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Biomedical subjects

Daniel Richardson

Publications and source records attributed to Daniel Richardson.

At least 19 recordsLinked to original sources
PubMed2006

The integration of figurative language and static depictions: an eye movement study of fictive motion.

Do we view the world differently if it is described to us in figurative rather than literal terms? An answer to this question would reveal something about both the conceptual representation of figurative language and the scope of top-down influences on scene perception. Previous work has shown that participants will look longer at a path region of a picture when it is described with a type of figurative language called fictive motion (The road goes through the desert) rather than without (The road is in the desert). The current experiment provided evidence that such fictive motion descriptions affect eye movements by evoking mental representations of motion. If participants heard contextual information that would hinder actual motion, it influenced how they viewed a picture when it was described with fictive motion. Inspection times and eye movements scanning along the path increased during fictive motion descriptions when the terrain was first described as difficult (The desert is hilly) as compared to easy (The desert is flat); there were no such effects for descriptions without fictive motion. It is argued that fictive motion evokes a mental simulation of motion that is immediately integrated with visual processing, and hence figurative language can have a distinct effect on perception.

Eye Movements↗
PubMed2006

A qualitative pilot study of islamic men with lifelong premature (rapid) ejaculation.

INTRODUCTION: Premature ejaculation is a common sexual problem in men. Although the etiology is unclear, there is emerging evidence that men from different ethnic backgrounds may be more at risk. AIM AND OBJECTIVE: The aim of this study was to generate themes and hypotheses around the etiology of premature ejaculation with particular reference to men from Islamic backgrounds. METHODS: This is an explorative qualitative study using semi-structured interviews with 10 male volunteers with a clinical diagnosis of premature ejaculation. Interviews were tape-recorded and transcribed. Transcriptions were then hand-coded and analyzed using grounded theory. RESULTS: Anxious first sexual experience (with subtheme: fear of being discovered and wanting to finish early); sex before marriage; sex outside of marriage; religion; "stress;" exposure to Western images; living in the United Kingdom; and the subsequent feeling of freedom were themes that emerged from the transcripts. CONCLUSIONS: We have identified factors associated with premature ejaculation in patients with Islamic backgrounds attending our unit. This may have useful therapeutic implications when consulting Islamic men with premature ejaculation.

Adult↗
PubMed2006

Recommendations for the management of retarded ejaculation: BASHH Special Interest Group for Sexual Dysfunction.

We present the British Association of Sexual Health and HIV (BASHH) special interest group in sexual dysfunction recommendations for the management of retarded ejaculation. The recommendations outline the physiology, prevalence, definitions, aetiological factors and patient assessment for this sexual problem. We suggest treatment strategies, recommendations for management and an auditable outcome.

Adolescent↗
PubMed2006

Recommendations for the management of premature ejaculation: BASHH Special Interest Group for Sexual Dysfunction.

We present the British Association for Sexual Health and HIV (BASHH), Special Interest Group for Sexual Dysfunction updated recommendations for the management of premature ejaculation. The recommendations outline the physiology, prevalence, definitions, aetiological factors and patient assessment for this common sexual problem. Behavioural, local and systemic pharmacological treatments are discussed along with general recommendations and auditable outcomes.

Adolescent↗
PubMed2006

Recommendations for the management of vaginismus: BASHH Special Interest Group for Sexual Dysfunction.

We present the British Association for Sexual Health and HIV (BASHH) Special Interest Group for Sexual Dysfunction recommendations for the management of vaginismus. The recommendations outline the history, prevalence, aetiological factors, patient assessment and management for this sexual problem. Treatment strategies are discussed along with general recommendations and auditable outcomes.

Female↗
PubMed2006

Retarded ejaculation - a review.

Retarded ejaculation, now termed the male orgasmic disorder is not only difficult to manage, but also the scientific evidence for aetiology, treatment and outcome is poor. This is compounded by incomplete consensus regarding definition from the scientific community. In this review, we intend to collate the available information on this sexual problem including definitions, possible aetiological factors and treatment options.

Ejaculation↗
PubMed2006

An atypical herpetic vulval ulcer in an African woman: an important lesson.

A 43-year-old woman from Southern Africa presented with an eight-month history of a painless vulval ulcer. She did not have any relevant past medical or drug history. She had never had, or ever been offered an HIV antibody test despite being from an endemic region. On examination, there was an ulcer on her right labia and a painless right inguinal lymph node. Herpes simplex virus (HSV) type 2 culture was positive. The HIV antibody test was also positive. Other cultures and serology including syphilis were negative. A biopsy was suggestive of herpes simplex. The vulval ulcer resolved on oral aciclovir only. Atypical genital herpes has been described in HIV disease, although it is often painful. This case emphasises the importance of offering an HIV antibody test to patients presenting with atypical genital ulcers. Moreover, it reinforces the paradigm that 'any anogenital ulcer (painful or not) can be herpetic in origin'.

