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Biomedical subjects

G Turnbull

Publications and source records attributed to G Turnbull.

At least 19 recordsLinked to original sources
PubMed2001

Anxiety and the schizophrenic process: clinical and epidemiological evidence.

BACKGROUND: The authors hypothesise that anxiety is an integral part of the development of schizophrenia in a significant sub-group of cases. This paper reviews the evidence for an epidemiological link between anxiety and schizophrenia, emphasising those studies that imply a temporal sequence. METHOD: An augmented systematic search of electronic databases was conducted, and the methods and results of the studies identified were reviewed. RESULTS: Panic disorder was identified in around 20% of cases of schizophrenia in clinical studies (range 5-33 %). Other anxiety disorders were less often studied, but were also frequent. Epidemiological studies from the Epidemiological Catchment Area Program confirm the strong association between anxiety disorders and schizophrenia. Finally, cohort studies identify anxiety as an early antecedent of schizophrenia. CONCLUSION: There is a significant link between anxiety and schizophrenia. This may represent a psychological process integral to an appreciable number of cases of schizophrenia. Focused psychological studies are needed to determine whether this is so.

Anxiety Disorders↗
PubMed1998

Deliberate self harm assessment by accident and emergency staff--an intervention study.

OBJECTIVE: To examine the impact of specific training for accident and emergency (A&E) staff on the quality of psychosocial assessment of deliberate self harm patients. METHODS: A non-randomised intervention study that compared the psychosocial assessment of deliberate self harm patients before and after a one hour teaching session for the A&E departments nursing and junior medical staff. Adequacy of psychosocial assessment was judged by examining A&E case notes. The records of the hospital's parasuicide team were examined to assess administrative changes. Staff attitude to and knowledge of deliberate self harm were also measured before and after the intervention. RESULTS: 45 of 52 nurses and all 15 junior medical staff attended the teaching session. Sixteen (13%) of 125 sets of records before and 58 (46%) of 127 sets of records after the intervention were judged to be adequate. In the postintervention period, notes were more likely to be judged adequate when a proforma was used as part of the assessment (52 of 66 with a proforma and six of 61 without a proforma, chi2 = 60, p < 0.01). Following the intervention, communication between A&E staff and the hospitals parasuicide team improved. CONCLUSIONS: An intervention that provides teaching to A&E staff can lead to improvements in the quality of psychosocial assessment of patients with deliberate self harm.

Chi-Square Distribution↗
PubMed1997

Comparative analysis of adult and fetal human small intestinal microvilli.

The aim was to study the development of human small intestinal microvillus membranes. We compared the protein patterns of human fetal and adult small intestinal microvillus membranes using the high-resolution technique of sodium dodecyl sulphate-polyacrylamide gel electrophoresis. We also examined the synthesis of brush border membrane proteins from the adult small intestine using small intestinal biopsy organ culture 35S-methionine uptake and subsequent gel electrophoresis. We observed that the fetal and colonic microvillus membranes were similar, but differed in certain respects from adult small intestinal microvillus membranes. The jejunal biopsy organ culture revealed that synthesised brush border membrane proteins could be recognized by gel electrophoresis.

Adult↗
PubMed1997

Hostage retrieval.

Explore the source record for details and available documents.

Adaptation, Psychological↗
PubMed1996

Laparoscopically assisted abdomino-perineal excision of the rectum. Is it of benefit to our patients?

We believe that by utilising a minimal access surgical approach we are able to more suitably meet the needs of a particular group of patients who would otherwise experience a substantial amount of pain for relatively small gain. The advent of therapeutic laparoscopy and its growing applications in general surgery represent a tremendous advance in the surgical treatment of intra-abdominal disease. The laparoscope is a widely accepted diagnostic tool and has recently gained popularity as an alternative to major open abdominal surgery. The advantages of MAS are quoted most regularly as being the absence of a large abdominal wound, a shorter hospital stay, reduced pain and a more expeditious return to normal activity. Preliminary results suggest that in experienced hands colon resections yield adequate surgical specimens and may be preferable to an open technique in terms of comfort and recovery.

Colostomy↗
PubMed1995

Parasuicide in the first postnatal year.

Data were collected on a consecutive 6 month sample of women aged 15-44 years attending their catchment area Casualty Department because of parasuicide. Information included age and childbirth within the previous year. Using this information and catchment area data on population size and births, an odds ratio for parasuicide in postnatal as compared to non-postnatal women was calculated. Five of 131 study subjects had delivered a baby in the previous 12 months. The odds ratio was calculated to 0.43 (95% confidence interval 0.17-0.95). These findings suggest that the rate of parasuicide in the first postnatal year is low despite the high rate of psychiatric morbidity at this time. The result supports previous findings on suicide and suggests that postnatal women, despite their high rates of psychiatric disorder, are protected against fatal and non-fatal self harm. The implications for postnatal and suicide prevention services are discussed.

Adolescent↗
PubMed1995

Weaving reimbursement of surgical dressings into the plan of treatment.

