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Biomedical subjects

J Hillier

Publications and source records attributed to J Hillier.

18 recordsLinked to original sources
PubMed2003

Anaesthesia for lung volume reduction surgery.

Lung volume reduction surgery is a surgical treatment for severe emphysema that is increasing in popularity. The aim is to reverse the hyperexpansion of the lungs that leads to expiratory airflow limitation, compromises the diaphragm and chest wall mechanics, and tamponades the right ventricle. Optimal patient selection has not yet been established, but it has become clear that those patients with the most severe disease have an unacceptably high surgical mortality. The anaesthetic management of patients undergoing lung volume reduction surgery requires a good understanding of both the pathophysiology of the disease and the surgical procedure. It is important for the anaesthetist and the surgeon to work closely, supported by a large multidisciplinary team. Excellent analgesia is essential to a successful outcome; whether this is best provided by thoracic epidural is as yet unclear.

Analgesia↗
PubMed1996

Screening for psychiatric morbidity in subjects presenting with chronic fatigue syndrome.

BACKGROUND: There is a need for a valid self-rating questionnaire to screen for psychiatric morbidity in patients with chronic fatigue syndrome (CFS). This study had the aim of assessing the utility and validity of two commonly used measures. METHOD: Scores obtained on the General Health Questionnaire (GHQ) and the Beck Depression Inventory (BDI) were compared with various diagnostic and severity ratings obtained via a validating clinical interview, the Schedules for the Clinical Assessment of Neuropsychiatry (SCAN) in 95 consecutively referred subjects at a medical out-patient clinic who fulfilled standard criteria for CFS, and 48 healthy controls. Outcome measures were validating coefficients and receiver operating characteristics (ROC) for different thresholds and scoring on GHQ and BDI and index of definition (ID) as measured by SCAN; and Pearson and point by serial correlation coefficients for different diagnostic groups derived via SCAN and defined according to ICD-10 and DSM-III-R. RESULTS: GHQ and BDI perform poorly as screeners of psychiatric morbidity in CFS subjects when compared with various SCAN derived ratings although results for controls are comparable with other studies. CONCLUSIONS: Neither the GHQ nor BDI alone can be recommended as screeners for psychiatric morbidity in CFS subjects.

Fatigue Syndrome, Chronic↗
PubMed1995

Neuraesthenia revisited: ICD-10 and DSM-III-R psychiatric syndromes in chronic fatigue patients and comparison subjects.

BACKGROUND: Different definitions of chronic fatigue syndrome (CFS) have different psychiatric exclusion criteria and this affects the type and frequency of associated psychiatric morbidity found. The operational criteria for neuraesthenia in ICD-10 vary in this and other respects from the Centers for Disease Control and Prevention (CDC) criteria for CFS. Neuraesthenia and associated psychiatric morbidity in CDC-defined CFS are evaluated. METHOD: CFS subjects and controls were interviewed with the Schedule for the Clinical Assessment of Neuropsychiatry (SCAN). The computerised scoring program for SCAN (CATEGO5) facilitates the assignment of operational definitions according to DSM-III-R and ICD-10. Subjects were re-interviewed with SCAN an average of 11 months later. No specific treatments or interventions were given during this period. RESULTS: The majority of subjects fulfilled ICD-10 operational criteria for neuraesthenia and had two and a half times the rate of psychiatric morbidity as the healthy comparison group according to the CATEGO5 Index of Definition (ID). Approximately 80% of subjects fulfilled both DSM-III-R and ICD-10 criteria for sleep disorders. There was a significant fall in the number of subjects fulfilling criteria for depression and anxiety disorders and a significant increase in the number of subjects with no diagnosis for DSM-III-R criteria over time. There were no significant changes over time for any diagnosis according to ICD-10 criteria or for overall levels of psychopathology as reflected in CATEGO5 ID levels. CONCLUSIONS: The ICD-10 'neuraesthenia' definition identifies almost all subjects with CDC-defined CFS. Fifty percent of CFS subjects also had depressive or anxiety disorders, some categories of which remit spontaneously over time.

Adult↗
PubMed1985

Cell surface abnormality in clones of skin fibroblasts from a carrier of Duchenne muscular dystrophy.

We have previously reported that skin fibroblasts from patients with Duchenne muscular dystrophy (DMD) have a lower intercellular adhesiveness than control cells, and that cells from carriers of DMD have normal adhesiveness instead of the expected intermediate value. We have now cloned skin fibroblasts from a carrier of DMD (subject AS) who is also heterozygous for G6PD B/G6PD Mediterranean and determined the intercellular adhesiveness and G6PD phenotypes of the clones. G6PD activity was determined using the 2d-G6P/G6P ratio method. Normal cells had a percentage utilisation of 7.31% and uncloned cells from AS a value of 25.16%. Of 16 clones, 15 had normal values (mean 8.72%) while one clone was G6PD Med with a value of 57.5%. Mean intercellular adhesiveness of normal and uncloned cells from AS were 2.95 and 2.90 respectively. Of 11 clones tested, nine had normal values of adhesiveness (mean 3.1) and all these clones were G6PD B. The single G6PD Med clone had a value of 0.88, compared with 1.39 for DMD cells. We have no explanation at present for the single clone that was G6PD B but DMD-like on aggregation.

Adhesiveness↗