Adult↗
PubMed2006

Factors associated with sexual dysfunction in men with HIV infection.

Where men have had access to successful treatment for HIV (highly active antiretroviral therapy), expectations of both patients and physicians alike have changed significantly over the past decade. Such men, living with HIV, expect to lead fully functional lives including a normal sex life. Sexual dysfunction is well described among men with HIV. We retrospectively analysed details of 190 consecutive men attending a dedicated sexual dysfunction service in our HIV unit over an 18-month period. We took note of the specifics of their HIV disease, illnesses other than HIV, as well as other risk factors associated with sexual dysfunction. Men with sexual dysfunction all commonly reported recreational drug use, hepatitis B and C co-infection, anxiety and depressive illnesses, peripheral neuropathy and lipodystrophy. There was a significant relationship between men complaining of retarded ejaculation and peripheral neuropathy. Sexual dysfunction in non-HIV settings is known to lead to poor adherence to prescribed medications, e.g. antihypertensive agents. Iatrogenic sexual dysfunction in patients may similarly have a potential to lead to poor antiretroviral compliance if not addressed.

Adult↗
PubMed2006

HIV-associated female sexual dysfunction - clinical experience and literature review.

Women form an increasing proportion of HIV-infected individuals in the developed world. Early data suggest that women with HIV are at particular risk of developing sexual problems. The aim of this study was to describe our anecdotal experience of HIV-infected women and to ascertain their sexual dysfunction, and also to conduct a national survey to evaluate what sexual dysfunction services are provided for women in other UK HIV centres. Retrospective analysis of clinic notes of women attending our HIV clinic and letter surveys of HIV centres in the UK were carried out. About half our cohort reported that they had sexual problems or were not satisfied with sex over the preceding 12 months. Contextual issues seemed to be the commonest cause of these problems. Sixty percent of HIV physicians in the UK rarely/never ask their female HIV patients about sexual functioning. Sexual dysfunction is probably common in HIV-infected women. Most physicians seeing women with HIV in the UK do not ask about sexual functioning. 'Physician coaching' could help to redress this situation, so that at the least the sexual problems could be brought up in discussion.

Adolescent↗
PubMed2005

Premature ejaculation--does country of origin tell us anything about etiology?

INTRODUCTION: Premature ejaculation is a common sexual problem. The etiology of this condition is unclear. It has been suggested that some racial groups may be more at risk than others. We had a clinical impression that in our unit in London, UK, there was a preponderance of men from Islamic and Asian backgrounds. AIM: We therefore undertook a retrospective analysis of our clinic population over an eighteen-month period. METHODS: A total of 123 patients were identified with a clinical diagnosis of PE based on the DSM-IV and UK national guidelines. MAIN OUTCOME MEASURE: Demographic and clinical data were collected retrospectively: parameters of patients seen in the previous 18 months were identified, including self-identified ethnicity and age. Patient-defined ethnicity was compared with the ethnicity of self-referring patients attending our general sexual health services (outpatients), and also with local population census data. RESULTS: A total of 60% of patients were from Islamic or Asian backgrounds but 12% and 11% came from those racial groups in local population census data and our general clinic population respectively (P<0.001). CONCLUSIONS: It thus appears that there is a preponderance of men from Islamic and Asian backgrounds presenting to our unit with premature ejaculation. The reasons for this are unclear. Possible mechanisms include psychosocial, familial, or genetic influences.

Adult↗
PubMed2005

Romantic love and sexually transmitted infection acquisition: hypothesis and review.

Rates of sexually transmitted infections (STI) in the UK continue to increase. A discrepancy between knowledge and awareness of STIs, and sexual behaviour appears to be ubiquitous throughout the world. We hypothesize that human beings are biologically programmed to fall in love and bond in powerful relationships, which, at least in the short term, prevents them from using knowledge and cognitive strategies to prevent STI acquisition. We compare this with obsessive thoughts and compulsive behaviours seen in obsessive-compulsive disorders. We suggest how romantic love might overwhelm logical thought processes to cause a deterministic and non-logical response to have sex and thus acquire STIs. An understanding of this concept may help us humans to be more insightful and thoughtful about STI acquisition.

Female↗
PubMed2005

A review of controlled trials in the pharmacological treatment of premature ejaculation.

