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Biomedical subjects

F Morrison

Publications and source records attributed to F Morrison.

15 recordsLinked to original sources

A waste of time: non-attendance at out-patient clinics in a Scottish NHS Trust.

UNLABELLED: The Patient's Charter states that patients have a responsibility to attend out-patient appointments or to notify the hospital if they are unable to do so. Non-attendance without notification has substantial financial costs for the NHS and may have clinical implications to the non-attender and other patients on the waiting list. OBJECTIVE: To identify reasons for non-attendance of patients for their first appointment after referral. DESIGN: A survey by questionnaire of a random sample of non-attenders of an NHS trust. SETTING: Aberdeen Royal Hospitals NHS Trust. SUBJECTS: Ten per cent of all non-attenders to the Trust out-patient clinics over a twelve month period. RESULTS: One hundred and fifty five (32%) patients contributed to the survey. Cancellations accounted for 22% (34) of missed appointments with factors relating to illness or treatment, being the most common reason (14; 44%). Patients failing to attend without prior notification stated that hospital administrative problems (75; 57%) and personal administrative problems (31; 23%) were the primary reasons. Clinical speciality, day of the week, the month, availability of a telephone or car, and socioeconomic group were not significantly associated with non-attendance. CONCLUSION: The majority of patients show a responsible attitude to attendance at outpatients when appointments were received. Non-attendance was found to be due to a combination of institutional factors (commonly administrative) and patient factors such as forgetting about the appointment.

Adult↗

Salmonella tel-el-kebir and terrapins.

OBJECTIVES: An outbreak of Salmonella tel-el-kebir occurring over a 6-month period is described in this report. This is the first outbreak of S. tel-el-kebir in the reported literature. METHODS: S. tel-el-kebir was isolated from human faecal samples using conventional laboratory methods. RESULTS: Eight patients had S. tel-el-kebir isolated from faeces. All patients were owners of, or in close contact with, pet terrapins. The terrapins were purchased in the same pet shop, where they were imported from America. The epidemiological link with these pets was confirmed, as S. tel-el-kebir was isolated from cloacal swabs from the terrapins, and from terrapin water. Molecular biology studies using DNA amplification fingerprinting (DAF) gave identical fingerprint patterns for all human and terrapin isolates. CONCLUSIONS: Salmonellosis associated with exotic pets is a re-emerging disease in the 1990s, and measures to reduce this are discussed.

Adult↗

Sleep disorders and the dental patient: an overview.

This article is intended to briefly describe common sleep disorders of interest to the dental profession and to render general management guidelines. Topics include sleep-related bruxism, xerostomia, hypersalivation, gastroesophageal reflux, apnea, and the effect of orofacial pain on sleep quality. The term sleep-related is used instead of the term nocturnal because some of the activities described can occur with daytime sleep.

Bruxism↗

The treatment of six men with a learning disability convicted of sex offences with children.

This paper describes a cognitive therapy for men with a learning disability convicted of sex offences against children. Methods are described which focus the session, emphasize confidentiality, ensure that the patient accepts responsibility for the offence, and deal with issues of intent, harm done to the victim and sequences of offending behaviour. Methods for producing cognitive change are described. Patients were assessed regularly and data are presented in detail. While all six men showed improvement, there were several variables which interfered with the course of treatment. The study attempts to address two major problems in work with sex offenders: the difficulty of employing a controlled treatment design and the importance of a long follow-up period.

Adult↗

The global epidemiology of the HIV/AIDS pandemic and its projected demographic impact in Africa.

The global epidemiology of HIV/AIDS has evolved to the point that the pandemic now predominantly affects heterosexuals, especially in developing countries. This article summarizes the status of the HIV/AIDS pandemic as of the early 1990s; provides estimates and short-term projections of AIDS mortality in a hypothetical country of sub-Saharan Africa; projects the potential demographic impact of AIDS in a hypothetical sub-Saharan country; and describes the major problems associated with modelling the long-term demographic impact of this pandemic. Estimated AIDS cases and deaths up to 1992 were extrapolated from public health surveillance data and through use of the WHO model. Estimates of HIV seroprevalence were based on available HIV serological data. For developed countries, HIV estimates developed by national experts and/or national AIDS programmes were used, and for developing countries estimates by regional experts were used or were prepared by WHO. For the first half of the 1990s, projections of AIDS cases and deaths were derived from the WHO model; beyond the mid-1990s, the potential effects of AIDS on selected demographic indicators were derived from a demographic projection model developed by the World Bank. Although estimates and long-term projections cannot be made with great precision, the general dimensions of the HIV/AIDS pandemic have been more clearly delineated now at the start of its second decade. Epidemiological data indicate that in industrialized countries, where extensive spread of HIV began in the late 1970s or early 1980s, the majority of HIV infections occurred during the first half of the 1980s.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗

Comparison of lymphangiography and computed tomography scanning in evaluating abdominal disease in stages III and IV Hodgkin's disease. A Southwest Oncology Group study.

