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Considerable Individual Variation (considerable + individual_variation)
Selected AbstractsClinical issues in using buprenorphine in the treatment of opiate dependenceDRUG AND ALCOHOL REVIEW, Issue 3 2000Dr A. Chadderton MB Abstract This paper looks at the current role of buprenorphine in the treatment of opiate dependence. It suggests that buprenorphine is a useful alternative to methadone and that in at least some cases it may be the preferred option. Buprenorphineis a partial agonist and a partial antagonist with a ceiling of opiate activity probably approximately equal to 30mg methadone. It achieves this at a dose of 10-12mg, although there is considerable individual variation. Because of its ceiling effect it has a good safety profile compared to full agonists such as methadone although some overdose deaths, particularly in conjunction with benzodiazepine abuse, have been reported in France. Induction of buprenorphine may take slightly longer than for methadone and there is a higher dropout rate compared to methadone in the first 2 weeks. This is probably due to the antagonist action of buprenorphine causing more withdrawal symptoms in comparison to methadone. Also, the ceiling effect for buprenorphine means that some clients do not experience sufficient opiate activity to satisfy them. Buprenorphine has a long half-life and dissociates slowly from opiate receptors. Most clients can be dosed second-daily but some find this unacceptable due to mood swings and/or withdrawal symptomson the second day. For these clients daily dosing is required. Transferring from buprenorphine to methadone is straightforward and well tolerated by clients. Transferring from methadone to buprenorphine, however, is more difficult because of the partial antagonist action of buprenorphine. Clients experience withdrawal symptoms that can take up to 2 weeks to settle. Most clients find these symptoms unacceptable when transferring from doses of over 30mg of methadone. The optimum method for transferring from methadone to buprenorphine is still to be determined. Withdrawal from buprenorphine appears to be relatively easier than from methadone. This is presumably due to buprenorphine's partial agonist effect at mureceptors. It is expected that during 2000 buprenorphine will be approved for use in Australia for the treatment of opiate dependence. It may well becomea first-line choice for opiate replacement in heroin dependence. It is also likely to be useful in assisting detoxification fromboth methadone and heroin. [source] Association of vasopressin 1a receptor levels with a regulatory microsatellite and behaviorGENES, BRAIN AND BEHAVIOR, Issue 5 2005E. A. D. Hammock Vasopressin regulates complex behaviors such as anxiety, parenting, social engagement and attachment and aggression in a species-specific manner. The capacity of vasopressin to modulate these behaviors is thought to depend on the species-specific distribution patterns of vasopressin 1a receptors (V1aRs) in the brain. There is considerable individual variation in the pattern of V1aR binding in the brains of the prairie vole species, Microtus ochrogaster. We hypothesize that this individual variability in V1aR expression levels is associated with individual variation in a polymorphic microsatellite in the 5, regulatory region of the prairie vole v1ar gene. Additionally, we hypothesize that individual variation in V1aR expression contributes to individual variation in vasopressin-dependent behaviors. To test these hypotheses, we first screened 20 adult male prairie voles for behavioral variation using tests that measure anxiety-related and social behaviors. We then assessed the brains of those animals for V1aR variability with receptor autoradiography and used polymerase chain reaction to genotype the same animals for the length of their 5, microsatellite polymorphism in the v1ar gene. In this report, we describe the results of this discovery-based experimental approach to identify potential gene, brain and behavior interrelationships. The analysis reveals that V1aR levels, in some but not all brain regions, are associated with microsatellite length and that V1aR levels in those and other brain regions correlate with anxiety-related and social behaviors. These results generate novel hypotheses regarding neural control of anxiety-related and social behaviors and yield insight into potential mechanisms by which non-coding gene polymorphisms may influence behavioral traits. [source] Consistency, context and confidence in judgements of affective communication in adults with profound intellectual and multiple disabilitiesJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 1 2001J. Hogg Abstract Twenty-four service providers rated 12 video samples of four service users with whom they were familiar for affective behaviour (i.e. ,like'/,dislike') and confidence (i.e. ,certain'/'uncertain') in their judgement. Each video sample had been recorded as part of a stimulus preference assessment during which a wide range of specific stimuli were presented to each service user. Each video sample was presented twice in a counterbalanced design either with contextual information, i.e. what the presented stimulus was (C) or without such information, i.e. context free (CF). The