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Biomedical subjects

D P Watson

Publications and source records attributed to D P Watson.

11 recordsLinked to original sources
PubMed1996

The homeless in the emergency department: a patient profile.

OBJECTIVE: To explore the possibility that homeless people use the accident and emergency (A&E) department as a substitute for primary care and to quantify the role of alcohol abuse in their attendances. METHODS: The study period lasted six months. Attendances of all patients registering with "No fixed abode" as their address were analysed from the A&E notes. Information gathered included details of the presenting complaint, general practitioner (GP) registration, and alcohol involvement in the presentation. RESULTS: 135 homeless patients attended the department 233 times; 91% of patients were male with an average age of 40 years; 46% of attendances were during office hours; 81.5% of presentations were for minor problems; 65.2% of patients had co-existing medical problems, with 14.8% having a chronic alcohol problem; 23.7% of patients gave details of their GP and the remainder were either not registered or did not know their GP registration status; 29.6% of attendances directly involved alcohol and another 10.3% were requests for inpatient or outpatient alcohol detoxification; 42.1% of patients questioned said they were aware of the medical facilities available to homeless people in the community; 52.6% of those questioned said they preferred being seen in the A&E department when ill, with 23.7% preferring GP treatment and 10.5% attending community homeless clinics. CONCLUSIONS: The local homeless population may be using the A&E department as a substitute for primary care even in the presence of homeless healthcare facilities in the community. Heightened awareness of these facilities may improve their uptake. Alcohol plays a large role in homeless people seeking medical help in the A&E department. More accessible community facilities for dealing with this problem in this patient group are needed.

Adolescent↗
PubMed1993

Use of anti-D in an accident and emergency department.

A retrospective study was made of the use of anti-D in an accident and emergency (A&E) department in 1 month. Patients who are discharged home with a diagnosis of threatened miscarriage should have their blood group determined and anti-D should be given to those who are rhesus negative. We found that only 8/29 patients discharged from the department had their blood group determined and none of the rhesus negative patients was given anti-D. We have introduced a practical method of reminding medical staff to give anti-D to patients who require it.

Abortion, Threatened↗
PubMed1991

Dementia as a neuropsychological consequence of chronic occupational exposure to polychlorinated biphenyls (PCBs).

Previous epidemiological and clinical studies of humans exposed to polychlorinated biphenyls (PCBs) indicate that the majority of patients have neurological complaints (e.g., headache, vertigo, paresthesias, poor memory and concentration, fatigue, depression). Since only a small minority of PCB-exposed patients demonstrate abnormalities on objective neurological measures (e.g., CT-scans, EEC, nerve conduction velocity), it is particularly unfortunate that objective neuropsychological data has not been published to substantiate patient complaints. The present study provides neuropsychological test data on two patients exposed to PCBs. In both cases, PCB exposure is documented by an analysis of PCB levels in the patients' work environments. Despite the absence of abnormalities on CT-scans and EEC, both patients displayed a variety of cognitive deficits and emotional disturbance. Serial assessment of one patient with high blood levels of PCBs revealed a dementia (sharing certain features with Alzheimer's disease) and an organic affective syndrome. Assessment of a second patient exposed to PCBs (but with no detectable blood levels of PCBs) suggested that his cognitive impairments were not due to PCB exposure. The present study provides data which points to the importance and sensitivity of neuropsychological examination in cases of PCB-exposure.

Journal Article↗
PubMed1987

Aspiration cytology and its relevance to the diagnosis of solid tumors of the breast.

There is a wide variance in the reported values for the diagnostic accuracy of fine needle aspiration (FNA) cytologic study and its role in the management of palpable lumps of the breast is controversial. For these reasons, the results of 350 aspirations of the breast performed at this unit were analyzed and the benefits of aspiration cytology were evaluated. The results were encouraging with a diagnostic accuracy rate of 95.0 per cent, a sensitivity rate of 74.0 per cent, a specificity rate of 99.6 per cent and a positive predictive value of 98.0 per cent. There was one false-positive result emphasizing that aspiration cytology must be used in combination with other indicants of the nature of a mammary lump. The sites and the age of presentation of both benign and malignant lesions of the breast were briefly examined. Limitations of this technique were also discussed. A positive FNA result may obviate the need for frozen section. FNA cytology has been found to be a useful and accurate adjunct in the diagnosis of the nature of mammary lumps and is now an integral part in the management of these patients in this unit.

Adenocarcinoma↗
PubMedDate not supplied

Patient accidents.

Explore the source record for details and available documents.

Accidents↗
PubMedDate not supplied

Ruptured diaphragm: the latent phase.

Traumatic rupture of the diaphragm is an uncommon injury which can be missed unless there is a high index of suspicion. In the interval between rupture of the diaphragm and herniation of abdominal contents, signs and symptoms are nonspecific and the chest X-ray may be normal.

Accidents, Traffic↗