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Biomedical subjects

D Burge

Publications and source records attributed to D Burge.

16 recordsLinked to original sources

Macular capillary hemodynamic changes associated with Raynaud's phenomenon.

BACKGROUND: Raynaud's phenomenon is an episodic, reversible spasm of the digital arterioles. Previous studies have suggested that Raynaud's phenomenon may be associated with alterations in the ocular circulation. The authors used the blue field entoptic simulation technique to study macular retinal capillary hemodynamics in patients with Raynaud's phenomenon. METHODS: Forty-two volunteers participated in the study: 18 with a connective tissue disease and secondary Raynaud's phenomenon, 8 with a connective tissue disease and no Raynaud's phenomenon, and 16 healthy volunteers. The mean of three blue field entoptic density and velocity measurements was determined before as well as during and 10 minutes after the immersion of one hand in ice water. RESULTS: Patients with severe Raynaud's phenomenon demonstrated a statistically significant 30% decrease in retinal capillary flow during immersion of a hand in ice water (P less than 0.05), which remained 17% reduced (P less than 0.05) for at least 10 minutes after removal. The decrease in capillary flow was not observed in control individuals or in individuals with connective tissue disease who demonstrated minimal or no Raynaud's phenomenon. CONCLUSION: The prolonged reduction in retinal capillary flow observed in subjects with Raynaud's phenomenon is probably caused by retinal arteriolar vasoconstriction and is similar to concurrent arteriolar vasoconstriction reported in other systemic vascular beds. In the retina, the recurrent ischemic episodes may result in dysfunction or injury.

Adult

Maternal communication: predictors of outcome at follow-up in a sample of children at high and low risk for depression.

Separate lines of investigation have shown the increased risk of dysfunction for children of depressed women and impaired interaction between depressed mothers and their children. The link between the two was examined in 57 children at high and low risk for depression. Children of unipolar depressed, bipolar depressed, chronically medically ill, and normal mothers were evaluated at a 6-month follow-up. Hierarchical regression analyses suggested a relation between maternal interaction behavior on two dimensions, task focus and affective quality, and children's subsequent depression and school behavior; academic performance was related only to affective quality of interaction. Chronic stress was predictive of more negative, critical maternal behavior, whereas depressed mood was associated with less task involvement. Maternal interactions are viewed as a marker of a complex, mutual process involving interpersonal relationships in an adverse environmental context.

Adolescent

Timing of mother and child depression in a longitudinal study of children at risk.

Temporal associations of diagnoses in mothers and children were examined in a 3-year longitudinal study of unipolar, bipolar, and comparison women and their 8- to 16-year-old offspring. There was a significant temporal association between mother and child diagnoses, especially in unipolar families, and most children who experienced a major depressive episode did so in close proximity to maternal depression. Regression analyses indicated that children's own stressful life events, maternal disorder, and the interaction of the two significantly predicted children's changes in depression. Children exposed to high stress but with nonsymptomatic mothers were significantly less depressed subsequent to stressors than those who also had symptomatic mothers. The results are discussed in terms of the reciprocal, interpersonal context of depression.

Adolescent

Longitudinal study of diagnoses in children of women with unipolar and bipolar affective disorder.

School-age children of unipolar depressed, bipolar, chronically medically ill, or normal women were diagnosed every 6 months for up to 3 years. Offspring of unipolar women had the highest rates of disorder at all evaluations, but children of bipolar and medically ill mothers also experienced significant rates of disorder. Observing diagnoses from both past lifetime and prospective follow-up assessments, it appeared that most children who had diagnoses had onsets in preadolescence and continued a chronic or intermittent course of disorder. Thus, risk to offspring of ill mothers is not transitory and indicates a pernicious course that commonly includes effective disorders alone or in combination with behavior and anxiety disorders.

Adolescent

Comparison of intracranial pressure between spina bifida patients and normal subjects using a non-invasive pressure assessment technique.

A comparison of mean intracranial pressure (ICP) between 36 spina bifida patients and 24 patients with clinically normal ICP was undertaken. A new non-invasive method of assessing ICP was used throughout this study. The technique relates tympanic membrane displacement to ICP and has been shown to be a reliable measure of mean ICP by comparison with direct measures via ventricular catheters and reservoirs, subdural catheters and lumbar punctures. Using this non-invasive method the results of this study indicated that the patients with spina bifida and without a ventricular shunt have a higher than average mean ICP. The results demonstrated a significant difference (99.9%) in the measures of ICP between the spina bifida and normal populations. A significant difference (99.9%) in the ICP was also found between patients with spina bifida and with and without ventricular shunts, and thus presumably those with and without diagnosed hydrocephalus. It is suggested that patients with spina bifida and without ventricular shunts probably have higher than average mean ICP when compared with the normal population.

