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Biomedical subjects

W D Mitchell

Publications and source records attributed to W D Mitchell.

At least 37 records · Page 2Linked to original sources
PubMed1985

Research problems for consultation-liaison psychiatry in the DRG era.

Psychiatry needs to conduct more rigorously designed empirical research studies to demonstrate its cost-effectiveness, especially since the DRG era is becoming more firmly established. The effectiveness of psychiatric intervention can be evaluated on its abilities to improve physical functioning as well as its improvement of psychosocial symptoms and cost savings. Some of the problems in consultation-liaison research are discussed, including the potentially confounding influences of demographic variables, type and severity of somatic disease, time since diagnosis, level of psychosocial stress, and initial level of physical functioning. Several types of research measures used in assessing physical and psychosocial functioning are discussed, and some of the dilemmas for psychiatry in utilizing individual versus standardized research interventions are explored.

Activities of Daily Living↗
PubMed1983

Hypocholesterolaemia and non-cardiovascular disease: metabolic studies on subjects with low plasma cholesterol concentrations.

Some epidemiological studies have suggested an inverse relation between serum cholesterol concentration and mortality from cancer. Two hypotheses that might explain such a relation were investigated. To assay potentially deleterious effects of hypocholesterolaemia on cell membranes the lipid content and fluidity of blood mononuclear cells were measured in healthy male volunteers with a wide range of serum cholesterol concentration (3.2-10.0 mmol/l (124-387 mg/100 ml)). Fluidity, unesterified cholesterol content, and the ratio of cholesterol to phospholipid were unrelated to serum cholesterol and to low density lipoprotein cholesterol concentrations. Similar measurements were made on fibroblasts and mononuclear cells incubated with a range of concentrations of low density lipoprotein; fluidity was altered only at extremely low concentrations, suggesting that changes in cell membranes are unlikely to occur at serum cholesterol concentrations attainable by dietary or drug treatment of hyperlipidaemia. In the same population direct relations were confirmed between low density lipoprotein concentration and plasma concentrations of retinol and beta carotene. This is compatible with the suggestion that an association between low cholesterol concentration and cancer may be secondary to a relation between low retinoid concentrations and cancer.

Adult↗
PubMed1983

Underrecognition of patients' psychosocial distress in a university hospital medical clinic.

Seventeen areas of psychosocial distress were evaluated in 87 university hospital internal medicine clinic patients by a self-administered questionnaire and a psychiatric interview. These patients' internists then predicted the patients' distress level in each area. Their predictions correlated significantly with their patients' self-reports of distress-level problems in only 3 of the 17 areas. Even when the internists felt that they had sufficient information to make an accurate prediction, their perceptions were often erroneous, including evaluations of such areas as suicidal ideation and drug use. These data suggest the need for active psychiatric education components in internal medicine training programs.

Ambulatory Care↗
PubMed1979

A rapid and simple method for the quantification in human plasma of tricyclic antidepressant drugs taken in overdose.

A rapid and simple extraction procedure followed by gas chromatography using a nitrogen detector is described for the analysis of amitriptyline, nortriptyline, imipramine, and desipramine in 100 microliter plasma. No derivitisation of the drugs is required. Recoveries ranged from 93.7 to 104.6%. Within-batch precision and day-to-day variation showed coefficients of variation of less than 10% with the exception of desipramine, for which the day-to-day coefficient of variation was 15.2%. The method was developed to measure plasma concentrations in patients who had taken non-fatal and fatal overdoses of the drugs.

Antidepressive Agents, Tricyclic↗
PubMed1978

Complex nature of serum lysozyme activity: evidence of thermolability in inflammatory bowel disease.

In patients with Crohn's disease and ulcerative colitis, alterations in serum storage temperature produced significant changes in serum lysozyme activity (SLA) as measured by the lysoplate method. This was not the case in healthy controls or in a group with other gastrointestinal disorders. Electrophoretic separation of serum revealed two components of lysozyme-type lytic activity but only one in extracts of gut mucosa, leucocytes, and egg white. The major lytic component of serum migrated towards the cathode and reacted with specific antilysozyme serum, but the minor component which migrated towards the anode did not. Although the cause of this anionic lytic activity is uncertain, it contributes to total serum activity as estimated by any method utilising the lysis of Micrococcus lysodeikticus, and may possibly be related to the observed thermolability.

Adult↗
PubMed1977

Variation in the incidence of diverticular disease within the city of Edinburgh.

An estimate of the incidence of diverticular disease of the colon was based on all the barium enema examinations in Edinburgh over four years (12 335 cases); using the census data for 1971, incidence rates for the city by age, sex, and electoral ward were calculated. The overall annual incidence rate was 1-55/1000, the rate rising sharply with increasing age. The incidence of diverticular disease varies from ward to ward (range 0-92-2-04/1000), adjacent wards have similar incidence rates and the six wards with the lowest rates are clustered together in the South East of the city. Ward incidence rates have a significant negative association with the percentage of owner occupiers living in that area.

Adolescent↗
PubMed1976

Fecal characteristics contrasted in the irritable bowel syndrome and diverticular disease.

A comparison has been made of the fecal characteristics in controls and patients with the irritable bowel syndrome and diverticular disease. No detectable difference was found in the fecal wet weight, dry weight, or total bile acid excretion in the four groups. A significant increase in the percentage of the water content of the stool was seen in the idiopathic diarrhea group with irritable bowel syndrome. Significantly less magnesium, potassium, and calcium was found in the stools of patients with diverticular disease and a similar trend was noted in patients with the spastic colon. These changes did not relate to the age of the patients. This suggests a common etiology for these disorders. The presence of increased water and primary bile acids in the feces of patients with idiopathic diarrhea suggests that this is a separate entity.

Adult↗
PubMed1976

A method to measure the adsorption of bile salts to vegetable fiber of differing water holding capacity.

Dietary vegetable fibers have physico-chemical properties which may influence their role in nutrition. A method is described which measures bile acid adsorption to fibers of differing water holding capacity. Such absorption studies are complicated by the water held in the fiber matrix which includes bile acid in solution. The entrapped solution gives some apparent adsorption but this can be removed by washing the fibers with water. This method differentiates between strong adsorption and reversible adsorption. This enables dietary vegetable fibers to be classified according to their bile acid absorption capacity which may be useful in selecting fibers for clinical trials.

Adsorption↗