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Biomedical subjects

A J Scott

Publications and source records attributed to A J Scott.

62 records · Page 4Linked to original sources
PubMedDate not supplied

Diagnostic accuracy would be improved by developing more categories of "non-disease".

Studies on the ways in which doctors think have shown the importance of intuitive processes in the formulation of a diagnosis. They have also suggested that intuitively generated diagnoses are used to aid the memory of relevant clinical facts during a clinical consultation. Only some symptoms and signs can be ordered into or subsumed under a diagnostic label. Others, which have not been thought of as constituting a disease, will tend to be lost from memory. If a diagnosis were to be thought of, not as the label of a disease but as a mental construct by means of which data are ordered and remembered, that is, as an invention whose utility is to be judged by the degree to which clinical thinking is facilitated, it would become reasonable to develop diagnoses to cover larger areas of clinical phenomenology. Some examples of the usefulness of such diagnoses of "non-disease" are given ant it is suggested that clinical thinking might be improved by the wider use of the concept.

Diagnosis↗
PubMedDate not supplied

Respiratory sinus arrhythmia in persons with organic solvent exposure: comparisons with anxiety patients and controls.

Persons exposed to organic solvents have psychiatric symptomatology and cognitive impairments. The results of several studies have suggested that some psychiatric symptoms in these patients reflect similar reactions observed in patients with anxiety disorders. Respiratory sinus arrhythmia provides an indication of impaired autonomic functioning. Whereas decreased respiratory sinus arrhythmia has been reported in anxiety patients, investigators have also noted that higher respiratory rates in these patients obscure differentiation of respiratory sinus arrhythmia from normal values. In this study, the authors recorded multiple parameters of respiratory sinus arrhythmia under a paced-breathing condition in 28 patients with solvent exposure, in 18 patients with anxiety disorder, and in 31 controls. The authors observed a high 1-y retest reliability for a subset of the subjects. Significantly reduced respiratory sinus arrhythmia was observed in both anxiety and solvent-exposed patients, compared with controls. Maximum mean heart rates/cycle did not differ among groups, but minimum heart rates were significantly lower for controls than for the two patient groups. The findings suggested that reduced respiratory sinus arrhythmia among patients is not related to higher maximum rates but, rather, to a decrease in vagally mediated alteration associated with respiratory changes observed in both patient groups.

Adult↗
PubMedDate not supplied

Treatment of vaginal candidiasis with miconazole.

An open trial was carried out in 50 women with clinical signs and mycological evidence of vaginal candidiasis to compare the effectiveness of treatment with 2% miconazole cream with that of nystatin pessaries. Both groups were given intravaginal treatment for 14 days and were followed up at monthly intervals for 3 months. Relief of symptoms and clinical signs was comparable in the two groups but the mycological cure rate at 1 month was higher with miconazole. At 2 and 3 months, however, there was no significant difference between the cure rate obtained with the two treatments in the patients still included in the study.

Candidiasis, Vulvovaginal↗
PubMedDate not supplied

Hemiarthroplasty for cuff tear arthropathy.

A retrospective review was conducted on 15 cases of shoulder hemiarthroplasty performed for cuff tear arthropathy. All cases had advanced glenohumeral arthritis with complete supraspinatus and infraspinatus rupture and substantial involvement of the teres minor and subscapularis. The mean patient age was 73 years; the mean follow-up was 28.2 months. Range of motion, functional ability, pain relief, and overall patient satisfaction were assessed preoperatively and postoperatively. The average active forward elevation increased from 69 degrees to 86 degrees, and the average active external rotation increased from 15 degrees to 29 degrees. Thirteen patients had an increase in their ability to perform activities of daily living, 1 patient was unchanged, and 1 patient had a decrease in ability to perform activities of daily living. Pain relief was significantly improved in all but 1 patient. Eleven patients (13 of 15 shoulders, 87%) expressed an overall satisfaction with their surgery. Patients were assessed preoperatively and postoperatively through use of the UCLA Rating Scale; the average increase was 11 to 22 points. In addition, isokinetic strength testing was performed preoperatively and postoperatively on 6 of the 15 involved shoulders. An increase in peak torque in forward elevation, abduction, and external rotation was noted postoperatively. The findings of this study indicate that favorable clinical results can be obtained after hemiarthroplasty of the shoulder with associated massive rotator cuff deficiency.

Aged↗
PubMedDate not supplied

Shiftwork: effects on sleep and health with recommendations for medical surveillance and screening.

This article reviews diseases that are aggravated by shiftwork (gastrointestinal and cardiovascular disorders), the potential of shiftwork to adversely affect pregnancy, shift maladaptation syndrome, and the ability of shiftwork to exacerbate existing disorders and interfere with pharmacological treatments. It offers guidelines for pre-employment screening and medical surveillance of shiftworkers.

Biological Clocks↗