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Biomedical subjects

A D Towell

Publications and source records attributed to A D Towell.

9 recordsLinked to original sources
PubMed2003

A preliminary investigation into quality of life, psychological distress and social competence in children with cloacal exstrophy.

PURPOSE: Cloacal exstrophy is a complex multisystem anomaly. Due to ambiguous genitalia gender assignment or reassignment is common. The psychological, emotional and behavioral impact of this condition has rarely been investigated. MATERIALS AND METHODS: We recruited 8 children with cloacal exstrophy born with genital ambiguity and a control group of 12 with cloacal anomalies born without genital ambiguity were recruited via urology-endocrine clinics at Great Ormond Street Hospital for Children. Patient age was 5 to 18 years (average 11.3). The child behavior checklist, child health related quality of life and social cognition questionnaire were administered to assess perceived levels of social competence and adjustment, emotional and behavioral distress, and perceived quality of life. RESULTS: Social and behavioral competence as well as psychological problems were comparable with normative data for the 2 groups. There were no statistically significant differences in the 2 groups on any competence, problem or social adjustment scale. A quality of life measure again revealed no significant differences in the groups. The scores obtained were comparable with those reported for other chronic illnesses. CONCLUSIONS: Results suggest that being born with cloacal exstrophy or anomaly and gender assignment or reassignment does not necessarily result in childhood psychological, emotional or behavioral distress and/or problems, lower levels of social competence or subjective reports of poor quality of life. It is suggested that longitudinal and larger studies are required to assess the long-term implications of this condition.

Adolescent↗
PubMed2000

Seasonality, social zeitgebers and mood variability in entrainment of mood. Implications for seasonal affective disorder.

BACKGROUND: Seasonal variations in mood (seasonality) appear to be entrained to light, a physical zeitgeber. We hypothesised that people high in seasonality may be responsive to a range of zeitgebers, because of greater mood variability. We investigated whether the moods of people high in seasonality were more strongly entrained to the calendar week, a social zeitgeber, and whether any such effect was dependent on variability of mood. METHODS: 53 participants (14 male, 39 female; overall mean age=30) completed a daily mood report, over 56 consecutive days. Participants also completed the Seasonality Score Index (SSI) of the Seasonal Pattern Assessment Questionnaire. Each participant's time series of daily mood was analysed by spectral analysis to quantify the strength of their weekly mood cycle. RESULTS: Participants with high SSI scores (> or =11) had significantly stronger weekly mood cycles than those with low SSI scores (<11), and significantly greater variability in mood. Covarying for mood variability reduced the difference between high and low SSI groups in mean strength of weekly mood cycle to non-significance. LIMITATIONS: The time series of moods obtained was relatively short, and moods among high seasonal participants may have been affected by seasonal weather variability. CONCLUSIONS: People high in seasonality appear to be more responsive to external zeitgebers, and this could be linked to their greater variability in mood. The integration of research on mood variability with research on SAD appears to be warranted.

Adult↗
PubMed1999

Health-related correlates of gambling on the British National Lottery.

The National Lottery has been estimated as being played by 65% of the adult British population. This study investigated whether higher average weekly spending on the Lottery is associated with various health-related variables. Results from a survey of 482 British adults (mean age = 33.3 yr.), consisting of 107 students and 375 people in employment, indicated that those who spent more on the Lottery had significantly poorer social functioning (Social Functioning scale of the SF-36 Health Survey), higher weekly alcohol and cigarette consumption, and lower frequency of social support (Emotional and Social Interaction scales of the Medical Outcomes Study Social Support Survey). By contrast, higher lottery spending was not associated with poorer general mental health (General Health Questionnaire). Manual workers spent over twice the weekly amount on the Lottery compared to nonmanual workers. Consumption of alcohol and cigarettes was lower than recently published UK norms. Results suggest that higher Lottery spending among the general adult population possibly may be linked specifically to restrictions in social activity. The association of Lottery spending with alcohol and cigarette use among a sample whose consumption was relatively low appears to require explanation within psychological theories of addiction. The over-all pattern of results is discussed in relation both to addiction theory and to the Lottery's widespread appeal and availability.

Adult↗
PubMed1996

CO2 laser activation of nociceptive and non-nociceptive thermal afferents from hairy and glabrous skin.

In 8 healthy subjects we have recorded cerebral evoked potentials and reaction time (RT) to CO2 laser stimulation of the hairy and glabrous skin at low and high stimulus intensities, corresponding to subjective reporting of detection and pain, respectively. At each intensity we were able to identify an evoked potential; the latencies of the major vertex positive (VP) components fell into 2 distinct populations 320 +/- 30 (VP300) and 778 +/- 80 (VP800) which did not differ between stimulation sites. The frequency of the VP300 responses was greatest in the high stimulus conditions and lower in the low stimulus conditions whilst the opposite was true for the VP800 responses. BImodal distributions of RT were seen at both stimulus intensities. In a further group of of 10 subjects we recorded the latency shift of the vertex negativity following proximal and distal stimulation of hairy skin of the left upper limb and derived conduction velocities for the VP300 (13.21 +/- 2.8 m/sec) and VP800 (1.26 +/- 0.29 m/sec) responses. These results suggest that, following CO2 laser stimulation of both hairy and glabrous skin, two different fibre populations are activated. The VP300 responses appear to be related to A delta activation, while the characteristics of the VP800 responses are consistent with activation of thermoreceptors mediated by C fibres.

