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Biomedical subjects

David Rawlings

Publications and source records attributed to David Rawlings.

9 recordsLinked to original sources
PubMed2006

The BPQ: a scale for the assessment of borderline personality based on DSM-IV criteria.

The aim of the study was to develop a self-report measure that assesses borderline personality traits as defined by DSM-IV criteria, including separate subscales for each criterion. A sample of normal subjects from community colleges in the midwestern region of the United States was used to develop the scale. The psychometric properties of the scale were examined using an additional United States sample and student samples from England and Australia. The scale was compared with existing measures of borderline and schizotypal personality. Evidence for the internal consistency and convergent and divergent validity of the new scale is presented. The results of several analyses of variance comparing males and females in the three national groups are reported. A Principal Components Analysis of the subscales suggested either a single factor or two correlated factors. Oblique rotation yielded a structure that distinguished identity/interpersonal and impulsivity borderline personality traits. It is concluded that the new scale provides a useful tool for clinicians and researchers interested in screening for borderline personality traits in both general and clinical populations. Suggestions for further research are indicated.

Adult↗
PubMed2005

Early warning signs of relapse following a first episode of psychosis.

Research in schizophrenia has provided empirical support for the use of self-report inventories for early warning signs of relapse, but to date no published studies have reported on the predictive validity of self-reported early warning signs of relapse in a first-episode cohort. Sixty patients, who had remitted following their first episode of psychosis, participated in a 9-12 month prospective follow-up study. Outcome data on putative prodromal symptoms was available on 46 participants. The Early Signs Scale (ESS) achieved adequate sensitivity but poor specificity and positive predictive validity (PPV) in predicting relapse or symptom exacerbations, although a post hoc increase in the established cut-off significantly improved the outcome. The findings provide qualified support for the use of the ESS in relapse prevention with first-episode patients who are in remission. Further prospective studies with larger numbers of first-episode patients will enable sample sizes enable the comparison of the effectiveness of several prodromal scales using ROC analysis, or a combination of risk factors using regression models.

Adolescent↗
PubMed2005

A reliable DEXA measurement technique for metal-on-metal hip resurfacing.

INTRODUCTION: Dual energy X-ray absorptiometry (DEXA) has been used to measure bone mineral density (BMD) around total hip prostheses. With the recent increase in the use of metal-on-metal hip resurfacing, such as the Birmingham hip resurfacing (BHR), we aimed to produce a reliable method of measuring bone density around a metal-on-metal hip resurfacing. METHODS: We performed DEXA scans on 5 patients (7 BHRs), who had undergone resurfacing with the BHR within the past 2 years. A zonal reporting technique was devised and evaluated. RESULTS: The intraclass correlation (i.e. the correlation between any two assessments of one region of interest) was 0.997, with an overall coefficient of variation of 5%. INTERPRETATION: We have designed and demonstrated a safe, noninvasive and highly reproducible method for interpreting and reporting the results of DEXA scanning of BHR implants in vivo. We will now use this method to prospectively study our BHR population to assess the changes in bone density following BHR within the femoral neck. This method may add to the current techniques available for detection of impending failure.

Absorptiometry, Photon↗
PubMed2005

Agreeableness and neuroticism as predictors of relapse after first-episode psychosis: a prospective follow-up study.

Cross-sectional investigations, using the five-factor model of personality have evinced relationships among neuroticism, agreeableness, and psychotic symptoms. The current study examined these relationships via a prospective follow-up study with remitted first-episode psychosis patients. Baseline five-factor model personality profiles, diagnoses, symptom ratings, and premorbid adjustment ratings were followed by nine monthly ratings on Brief Psychiatric Rating Scale psychosis items in 60 first-episode patients. Valid baseline personality profiles were completed by 40 patients. Patients who had a return of symptoms scored higher on baseline neuroticism and agreeableness than those who remained in remission. Premorbid adjustment also predicted return of symptoms. After premorbid adjustment was controlled for, the agreeableness differences remained significant, but the neuroticism scores were no longer significantly different. It is concluded that lower agreeableness acts as a mediating variable in relapse. Further studies should clarify whether agreeableness is associated with specific biases in processing interpersonal information, and interpersonal behaviors.