Adolescent

Observations of interactions of depressed women with their children.

Dysfunctional interactions between mothers with major affective disorders and their children may contribute to the children's high risk of disorder. This study investigated the behavior of mothers with recurrent unipolar depression, bipolar disorder, or chronic medical illness and of normal subjects toward their children during a directly observed conflict discussion task. In addition, lifetime history of depression, current mood, and chronic stress were investigated as predictors of maternal interaction. Unipolar depressed women displayed relatively more negative, less positive, and less task-focused behaviour toward their children. Current mood and chronic stress, more than psychiatric history, contributed to the prediction of interaction style.

Adolescent

Cognitive vulnerability in children at risk for depression.

Cognitive, developmental, and psychodynamic theories all hypothesize that negative self-concepts acquired in childhood may induce vulnerability to depression. Children at risk because of maternal major affective disorder, compared with children of medically ill and normal mothers, were examined for evidence of negative cognitions about themselves, and were found to have more negative self-concept, less positive self-schemas, and more negative attributional style. It was further predicted that negative cognitions about the self would be related to maternal depression and chronic stress, and to the quality of perceived and actual interactions with the mother. In general, the predicted associations were obtained, supporting speculations about how maternal affective disorder is associated with stress and with relatively negative and unsupportive relationships with children that in turn diminish children's self-regard.

Adolescent

Maternal affective disorders, illness, and stress: risk for children's psychopathology.

Stressful circumstances that covary with maternal affective disorder may account for some of the risk to children for psychological dysfunction. Children (ages 8-16) of mothers with unipolar or bipolar disorders were compared with children of mothers who had chronic medical illness and children of normal mothers. Comparisons included Kiddie-SADS (Schedule for Affective Disorders and Schizophrenia) diagnoses and evaluations of behavior problems, school functioning, and social competence. Compared to the other groups, children of mothers with affective disorder (especially unipolar) had high rates of diagnosis. With the effects of chronic stress statistically controlled, psychosocial outcome variables showed fewer differences between groups but indicated particular impairment for children of unipolar mothers.

Adolescent

Nodular lymphoid hyperplasia of the intestinal tract in infancy and childhood.

Over an 18-year period we have diagnosed nodular lymphoid polyposis of the intestinal tract in 6 patients. The site of the polyposis, which was due to prominent lymphoid hyperplasia, was ileal (3), colonic (2), and rectal (1). The diagnosis was made following complications arising from the polyps, which included recurrent intussusception (2), rectal prolapse (1), intestinal or pseudointestinal obstruction (2), and rectal bleeding (1). Immunoglobulin staining was performed on all the bowel specimens and in every case secretory IgA was present on the mucosal surfaces and IgG and IgA were seen in the lamina propria, thus excluding immunodeficiency in these patients. Viral studies were performed in 3 patients and all were positive. In one patient Echovirus II was seen in tissue homogenate from a mesenteric lymph node and in another, adenovirus type II was cultured from lymphoid polyps of the rectum. A further patient had positive serological tests for adenovirus. Thus it appears that nodular lymphoid hyperplasia is part of the generalized lymphoid hyperplasia associated with viral infections in infancy and childhood. Immunodeficiency states as a cause of the lymphoid hyperplasia should always be excluded by estimation of serum immunoglobulins.

Child

Favourite words.

A prospective survey of language used by children aged between 2 and 16 years for 'taboo subjects' was carried out on a paediatric surgical ward and in the outpatients clinic. The children were interviewed in the presence of their parent(s). A remarkable diversity of words and phrases was noted. Language was affected by the age and sex of the patient. This survey is of interest to all clinicians who need to communicate with children.

Adolescent

Paediatrics: developing family information leaflets.

The authors offer advice on how to prepare information leaflets for the families of children admitted to paediatric units, and describe the successful implementation of such a scheme at the University Hospital, Southampton. The development of family information leaflets comprises an important part of setting quality standards.

Child