PubMed Health⌕ Search

Biomedical subjects

J Heron

Publications and source records attributed to J Heron.

14 recordsLinked to original sources
PubMed2005

Bedside monitoring of CBF with xenon-CT and a mobile scanner: a novel method in neurointensive care.

Combining previously independently established techniques our objective was to develop and evaluate a method for bedside qualitative assessment of cerebral blood flow in neurointensive care (NICU) patients. The CT-protocol was optimized using phantoms and comparing a mobile CT-scanner (Tomoscan-M, Philips) with two stationary CT scanners. Thirty-two per cent xenon was delivered with standard equipment (Enhancer 3000). Mean cortical flow in volunteers was 48 ml/min/100 g, with the mean vascular territorial flow varying between 45 and 66 ml/min/100 g. The potential clinical usefulness was illustrated in three patients with vasospasm following subarachnoid haemorrhage. Our conclusion is that quantitative bedside measurements of CBF can be repeatedly performed in an easy and safe way in a standard NICU-setting, using xenon-inhalation and a mobile CT-scanner. The method is useful for the decision-making, and is a good example of how the quality of multi-modality monitoring in the NICU can be developed and further diversified.

Adult↗
PubMed2005

Nocturnal enuresis: a survey of parental coping strategies at 7 1/2 years.

BACKGROUND: Childhood nocturnal enuresis is a potentially distressing experience. Parents have been found to adopt many approaches designed to help their child become dry at night. This study sought to understand, through a large cohort of children at 7 1/2 years of age, the strategies parents adopt, both during the child's development and currently, to help their child overcome bed-wetting. METHODS: A longitudinal cohort of 13,971 children with expected date of delivery between April 1991-December 1992, in the County of Avon (Bristol) formed the population study group. At 7 1/2 years parents were asked, as part of a regular self-report questionnaire, what methods they had tried or were currently using to help their child stop bed-wetting. Eleven options were supplied. RESULTS: Of 8269 parents responding to the questionnaire, 3376 (40.8%) indicated they had tried at least one of 11 strategies, with restricting night-time fluids and lifting being the predominant methods employed. Amongst strategies employed in the past, lifting and showing displeasure were used significantly more by parents of children with nocturnal enuresis than by those with children dry at 7 1/2 years. However, a greater proportion of parents of dry children encouraged their offspring to toilet more regularly in the daytime than parents of those with nocturnal enuresis or infrequent wetting. In terms of treatment interventions, the enuresis alarm had been employed with 19.2% and medication with 13.1% of those with nocturnal enuresis, although only 31.9% of those with nocturnal enuresis had seen a health worker. The results are discussed in relation to preventative and clinical implications.

Adaptation, Psychological↗
PubMed2004

Sensory uncertainty governs the extent of audio-visual interaction.

Auditory signals have been shown to exert a marked influence on visual perception in a wide range of tasks. However, the mechanisms of these interactions are, at present, poorly understood. Here we present a series of experiments where a temporal cue within the auditory domain can significantly affect the localisation of a moving visual target. To investigate the mechanism of this interaction, we first modulated the spatial positional uncertainty of the visual target by varying its size. When visual positional uncertainty was low (small target size), auditory signals had little or no influence on perceived visual location. However, with increasing visual uncertainty (larger target sizes), auditory signals exerted a significantly greater influence on perceived visual location. We then altered the temporal profile of the auditory signal by modulating the spread of its Gaussian temporal envelope. Introducing this temporal uncertainty to the auditory signal greatly reduced its effect on visual localisation judgements. These findings support the view that the relative uncertainty in individual sensory domains governs the perceptual outcome of multisensory integration.

Acoustic Stimulation↗
PubMed2003

Self-reported schizotypy and bipolar disorder: demonstration of a lack of specificity of the Kings Schizotypy Questionnaire.

