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Biomedical subjects

A Bedford

Publications and source records attributed to A Bedford.

At least 19 recordsLinked to original sources
PubMed2000

Primary gallbladder cancer: recognition of risk factors and the role of prophylactic cholecystectomy.

The objective of this article is to review the available literature on the epidemiology, predisposing factors, and conditions associated with primary gallbladder cancer, and to discuss the role of prophylactic cholecystectomy in high-risk patient populations. Gallbladder cancer is a highly malignant tumor with a poor 5-yr-survival rate. It is a tumor of the elderly and has striking genetic, racial, and geographic characteristics, with an extremely high prevalence in Native Americans and Chileans. Cholelithiasis is a well-established risk factor for gallbladder cancer and the risk seems to correlate with stone size. Polyps that are >1 cm, single, sessile, and echopenic are associated with a higher risk of malignancy. Anomalous junction of pancreaticobiliary ducts (AJPBD), especially without choledochal cyst, and porcelain gallbladder are additional factors that predispose to gallbladder cancer. Lesser associations include chronic bacterial infections of the gallbladder, typhoid carrier state, certain occupational and environmental carcinogens, hormonal changes in women, and certain social, dietary, and familial factors. It is important to identify high-risk groups for gallbladder cancer because of the dismal nature of this tumor. In patients with porcelain gallbladder and anomalous junction of the pancreatic and biliary ducts, cholecystectomy is recommended provided that the patient is a good operative candidate. Patients with large solitary polyps or gallstones require close ultrasonic follow-up. With the advent of endoscopic ultrasound it is expected that early changes of malignancy in polyps will be reliably detected, and more patients will potentially be cured with a simple cholecystectomy. Through a MEDLINE/PAPERCHASE search we identified and reviewed articles regarding gallbladder cancer published in English-language journals between 1966 and 1999, using the key words biliary tract and gallbladder diseases, cancer, neoplasms, surgery, cholelithiasis, gallstones, cholecystitis, gallbladder polyps, risk factors, chemical industry, occupational diseases, typhoid, porcelain gallbladder, bacteremia, and precancerous conditions. We also used the bibliography of relevant articles to increase our search. A total of 122 publications were selected using the mentioned data source.

Cholecystectomy↗
PubMed1997

On Clark-Watson's tripartite model of anxiety and depression.

Clark and Watson's tripartite model of anxiety and depression symptoms is reinterpreted using their data. It is suggested that a parsimonious view of the factor loadings is a three-factor structure of "general psychological distress," "high positive affect," and "somatic anxiety."

Adult↗
PubMed1995

Use of the delusions-symptoms-states inventory to detect psychiatric symptoms in a sample of homeless men.

BACKGROUND: Previous research, often using the symptom-sign inventory, had demonstrated a high prevalence of psychiatric disorder among homeless people. The delusions-symptoms-states inventory detects the presence or absence of four classes of psychiatric illness--delusions of disintegration, integrated delusions, neurotic symptoms and dysthymic states. AIM: A study was undertaken to determine the utility of the delusions-symptoms-states inventory in a sample of homeless men, and the prevalence of psychiatric symptoms in this group. METHOD: The inventory was administered to 55 homeless men in a reception centre in Sheffield. RESULTS: Nearly half of the men obtained scores on the inventory suggesting that they had psychiatric symptoms. There was an overlap of syndromes, particularly among those with severe psychiatric illness. For example, seven men had all four classes of psychiatric illness. CONCLUSION: Use of the questionnaire proved satisfactory. The findings support the contention that reception centres and similar accommodation are repositories for homeless mentally ill people.

England↗
PubMed1993

Ethnic differences in risk markers for heart disease in Bradford and implications for preventive strategies.

