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Biomedical subjects

D S Bell

Publications and source records attributed to D S Bell.

At least 109 records · Page 6Linked to original sources
PubMed1982

Diabetic neuropathy: peripheral and autonomic syndromes.

Incidence and prevalence of diabetic neuropathy increase with age and increasing duration of diabetes. Evidence supports an ischemic cause for mononeuropathies, but the pathogenesis of polyneuropathy is still uncertain. Mononeuropathies, involving discrete cranial or peripheral nerves, usually resolve spontaneously or respond to therapy. Distal symmetrical polyneuropathy, the most common form of diabetic neuropathy, tends to be progressive and difficult to treat. Autonomic neuropathy occurs as an extension of polyneuropathy in up to 70% of diabetics. Since no organ supplied by the autonomic nervous system is immune.

Cachexia↗
PubMed1982

HLA-A, -B, and -DR associations in type I diabetes mellitus with onset after age forty.

It remains to be convincingly demonstrated whether insulin-requiring, ketosis-prone, lean-at-onset, type I diabetics who develop their disease after age 40 have the same disease as the children with similar characteristics. To address this question, we examined the population HLA genetic associations of this group. One hundred forty white, insulin-using diabetics with onset of disease past age 40 yr and 268 normal white controls have thus far been analyzed for HLA type. In the group of patients who were lean-at-onset and/or ketosis-prone (N = 54), there was a significantly increased frequency of DR4 (RR = 4.63; P less than 0.01) and significantly decreased frequency of DR2 (RR = 0.18; P less than 0.05) after correction. DR4 was also significantly increased after correction (RR = 5.72; P less than 0.25) in the subgroup who were both lean and ketosis-prone (N = 23). No significant differences in HLA-DR frequencies were found between the obese and not-ketosis-prone group (N = 69) and controls. No significant associations of HLA-A or-B antigens with either group were observed after correction for the number of antigens tested. To our knowledge, this is the first such study in the United States, and the first demonstrating that late onset diabetics who are lean-at-onset and/or ketosis-prone exhibit HLA-DR antigen associations which are similar to early onset cases.

Adult↗
PubMed1982

Diagnostic, pathogenetic, and therapeutic aspects of diabetic neuropathy.

Since nearly all patients with diabetes mellitus will manifest evidence of dysfunction of their peripheral and autonomic nerves, neuropathy can be considered to be the most common of the so-called "late complications of diabetes." Mononeuropathies are uncommon, but can affect virtually any cranial or nerve and are thought to be due to vascular occlusion. Distal symmetrical polyneuropathy usually begins insidiously with the development of sensory symptoms involving the feet. These symptoms progressively ascend and are accompanied by progressive motor dysfunction as well as cardiac, gastrointestinal, and genitourinary manifestations of autonomic neuropathy. Numerous biochemical abnormalities including impaired neural protein synthesis, abnormal axoplasmic transport, disturbed polyol pathway activity, and abnormal myo-inositol metabolism have been described and have been postulated to underlie the development of diabetic peripheral and autonomic neuropathies. At the present time, the available treatments for diabetic neuropathies are largely palliative and are not curative. In the future, a better understanding of the pathophysiologic basis of diabetic neuropathy will undoubtedly lead to the development of more rational therapeutic approaches.

Aging↗
PubMed1980

Monitoring trends in drug use.

The pattern of drug use in a community can alter so rapidly that the conventional methods of survey do not adequately assess the dynamics of the situation. Monitoring may indicate changes in prevalence, attitudes, and a variety of other criteria in the course of time, and from this base allow assessment of intervention measures and the prediction of trends. Annual surveys of selected population groups with a self-administered questionnaire established the utility of this technique of monitoring, and revealed a progressive increase in the use of licit and illicit drugs, principally alcohol and marijuana. The only group of drugs to show a decrease in use were the stimulants.

Adolescent↗
PubMed1980

Attitudes toward drug use: trends and correlations with actual use.