Adult↗
PubMed1996

Discrimination of speech sounds in a boy with Landau-Kleffner syndrome: an intraoperative event-related potential study.

A 7-year-old boy with severe acquired epileptic aphasia (Landau-Kleffner syndrome) was treated by multiple subpial transections to the left temporal lobe. In the course of electrocorticography, event-related potentials (ERP) were recorded to the phonemes /ba/ and /ga/; /ba/ occurred 72.5% of the time and /ga/ 27.5%, in a pseudo-random sequence. The ERPs were distributed over the middle and inferior temporal gyri and there was a marked overlap with the area of maximal spiking detected on the electrocorticogram. Repetition of the frequent syllable /ba/ was associated with diminution of the prominent negative component of the ERP culminating around 550 ms suggesting habituation. Presentation of the novel syllable /ga/ restored the amplitude of this negative component, showing that discrimination was preserved despite the apparent global aphasia. This finding supports clinical evidence that some children with epileptic aphasia can still process auditory speech input. Intraoperative ERP recording may help improve our understanding of the relationship between epileptiform activity and aspects of language processing in Landau-Kleffner syndrome where lack of cooperation precludes detailed clinical testing.

Aphasia↗
PubMed1991

The pathophysiology of acute optic neuritis. An association of gadolinium leakage with clinical and electrophysiological deficits.

Eighteen patients with acute optic neuritis underwent optic nerve magnetic resonance imaging (MRI) before and after injection of gadolinium-diethylene triamine pentacetic acid (Gd-DTPA). Ten were re-examined 4 weeks later. Leakage of Gd-DTPA across the blood-optic nerve barrier was a consistent finding in the acute lesion, and its presence was associated with abnormal visual acuity and colour vision, retro-ocular pain on eye movement, and afferent pupillary defect, and a reduced amplitude of the P100 component of the visual evoked potential. Gd-DTPA leakage had ceased in 9/11 nerves when restudied 4 wks later, and this evolution was associated with improved visual acuity and an increased P100 amplitude. Leakage is likely to reflect inflammation, and we conclude that the latter plays an important part in the production of conduction block and clinical deficit, and that its resolution is an important step in clinical remission from acute episodes of demyelination.

Adolescent↗
PubMed1989

Cognitive event-related potentials in multiple sclerosis.

Twenty-three patients with multiple sclerosis (MS) and 1 patient with isolated optic neuritis (mean age 37.5 yrs, average duration of disease 10 yrs) were tested with auditory and visual cognitive event-related potentials (ERPs) using an oddball paradigm. The results were compared with data from 19 age-matched healthy controls. All patients had magnetic resonance imaging (MRI) head scans and 19 had comprehensive neuropsychological testing. The stimulus-related components of the ERPs were normal for nearly all patients, but 10 showed abnormalities of the later cognitive-related components and another 3 had waveforms in which the cognitive components could not be identified. These abnormalities were found mainly for the auditory test. Of these 13 patients, 11 had significantly prolonged reaction times (RT) or reduced target recognition performance. Five of 8 MS patients with normal IQ and memory function tests had abnormal ERPs with the reverse being true for 4 of 10 patients. Patients with abnormal ERPs showed a higher MRI cerebral lesion score and had a longer duration of illness and greater physical disability than patients with normal ERPs. It is concluded that the generation of ERPs is in part dependent on the integrity of cerebral white matter and that ERPs may indicate subtle degrees of cognitive dysfunction not always detected by standard tests of intellect.

Adult↗
PubMedDate not supplied

Sensory and cognitive components of the CO2 laser evoked cerebral potential.

We recorded CO2 laser evoked cerebral potentials in 6 healthy subjects using both a standard technique and an oddball paradigm. In the standard technique stimuli were aimed at the dorsum of the left hand with the subject passive; in the oddball paradigm, target infrequent stimuli (P = 0.15) were directed to one side of the dorsum of the left hand and the subject was instructed to count their occurrence, the frequent stimulus being delivered to the other side of the hand. In both standard and oddball frequent recordings, CO2 laser evoked potentials were a well-formed negative-positive complex with a peak latency and amplitude around 305 msec (to positivity) and 32 microV respectively. However, in the oddball target task a later potential was also recorded, with a mean latency and amplitude of 621 msec and 24 microV respectively which we believe to be a laser oddball potential. These results demonstrate that the CO2 potential is not altered by manipulations of attention to any significant extent and suggests that it is therefore closely related to the primary sensory input. They also provide further evidence of the non-specificity of the oddball potential across sensory modalities.

Adult↗