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Biomedical subjects

J Dobbs

Publications and source records attributed to J Dobbs.

18 recordsLinked to original sources
PubMed2001

Prevalence of tics and Tourette syndrome in an inpatient adult psychiatry setting.

OBJECTIVE: Given the widely recognized genetic basis for Gilles de la Tourette syndrome (TS) and the suggestion that the putative TS gene(s) may be expressed as or associated with a variety of psychiatric illnesses, this study was undertaken to assess the prevalence of tics and TS in a psychiatric inpatient population. DESIGN: Cross-sectional study. SETTING AND PATIENTS: 200 consecutive adult patients who were admitted to the psychiatric wards of University College London Teaching Hospitals. OUTCOME MEASURES: TS and related behaviours, as assessed by the comprehensive semi-structured National Hospital Interview Schedule. RESULTS: None of the 200 patients had definite TS, but 2 were observed to have motor tics; 10 had a history of tics (present for less than a year), and 7 reported a family history of tics. Thus, 19 (9.5%) inpatients qualified for inclusion in a broadly defined TS diathesis. These rates are significantly lower than those reported in a similar community based epidemiological study of adolescents (p = 0.018). CONCLUSIONS: Our findings do not support the theory that TS and related behaviours are over-represented among adult inpatients with psychiatric illnesses.

Adolescent↗
PubMed1997

Konno-aortoventriculoplasty with mechanical prosthesis in dealing with small aortic root: a good surgical option.

OBJECTIVE: This study was undertaken to evaluate the effectiveness and the results with the Konno-aortoventriculoplasty. METHODS: Over a 10-year period, 21 Konno-aortoventriculoplasties were performed in 20 patients utilizing mechanical cardiac valvular prostheses, in 14 male and 6 female patients for complex left ventricular outflow tract stenosis. The mean age was 9.2 years (range 1.7-25.7 years). The pre-enlargement mean aortic annular size was 11.5 mm (6-16 mm). The mean size of the prostheses implanted was 20.4 mm (19-23 mm). In a typical case, the aortic annulus was enlarged to twice its original size. RESULTS: The only operative death was in a 8 kg, 20-month old child with previous commissurotomy, due to intractable bleeding and low output state. The mean hospital stay was 9.4 days (1-15 days), and the mean ICU stay was 3.3 days (1-7 days). The only late death was in a patient who went on to have cardiac transplantation for progressive left ventricular dysfunction. The 10-year acturial survival was 90 +/- 7%, and the reoperation free survival was 89 +/- 7%. All of the 18 surviving patients are asymptomatic at the time of last clinic visit (mean follow-up of 61.1 +/- 31.7 months, range 0-139 months). All patients had resolutions of their left ventricular hypertrophy with insignificant gradient across the repair by echocardiography. CONCLUSIONS: Konno-aortoventriculoplasty is extremely effective in the treatment of small aortic annuli and complex left ventricular outflow tract obstruction. In the present era of increasing popularity of autograft and homograft operations, the Konno procedure should remain in the technical armamentarium of the cardiac surgeon.

Adolescent↗
PubMed1995

Adverse life events and breast cancer: case-control study.

OBJECTIVE: To investigate the strength of association between past life events and the development of breast cancer. DESIGN: Case-control study. A standardised life events interview and rating was administered before a definitive diagnosis. SETTING: Breast Cancer Screening Assessment Unit and surgical outpatient clinics at King's College Hospital, London. SUBJECTS: 119 consecutive women aged 20-70 who were referred for biopsy of a suspicious breast lesion. MAIN OUTCOME MEASURES: Odds ratio of the risk of developing breast cancer after life events in the preceding five years after adjustment for confounders. RESULTS: 41 women were diagnosed as having malignant disease while the remainder had benign conditions. Severe life events increased the risk of breast cancer. The crude odds ratio was 3.2 (95% confidence interval 1.35 to 7.6). After adjustment for age and the menopause and other potential confounders this rose to 11.6 (3.1 to 43.7). Multiple logistic regression analysis showed that all severe events and coping with the stress of adverse events by confronting them and focusing on the problems significantly predicted a diagnosis of breast cancer. Non-severe life events and long term difficulties had no significant association. CONCLUSION: These findings suggest an aetiological association between life stress and breast cancer.

Adaptation, Psychological↗
PubMed1993

Clinical results of cryopreserved valved conduits in the pulmonary ventricle-to-pulmonary artery position.

Aortic valved homograft conduits (AVHC) have become valuable in the pulmonary ventricle (PV)-to-main pulmonary artery (MPA) reconstruction in congenital heart defects. Since 1985, 45 patients, ranging in age from 12 days to 32 years, underwent PV-to-MPA reconstruction utilizing cryopreserved AVHC. Operative deaths included seven patients (16%), six of whom died as a result of the complexity of their underlying heart defects. One late death (2%) occurred as a result of infective endocarditis 48 months after conduit placement. The 38 patients who survived the operation remained in the intensive care unit for a mean of 5.7 +/- 1.0 days (median: 4 days; range: 2 to 37 days). The mean hospital stay was 13.0 +/- 1.8 days (median: 9 days; range: 6 to 63 days). The mean follow-up was 40.0 +/- 3.6 months (median: 40 months; range: 10 months to 7.1 years). Only two patients (5%) required reoperation for conduit stenosis with systolic pressure gradients of 60 to 80 mm Hg at 10 and 14 months, respectively, after operation, and both reoperations were successful. During outpatient visits, 16 patients are totally asymptomatic, and 21 patients have minimal symptoms (New York Heart Association class II). Only 10 patients (26%) require digoxin, and 2 patients (5%) need diuretics as part of their medical regimen. Recent echocardiographic examinations show insignificant pressure gradients in all 37 currently surviving patients. Thus, barring operative mortality, which is almost always associated with the nature of the underlying heart defect, the use of cryopreserved AVHC is a safe and effective alternative for PV-to-MPA reconstruction.