OBJECTIVES: To assess and compare the prevalence of established risk markers for ischaemic heart disease in a sample of Asian and non-Asian men and to relate these observations to preventive strategies. SETTING: Two factories in the textile industry in Bradford, West Yorkshire, UK. Subjects--288 male manual workers aged 20 to 65 years. DESIGN: Cross sectional study within one occupational/social class stratum. MEASUREMENTS AND MAIN RESULTS: Age, body mass index, plasma lipids, fibrinogen and serum insulin values, blood pressure, smoking habits, alcohol consumption, and exercise routines were recorded. Plasma total cholesterol concentrations were significantly lower in Asian than non-Asian men (5.3 mmol/l v 5.8 mmol/l respectively, p < 0.0001), as were low density lipoprotein cholesterol concentrations (3.4 mmol/l v 3.7 mmol/l, p = 0.0150), and high density lipoprotein (HDL) cholesterol (1.1 mmol/l v 1.3 mmol/l, p < 0.0001). Hypercholesterolaemia (concentration > 6.5mM) was present in nearly one quarter of non-Asians but less than one eighth of Asian men. Triglyceride values were not significantly higher in Asians. Smoking rates were high in non-Asians (43.8%) and only slightly lower in Asians (39.1%). Asian smokers smoked fewer cigarettes per day on average (9.3 v 16.1, p = 0.0001). Almost a quarter of non-Asian men (23.1%) and 26.6% of Asian men had raised blood pressure. Systolic pressures were higher in non-Asian men (138.3 mmHg v 133.0 mmHg, p = 0.0070), but diastolic pressures showed no ethnic differences. Diabetes was more prevalent in Asian men (10.9% v 4.4% p < 0.05), who also showed higher serum insulin concentrations after glucose loading (22.3 mU/l v 10.2 mU/l, p < 0.0001). Plasma fibrinogen values were higher in non-Asian men (2.9 g/l v 2.6 g/l, p < 0.0001) and these were associated with smoking. Nearly all non-Asians (92.5%) consumed alcohol at some time whereas 62.5% of Asians habitually abstained from alcohol consumption. Among the drinkers, non-Asian men consumed on average, 23.9 units per week and Asian men 18.4 units per week (p = 0.083). The mean body mass index for Asian men was 24.5 kg/m2 which was not significantly different to the mean in non-Asian men (25.2 kg/m2). The frequency of exercise in leisure time was low in both groups with 44.4% of non-Asian and 21.1% of Asian men taking moderate exercise weekly, and even fewer, regular strenuous exercise (16.3% and 8.6% respectively). CONCLUSIONS: The plasma cholesterol and fibrinogen concentrations, prevalence of hypertension, smoking habits, alcohol intakes, and infrequency of exercise in leisure time in these non-Asian men in Bradford were consistent with an increased risk of heart disease. The pattern of risk markers was clearly different in Asian men. Only their lower HDL cholesterol concentrations, marginally higher triglyceride values, higher prevalence of diabetes, and very low frequency of exercise in leisure time would be consistent with a higher risk of heart disease compared with non-Asians. The implications of these observations for heart disease preventive strategies are discussed.

Adult↗
PubMed1993

Is psychopathic disorder a treatable condition?

This article extends upon material presented in a previous issue of this journal (Med. Sci. Law, 1990, 30, 39-44). Three groups of respondents were asked to comment upon the degree to which they considered psychopathic disorder to be a treatable condition. The modest findings suggest that although few clear cut views exist as to the best treatment modality there are firmer indications as to those thought to be unhelpful.

Antisocial Personality Disorder↗
PubMed1992

Insulin resistance, diabetes, and risk markers for ischaemic heart disease in Asian men and non-Asian in Bradford.

OBJECTIVE: To examine the hypothesis, in a community not studied before, that insulin resistance associated with centralised adiposity is the mechanism underlying the predisposition of Asian immigrant communities to both ischaemic heart disease and diabetes mellitus. DESIGN: Cross sectional study within one socioeconomic stratum. SETTING: Two factories in the textile sector in Bradford, West Yorkshire. SUBJECTS: Male manual workers of Asian (110) and non-Asian origin (156) aged 20-65 years. RESULTS: Diabetes was almost three times more prevalent in the Asian group. Two hours after an oral glucose load Asian men had double the serum insulin concentrations of non-Asian men (p < 0.0001). Asian men also had significantly lower concentrations of plasma total cholesterol (p < 0.03), high density lipoprotein cholesterol (HDL) (HDL2, p < 0.0001; HDL3, p < 0.0001), and apolipoprotein AI (p < 0.0001). Fasting plasma triglyceride concentrations were slightly higher (p = 0.072) in the Asian men; thus the ratio of triglyceride cholesterol was higher (p = 0.006). The inter-relation between serum insulin and plasma lipid concentrations indicated metabolic differences between the ethnic groups. Insulin concentrations were associated with cholesterol concentrations in the Asian men only and there was a lack of association between triglyceride, low density lipoprotein cholesterol, and HDL cholesterol in this group. The risk marker profile in the Asian men was therefore quite different to that of their non-Asian counterparts and was associated with a greater tendency to centralised adiposity. CONCLUSION: These data support the insulin resistance hypothesis and thus have important implications for strategies for the prevention of heart disease in Asian communities in the United Kingdom.

Adult↗
PubMed1990

Psychopathic disorder--a useful clinical concept?

The study reported upon here set out to investigate the degree to which the clinical concept of psychopathic disorder was shared between psychiatrists, psychologists and probation officers. Despite the small sample of respondents, it seems not unreasonable to conclude from the results reported below that the diagnosis of psychopathic disorder is still considered to be a useful one.

