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Biomedical subjects

A Maden

Publications and source records attributed to A Maden.

At least 19 recordsLinked to original sources
PubMed2001

Aspergillus niger infection of exenterated orbit.

PURPOSE: To present two immunocompetent patients with Aspergillus niger infection of the exenterated orbit. METHODS: Case reports. RESULTS: The patients were treated with oral itraconazole and socket irrigation with amphotericin B. The sockets cleared completely; no growth was observed on reculturing. CONCLUSIONS: A niger infection of an exenterated socket can be effectively treated with oral itraconazole and topical amphotericin B in immunocompetent patients.

Aged↗
PubMed2000

Substance misuse as a marker of vulnerability among male prisoners on remand.

BACKGROUND: More treatment for substance misuse should be provided within prisons. AIMS: To examine differences between prisoners on remand with substance misuse problems and other prisoners on remand. METHOD: Random selection and interview of unconvicted male prisoners (n = 750, a 9.4% sample), plus examination of the prison medical record. RESULTS: Of the sample of 750, 253 subjects (33.7%) reported either drug- or alcohol-related health problems or dependency. Compared with other prisoners on remand, they reported more childhood adversity, conduct disorder, self-harm, past psychiatric treatment and current mood disorder, and had fewer qualifications, were more likely to be unemployed and have more housing difficulties. CONCLUSIONS: One-third of unconvicted men in prison report substance-related problems, and these are a marker for vulnerability within a disadvantaged population. Health care providers should involve this group in treatment and rehabilitation, both inside prison and following release.

Adolescent↗
PubMed1999

Outcome of admission to a medium secure psychiatric unit. I. Short- and long-term outcome.

BACKGROUND: This is the first long-term follow-up of patients discharged from a medium secure unit. AIMS: To describe the short- and long-term outcomes of admission for all patients discharged during a 14-year period. METHOD: A longitudinal cohort study of all 234 patients discharged from the Denis Hill Unit, Bethlem Royal Hospital, between 1980 and 1994, followed for an average 6.6 years. RESULTS: Although 48% of admissions were from prison, only 8% returned there, with most being transferred to another psychiatric bed. One-fifth of patients spent none of the follow-up time in the community; 75% of patients had at least one readmission; only 24% were convicted of further offences. CONCLUSIONS: Re-offending rates are comparable with those for patients discharged from high-security hospitals, and much lower than those for released prisoners. The high readmission rates indicate the need for a range of services to maintain former patients in the community.

Adolescent↗
PubMed1999

Outcome of admission to a medium secure psychiatric unit. 2. Role of ethnic origin.

BACKGROUND: A follow-up of patients discharged from medium secure psychiatric units is used to compare outcome in patients of different ethnic origin. AIMS: To test the hypothesis that there are systematic differences in clinical outcome between ethnic groups. METHOD: A descriptive, longitudinal cohort study of discharges from a medium secure unit is used to compare the 125 patients of White/European ethnic origin and the 104 patients of Black/African-Caribbean origin. RESULTS: Patients of African-Caribbean origin were admitted at three times the rate of White patients, had a higher prevalence of psychosis and a lower prevalence of personality disorder. There was no difference in outcome as measured by location at follow-up, readmission or re-offending. CONCLUSIONS: The higher rate of admission of African-Caribbean patients is consistent with a higher level of demand. There is a need for studies of the pathways by which patients from ethnic minorities reach medium-security accommodation, with a view to early intervention.

Adult↗
PubMed1998

Keratitis complicated by endophthalmitis 3 years after astigmatic keratotomy.

Endophthalmitis after keratotomy is rare and usually occurs soon after surgery. A 56-year-old woman with mild dry-eye symptoms developed keratitis complicated by endophthalmitis 3 years after astigmatic keratotomy (AK). The keratitis lasted for less than 1 day in the upper keratotomy incision. Corneal cultures yielded. Pseudomonas aeruginosa. Keratitis progressed to endophthalmitis 1 day after the detection of keratitis. The inflammation was controlled with intravitreal, subconjunctival, topical, and systemic antibiotics. This case demonstrates the potential risk of endophthalmitis developing very shortly after late keratitis of AK incisions. Vigorous early treatment and close follow-up seem justifiable in any keratitis associated with a keratotomy incision.

Anti-Bacterial Agents↗
PubMed1998

Substance misusers remanded to prison--a treatment opportunity?

AIMS: To describe self-reported levels of substance misuse before arrest among remanded prisoners (unconvicted prisoners awaiting trial), to assess their degree of dependency on opiates and stimulants and to record their experiences of treatment in prison. DESIGN: Random selection of subjects from prisons chosen to give a geographical spread across England and Wales; self-report at semi-structured interview, plus examination of the prison medical record. SETTING: Thirteen male prisons, three Young Offenders' Institutions and three womens' prisons. PARTICIPANTS: Nine hundred and ninety-five consenting, unconvicted prisoners, randomly selected from all locations within the prisons: 750 men (9.4% sample) and 245 women (82.2% of all remanded women). MEASUREMENTS: CAGE Questionnaire, Severity of Dependence Scales (SDS) for daily users of opiates and/or stimulants. FINDINGS: Before arrest, 145 (19.3%) men and 72 (29.4%) women had been dependent on street drugs; 91 (12.1%) men and 16 (6.5%) women were solely dependent on alcohol. Seventeen (2.3%) men and four (1.6%) women reported injecting drugs during this imprisonment. Mean SDS scores were 10.6 for opiate and 7.7 for stimulant users. 244 (25%) of all subjects described withdrawal symptoms on reception into custody; 157 (16%) reported being prescribed some symptomatic relief; 235 (24%) requested treatment at interview. CONCLUSIONS: By extrapolation, 1905 people--23% of all unconvicted prisoners--want treatment for substance misuse. This apparent shortfall in provision must be addressed; the rapidity with which remanded prisoners return to the community dictates that prison and community services should be closely linked.