Adolescent↗
PubMed1992

'I thought it would go away': patient denial in breast cancer.

A significant proportion of patients with cancer present late to the doctor. The characteristics of these patients and the reasons behind their delaying behaviour is poorly understood. In this study a group of 30 women with breast cancer who delayed their presentation were compared with a randomly selected group with the same disease. The women who presented late did not appear to fit into any particular socio-demographic category, but examination of their histories revealed widespread denial of illness and a diversity of beliefs and behaviour.

Aged↗
PubMed1984

Suicide inactivation of chymotrypsin by benzoxazinones.

The benzoxazinones 2-ethoxy-4H-3,1- benzoxazin -4-one (1a) and 2-(trifluoromethyl)-4H-3,1- benzoxazin -4-one (1d) inactivate chymotrypsin. The inactivation is stoichiometric and proceeds with rate constants of 7 X 10(5) M-1 min-1 and greater than 4 X 10(6) M-1 min-1, respectively. The inactivated enzyme recovers catalytic activity slowly, k = 2.3 X 10(-3) min-1 and 3.7 X 10(-2) min-1 (pH 7.1). When the enzyme regains catalytic activity, 2-[N-(ethoxycarbonyl)amino]benzoic acid is released from enzyme inactivated with 1a and N-(trifluoroacetyl)anthranilic acid from enzyme inactivated with 1d. The mechanism of inactivation involves attack of the active site serine on the C-4 carbonyl of the inactivator which leads to ring opening and formation of an ortho-substituted benzoylchymotrypsin , which hydrolyzes slowly due to electron releasing ability of the substituents. The rate of hydrolysis of the benzoylchymotrypsin from 1a or 1d is in close agreement with those predicted from the Hammett parameters (sigma, rho) for hydrolysis of their para-substituted analogues [ Caplow , M., & Jencks , W. P. (1962) Biochemistry 1, 883-893]. The inactivation of chymotrypsin by 2-methyl-4H-3,1- benzoxazin -4-one (1b) is an equilibrium process (kinact = 1 X 10(4) M-1 min-1 and Keq = 2 X 10(6) M-1). Formation of a benzoylchymotrypsin is demonstrated by spectral changes and methanol trapping. The benzoylchymotrypsin can also decay by direct hydrolysis to N- acetylanthranilic acid.(ABSTRACT TRUNCATED AT 250 WORDS)

Chymotrypsin↗
PubMed1984

Characterization of chronically implanted ventricular endocardial pacing leads.

The expected implant lifetime of pacemaker generators has been extended with the introduction of lithium power sources. Consequently, the pacing lead may become the component that determines the total implant lifetime of the pacemaker. This fact emphasizes the necessity for accurate assessment of the integrity of a chronically implanted lead. In this study, chronic threshold and impedance data from 61 patients having the same type of ventricular endocardial lead for up to 10 years were retrospectively analyzed. The mean acute current threshold was 0.81 +/- 0.33 mA. The chronic current threshold had a range of between 1 and 5 mA, which was approximately two to five times greater than the acute implant value. Chronic voltage threshold and impedance were 0.7 to 4 V and 335 to 775 omega, respectively. The findings of this study provide general guidelines for chronic lead parameters and illustrate some of the difficulties encountered in gathering and interpreting long-term lead data.

Electric Conductivity↗
PubMed1982

Type and timing of permanent pacemaker failure.

Availability of lithium batteries will decrease the incidence of early pacemaker failure. Pacemaker malfunction, exclusive of that due to battery exhaustion, can still occur. Defined as any repeat surgical procedure required after initial implantation, pacemaker system failure occurred in 22 of 115 (19 percent) pacemaker patients. Failure occurred within the first month in 12 with ten being lead-related. Insertion site problems occurred in nine patients. Though most endocardial pacemaker complications occur early, patients continue to be at risk for as long as the units are in place. Despite improvements in the batteries, there continue to be sufficient problems with pacemakers to emphasize the need for selectivity in determining which patients receive permanent units.

Adult↗
PubMed1979

Multiple bladder diverticula in Williams "Elfin-Facies" syndrome.

Twenty-three children with Williams "elfin-facies" syndrome were reviewed. A striking incidence of multiple bladder diverticula was found (8 children of 14 who had voiding cystourethrograms). The diverticula were usually not identifiable on excretory urography. Children generally have a low incidence of bladder diverticula (excluding "Hutch" diverticula), especially multiple diverticula; thus one should strongly consider the diagnosis of Williams syndrome and other connective tissue diseases when multiple bladder diverticula are identified.

Abnormalities, Multiple↗
PubMed1977

Altered yolk structure and reduced hatchability of eggs from birds fed single doses of petroleum oils.

Yolk deposited by Japanese quail was abnormal for 24 hours after the oral administration of a single capsule containing 200 milligrams of bunker C oil. Both the structure and the staining properties of the yolk were affected. Fewer eggs were laid during the 4 days after dosing, compared to controls, and hatchability was drastically reduced. Hatchability returned to normal in 4 days. Three other reference oils also affected yolk structure. Canada geese given 2 grams and chickens given 500 milligrams of bunker C oil produced eggs with abnormal yolk rings.

Administration, Oral↗