Antisocial Personality Disorder↗
PubMed1984

Evaluation of the role of computed tomography in radiotherapy treatment planning.

The role of computed tomography (CT) in radiotherapy treatment planning was assessed in a series of 231 patients in whom treatment was planned with radical intent. For each patient, a treatment plan was produced by the best conventional techniques in use at the Middlesex Hospital. Each patient then underwent a CT scan in which the treatment conditions were closely simulated. As a result of the CT scan images, alteration was made to the planned treatment in 47% of 198 assessable patients. Large differences were seen in the usefulness of CT treatment planning for tumours in different sites, with the greatest contribution made to treatment of tumours of the sinuses and nasopharynx and of the bladder. Although its unit cost is high, computed tomography can be a very useful tool in radiotherapy treatment planning and can contribute uniquely to improved patient management for adequately selected patients.

Bronchial Neoplasms↗
PubMed1979

Changes in self-rating of symptoms: a comparison of questionnaire graphic scales with test cards.

Forty-five in-patients, with primary diagnoses of neurosis or personality disorder, completed the test cards and booklet versions of the Symptom Rating Test--Day (SRT). In order to facilitate retroactive interference the Manifest Anxiety Scale (MAS) and the Maudsley Personality Inventory (MPI) were administered between the two forms of the SRT. On the next day the patients were given the SRT (Week). The initial SRT, MAS and MPI testing was repeated one week later. On the assumption that positional set is an important consideration predictions were made as to the expected differences between the test cards and booklet modes of SRT administration. The results add support to the practical use of the SRT in its more recent standardized format.

Adult↗
PubMed1978

Foulds' "general instability" and "psychopathy" 16PF scales and their relationship to psychiatric mood state.

Previous research examined "general instability" and "psychopathy" scales, derived from the 16PF, in terms of Foulds' criteria of content, group differentiation, change over time, and score distributions. When the external criterion of a newly validated measure of psychiatric mood state (the DSSI/sAD) was used, it was confirmed in both a patient and a normal group that the "general instability" scale is related significantly to symptomatology, while the "psychopathy" scale is relatively independent of present state.

Adolescent↗
PubMed1978

A further test of Foulds' personality and personal illness differentiae in a psychiatric group.

Test and retest scores on the Symptom Rating Test (SRT), Manifest Anxiety Scale (MAS) and Maudsley Personality Inventory (MPI) were obtained from 45 non-psychotic psychiatric in-patients. The change in scores and the score distributions were examined to assess the extent to which these tests meet Foulds' criteria for measures belonging respectively to the universes of personality and personal illness. MPI Extraversion emerged as a stable, normally distributed, personality trait in contrast to the SRT which showed the characteristics of a symptom-state measure. MPI Neuroticism and MAS scores could not be allocated definitively to either universe and seemed to be hybrids. It is suggested that more attention be paid to the 'purity' of scales if meaningful interpretation is to be made in treatment assessment.

Adult↗
PubMed1978

Symptom patterns among chronic schizophrenic in-patients.

The Delusions-Symptoms-States Inventory (DSSI) was administered to 33 chronic non-paranoid schizophrenic patients resident on long-stay wards. It was found that the vast majority of cases (81 per cent) produced symptom patterns conforming to the hierarchy of classes of personal illness model, but with a radically different distribution among the classes from that in acutely ill patients. Within the model a half of the patients were allotted to the two lowest classes--Class 0 (Symptom-free) and Class 1 (Dysthymic States). When each set of items was considered separately and independently of the model, it was found that a half of the group professed to have recently experienced delusions. Affective states and depressive symptoms were reported by over a third of the patients.

Adult↗
PubMed1977

Hierarchies of personality deviance and personal illness.

Three hundred and twenty-five psychiatric patients were allocated to classes within the hierarchy of personal illness by means of the Delusions-Symptoms-States Inventory. They were then given the Personality Deviance Scales. The results showed that the classes ranked in the same hierarchical order as on the DSSI on extrapunitiveness and intropunitiveness, but not on dominance. Maladjustive personality deviance, as statistically defined, was 3 1/2 times as frequent among patients as among non-patients. Whereas symptom measures had previously been shown to change considerably after one month, personality measures did not. Longer follow-up periods are needed before it can be decided whether personality measures contribute substantially to prediction of type of illness or whether they are determined, at least in part, by the type of illness. In the latter event, personality measures might still prove useful in providing a more fundamental estimate of long-term clinical improvement than symptom measures alone if they were found to change more slowly or only with more intensive clincial effort.

Adult↗