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Biomedical subjects

R Walsh

Publications and source records attributed to R Walsh.

At least 19 recordsLinked to original sources
PubMed1992

Drug use in Australia: a community prevalence study.

OBJECTIVE: To estimate the prevalence of drug use in a representative Australian community. DESIGN: Using a Census district sampling framework supplied by the Australian Bureau of Statistics, we randomly selected dwellings for our survey. A household was defined as all those people living permanently at the postal address. All eligible members of each household, 15 years and older, were asked to participate. SETTING: The data were collected in the context of a large scale general population survey of health practices and attitudes, conducted in the Greater Newcastle area of New South Wales, during 1987 and 1988. PARTICIPANTS: Seventy-two per cent of eligible individuals approached (2623) agreed to participate in the survey. MAIN OUTCOME MEASURES: Participants were asked about their use of a number of drug types: medically prescribed drugs, non-prescription drugs, tobacco, alcohol and illicit drugs. For alcohol, only the results for use at a hazardous level according to the National Health and Medical Research Council guidelines are reported here. RESULTS: Seventy-eight per cent (95% confidence interval, 76%-80%) of the community sample reported having recently consumed at least one of these drug types. There were significant age and sex differences in drug use. A greater proportion of women and the older age groups (over 45 years) reported the use of both non-prescription and prescription medications than did men and the younger age groups. Conversely, a significantly greater proportion of men and the younger age groups reported the use of social and illicit drugs. CONCLUSION: The importance of regular, representative, methodologically comparable community studies of drug use is stressed, particularly in view of the inadequacy of the current routine sources of epidemiological data on drug use.

Adolescent↗
PubMed1992

A comparative study of calcium sodium alginate (Kaltostat) and bismuth tribromophenate (Xeroform) packing in the management of epistaxis.

A prospective study was undertaken to compare the efficacy of calcium sodium alginate fibre (Kaltostat) to petrolatum gauze impregnated with bismuth tribromophenate (Xeroform) for the control of epistaxes that require hospital admission. Forty patients presenting with severe epistaxis requring hospital admission were treated with either Kaltostat or Xeroform nasal packs. Allocation to either treatment group was made randomly. The composition of each group in terms of age, sex distribution, aetiology of epistaxis and severity of bleed was not significantly different. There was no significant difference in the efficacy or patient acceptability of either therapeutic agent. It is concluded that calcium sodium alginate fibre should be considered as an acceptable alternative to traditional gauze packing.

Adolescent↗
PubMed1992

Oxidant-evoked release of acetylcholine from enteric neurons of the rat colon.

In the presence of halides, granulocytes generate hypochlorous acid and, subsequently, chlorinated amines (chloramines). These lipophilic, potent reactive oxygen metabolites may contribute to the mucosal pathophysiology associated with inflammatory bowel disease. A common symptom of inflammatory bowel disease is mucosal secretion of fluid and electrolytes, leading to diarrhea. Because acetylcholine (Ach) can stimulate colonic fluid secretion, we determined the effect of monochloramine (NH2Cl) on Ach release by mucosal/submucosal nerves. Mucosa from the rat colon was separated from outer muscle layers and minced before incubation with [14C]choline to label stores of Ach in cholinergic neurons. Release of [14C]Ach was evoked with NH2Cl in the absence and presence of 5-aminosalicylic acid, glutathione, nordihydroguaiarectic acid or the cyclooxygenase inhibitor piroxicam. NH2Cl produced concentration-related increases in [14C] Ach release into the medium; greater than 100% over base line was observed at 0.5 mM. Glutathione inhibited the NH2Cl-evoked release in a concentration-dependent fashion. Release induced by 0.1 mM NH2Cl was abolished by 5-aminosalicylic acid and significantly inhibited by nordihydroguaiarectic acid. Piroxicam also prevented the effect of NH2Cl on release of [14C] Ach. None of these agents alone had any effect on base line [14C]Ach release. Tetrodotoxin (5 microM) did not significantly inhibit the NH2Cl-evoked transmitter release. We conclude that NH2Cl, at concentrations believed to exist in inflamed tissue, causes the release of Ach from mucosal/submucosal nerves primarily through nonspecific neural membrane injury. Endogenous prostaglandins, possibly liberated as a consequence of the injury, may be involved in the Ach release process.

Acetylcholine↗
PubMed1991

Agreement between two measures of drug use in a low-prevalence population.