Previous studies have demonstrated that schizophrenia patients score highly on self-reported measures of schizotypy such as the Kings Schizotypy Questionnaire (KSQ), but relatively little is known about the specificity of these self-reported features to schizophrenia. We aimed to explore the specificity of schizotypal features to schizophrenia by measuring their prevalence in subjects with bipolar disorder. The Kings Schizotypy Questionnaire (KSQ) was administered to participants (n=92) in a sibling-pair genetic linkage study of bipolar disorder. Scores were compared with those of participants in a similarly designed, concurrent family study of schizophrenia (n=135) and psychiatrically well controls (n=263). The bipolar group had significantly more schizotypal features than controls but significantly less than schizophrenia patients. Whether a bipolar subject had experienced positive psychosis had no effect on his/her schizotypy score. We conclude that elevated self-reported schizotypy as measured by the KSQ is not specific to schizophrenia, and may be associated with functional psychosis in general.

Adult↗
PubMed2002

The Wellcome trust UK-Irish bipolar affective disorder sibling-pair genome screen: first stage report.

We have completed the first stage of a two-stage genome wide screen designed to identify chromosomal regions that may harbour susceptibility genes for bipolar affective disorder. The first stage screening sample included 509 subjects from 151 nuclear families recruited within the United Kingdom and Republic of Ireland. This sample contained 154 narrowly defined affected sibling pairs (DSM-IV BPI) and 258 broadly defined affected sibling pairs (DSM-IV BPI, SABP, BPII, BPNOS or MDD(R)), approximately two thirds of all families contained at least one other additional typed individual. All individuals were genotyped using 398 highly polymorphic microsatellite markers from Applied Biosystems's Linkage Mapping Set Version 2. The average inter-marker distance was 9.6 cM and the mean heterozygosity was 0.78. Analysis of these data using non-parametric linkage methods (MAPMAKER/SIBS) found no evidence for loci of major effect and no regions reached genome-wide significance for either suggestive or significant linkage. We identified 19 points across the genome where the MLS exceeded a value set for follow up in our second stage screen (MLS > or = 0.74 (equivalent to a nominal pointwise significance of 5%) under the narrowest diagnostic model). These points were on chromosomes 2, 3, 4, 6, 7, 9, 10, 12, 17, 18 & X. Some of these points overlapped with previous linkage reports both within bipolar affective disorder and other psychiatric illnesses. Under the narrowest diagnostic model, the single most significant multipoint linkage was on chromosome 18 at marker D18S452 (MLS=1.54). Overall the highest MLS was 1.70 on chromosome 2 at marker D2S125, under the broadest diagnostic model.

Adult↗
PubMed2002

The relationship between Caesarean section and subfertility in a population-based sample of 14 541 pregnancies.

BACKGROUND: There has been a threefold increase in the rate of Caesarean section over the past 25 years. The long-term consequences of Caesarean section may include subsequent subfertility. METHODS: We investigated the relationship between Caesarean section and subfertility within a cohort of 14 541 pregnant women. RESULTS: A history of previous Caesarean section was associated with an increased risk of taking >1 year to conceive from the time of planning a pregnancy, adjusted odds ratio (OR) 1.53 [95% confidence interval (CI) 1.09, 2.14]. This association was stronger for women of parity > or =2, adjusted OR 2.97 (95% CI 1.72, 5.10). Nulliparous women with a history of subfertility were at increased risk of delivery by Caesarean section, adjusted OR 1.56 (1.22, 2.00) and OR 2.33 (1.64, 3.30) for durations of >1 and >3 years respectively. CONCLUSIONS: These findings suggest a complex relationship between Caesarean section and subfertility where subfertility may both precede and be a consequence of Caesarean section.

Cesarean Section↗
PubMed2001

Cohort study of depressed mood during pregnancy and after childbirth.

OBJECTIVE: To follow mothers' mood through pregnancy and after childbirth and compare reported symptoms of depression at each stage. DESIGN: Longitudinal cohort study. SETTING: Avon. PARTICIPANTS: Pregnant women resident within Avon with an expected date of delivery between 1 April 1991 and 31 December 1992. MAIN OUTCOME MEASURES: Symptom scores from the Edinburgh postnatal depression scale at 18 and 32 weeks of pregnancy and 8 weeks and 8 months postpartum. Proportion of women above a threshold indicating probable depressive disorder. RESULTS: Depression scores were higher at 32 weeks of pregnancy than 8 weeks postpartum (difference in means 0.88, 95% confidence interval 0.79 to 0.97). There was no difference in the distribution of total scores or scores for individual items at the four time points. 1222 (13.5%) women scored above threshold for probable depression at 32 weeks of pregnancy, 821 (9.1%) at 8 weeks postpartum, and 147 (1.6%) throughout. More mothers moved above the threshold for depression between 18 weeks and 32 weeks of pregnancy than between 32 weeks of pregnancy and 8 weeks postpartum. CONCLUSIONS: Symptoms of depression are not more common or severe after childbirth than during pregnancy. Research and clinical efforts need to be moved towards understanding, recognising, and treating antenatal depression.

