101
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Tejada S, Essery E, Nichols D, Sanborn C, Martin J, Coviak C. Follow-Up Assessment of Bone Mineral Density in Middle School Girls and Boys. Med Sci Sports Exerc 2007. [DOI: 10.1249/01.mss.0000273053.57805.a7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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102
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Rocha-Sanchez SMS, Morris KA, Kachar B, Nichols D, Fritzsch B, Beisel KW. Developmental expression of Kcnq4 in vestibular neurons and neurosensory epithelia. Brain Res 2007; 1139:117-25. [PMID: 17292869 PMCID: PMC1858668 DOI: 10.1016/j.brainres.2006.12.087] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2006] [Revised: 12/19/2006] [Accepted: 12/21/2006] [Indexed: 10/23/2022]
Abstract
Sensory signal transduction of the inner ear afferent neurons and hair cells (HCs) requires numerous ionic conductances. The KCNQ4 voltage-gated M-type potassium channel is thought to set the resting membrane potential in cochlear HCs. Here we describe the spatiotemporal expression patterns of Kcnq4 and the associated alternative splice forms in the HCs of vestibular labyrinth. Whole mount immunodetection, qualitative and quantitative RT-PCR were performed to characterize the expression patterns of Kcnq4 transcripts and proteins. A topographical expression and upregulation of Kcnq4 during development was observed and indicated that Kcnq4 is not restricted to either a specific vestibular structure or cell type, but is present in afferent calyxes, vestibular ganglion neurons, and both type I and type II HCs. Of the four alternative splice variants, Kcnq4_v1 transcripts were the predominant form in the HCs, while Kcnq4_v3 was the major variant in the vestibular neurons. Differential quantitative expression of Kcnq4_v1 and Kcnq4_v3 were respectively detected in the striolar and extra-striolar regions of the utricle and saccule. Analysis of gerbils and rats yielded results similar to those obtained in mice, suggesting that the spatiotemporal expression pattern of Kcnq4 in the vestibular system is conserved among rodents. Analyses of vestibular HCs of Bdnf conditional mutant mice, which are devoid of any innervation, demonstrate that regulation of Kcnq4 expression in vestibular HCs is independent of innervation.
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MESH Headings
- Alternative Splicing
- Animals
- Brain-Derived Neurotrophic Factor/genetics
- Brain-Derived Neurotrophic Factor/metabolism
- Gene Expression Regulation, Developmental
- Hair Cells, Vestibular/cytology
- Hair Cells, Vestibular/metabolism
- Immunohistochemistry
- KCNQ Potassium Channels/genetics
- KCNQ Potassium Channels/metabolism
- Mice
- Mice, Mutant Strains
- Neurons, Afferent/cytology
- Neurons, Afferent/metabolism
- Orientation/physiology
- RNA, Messenger/analysis
- Tissue Distribution
- Vestibule, Labyrinth/cytology
- Vestibule, Labyrinth/growth & development
- Vestibule, Labyrinth/innervation
- Vestibule, Labyrinth/metabolism
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Affiliation(s)
- Sonia M S Rocha-Sanchez
- Department of Oral Biology, Creighton University School of Dentistry, 2500 California Plaza, Omaha, NE 68178, USA.
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Hagg D, Malkoski S, Phillips C, Nichols D, Jacoby D. The biphasic aPTT waveform to diagnose sepsis in patients with systemic inflammatory response syndrome. Crit Care 2007. [PMCID: PMC4095105 DOI: 10.1186/cc5211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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104
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Smith JD, Schroeder CA, Nichols D. Assessing Pedometer Acuracy While Walking, Skipping, Galloping, Sliding, and Hopping. Med Sci Sports Exerc 2006. [DOI: 10.1249/00005768-200605001-02561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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105
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Nichols D. Wrongful diagnosis of child abuse. J R Soc Med 2005. [DOI: 10.1258/jrsm.98.8.386-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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106
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107
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Miletello WM, Kwon YH, Wilkerson JD, Nichols D. A Biomechanical Analysis Of Punching During Martial Artsinspired Exercise. Med Sci Sports Exerc 2005. [DOI: 10.1249/00005768-200505001-00603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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108
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Miletello WM, Kwon YH, Wilkerson JD, Nichols D. A Biomechanical Analysis Of Punching During Martial Artsinspired Exercise. Med Sci Sports Exerc 2005. [DOI: 10.1097/00005768-200505001-00603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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109
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Barfknecht C, Nichols D. Additions and Corrections - Potential Psychotomimetics. Bromomethoxyamphetamines. J Med Chem 2004. [DOI: 10.1021/jm00294a605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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110
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Speed CA, Nichols D, Wies J, Humphreys H, Richards C, Burnet S, Hazleman BL. Extracorporeal shock wave therapy for plantar fasciitis. A double blind randomised controlled trial. J Orthop Res 2003; 21:937-40. [PMID: 12919884 DOI: 10.1016/s0736-0266(03)00048-2] [Citation(s) in RCA: 123] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Extracorporeal shock wave therapy (ESWT) is an increasingly popular therapeutic approach in the management of a number of tendinopathies. Benefit has been shown in calcific tendinitis of the rotator cuff, but evidence for its use in non-calcific disorders is limited. AIMS To perform a double blind randomised controlled trial of moderate dose shock wave therapy in plantar fasciitis. METHODS Adults with plantar fasciitis for at least 3 months were randomised to receive either active treatment (0.12 mJ/mm(2)) or sham therapy, monthly for 3 months. Pain in the day, nocturnal pain and morning start-up pain were assessed at baseline, before each treatment and 1 and 3 months after completion of therapy. RESULTS Eighty-eight subjects participated and no differences existed between the groups at baseline. At 3 months, 37% of the subjects in the ESWT group and 24% in the sham group showed a positive response (50% improvement from baseline) with respect to pain. Positive responses in night pain occurred in 41% and 31% in the ESWT and sham groups, respectively. Positive responses in start-up pain occurred in 37% and 36% in the ESWT and sham groups, respectively. Both groups showed significant improvement over the course of the study, but no statistically significant difference existed between the groups with respect to the changes were seen in any of the outcome measures over the 6-month period. CONCLUSIONS There appears to be no treatment effect of moderate dose ESWT in subjects with plantar fasciitis. Efficacy may be highly dependent upon machine types and treatment protocols. Further research is needed to develop evidence based recommendation for the use ESWT in musculoskeletal complaints.
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Affiliation(s)
- C A Speed
- Department of Medicine, Rheumatology, Sports and Exercise Medicine, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 2QQ, UK.
