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Biomedical subjects

J Fraser

Publications and source records attributed to J Fraser.

At least 55 records · Page 3Linked to original sources
PubMed1999

Prevalence and predictors of parasuicide in chronic psychosis. UK700 group.

OBJECTIVE: This study estimates the prevalence of and risk factors for parasuicide in a large community-based sample of patients with chronic psychosis. METHOD: A total of 704 subjects with chronic psychosis were interviewed using a battery of instruments. The 2-year prevalence of parasuicide was estimated and a comparison was made between attempters and nonattempters on a wide range of sociodemographic and clinical variables. RESULTS: The 2-year prevalence of parasuicide was 18.8%. Attempters were significantly more likely to be younger, of white ethnic origin, to have a diagnosis of affective disorder, to be currently depressed, to have experienced more auditory hallucinations and to have received treatment with antipsychotic drugs for a longer period. CONCLUSION: Parasuicide was found to present a considerable clinical problem in this group. Continual risk assessment is essential to reduce this unacceptably high rate.

Adolescent↗
PubMed1999

Prevalence and characteristics of patients with severe mental illness and borderline intellectual functioning. Report from the UK700 randomised controlled trial of case management.

BACKGROUND: Low cognitive ability and developmental delays have been implicated in the causation of mental illness. AIMS: To examine the prevalence, socio-demographic characteristics, psychopathology and social functioning profiles of people with low intelligence and recurrent psychotic illness. METHOD: A multi-centre randomised controlled trial of case management provided the opportunity to explore associations between mental illness and borderline intellectual functioning (assessed using the National Adult Reading test). RESULTS: Overall prevalence of borderline intelligence was 18%. Significant positive associations were shown with: being Black Caribbean; having a father who worked in a manual occupation; lower educational achievement; having had special education; longer course of illness. Those with borderline intelligence had greater disability and were more likely to suffer extrapyramidal side-effects and show evidence of negative symptoms. Educational achievement, history of special education and social class were the best socio-demographic predictors of intellectual level. CONCLUSIONS: Many patients who attend generic psychiatric services have considerable intellectual deficits. This may lead to difficulties in other domains of adaptive functioning, and merits further investigation as well as clinical vigilance.

Adolescent↗
PubMed1999

Caring for Ann.

Explore the source record for details and available documents.

Communication Barriers↗
PubMed1999

Knee and hip joint replacements. Longer lasting prostheses.

BACKGROUND: Conventional hip replacement prostheses consist of a metal femoral stem and head articulating with a polyethylene acetabular component fixed to the skeleton by polymethylmethacrylate 'cement'. In these prostheses the main problems are breakdown of cement and wear of the polyethylene acetabular articulation. Particles produced by this wearing process contribute to osteolysis (bone stock loss). These problems affect the long term results of joint replacements particularly in the younger, active patients. OBJECTIVE: This article discusses new advances in prosthesis design, which reduce these problems, and techniques to overcome bone loss in revision procedures. DISCUSSION: Improved fixation to the skeleton using cementless prostheses may improve long term results for younger, active patients. The problems of wear and osteolysis may be reduced by the utilisation of metal on metal or ceramic on ceramic articular surfaces.

Arthroplasty, Replacement, Hip↗
PubMed1998

The prevalence and perception of pain amongst hospital in-patients.

The aim of this paper is to describe the prevalence and perceptions of pain and pain management amongst hospital in-patients. A cross-sectional descriptive survey of 205 patients was conducted. Presence and severity of pain was assessed using verbal descriptor and visual analogue scales, and perceptions of pain were assessed using multi-item scales. Although the severity of pain reported was consistent across age groups and clinical areas, women in the study sample were significantly more likely to report high levels of pain than men. Differences in how men and women communicate their pain were observed, with women indicating that they were less willing to ask for help with their pain. Results suggest that pain continues to be an important problem for a large number of men and women in hospital, and that the experience of pain impacts negatively upon their well-being. Gender differences in the experience of and response to pain remain important considerations for clinical nurses who have major responsibilities for the management of pain in hospitalized patients.

