PubMed Health⌕ Search

Biomedical subjects

A Mathews

Publications and source records attributed to A Mathews.

At least 55 records · Page 3Linked to original sources
PubMed1987

Clinical pharmacokinetics, toxicity and cost effectiveness analysis of aminoglycosides and aminoglycoside dosing services.

This article reviews the clinical pharmacokinetics, clinical toxicity and cost-effectiveness analysis of aminoglycosides and of dosing services for aminoglycosides. The reader is referred elsewhere for a review of the pharmacology, antimicrobial spectrum of activity and clinical use of these drugs. A critique of the more commonly used methods of aminoglycoside dosage determinations is included, based on the inter-individual variation in aminoglycoside disposition parameters. The advantages and disadvantages of arbitrary, predictive, and pharmacokinetic methods of dosing determination are summarized. Justification for the routine determination of serum aminoglycoside concentrations is reviewed. We review the lack of standardization of definitions for aminoglycoside-associated nephrotoxicity in published studies, and studies which illustrate these differences are highlighted. Evidence for the association between serum aminoglycoside concentrations and nephrotoxicity is examined. Ototoxicity is similarly reviewed. The concept of cost-effectiveness analysis is examined extensively in this review. We discuss the literature concerning the cost benefit analysis of drug dosing services.

Amikacin↗
PubMed1987

Is aminoglycoside-associated nephrotoxicity uncommon in the U.K?

Fifty adult patients who were treated with aminoglycosides (AG) were studied prospectively. All patients were assessed by the investigators for AG-associated nephrotoxicity using criteria as defined by each prescriber, compared to a standard published set of criteria. The prescribers stated that none of the patients suffered toxicity using their criteria. Thirteen patients (26%) suffered toxicity using the published criteria. No patients were dosed on a pharmacokinetic basis. All patients with toxicity had trough levels greater than 2.0 mg/l, and those six patients with severe toxicity also had peak levels greater than 10.0 mg/l. It is suggested that prescribers in the U.K. may not be as familiar or concerned with AG dosing methods and nephrotoxicity as their U.S. counterparts.

Adolescent↗
PubMed1987

Perception of emotionally valenced information in depression.

Bower's (1981) associative network model of mood and cognition predicts that depression will selectively facilitate the perception of negatively toned words. Recent studies by Clark et al. (1983) and by Powell & Hemsley (1984) have, however, produced apparently discrepant results. Alternative means of accommodating the discrepancy are considered, and the current experiment empirically distinguishes between these possibilities. The results are inconsistent with Bower's model.

Adult↗
PubMed1986

Factors related to successful outcome in the treatment of sexually unresponsive women.

Couples in whom the main complaint was of a lack of female sexual response were treated using a practical counselling approach. A number of pre-treatment measures were studied to determine which factors were predictive of treatment outcome. While age and chronicity were not predictive, the quality of the general relationship and measures of sexual attitude did give useful indications of likely outcome.

Adult↗
PubMed1983

Progress in the treatment of female sexual dysfunction.

Over a decade of research since the publication of Human Sexual Inadequacy by Masters and Johnson has confirmed the effectiveness of psychological treatment for sexual problems, but has not advanced our understanding of aetiology very much. It is generally assumed that anxiety blocks normal function in sexual disorders such as impotence or frigidity, although hormonal changes have also been suggested. Evidence for either proposition is lacking. Our own attempts to understand mechanisms have included the use of a dismantling strategy to investigate the effective components of psychological treatment, and latterly the role of exogenous androgens. In our first study, brief treatment modelled on that of Masters and Johnson proved superior to another version of graded practice in sexual contact which lacked the counselling component. Similarly, the fuller version had more effect than did imaginal desensitization, suggesting that sexual dysfunctions cannot be treated like phobic anxiety. A second study focused on women complaining of little sexual interest or enjoyment. The use of a minor tranquillizer was compared with that of androgen (testoral) in the hope that different treatments would be shown to be best for different types of disorder. Unexpectedly, the androgen proved best overall while another variable, monthly vs weekly sessions, did not produce any differences in effect. In the most recent study, a further 48 women were given androgens or placebo, and were seen weekly or monthly for four months by either one or two therapists. There were few significant differences, the most consistent being greater subjective improvement by the women being seen at weekly intervals. The failure to find a positive hormone effect in comparison with placebo raises the possibility that the anxiolytic used earlier may have been counter-productive. If so, it seems unlikely that either excessive anxiety or simple androgen deficiency is an adequate aetiological explanation for female sexual dysfunction.

Anxiety↗
PubMed1983

Psychological and hormonal factors in the treatment of female sexual dysfunction.

Forty-eight couples with a presenting problem of female sexual unresponsiveness were treated in a controlled study using a balanced factorial design. The factors varied in this design were medication (testosterone or placebo), treatment frequency (weekly or monthly sessions), and the number of therapists involved (one female or a male/female pair). All counselling was adapted from that described by Masters & Johnson (1970) and Heiman et al. (1976). Results were assessed before and after a 3-month treatment period, and again 6 months later. Contrary to expectations from earlier work, there was no benefit attributable to testosterone or to the use of two therapists; self-ratings favoured weekly sessions with one therapist. It was concluded that testosterone (at least in the dosage used) is unlikely to have a useful place in the treatment of sexually unresponsive women, but that weekly counselling sessions with a single therapist is a reasonably effective and economic form of sex therapy. Findings from this research suggest the need for a clearer understanding of aetiological and treatment mechanisms.

Adult↗
PubMed1983

Negative self-schemata in clinical depression.

Predictions from a negative self-schema model of depression were tested using decision speed and recall measures for self and other person-referent positive and negative adjectives. Clinical depressives, compared to non-psychiatric controls, recalled more negative than positive self-referent adjectives, although there were no differences between groups in decision speed. Depressives' negative bias in recall applied only to the self-referent conditions; in the other referent conditions they exhibited the normal tendency towards positive recall bias. The self-referent recall bias in depressives did not relate significantly to either duration or intensity of depression. The results appear to be consistent with expectations derived from a negative self-schema model of depression, but alternative explanations remain to be investigated.

Decision Making↗
PubMed1982

Psychological preparation for surgery: a comparison of methods.

Sixty hysterectomy patients were randomly assigned to one of three types of psychological preparation prior to surgery, while an additional 10 patients declined psychological help. Twenty patients received information about the surgical procedure and its effects, another 20 were instructed in a cognitive coping technique, and the remainder were given general information about the ward. Interventions were shown to have different effects on a number of pre- and post-surgical measures; notably on knowledge about hysterectomy, analgesic usage, reported days of pain after discharge, and belief in the usefulness of intervention methods. Whereas information about surgery enhanced knowledge and usefulness ratings, cognitive coping appeared to have most effect on indices of recovery. Patients declining preparation responded badly immediately after surgery, but made a satisfactory recovery after discharge. Cognitive coping methods seem to be an effective way of managing specific worries about the operation, and it is suggested that this underlies differences in patterns of recovery following surgery.

Adaptation, Psychological↗