Biomedical subjects
M Watson
Publications and source records attributed to M Watson.
Searching for signs of revival. Uses and abuses of the Glasgow coma scale.
The Glasgow coma scale is widely used to measure patients' levels of consciousness. Attention to detail and an understanding of the scale's assessment criteria are essential to avoid misuse.
Comparison of lisinopril versus atenolol for mild to moderate essential hypertension.
The antihypertensive effects and safety profiles of lisinopril (10 to 40 mg) and atenolol (50 to 100 mg) were compared in a randomized, double-blind, parallel group trial in 144 patients with essential hypertension. After 8 weeks of therapy, seated blood pressure (BP) decreased by 26/15 mm Hg with lisinopril and by 19/14 mm Hg with atenolol. Lisinopril produced a greater reduction (p less than 0.05) in sitting systolic BP than did atenolol. Standing BP decreased by 25/15 mm Hg with lisinopril and by 19/14 mm Hg with atenolol. No important changes in hematologic and biochemical profiles were seen with either drug. Eleven patients, 7 receiving lisinopril and 4 receiving atenolol, were withdrawn because of adverse experiences; another 3 patients defaulted during treatment, 1 in the lisinopril group and 2 in the atenolol group. Both drugs were well-tolerated and are therefore suitable for first-line therapy in essential hypertension.
Immediate gross hemolysis due to hypotonic fluid administration during plasma exchange: a case report.
Explore the source record for details and available documents.
Relationships between emotional control, adjustment to cancer and depression and anxiety in breast cancer patients.
The possible relationship between psychological responses among breast cancer patients and disease outcome continues to be an area of controversy and debate. Two parallel findings are reported separately in the literature: first, that emotional control is more common among women with breast cancer than in women with benign breast disease or in healthy controls and second, that a helpless attitude towards the disease is related to a poor prognosis. These previously unrelated psychological responses are examined here in a group of women (N = 359) with early stage breast cancer, who were seen one to three months after diagnosis. The relationships between emotional control, adjustment to cancer and psychological morbidity were examined. Prevalence levels of 16 and 6% were observed for anxiety and depression respectively, which are lower than reported more generally in the literature. The results indicated a highly significant association between scores for the tendency to control emotional reactions and a fatalistic attitude toward cancer. A significant association was observed between anger control and a helpless attitude. Psychological morbidity was also linked to type of adjustment to cancer. The data are interpreted in terms of a process model of psychological responses which suggests that emotional control (an important component of the Type C behaviour pattern) fatalism, helplessness and psychological morbidity are linked.
The factor structure and factor stability of the hospital anxiety and depression scale in patients with cancer.
An exploratory factor analysis of the HAD was carried out in 568 cancer patients. Two distinct, but correlated, factors emerged which corresponded to the questionnaire's anxiety and depression subscales. The factor structure proved stable when subsamples of the total sample were investigated. The internal consistency of the two subscales was also high. These results provide support for the use of the separate subscales of the HAD in studies of emotional disturbance in cancer patients.
Health promotion: working together for Project health.
Explore the source record for details and available documents.
Toward a rational therapeutic strategy for arachnoiditis. A possible role for d-penicillamine.
Twenty-six patients (13 men and 13 women), ranging in age from 38 to 75 years, with surgical and/or radiculographic evidence of chronic adhesive spinal arachnoiditis (CASA) were admitted to a randomly allocated, double-blind, 6-month crossover trial of d-penicillamine (500 mg/day) versus matching placebo. Assessments using subjective and objective criteria at 3-month intervals demonstrated no statistically significant effect with either d-penicillamine or placebo or between them. Thirteen of the 17 patients completing the trial expressed no clear preference. One patient preferred placebo. The remaining three patients who expressed strong preference for d-penicillamine (supported by objective data) subsequently maintained improvement on long-term therapy for up to 5 years. It is concluded that there may be a small subgroup of patients with CASA who might benefit from d-penicillamine therapy.
Effect of autologous serum on human leucocyte Na+/H+ exchange and intracellular pH.
1. Leucocyte Na+/H+ exchange and intracellular pH were investigated in physiological buffer containing bicarbonate. 2. The amiloride analogue 5-(N,N-hexamethylene) amiloride (1 x 10(-5) mol/l), an inhibitor of Na+/H+ exchange, had no significant effect on resting leucocyte pH, Na+ influx or Na+ content. 3. Ammonium chloride washout induced a profound intracellular acidosis, stimulating Na+/H+ exchange. This led to a 236% increase in Na+ influx. Eighty-eight per cent of this increase was inhibited by 5-(N,N-hexamethylene) amiloride. This demonstrates that 5-(N,N-hexamethylene) amiloride is an effective inhibitor of Na+/H+ exchange in human leucocytes. 4. The recovery from intracellular acidosis was shown to be dependent entirely on the presence of extracellular Na+. The Ki for inhibition by 5-(N,N-hexamethylene) amiloride of the recovery was 0.5 mumol/l. 5. Incubation with serum increased Na+ influx and Na+ content: the maximal effect was reached at 20% dilution. Serum (10%, v/v) increased influx by 40%, and 20% (v/v) serum by 102%, over resting levels. Only 43% of the serum-induced increase in Na+ influx was inhibited by 5-(N,N-hexamethylene) amiloride. This represented one-fifth of total Na+ influx. 6. Leucocyte intracellular pH increased on incubation with serum. This alkalinization was inhibited using 5-(N,N-hexamethylene) amiloride. 7. Studies of Na+/H+ exchange in leucocytes in physiological and pathological states are more likely to reflect the state in vivo if carried out in the presence of autologous serum.
