PubMed Health⌕ Search

Biomedical subjects

P Skinner

Publications and source records attributed to P Skinner.

8 recordsLinked to original sources
PubMed1992

Doctors' views on anxiety management in general practice.

Various guidelines have been issued to doctors concerning the treatment of anxiety in primary care and particularly on the use of benzodiazepines. Little has been reported about how this advice has influenced doctors' opinions and practice. This paper describes results of interviews with 15 general practitioners and 15 general practitioner trainees on their management of anxiety problems. Most respondents admitted prescribing benzodiazepines for anxiety but reported doing so only in cases of severe distress and for short periods of time. Trainees appeared more cautious in their use of benzodiazepines than the experienced practitioners. Most doctors agreed that counselling could be as effective as benzodiazepines in treating moderate anxiety but several respondents felt it too demanding of their time. Two-thirds of doctors were in favour of employing counsellors in general practice though many foresaw practical difficulties in doing so. Increased availability of clinical psychology services was the development which most respondents felt would improve their management of anxiety problems in primary care.

Anxiety↗
PubMed1979

Cardiocirculatory effects of afterload reduction with oral trimazosin in severe chronic congestive heart failure.

Because improved long-term oral vasodilator therapy for chronic congestive heart failure is needed, the cardiocirculatory effects of the new antihypertensive quinazoline derivative, trimazosin, were evaluated with use of concomitant cardiac catheterization and forearm plethysmography in nine patients with severe chronic congestive heart failure due to coronary disease. After ingestion of 100 to 300 mg (average 172 mg) of trimazosin, the greatly elevated left ventricular filling pressure decreased from 30 to 23 mm Hg and the lowered cardiac index rose from 2.02 to 2.59 liters/min per m2. Considerable improvement in cardiac function occurred within 1 hour after ingestion of trimazosin; peak efficacy was achieved after 2 hours and persisted in the 3rd hour. Heart rate was unchanged and systemic blood pressure was mildly reduced. Because pump performance was enhanced while indexes of myocardial oxygen consumption declined, ventricular efficiency increased. Vascular relaxation was produced in both the systemic resistance and capacitance beds, with venodilation slightly more prominent. This clinical investigation of the acute hemodynamic effects of trimazosin objectively demonstrates that the drug provides considerable hemodynamic benefit in cardiac dysfunction and is therefore a potentially salutary agent for treatment of patients with chronic severe congestive heart failure.

Administration, Oral↗
PubMed1978

Relation between sound intensity and the latency and amplitude of the brainstem auditory evoked response.

This study investigated the relation of peak amplitude and latency to signal intensity for the brainstem auditory evoked response (BSAER). One thousand clicks were presented to obtain each averaged response. Responses were obtained to clicks presented at sensation levels of 15, 20, 30, 40, 50, 60, and 70 dB. Five adult males who demonstrated normal hearing served as subjects. Latency and amplitude for various wavelets were plotted against signal intensity. A consistent trend of decreased peak latency occurred with increased signal intensity. Contrary to previous reports, the amplitude of Wavelet V showed a linear growth with increased signal intensity.

Brain Stem↗
PubMed1978

Effects of signal rise time and frequency on the brainstem auditory evoked response.

Two experiments studied the effects of signal rise time and frequency on the brainstem auditory evoked response. In Experiment 1, five different rise times were presented, fast (10 microseconds), 0.5, 1, 2.5, and 5 msec at a center frequency of 1000 Hz at three sensation levels, 20, 40, and 60 dB. As rise time was increased, response amplitude and detectability decreased and response latency increased. In Experiment 2, tonal pips were presented at 250, 500, 1000, 2000, 4000, and 8000 Hz at 40-dB sensation level. Although the effects of frequency and signal rise time were confounded, no frequency effect was apparent.

Acoustic Stimulation↗
PubMed1977

Electrophysiologic response audiometry: state of the art.

Electrophysiologic response audiometry (ERA) is based upon recording neuroelectric potentials from sites extending from the cochlea to the cortex. These recordings rely on the use of averaging computers to extricate desired neuroelectric responses from the ongoing background electrical activity of the human auditory system and brain. The different neuroelectric responses are distinguished by response latency, response waveform, and probable site of origin. Responses which occur within the latency range of 1 to 5 msec originate from the cochlea and auditory nerve. Responses in the 4- to 8-msec latency range have the brain stem as their origin. Responses with latencies from about 8 to 50 msec presumably arise from the upper brain stem and primary projection areas. Responses with a fast waveform include those with latencies between 1 and 50 msec. Slow wave responses from about 50 to 300 msec originate as a secondary discharge from the primary cortical projection areas and surrounding secondary and association areas. The longest latency potentials (300 msec) are slow shifts that appear to arise from the prefrontal and secondary or association areas of the cortex. These response classes are discussed in terms of their clinical utility for threshold estimation and diagnostic value.

Action Potentials↗
PubMedDate not supplied

A comparison of the effects of sedatives on the auditory evoked cortical response.

Several sedatives were selected that were judged to be amenable for routine clinical use in electroencephalic response audiometry (ERA). These sedatives were investigated to determine which were most effective for ERA; the relationship between sleep stages and the auditory evoked cortical response (AECR), the reliability of the AECR in sleep, and whether either the early or late response was more consistent or detectable during sedation. The early response was evoked by tone pips with a 10-musec rise-decay time and an acoustic duration of 5 msec. Tone pips were presented at a rate of 8 per sec and an averaged response was based upon 1500 stimulus presentations. The late response was evoked by tone bursts centered at 1000 Hz with a 10-msec rise-decay time and an acoustic duration of 150 msec. All tone pips and tone bursts were presented at 40 dB sensation level. Eleven normal hearing adults were selected as subjects who demonstrated clear and consistent eerly and late AECR's while awake and in natural sleep. Early and late responses were analyzed to determine the percentage of detectable responses, and amplitude and latency under all sedatives and different sleep stages. The results showed that nonbarbiturates and sleep stage 2 and 3 were more effective for ERA.

Adult↗