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Biomedical subjects

G Waddell

Publications and source records attributed to G Waddell.

At least 73 records · Page 4Linked to original sources
PubMed1985

Psychological assessment in general orthopaedic practice.

The importance of psychologic distress and illness behavior is well recognized in low-back pain but has rarely been studied in other orthopedic conditions. Psychologic and clinical assessment of 100 patients undergoing elective surgery for minor leg conditions or joint replacement for osteoarthritis or rheumatoid arthritis showed surprisingly little psychologic distress or illness behavior, particularly when compared with 235 patients with low-back pain. The most striking finding was that in low-back pain there was a close relation between psychologic disturbance and failed surgery, but the nonspinal patients showed a complete absence of such a relation. This type of psychologic assessment is neither necessary nor helpful in the routine management of most clearly defined, nonspinal, correctly managed orthopedic conditions.

Adult↗
PubMed1984

Symptoms and signs: physical disease or illness behaviour?

The amount of treatment received by 380 patients with backache was found to have been influenced more by their distress and illness behaviour than by the actual physical disease. Patients showing a large amount of inappropriate illness behaviour had received significantly more treatment (p less than 0.001). The symptoms and signs of illness behaviour need to be clearly distinguished from those of physical disease, and better assessment of illness behaviour is essential if everyday clinical practice is to fulfil the ideal of treating patients as well as diseases.

Adult↗
PubMed1984

Chronic low-back pain, psychologic distress, and illness behavior.

The authors have calculated the mathematic relationship between measured elements of illness behavior in chronic low-back pain. Objective physical impairment accounts for about one-half the total disability that also is affected by psychologic reactions. The most important psychologic disturbance in low-back pain is emotional distress, measured on questionnaires as increased bodily awareness and depression and presenting clinically as inappropriate descriptions of symptoms and inappropriate responses to physical examination. Simple methods for the assessment of distress and illness behavior in chronic low-back pain are developed and described.

Adult↗
PubMed1982

Normality and reliability in the clinical assessment of backache.

Backache is common yet its routine medical assessment is imprecise, unreliable, and poorly interpreted. Reproducibility studies on 475 patients improved the reliability of clinical interview and examination in backache, while studies of 335 normal subjects defined the limits of normality. Assessment of nerve function was found to be reliable but assessment of the back itself had to be considerably modified and examination improved by incorporating actual measurements. The validity and clinical utility of the information were analysed to determine the minimum amount of information which should be collected to permit clear diagnosis and management.

Adult↗
PubMed1981

Comparison of the antihypertensive effects of indapamide and cyclopenthiazide.

The antihypertensive effects of indapamide, 2.5 mg, and cyclopenthiazide, 0.5 mg daily were compared over a two week period. The falls in both diastolic and systolic blood pressure were greater with indapamide than with cyclopenthiazide reaching statistical significance for the supine diastolic values. This difference was still seen when matching patient groups of similar age, sex or severity of blood pressure were compared.

Antihypertensive Agents↗
PubMed1980

Variation of the lumbosacral myotomes with bony segmental anomalies.

Clinical localisation of a disc prolapse required dependable knowledge of the muscles supplied by the lumbosacral nerve roots. Localisation is most difficult in the 10 per cent of patients who have lumbosacral bony segmental anomalies. The lumbosacral plexus has been dissected in 11 cadavers with such anomalies and electrical stimulation studies carried out in 15 patients similarly afflicted. It is suggested that whatever the anomaly the "last fully mobile level" should be identified as the lowest level with a fully formed disc space, bilateral facet joints and two free transverse processes which do not articulate with the sacrum or pelvis. In three out of four patients with bony segmental anomalies the fifth lumbar root emerges at the last fully mobile level.

Adult↗
PubMed1979

Videotaping epileptic attacks during stereoelectroencephalography.