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111
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Parenteau CS, Viano DC, Shah M, Gopal M, Davies J, Nichols D, Broden J. Field relevance of a suite of rollover tests to real-world crashes and injuries. Accid Anal Prev 2003; 35:103-110. [PMID: 12479901 DOI: 10.1016/s0001-4575(01)00094-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The objective of this study was to assess the distribution of rollover accidents occurring in the field and to compare the vehicle kinematics in the predominant field crash modes with available laboratory tests. For this purpose, US accident data were analyzed to identify types and circumstances for vehicle rollovers. Rollovers were most commonly induced when the lateral motion of the vehicle was suddenly slowed or stopped. This type of rollover mechanism is referred to as "trip-over". Trip-overs accounted for 57% of passenger car and 51% of light truck vehicle (LTV) rollovers. More than 90% of trip-overs were initiated by ground contact. Fall-overs were the second most common rollover type, accounting for 13% of passenger car and 15% of LTV rollovers. Bounce-overs only accounted for 8% of both passenger car and LTV rollovers. The FMVSS 208 dolly and the ADAC corkscrew rollover tests are well-known laboratory tests, but do not simulate many of the real-world rollovers. Three additional tests have been devised to more fully address the field relevant conditions identified in this study. To do so, assumptions were made and adding the new laboratory tests (soil-trip, curb-trip and ditch fall-over) increases representativeness to 83% of passenger car and 75% of LTV rollovers reported in the field. Accident data were also used to identify injuries in belted drivers so the information could later be used to better understand occupant kinematics in various roll conditions. The injury distribution for belted/non-ejected drivers was assessed for trip-over, fall-over and bounce-over accidents. Serious injuries (AIS 3+) were most common to the head and thorax, in particular for bounce-overs. Head injuries occurred from contact with the roof, pillar and the interior, while thoracic injuries resulted from contact with the interior and steering wheel assembly. Field data are useful in the development of laboratory test conditions for rollovers as it provides insights on the significance of various rollover types, understanding of injury biomechanics, guidance for future testing and inputs for mathematical modeling.
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112
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Nichols D. Who was..... Percy Sladen? Biologist (London) 2002; 49:227-8. [PMID: 12391415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
The enigmatic echinoderms attracted few adherents in the 19th century, but this Yorkshireman almost-literally gave his life to them. He amassed the finest collection in private hands, which has been on display in the Exeter Museum since 1910.
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113
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Speed CA, Nichols D, Richards C, Humphreys H, Wies JT, Burnet S, Hazleman BL. Extracorporeal shock wave therapy for lateral epicondylitis--a double blind randomised controlled trial. J Orthop Res 2002; 20:895-8. [PMID: 12382950 DOI: 10.1016/s0736-0266(02)00013-x] [Citation(s) in RCA: 134] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
UNLABELLED Extracorporeal shock wave therapy (ESWT) is an increasingly popular therapeutic approach to the treatment of a number of soft tissue complaints. Whilst benefit has been demonstrated in calcific tendinitis, evidence is lacking for benefit in the management of non-calcific rotator cuff disorders. AIMS To perform a double-blind placebo controlled trial of moderate dose ESWT in chronic lateral epicondylitis. METHODS Adults with lateral epicondylitis were randomised to receive either active treatment (1500 pulses ESWT at 0.12 mJ/ mm2) or sham therapy, monthly for three months. All were assessed before each treatment and one month after completion of therapy. Outcome measures consisted of visual analogue scores for pain in the day and at night. RESULTS Seventy-five subjects participated and there were no significant differences between the two groups at baseline. The mean duration of symptoms was 15.9 and 12 months in the ESWT and sham groups, respectively. Both groups showed significant improvements from two months. No significant difference existed between the groups with respect to the degrees of change in pain scores over the study period. In the ESWT group the mean (SD, range) pain score was 73.4 (14.5, 38-99) at baseline and 47.9 (31.4, 3-100) at three months. In the sham group the mean (SD, range) pain score was 67.2 (21.7, 12-100) at baseline and 51.5 (32.5, 3-100) at three months. At three months, 50% improvement from baseline was noted in 35% of the ESWT group and 34% of the sham group with respect to pain. CONCLUSIONS There appears to be a significant placebo effect of moderate dose ESWT in subjects with lateral epicondylitis but there is no evidence of added benefit of treatment when compared to sham therapy.
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Affiliation(s)
- C A Speed
- Rheumatology Research Unit, Addenbrooke's Hospital, Cambridge, UK.
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114
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Speed CA, Richards C, Nichols D, Burnet S, Wies JT, Humphreys H, Hazleman BL. Extracorporeal shock-wave therapy for tendonitis of the rotator cuff. A double-blind, randomised, controlled trial. J Bone Joint Surg Br 2002; 84:509-12. [PMID: 12043769 DOI: 10.1302/0301-620x.84b4.12318] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We have performed a double-blind placebo-controlled trial of moderate doses of extracorporeal shock-wave therapy (ESWT) for non-calcific tendonitis of the rotator cuff. Adults (74) with chronic tendonitis of the rotator cuff were randomised to receive either active (1500 pulses ESWT at 0.12 mJ/mm2) or sham treatment, monthly for three months. All were assessed before each treatment, and at one and three months after the completion of treatment. The outcome was measured with regard to pain in the shoulder, including a visual analogue score for night pain, and a disability index. There were no significant differences between the two groups before treatment. The mean duration of symptoms in both groups was 23.3 months. Both showed significant and sustained improvements from two months onwards. There was no significant difference between them with respect to change in the Shoulder Pain and Disability Index (SPADI) scores or night pain over the six-month period. A mean (+/-SD; range) change in SPADI of 16.1 +/- 27.2 (0 to 82) in the treatment group and 24.3 +/- 24.8 (-11 to 83) in the sham group was noted at three months. At six months the mean changes were 28.4 +/- 25.9 (-24 to 69) and 30.4 +/- 31.2 (-12 to 88), respectively. Similar results were noted for night pain. We conclude that there is a significant and sustained placebo effect after moderate doses of ESWT in patients with non-calcific tendonitis of the rotator cuff, but there is no evidence of added benefit when compared with sham treatment.
