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C Platz

Publications and source records attributed to C Platz.

13 recordsLinked to original sources

Clinical survey of a psychiatric mother and baby unit: characteristics of 100 consecutive admissions.

Demographic, obstetric, clinical features and clinical outcome of 100 consecutive admissions to a psychiatric mother and baby unit are presented. Referral patterns by health services involved are also examined. 56% of admissions occurred within 2 weeks of delivery and the mean duration of admission was 2 months. Patients were categorized as having schizophrenia (n = 20), affective psychosis (n = 56) or non-psychotic disorders (n = 24) and these three groups were compared. There were few demographic and obstetric differences between diagnostic categories. The affective psychosis group were more likely to have acute illnesses with an onset and admission occurring within 2 weeks of delivery. Women with non-psychotic disorders were also most likely to become ill within 2 weeks of delivery but tended to be admitted later. Only 7% of the affective psychotic and non-psychotic women were discharged separated from their infants. Women with schizophrenia were less likely to have acute admissions and required greater input of nursing and service resources than mothers with other illnesses but 50% were discharged without their infants. More research is needed into matching models of care to the needs of mothers with different kinds of chronic, recurrent and new episodes of mental illness that present after childbirth. There are few guidelines to aid clinical staff in assessing the risk, current or future, of significant harm to an infant as a consequence of maternal mental illness, particularly of schizophrenia.

Adult↗

Screening women for high risk of postnatal depression.

A ten-item screening questionnaire was constructed from previous reports on risk factors for postnatal depression, and its ability to predict antenatally the development of postnatal depression was tested. Women attending an antenatal clinic at 36 wk gestation completed the questionnaire and, at 8 wk postpartum, were assessed for the presence of depression using the Edinburgh Postnatal Depression Scale (EPDS). Although antenatal questionnaire scores correlated significantly with postnatal EPDS scores, this was largely because the questionnaire was able to identify correctly those who would not become depressed. Neither the questionnaire as a whole, nor groups of items, was able to discriminate well between women who later did or did not become depressed. However, women who reported previous or current treatment for depression were at a threefold greater risk of becoming or remaining depressed postnatally. Possible reasons for the negative results are discussed, including the heterogeneity of depression occurring in the postnatal period.

Adult↗

Changes in tibial bone mass after primary cementless and revision cementless total hip arthroplasty in canine models.

The purpose of this study was to examine right-left differences in tibial bone mass after unilateral (left) cementless total hip arthroplasty (THA). Of 39 dogs with THAs, 9 had primary cementless porous-coated femoral stems for 6 months and 15 had similar stems for 2 years. Five dogs had aseptically failed cemented hips, and 10 had aseptically failed cemented hips that were revised with cementless porous-coated femoral stems (5 without bone graft and 5 with autogenous bone graft). These animals were sacrificed 6 months after the revision surgery. The primary cementless dogs showed no right-left difference in tibial bone mineral content (BMC) or cortical bone cross-sectional geometry after 6 months, but after 2 years there was a distal right-left difference in BMC of 6% caused by expansion of the medullary canal in the tibia of the operated limb. Tibial BMC was more than 20% lower in the operated limb of the failed cemented dogs, approximately 15% lower in the nongrafted group, and 7% lower in the grafted group. The right-left tibial difference in BMC in the 2-year primary cementless group is most probably because of subclinical disuse of the operated limb. Among the dogs with failed cemented stems, the lower right-left difference in the two revised groups compared with the non-revised group suggests that improved limb function after cementless revision THA may cause gain of previously lost bone.

Animals↗

Incidence of surgical margin involvement in various forms of radical prostatectomy.

The pathologic specimens of 64 patients who underwent radical prostatectomy for clinical Stage A or B carcinoma of the prostate were reviewed retrospectively for surgical margin involvement with cancer. Fourteen of the operations were performed by the radical transperineal method, 30 by the standard radical retropubic approach, and 20 by the nerve-sparing radical retropubic technique. Seventy-eight percent of the radical transperineal group had resection margin involvement, as opposed to 30 percent of the standard radical retropubic cases, and 45 percent of the nerve-sparing radical retropubic cases. The average tumor burden of the transperineal group was larger than that of the other two groups. Resection margin involvement in all groups was associated with a higher Gleason histologic score. No significant difference was noted between the two retropubic groups in terms of resection margin involvement (P = 0.28), suggesting that nerve-sparing radical retropubic prostatectomy does not compromise the surgical goal of radical prostatectomy for carcinoma over that of the standard radical retropubic prostatectomy.

Aged↗

Puerperal insanity in the 19th and 20th centuries.