Adolescent↗
PubMed1997

Monoscleral fixated lens implantation in eyes with partial loss of capsular or zonular support.

A technique is described in which a posterior chamber intraocular lens (IOL) is implanted in eyes with partial loss of posterior capsule or zonular support. The IOL's inferior haptic is placed over the residual capsule and the superior haptic is fixated to the ciliary sulcus with a polypropylene suture. In 17 eyes that had surgery using this technique, mean postoperative visual acuity was 20/25; complications included irregular pupil, iris capture, pupil block, hyphema, localized peripheral anterior synechia, IOL tilt, suture exposure, and cystoid macular edema.

Adult↗
PubMed1997

The Bentham Unit: a pilot remand and assessment service for male mentally disordered remand prisoners. II: Report of an independent evaluation.

BACKGROUND: Findings are presented from an evaluation of a pilot remand and assessment service--the Bentham Unit. The aims of the Bentham Unit are to provide rapid assessment, identify mentally disordered remand prisoners, and speed their transfer from prison to NHS care, where a need is indicated. METHOD: The number, rate and speed of referral, assessment and transfer to NHS care of offenders remanded to Wormwood Scrubs prison during periods before and after the Bentham Unit opened were compared. RESULTS: The service attracted a large volume of referrals. Between the two periods, significant increases in the numbers of referrals and hospital disposals, and major reductions in the interval between reception on remand into the prison, NHS assessment and transfer to NHS care, were observed. CONCLUSIONS: The aims of the unit were met. Implications for service configurations are discussed.

England↗
PubMed1996

Point prevalence of mental disorder in unconvicted male prisoners in England and Wales.

OBJECTIVES: To determine prevalence of mental disorder among male unconvicted prisoners and to assess the treatment needs of this population. DESIGN: Semi-structured interview and case note review of randomly selected cross section of male remand population. Non-attenders were replaced by the next name on prison roll. SETTING: Three young offenders' institutions and 13 adult men's prisons. SUBJECTS: 750 prisoners, representing 9.4% cross sectional sample of male unconvicted population. MAIN OUTCOME MEASURES: Prevalence of ICD-10 diagnoses of mental disorder, and associated treatment needs. RESULTS: Psychiatric disorder was diagnosed in 469 (63%) inmates. The main diagnoses were: substance misuse, 285 (38%); neurotic illness, 192 (26%); personality disorder, 84 (11%); psychosis, 36 (5%); other and uncertain, 36 (0.5%). Subjects could have more than one diagnosis. The average refusal rate was 18%. In total 414 inmates (55%) were judged to have an immediate treatment need: transfer to an NHS bed, 64 (9%); treatment by prison health care services, 131 (17%); motivational interviewing for substance misuse, 115 (15%); and therapeutic community placement, 104 (14%). CONCLUSIONS: Mental disorder was common among male unconvicted prisoners. Psychosis was present at four or five times the level found in the general population. Extrapolation of our results suggests that remand population as a whole probably contains about 680 men who need transfer to hospital for psychiatric treatment, including about 380 prisoners with serious mental illness.

Adult↗
PubMed1992

Gonioscopic changes in eyes with posterior chamber intraocular lenses.

The aim of this study is to determine the effects of posterior chamber implantation on angle structures. First, without previous knowledge of the position of lens haptics, 360 degrees gonioscopy was performed and any changes in the angle structures were recorded. Then, the pupil was dilated to determine the exact position of the intraocular lens haptics. The apposition of peripheral iris to angle structures or, at least, the narrowing of the angle corresponding to the lens haptic position was observed in almost all of the 117 examined eyes, with no difference found between bag and sulcus implantation. Peripheral anterior synechia overlying the lens haptic was observed in 49 (41.8%) of 117 eyes. Interestingly, we also noted that there was marked and well-limited clumping of pigment in the angle at 6 o'clock position in 67 (57.2%) of 117 eyes. In conclusion, we feel that posterior chamber intraocular lenses are not completely innocuous to the angle structures.

Adult↗
PubMed1992

Magnetic resonance imaging and computed tomography in the detection and localization of intraocular foreign bodies.

In this experimental study, various foreign bodies were inserted into fresh bovine eyes, in different localizations. Twenty-one magnetic and non-magnetic foreign bodies, dimensions of which varied from 1.5 x 1.5 x 2 mm to 3.5 x 6 x 7 mm, were tried to detect by computed tomography (CT) and magnetic resonance imaging (MRI) scanning. In addition, further dissections were applied to check the ocular damage attributable to movement of the foreign bodies. Ferromagnetic foreign bodies have been shown to move in the eye and the risk of torsional forces being applied to the ferromagnetic foreign body seemed to cause intraocular complications during MRI scanning. All of the foreign bodies that were implanted in bovine eyes were recognized on CT scanning, except intraocular lenses. As a general rule, metallic foreign bodies produced beam-hardening artifacts, but these artifacts did not cause any problem in detecting the localizations of foreign bodies.

Animals↗