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Affiliation(s)
- C A Speed
- Addenbrooke's Hospital, Cambridge, England, UK
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115
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Shaw E, Arusell R, Scheithauer B, O'Fallon J, O'Neill B, Dinapoli R, Nelson D, Earle J, Jones C, Cascino T, Nichols D, Ivnik R, Hellman R, Curran W, Abrams R. Prospective randomized trial of low- versus high-dose radiation therapy in adults with supratentorial low-grade glioma: initial report of a North Central Cancer Treatment Group/Radiation Therapy Oncology Group/Eastern Cooperative Oncology Group study. J Clin Oncol 2002; 20:2267-76. [PMID: 11980997 DOI: 10.1200/jco.2002.09.126] [Citation(s) in RCA: 453] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To compare survival and toxicity in adult patients treated with low-dose (50.4 Gy/28 fractions) versus high-dose (64.8 Gy/36 fractions) localized radiation therapy (RT) for supratentorial low-grade astrocytoma, oligodendroglioma, and mixed oligoastrocytoma. PATIENTS AND METHODS From 1986 to 1994, 203 eligible/analyzable patients were randomized: 101 to low-dose RT, 102 to high-dose RT. Almost half were younger than 40 years, and 95% had grade 2 tumors. Histologic subtype was astrocytoma (or mixed oligo-astrocytoma with astrocytoma dominant) in 32% of patients and oligodendroglioma (or oligoastrocytoma with oligodendroglioma dominant) in 68%. Tumor diameter was less than 5 cm in 35% of patients, and 41% of tumors showed some degree of contrast enhancement. Extent of resection was gross total in 14% of patients, subtotal in 35%, and biopsy only in 51%. RESULTS At the time of the present analysis, 83 patients (41%) are dead, and median follow-up is 6.43 years in the 120 who are still alive. Survival at 2 and 5 years is nonsignificantly better with low-dose RT; survival at 2 and 5 years was 94% and 72%, respectively, with low-dose RT and 85% and 64%, respectively, with high-dose RT (log rank P =.48). Multivariate analysis identified histologic subtype, tumor size, and age as the most significant prognostic factors. Survival is significantly better in patients who are younger than 40 years and in patients who have oligodendroglioma or oligo-dominant histology. Grade 3 to 5 radiation neurotoxicity (necrosis) was observed in seven patients, with one fatality in each treatment arm. The 2-year actuarial incidence of grade 3 to 5 radiation necrosis was 2.5% with low-dose RT and 5% with high-dose RT. CONCLUSION This phase III prospective randomized trial of low- versus high-dose radiation therapy for adults with supratentorial low-grade astrocytoma, oligodendroglioma, and oligoastrocytoma found somewhat lower survival and slightly higher incidence of radiation necrosis in the high-dose RT arm. The most important prognostic factors for survival are histologic subtype, tumor size, and age. The study design of the ongoing intergroup trial in this population will be discussed.
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Affiliation(s)
- E Shaw
- North Central Cancer Treatment Group Operations Office, Rochester, MN, USA.
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116
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Speed CA, Richards C, Nichols D, Burnet S, Wies JT, Humphreys H, Hazleman BL. Extracorporeal shock-wave therapy for tendonitis of the rotator cuff. ACTA ACUST UNITED AC 2002. [DOI: 10.1302/0301-620x.84b4.0840509] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We have performed a double-blind placebo-controlled trial of moderate doses of extracorporeal shock-wave therapy (ESWT) for non-calcific tendonitis of the rotator cuff. Adults (74) with chronic tendonitis of the rotator cuff were randomised to receive either active (1500 pulses ESWT at 0.12 mJ/mm2) or sham treatment, monthly for three months. All were assessed before each treatment, and at one and three months after the completion of treatment. The outcome was measured with regard to pain in the shoulder, including a visual analogue score for night pain, and a disability index. There were no significant differences between the two groups before treatment. The mean duration of symptoms in both groups was 23.3 months. Both showed significant and sustained improvements from two months onwards. There was no significant difference between them with respect to change in the Shoulder Pain and Disability Index (SPADI) scores or night pain over the six-month period. A mean (±sd; range) change in SPADI of 16.1 ± 27.2 (0 to 82) in the treatment group and 24.3 ± 24.8 (−11 to 83) in the sham group was noted at three months. At six months the mean changes were 28.4 ± 25.9 (−24 to 69) and 30.4 ± 31.2 (−12 to 88), respectively. Similar results were noted for night pain. We conclude that there is a significant and sustained placebo effect after moderate doses of ESWT in patients with non-calcific tendonitis of the rotator cuff, but there is no evidence of added benefit when compared with sham treatment.
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Affiliation(s)
- C. A. Speed
- Rheumatology, Sports and Exercise Medicine, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 2QQ, UK
| | - C. Richards
- Rheumatology, Sports and Exercise Medicine, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 2QQ, UK
| | - D. Nichols
- Rheumatology, Sports and Exercise Medicine, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 2QQ, UK
| | - S. Burnet
- Rheumatology, Sports and Exercise Medicine, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 2QQ, UK
| | - J. T. Wies
- Rheumatology, Sports and Exercise Medicine, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 2QQ, UK
| | - H. Humphreys
- Rheumatology, Sports and Exercise Medicine, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 2QQ, UK
| | - B. L. Hazleman
- Rheumatology, Sports and Exercise Medicine, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 2QQ, UK
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117
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Fu SQ, Abboud CN, Brennan JK, Ifthikharuddin JJ, Nichols D, Liesveld JL. Impact of mobilized blood progenitor cell quality determined by the CFU-GM/CD34+ ratio on rapid engraftment after blood stem cell transplantation. Blood Cells Mol Dis 2002; 28:315-21. [PMID: 12367578 DOI: 10.1006/bcmd.2002.0519] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
To find a parameter to predict the quality of collected mobilized CD34+ blood as hemopoietic reconstituting cells, the ratio of CFU-GM to CD34+ cells was examined. One hundred six consecutive patients who underwent blood stem cell transplantation at the University of Rochester from 01/01/99 to 12/31/99 were examined retrospectively for the number of days to reach an absolute neutrophil count of 500 or 1000 cells/microl and an absolute platelet count of 20,000 or 50,000 cells/microl without transfusion support as measures of engraftment. Linear regression analyses were conducted to determine factors influencing engraftment. The number of CD34+ cells/kg and CFU-GM/kg correlated highly with the number of nucleated blood cells/kg. In this population, in which 90% of patients received >2 x 10(6) CD34+ cells/kg, neither the number of CD34+ cells/kg nor the number of CFU-GM/kg correlated with the time to engraftment as judged by neutrophil or platelet levels. In contrast, the lower the ratio of CFU-GM to CD34+ cells, the more rapid the reconstitution of platelets to 20,000/microl (P = 0.03) and 50,000/microl (P = 0.02). Thus, a lower ratio of the CFU-GM/CD34+ appended to reflect a greater number of hematopoietic reconstituting cells in the blood cell collection. The CFU-GM/CD34+ ratio is an apparent predictor of earlier platelet engraftment, suggesting that the ratio reflects the engraftment potential of mobilized donor progenitor cells.
