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Biomedical subjects

R A Emsley

Publications and source records attributed to R A Emsley.

51 records · Page 3Linked to original sources
PubMed1992

Screening for syphilis and neurosyphilis in acute psychiatric admissions.

The value of blood screening for syphilis and cerebrospinal fluid (CSF) screening for neurosyphilis in acute psychiatric admissions is assessed. Of 1,296 patients, 248 (19%) had evidence of previous or current syphilis as shown by a positive Treponema pallidum haemagglutination test, and 68 (5.2%) had potentially treatable syphilis as shown by a positive Venereal Disease Research Laboratory (VDRL) titre. CSF examination was performed on 169 patients with a positive blood test. Seventeen (i.e. 1.3% of all patients included in the study) met our criteria for neurosyphilis. The best predictor for neurosyphilis was the presence of a reactive serum VDRL. However, it is recommended that all patients with a positive blood test and symptoms that could possibly be ascribed to neurosyphilis undergo CSF examination.

Adult↗
PubMed1990

Inappropriate antidiuretic state in long-term psychiatric inpatients.

To investigate the occurrence of an inappropriate antidiuretic state in a long-term psychiatric inpatient population, 690 patients underwent serum sodium determination. Forty-four patients (6.4%) had levels less than 133 mmol/l. Fifteen of these patients could be investigated further and the biochemical findings in all were consistent with an inappropriate antidiuretic state. Evidence of previous episodes of water intoxication was found in 80% of these patients. Although more than one possible cause was present in most patients, the two factors most strongly incriminated in the pathogenesis of the inappropriate antidiuretic state were the drugs carbamazepine and hydrochlorothiazide.

Adult↗
PubMed1988

Self-induced water intoxication. A case report.

A 19-year-old female schizophrenic with self-induced water intoxication is described. Factors of pathogenic significance included primary polydipsia and non-maximal urinary diluting capacity.

Adult↗
PubMed1987

Impaired water excretion and elevated plasma vasopressin in patients with alcohol-withdrawal symptoms.

Reports describing the fluid balance status of alcoholics in withdrawal are varied, and conflicting. We examined this question by recording values for a variety of parameters in response to a standard water load test. Compared with age and sex matched healthy volunteers (n = 14), alcoholics in withdrawal (n = 17) exhibited lower cumulative urine output (p = 0.0001), higher minimum urine osmolality (p = 0.0001), lower serum sodium (p = 0.0024 before loading) and elevated plasma arginine vasopressin levels (p = 0.0045 before loading). We believe that these findings are best explained by a resetting of osmoreceptors, a supposition in keeping with contemporary views on the pathogenesis of alcohol dependence and withdrawal. This additional evidence of an antidiuretic state in alcohol withdrawal leads us to question the practice of fluid supplementation in its management and we suggest that this policy be revised.

Adult↗
PubMed1986

Computed tomography in psychiatric patients.

In a retrospective study of 100 consecutive adult psychiatric patients referred for computed tomography (CT) for suspected intracranial lesions, abnormalities were found in 61%. Of these, 23% had focal lesions significantly associated with alcohol abuse, previous craniocerebral trauma and focal neurological signs. Detection of focal lesions influenced patient management in over half the cases. No single factor was able to predict all patients with focal lesions and the correlation between electroencephalogram and CT results was weak. If criteria for CT in psychiatric patients are too restrictive, some cases of occult brain disease may escape detection.

Adolescent↗
PubMed1985

Lipoid proteinosis presenting with neuropsychiatric manifestations.

Two patients with lipoid proteinosis are reported in whom paranoid symptoms were the presenting feature. Both had a long standing impairment of memory and bilateral medial temporal lobe calcification demonstrated by CT scan. Possible associations between the anatomical site of these lesions and the neuropsychiatric manifestations are discussed.

Adolescent↗
PubMedDate not supplied

DSM-III-R classification of psychiatric symptoms in systemic lupus erythematosus.

DSM-III-R criteria applied in the evaluation of 88 systemic lupus erythematosus patients revealed a point prevalence rate of 18.2% for psychiatric disorders, the most common diagnosis being adjustment disorder (11.4%). No patients had disorders compatible with a functional psychosis. Psychiatric morbidity was not associated with increased disease activity, corticosteroid use, brain magnetic resonance imaging abnormalities, or electroencephalogram abnormalities. High scores on a life event scale were associated with psychiatric disorders, suggesting that psychosocial stress is etiologically important. Cognitive testing showed that poor performance on the Stroop Colour-Word Inference Test was associated with psychiatric disorders.

Adolescent↗
PubMedDate not supplied

Stereotypies: prevalence and association with compulsive and impulsive symptoms in college students.

BACKGROUND: Although stereotypic behaviors have been well described in patients with mental retardation, there has been relatively little work on the prevalence and nature of these phenomena in intellectually normal subjects. Stereotypies may conceivably be related to obsessive-compulsive disorder, to perfectionism, or to impulse dyscontrol. METHODS: This study attempted to assess the prevalence of stereotypic behaviors in a college population and to determine their relationship to compulsive and impulsive symptoms and traits by means of self-rated questionnaires. Questionnaires assessed stereotypies as well as obsessive-compulsive symptoms, perfectionism, and impulsive-aggressive traits. RESULTS: Stereotypic behaviors were common in this population, and they were time-consuming or problematic in a subgroup of subjects. The total number of stereotypic behaviors was significantly associated with increased scores of obsessive-compulsive symptoms, of perfectionism, and of impulsive-aggressive traits. Other measures of the severity of stereotypic behavior were also associated with obsessive-compulsive symptoms and perfectionism. CONCLUSIONS: Although the nature of stereotypic behaviors is not well understood, these phenomena can be clinically important in intellectually normal subjects. Stereotypic behaviors deserve further attention from researchers and clinicians.

Adolescent↗
PubMedDate not supplied

Shoplifting associated with normal-pressure hydrocephalus: report of a case.

A 52-year-old woman who had been apprehended for shoplifting was found to have normal-pressure hydrocephalus due to aqueduct stenosis. We ascribe the shoplifting to impairment of social judgment, which was one of the observed features of a dementia. Cerebrospinal fluid diversion by means of a ventriculo-peritoneal shunt resulted in resolution of her symptoms.

Cerebrospinal Fluid Shunts↗