The authors reviewed the records of 139 patients who had laparotomy plus computed tomography (CT) and/or lymphangiograms (LAG) as part of a their staging workup for Hodgkin's disease, in accordance with Southwest Oncology Group (SWOG) protocol 7808. They evaluated the relative ability of CT and LAG to detect disease in the abdomen. Two regions of the abdomen were designated, the upper and the lower, to further examine the capabilities of CT and LAG in the lower abdomen and CT in the upper abdomen. A LAG was more sensitive (P less than 0.05) than CT in detecting positive lower abdominal nodes. In the upper abdomen, CT scan had low sensitivity for detecting positive nodes, liver, or spleen. This study suggests that LAG of the lower abdomen provided more information than CT, and therefore should not be abandoned as a valid method for detecting nodal disease.

Abdomen↗

Treatment of acute lymphoblastic leukemia in adults with intensive induction, consolidation, and maintenance chemotherapy.

The Southwest Oncology Group conducted a study of acute lymphoblastic leukemia (ALL) in adults over a 5-year period, testing the utility of the L-10M regimen initially described by the group from Memorial Sloan-Kettering Cancer Center. One hundred sixty-eight eligible patients were treated with this intensive combination chemotherapy regimen. One hundred fifteen (68%) achieved complete remission. With the current median follow-up time of 34.5 months, the median durations of remission, relapse-free survival, and overall survival were 22.9, 20.9, and 17.7 months, respectively. Only 35% of the patients over 50 years of age achieved a complete remission. Age was a significant prognostic factor for complete response, survival, relapse-free survival, and remission duration. In addition, a low initial WBC count was found to have a statistically significant association with longer remission duration. Responders between the ages of 20 and 49 years with WBC counts of less than 15,000 appear to have an exceptionally good prognosis.

Adolescent↗

Hippocampal influence on amygdala unit activity in awake squirrel monkeys.

The influence of hippocampal electrical stimulation on amygdala extracellular unit activity was studied in the awake squirrel monkey. Hippocampal influence was topographically organized. Stimulation elicited responses in 20% of 476 units tested. Ipsilateral anterior stimulation was more effective than posterior or contralateral stimulation. In the 6 areas with more than 25 tested units, the basomedial nucleus had the highest percentage of responsive units (39%), followed by the accessory basolateral (33%), central (22%y, basolateral (21%), and lateral (5%) nuclei, and the anterior amygdala area (4%). Initial excitation (E) was more prevalent than initial inhibition (I) in the central (90% E vs 10% I) and basomedial (82% E vs 18% I) nuclei; but initial inhibition was more common in basolateral (37% E vs 63% I) and accessory basolateral (33% E vs 67% I) nuclei. The mean response latency was 30.8 msec, ranging from 12 to 130 msec. The basomedial nucleus appears to receive the most potent hippocampal influence. Response characteristics are consistent with a hypothesized relay of nonfornix hippocampal influences on basal forebrain and hypothalamus via the basomedial nucleus. Possible pathways of hippocampal influence and the implications of our results for concepts of hippocampal and amygdala function are discussed.

Amygdala↗

Chromomycin A3 for advanced breast cancer: a Southwest Oncology Group study.

Chromomycin A3 was administered iv to 26 patients in a phase I trial. The maximum tolerated dose established in this study was 0.75 mg/m2/day iv X 5 days. The drug was then given to 48 evaluable patients with far-advanced disseminated breast cancer. Two short partial remissions and one clinical improvement were seen. Toxic manifestations consisted of frequent and usually reversible renal toxicity, nausea and vomiting, occasional thrombocytopenia, hypocalcemia, and two instances of semicoma. Drug toxicity may have contributed to the death of two patients.

Breast Neoplasms↗

HIV seropositivity as a major risk factor for suicide in the general hospital.

The purpose of this study was to assess the suicide rate in people infected with the human immunodeficiency virus (HIV) in the general hospital population. A retrospective study of 2,363 psychiatric consultations was done in 1989 and 1990 at an urban municipal teaching hospital in New York City. The sample included 2,363 patients admitted to adult general care from January 1, 1989, to December 31, 1990, for whom consultations were requested from the consultation-liaison psychiatry service. Suicidal behavior was the reason for consultation in 21.8% of HIV-positive persons and in 19.8% of persons with acquired immunodeficiency syndrome. It was the reason for consultation in only 13.9% of persons with unknown HIV serostatus. This difference is statistically significant. The authors conclude that HIV seropositivity may be a significant risk factor for suicide in the general hospital patient population.

Acquired Immunodeficiency Syndrome↗