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Biomedical subjects

D Hay

Publications and source records attributed to D Hay.

At least 19 recordsLinked to original sources
PubMed2001

A current review of olanzapine's safety in the geriatric patient: from pre-clinical pharmacology to clinical data.

OBJECTIVE: Olanzapine (OLZ) is unique among currently available antipsychotic medications in its antagonism of a range of receptor systems including dopamine, norepinephrine, serotonin, acetylcholine, and histamine. Olanzapine's mechanistic complexity provides a broad efficacy profile in patients with schizophrenia and acute, pure or mixed mania. Patients experience symptomatic relief of mania, anxiety, hallucinations, delusions, and agitation/aggression and reduced depressive, negative, and some cognitive symptoms. This paper will review the safety profile of OLZ, focusing on the elderly, where data are available. METHOD: Preclinical and clinical studies of OLZ are reviewed, with emphasis on its possible effects on the cholinergic system and the histamine H(1) receptor. Weight change and related metabolic considerations, cardiac and cardiovascular safety, and motor function during treatment with OLZ are also reviewed. RESULTS AND CONCLUSION: In vitro receptor characterization methods, when done using physiologically relevant conditions allow accurate prediction of the relatively low rate of anticholinergic-like adverse events, extrapyramidal symptoms, and cardiovascular adverse events during treatment with OLZ. Currently available clinical data suggest olanzapine is predictably safe in treating adult patients of any age with schizophrenia and acute bipolar mania, as well as in treatment of patients with some types of neurodegenerative disorders.

Adverse Drug Reaction Reporting Systems↗
PubMed2001

Mutation in the gene encoding ferritin light polypeptide causes dominant adult-onset basal ganglia disease.

We describe here a previously unknown, dominantly inherited, late-onset basal ganglia disease, variably presenting with extrapyramidal features similar to those of Huntington's disease (HD) or parkinsonism. We mapped the disorder, by linkage analysis, to 19q13.3, which contains the gene for ferritin light polypeptide (FTL). We found an adenine insertion at position 460-461 that is predicted to alter carboxy-terminal residues of the gene product. Brain histochemistry disclosed abnormal aggregates of ferritin and iron. Low serum ferritin levels also characterized patients. Ferritin, the main iron storage protein, is composed of 24 subunits of two types (heavy, H and light, L) which form a soluble, hollow sphere. Brain iron deposition increases normally with age, especially in the basal ganglia, and is a suspected causative factor in several neurodegenerative diseases in which it correlates with visible pathology, possibly by its involvement in toxic free-radical reactions. We found the same mutation in five apparently unrelated subjects with similar extrapyramidal symptoms. An abnormality in ferritin strongly indicates a primary function for iron in the pathogenesis of this new disease, for which we propose the name 'neuroferritinopathy'.

Adult↗
PubMed2000

Air pollution.

Explore the source record for details and available documents.

Air Pollution↗
PubMed2000

Seasonal variation in hospital admission for bipolar disorder, depression and schizophrenia in Tasmania.

OBJECTIVE: Seasonal variation has been reported for both affective disorders and schizophrenia. The current study examines seasonal variation in admissions in schizophrenia, depression and bipolar disorder in Tasmania, the southernmost state of Australia. METHOD: All admissions with a diagnosis of schizophrenia, bipolar disorder and depression in Tasmania between 1983 and 1989 were examined for evidence of seasonal variation in admission patterns. RESULTS: Using the modified Kolmogorov-Smirnov statistic defined by Freedman no significant seasonal variation was found in admissions with diagnoses of mania, depression or schizophrenia. There was a significant seasonal variation in admissions with schizoaffective disorder (winter peak). CONCLUSION: There is no significant seasonal variation in admissions with schizophrenia, depression or bipolar disorder in Tasmania. This may be due to a combination of geographical location and the stringent test of seasonal variation used in the current study.

Bipolar Disorder↗
PubMed2000

The role of informatics to support evidence-based practice and clinician education.

This paper reports the results of a national event held during November 1998 to educate health professionals representing multiple disciplines about evidence-based practice (EBP), its implementation and the use of informatics to support EBP. A combination of educational delivery methods and multimedia was used. Through local group work, participants identified obstacles to EBP implementation and developed strategies to overcome these in their own local environments. Major and common findings were a lack of management support and infrastructures needed for the successful adoption of evidence-based practices by all.

