Traumatic sciatic neuropathy: a novel cause, local experience, and a review of the literature.
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Adult↗
Biomedical subjects
C Wallace
Publications and source records attributed to C Wallace.
Behavioural changes in the rat following infection with varicella-zoster virus.
Following the establishment of a chronic varicella-zoster virus infection in the rat, behavioural allodynia and hyperalgesia were observed in the injected, but not the contralateral hind limb up to 33 days post-infection. This model may prove useful in investigating mechanisms involved in the establishment of post-herpetic neuralgia.
Animals↗
Evolution, partnerships and cooperation.
In an evolutionary game theoretic setting, players are allowed to choose not only their strategies for a particular interaction, but also to some extent with whom they will play. A stability concept is presented and examined which allows agents to endogenously construct fixed partnerships. A strategy-matching type is said to be recoverable if a population in which it is used by all players is both internally and externally stable to random mutations. Such a strategy-matching type always exists and maximises social efficiency in the population. Some examples are considered in the light of this concept. The ability to form fixed partnerships enables players to coordinate on efficient outcomes. In particular, cooperation is achieved in the Prisoners' Dilemma without recourse to repetition or rigid spatial restriction.
Animals↗
Patient satisfaction with screening mammography: online vs off-line interpretation.
RATIONALE AND OBJECTIVES: The purpose of this study was to determine patient satisfaction with online and off-line methods of interpreting screening mammograms and to determine those characteristics that most influence patient preferences. MATERIALS AND METHODS: A survey consisting of 17 questions assessing satisfaction and demographics was distributed to women whose screening mammograms were read in one of two ways at the same facility: (a) the "online" method, in which all additional requested studies are completed and results are immediately communicated, and (b) the "off-line" method, in which mammograms are read in batches the next day, results are communicated at a later time, and patients return for diagnostic studies. To ensure statistical power, at least 174 surveys were collected from each group. RESULTS: Of 192 women whose mammograms were interpreted online, 188 (97%) responded, and of 247 women whose mammograms were interpreted off-line, 181 (73%) responded. Overall mean satisfaction with the mammographic experience and with the time it took to receive results differed significantly between the two groups (P < .002). Analysis of the subgroup of very satisfied respondents disclosed that 92% of patients in the online group and 59% of patients in the off-line group were very satisfied with their mammography experience. If allowed to choose the method of interpretation, 97% of patients in the online group and 91% of patients in the off-line group would choose online interpretation. CONCLUSION: Patients preferred online mammographic interpretation of screening studies.
Adult↗
Sudden death in psychiatric patients.
BACKGROUND: The present study investigated histories of prior psychiatric treatment in cases of sudden death reported to the coroner. METHODS: A matching survey linked the register of deaths reported to the coroner with a comprehensive statewide psychiatric case register covering both in-patient and community-based services. RESULTS: Sudden death was five times higher in people with histories of psychiatric contact. Suicide accounted for part of this excess mortality but deaths from natural causes and accidents were also elevated. Schizophrenic and affective disorders had similar suicide rates. Comorbid substance misuse doubled the risk of sudden death in affective and schizophrenic disorders. CONCLUSIONS: The rates of sudden death are sufficiently elevated to raise questions about current priorities in mental health care. There is a need both for greater attention to suicide risk, most notably among young people with schizophrenia, to the early detection of cardiovascular disorders and to the vigorous management of comorbid substance misuse.
Accidents↗
Serious criminal offending and mental disorder. Case linkage study.
BACKGROUND: A relationship exists between mental disorder and offending behaviours but the nature and extent of the association remains in doubt. METHOD: Those convicted in the higher courts of Victoria between 1993 and 1995 had their psychiatric history explored by case linkage to a register listing virtually all contacts with the public psychiatric services. RESULTS: Prior psychiatric contact was found in 25% of offenders, but the personality disorder and substance misuse accounted for much of this relationship. Schizophrenia and affective disorders were also over-represented, particularly those with coexisting substance misuse. CONCLUSIONS: The increased offending in schizophrenia and affective illness is modest and may often be mediated by coexisting substance misuse. The risk of a serious crime being committed by someone with a major mental illness is small and does not justify subjecting them, as a group, to either increased institutional containment or greater coercion.