Caring for chronic wounds in today's rapidly changing healthcare environment can present a variety of challenges to the nurse. The risk of these challenges being transformed into obstacles is exacerbated by a lack of knowledge of the reimbursement mechanisms for the dressings needed for wound management. A clear and current understanding of reimbursement should be integrated into the plan of treatment. This article attempts to clarify present Medicare policy for coverage and reimbursement of dressings utilized for chronic wound care.

Bandages↗
PubMed1994

Convergent validity of measures of post-traumatic stress disorder in a mixed military and civilian population.

The authors evaluated the validity of the Post-Traumatic Stress Disorder (PTSD) subscale of the Minnesota Multiphasic Personality Inventory (MMPI), the Impact of Event Scale (IES) and the Symptom Check List 90 (SCL-90) as continuous and dichotomous measures of PTSD in a mixed military and civilian group of 70 subjects in the United Kingdom. The MMPI-PTSD and the IES are designed specifically as measures of PTSD and the Global Symptom Index of the SCL-90 is a general measure of neurosis. All measures produced significant positive correlations with scores from the Clinician Administered Post-Traumatic Stress Disorder Scale (CAPS-1) and with each other. The IES was the most useful dichotomous measure. The optimum cut-off score for the IES producing the highest Positive Predictive Value and the lowest Apparent Total Misclassification Error Rate has been determined.

Adult↗
PubMed1988

The variations between heparin sensitivity of different lots of activated partial thromboplastin time reagent produced by the same manufacturer.

The variations between different lots of activated partial thromboplastin time (APTT) produced by three major North American suppliers were evaluated over the past eight years. The authors found significant variations between the heparin sensitivity of the APTT reagents produced under the same name by the same supplier. The variations were so much that, using the recommended APTT ratio or prolongation of APTT for monitoring heparin therapy, one would have achieved significantly different intensity of heparinization from year to year.

Blood Coagulation Tests↗
PubMed1987

Effect of heparin on platelet count and platelet aggregation.

The in vitro effect of heparin on platelet aggregation was studied in three groups: in 26 subjects recently treated with heparin, in 18 subjects on maintenance hemodialysis, and in 20 normal controls. With the aid of Technicon H6000, platelet counts and platelet aggregations were compared in whole blood samples collected in ethylenediaminetetraacetic acid (EDTA) and in heparinized tubes. Although there was no significant difference between platelet count of heparinized and EDTA blood in the control group, the dialysis group and the group recently treated with heparin showed significantly lower platelet counts and more platelet aggregation in heparinized tubes than in EDTA tubes. We speculate that the majority of subjects exposed to heparin develop an antibody or a proaggregator which can aggregate or agglutinate platelets in the presence of heparin and causes destruction of platelets; but only in a small percentage of subjects receiving heparin is this reaction severe enough to cause thrombocytopenia.

Edetic Acid↗
PubMedDate not supplied

A cost-minimization analysis of intracervical prostaglandin E2 for cervical ripening in an outpatient versus inpatient setting.

This investigation was undertaken to compare the cost impact of prostaglandin E2 gel delivered intracervically in an outpatient versus an inpatient setting. Eligible pregnant women with a singleton gestation that was beyond 37 weeks gestational age and who had an unfavorable cervix (Bishop score < or = 4) received a single dose of 0.5 mg of prostaglandin E2 intracervically as an outpatient or one or more doses as an inpatient the day before a scheduled induction of labor. After gel placement, the outpatient group was monitored for 2 hours with electronic fetal monitoring before being sent home, while the inpatient group was monitored for 2 hours in a labor and delivery unit and then sent to the maternity unit overnight. The outpatient (n = 40) and inpatient (n = 36) groups were not different in terms of maternal age, race, parity, gestational age, maternal weight, predose Bishop score, or indication for delivery. Patients in the outpatient group incurred significantly less costs ($3835.00 +/- 2172.00 vs $5049.00 +/- 2060.00) and time (74.4 +/- 33.1 hours vs 100.3 +/- 41.6 hours) in the hospital than did patients in the inpatient group. Multiparous patients in the outpatient group, compared with those in the inpatient group, spent fewer total hours in the hospital (56.6 +/- 19.3 vs 90.3 +/- 41.0 hours) and had a lower hospital cost ($2891.00 +/- 1236.00 vs $4704.00 +/- 2100.00). The only difference between the nulliparous groups favored outpatient therapy because of less intrapartum expenses ($730.00 +/- 405.00 vs $1036.00 +/- 487.00). There were no differences between the inpatient and outpatient groups for the frequencies of failed inductions, abnormal fetal heart rate patterns, and cesarean sections. No adverse maternal or neonatal effects with therapy were encountered in either setting. Substantial cost savings were found with prostaglandin E2 therapy in an outpatient rather than an inpatient setting for patients who required an induction of labor and were candidates for outpatient cervical ripening.

Administration, Intravaginal↗