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Biomedical subjects

D M Foreman

Publications and source records attributed to D M Foreman.

25 records · Page 2Linked to original sources
PubMed1993

Ethical use of covert videoing techniques in detecting Munchausen syndrome by proxy.

Munchausen syndrome by proxy is an especially malignant form of child abuse in which the carer (usually the mother) fabricates or exacerbates illness in the child to obtain medical attention. It can result in serious illness and even death of the child and it is difficult to detect. Some investigators have used video to monitor the carer's interaction with the child without obtaining consent--covert videoing. The technique presents several ethical problems, including exposure of the child to further abuse and a breach of trust between carer, child, and the professionals. Although covert videoing can be justified in restricted circumstances, new abuse procedures under the Children Act now seem to make its use unethical in most cases. Sufficient evidence should mostly be obtained from separation of the child and carer or videoing with consent to enable action to be taken to protect the child under an assessment order. If the new statutory instruments prove ineffective in Munchausen syndrome by proxy covert videoing may need to be re-evaluated.

Child↗
PubMed1992

Control of scarring in adult wounds by neutralising antibody to transforming growth factor beta.

Adult wounds heal with scar-tissue formation, whereas fetal wounds heal without scarring and with a lesser inflammatory and cytokine response. We injected the margins of healing dermal wounds in adult rats with neutralising antibody (NA) to transforming growth factor-beta (TGF-beta). All control wounds (irrelevant antibody, or TGF-beta, or no injection) healed with scarring, whereas the NA-treated wounds healed without scar-tissue formation; NA-treated wounds had fewer macrophages and blood vessels, lower collagen and fibronectin contents, but identical tensile strength and more normal dermal architecture than the other wounds. Early manipulation of the concentrations of selected cytokines may be a new approach to the control of scarring.

Animals↗
PubMed1992

The effects of transforming growth factor-beta 1 on protein production by mouse embryonic palate mesenchymal cells in the presence or absence of serum.

Mouse embryonic palatal mesenchyme cells were cultured on a variety of substrata (plastic, on a collagen gel or within a collagen gel). On each substratum TGF-beta 1 (1 ng/ml) inhibited cell proliferation. Cells cultured within a collagen gel had the lowest rate of proliferation, but were metabolically the most active in terms of incorporation of [3H]-proline into both collagenous and non-collagenous proteins. TGF-beta 1, in the presence of 2.5% donor calf serum stimulated the production of fibronectin and the major collagen types I, III and V. However, in serum-free medium, TGF-beta 1 induced a large reduction in total collagen production, mainly due to an effect on type I collagen, whilst stimulating production of some non-collagenous proteins. Experiments involving combinations of TGF-beta 1 with other growth factors suggested that the different effects of TGF-beta 1 on collagen production, in the presence and absence of serum, may be due to an interaction with platelet-derived growth factor.

Animals↗
PubMed1991

Comparative biochemistry of mouse and chick secondary-palate development in vivo and in vitro with particular emphasis on extracellular matrix molecules and the effects of growth factors on their synthesis.

A biochemical study analysing the wet weight, dry weight, water, protein and DNA content, collagen and GAG composition of all stages of the developing secondary palate in vivo and in vitro was undertaken to investigate differences between a species in which the palatal shelves elevate (mouse) and one in which they do not (chick). The effects of EGF, bFGF, PDGF and TFG-beta 1 on collagen and GAG synthesis by cultured mouse and chick palatal shelves of different embryonic stages were also studied. The total GAG content of developing mouse palatal shelves decreased with developmental time; heparan sulphate proteoglycan formed the major species in early palates but hyaluronan was the major species in mid-late palates. There was a peak of hyaluronan synthesis in embryonic palatal shelves in vitro at day 13 (T.21), i.e. immediately before shelf elevation. By contrast the total GAG content of chick palates increased with development; chondroitin-6-sulphate formed the major GAG species and there was no peak in hyaluronan synthesis. The water content of developing murine palates rose rapidly at day 14 (T.22), i.e. the time of shelf elevation. No such peak was seen in the chick, where the water content rose exponentially with developmental time. Mouse palates synthesized chondroitin-4-sulphate and novel proteins around the time of shelf elevation; chick palates synthesized chondroitin-6-sulphate and no novel proteins at any developmental stage. Collagen synthesis also peaked in vitro in T.21 murine palates. EGF markedly stimulated murine palatal collagens and GAG synthesis between stages T.20-T.22, but had no effect thereafter. Basic FGF had similar but smaller stage-related effects. PDGF had no effect on mouse palatal collagen and GAG synthesis whilst TGF-beta 1 inhibited GAG synthesis at T.21. The ratios of collagens I, III and V produced by mouse palates were unaltered by the growth factors. All the growth factors had no effect on chick palatal collagen synthesis at any stage and minimal effect on GAG synthesis; TGF-beta 1 stimulated it in early but inhibited it in mid- to late-stage chick palates. These data indicate that extracellular matrix molecule metabolism within the palate is markedly different in the two species studied and suggest that the differing profiles of such molecules may be regulated at certain developmental stages by specific growth factors.

Animals↗
PubMed1990

The ethical use of paradoxical interventions in psychotherapy.

The purpose of this paper is to establish ethical guidelines for the use of paradoxical interventions in psychotherapy. These are defined as interventions which are counterintuitive, coercive, and which require non-observance by the client. Arguments are developed to show that such interventions are associated with a psychology that understands individuals solely in terms of their relationship: a 'strong interactionist' position. Ethical principles consistent with such a position are considered, and from these it is derived that: paradox is an ethical technique with resistive patients; it requires consent; its content should be consistent with general ethical principles, especially those of beneficence and non-maleficence; non-paradoxical techniques should be preferred when possible; and it should not be used as an assessment procedure. It is concluded that research is needed to explore the effect of such ethical guidelines of effectiveness, though preliminary impressions are encouraging.

Behavior Control↗
PubMed1988

Salivary cortisol hypersecretion in juvenile depression.

Thirty depressed inpatients aged 7-16 yrs were compared for salivary hypercortisolism with a control group of 16 inpatients of mixed diagnosis matched for age and sex. Four cortisol samples were taken over a 48 hr period: 8 a.m. and 11 p.m. on the first day; then, with 1 mg of dexamethasone given immediately after the second sample, at 4 p.m. and 11 p.m. on the second day. All except the 8 a.m. value were significantly greater (P less than 0.03) in the depressed group. A 4 nmol/l cutoff for the 4 p.m. sample gave 48% sensitivity and 91% specificity for discriminating depressed cases (P = 0.03). The results indicate that the salivary method for estimating cortisol levels in children and adolescents with depression warrants further study.

Adjustment Disorders↗