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Biomedical subjects

R D Griffiths

Publications and source records attributed to R D Griffiths.

At least 55 records · Page 3Linked to original sources
PubMed1993

How important is the assessment of social skills in current long-stay in-patients? An evaluation of clinical response to needs for assessment, treatment, and care in a long-stay psychiatric in-patient population.

Service response to problems in 20 clinical and social competence areas was assessed in 156 long-stay in-patients, using the Needs for Care Assessment (NFC). Although there were few unmet needs for treatment, over 200 instances of unmet needs for the assessment of social skills were found, and reasons for this are discussed, as is the importance of social-skills assessment in this group. In around a third of the sample most of the social-skill areas in the NFC were not applicable.

Activities of Daily Living↗
PubMed1993

Patients' attitudes toward screening for gestational diabetes mellitus in the Illawarra area, Australia.

OBJECTIVE: To examine the attitudes toward screening of a group of women who have had GDM compared with a group who were screened but did not have GDM. RESEARCH DESIGN AND METHODS: We surveyed 90 women with GDM and 100 control women with a postal questionnaire. They were asked to mark on a six-point Likert scale their responses to statements about certain aspects of screening for diabetes in pregnancy. RESULTS: No significant differences were found in mean responses between the two groups. The method of screening was found to be convenient (GDM group, 5.02; control group, 4.77). A strong belief that all women should be screened in pregnancy (GDM group, 5.76; control group, 5.66) and a personal desire for screening in any future pregnancy (GDM group, 5.73; control group, 5.62) were expressed. CONCLUSIONS: Both groups of women surveyed in this study were extremely positive about the convenience of the screening method used, the need for all women to be screened in pregnancy, and their desire for screening in future pregnancies.

Attitude to Health↗
PubMed1993

A tool to measure the change in health status of selected adult patients before and after intensive care.

If the effect of intensive care on the patient is to be fully assessed then the health status of patients before and after admission to ICU must be measured. The validity of a simplified system which can also use relatives, where necessary, as informants on the patients' pre-morbid health status has been evaluated. In a District General Hospital Intensive Care Unit a questionnaire based survey of 85 patients admitted over a period of eight months used a new specially-designed instrument and compared this with the Functional Limitations Profile (FLP) and the Perceived Quality of Life instrument (PQL). Relatives completed the health status questionnaire as soon as possible after the patient's admission and patients completed a suitably modified version at discharge from ICU. Patients were sent the FLP, PQL and modified health status questionnaire six months and one year after discharge. Questionnaires were completed by 59 paired relatives and patients. Questions were answered in the same way by relatives and patients; 42 of the 59 pairs of results were in agreement within two points of better or worse health. The closest responses were provided by wives in daily contact with their partner. At six months post ICU discharge, 49 patients completed the follow-up questionnaires, 12 patients had died and three were too confused to co-operate. Twenty-one patients (25%) were lost to follow-up. At one year post ICU discharge, 43 patients completed the follow-up questionnaires, one other patient had died and three still remained confused.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Intestinal permeability in the critically ill.

Alterations in intestinal permeability reflect one component of intestinal epithelial barrier function. The objective of this study was to assess the degree of derangement of intestinal permeability in critically ill patients and to investigate the relationship of this to markers of disease severity and sepsis. Sixteen patients admitted to the intensive care unit for a variety of problems were studied with the severity of illness and degree of sepsis recorded daily. A differential sugar absorption test, using lactulose and mannitol as markers, was performed, and in 10 patients this was repeated after an interval of between 4-11 days. The use of the lactulose/mannitol (L/M) ratio corrects for variables unrelated to permeability such as gastric emptying. The L/M ratio was significantly higher in patients (median 0.98) compared to normal controls (median 0.008). The ratios showed no relation to disease severity or sepsis. These results establish that increased intestinal permeability occurs in the general ICU patient but that it is not uniquely related to sepsis. The extent of this abnormality suggests that further study is required to show the various influences on this process.

Adult↗
PubMed1991

Necrotizing myopathy in critically-ill patients.

Skeletal muscle wasting is commonly observed in critically-ill patients and has been attributed to catabolic fibre atrophy and to neuropathy. This study describes the occurrence of a necrotizing myopathy in 15 out of 31 critically-ill patients who had percutaneous biopsies taken from the tibialis anterior muscles. While most cases showed necrosis of isolated fibres, 5 of the 12 patients who had serial biopsies showed progressive necrosis of up to 95 per cent of the fibres. One other case showed infarction and one case had staphylococcal vasculitis. Atrophy of type 1 and/or type 2 fibres was documented by morphometry in 12 cases. Myoglobin-containing casts were demonstrated immunohistochemically in renal tubules on either biopsy or necropsy material in 5 out of 7 cases. The presence of muscle necrosis was a clinically unexpected finding which may contribute to weakness, complicate the interpretation of tissue biochemistry and energy balance studies, and potentiate renal failure. The necrosis is probably multifactorial in origin, with ischaemia and sepsis contributing factors.

Acetaminophen↗
PubMed1991

Fast-scan magnetic resonance imaging in fetal visualization.