The present study examined the agreement between two measures of prevalence of drug use in the community: self-report and specific pharmacological analyses of urine samples. The data were collected in the context of a random community survey of health practices and attitudes. A random 20% of the households participating in the health study were targeted for biochemical assay. Compliance with urine delivery was relatively high at 79%. Urine samples were screened qualitatively for cannabinoids and benzodiazepines using the enzyme multiplied immunoassay technique (EMIT) (Syva Diagnostics, Palo Alto, CA). Screening for pharmaceuticals used a standard thin-layer chromatography (TLC) technique. Agreement between the self-report and biochemical assay estimates of prevalence was statistically significant (p less than .05). While self-report of substance use is not a perfect measure of consumption, it remains a relatively economical and reasonably accurate method of obtaining estimates of substance use in community samples.

Adolescent↗
PubMed1991

Training medical practitioners in information transfer skills: the new challenge.

Traditionally, undergraduate medical education has concentrated on teaching students how to gather information or take medical histories from their patients. However, research increasingly indicates that there is a need for medical practitioners to improve their skills in information transfer in a way which will increase the probability that patients are active collaborators in their treatment. Consequently, Newcastle Medical School has sought to develop training packages for medical students in information transfer skills. This paper describes the resulting training programme with particular emphasis on the areas selected for training, the methods by which students are taught, the necessary interactional skills and the assessment procedures which are applied.

Clinical Competence↗
PubMed1989

Toward a psychology of human survival: psychological approaches to contemporary global threats.

Nuclear weapons, population explosion, resource and food-supply depletion, and environmental deterioration have been posing increasing threats to human survival. Moreover, for the first time in history, all these major global threats are human caused and can, therefore, be traced in large part to psychological origins. After a brief overview of the nature and extent of current threats, this paper suggests criteria for an adequate psychology of human survival. The causes and effects of the threats are examined from various psychological perspectives and the psychological principles underlying effective responses are deduced. The ways in which mental health professionals may contribute to this most crucial task are discussed.

Conservation of Natural Resources↗
PubMed1989

Visual superiority effect in televised prevention of victimization programs for preschool children.

Preschool children have been reported to remember more visual than auditory content from television programs. 80 preschool children were randomly assigned to conditions where visual or auditory components of a televised program on personal safety were manipulated. Visually modeled actions were slightly more salient for preschool-age children than actions represented auditorily. The combination of visual and auditory input provided the superior educational method.

Attention↗
PubMed1989

Purine-enriched asanguineous cardioplegia retards adenosine triphosphate degradation during ischemia and improves postischemic ventricular function.

Myocardial dysfunction after induced ischemic arrest is an important problem in cardiac surgery. Adenosine-5'-triphosphate content in myocardial tissue remains depressed for days after ischemia, perhaps because of reperfusion washout of diffusable purine substrates. Left ventricular function is also depressed after ischemia, but its relationship to absolute tissue adenosine triphosphate content is unclear. We tested the hypothesis that arresting hearts with a cardioplegic solution containing adenosine, hypoxanthine, and ribose would result in improved tissue adenosine triphosphate content and left ventricular function after 1 hour of normothermic global ischemia in dogs supported by cardiopulmonary bypass. Animals with ischemic arrest initiated with a crystalloid cardioplegic solution containing adenosine 100 mumol/L, hypoxanthine 100 mumol/L, and ribose 2 mmol/L demonstrated significant improvement (p less than 0.05) during postischemic reperfusion. A significant correlation (p less than 0.05) existed between myocardial adenosine triphosphate content and the recovery of left ventricular function. These experiments demonstrate that an asanguineous cardioplegic solution containing adenosine, hypoxanthine, and ribose maintains myocardial adenosine triphosphate content during ischemia and reperfusion and enhances functional recovery during the postischemic period.

Adenosine↗
PubMed1988

Primary culture of bovine mammary acini on a collagen matrix.

Lactating bovine mammary epithelial acini were isolated and primary culture on rat tail attached collagen gels are described. Acini rapidly attach to the gels and morphologically change little over days of culture under the culture conditions described herein. Cells release lactose, alpha-lactalbumin and alpha-s1 casein over a 6-day period. A new HPLC method for measuring lactose in mammary cell culture media is described. Comparisons of acini cultures with individual cell cultures show acini to be 1.5-5 times more productive than cells in secreting lactose and casein, respectively.

Animals↗
PubMed1988

Rescreening of a group at high risk for colorectal neoplasia using immunochemical tests for faecal occult blood.

