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Biomedical subjects

David Fowler

Publications and source records attributed to David Fowler.

45 records · Page 3Linked to original sources
PubMed2003

Tayside-Fife clinical trial of cognitive-behavioural therapy for medication-resistant psychotic symptoms. Results to 3-month follow-up.

BACKGROUND: Evidence for the efficacy of cognitive-behavioural therapy for schizophrenia is promising but evidence for clinical effectiveness is limited. AIMS: To test the effectiveness of cognitive-behavioural therapy delivered by clinical nurse specialists in routine practice. METHOD: Of 274 referrals, 66 were allocated randomly to 9 months of treatment as usual (TAU), cognitive-behavioural therapy plus TAU (CBT) or supportive psychotherapy plus TAU (SPT) and followed up for 3 months. RESULTS: Treatment effects were modest but the CBT condition gave significantly greater improvement in overall symptom severity than the SPT or TAU conditions combined (F (1,53)=4.14; P=0.05). Both the CBT and SPT conditions combined gave significantly greater improvement in severity of delusions than did the TAU condition (F (1,53)=4.83; P=0.03). Clinically significant improvements were achieved by 7/21 in the CBT condition (33%), 3/19 in the SPT condition (16%) and 2/17 in the TAU condition (12%). CONCLUSIONS: Cognitive-behavioural therapy delivered by clinical nurse specialists is a helpful adjunct to routine care for some people with chronic psychosis.

Adolescent↗
PubMed2003

A comparison of the analgesic effects of butorphanol with those of meloxicam after elective ovariohysterectomy in dogs.

This study was designed to compare the analgesic effects of butorphanol with those of meloxicam following ovariohysterectomy. Fifteen dogs were premedicated with 0.05 mg/kg body weight (BW) of acepromazine by intramuscular (IM) injection, plus 0.2 mg/kg BW of meloxicam by subcutaneous (SC) injection. Fifteen dogs were premedicated with 0.05 mg/kg BW of Acepromazine, IM, plus 0.2 mg/kg BW of butorphanol, IM. Anesthesia was induced with thiopental, and dogs were maintained on halothane. All pain measurements were performed by 1 experienced individual, blinded to treatment. Pain scores and visual analogue scales (VAS) were performed at 2, 3, 4, 6, 8, 12, and 24 hours postpremedication. An analgesiometer was used to determine the pressure required to produce an active avoidance response to pressure applied at the incision line. Pain scores, VAS, and analgesiometer scores were analyzed by using a generalized estimating equations method. A significance level of P < 0.05 was considered significant. Animals that received meloxicam demonstrated significantly lower pain scores and VAS than did animals that received butorphanol in the first 12 hours after surgery. Results of this study suggest that meloxicam will produce better postoperative analgesia than will butorphanol. Mucosal bleeding times were performed on cooperative animals in the study group (11 butorphanol, 13 meloxicam). Bleeding times were performed prior to premedication, 6 hours following premedication, and 24 hours after premedication. The 6- and 24-hour readings were compared with baseline bleeding times by using a paired t-test with a Bonferroni correction (a significance level of P < 0.025). Bleeding times did not change significantly over time.

Analgesics, Non-Narcotic↗
PubMed2003

An evaluation of the analgesic effects of meloxicam in addition to epidural morphine/mepivacaine in dogs undergoing cranial cruciate ligament repair.

The analgesic efficacy of an epidural morphine/mepivacaine combination alone versus epidural morphine/mepivacaine in combination with meloxicam administered prior to the onset of anesthesia was assessed in 20 dogs undergoing cranial cruciate ligament repair. Numerical and visual analog pain scores were performed prior to anesthesia and at 6, 8, 12, 16, and 24 hours after epidural administration by a trained observer, blinded to treatment. An analgesiometer was used to determine the amount of pressure required to produce an avoidance response at the incision site. Animals that received meloxicam demonstrated a trend toward decreased pain scores over all time periods. Visual analog pain scores tended to be lower in dogs receiving meloxicam across all time periods, with a significant interaction between time and visual analog score at 6 and 8 hours (P < 0.05). No dogs receiving meloxicam required rescue analgesia, while 3 of 10 dogs in the epidural only group required rescue analgesia. Administration of meloxicam in addition to epidural morphine plus mepivacaine conveys improved analgesia as compared with epidural alone. Postoperative analgesia is reliably maintained for 24 hours following administration.