observers showed considerable individual variation in their judgements, largely uninfluenced by the availability or otherwise of contextual information. However, as a group, observers significantly distinguished between video samples with regard to affective communication (determined through multiple analyses of variance) and the pattern of judgements, i.e. the relative judgement of positive or negative affect, from one sample to another. This showed a good level of consistency between observers (determined through principal components analysis). The impact of contextual information was not apparent for all video samples. However, contextual information significantly influenced judgements in four samples, typically making them more extreme; for example, a response indicative of positive affect in the CF situation became more positive when contextual information was provided, indicating that the stimulus was one that the participant was thought to like. [source] Health-related quality of life in a cohort of adult patients with mild hemophilia AJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 5 2008M. WALSH Summary.,Objectives:,To compare the health-related quality of life among adult males affected with mild hemophilia A due to the same mutation (Val2016ala) to that of unaffected age and sex matched controls from the same general population. Methods:,The Short-Form 36 (SF-36) and Health Assessment Questionnaire (HAQ) were used to measure health-related quality of life and physical function. Other measures included bleeding history, a measure of joint damage, body mass index, age, and viral infection status. Cross-sectional data were collected through research clinics and a retrospective chart audit over a two-year period. Results and Conclusions:,The study included 47 affected males and 33 controls. The affected males had a higher level of co-morbidity, prior bleeding, and existing joint damage than controls. With the exception of the social function and health transition scales, mean scores for each of the SF-36 domains were worse among affected males. Mean differences were more than a clinically important five points in five of eight domains, with the general health scale showing more than a 10-point difference. Despite the degree of difference noted, only two of the differences were statistically significant (general health and role emotional scales) because of the small sample size and considerable individual variation in SF-36 scale scores. Multiple regression analyses suggested existing joint damage and presence of heart disease as the strongest associates of lower physical health-related quality of life. Joint damage in turn was partly related to prior hemarthroses. Compared to the Canadian population, affected males had lower scores in six out of eight SF-36 domains as well as the physical component summary score. There were no significant differences found in the HAQ scores between the two groups. So-called mild hemophilia A was associated with a negative effect on physical health-related quality of life, contributed to by joint damage as a result of prior bleeding. [source] FEEDING PREFERENCES OF THE MONKEY MIA DOLPHINS: RESULTS FROM A SIMULTANEOUS CHOICE PROTOCOLMARINE MAMMAL SCIENCE, Issue 4 2003Lawrence M. Dill Abstract The semiwild beach-feeding bottlenose dolphins (Tursiops aduncus) of Monkey Mia, Western Australia, provide an unparalleled opportunity to examine prey preference of this species. In a series of binary-choice feeding experiments, we took advantage of the animals' willingness to be fed by hand, to explore their preferences for fish species, size, and state (freshly caught or previously frozen). At the end of each beach visit, each dolphin was provided with a pair of fish but allowed to eat only the first one chosen. The dolphins appeared indifferent among the three species of fish offered to them (yellowtail trumpeter, Amniataba caudovittatus; striped trumpeter, Pelates sexlineatus; and western butterfish, Pentapodus vitta), which were of similar body form and matched for mass. Overall, the dolphins showed a slight preference for the larger of two yellowtail trumpeter offered, suggesting the capability for rational choice when there was a basis for it (most likely energy in this case), although there was considerable individual variation. The dolphins did not distinguish between freshly caught and previously frozen yellowtail. The methodology we describe can be used to generate data of potential value for understanding food and habitat selection of wild dolphins, and for modifying management practices for semiwild dolphins at Monkey Mia and elsewhere. [source] HAUL-OUT ACTIVITY OF RINGED SEALS (PHOCA HISPIDA) DETERMINED FROM SATELLITE TELEMETRYMARINE MAMMAL SCIENCE, Issue 1 2002E. W. Born Abstract The haul-out activity of 15 ringed seals (Phoca hispida) equipped with satellite-linked radio transmitters was studied in NW Greenland (ca. 73°-78°N). Between 19 June 1997 and 30 June 1999, telemetry data on haulout activity were obtained by the "Land-Sea-Reporter" (LSR), "Time-at-Depth" (TAD), and "Timelines" (TIM) systems housed within the satellite transmitters. The haul-out activity (% of total time hauled out) reported by the TIM system, which is specifically designed for collecting haul-out data, was about 1.4 times