The results of a screening programme for colorectal neoplasia in a high risk group using an immunochemical test for blood has been reported recently. This test is known as the faecal human haemoglobin (FHH) test. This paper reports the results of rescreening this group after an interval of 1-2 years. The FHH test was compared with a paper disc method. All individuals with positive tests were investigated and those with negative tests were offered investigation. The results confirm the value of the FHH test in screening a high risk group: 19 individuals in 1,153 participants were found to have a significant neoplasm (1.6%). The predictive value of the test for a significant neoplasm was 42%. A false negative rate of 2.6% was found, all lesions being benign. It appears to be more reliable than the paper disc method but the differences do not reach statistical significance. The FHH test is recommended for screening the general population over the age of 40 years, with rescreening annually.

Australia↗
PubMed1988

Two Asian psychologies and their implications for Western psychotherapists.

In the past, mainstream Western mental health professionals tended to ignore or dismiss Asian psychologies. However, in recent years they have attracted increasing attention and growing evidence suggests that we may have underestimated their potential contributions. This paper provides an introduction to two classical Asian psychologies and certain of their key concepts about human nature, pathology, and potential and psychotherapeutic techniques. Relevant Western research and theory are reviewed, and the implications of these Asian psychologies for, and areas of possible interface with, Western psychology, psychotherapy, and science are examined.

Buddhism↗
PubMed1987

Evaluation of an immunochemical test for faecal occult blood in screening for colorectal neoplasia in a high risk group.

A group of 1615 asymptomatic individuals presumed to be at increased risk of colorectal neoplasia were selected as the study group. All were tested by an immunochemical test for faecal occult blood. In the second half of the study, individuals who were occult blood negative were offered colonoscopy. Ninety-nine individuals (6.1%) returned stools which were occult blood positive. Investigation by full colonoscopy was possible in 90 cases, revealing nine patients (10%) with invasive cancers, four patients (4.4%) with carcinomata in situ, and 36 patients (40%) with adenomata. Non-neoplastic pathology capable of producing occult blood positive stools was found in 31 individuals (34.4%). No pathology was found in 10 instances (11.1%). Of the 53 occult blood negative subjects who underwent colonoscopy, eight were found to have adenomata. Only one of these was larger than 5 mm in diameter (18 mm). No carcinomata were found. The site within the large bowel of the tumour did not appear to significantly affect the occult blood status of the faeces but the size of the tumours detected suggests that the presence of blood within the stool is more likely to be associated with larger lesions. The frequency of detection of both carcinomata and adenomata was greatest in individuals who had a past history of colorectal neoplasia. The individual cost of this immunochemical test is nominal. The high diagnostic yield and low false positive and negative rates suggest that case follow-up, surveillance, or screening utilizing this test is justified.

Adult↗
PubMed1985

Improvement in symptoms and exercise tolerance by metoprolol in patients with dilated cardiomyopathy: a double-blind, randomized, placebo-controlled trial.

It has been suspected that the increased sympathetic activity seen in patients with chronic congestive heart failure from dilated cardiomyopathy may be harmful. We therefore tested the long-term effect of metoprolol on eight patients in a double-blind, randomized protocol and 12 patients in an unblinded, crossover protocol who were treated for 12 months (range 10 to 24), and compared them with 16 similar subjects who were treated with placebo for 10 months (range 6 to 12) in a double-blind, randomized protocol. Patients were followed by serial clinical assessment, treadmill testing, radionuclide ventriculography, and echocardiography. Metoprolol-treated patients had an improvement in mean exercise capacity by 3 mets (p less than .0001) while experiencing a significant improvement in functional classification (p less than .001) during both the double-blind and open-label crossover studies and had an improved ejection fraction during the double-blind study (p less than .02). These improvements were not seen in matched control subjects receiving placebo. Seven of 20 patients receiving long-term metoprolol therapy had resolution of nearly all symptoms of heart failure, doubled their exercise capacity, and had progressive improvement in resting radionuclide left ventricular ejection fraction (12.6 +/- 3% to 26.9 +/- 6%) and echocardiographic left ventricular end-diastolic dimension (7.7 +/- 0.5 to 6.5 +/- 0.5 cm). Only one of 21 patients treated was intolerant of metoprolol. We conclude that metoprolol can be given safely to a select group of patients with dilated cardiomyopathy in doses that substantially reduce both resting and exercise heart rates. Long-term beta-blockade improved functional class and exercise capacity in 14 of 20 patients while producing an exceptional clinical response in seven that was accompanied by improved resting parameters of left ventricular function.

Adult↗