Magnetic resonance imaging has potential as an imaging technique in obstetrics. Its application has been limited by the amount of image degradation that occurs as a result of fetal movement during the long imaging times. By use of a fast-scan imaging technique good images are obtained of fetal anatomy in 3 to 14 seconds per image, depending on the setting used. Different organs could be visualized by varying the setting. Magnetic resonance imaging complements the role of ultrasonography in fetal visualization. It also allows clear fetal imaging in such high-risk situations as maternal obesity and oligohydramnios, where it may be difficult to produce clear images by ultrasonography. This technique will allow wider application of magnetic resonance imaging in obstetrics and give additional information about the developing fetus.

Female↗
PubMed1991

Fast-scan magnetic resonance imaging of fetal anomalies.

OBJECTIVE: To identify those congenital fetal anomalies, previously identified by ultrasound scanning, in which fast-scan magnetic resonance imaging (F-SMRI) would give additional information for the perinatal management of the infants. DESIGN: Observational clinical study. SETTING: Hospital Department of Obstetrics and Gynaecology/Resonance Research Centre. SUBJECTS: Seven women carrying eight fetuses in whom congenital abnormalities had been identified using ultrasound scans. The duration of the pregnancies was 28 to 39 weeks gestation. INTERVENTIONS: Fast-scan magnetic resonance imaging at between 28 and 39 weeks gestation. MAIN OUTCOME MEASURES: Identification of fetal abnormalities. RESULTS AND CONCLUSIONS: F-SMRI was of limited value in the diagnosis of further assessment of fetuses with abnormalities of accumulation of tissue fluid. Renal anomalies were poorly identified unless associated with cystic formation of the kidney. Further study is required in the imaging of fetal central nervous system anomalies. Until echoplanar imaging is more widely available, MRI does not contribute to the diagnosis of cardiac anomalies. F-SMRI appears to be most useful in the diagnosis and management of soft tissue gastro intestinal abnormalities.

Abdominal Muscles↗
PubMed1991

Phosphorus metabolites in the human placenta estimated in vivo by magnetic resonance spectroscopy.

Normal human placental metabolism has been studied in vivo by image localised 31P magnetic resonance spectroscopy in 13 women with anterior placentas; five, however, were too fat for useful spectral signals to be obtained. Magnetic resonance spectra of good quality which were considered to have arisen from the placenta were obtained from seven women with uncomplicated pregnancies (median gestational age 35 weeks, range 28-39). One other woman had a twin pregnancy in which one fetus had died a few days before. The phosphodiester signal from the placenta of the dead fetus was outside the 95% confidence intervals for normal placentas, suggesting that this technique may potentially be useful in the assessment of placental function.

Female↗
PubMed1991

The nature and severity of disabilities in long-stay psychiatric in-patients in South Glamorgan.

Long-stay psychiatric in-patients in South Glamorgan were reviewed using the MRC Needs for Care assessment. The majority were middle aged or elderly and were severely disabled, with problems encompassing symptoms/behavioural difficulties, social skills, and physical health. In most, long-standing psychiatric illness was compounded by physical illness and cognitive deficits as age advanced, producing care needs that were greater than existing community services could meet.

Activities of Daily Living↗
PubMed1991

Assessment of fetal well-being with magnetic resonance.

The application of magnetic resonance techniques in the assessment of fetal growth, fetal growth patterns and fetal health was assessed. Eighty-four sets of fetal images were obtained using a fast-scan magnetic resonance imaging technique. Measurements were made of fetal subcutaneous fat thickness, uterine cavity length and width, fetal and uterine cross-sectional areas and fetal volume. Fetal area and fetal volume measurements were found to correlate well with birth weight. Measurement of subcutaneous fat thickness may prove to be a means of differentiating between those fetuses who are constitutionally as opposed to pathologically large or small. Thirteen women had additional spectroscopic studies carried out. Twelve of the women had normal pregnancies. One woman had a twin pregnancy in which one twin died. 31P phosphorus spectra were obtained from seven of the normal pregnancies. In the remainder, the depth of the abdominal wall prevented spectra being obtained from the placenta. Differences in phosphorus metabolites were obtained from the placenta of the dead twin compared to those from the healthy pregnancies.

Adipose Tissue↗
PubMed1990

An evaluation of the costs and outcome of adult intensive care in two units in the UK.

To test the feasibility and value of an economic appraisal of intensive care, a retrospective follow-up study was performed in two intensive care units in England. Clinical activity data was extracted from the records of 100 consecutive admissions to each unit and used to cost the care received by each patient during their stay in the units. Outcome was measured in terms of survival and quality of life six months after admission. Mortality at discharge from the units was 25% and 15% rising to 31% and 38% respectively six months after admission. Between one-third and one-half of patients alive at six months reported that their health continued to restrict aspects of their daily activities and one-fifth reported serious disability or distress. Total costs averaged 2,000 pounds and 2,280 pounds, equivalent to 525 pounds and 465 pounds per in-patient day. Poor outcome was associated, though not always significantly, with increased age, severity of illness and increased costs. The small sample size and heterogeneous nature of intensive care prevent firm conclusions being drawn from this study but the results indicate that such investigations are both feasible and potentially rewarding.

Adolescent↗