Australia↗
PubMed1999

Validity of the visual function index (VF-14) in patients with retinal disease.

OBJECTIVE: To test the validity of the Visual Function Index (VF-14) in patients with retinal disease. DESIGN: A self-administered questionnaire package in association with clinical examination findings. PARTICIPANTS: Consecutive patients attending the Vancouver General Hospital Eye Care Centre, Vancouver, British Columbia, retina clinic between May 1 and August 15, 1998. MAIN OUTCOME MEASURES: Responses to the questionnaire package as they relate to global self-assessment scales and visual acuity. In addition, correlations were calculated between the VF-14, the 36-Item Short-Form Health Survey, a Weighted Comorbidity Scale, and visual acuity scores. RESULT: Five hundred forty-seven patients were given the questionnaire package to complete. The VF-14 demonstrated a moderately strong positive association with patient self-rating of amount of trouble, satisfaction, and overall quality of vision. Correlations between the 36-Item Short-Form Health Survey, visual acuity, and the global scales were mild to moderate. The VF-14 was moderately correlated with visual acuity in the better and the worse eyes. CONCLUSIONS: This study provides support for the validity of the VF-14 as a measure of functional impairment in patients with retinal disease. Once responsiveness has been measured and an analysis of disease subtypes has been carried out, the VF-14 will be ready for inclusion in clinical trials to evaluate patients' functional ability. Further implementation and development of this outcome measure will better our understanding of the utility of the functional assessment format for patients with retinal disease.

Adolescent↗
PubMed1999

Age-related macular degeneration in Chinese-Canadians.

BACKGROUND: Ethnicity has long been suspected to play a role in the risk of macular degeneration as well as its neovascular complications. We carried out a study to determine the prevalence of retinal diseases in Chinese-Canadians presenting for fluorescein angiography compared to a matched group of Canadians of European origin. METHODS: We reviewed 20,000 consecutive fluorescein angiograms obtained between December 1987 and November 1993 at a tertiary referral centre for ophthalmic care in Vancouver. All patients identified by name as being of Chinese ancestry were identified and matched to a patient of European ancestry. The two groups were compared in regard to the prevalence of specific retinal diseases, including age-related macular degeneration (AMD). RESULTS: Among the first 10,000 fluorescein angiograms, 417 patients of Chinese ancestry were identified, of whom 61 (14.6%) had the primary diagnosis of AMD. The rate among the patients of European ancestry was 30.4% (127/417) (odds ratio [OR] 2.12, 95% confidence interval [CI] 1.79 to 2.56) (p < 0.001). A total of 88 ethnic Chinese patients were identified among the subsequent 10,000 angiograms. Pigment epithelial detachments were more than twice as common in the overall group of ethnic Chinese patients as in their counterparts of European ancestry (OR 2.6, 95% CI 0.7 to 10.1). Choroidal neovascularization was 1.6 times more common in the latter group (95% CI 0.98 to 2.8). INTERPRETATION: The findings support the growing clinical observations of a lower prevalence of AMD in nonwhite populations in addition to an increased prevalence of pigment epithelial detachments in ethnic Chinese patients.

Aged↗
PubMed1997

Key issues in the development of aggression and violence from childhood to early adulthood.

Different manifestations of aggression from childhood to early adulthood are reviewed to establish how early manifestations are related to later manifestations. Similarities and differences in manifestations of aggression between the two genders are noted. Developmental sequences and pathways from minor aggression to violence are highlighted. Long-term escalation is contrasted with short-term escalation at older ages. Although studies have emphasized high stability of aggression over time, data show that a substantial proportion of aggressive youth desist over time. Temperamental, emotional, and cognitive aspects of aggression are reviewed, either as precursors or co-occurring conditions to aggression. Selected processes in the realms of the family, peers, and neighborhoods are highlighted that are known to be associated with juvenile aggression. Cumulative, long-term causes are contrasted with short-term causes, and causes associated with desistance in aggression are reviewed.

Adolescent↗
PubMed1996

Twin sibling differences in parental reports of ADHD, speech, reading and behaviour problems.

