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Biomedical subjects

P Sherwood

Publications and source records attributed to P Sherwood.

16 recordsLinked to original sources
PubMed2001

How are abnormal results for liver function tests dealt with in primary care? Audit of yield and impact.

OBJECTIVE: To determine whether abnormal results for liver function tests are investigated in primary care and findings on full investigation. DESIGN: Retrospective audit and prospective clinical investigation. SETTING: University hospital and surrounding general practices serving around 330 000 people. SUBJECTS: Adults with abnormal results for liver function based on tests requested by their doctor between 1 January and 30 June 1995. INTERVENTIONS: All patients with gamma-glutamyltransferase, alanine aminotransferase, or alkaline phosphatase concentrations at least twice the upper limit of the reference range were studied. A median of 15 months later (range 12-21) records of hospital attendances and further investigations were examined. Where investigations were incomplete the records from the general practice were examined, and suitable patients were invited to attend the liver clinic. MAIN OUTCOME MEASURES: Investigations requested by the doctor and final diagnoses reached. RESULTS: 933 patients with abnormal liver function tests were identified; follow up data were obtained in 873 (94%). 531 patients were already under hospital review. Of the remaining 342 patients, 157 were suitable for investigation; the others had died, moved away, were elderly, or had repeat liver function tests with normal results. No further tests were requested for 91 (58%) of these patients. 66 had been partially investigated by their doctor, and in seven patients results suggesting a treatable chronic liver disease had not been followed up. On investigation, 97 (62%) had an identifiable diagnosis requiring hospital intervention or follow up, or both. CONCLUSIONS: Abnormal results for liver function are often not adequately investigated, missing an important chance of identifying treatable chronic liver disease.

Alanine Transaminase↗
PubMed2000

Patterns of use of complementary health services in the south-west of Western Australia.

The objective of this research was to identify patterns of complementary health service usage by rural Western Australians in the south-west of the State. Complementary health providers identified by health users included homeopaths, chiropractors, naturopaths, acupuncturists, faith healers, herbalists, reiki or energy workers, counsellors, physiotherapists, osteopaths, podiatrists and reflexologists. More than half of the health provider usage in the region was with complementary therapists and the remainder with medical doctors. The main reason identified for using complementary therapists was their level of skills and the main reason identified for not using them was a lack of knowledge about what their services could provide.

Adolescent↗
PubMed2000

Experience awareness tools for preventing burnout in nurses.

Philophonetics counselling is a radically new method of coping with stress through the development of individually tailored self-controlling emotional and cognitive strategies. This paper proposes that philophonetics counselling provides an innovative holistic approach of dealing with burnout in the nursing profession.

Adaptation, Psychological↗
PubMed1996

Spontaneous splenic rupture in uncomplicated multiple myeloma.

We report a case of spontaneous splenic rupture due to myelomatous infiltration of the spleen without any evidence of amyloidosis or any other complicating factors. A computer search of Medline since 1966 did not reveal any previously reported case of spontaneous splenic rupture in uncomplicated myeloma.

Bone Marrow↗
PubMed1993

Changes in appetite and weight during the pharmacological treatment of patients with panic disorder.

Antidepressants reportedly increase appetite, carbohydrate craving and weight in some patients with depression and panic disorder. This paper presents the results of changes in appetite and weight in patients with panic disorder treated with imipramine, diazepam or placebo in a double-blind prospective study. Forty-four patients with panic disorder were randomly assigned imipramine, diazepam and placebo. The investigators monitored weight and the patients rated their appetite and cravings during the eight week study. No significant increases in weight or appetite were found in the patients with panic disorder patients.

Adult↗
PubMed1991

Heart rate variability in patients with major depression.

We have previously reported decreased heart rate variability upon standing in panic disorder patients compared with controls. In this study, we extend our report to include patients with major depression (n = 19). Compared to normal controls (n = 20) and panic disorder patients (n = 30), there was no significant difference in the immediate changes in heart rate upon standing in the depressed group. The standing heart rate variability (R-R variability) was significantly lower in panic disorder patients compared to both normal controls and depressed patients as indicated by the corrected standard deviations, the corrected mean consecutive difference, the corrected standard deviation of the mean consecutive difference of the R-R intervals, and the high frequency variability in successive R-R intervals, suggesting an increased vagal withdrawal in panic disorder patients, especially upon standing. There was no significant difference in any of the heart rate variability measures between depressed patients and normal controls.

Adult↗
PubMed1988

Carbohydrate craving and increased appetite associated with antidepressant therapy.

The symptom of carbohydrate craving and increased appetite (CHH) was studied in 180 outpatients receiving antidepressant treatment. One hundred and fifty-eight of these patients had a DSM-III diagnosis of panic disorder and 17, major depression. The incidence of CHH was similar in both diagnostic groups. Thus, antidepressant treatment is associated with CHH in patients with diagnoses, other than depression. Desipramine was least likely to induce CHH compared to imipramine, amitriptyline and doxepin. Most patients who developed CHH on imipramine no longer experienced this side effect when switched to desipramine. CHH was not more frequent among women and not associated with antidepressant dosage or treatment response. Histamine H-1 receptor blockade may be an important factor in the etiology of CHH.

Adult↗
PubMedDate not supplied

Risk factors for cardiovascular illness in panic disorder patients.

Supine and standing heart rate (HR) and blood pressure measures were compared among 19 nonsmoking normal controls, 29 smoking patients and 36 nonsmoking patients with panic disorder. The smoking patients had a significantly higher supine HR, standing diastolic blood pressure, standing mean blood pressure and supine and standing cardiac load measures compared to both patient nonsmokers and controls. There was no significant difference between controls and nonsmoking patients for any of the above measures except for the higher standing HR and the delta increase in HR upon standing in female panic disorder patients which suggests increased adrenergic activity. When lipid values of panic disorder patients (n = 92) were compared to National Reference Values for their sex and age for an increased risk of cardiovascular illness, there was no significant risk with regard to plasma levels of total cholesterol, high-density lipoprotein cholesterol or low-density lipoprotein cholesterol.

Adult↗