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Biomedical subjects

J Catalan

Publications and source records attributed to J Catalan.

160 records · Page 9Linked to original sources
PubMed1980

Comparison of doctors and nurses in the assessment of deliberate self-poisoning patients.

The assessments of deliberate self-poisoning patients carried out by 8 doctors and 8 nurses were compared. Both groups of staff had undergone special training in the assessment procedure. The adequacy of the assessments was determined by blind judges' ratings of transcripts of assessment interviews, comparisons of the types of treatment offered and repetition of self-poisoning The attitudes of the patients and their general practitioners were also investigated. No major differences were found between the assessments of the 2 groups of subjects. It is concluded that nurses under supervision of a senior psychiatrist can safely carry out the assessment of self-poisoning patients, provided they have received appropriate training. The findings suggest that services in which nurses assess most self-poisoning patients could be established in district general hospitals. This would reduce the demands currently placed on psychiatrists and physicians.

Adult↗
PubMedDate not supplied

Fears and phobias in people with diabetes.

Phobic disorders are more common in people with diabetes than in the general population. The management of phobic disorders in patients with diabetes, particularly when associated with a fear of hypoglycaemia, is especially challenging and requires close collaboration between psychological medicine and diabetes teams. Difficulty in distinguishing symptoms of anxiety from those of hypoglycaemia, and the real dangers associated with hypoglycaemia, complicate the delivery of psychological interventions that are used routinely in the treatment of phobias. Avoidance of hypoglycaemia can lead to deterioration in diabetes control. This case report describes a man with Type 1 diabetes who developed agoraphobia with panic disorder, associated with fear of hypoglycaemia and deterioration in glycaemic control. The management of patients with diabetes and phobic disorders, with particular reference to those associated with fear of hypoglycaemia, is discussed.

Adult↗
PubMedDate not supplied

Auditory and visual event-related potentials in a controlled investigation of HIV infection.

Auditory and visual event-related brain potentials (ERPs) were used to complement neuropsychological and medical assessment in neurologically healthy subjects with asymptomatic and symptomatic human immunodeficiency virus type 1 (HIV-1) infection. Auditory and visual ERPs, recorded using standard oddball paradigms, disclosed delays in late waves (N2 and P3) in symptomatic subjects (CDC stage IV) when compared with matched controls. Abnormally delayed P3 waves in at least one modality were recorded in 41% of symptomatics and this was associated with deficits in neuropsychological performance, particularly psychomotor slowing. However, no differences in late wave latencies between asymptomatic and control subjects were found, though asymptomatics showed delays in auditory N1 and P2 latencies. The number of morphological abnormalities, such as indiscernible late waves as well as topographical variability of the P3 wave, was increased in both HIV seropositive groups and possibly indicates a distinct mechanism of impairment, different from latency delay. Whilst P3 delay in symptomatics was not associated with changes in immune function (T4 cells) there was, however, a link with anaemia and subclinical hepatic dysfunction.

Adult↗
PubMedDate not supplied

Investigation of genetic linkage between myosin and actin genes using an interspecific mouse back-cross.

The introduction of cloned probes to follow the segregation of DNA restriction fragment length polymorphisms (RFLPs) has led to a revival of mendelian genetics in attempts to map the human genome. In the mouse, however, it has often proved difficult to detect an RFLP with a DNA probe between different inbred strains of the laboratory mouse. To circumvent this problem, we have used two species, Mus musculus domesticus and Mus spretus which interact as sympatric species but can be interbred under laboratory conditions. Because of the relative evolutionary distance between these species, they exhibit polymorphism at many more loci than do different strains of the usual M. m. domesticus laboratory mouse. This is also observed at the DNA level when the sizes of restriction fragments encoding a specific gene are compared. We have used these RFLPs between M. m. domesticus and M. spretus to follow the segregation of genes encoding different isoforms of myosin alkali light chains in the backcross progeny between these species and to compare this with that of other contractile protein genes. No linkage between these genes was observed.

Actins↗
PubMedDate not supplied

Developmental stability in house mice heterozygous for single Robertsonian fusions.

Fluctuating asymmetry (FA) of tooth traits has been reported to be increased in Down syndrome patients as well as hybrids between chromosomal races of the house mouse differing in several Robertsonian (Rb) fusions. Developmental stability, assessed by FA, is thus thought to be impaired by spontaneous chromosomal abnormality or by chromosomal heterozygosity. Although the effect of a single fusion on developmental stability could theoretically be expected, it has never been documented. Crosses involving two chromosomal races of the house mouse diverging for one Rb fusion were performed to assess developmental stability in parental homozygous races as well as in their hybrids. Moreover, the occurrence of a spontaneous chromosomal mutation (WART type-b) allowed us to study the instantaneous effect of such a translocation on developmental stability. No difference in fluctuating asymmetry levels was detected among the groups considered in this study. This result suggested that a single stable or spontaneous balanced structural rearrangement did not inherently disturb developmental stability. In addition, the differential effect on developmental stability of one versus many heterozygous Rb fusions highlights the role of their quantitative accumulation in the disruption of coadaptation in chromosomal hybrids.