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Affiliation(s)
- S Q Fu
- Blood and Marrow Stem Cell Transplant Program, Department of Internal Medicine and The James P. Wilmot Cancer Center, University of Rochester, New York 14642, USA
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118
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Abstract
BACKGROUND Anesthetic techniques and problems in volunteer medical services abroad are different from those of either the developed countries from which volunteers originate or the host country in which they serve because of differences in patient population, facilities, and goals for elective surgery. Assessing outcomes is hampered by the transience of medical teams and the global dispersion of providers. We studied general anesthesia techniques and outcomes in a large international voluntary surgical program. METHODS Anesthesia providers and nurses participating in care of patients undergoing reconstructive plastic and orthopedic surgery by Operation Smile over an 18-month period were asked to complete a quality assurance data record for each case. Incomplete data were supplemented by reviewing the original patient records. RESULTS General anesthesia was used in 87.1% of the 6,037 cases reviewed. The median age was 5 yr (25th-75th percentiles: 2-9 yr). Orofacial clefts accounted for more than 80% of procedures. Halothane mask induction was performed in 85.6% of patients; 96.3% of patients had tracheal intubation, which was facilitated with a muscle relaxant in 19.3%. Respiratory complications occurred during anesthesia in 5.0% of patients and during recovery (postanesthesia care unit) in 3.3%. Arrhythmias requiring therapy occurred in 1.5%, including three patients to whom cardiopulmonary resuscitation was administered. Prolonged ventilatory support was required in seven patients. There was one death. Inadvertent extubation during surgery occurred in 38 patients. Cancellation of surgery after induction of anesthesia occurred in 25 patients. Overall, complications were more common in younger children. CONCLUSIONS Our study showed that in this setting it is feasible to track anesthesia practice patterns and adverse perioperative events. We identified issues for further examination.
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Affiliation(s)
- Q A Fisher
- Department of Anesthesiology and Critical Medicine, George Washington University, Washington, DC, USA.
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119
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Eguchi M, Ostrowski M, Fegatella F, Bowman J, Nichols D, Nishino T, Cavicchioli R. Sphingomonas alaskensis strain AFO1, an abundant oligotrophic ultramicrobacterium from the North Pacific. Appl Environ Microbiol 2001; 67:4945-54. [PMID: 11679312 PMCID: PMC93257 DOI: 10.1128/aem.67.11.4945-4954.2001] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2001] [Accepted: 08/07/2001] [Indexed: 11/20/2022] Open
Abstract
Numerous studies have established the importance of picoplankton (microorganisms of < or =2 microm in length) in energy flow and nutrient cycling in marine oligotrophic environments, and significant effort has been directed at identifying and isolating heterotrophic picoplankton from the world's oceans. Using a method of diluting natural seawater to extinction followed by monthly subculturing for 12 months, a bacterium was isolated that was able to form colonies on solid medium. The strain was isolated from a 10(5) dilution of seawater where the standing bacterial count was 3.1 x 10(5) cells ml(-1). This indicated that the isolate was representative of the most abundant bacteria at the sampling site, 1.5 km from Cape Muroto, Japan. The bacterium was characterized and found to be ultramicrosized (less than 0.1 microm(3)), and the size varied to only a small degree when the cells were starved or grown in rich media. A detailed molecular (16S rRNA sequence, DNA-DNA hybridization, G+C mol%, genome size), chemotaxonomic (lipid analysis, morphology), and physiological (resistance to hydrogen peroxide, heat, and ethanol) characterization of the bacterium revealed that it was a strain of Sphingomonas alaskensis. The type strain, RB2256, was previously isolated from Resurrection Bay, Alaska, and similar isolates have been obtained from the North Sea. The isolation of this species over an extended period, its high abundance at the time of sampling, and its geographical distribution indicate that it has the capacity to proliferate in ocean waters and is therefore likely to be an important contributor in terms of biomass and nutrient cycling in marine environments.
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MESH Headings
- Base Composition
- Colony Count, Microbial
- DNA, Bacterial/analysis
- DNA, Bacterial/chemistry
- DNA, Bacterial/genetics
- DNA, Ribosomal/analysis
- DNA, Ribosomal/chemistry
- DNA, Ribosomal/genetics
- Fatty Acids/analysis
- Heat-Shock Response
- Molecular Sequence Data
- Nucleic Acid Hybridization
- Pacific Ocean
- Phylogeny
- RNA, Ribosomal, 16S/genetics
- Seawater/microbiology
- Sequence Analysis, DNA
- Sphingomonas/classification
- Sphingomonas/genetics
- Sphingomonas/isolation & purification
- Sphingomonas/ultrastructure
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Affiliation(s)
- M Eguchi
- Department of Fisheries, Kinki University, Nara 631-8505, Japan
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120
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Slaughter JR, Slaughter KA, Nichols D, Holmes SE, Martens MP. Prevalence, clinical manifestations, etiology, and treatment of depression in Parkinson's disease. J Neuropsychiatry Clin Neurosci 2001; 13:187-96. [PMID: 11449025 DOI: 10.1176/jnp.13.2.187] [Citation(s) in RCA: 143] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To determine the extent to which depression complicates Parkinson's disease (PD), the authors analyzed the literature on depression in PD in order to report on its prevalence, clinical manifestations, and treatment. By means of MEDLINE literature searches, the analysis focused on 45 PD depression studies conducted from 1922 through 1998. The results indicate that the prevalence of depression is 31% for all PD patients. The clinical manifestations of PD depression include apathy, psychomotor retardation, memory impairment, pessimism, irrationality, and suicidal ideation without suicidal behavior. PD depression is effectively treated with a variety of antidepressants, most commonly at present the selective serotonin reuptake inhibitors. Anecdotal evidence supports the use of sertraline to treat PD depression.
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Affiliation(s)
- J R Slaughter
- Department of Psychiatry and Neurology, University of Missouri School of Medicine, Columbia 65212, USA
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Hannan KL, Berg DE, Baumzweiger W, Harrison HH, Berg LH, Ramirez R, Nichols D. Activation of the coagulation system in Gulf War Illness: a potential pathophysiologic link with chronic fatigue syndrome. A laboratory approach to diagnosis. Blood Coagul Fibrinolysis 2000; 11:673-8. [PMID: 11085289 DOI: 10.1097/00001721-200010000-00013] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Most symptoms of Gulf War Illness (GWI) are similar to Chronic Fatigue Syndrome (CFS) and/or Fibromyalgia (FM). We investigated whether these symptoms are associated with an activated coagulation system as has been reported in some cases of CFS/FM. The coagulation assays include activation markers of the cascade, platelet activation and hereditary risk factors. Our findings show activation of the coagulation system in GWI. This evidence of a hypercoagulable state suggests that symptoms may be due to poor blood flow and, therefore, a basis for the potential utility of anticoagulant therapy.
