disorder.
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100
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Kushner MG, Thomas AM, Bartels KM, Beitman BD. Panic disorder history in the families of patients with angiographically normal coronary arteries. Am J Psychiatry 1992; 149:1563-7. [PMID: 1415825 DOI: 10.1176/ajp.149.11.1563] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The authors evaluated the diagnostic validity of an interview-based panic disorder diagnosis in cardiology chest pain patients with angiographically normal coronary arteries. METHOD Patient probands with normal coronary arteries (N = 65) were first contracted immediately after their normal angiogram and were given a structured diagnostic interview. On the basis of the results of the interview, probands were grouped as having panic disorder (N = 19), panic attacks that did not meet frequency criteria for panic disorder (N = 17), or no panic (N = 29). At a later time, patient probands were recontacted and given a structured family history interview that inquired about psychopathology in their first-degree biological relatives (N = 544). RESULTS As predicted, panic disorder was significantly more prevalent among the first-degree relatives of probands with normal coronary arteries diagnosed with panic disorder or panic attacks than among the family members of probands with normal coronary arteries without panic (17.4% versus 15.7% versus 4.0%). Family members of probands with panic attacks were significantly more likely to be diagnosed with major depression than were the family members of probands with no panic; however, differences did not reach significance for family members of the panic disorder proband group. Groups did not differ significantly in familial alcoholism. CONCLUSIONS These data support the construct validity of an interview-based panic disorder diagnosis among patients with chest pain and normal coronary arteries and suggest that these patients could benefit from treatment for panic disorder.
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