All patients with puerperal psychosis admitted to the Royal Edinburgh Hospital within 90 days of childbirth during the periods 1880-90 and 1971-80 were compared. The majority of cases in both groups had an affective illness with an acute presentation and a fixed interval of onset. The 19th-century cases had a more florid presentation and a greater length of admission (mean, 151 days) to the hospital than the 20th-century ones (mean, 39 days). The incidence of the disorder rose from 0.34 per 1000 childbirths per year in the 19th-century group to 1.04 in the 20th-century one, but this could be explained by nosocomial factors. Most 19th-century cases occurred in multigravid women, which questions the association of puerperal psychosis with primiparae.

Female↗

Perception testing in surgical pathology.

A test predictive of mature pathologic expertise could be of great value in the selection of individuals entering the field. Some individuals may have an aptitude superior to others to discriminate images based on the discovery of distinctive image features. This may enhance their ability to draw pathologic conclusions from clinical images and may favorably affect their performance as pathologists. A form of the Facial Recognition Test was administered to pathology residents and faculty to test this hypothesis. Facial recognition results correlated well with resident performance measured by overall faculty ratings, but only marginally with performance measured by scores on "direct recognition" slides of the American Society of Clinical Pathologists' in-service pathology exams. These preliminary results indicate that testing of visual discrimination may be predictive of resident performance in pathology. A test of this type could eventually be useful in selection and self selection of resident candidates and in development of remedial training for residents experiencing difficulty in learning morphologic interpretation.

Humans↗

A matched-control follow-up and family study of 'puerperal psychoses'.

A hundred and ten women admitted to a psychiatric hospital within 90 days of childbirth were individually matched for age, psychiatric syndrome, and year of admission with women admitted to the same hospital with illnesses unrelated to childbirth. Both groups were followed up after a mean interval of nine years, and 72 matched pairs of patients for whom adequate information was obtained were then compared. The previous and subsequent psychiatric morbidity of these two groups, their subsequent obstetric careers, and the psychiatric morbidity of their first-degree relatives were all very similar. However, the puerperal women had significantly fewer relapses in the follow-up period, fewer committed suicide, and the psychiatric morbidity of their relatives tended to be lower. This better outcome was most marked in puerperal subjects with major depressions; those with manic disorders fared no better than controls. These results suggest that puerperal psychoses are basically the same as affective illnesses occurring at other times but, because childbirth is a uniquely potent precipitant of affective illness, some of those who develop puerperal episodes have a lesser genetic predisposition to affective illness than the generality of women with affective disorders.

Affective Disorders, Psychotic↗

Epidemiology of puerperal psychoses.

Computer linkage of an obstetric register and a psychiatric case register made it possible to investigate the temporal relationship between childbirth and psychiatric contact in a population of 470 000 people over a 12-year period: 54 087 births resulted in 120 psychiatric admissions within 90 days of parturition [corrected]. The 'relative risk' of admission to a psychiatric hospital with a psychotic illness was extremely high in the first 30 days after childbirth, particularly in primiparae, suggesting that metabolic factors are involved in the genesis of puerperal psychoses. However, being unmarried, having a first baby, Caesarian section and perinatal death were all associated with an increased risk of psychiatric admission or contact, or both, suggesting that psychological stresses also contribute to this high psychiatric morbidity. Women with a history of manic depressive illness, manic or depressive, had a much higher risk of psychiatric admission in the puerperium than those with a history of schizophrenia or depressive neuroses, and the majority of puerperal admissions met Research Diagnostic Criteria for manic or depressive disorder. Probably, therefore, puerperal psychoses are manic depressive illnesses and unrelated to schizophrenia.

Adolescent↗

Increasing the efficacy of gastric operations for the control of morbid obesity.

Based upon observations with double application of the TA90 surgical stapler in a stapled-in-continuity gastroplasty, we recommend a double application of gastric partitioning in the treatment of morbid obesity. The staple application should be closer than 0.5 cm or at least 2.0 cm apart to prevent necrosis of the intervening stomach. Division of the stomach between two staple applications with oversewing of the cut edges would preclude either staple line disruption or the danger of necrosis in the stomach intervening between stapler applications.

Animals↗

The otologic manifestations of mucopolysaccharidoses.

Patients with mucopolysaccharidoses are frequently hard of hearing. This disorder is often conductive in nature and considered the result of chronic serous otitis media. Such patients frequently undergo myringotomy. A coexisting progressive neurosensory hearing loss in some children is recognized far less often. Examination of temporal bones in such patients suggests arrested development including incomplete pneumatization. Hair cell dysfunction is implicated in the neurosensory component. Close communication among pediatrician, otolaryngologist, and speech and hearing personnel is essential to maximize the communicative skills of these patients.

Adolescent↗