Depression↗
PubMed1996

Cost of treating advanced colorectal cancer: a retrospective comparison of treatment regimens.

Introduction of new agents on to hospital drug formularies requires the demonstration of efficacy, safety and cost advantages. An audit of the total monthly costs of 'Tomudex' (raltitrexed; administered every 3 weeks), a drug recently introduced for the treatment of advanced colorectal cancer, and three 5-fluorouracil-based regimens [5-day daily bolus (Mayo); continuous ambulatory pump; 48-h continuous infusion (De Gramont)] was undertaken. Patient-specific costs associated with fluids, concomitant medication and consumables were largely negligible, but chemotherapy was the main cost driver in the raltitrexed and De Gramont groups. Fixed inpatient costs were highest for the patients receiving the De Gramont regimen which required more impatient stays each month. Total costs (patient-specific plus fixed costs) were lowest in patients on the Mayo regimen (mean 954.03 Pounds; median 659.68 Pounds), followed by patients in the ambulatory pump (mean 1207.61 Pounds; median 749.19 Pounds), raltitrexed [mean 1256.93 Pounds; median 1087.14 Pounds (mean 1117.85 Pounds; median 959.34 Pounds when costs of protocol-driven visits were excluded)], and De Gramont groups (mean 2028.52 Pounds; median 1775.66 Pounds). The pattern of costs varied considerably between regimens, such that high drug costs, for example those associated with raltitrexed therapy, were partially offset by reductions in hospital visits and stays.

Adult↗
PubMed1989

Weakness, numbness, tingling and multiple sclerosis.

Multiple sclerosis is the most common serious neurological disease in young patients but it is not the only cause of paraesthesiae. Such sensory symptoms occur frequently and reflect a variety of underlying conditions.

Adolescent↗
PubMed1981

Multiple sclerosis. Luminance threshold and measurements of temporal characteristics of vision.

Luminance threshold, perceptual latency, double-flash resolution, and critical flicker frequency were examined in patients with multiple sclerosis (MS) and in normal control subjects. The intensities of the stimuli used to test the temporal properties of vision were equalized with respect to individual luminance thresholds. In eight patients with MS, all the properties tested showed abnormality, double-flash resolution being most commonly affected. Retinal sites were not however, uniformly abnormal according to these measures. We conclude that abnormal temporal properties of vision in patients with MS are not a simple functional consequence of altered luminance thresholds.

Adult↗
PubMedDate not supplied

Can physicians warn patients of potential side effects without fear of causing those side effects?

BACKGROUND: When initiating treatment, it has been shown that only one quarter of the physicians discuss potential side effects with patients. There are several possible reasons, but, in particular, many physicians are concerned that the power of suggestion may lead some patients to experience an increase in side effects if they are fully informed. Accordingly, this study was designed to determine whether providing patients with information about potential side effects of new medications increases the reported incidence of those side effects. METHODS: All clinic patients are randomly assigned to one of four firms. Two firms served as the intervention group and two served as control groups. All patients receiving new prescriptions for the angiotensin-converting enzyme inhibitors, trimethoprim/sulfamethoxazole, or nonsteroidal anti-inflammatory drugs were recruited. Patients without telephones were excluded. Intervention patients received verbal instructions and a handout describing the name, purpose, dose, and three most common side effects of the drug. Control patients received usual discharge instructions. Patients were interviewed 14 to 21 days later using a standardized questionnaire. RESULTS: There was no difference in incidence of targeted side effects for specific medications between the study groups (38% vs 37%). Study groups were similar with regard to age, sex, financial status, and type of medication prescribed. CONCLUSION: Informing patients of potential side effects prior to starting a new medication does not lead to an increased incidence of those side effects. This should not be a reason for physicians to avoid warning patients of potential side effects.

Drug-Related Side Effects and Adverse Reactions↗