Adolescent↗
PubMed1998

Which depressed patients respond to cognitive-behavioral treatment?

OBJECTIVE: To identify predictors of remission from major depression in adolescent patients given cognitive-behavioral therapy (CBT). METHOD: The study was based on 50 patients aged between 10 and 17 years who were obtained from two studies of CBT. A wide range of possible predictors was examined. RESULTS: Sixty percent remitted by the end of treatment. In multivariate analyses remission was associated with younger age and less social impairment. CONCLUSIONS: Depressed patients who respond to CBT tend to be younger and less severely impaired than those who do not respond.

Adolescent↗
PubMed1998

Prolonged mechanical ventilation as a consequence of acute illness.

OBJECTIVE: To determine why acutely ill children become dependent upon mechanical ventilation and what happens to them. METHODS: A retrospective medical record study of all patients aged between 1 month and 16 years from 1983 to 1996 who required ventilation for more than 28 days. RESULTS: Forty children were ventilated for between 36 and 180 days before discharge or death. Before their presenting illness, 13 (33%) were normal, 15 (37%) had documented predisposing conditions such as bronchopulmonary dysplasia, and the remaining 12 (30%) had diagnoses made after admission. The cause of respiratory failure was central in four patients (10%), spinal cord in eight (20%), neuromuscular in 11 (28%), and pulmonary in 17 (42%). Severe nosocomial infection requiring treatment with intravenous antibiotics occurred in 22. To date, 16 children (40%) have died, and 10 (25%) remain ventilator dependent. Of the 24 survivors, seven (29%) have severe residual neurological deficit. CONCLUSIONS: Increasingly, children are surviving intensive care only to remain ventilator dependent and at risk of significant comorbidity. This study should inform further debate on why such children remain ventilator dependent, and how and where they are managed.

Acute Disease↗
PubMed1998

Induction of acute inflammation in vivo by staphylococcal superantigens I: Leukocyte recruitment occurs independently of T lymphocytes and major histocompatibility complex Class II molecules.

Studies in our laboratory and others have recently shown that staphylococcal enterotoxin-derived superantigens stimulate proinflammatory cytokine gene expression in vitro. We have therefore investigated the ability of superantigens to induce leukocyte accumulation at extravascular sites in vivo using the subcutaneous air pouch model. Injection of staphylococcal enterotoxin A (SEA) induced a significant accumulation of leukocytes over basal levels in a time- and dose-dependent manner. It was also shown that superantigens are capable of inducing this response in mice depleted of CD4 T cells, as well as in severe combined immune-deficient and nude mice. These observations suggest that superantigens are capable of inducing leukocyte accumulation independently of the presence of T lymphocytes. Experiments were also conducted using mutant SEAs that have a reduced binding affinity for major histocompatibility complex (MHC) Class II molecules, as well as using MHC Class II-deficient mice. The results of these experiments indicated that MHC Class II molecules are not required for the observed effect of superantigens in vivo. Taken together, these results indicate, first, that bacterial superantigens promote inflammation in subcutaneous tissue in vivo and, second, the potential existence of a novel receptor for superantigens that mediates this subcutaneous inflammatory response.

Acute Disease↗
PubMed1997

Kaposi's sarcoma-associated herpesvirus infection of bone marrow dendritic cells from multiple myeloma patients.

Kaposi's sarcoma-associated herpesvirus (KSHV) was found in the bone marrow dendritic cells of multiple myeloma patients but not in malignant plasma cells or bone marrow dendritic cells from normal individuals or patients with other malignancies. In addition the virus was detected in the bone marrow dendritic cells from two out of eight patients with monoclonal gammopathy of undetermined significance (MGUS), a precursor to myeloma. Viral interleukin-6, the human homolog of which is a growth factor for myeloma, was found to be transcribed in the myeloma bone marrow dendritic cells. KSHV may be required for transformation from MGUS to myeloma and perpetuate the growth of malignant plasma cells.

Blotting, Southern↗
PubMed1997

Scrapie infection alters the membrane and synaptic properties of mouse hippocampal CA1 pyramidal neurones.

