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Biomedical subjects

D Neilson

Publications and source records attributed to D Neilson.

36 records · Page 2Linked to original sources

Severe mental disorder in Afro-Caribbean patients: some social, demographic and service factors.

Forty-two consecutively identified Afro-Caribbean patients with a first episode of psychosis were compared with a similar group of non-Caribbean patients. A number of differences emerged, although the same proportion of patients in each group had symptoms for 6 months or more prior to psychiatric contact. Afro-Caribbean patients showed greater delay in seeking help, more 'disturbance' later in the course of their illness and were more likely to be admitted compulsorily. The social geography of the two groups suggests that the high rates of schizophrenia and related psychoses that we previously reported cannot be explained simply by differences in area of residence at the time of presentation.

Adult↗

Squamous cell carcinoma of skin developing in a skin graft donor site.

We report a case of squamous cell carcinoma of the skin of the right ring finger which was treated by excision and split skin grafting. Three months later the patient presented with a further lesion at the margin of the skin graft donor site on the right thigh. Excision biopsy of this second lesion revealed a squamous cell carcinoma of a similar pathological appearance to the original lesion. We have been unable to trace any previous similar reports. A possible pathological basis for the sequence of events is discussed.

Carcinoma, Squamous Cell↗

Carcinoma cuniculatum of the hand.

Carcinoma (epithelioma) cuniculatum is an uncommon variety of squamous cell carcinoma formerly considered to be limited to the foot. It has recently been reported in other parts of the body. We report a case in the hand and describe its management.

Carcinoma, Squamous Cell↗

Determinants of wound infection incidence after isolated coronary artery bypass surgery in patients randomized to receive prophylactic cefuroxime or cefazolin.

In this open-label, randomized drug study, we compared two cephalosporin prophylactic regimens, one using cefazolin and one using cefuroxime, in 100 patients having coronary bypass surgery. Additional epidemiological data were collected to identify the patient at higher risk for acquiring an infection. Patients were categorized into four groups: (1) no infection; (2) clinically determined infection without a culture or prescription of additional antibiotics; (3) clinical infection with no or negative wound culture and prescription of additional antibiotics; and (4) clinical infection with positive culture and need for additional antibiotics. Seven cefuroxime patients (13.5%) and 9 cefazolin patients (18.8%; p = 0.471) had a wound that became clinically infected (Groups 2-4). In a univariate analysis, 11 variables were statistically associated with the development of a wound infection. A logistic regression model defined 3 variables at an alpha level of 0.05 and 3 at an alpha level of 0.10 that predicted a wound infection. Patients were identified at high risk of wound infection if they had postoperative weight gain, long operative hospitalization, prolonged use of a Foley catheter, postoperative use of blood products, and operation performed by two specific surgeons. Our results indicated that closer observation of the high-risk patients and a definition of the mechanism of the infections are needed.

Cefazolin↗

A prospective study of severe mental disorder in Afro-Caribbean patients.

Several previous studies have reported increased rates of schizophrenia among Afro-Caribbean immigrants, although doubt has been cast upon the value of case-note diagnoses and retrospective case-finding. A prospective study was therefore undertaken, including all patients of Afro-Caribbean ethnic origin with a first onset psychosis presenting to the psychiatric services from a defined catchment area. Utilizing several diagnostic classifications, rates for schizophrenia were found to be substantially increased in the Afro-Caribbean community, and especially in the 'second generation' British born. Mode of onset and symptom profiles of psychoses suggest that atypical syndromes, and by implication 'misdiagnoses', do not account for reported higher rates of schizophrenic illness in these patients.

Adolescent↗