Differences between twins and siblings in behaviour problems were investigated in a non-selected sample of 1938 families with children aged 4-12 years. Families were sent a questionnaire based on DSM-III-R criteria for Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), Conduct Disorder (CD) and Separation Anxiety (SA), which was validated by formal clinical interview. The questionnaire also included measures of speech and reading problems. There were significant differences between twins and siblings for ADHD symptoms, but not for symptoms of ODD, CD or SA. Twins and siblings differed significantly for gestational age, birth weight, speech and reading problems. While there was little evidence for birth weight or gestational age contributing to the difference in ADHD symptoms, there was a strong association between ADHD symptoms and speech and reading problems.

Anxiety, Separation↗
PubMed1995

Asymmetries in the covert orienting of visual spatial attention in schizophrenia.

The presence of attentional asymmetries in patients with schizophrenia was investigated with particular emphasis on the effects of stage of disease, medication status and clinical symptom severity. A modified version of Posner's covert orienting of visual attention task (COVAT) which included both spatial and non-spatial cues was administered to six volunteer samples of subjects which consisted of (i) 15 unmedicated and acutely psychotic male subjects with schizophrenia, (ii) 15 male subjects with schizophrenia who had been receiving medication for 14-21 days, (iii) 10 chronic male schizophrenic subjects who had been receiving medication for at least two years, (iv) 10 acutely psychotic male subjects with non-schizophrenic psychoses, (v) 15 subjects with unilateral brain frontal lobe (n = 6) or parietal lobe (n = 9) lesions, (vi) and 15 male control subjects. Measures of saccadic and pursuit eye movements were also obtained from unmedicated and recently medicated subjects with schizophrenia. COVAT attentional asymmetries were present in unmedicated subjects with schizophrenia for the 150 msec stimulus onset asynchrony (SOA). These asymmetries arose because reaction times (RTs) to right visual field targets were significantly slower than RTs to left visual field targets when targets followed invalid spatial or non-spatial cues. These asymmetries were qualitatively similar to those found in the patients with unilateral parietal lobe lesions. Attentional asymmetries partially resolved with brief periods of medication and completely resolved with long periods of medication. No asymmetries were found in controls nor in unmedicated subjects without schizophrenia. No asymmetries of ocular motor function were found. In schizophrenia, attentional asymmetries may reflect a deficit in the disengagement of visual attention from the right visual field and appear to be a stage marker for the disease. However this attentional deficit is dynamic and may reflect disruption to the neurocognitive network controlling attention at the level of the anterior cingulate cortex.

Adolescent↗
PubMed1995

Seasonality of mania: a Tasmanian study.

OBJECTIVE: The aim of the study was to examine the seasonal incidence of mania in a new Southern Hemisphere location. METHOD: Using the Tasmanian psychiatric database, monthly admission rates were compared with expected admission rates for mania for the period 1983 to 1989. ICD-9 criteria for mania single episode (296.0) and mania recurrent episodes (296.1) were used, excluding individuals with a bipolar disorder (296.4 to 296.89). RESULTS: One thousand three hundred and twenty-eight persons were admitted during this period. There was a significant monthly variation with admissions occurring most commonly in the summer, but this was not consistent during the seven year period. CONCLUSIONS: There was a statistically significant but inconstant summer excess. The inconstancy of the finding suggests that the phenomenon is not a simple consequence of light duration, and closer examination of these inconsistencies may lead to further elucidation of the phenomenon.

Adolescent↗
PubMed1994

Survival analysis and readmission in mood disorder.

BACKGROUND: This is an exploratory study of readmission in mood disorder. METHOD: The study is naturalistic and employs survival analysis. We identified 821 individuals with ICD-9 diagnoses, drawn from the Tasmanian Mental Health Register. RESULTS: No demographic variables influence the time to readmission. Two groups emerge: those with affective psychoses, and those with neurotic depression, brief depressive reaction and depressive disorders not elsewhere classified. The former group demonstrated shorter times to readmission than the latter. There was no support for a unipolar-bipolar distinction. CONCLUSIONS: Affective psychoses have a less favourable outcome than expected. There was support for an endogenous-neurotic distinction.

Adult↗