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Biomedical subjects

C Hepworth

Publications and source records attributed to C Hepworth.

5 recordsLinked to original sources
PubMed1996

Cutting thread at flexible endoscopy.

BACKGROUND: New thread-cutting techniques were developed for use at flexible endoscopy. A guillotine was designed to follow and cut thread at the endoscope tip. A new method was developed for guiding suture cutters. Efficacy of Nd: YAG laser cutting of threads was studied. Experimental and clinical experience with thread-cutting methods is presented. METHODS: A 2.4 mm diameter flexible thread-cutting guillotine was constructed featuring two lateral holes with sharp edges through which sutures to be cut are passed. Standard suture cutters were guided by backloading thread through the cutters extracorporeally. A snare cutter was constructed to retrieve objects sewn to tissue. Efficacy and speed of Nd: YAG laser in cutting twelve different threads were studied. RESULTS: The guillotine cut thread faster (p < 0.05) than standard suture cutters. Backloading thread shortened time taken to cut thread (p < 0.001) compared with free-hand cutting. Nd: YAG laser was ineffective in cutting uncolored threads and slower than mechanical cutters. Results of thread cutting in clinical studies using sewing machine (n = 77 cutting episodes in 21 patients), in-vivo experiments (n = 156), and postsurgical cases (n = 15 over 15 years) are presented. CONCLUSIONS: New thread-cutting methods are described and their efficacy demonstrated in experimental and clinical studies.

Animals↗
PubMed1995

Loss, humiliation and entrapment among women developing depression: a patient and non-patient comparison.

This paper is part of a series dealing with the role of life events in the onset of depressive disorders. Women who developed depression in a general population sample in Islington in North London are contrasted with a National Health Service-treated series of depressed patients in the same area. Findings among the latter confirm the importance of a severely threatening provoking event for onset among the majority of depressed women patients. The results for the two series are similar except for a small subgroup of patients characterized by a melancholic/psychotic condition with a prior episode. The severe events of importance have been recognized for some time by the traditional ratings of the Life Events and Difficulty Schedule (LEDS). However, the full descriptive material collected by the LEDS has been used to develop a new refined measure reflecting the likelihood of feelings of humiliation and being trapped following a severely threatening event, in addition to existing measures of loss or danger. The experience of humiliation and entrapment was important in provoking depression in both the patient and non-patient series. It proved to be associated with a far greater risk of depression than the experience of loss or danger without humiliation or entrapment.

Adolescent↗
PubMed1994

Life events and endogenous depression. A puzzle reexamined.

BACKGROUND: Research has failed to find the expected clear-cut difference in the presence of events provoking onset in endogenous and nonendogenous depression. METHODS: A longitudinal study of 127 depressed female patients from two psychiatric departments were studied using the Present State Examination and the Life Event and Difficulty Schedule. Two earlier patient series using the same measures were employed to check findings, and two general population series were used to estimate the expected rate of life events. RESULTS: A large proportion of patients experienced a severely threatening event before onset, with the exception of a group defined by a British diagnostic category (a relatively small group of patients with melancholic/psychotic depression who were not experiencing their first episode). The results were broadly replicated in the two other patient series. The proportions of patients who experienced ongoing major difficulties did not differ between the groups. CONCLUSIONS: The relative size of this melancholic/psychotic group of patients with a prior onset may well have varied markedly from study to study in previous research, and this may help to explain the puzzling variability in findings concerning the role of stressful events in endogenous depression.

Adolescent↗
PubMed1994

Clinical and psychosocial origins of chronic depressive episodes. II. A patient enquiry.

BACKGROUND: We consider how well the psychosocial and clinical factors found to predict a chronic course for depressive episodes in the community, held for female psychiatric patients. METHOD: A consecutive series of depressed patients, aged 18 to 60, treated as in-patients, out-patients or day-patients at psychiatric departments of two London hospitals, were interviewed initially and at follow-up two years later. RESULTS: Indices of childhood adversity and current interpersonal difficulties predicted episodes taking a chronic course (of more than 12 months' duration). Half of the episodes associated with one or the other factor were chronic, compared with 22% of those with neither. The patients were at higher risk than the community series (75% v. 34%) and this explains their much greater rate of chronicity. There was also some evidence that social support reduced risk. Clinical features and the presence of a personality disorder were unrelated to chronicity. CONCLUSIONS: Similar psychosocial factors are important for predicting chronicity in both community and patient series.

Adolescent↗