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Affiliation(s)
- K L Hannan
- Osceola Hospital, Kissimmee, Orlando, Florida, USA
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Smith ML, Shimomura ET, Summers J, Paul BD, Nichols D, Shippee R, Jenkins AJ, Darwin WD, Cone EJ. Detection times and analytical performance of commercial urine opiate immunoassays following heroin administration. J Anal Toxicol 2000; 24:522-9. [PMID: 11043654 DOI: 10.1093/jat/24.7.522] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The Federal Workplace Drug Testing Program changed urine screening and confirmation cutoff concentrations for opiate testing from 300 to 2000 ng/mL in 1998. Morphine was the designated target compound. An additional heroin metabolite, 6-acetylmorphine (6-AM), was added to the testing procedure with a cutoff concentration > or = 10 ng/mL. Testing of 6-AM was required if morphine was positive to assist in medical review. A comparison of the new opiate cutoff concentrations was made with the older cutoff concentration at 300 ng/mL. Six commercial opiate immunoassays, four with a 300-ng/mL cutoff, ONLINE, EMIT, CEDIA and AxSym, and two with 2000-ng/mL cutoffs, ONLINE and EMIT, were selected to test 920 urine samples collected from 11 male human subjects following single doses of heroin. Eight received intravenous doses of 3, 6, and 12 mg heroin HCl and four smoked 3.5-, 5.2-, 10.5-, or 13.9-mg doses of heroin (base). In addition, 183 urine-based blind quality-control specimens were added to the study set to assess linearity, cross-reactivity, and interference. Total morphine, free morphine, and 6-AM were measured in each sample by gas chromatography-mass spectrometry (GC-MS). Linearity, cross-reactivity, and interference results for each immunoassay are described. Detection times, sensitivity, specificity, and efficiency of each assay were determined using data from the specimens collected after heroin administration. Detection times for morphine using the 300-ng/mL cutoff assays was approximately 12 h for low dose and 24 to 48 h for higher doses of heroin. For the two 2000-ng/mL cutoff concentration assays detection time was about 12 h. This was also the detection time for 6-AM by GC-MS. ONLINE had the lowest sensitivity, 60-74%, highest specificity, 98.8-100%, and least interference from a selection of common over-the-counter drugs and opioids. Increasing the cutoff to 2000 ng/mL from 300 ng/mL increased efficiencies of the assays from 72.7 to 82.6% to over 97%.
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Affiliation(s)
- M L Smith
- Division of Forensic Toxicology, Office of the Armed Forces Medical Examiner, Armed Forces Institute of Pathology, Washington, D.C. 20306-6000, USA
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Schoenthaler SJ, Bier ID, Young K, Nichols D, Jansenns S. The effect of vitamin-mineral supplementation on the intelligence of American schoolchildren: a randomized, double-blind placebo-controlled trial. J Altern Complement Med 2000; 6:19-29. [PMID: 10706232 DOI: 10.1089/acm.2000.6.19] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
CONTEXT Many medical, nutrition, and education professionals have long suspected that poor diet impairs the academic performance of Western schoolchildren; academic performance often improves after improved diet. However, others have suggested that such academic gains may be due to psychologic effects rather than nutrition. To resolve this issue, two independent research teams conducted randomized trials in which children were given placebos or low-dose vitamin-mineral tablets designed to raise nutrient intake to the equivalent of a well-balanced diet. Both teams reported significantly greater gains in nonverbal intelligence among the supplemented groups. The findings were important because of the apparent inadequacy of diet they revealed and the magnitude of the potential for increased intelligence. However, none of the ten subsequent replications, or the two original trials, were without limitations leaving this issue in controversy. OBJECTIVES To determine if schoolchildren who consume low-dose vitamin-mineral tablets will have a significantly larger increase in nonverbal intelligence than children who consume placebos in a study that overcomes the primary criticisms directed at the previous 12 controlled trials. DESIGN A double-blind, placebo-controlled trial using stratified randomization within each teacher's class based on preintervention nonverbal intelligence. SETTINGS AND SUBJECTS Two "working class," primarily Hispanic, elementary schools in Phoenix, Arizona, participated in the study. Slightly more than half the teachers in each school distributed the tablets daily to 245 schoolchildren aged 6 to 12 years. INTERVENTION Daily vitamin-mineral supplementation at 50% of the U.S. daily recommended allowance (RDA) for 3 months versus placebo. OUTCOME MEASURES Post-test nonverbal IQ, as measured by the Wechsler Intelligence Scale for Children-Revised (WISC-R), while controlling for pretest nonverbal IQ as a covariate. FOUR MAIN RESULTS: First, a significant difference of 2.5 IQ points (95% CI: 1.85-3.15) was found between 125 children given active tablets and 120 children given placebo tablets (p = 0.038). Second, this finding is consistent with the mean 3.2 IQ point net gain found in the 12 similar but less rigorous studies. Third, a significantly higher proportion of children in the active group gained 15 or more IQ points when compared to the placebo group (p < 0.01). Fourth, although 81 matched pairs produced no difference at all in nonverbal IQ gain, the modest 2.5 IQ point net gain for the entire sample can be explained by the remaining 24 children who took active tablets, and had a 16 point higher net gain in IQ than the remaining 19 placebo controls. CONCLUSIONS This study confirms that vitamin-mineral supplementation modestly raised the nonverbal intelligence of some groups of Western schoolchildren by 2 to 3 points but not that of most Western schoolchildren, presumably because the majority were already adequately nourished. This study also confirms that vitamin-mineral supplementation markedly raises the non-verbal intelligence of a minority of Western schoolchildren, presumably because they were too poorly nourished before supplementation for optimal brain function. Because nonverbal intelligence is closely associated with academic performance, it follows that schools with children who consume substandard diets should find it difficult to produce academic performance equal to those schools with children who consume diets that come closer to providing the nutrients suggested in the U.S. RDA. The parents of schoolchildren whose academic performance is substandard would be well advised to seek a nutritionally oriented physician for assessment of their children's nutritional status as a possible etiology.
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Affiliation(s)
- S J Schoenthaler
- Department of Sociology and Criminal Justice, California State University, Stanislaus, Turlock 95380, USA.