Monitoring revealed a consistent relationship between attitude and use for those drugs which showed a definite trend in use, whether upward or downward. Increasing use, which applied to five of the eight groups of drugs surveyed, was associated with more permissive attitude to use and an increasing denial of danger. The reverse applied to decreasing use, found only in the case of the stimulants. On the other hand, in the case of drugs which showed no change in the rate of use, a change in attitudes could still occur. In the case of tobacco and narcotics, which showed no significant overall change in use during the 3 years of monitoring, the change in attitudes reflected the effects of intervention programs. The data are interpreted to indicate that health education had arrested an upward trend in use by discouraging the potential moderate user, but failed to influence the heavy user, whose numbers increased. Reflecting the associated change in attitudes, nonusers became increasingly inclined to prohibition, all groups increasingly recognized the dangers of use, and the heavy users showed less denial of danger and a more realistic self-estimation of use than was apparent for all other groups of drugs. The relative stability of narcotics use would seem to result from the containment exerted by vigorous law enforcement rather than from a favorable response of the community to education. Overall, the attitudes became increasingly permissive and inclined to denial of danger. The data suggest that the potentiality for an upward trend in use remains a constant danger.

Attitude↗
PubMed1979

Deviancy, delinquency and drug use.

A system for monitoring drug use was based on the data from annual surveys of two contrasting population groups, a general cross-section of young people and a cross-section of antisocial deviants. Correlation of deviancy and drug use established that drug use, both licit and illicit, was more extensive among those who suffered parental deprivation, whose parents were divorced or separated, who had psychiatric illness and particularly those who had committed antisocial acts. The degree of antisocial deviancy correlated with the extent of drug use.

Adolescent↗
PubMed1978

Methadone.

Explore the source record for details and available documents.

Female↗
PubMed1975

Psychotherapy in a large open family group.

A technique of psychotherapy is reported, using a large open group of theoretically unlimited lifetime. Family and friends are encouraged to attend and new members are added independently of those leaving the group. Various features of such a group are comparable to small group analysis. The group may be used for the exploration and treatment of family psychopathology. Meetings containing 20 or more members, with several families being represented, are not uncommon. Observers likewise are not limited in number and the group serves a useful teaching and training function as a consequence. A wide range of patients, including those regarded as unsuitable or too difficult for conventional psychotherapeutic management, may be treated by this technique. Illustrative cases are described. The purpose of this paper is to describe a technique of group psychotherapy which has been practised over a period of several years and which differs in some important respects from established methods. This technique, the large open family group, has proven itself to be useful in treating a wide range of patients.

Adolescent↗
PubMed1974

Neurosurgical disease encountered in a psychiatric service.

One hundred and seven patients with neurosurgical disease treated in a combined neurosurgical, neurological, and psychiatric unit within a psychiatric service were reviewed retrospectively. Most patients had acute confusional states or dementia without gross localizing signs and in only three cases did the neurosurgical illness closely resemble a non-organic psychiatric syndrome. The great majority showed abnormalities on physical examination and simple investigations. A past history of alcoholism and/or other psychiatric illness was common. Many apparently had been referred to psychiatric hospitals simply because they presented problems of management. Consequently, the staff of the psychiatric hospitals must be aware of neurosurgical disease and have free access to facilities for its investigation and management. If these requirements are fulfilled, the referral of patients with acute confusional states and dementia to psychiatric hospitals may indeed be preferable to their management in general hospitals, where their disturbed behaviour presents a variety of problems with which these hospitals are not usually equipped to cope.

Alcoholism↗
PubMed1974

Stereotactic amygdaloidotomy for aggressive behaviour.

Amygdaloidotomy was performed bilaterally on 15 and unilaterally on three patients exhibiting severe aggressive or self-mutilating behaviour. Nine subjects (50%) were improved a year after operation; improvement was maintained in seven (39%) for periods ranging from 27 months to nearly six years. Four non-epileptic cases had convulsions during the period of review; one of them has a persistent mild hemiparesis dating from the postoperative period. There was a tendency for epileptics to respond better than non-epileptics and for mentally retarded patients to respond poorly, but none of the differences was statistically significant.

Adolescent↗