Relating the onset of clinical attacks as recorded on a videotape to surface and depth electrographic events improves our ability to define the local or diffuse origin of seizures. In two patients with complex partial seizures, all 14 attacks appeared 3 to 6 seconds after focal discharges began in the amygdala or hippocampus. This meant that the spread of focal electroencephalographic (EEG) paroxysms caused the eventual clinical seizure. In two other patients with 392 generalized seizures and secondary bilateral synchronous paroxysms, a significant number of clinical attacks preceded the first depth or surface electrographic event. This suggested that the attacks originated from brain regions remote from the recording electrodes.

Adult↗
PubMed1979

Failed lumbar disc surgery and repeat surgery following industrial injuries.

One hundred and seventy-nine of the compensation patients in this study who had one low-back operation had to have repeat back surgery. One hundred and three Workmen's Compensation Board patients who were reoperated on by a number of surgeons in the Toronto area were independently reviewed with one to two years of follow-up. Many had residual back pain, limited lumbar movement, presisting nerve-root deficits, and psychological disturbances. Forty per cent of the second operations were successful. Subsequent operations yielded progressively poorer results and made more patients worse than better. Operations were frequently undertaken without clear indications or evidence of correctable organic lesions. The results of repeat operations were better when the preceding operation had given more than six months' relief, when sciatica overshadowed back pain, and when a definite recurrent disc herniation was found. Scarring and neurolysis, previous infection, repair of a pseudarthrosis, and adverse psychological factors precluded a good result. Careful patient selection based on total evaluation of the disability including psychological assessment, accurate localization of the lesion by detailed investigation, and, most important, a logical sequence of decisions based on clear, objective criteria are prerequisites for this complex and demanding surgery. Caution and restraint are required when contemplating repeat back surgery.

Accidents, Occupational↗
PubMed1978

Proglonged epileptic twilight states: continuous recordings with nasopharyngeal electrodes and videotape analysis.

Confusion, speech arrest, automatic behavior, and amnesia characterize the prolonged twilight states of both petit mal and psychomotor status. However, in psychomotor status two electroclinical phases were differentiated: (1) A continuous twilight state with partial responsiveness and reactive automatisms interrupted by (2) staring, total loss of responsiveness, and stereotyped automatisms. During the first phase, with reactive behavior, the EEG showed bilateral diffuse slowing. During the second phase, with stereotyped automatisms, there were spreading right temporal 4- to 12-Hz discharges. Petit mal status had one continuous twilight state, during which both stereotyped and reactive automatisms merged as 1.5- to 4-Hz spike-wave complexes, and bimedial temporal 4-Hz discharges' appeared in the EEG.

Adult↗
PubMed1978

Lateral lumbar discography.

The technique of lateral lumbar discography is described and compared with that of posterior lumbar discography. Its safety is demonstrated in a series of 1500 patients, only four of whom developed complications of note. Of these four, three developed discitis and one a retroperitoneal haemorrhage, all of which settled with conservative treatment.

Humans↗
PubMed1977

Lapse of consciousness and automatisms in temporal lobe epilepsy: a videotape analysis.

Videotape analysis of 76 attacks in 14 epileptics showed two electro-clinical types of psychomotor attacks. The first and most common type had three clinical phases, consisting of an initial motionless stare, stereotyped movements, and reactive automatisms during impaired consciousness. The second and less common type started with stereotyped and reactive automatisms. In the first type, focal temporal or lateralizing features were common. In the second type, there were only diffuse changes in the electroencephalogram. The value of recording attacks with nasopharyngeal electrodes was emphasized by a high yield for focal-lateralizing electroencephalographic features.

Adult↗
PubMed1976

Ambulance transport of obstetric emergencies.

Ninety-eight patient records from obstetric flying squad calls were reviewed. The reasons for call-out and the effect of transport on maternal and foetal cardiovascular parameters were analysed. The main reason for calling the flying squad is now antepartum haemorrhage. Transporting the patient to hospital has little effect on the cardiovascular state.

Adult↗