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Abstract
Postprandial insulin responses (integrated area under the curve) to an oral glucose load after a period of aerobic exercise and no exercise (control) were compared in sedentary normoglycemic Mexican American and non-Hispanic women pair-matched (n = 9) on total body fat mass (21.8 +/- 3.5 kg). The age (27.4 +/- 3.0 years), body mass index (BMI) (23.6 +/- 1.4 kg/m2), waist to hip ratio (WHR) (0.85 +/- .02), waist circumference (83.5 +/- 4.5 cm), lean mass (36.2 +/- 1.5 kg), and maximal O2 consumption ([VO2 max] 32.9 +/- 1.6 mL x kg(-1) x min(-1)) were similar, although the centrality index (subscapular/triceps skinfolds) was significantly greater in Mexican Americans (0.88 +/- 0.06 v 0.70 +/- 0.05, P < .01). Exercise (treadmill walking for 50 minutes at 70% VO2 max) and control trials were performed 4 weeks apart and 5 to 12 days after the onset of menstruation. A 75-g oral glucose load was administered 15 hours after the completion of each trial, with the subjects 12 hours postprandial. Blood samples were drawn prior to glucose ingestion (fasting, 0 minutes) and at minutes 15, 30, 60, 90, 120, and 150 postingestion. The postprandial insulin response was calculated using a trapezoidal method. In Mexican Americans, significant (P < .02) reductions in the postprandial insulin response (exercise v control, 6.5 +/- 1.0 v 8.5 +/- 1.4 pmol/L x min x 10(4)) and fasting insulin (exercise v control, 77.4 +/- 7.0 v 88.5 +/- 10.3 pmol/L) occurred after exercise compared with the control condition. In non-Hispanics, neither the postprandial insulin response (exercise v control, 7.2 +/- 1.0 v 6.2 +/- 0.9 pmol/L x min x 10(4)) nor fasting insulin (exercise v control, 77.0 +/- 8.2 v 82.9 +/- 8.9 pmol/L) were significantly different between trials. The postprandial insulin response in the control trial was significantly correlated with the change in the insulin response (control minus exercise) in the 18 women (r = .56, P = .01). No trial or group differences were found for postprandial glucose and C-peptide responses. Mexican American women have a high risk of developing type 2 diabetes, and aerobic exercise may be valuable in the prevention or delay of onset of diabetes by reducing peripheral insulin resistance.
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Affiliation(s)
- C Jankowski
- Department of Kinesiology, Texas Woman's University, Denton 76204, USA
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Rivers FM, Lavallee SM, Nenninger KM, Nichols D. Evaluation of a bed utilization system in a surgical nursing section. Mil Med 1998; 163:839-43. [PMID: 9866364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
This research study evaluated a new bed utilization program established in the surgical nursing section at a major military medical facility. The study involved four wards with 83 beds before the new system was implemented, and three wards with 71 beds after the implementation. Five variables were identified as having an effect on the bed management program. These variables were time of discharge, escort compliance, bed availability, staff satisfaction, and patient satisfaction. Both a paired t test and an independent t test were applied for statistical analysis at the 0.05 level of significance. Data were collected for 1 month at two different intervals for comparison, using two surveys, patient records, 24-hour nursing reports, and same-day surgical schedules. A sample size of 103 was used as a basis for time of discharge and staff and patient satisfaction. The staff satisfaction survey also included a demographic data sheet. Escort compliance and bed availability were based on a 30-day time frame. The sample subjects included all patients who entered the surgical nursing section and their health care providers. Data analysis revealed significant differences in escort compliance and bed availability between the pre and post data. Findings from this study support the need for a functional, efficient bed management system.
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Affiliation(s)
- F M Rivers
- Surgical Nursing Section, Tripler Army Medical Center, Honolulu, HI 96859-5000, USA
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126
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Nichols D. Intracranial angioplasty: a little science enters into the mix. AJNR Am J Neuroradiol 1998; 19:1387. [PMID: 9763365 PMCID: PMC8338701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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127
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Nichols D. ACNP/SNM Government Relations Office midyear report: January-May 1998. American College of Nuclear Physicians/Society of Nuclear Medicine. J Nucl Med 1998; 39:24N-25N. [PMID: 9627320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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128
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Cordero de Troconis MI, Pfaff R, Nichols D. [Molecular modeling of N-isopropyl lisergamides analogous to LSD using molecular mechanics and quantum mechanical calculations]. Acta Cient Venez 1998; 48:85-90. [PMID: 9567327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Molecular mechanics and quantum mechanics were used to study the preferred conformations, electron densities and frontier orbitals of d-LSD and their analogs with the isopropyl amide group, compounds with reported activity over the serotonin receptor. Electron densities and frontier orbitals for isopropyl analogs were similar to d-LSD, so these properties can not be related with the changes in biological activity previously reported. It was found that isopropyl analogs have preferred conformations similar to d-LSD with small variation in the alkylamide group. The variation in the alkylamide group causes small variations in the orientation of the carbonyl amide group, our study suggests that this variation could affect the binding with the hydrophobic region of the receptor.
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Affiliation(s)
- M I Cordero de Troconis
- Departamento de Química, Fac. de Farmacia, Universidad Central de Venezuela, Caracas, Venezuela
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Abstract
Computer users experience high rates of injury and disability, broadly termed repetitive strain injury (RSI). With more than 60 million Americans using computers in offices and homes, the potential magnitude of the RSI problem indicates a need for increased attention to prevention and treatment. The purpose of this article is to: 1) present a conceptual model of RSI as a kinetic-chain, multifactorial disorder; 2) outline the salient features of the clinical evaluation of the RSI patient; 3) describe the role of postural deviation in the pathogenesis of RSI; 4) present the principles of individual manual therapy; and 5) discuss the rationale, admission criteria, educational principles, and outcome of a multidisciplinary group intervention.
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Affiliation(s)
- K Keller
- West Side Dance Physical Therapy, New York, New York 10023, USA
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130
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Nichols D. Pharmacy compounding: background on the latest federal initiatives. J Nucl Med 1998; 39:26N. [PMID: 9443726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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131
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Nichols D. Nuclear medicine wins decision in FDA PET case. J Nucl Med 1997; 38:23N. [PMID: 9430453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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132
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Nichols D, Zallar MJ. Care coordination. A new role in a customer-focused healthcare system. Nurs Case Manag 1997; 2:269-74. [PMID: 9481316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In the current healthcare environment, all healthcare providers are challenged to provide quality patient care in an efficient, cost-effective manner. Managed care organizations and third-party payors actively collect data related to cost, length of stay, resource use, and patient outcomes for use in affiliating and contracting with healthcare facilities and providers. The authors, in this article, outline one organization's evolution from a "utilization review"-based discharge planning process to a proactive "utilization management" approach to care coordination.
