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Biomedical subjects

K R Krishnan

Publications and source records attributed to K R Krishnan.

At least 217 records · Page 12Linked to original sources
PubMed1986

Depression as a psychopathological disorder in chronic low back pain patients.

An association between chronic pain and depression has been recognised for a long time. However, the exact nature of this association remains unclear. The authors studied 80 consecutive patients with chronic low back pain. Different types of depression were diagnosed using Research Diagnostic Criteria. The relationship between different types of depression and clinical and demographic variables are presented. Beck Depression Inventory and the Montgomery-Asberg Depression Rating Scale were used in an attempt to discriminate between the different types of depression.

Adjustment Disorders↗
PubMed1986

The artificial ventilation of acute spinal cord damaged patients: a retrospective study of forty-four patients.

The case histories of the 44 ventilated spinal cord damaged patients who have been treated at the Mersey Regional Spinal Injuries Centre prior to 1985 were reviewed. Complications of ventilation were commoner in patients whose ventilation was initiated prior to transfer to the specialised centre. Inappropriate early management before or during transfer to the spinal injuries centre led to the need for ventilation in several cases. Spinal cord damaged patients should be transferred to a specialised comprehensive centre as soon as possible after injury so that the requirement for ventilation can be minimised, the incidence of cardiac and respiratory arrest reduced, optimal methods of ventilation and weaning employed and global emotional and educational support provided from the outset for the patient and his family.

Acute Disease↗
PubMed1986

An assessment of the Newcastle Anxiety Depression Index.

The Newcastle Anxiety and Depression Diagnostic Index (NADDI) has been reviewed, and its advantages and disadvantages discussed. One hundred eighty-seven patients were examined, and grouped into three categories by means of the NADDI, which produced a unimodal distribution of score. These three groups were studied in respect of the Hamilton Depression and SCL-90 self-rating scales. Significant profile differences were found on both scales. Patients with pure anxiety and pure depression were more distressed than the intermediate group of mixed anxiety-depressed patients. The NADDI scale items were compared in four clinical groups of primary endogenous, primary nonendogenous depression, generalized anxiety, and panic disorder. Most differences were found when panic disorder was compared to the other three groups, and generalized anxiety disorder received minimal validation. Treatment response was also examined.

Adult↗
PubMed1986

Serial concentrations of C-reactive protein as an indicator of urinary tract infection in patients with spinal injury.

C-reactive protein (CRP) was measured serially in 16 patients with an acute spinal injury. Twelve episodes of acute urinary tract infection (UTI) occurred during the study period. These were all associated with an increased concentration of CRP greater than 50 mg/l, which returned to normal after successful treatment. Thirteen episodes of asymptomatic bacteriuria associated with increased concentrations of CRP greater than 20 mg/l occurred, indicating tissue damage. More commonly, significant bacteriuria was associated with normal concentrations of CRP, and presumably, simple colonisation of the urinary tract, which, we suggest, does not require treatment with antibiotics. Serial measurement of CRP in patients with spinal injury may help distinguish between urinary tract colonisation and infection and be useful in monitoring the response to the treatment of clinical UTI.

Acute Kidney Injury↗
PubMed1985

Ventilation or dignified death for patients with high tetraplegia.

The case histories of the 37 patients of the Mersey Regional Spinal Injuries Centre who were artificially ventilated between 1968 and 1984 were reviewed. The patients and caring relatives were interviewed separately to determine their views. Of 21 patients who were still alive, 18 said that they would wish to be temporarily ventilated again if the need arose, two were undecided, and one said that she would wish to be allowed to die. Sixteen caring relatives said that they were glad that the decision to ventilate had been taken. Those who were not glad were all young mothers. The outcome from any combination of factors that existed before injury could not be predicted except that most patients over age 59 fared badly. Patients with spinal cord damage should be artificially ventilated if required, provided that this can be carried out well and that total emotional, educational, and physical support can be provided and maintained. Whether or not scarce resources should be deployed in this manner requires discussion.

Adolescent↗
PubMed1985

What does the dexamethasone suppression test identify?

The authors studied the Dexamethasone Suppression Test (DST) in chronic pain patients with and without major depression, using items from a modified version of the Hamilton Depression Scale, the Hamilton Anxiety Scale, and the Montgomery-Asberg Depression Rating Scale. The purpose of the study was to identify the factor or factors which discriminated DST suppressors from nonsuppressors. The data suggest that depression and its profile are efficient discriminators of suppressors and nonsuppressors. Anxiety-related items were not as good as discriminators. The items that identified nonsuppression were the items that are often seen in combination in endogenous depression.

Adult↗
PubMed1985

The management of upper urinary tract calculi in spinal cord damaged patients.

The management of upper urinary tract calculi in 49 patients in the Mersey Regional Spinal Injuries Centre was reviewed retrospectively. Morbidity in nine patients was increased by either delay in operative intervention (5 cases) or inadequate follow up evaluation (4 cases). Earlier active treatment using modern endourological techniques and lithotripter technology is encouraged. A clinical algorithm incorporating these new techniques is shown.

Female↗
PubMed1984

The role of urodynamics in the management of spinal cord injured patients.

The urological management of 1126 consecutive patients treated at the Mersey Regional Spinal Injuries Centre between 1947 and 1983 is reviewed. It is concluded that when urodynamics is included in the urological investigative profile, in addition to clinical, biochemical, intravenous urographic and cystourethrographic assessments, then treatment failure is less likely.

Humans↗
PubMed1984

Urodynamic observations on patients with sacral anterior root stimulators.

The urodynamic changes produced by sacral anterior root stimulators have been assessed in 13 patients with spinal injuries. Before surgery all of the eleven men and two women had poor or absent bladder control with large residual volumes. Videocysto-urethrography with pressure and flow studies was performed pre-operatively and repeated once post-operatively, at intervals of 6 months to 5 years. In all cases the residual volume was reduced to less than 50 ml and the functional bladder capacity increased to within the normal range. All the patients were able to void voluntarily by activating their implants in bursts. This produced an interrupted stream at normal voiding pressures and acceptable flow rates. There was definite improvement in vesico-ureteric reflux and decrease in bladder trabeculation following implantation of the stimulator. Use of the stimulator has enabled nine of the patients to be continent at night. Eight of them are also dry during the day.

Adult↗
PubMed1984

Differentiation of depression from chronic pain with the dexamethasone suppression test and DSM-III.

The concept of chronic pain has become enmeshed with depression. In an attempt to unravel this complex relationship, the authors studied a uniform group of 42 patients with chronic pain, i.e., patients who had chronic low back pain with defined organic pathology, in relation to the dexamethasone suppression test (DST). The results were analyzed in relation to the presence or absence of major depression and cortisol suppression. Forty-one percent of the patients with major depression had abnormal cortisol responses to dexamethasone administration; all patients without major depression had normal responses. These results suggest that chronic pain patients differ from patients with major depression and a positive DST.

Adolescent↗