Free testosterone and depression in male rheumatoid arthritis (RA)
Explore the source record for details and available documents.
Identification of time-compressed sentential stimuli by good vs poor readers.
Ability of eight good and eight poor readers (in Grade 1, ages ranging from 6.7 to 7.4 yr.) to discriminate phonemic contrasts presented in 50% time-compressed sentential stimuli (Subtest 13 of the Carrow-Auditory Visual Abilities Test) was measured. Good readers exhibited a significantly higher over-all mean performance than poor readers on the time-compressed task. Effects of time-compression on the perception of manner, place, voicing and frequency contrasts showed a similar pattern of errors for both groups of readers. Implications of the effects of auditory discrimination on reading abilities are discussed.
Locus of control and adjustment to cancer.
The English form of the Cancer Locus of Control Scale was administered to an heterogeneous sample of 68 cancer patients. A principal components analysis confirmed the three subscales described in the original Dutch form, however, with five items excluded. Correlations with other measures indicated that high internal control over the course of the illness was associated with a tendency to adopt an attitude toward cancer of 'fighting spirit' whereas high internal control over the cause of the illness was associated with an 'anxious preoccupation' about cancer. No specific relationship was found between scale scores and either depression and anxiety or the tendency to be emotionally controlled. It was concluded that the scale provides a valid measure of perceptions of control of cancer patients and is a useful method of assessing these important psychological responses.
'A profile of dentists working in the general and community dental services in Scotland in 1987'.
Explore the source record for details and available documents.
M2 muscarinic receptor agonists produce hypotension and bradycardia when injected into the nucleus tractus solitarii.
Bilateral microinjections (0.2-2 nmol/site) of a potent M2 muscarinic receptor agonist, cis-methyldioxolane (CD), but not those of a relatively selective M1 receptor agonist (McN-A343; 3 nmol/site), into the intermediate portion of nucleus tractus solitarii (NTS) of pentobarbital-anesthetized rats elicited a decrease in blood pressure (23-52 mm Hg) and heart rate (16-50 bpm). Previous microinjections of a selective competitive M2 receptor antagonist (AFDX-116; 0.8 nmol/site), but not those of a potent selective M1 receptor antagonist (pirenzepine; 2 nmol/site), into the NTS blocked the effects of CD. These results indicate that the muscarinic receptors in the intermediate portion of NTS are of M2 type.
The effect of thyroid status on the growth hormone response to growth hormone releasing hormone 1-44.
The growth hormone (GH) response to iv injection of GH releasing hormone 1-44 (GHRH 1-44) has been examined in 10 hyperthyroid and 6 hypothyroid patients. Both groups of patients were studied at presentation and when euthyroid (mean 5 months for hyperthyroid, 8 months for hypothyroid). Hyperthyroid subjects demonstrated a peak mean (+/- SE) level of 17.7 +/- 3.8 mU/l, with an integrated GH 29.3 +/- 6.4 mU/l.h. When euthyroid the peak mean level was 17.0 +/- 5.0 mU/l and the integrated GH 22.8 +/- 4.2 mU/l.h. Neither change was statistically significant. Hypothyroid subjects had a peak mean level of 5.0 +/- 2.7 mU/l and integrated GH of 5.9 +/- 1.7 mU/l.h and when euthyroid a peak mean level of 7.1 +/- 4.8 mU/l and integrated GH of 8.1 +/- 3.6 mU/l.h. Body weight did not change significantly in this group of hypothyroid subjects with prolonged treatment. The increase in GH response to GHRH previously reported following replacement therapy may reflect a treatment-induced decrease in body weight, or may be a short term effect.
Patients' adjustment to cancer: the Mental Adjustment to Cancer (MAC) scale vs clinical ratings.
Broad categories of adjustment to cancer were originally identified clinically. Subsequently, a self-rating questionnaire--the MAC (Mental Adjustment to Cancer) scale--was developed to measure these categories of adjustment. We report here a validation study of the MAC scale. Fifty-four consecutively referred patients with various cancers were given the MAC scale. The patients' adjustment to cancer was also rated clinically by two psychiatrists who had no knowledge of the MAC scale scores. Statistical comparisons between these scores and the clinical ratings are reported. The level of agreement obtained was 79%--Kappa 0.72.
Rotator cuff function in the impingement syndrome.
Thirty-three patients with impingement syndrome of the rotator cuff were studied before and at operation. It was shown that the rotator cuff lengthens and twists during elevation of the arm. Elevation is achieved by early glenohumeral abduction and continuous flexion and external rotation. The range of free rotation at the glenohumeral joint diminishes progressively during elevation. Rotator cuff impingement occurs towards the end of the early glenohumeral abduction. Excision arthroplasty of the acromioclavicular joint and anterior acromioplasty is highly effective for impingement under the acromion, but only moderately effective where impingement is under the acromioclavicular joint.
Drug use and policy in Poland in the 1980s.
In this article, the author describes the recent changes in patterns of drug use in Poland in the light of available data. A much higher incidence of use has been seen in the 1980s, and there are indications that this can be accounted for by increased use among young people from the manual working class. Social deprivation may play a part in the etiology of the 1980s "epidemic," and evidence is put forward in support of this view. Both patterns of use and the policies that have been introduced to deal with them are viewed in terms of the political, economic, and social context of post-Solidarity perestroika.