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Affiliation(s)
- D Nichols
- Northwest Texas Healthcare System, Universal Health Services, Amarillo, TX 79175, USA
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Nichols D. ACNP/SNM work to amend FDA reform bill. American College of Nuclear Physicians/Society of Nuclear Medicine. J Nucl Med 1997; 38:39N-40N. [PMID: 9293781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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134
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Kendrick K, Jankowski C, Nichols D, Ben-Ezra V. INSULIN RESPONSES FOLLOWING ACUTE AEROBIC AND RESISTANCE EXERCISE1146. Med Sci Sports Exerc 1997. [DOI: 10.1097/00005768-199705001-01144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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135
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Nichols D. Compounding language drafted by congress. J Nucl Med 1997; 38:23N-24N. [PMID: 9098189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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136
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Suarez L, Roche RA, Nichols D, Simpson DM. Knowledge, behavior, and fears concerning breast and cervical cancer among older low-income Mexican-American women. Am J Prev Med 1997; 13:137-42. [PMID: 9088451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Although recent studies have documented the low participation level of Hispanic women in cancer screening, few have examined their predisposing knowledge and attitudes concerning cancer. We documented the knowledge and fears concerning cancer of an older population of Mexican-American women and how these factors relate to screening behavior and sociodemographic characteristics. METHODS The data are from baseline surveys conducted before the start of a community cancer awareness and prevention program. Nine hundred twenty-three Mexican-American women were interviewed in-person about their knowledge, attitudes, and Pap smear and mammogram screening practices. RESULTS Knowledge and attitude about cancer varied with age, education, type of health insurance, ability to speak English, and place of birth. Women 65 years of age and older were least knowledgeable of cancer-detection methods and screening guidelines. Those with only Medicare or Medicaid knew far less even compared to uninsured women. Women who did not speak English well were more likely not to know the cancer signs and symptoms, risk factors, and screening guidelines. Women who had knowledge of guidelines and detection methods were more likely to have had a recent screening. Older Mexican-American women with more fatalistic and fearful attitudes toward cancer were less likely to have had a recent Pap smear. CONCLUSIONS The low screening participation among Mexican-American women may be due to their limited awareness and knowledge about breast and cervical cancer screening examinations. Our study highlights the need for wide-scale cancer screening interventions consistent with Mexican-American beliefs.
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Affiliation(s)
- L Suarez
- Texas Department of Health, Austin, USA.
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137
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Nichols D. Regulatory issues are primary focus for nuclear medicine groups. J Nucl Med 1997; 38:17N. [PMID: 9025728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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138
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Nichols D. Capitol offense. With Washington promising action this year, what kinds of cuts can providers expect? Contemp Longterm Care 1997; 20:38-41. [PMID: 10164183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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139
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Abstract
Research has documented decreased strength and proprioception in people with arthritis. Both are components of balance, but reliable studies documenting balance deficits have not been done. This study tested standing balance in an adult population with osteoarthritis. The osteoarthritic group (N = 11) and the age-matched control group (N = 10) were tested on the Balance System. Each underwent two trials of six testing conditions [two visual conditions (eyes open, eyes closed) under each of three platform conditions (stable, angular rotation, and linear translation)] and completed a functional assessment scale. Individuals with knee osteoarthritis demonstrated significantly more postural sway than the control group across conditions (p < 0.02). The functional assessment scale developed to discriminate between the two groups demonstrated internal consistency (Cronbach's coefficient alpha = 0.83), and scores were significantly different between the two groups (p < 0.0001). Results suggest the importance of balance training in this population. The functional assessment scale may be a useful tool to document functional levels in knee osteoarthritis.
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Affiliation(s)
- L Wegener
- New Haven Orthopedic Surgeons, CT, USA
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140
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Sekadde-Kigondu C, Mwathe EG, Ruminjo JK, Nichols D, Katz K, Jessencky K, Liku J. Acceptability and discontinuation of Depo-Provera, IUCD and combined pill in Kenya. East Afr Med J 1996; 73:786-94. [PMID: 9103686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This paper reports on a prospective study conducted between June 1990 and June 1992 to determine method acceptability, user satisfaction and continuation rates for three highly effective and reversible contraceptive methods currently available in Kenya: the CuT 380A (IUCD), the injectable, Depo-Provera and the low-dose oral contraceptive pill, Microgynon. A non-randomised sample of volunteer participants was used. One thousand and seventy-six users were followed up for a period of one year or up to the time of discontinuation of the method, whichever came earlier. Analysis revealed method specific differences in users' characteristics. The OC users were younger and had fewer children than the IUCD or Depo-Provera users. The Depo-Provera users were older, and had the largest family sizes. Many OC users (almost 40%) were single, while almost three-quarters of IUCD and Depo-Provera users were married. IUCD users were also more educated compared to OC and Depo-Provera users. Survival analysis was used to calculate cumulative life table discontinuation rates by method for the 12 month period. Discontinuation rates were highest for OC users (80%) and lowest for IUCD users (20%) and intermediate for Depo-Provera users (39%). Ninety percent of OC and Depo-Provera users and 86% of IUCD users said they were satisfied with their respective methods. While OCs are among the most popular family planning methods in Kenya, they are also one of the most problematic, while IUCD has the fewest compliance problems. Service providers need to address the issue of high discontinuation rates among the young OC users.
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141
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Nichols D. Congress puts pressure on NRC. J Nucl Med 1996; 37:44N. [PMID: 8917167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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142
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Kamau RK, Karanja J, Sekadde-Kigondu C, Ruminjo JK, Nichols D, Liku J. Barriers to contraceptive use in Kenya. East Afr Med J 1996; 73:651-9. [PMID: 8997845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This study was designed to identify and to better understand the barriers to contraceptive use among Kenyan-couples. Data were collected through structured interviews and focus group discussions among couples not planning for pregnancy and not using any effective contraceptive method. The study was conducted in the Baba Dogo urban slum area of Nairobi, and Chwele, a rural sub-location in Bungoma, western Kenya. Some important barriers to contraceptive use were identified in couples wishing to space or limit further births. Those barriers included lack of agreement on contraceptive use and on reproductive intentions; husband's attitude on his role as a decision maker; perceived undesirable side effects, distribution and infant mortality; negative traditional practices and desires such as naming relatives, and preference for sons as security in old age. There were also gaps in knowledge on contraceptive methods, fears, rumours and misconceptions about specific methods and unavailability or poor quality of services in the areas studied. This paper recommends that information and educational programmes should be instituted to increase contraceptive knowledge, to emphasise the value of quality of life over traditional reproductive practices and desires, and to improve availability and quality of services.