Premature ejaculation is a common sexual problem which presents to genitourinary (GU) medicine services. Five main treatment approaches have been used in clinical trials: behavioural therapy, antidepressants, phosphodiesterase-5 (PDE5) inhibitors, topical anaesthetic agents and alpha-blockers. We have carried out a systematic review of published pharmacological trials. All antidepressants appeared to delay ejaculation to some extent at all doses. Anaesthetic creams appeared to be as successful in slowing ejaculation as antidepressants without systemic side-effects, although some patients did experience erectile problems or unpleasant local symptoms. Anecdotally, behavioural therapy is effective and appears to have long-lasting efficacy. There is a need for quality comparative trial of behavioural therapy, topical anaesthetic agents and antidepressants, including appropriate measures of relapse, follow-up and acceptability of continuing long-term treatment.

Adrenergic alpha-Antagonists↗
PubMed2005

Pharmacological treatment for premature ejaculation.

Premature ejaculation is a common male sexual dysfunction. Treatment modalities as recommended by the British Association of Sexual Health and HIV include behavioural therapy, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs) and local anaesthetic creams. We audited the clinical cohort from our dedicated sexual dysfunction clinic to determine the success of prescribed treatment and co-existing prostatitis/male pelvic pain, erectile dysfunction, phosphodiesterase-5 (PDE5) inhibitor use and anxiety. The use of SSRIs was successful in the treatment of premature ejaculation with or without the use of local anaesthetic cream. Co-existing prostatitis/male pelvic pain, erectile dysfunction, PDE5 inhibitor use and anxiety were high.

Antidepressive Agents, Tricyclic↗
PubMed2004

Addressing students' misconceptions of renal clearance.

Renal clearance is one of the more difficult concepts for students of physiology to learn. We hypothesized that this difficulty is rooted in a student's misunderstanding of virtual volume. This was tested by having students select from several drawings the one they thought plasma would look like after a certain volume of it has been cleared of sodium by the kidneys. About half the participating students selected plasma pictured as having a certain volume of it devoid of sodium molecules. That is, their misconception of clearance seemed to be due to a lack of understanding about virtual volume, a deficiency which is reinforced by the classic definition of clearance. To address this misconception, a demonstration was devised in which a beaker of concentrated colored water was used to represent plasma before renal clearance, a beaker of the same concentrated colored water in which the top third had been replaced by clear mineral oil was used to represent what the definition of clearance said would happen to plasma after a third of it had been cleared of sodium, and a beaker of dilute colored water was used to represent what really happens to plasma when a certain volume of it is cleared of a solute. Incorporating this demonstration into discussions of renal clearance helped students to understand this concept, as evidenced by improved scores on related questions.

Humans↗
PubMed2003

The use and effectiveness of an emergency department observation unit for elderly patients.

STUDY OBJECTIVE: Emergency department observation units are cost-effective alternatives to hospital admission for selected patients. However, the use and effectiveness of these units in the elderly population is unclear. We sought to describe the use of an ED observation unit by elderly patients (>or=65 years), to determine whether the ED observation unit is effective for them in terms of ED observation unit length of stay and hospital admission rates, and to compare efficacy and return visit rates between younger and older patients. METHODS: This is a retrospective observational cohort study of consecutive adult patients sent to an ED observation unit from 1996 to 2000 at a high-volume tertiary care suburban teaching hospital. ED observation unit length of stay of less than 18 hours and admittance rates of less than 30% were used as indicators of efficacy. Diagnosis, length of stay, hospital admission rates, and 30-day return visit rates were compared between younger and older patients. RESULTS: Twenty-two thousand five hundred and thirty adult patients were observed, with 37.2% older than 65 years of age. The most common diagnoses in elderly patients were chest pain (24.0%), dehydration (11.7%), syncope (6.5%), back pain (4.6%), and chronic obstructive pulmonary disease (3.8%). Length of stay in the ED observation unit was longer for the elderly than younger patients but still averaged less than 18 hours (15.8 hours [95% confidence interval (CI) 15.7 to 16.0] versus 14.4 hours [95% CI 14.3 to 14.5], respectively). Elderly patients were more likely to be admitted from the ED observation unit than younger patients (26.1% versus 18.5%); however, their overall admission rate remained less than 30%. Compared with younger patients, the odds ratios for inpatient admission of elderly patients was highest for back pain (2.10; 95% CI 1.62 to 2.73), pyelonephritis (1.78; 95% CI 1.16 to 2.71), and chest pain (1.65; 95% CI 1.44 to 1.89). Thirty-day related return visit rates between age groups were similar (9.4% versus 7.6%). CONCLUSION: Elderly ED observation unit patients had ED observation unit lengths of stay and hospital admission rates that were effective for an ED observation unit setting and ED return visits rates that were comparable with those of younger patients.

Adult↗