Age Distribution↗
Systemic sclerosis: using high-resolution CT to detect lung disease in children.
OBJECTIVE: The purpose of this study was to determine the prevalence of interstitial lung disease and the severity of disease in children with systemic sclerosis using high-resolution CT (HRCT). SUBJECTS AND METHODS: Eleven children (mean age, 11 years) with scleroderma underwent HRCT, chest radiography, and pulmonary function testing. Eight of these 11 patients also underwent follow-up HRCT. HRCT studies were assessed by two observers for ground-glass attenuation, honeycombing, and other abnormalities. Profusion scores for ground-glass attenuation and honeycombing were determined by multiplying severity of disease by the percentage of lung involvement. RESULTS: Chest radiographs predicted interstitial lung disease in only two patients, whereas HRCT showed interstitial lung disease in eight patients (p = .05). On HRCT, ground-glass attenuation was found in eight patients (73%), honeycombing in five patients (45%), linear opacities in six patients (55%), and subpleural micronodules in seven patients (64%). By the end of the study, 10 patients (91%) had evidence of interstitial lung disease on HRCT. Overall, profusion scores for these 10 patients showed four patients with mild, one with moderate, and five with severe disease. Also, HRCT revealed worsening disease in three of eight patients. We found no correlation between duration of scleroderma and severity of interstitial lung disease (p > .02). Seven patients with evidence of lung disease on HRCT had abnormal results on pulmonary function tests; patients with the highest scores for ground-glass attenuation had the most abnormal results on pulmonary function tests (p < .01). CONCLUSION: HRCT shows significant pulmonary disease in children with systemic sclerosis, revealing abnormalities in 91% of our patients. Pulmonary disease should be suspected in children with scleroderma, even if the chest radiograph has normal findings.
Adolescent↗
Malignant suprasellar gliomas: 4 case reports.
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Adult↗
General practitioners knowledge of and attitudes to the use of seat belts in pregnancy.
This study was designed to look at General Practitioner's knowledge of and attitudes to the use of seat belts in pregnancy. It has been shown that correct seat belt use does significantly reduce both maternal and fetal morbidity and mortality following RTAs. However, seat belts are infrequently and often incorrectly utilised by women during pregnancy. Passenger safety education is essential. General Practitioners in Ireland are in a prime position to provide this education in early pregnancy. A postal questionnaire was sent to all members of ICGP (n = 1,780). The results show that 70% of GPs are aware that women are obliged by law to use a seat belt while pregnant, and a similar number felt the subject of passenger safety education is an important medical issue. 75% feel women should wear seat belts in third trimester. However, only 30% provide regular advice and less than 50% indicated that they are aware of the correct advice to give. Also GPs are not asked by their pregnant patients for advice. There is no statistically significant difference between male and female GPs. GPs have the opportunity to and so should provide passenger safety advice. This advice must be accurate and safe.
Attitude of Health Personnel↗
The Pemberton sign.
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Goiter, Substernal↗
The eastern frontier of Western Europe: mobility in the buffer zone.
"The post-Communist countries of Poland, Hungary, [and] the Czech and Slovak Republics have become a buffer zone between East and West. In this article we analyse the way in which this occurs in terms of migration in and out of the region. Our analysis focuses upon the emerging role which this region plays in relation to other parts of Western and Eastern Europe and the way in which economic and political developments there have encouraged particular forms of migration. We attempt to build a picture of some of the different kinds of migration taking place in relation to the social and ethnic characteristics of migrants. The article concludes that these movements are better understood as part of the mobility and circulation of people rather than as one-way migration."
Culture↗
Pregnancy-induced Cushing's syndrome in multiple pregnancies.
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Adrenocorticotropic Hormone↗
Tibial mononeuropathy from a lower limb synovial cyst.