Analgesia↗
PubMed2002

Micrometeorological measurements of the urban heat budget and CO2 emissions on a city scale.

Direct measurements of urban CO2 emissions and heat fluxes are presented, made using the eddy covariance technique. The measurements were made from the top of a tower, approximately 65 m above the street level of Edinburgh, Scotland, and the fluxes are representative of footprint source areas of several square kilometers. The application of a stationarity test and spectral analysis techniques shows that at this height, the stationarity criterion for eddy covariance is fulfilled for wind directions from the city center for 93% of the time, while for other wind directions this declines to 59%, demonstrating that pollutant fluxes from urban areas can be measured. The average CO2 emission from the city center was 26 micromol m(-2) s(-1) (10 kt of C km(-2) yr(-1)), with typical daytime peaks of 50-75 and nighttime values of 10 micromol m(-2) s(-1). The correlation between CO2 emission and traffic flow is highly significant, while residential and institutional heating with natural gas are estimated to contribute about 39% to the emissions during the day and 64% at night. An analysis of the energy budget shows that, during the autumn, fossil fuel combustion within the city contributed one-third of the daily anthropogenic energy input of 3.8 MJ m(-2) d(-1), with the remainder coming from other energy sources, dominated by electricity. Conversely, the total energy input in late spring (May/June) was found to be approximately half this value.

Air Pollutants↗
PubMed2002

A cognitive model of persecutory delusions.

A multifactorial model of the formation and maintenance of persecutory delusions is presented. Persecutory delusions are conceptualized as threat beliefs. The beliefs are hypothesized to arise from a search for meaning for internal or external experiences that are unusual, anomalous, or emotionally significant for the individual. The persecutory explanations formed reflect an interaction between psychotic processes, pre-existing beliefs and personality (particularly emotion), and the environment. It is proposed that the delusions are maintained by processes that lead to the receipt of confirmatory evidence and processes that prevent the processing of disconfirmatory evidence. Novel features of the model include the (non-defended) direct roles given to emotion in delusion formation, the detailed consideration of both the content and form of delusions, and the hypotheses concerning the associated emotional distress. The clinical and research implications of the model are outlined.

Cognition Disorders↗
PubMed2002

Segmental aplasia of the caudal vena cava in a dog.

Ultrasonography, angiography, magnetic resonance imaging, and exploratory laparotomy of a 2-year-old wheaten terrier with lethargy, exercise intolerance, and ascites revealed segmental aplasia of the caudal vena cava with azygos continuation, complicated by thrombus formation. Surgeries were performed on the blind-ended vessel to remove thrombi, enhancing shunting of blood through the azygos vein.

Angiography↗
PubMed2002

A comparison of carboxyhemoglobin saturation values in postmortem heart blood and peripheral blood specimens.

The following is a study conducted to determine whether there was any significant difference in carboxyhemoglobin (COHb) saturation levels between the heart blood and blood collected from a peripheral site. The average heart blood to peripheral blood COHb saturation level ratio in the 42 cases studied was 1.09. Sixty-two percent (26 of 42) of the cases had a heart blood to peripheral blood ratio between 0.9 and 1.1; 74% (31 of 42) had a ratio between 0.8 and 1.2. Eighty-three percent (35 of 42) had a ratio between 0.7 and 1.3. There were four cases where the heart blood to peripheral blood ratio was either below 0.6 or greater than 1.4. The differences between the two sites were not statistically significant.

Blood Circulation↗
PubMedDate not supplied

A fatal intoxication following the ingestion of 5-methoxy-N,N-dimethyltryptamine in an ayahuasca preparation.

A case of a 25-year-old white male who was found dead the morning after consuming herbal extracts containing beta-carbolines and hallucinogenic tryptamines is presented. No anatomic cause of death was found at autopsy. Toxicologic analysis of the heart blood identified N,N-dimethyltryptamine (0.02 mg/L), 5-methoxy-N,N-dimethyltryptamine (1.88 mg/L), tetrahydroharmine (0.38 mg/L), harmaline (0.07 mg/L), and harmine (0.17 mg/L). All substances were extracted by a single-step n-butyl chloride extraction following alkalinization with borate buffer. Detection and quantitation was performed using liquid chromatography-electrospray mass spectrometry. The medical examiner ruled that the cause of death was hallucinogenic amine intoxication, and the manner of death was undetermined.

Adult↗