1. Electrophysiological recordings using conventional intracellular and extracellular techniques were made from the CA1 region of the hippocampus of ME7 scrapie-infected mice in a brain slice preparation at specific stages during the incubation period of the disease and compared with data obtained from age-matched control animals. 2. Extracellular field EPSP recordings in the stratum radiatum showed a gradual increase in the effective stimulus threshold and a reduction in amplitude of the response 5 months after inoculation with scrapie. Terminal animals showed a complete loss of the field EPSP. 3. Intracellular recordings from CA1 pyramidal cells of scrapie-infected animals after 5 months showed that the Schaffer collateral-evoked EPSP was attenuated, the effective stimulus threshold was increased and the rise time was slower in slices from scrapie-infected mice than in age-matched control mice. Inhibitory potentials evoked by the same stimulus also appeared weaker in scrapie-infected mice at this time. 4. To determine if the mechanisms of transmitter release during low-frequency stimulation of the Schaffer collaterals were altered in scrapie-infected mice, paired-pulse experiments were performed, but failed to show any differences between cells from scrapie-infected and control animals. 5. Pyramidal cells from scrapie-infected mice showed depolarized resting potentials and an increased membrane resistance compared with age-matched control cells. 6. The majority of scrapie-infected cells were spontaneously active, showing both single spike and bursting activity. The observed bursting activity was abolished and the spontaneous discharge rate of infected cells was markedly reduced by removing the CA3 area from the slice. 7. The action potential of cells from scrapie-infected mice showed a faster falling phase and larger amplitude fast and medium after-hyperpolarizations (AHPs) than age-matched control cells. In response to depolarizing current pulses cells from infected tissue showed a loss of early spike frequency adaptation. 8. Morphological observations of biocytin-labelled neurones confirmed our recordings were from pyramidal cells and showed that CA1 cells from scrapie-infected mice after 5 months showed a marked loss of dendritic spines and an abnormal dendritic morphology that included the appearance of vacuolar swellings. 9. The data show that membrane and synaptic abnormalities of the CA1 pyramidal neurones develop around 5 months after intracerebral infection of the mouse hippocampus with ME7 scrapie.

Action Potentials↗
PubMed1997

Further follow-up of New Zealand participants in United Kingdom atmospheric nuclear weapons tests in the Pacific.

We previously reported a study of deaths and cancer incidence in Royal New Zealand (RNZ) Navy personnel who participated in atmospheric nuclear weapons tests conducted by the United Kingdom in the Pacific in 1957-58. The study involved 528 men known to have participated in the tests, and a control group of 1,504 men who were in the RNZ Navy during the same period but were not involved in the tests. The original follow-up was carried out for the period 1957-87 with an observed increase in risk of leukemia and other hematologic cancers, but little or no increase of non-hematologic cancers or non-cancer deaths in test participants. Follow-up now has been extended for the period 1988-92. For the total follow-up period, there were 97 deaths in test participants and 256 deaths in controls, a relative risk (RR) of 1.1 (90 percent confidence interval [CI] = 0.9-1.3). The RR of death from causes other than cancer was 1.0 (CI = 0.8-1.3), whereas the RR of cancer death was 1.2 (CI = 0.8-1.7) and that of cancer incidence was 1.0 (CI = 0.8-1.4). For cancers other than hematologic malignancies, the RR was 1.0 (CI = 0.7-1.5) for mortality, and 1.0 (CI = 0.7-1.3) for incidence. However, there were eight deaths from hematologic cancers in test participants (RR = 3.8, CI = 1.4-10.8), including four leukemias (RR = 5.6, CI = 1.0-41.7). The RR for incidence of hematologic cancers was 1.9 (CI = 0.8-4.3), and that for leukemia was 5.6 (CI = 1.0-41.6). We concluded that the evidence is still consistent with the hypothesis that some leukemias and other hematologic cancers may have resulted from participation in the nuclear weapons test program, but the further follow-up strengthens the evidence that there is no increased risk for non-hematologic cancers or for causes of death other than cancer in the test participants.

Confidence Intervals↗