higher than that inferred from the LSR, but only about 0.7 of that inferred from TAD data. The TIM were used to describe haul-out activity. A total of 1,011 d with TIM were obtained (64.5% of a total of 1,568 "seal-days" monitored) representing data from nearly an entire annual cycle. No differences were found in percentage of time hauled out per month among various age categories. At all seasons the haul-out time showed considerable individual variation. There were no trends in percentage of time hauled out per month during late summer, fall, and winter (August-February). During the High Arctic winter darkness (November-January) the percentage of haul-out per month ranged between 3.9% in an adult (SD = 2.44, range: 1.1%-5.7%, n= 3 mo) and 15.7% in a subadult (SD = 1.95, range: 13.7%-17.6%, n= 3 mo). From late March there was a significant increase in haul-out time. Between 1 and 30 June, when aerial surveys of basking ringed seals usually are conducted, the haul-out time (% per day) increased from about 25% to about 57%. No tendencies in diel haul-out activity were revealed. [source] Children with Complex Mental Health Problems: Needs, Costs and Predictors over One YearCHILD AND ADOLESCENT MENTAL HEALTH, Issue 4 2005Andrew F. Clark Background:, Little is known regarding children of greatest concern with complex mental health problems. Method:, A one-year prospective study of psychiatric diagnosis, psychosocial functioning, need status and service receipt in 60 children identified as most concerning. Results:, Thirty-two (53%) had two or more disorders. The mean number of needs per child was five. One year later mean needs were unchanged but with considerable individual variation. Mean weekly costs were £1017 (,1627) (SD = £957 (,1531)). Higher costs related to social factors rather than diagnosis or need. Conclusions:, The mean annual cost of services to children with complex mental health problems is ten times that in other studies of children with mental health problems. [source] Optic nerve blood flow in glaucomaCLINICAL AND EXPERIMENTAL OPTOMETRY, Issue 3 2000Renuka Bathija FRACO FRACS Background: Glaucomatous optic neuropathy often occurs in the absence of elevated intraocular pressure and, conversely, elevated intraocular pressure may occur without associated damage of the optic nerve. These findings challenge the simple explanation of intraocular pressure being the sole cause of neural loss and have led to theories of ischaemic causes of the morbidity. This paper reviews the vascular anatomy of the optic disc, the factors that control its blood flow and the existing techniques for measurement of the blood flow. It also briefly discusses the possible role of apoptosis in glaucomatous visual loss. Method: Literature review. Conclusions: The posterior ciliary artery circulation is the main source of the blood supply to the optic nerve head with additional lesser supply via the central retinal artery and the choroidal circulation. There is considerable individual variation in the distribution of this circulation and complex regulatory systems govern its function. It is likely that microcirculatory changes in the vascular supply of the optic disc play a role in glaucoma, either as the primary abnormality or as a co-factor that increases susceptibility to damage from increased intraocular pressure through impaired auto-regulation. Clinical trials are currently in progress for the treatment of glaucoma with systemically administered agents that are antagonists of the receptors that mediate glutamine toxicity, a factor in the process of apoptosis. [source] Comparison of adefovir and tenofovir in the treatment of lamivudine-resistant hepatitis B virus infection,HEPATOLOGY, Issue 6 2004Florian van Bömmel Adefovir dipivoxil was recently approved for the treatment of wild-type and lamivudine-resistant hepatitis B virus (HBV) infection. Tenofovir disoproxil fumarate, a congender of adefovir that is used in the treatment of HIV infected patients, has recently been shown to also be effective in patients with lamivudine-resistant HBV infection. We therefore compared the two substances in a study of 53 patients defined by high HBV DNA (>6 log10 copies/mL) levels and genotypic evidence of lamivudine resistance. Thirty-five patients received tenofovir for 72 to 130 weeks, and 18 received adefovir for 60 to 80 weeks. Changes in HBV DNA levels were followed for the complete period of 48 weeks. Early viral kinetics were compared on matched subgroups of 5 patients each. Individually, all tenofovir-treated patients showed a strong and early suppression of HBV DNA within a few weeks whether they were coinfected with HIV or were without comorbidity. In contrast, considerable individual variations in HBV DNA decline were observed in the adefovir group. Thus at week 48, only 44% of these patients had HBV DNA levels below 105 copies/mL in contrast to 100% of the tenofovir-treated patients (P = .001). No severe side effects were noticed in either group. No evidence of phenotypic viral resistance could be demonstrated in the tenofovir-treated patients in the long term (up to 130 weeks). In conclusion, tenofovir may become an effective alternative for the treatment of patients with lamivudine-resistant HBV infection. (HEPATOLOGY 2004;40:1421,1425.) [source] | ||||||||||||||||