Animals↗
PubMedDate not supplied

Megestrol acetate vs cyproheptadine in the treatment of weight loss associated with HIV infection.

Two appetite stimulants, megestrol acetate and cyproheptadine were administered in a randomized trial to 14 patients who had no evidence of opportunistic infection or malabsorption but were wasted (had lost more than 5 kg body weight) as a result of human immunodeficiency virus (HIV) infection. Energy intakes were calculated from a 7 day weighed dietary record. Mean energy intakes per kilogramme body weight were similar in both treatment groups (greater than 34 kcal/kg) and were higher than that in well British males. Energy intakes increased by just over 500 kcal during both treatments, but fell to pretreatment levels after therapy. Patients in both treatment groups gained a moderate amount of weight. Megestrol acetate was associated with impotence in 4 patients. Insufficient calorie intake alone is not a common cause of wasting associated with HIV and the role of appetite stimulants is likely to be limited.

Appetite↗
PubMedDate not supplied

How should an AIDS diagnosis be given? The views of patients.

The report aimed at obtaining information about patients' experience of how the diagnosis of AIDS was given to them by their doctors, and about patients' satisfaction with the consultation. Thirty people with AIDS completed a self-report questionnaire enquiring about their views and satisfaction with the process of communication of the diagnosis. Results showed that about two-thirds of patients were satisfied, while almost a quarter were definitely not satisfied with the consultation. Satisfaction was associated with the general attitude of the person giving the diagnosis and with the quality of the information given. The relevance of the findings for the training of doctors is discussed.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Gender identity disorder and HIV disease.

Four cases of male-to-female transsexuals with HIV infection are described, showing that individuals with gender identity disorder are vulnerable to HIV infection through unsafe sexual behaviour and intravenous drug use. The various practical problems associated with carrying out major surgery on this group of individuals are discussed, as well as some of the ethical issues raised by their treatment needs.

Adult↗
PubMedDate not supplied

Why do antenatal attenders decide to have the HIV antibody test?

The aim of the study was to investigate factors influencing the parturient woman's decision to accept or decline the HIV antibody test in the antenatal clinic. Eighty-eight women attending an antenatal clinic, in a central London hospital, for an appointment at 28-32 weeks of pregnancy were given a structured face to face interview. Results indicated that 36% (n = 32) had elected to be tested. Reasons for declining included assumption of no risk, being in a stable relationship, not wanting to think about HIV when pregnant and not wanting to know if HIV positive. Reasons for accepting included fears for health of the baby and fears for own health. 52% (n = 46) had discussed the test with their partner, most of whom had agreed with the woman's decision or left the decision to her. Only 31% of the women were aware they had been automatically tested for syphilis. Knowledge about vertical transmission was poor. Anxiety levels of those tested and those not tested were not significantly different nor did either group differ over time. The groups did not differ on demographic variables, transmission knowledge or perceived likelihood of infection. Most women elected not to be tested and reasons around the decision are very individualistic and varied. HIV testing does not appear to cause anxiety when it is offered on a voluntary basis. Knowledge of routine testing and of vertical transmission is poor and should be the focus of health education intervention.

AIDS Serodiagnosis↗
PubMedDate not supplied

Preoperative HIV antibody testing: the views of surgeons and patients.

Fifty surgeons and 72 preoperative patients in 2 central London hospitals were asked their views on preoperative HIV antibody testing, who is at risk of HIV infection and HIV test counseling. A substantial proportion of both surgeons and preoperative patients, 48% and 54% respectively, supported compulsory HIV antibody testing without patient consent. They believed this should occur as a routine practice prior to surgery. However, surgeons and patients differed in the preoperative patients to be considered for such testing. All surgeons advocating compulsory testing believed that it was only necessary for those patients belonging to high risk groups whilst preoperative patients believed that all patients should be HIV tested prior to surgery. Surgeons and patients also differed in their views on who was at risk of HIV infection. Surgeons believed those at risk to be members of identifiable risk groups whilst patients believed everyone was at risk, especially those engaging in high risk behaviours. Finally, when asked which health professionals they thought should be involved in HIV test counselling, both surgeons and patients agreed that hospital doctors, including surgeons themselves, should take on the responsibility of test counselling. The implications of this and routine HIV antibody testing are discussed.

AIDS Serodiagnosis↗