Adaptation, Psychological↗
PubMed2004

Low-dose tiagabine effectiveness in anxiety disorders.

BACKGROUND: Gamma-aminobutyric acid (GABA), the predominant inhibitory neurotransmitter of the central nervous system, is involved in the pathophysiology of a wide variety of disorders, including anxiety. Tiagabine hydrochloride acts as a selective GABA reuptake inhibitor (SGRI). METHODS AND RESULTS: Consecutive patients were offered tiagabine in 1-mg incremental doses for the treatment of anxiety, primarily generalized anxiety disorder. Individuals failing anxiety treatment with benzodiazepines, selective serotonin reuptake inhibitors, and buspirone, and/or with a strong family or personal history of substance abuse were allowed trials. The SGRI tiagabine improved anxiety and was well tolerated by adult patients with generalized anxiety disorder as well as one patient with anxiety secondary to acute antidepressant withdrawal. One disinhibition treatment failure is also discussed. CONCLUSION: In acute anxiety treatment, very low initial dosing with gradual increases may be sufficient for anxiety effects, when compared with the higher doses of tiagabine used in epilepsy treatment. Tiagabine may be useful in the treatment of generalized anxiety disorder.

Adolescent↗
PubMed2004

Spontaneous tension pneumopericardium.

A 29-year-old man presented to the accident and emergency department complaining of a sudden onset of chest and upper abdominal pain. He had a past history of intravenous drug abuse and a previous stab wound to the left hypochondrium that had required laparotomy. On arrival he was distressed with grunting respiration. Initial chest X-ray showed a pneumopericardium. Despite titrated doses of opiate analgesia he became increasingly distressed, agitated and dyspnoeic. Repeat chest X-ray demonstrated an increase in the volume of air present within the pericardial sac. His clinical condition improved rapidly after needle pericardiocentesis decompression. A water-soluble contrast swallow revealed a diaphragmatic hernia with a filling defect in the greater curve of the stomach and contrast medium entering the pericardial sac. A thoraco-abdominal laparotomy confirmed a pre-existing diaphragmatic defect from the previous stab wound, with surrounding adhesions. A small portion of the stomach had herniated through this defect with a perforated gastric ulcer communicating directly into the pericardial sac.

Adult↗
PubMed2002

A crucial role for the p110delta subunit of phosphatidylinositol 3-kinase in B cell development and activation.

Mice lacking the p110delta catalytic subunit of phosphatidylinositol 3-kinase have reduced numbers of B1 and marginal zone B cells, reduced levels of serum immunoglobulins, respond poorly to immunization with type II thymus-independent antigen, and are defective in their primary and secondary responses to thymus-dependent antigen. p110delta(-/-) B cells proliferate poorly in response to B cell receptor (BCR) or CD40 signals in vitro, fail to activate protein kinase B, and are prone to apoptosis. p110delta function is required for BCR-mediated calcium flux, activation of phosphlipaseCgamma2, and Bruton's tyrosine kinase. Thus, p110delta plays a critical role in B cell homeostasis and function.

Agammaglobulinaemia Tyrosine Kinase↗
PubMed2002

Intramuscular hemangioma of the posterior belly of the digastric muscle failing to highlight on magnetic resonance imaging.

Intramuscular hemangiomas of the digastric muscle are rare. We present the fifth case reported and the second to be imaged in vivo with magnetic resonance imaging. Accurate preoperative diagnosis of these lesions is difficult, but may be facilitated by a high degree of clinical suspicion and imaging. Magnetic resonance imaging using T2-weighted sequencing has been reported to effectively highlight these lesions. We present a case in which magnetic resonance imaging failed to highlight an intramuscular hemangioma of the posterior belly of the digastric muscle. Possible reasons for this failure are discussed.

Adolescent↗