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Biomedical subjects

J C Duffy

Publications and source records attributed to J C Duffy.

At least 19 recordsLinked to original sources

Auditory P300 and eye tracking dysfunction in schizophrenic pedigrees.

Several psychophysiological abnormalities associated with schizophrenia have been proposed as genetic trait markers of vulnerability to the disorder. Smooth pursuit eye tracking dysfunction and abnormal long latency event-related potentials are the most promising candidates. Both are independent of the effects of psychotropic medication or mental state at the time of testing, and twin studies demonstrate that each has a high level of heritability. Having recorded smooth pursuit eye tracking and event-related potentials in 20 high-density schizophrenic families, we find abnormalities in one or both measures in most of the families studied. The abnormalities, when present, occur in the family members with schizophrenia and other forms of functional psychosis, and they have a bimodal distribution with approximately half the nonschizophrenic relatives also showing eye tracking dysfunction and/or abnormal event-related potentials. Some of these relatives had psychiatric symptoms; others were normal. Our results suggest that psychophysiological examination can help to clarify the boundaries of schizophrenia spectrum disorder. By helping to decide the phenotypic status of nonschizophrenic family members, this should increase the power of DNA linkage studies.

Acoustic Stimulation

Consultation in the aftermath of an air tragedy.

In the early morning hours of December 12, 1985, a chartered jet airliner carrying 248 soldiers crashed shortly after takeoff, killing all aboard. The day after, the authors were designated as a consultation team to the mental health staff at Fort Campbell who were providing services in the aftermath of the crash. This report describes and analyzes the experiences of this consultation on disaster management. Our consulting experience has been one of the most profound and demanding events of our professional lives. Salient lessons of the consultation include: (a) the need to clarify leadership roles among the local mental health care team; (b) the need to help the local team establish clear roles among team members; (c) the value of enabling the local team to mourn the loss of their fellow soldiers and community members; and (d) the value of establishing a clear plan of mental health services for both short-term and long-term management.

Aircraft

Management of the insensitive foot in diabetes: lessons learned from Hansen's disease.

Diabetes mellitus is the number one cause of lower extremity amputation (LEA) in the United States, accounting for about 60,000 cases per year. While the combination of reduced blood supply and the loss of sensation to the foot in a diabetic are responsible for the high incidence of LEAs, in most cases it is the loss of sensation that is primarily responsible for the initial foot wound and its failure to heal. The authors review the four mechanical causes for foot ulceration and eventual amputation. Based on an understanding of how feet ulcerate, the National Foot Treatment Center in Carville, LA has developed an insensitive foot screening and treatment program for "diabetic" foot ulcers that is more than 90% effective in healing plantar ulcers.

Diabetes Complications

A comparison of self-injury and self-poisoning from the Regional Poisoning Treatment Centre, Edinburgh.

Injury and poisoning episodes at the Regional Poisoning Treatment Centre, Edinburgh, were compared for the years 1980-1986. Injury was more likely to be associated with youth, male sex and single status. When these demographic differences were controlled for, injury was found to be associated with the following clinical variables: personality disorder, previous psychiatric inpatient status, use of alcohol at the time of parasuicide and alcohol problems, and the social variables-violence against others and received from relatives in the preceding 5 years, criminal record and unemployment. These have been consistently associated with repetition of parasuicide. A history of injury as a putative marker of repetition and the clinical implication of its association with alcohol problems are discussed.

Adolescent

Suicide in England and Wales 1946-1985: an age-period-cohort analysis.

Four decades of suicide mortality data for England and Wales were analysed within an age-period-cohort framework. Marked differences in results were found by sex. The analysis of the male data showed that the risk of suicide increased with age until men were in their mid-fifties (after allowing for period and cohort effects), and that suicide risk declined for males born from 1876 to 1915, but had increased over 4-fold for certain later-born cohorts. Female suicide risk was found to decline with later nativity (after adjusting for age and period effects). The identification of period effects in terms of known changes in the carbon monoxide (CO) content of domestic gas successfully accounted for temporal variation in male suicide risk, but fitted less well to the data for females.

Adult

Medical admissions in men: the risk among drinkers.

Information on alcohol consumption was elicited by the same method from men in a general population survey and from male medical inpatients in a hospital serving that population. A measure of risk controlling for age, the logarithm of the odds ratio, showed that for liver disorders, upper gastrointestinal disorders, myocardial infarction, other cardiovascular disorders, and respiratory disorders, rising consumption of alcohol was related to increased risk of hospital admission relative to abstention. The risk of admission for the remaining heterogeneous category of disorders was lower than that for abstention, perhaps reflecting the effect of chronic illness on drinking habits, and also suggesting that the link between alcohol consumption and medical diagnoses is not simply due to greater frankness about drinking in hospital inpatients.

Adolescent

Scotland's liquor licensing changes: an assessment.

The impact of the changes in Scotland's liquor licensing laws was assessed by comparing trends in alcohol related problems in Scotland with those in England and Wales. The study showed no appreciable effect on the level of alcohol related morbidity and mortality, though some improvements were noted in relation to the rates of convictions for drunkenness. The changes introduced since 1976 appeared to be popular and there was widespread perception that public drunkenness had become less common-place.

Alcohol Drinking

Long-term depot maintenance of chronic schizophrenic out-patients: the seven year follow-up of the Medical Research Council fluphenazine/placebo trial I. Course of illness, stability of diagnosis, and the role of a special maintenance clinic.

A follow-up study of all patients entering the MRC double-blind trial of fluphenazine decanoate in chronic schizophrenic out-patients achieved a trace rate of 94%. In general, these patients were severely disabled, continued under the care of the maintenance clinic, and their diagnoses remained remarkably consistent; more than one-fifth were found to be in acute schizophrenic relapse and in over a half of these cases, the relapse was not known to the treatment agency. The maintenance clinic attenders were little different from those who no longer used such a facility.

Adult

Long-term depot maintenance of chronic schizophrenic out-patients: the seven year follow-up of the Medical Research Council fluphenazine/placebo trial. II. The incidence of compliance problems, side-effects, neurotic symptoms and depression.

Seven years after the completion of the original trial, over 73% of patients were maintained on depot neuroleptics, and 70% had received such medication for over seven years. About 40% had presented with a problem of compliance at some time, and there was a significant correlation between poor compliance and in-patient admissions and schizophrenic relapses. The prevalence of parkinsonian side-effects, akathisia, and tardive dyskinesia was low. Non-psychotic symptoms were common, even in the absence of acute psychosis. Depression was found in a subgroup of patients; it was frequently reported as an indication for admission during follow-up period, and seemed to be part of the schizophrenic illness rather than a result of antipsychotic drug treatment.

Clinical Trials as Topic

Long-term depot maintenance of chronic schizophrenic out-patients: the seven year follow-up of the Medical Research Council fluphenazine/placebo trial. III. Relapse postponement or relapse prevention? The implications for long-term outcome.

The relapse and admission histories revealed a positive correlation between number of schizophrenic episodes and time on maintenance medication, probably reflecting severity of illness. Relapse rates after drug discontinuation rose to 45% within 13 months. There were no differences of predictive value between those relapsing on or off medication. The relationship between relapse rates, drug treatment, and social outcome is complex; antipsychotic drugs may postpone relapse, and frequent relapses might inhibit improvement in social performance long after florid symptoms have been controlled by medication.

Clinical Trials as Topic