BACKGROUND: Tibial mononeuropathy due to compression by a synovial cyst is uncommon with fewer than 10 cases reported in the literature. METHOD: Case Study. RESULTS: Tibial motor mononeuropathy with focal conduction block between the popliteal fossa and ankle was identified by electrophysiological testing. Magnetic resonance imaging and surgical exploration identified a synovial cyst compressing the nerve just distal to the popliteal fossa. CONCLUSIONS: The combination of electrophysiological localization and imaging in cases of unexplained tibial mononeuropathy may identify an unexpected structural cause.
Adult↗
Fetal thyrotoxicosis: a case report and recommendations for prediction, diagnosis, and treatment.
A maternal history of Graves' disease places the fetus at risk for thyrotoxicosis in utero via the placental transfer of thyroid-stimulating immunoglobulins. Methods for prediction of fetal hyperthyroidism are available, but are not widely used. Clinical assessment of fetal thyroid status by monitoring of fetal heart rate and growth may be inaccurate. This raises some uncertainty in the initial diagnosis of fetal thyrotoxicosis and complicates the assessment of fetal response to maternal propylthiouracil therapy. A case illustrating these pitfalls in the diagnosis and management of fetal hyperthyroidism is presented. The condition was correctly diagnosed, but treatment based on fetal heart rate resulted in biochemical hypothyroidism in the infant at birth. Current recommendations for diagnosis and treatment of fetal hyperthyroidism are reviewed along with recent developments in the field. A modified approach is proposed.
Adult↗
Clinical indicators contributing to I.C.U. length of stay in elective craniotomy patients with brain tumour.
The immediate purposes of this study are (a) to indicate the I.C.U. and hospital length of stay in elective craniotomy patients with brain tumour, and (b) to identify the clinical indicators that contribute to the I.C.U. length of stay. The ultimate purpose is to contribute to a growing body of knowledge in providing quality and cost effective patient outcomes by creating appropriate vehicles for further research in the field of neuroscience. The following clinical indicators are identified: pre-op patient admission to ward or same day admit unit, O.R. cancellations, type of tumour, nursing staff availability, intubation on admission, I.C.U. length of stay, and post-op complications. The results of this pilot study, with sample size of 55 patients, could assist us in the nursing profession to develop an appropriate Care Map for craniotomy patients with brain tumour.
Adult↗
Management of craniomandibular disorders. Part II: Clinical assessment of patients with craniocervical dysfunction.
Comprehensive evaluation of mandibular function requires a broader assessment of the head, neck, and jaws than is normally performed. Examining only the teeth and periodontium will fail to assess problems in muscles and joints, which should be considered in the management plan. Recognition of function-related symptoms is important in the prediction of treatment outcomes. Stress-induced muscle tension and traumatic oral habits may be linked with reported symptoms of headache, earache, and temporomandibular joint problems, and the significance of these symptoms should be assessed through detailed clinical examination.
Craniomandibular Disorders↗
Hepatotoxicity complicating flutamide treatment of hirsutism.
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Adult↗
Gamma aminobutyric acid radioreceptor-assay a possible biomarker for human exposure to certain agrochemicals.
Cyclodiene insecticides, hexachlorocyclohexanes, pyrethroids, bicyclophosphates, the bicycloorthocarboxylate insecticides and some of their metabolites and environmental degradation products are central nervous system toxicants with high specific binding affinity to the chloride channel of the gamma-aminobutyric acid (GABA)A receptor-ionophore sites. [35S] tertiary-butylbicyclophosphorothionate (TBPS) with specific activity higher than 60 Ci/mmole has a high binding affinity to the same sites and is now commercially available and can be used to label the GABAA receptor for the development of a radioreceptor assay technique. The GABA receptor was prepared by ultra centrifugation and dialysis of brain homogenates of either cow, goat, rat or catfish. The receptor was then labeled with [35S] TBPS and the assay was conducted by measuring the displacement of radioactivity following incubation with samples containing the analytes. A radioreceptor assay protocol was developed to measure the amount of the alpha-endosulfan in blood samples. The assay was extremely sensitive, and can detect 0.2 nM of endosulfan at a level equivalent to 0.08 ppb or 8 x 10(-11) gm of endosulfan in each ml of the blood samples.
Animals↗