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Affiliation(s)
- R K Kamau
- Department of Obstetrics and Gynaecology, University of Nairobi, Kenya
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143
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Abstract
The incidence and pattern of changes in thyroid function tests were studied in acutely hospitalized psychiatric patients and the cost effectiveness of a systematic screening program for thyroid dysfunction was estimated. Thyroid testing was performed on 1275 of 1424 (90%) admissions to the psychiatric wing of Strong Memorial Hospital between April 1, 1993 and March 30, 1994. Discharge samples were obtained in 232 patients who were hospitalized at least 2 days; 163 patients were admitted multiple times. Psychiatric diagnosis was coded using DSM-III-R criteria. TSH, T4, free T4, and T3 levels were measured within 48 h of admission. TSH values were most frequently abnormal (7.8%) and free T4 the least (1.3%). Admission and discharge thyroid tests were similar. Significant differences in the four parameters of thyroid function were present among the psychiatric groups. By analysis of variance every 1 microU/mL increase in TSH levels was associated with a 2.5% increase in length of stay (LOS) (95% confidence intervals: 0.21%, 4.75%), holding psychiatric diagnosis, age, and gender constant. For patients with elevated TSH levels, the average LOS was increased by 10.7 days (95% confidence intervals: 2.8, 18.7 days). It is concluded that patients hospitalized for psychiatric illness have an incidence of thyroid dysfunction at or slightly higher than the general population. However, patients with elevated TSH levels are hospitalized longer than those with normal or suppressed values.
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Affiliation(s)
- P D Woolf
- Department of Medicine, University of Rochester School of Medicine and Dentistry, New York 14642, USA
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144
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Jacobs P, Nichols D, Dubitz T. Comparative costs for substitutable services: inpatient and day surgery episodes of care. Healthc Manage Forum 1996; 8:36-43. [PMID: 10172521 DOI: 10.1016/s0840-4704(10)60917-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The authors analyze the differences in costs between inpatient and outpatient elective surgery, by case mix group*, using the University of Alberta Hospitals Patient Resource Consumption Profile database (PRCP), supplemented with additional data from other agencies. PRCP measures costs for both inpatient and outpatient cases and is linked to the hospital's medical records, so that individual case-costing and detailed cost comparisons can be made. The focus of the comparison is on cost per case, measured in terms of the entire episode of outpatient surgery.
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Affiliation(s)
- P Jacobs
- University of Alberta, Faculty of Medicine, Edmonton, Canada
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145
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Nichols D. Balancing the budget: will it work? J Nucl Med 1996; 37:16N-17N. [PMID: 8543987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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146
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Abstract
The purposes of the study were to compare insulin responses after rest and exercise of two different intensities and equal total energy expenditure and to examine these responses in normoglycemic women. Twenty-four untrained women (age 23.4 +/- 0.9 yr) completed three randomly assigned treatments over the course of a 3- to 4-wk period: rest, 40% maximal oxygen consumption x 87 min (Low), and 70% maximal oxygen consumption x 50 min (High). Total energy expenditure was 1,821 +/- 61 and 1,692 +/- 59 kJ, heart rate was 119 +/- 2 and 163 +/- 2 beats/min, and oxygen consumption was 17.1 and 27.2 ml.kg-1.min-1 for Low and High, respectively. Fifteen to 17 h posttreatment and 12 h postprandial, each subject drank a 75-g glucose solution (oral glucose tolerance test). Blood samples were drawn before and at 30, 60, 90, 120, and 150 min after ingestion and were analyzed for glucose and insulin. Glucose areas and responses at the same time points across treatments were similar. Area under the insulin curve was significantly lower (P < 0.05) after High (51,864 +/- 3,780 pM x min) compared with rest (61,009 +/- 4,425 pM x min), but Low (59,191 +/- 5,307 pM x min) was not different from either rest or High. The insulin level at the 120-min time point was significantly (P < 0.01) lower after High (290.8 pM) compared with rest (391.7 pM). On the basis of these results, exercise-related changes in insulin responses are more dependent on exercise intensity than on energy expenditure in untrained women.
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Affiliation(s)
- V Ben-Ezra
- Department of Kinesiology, Texas Woman's University, Denton 76204, USA
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147
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Jacobs P, Hall E, Henderson I, Nichols D. Episodic acute care costs: linking inpatient and home care. Can J Public Health 1995; 86:200-5. [PMID: 7671208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
STUDY OBJECTIVE To develop a measure of an acute care "episode of care" that incorporates hospital and home care portions of care, and to measure the costs of such episodes. DESIGN Patient level data from a home care program and an acute care hospital were linked using patient health insurance identification numbers. The linked database contained information on inpatient case mix, home care patient classification (i.e., type of care) and cost data for both settings. Data by patient classification were analyzed. MAIN RESULTS Patterns of resource use were very different for medical and surgical cases, home care costs being 25% of a medical episode and only 5% of a surgical episode. For surgical cases, the marginal cost of an extra surgical day is about equal to the marginal cost of an extra short-term home care case (i.e., a one-day reduction in a surgical inpatient length of stay would cover the cost of a home care stay). Medical cases would require a three-day reduction in inpatient cost.
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Affiliation(s)
- P Jacobs
- Department of Public Health Sciences, University of Alberta, Edmonton
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148
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Nichols D. Clearing the air. Many facilities are voluntarily adopting policies that snuff out secondhand smoke. Contemp Longterm Care 1995; 18:47-50. [PMID: 10142835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Faced with the need to prevent fires and protect nonsmokers from secondhand smoke--and, in some cases, to obey state or local anti-smoking laws--a growing number of administrators are restricting the use of cigarettes in their facilities. The trickiest part? Honoring the rights of residents who smoke.
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149
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Farrell S, Nichols D, Kendrick K, Ben-Ezra V. THE EFFECTS OF A BOUT OF STRENGTH TRAINING ON GLUCOSE AND INSULIN RESPONSES IN SEDENTARY WOMEN. Med Sci Sports Exerc 1995. [DOI: 10.1249/00005768-199505001-01101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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150
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Kendrick K, Nichols D, Jankowski C, Ben-Ezra V. THE EFFECT OF EXERCISE INTENSITY AND TOTAL WORK ON INSULIN RESPONSES IN MEN. Med Sci Sports Exerc 1995. [DOI: 10.1249/00005768-199505001-00736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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