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Biomedical subjects

J L Craven

Publications and source records attributed to J L Craven.

At least 37 records · Page 2Linked to original sources
PubMed1989

Major depression in renal dialysis patients: an open trial of antidepressant therapy.

Eight patients receiving renal dialysis who had concurrent major depression were treated with antidepressant therapy for 7 weeks under controlled clinical conditions. The treatment resulted in a clinically significant recovery from the depression in five patients, improvement in one, and discontinuation of the therapy in the other two. Systematic examination for depression in dialysis patients and the judicious use of an antidepressant such as desipramine are important.

Aged↗
PubMed1988

The Beck Depression Inventory as a screening device for major depression in renal dialysis patients.

Self-report measures of depressive symptoms have been frequently employed in medically ill samples despite the lack of information regarding their psychometric properties in these subjects. We have examined the agreement of the Beck Depression Inventory (BDI) with DSM-III diagnoses of depression in a sample of renal dialysis subjects (n = 99). A threshold of greater than or equal to 15 on the BDI produced optimal sensitivity (.92), negative predictive value (.99), and maximized Youden's index of validity (.72) for the use of the BDI as a screening device for depressive syndromes in dialysis patients. Higher BDI threshold levels decreased the sensitivity of the measure but did not produce a clinically meaningful increase in the positive predictive value.

Adult↗
PubMed1987

Cyproheptadine dependence associated with an atypical somatoform disorder.

A case is described of cyproheptadine dependence in a woman with a persistent belief that she was too thin, and diagnosed with an atypical somatoform disorder. The cyproheptadine was initially prescribed to promote weight gain but its continued use seemed related to other psychological and/or pharmacological effects. Cognitive impairment was present, possibly as a result of the longstanding cyproheptadine abuse. There have been no previous reports of cyproheptadine dependence or of CNS toxicity from its long-term use.

Adult↗
PubMed1987

PRN medication for psychiatric inpatients.

Little is known about the extent of the use of prn psychotropic medication in psychiatric inpatient units. A survey of the prn prescription and administration of psychotropic drugs in a psychiatric teaching hospital revealed that a large number of inpatients were prescribed and administered such drugs on a prn basis. Although 50% of the prescriptions were never administered, only 25% were actively discontinued by physicians. A diagnosis of personality disorder was the factor most frequently associated with the rate of prn prescriptions and of administrations. A large number of prn prescriptions had no instructions for indications, minimum time spacing between doses or maximum daily dosage. It is suggested that hospitals monitor the prn use of psychotropic medications in their inpatient units, and explore the reasons for such use. Psychotropic drug use on a prn basis should preferably be reserved for emergencies, and the instructions of prn prescriptions should be clear and detailed.

Adolescent↗
PubMed1984

Endoscopic examination of the gastric remnant 31-39 years after subtotal gastrectomy for peptic ulcer.

In York between 1941 and 1949, 632 patients underwent Polya partial gastrectomy for peptic ulcer. Of 307 patients who were followed up in the York Gastric Clinic from 1971 to 1980, nine died of gastric cancer, three times the expected number. If gastrectomy was performed for gastric ulcer the risk of later development of carcinoma (7%) was significantly greater than that following operation for duodenal ulcer (1.6%) (p less than 0.001). No cancers were diagnosed in the 54 patients endoscoped. Atrophic gastritis was found in 98% of patients and intestinal metaplasia in 44%. Dysplasia was present in 35% but in no case was it severe. Although we have found that there is an increased risk of cancer developing in the gastric remnant we do not consider routine endoscopic follow up of all postgastrectomy patients to be a practical proposition.

Adult↗
PubMed1980

The diagnosis of acute gallbladder disease by technetium-99m-labelled HIDA hepatobiliary scanning.

A series of 105 patients with upper abdominal pain suggestive of biliary colic who had hepatobiliary scans within 48 h of admission to hospital is presented. Fifty of the 65 patients with abnormal scans had operative treatment and gallbladder pathology was found in every case. Fourteen of these patients had hepatobiliary scans which also showed delayed excretion of tracer into the duodenum, and of these, 12 were found to have common bile duct stones and one a stricture of the distal end of the common bile duct. Of the 40 patients who had normal scans, 7 were found to have gallstones on further investigation. In these patients abnormal hepatobiliary scans have shown a 100 per cent correlation with gallbladder disease. We suggest that this is the investigation of choice for the surgeon contemplating early cholecystectomy on patients with suspected acute gallbladder disease.

Acute Disease↗
PubMed1978

The use of bulk evacuant in patients with haemorrhoids.

Fifty-three patients with symptomatic haemorrhoids have been studied in a double-blind cross-over trial of a bulk forming agent (ispaghula husk) against a placebo. Although only 11 per cent of patients ocmplained of constipation, a significant benefit in symptoms and improved bowel habit was demonstrated.

Cellulose↗
PubMed1978

Comparison of "early gastric cancer" in Britain and Japan.

Before the introduction of endoscopy, four out of 720 cases of gastric cancer were diagnosed before the cancer had breached the muscularis propia, an incidence of 0.5%. Using endoscopy and endoscopic biopsy, 10 out of 101 cases of gastric cancer were diagnosed at this "early" stage, an incidence of 10%. Their clinical, morphological, and histological characteristics are compared with those of Japanese "early gastric cancers" and reveal a remarkable similarity. The results of this study suggest that a higher proportion of British gastric cancers could be diagnosed at an "early" stage by more intensive investigation of dyspeptic patients using up to date radiological techniques, fibreoptic endoscopy, and endoscopic biopsy.

Adult↗
PubMed1977

Percutaneous cholangiography with the Okuda needle.

Percutaneous cholangiography with the Okuda needle was performed in 42 consecutive patients with a clinical diagnosis of obstructive jaundice. Six had intrahepatic cholestasis. The technique demonstrated the biliary anatomy in 41 patients and the radiological diagnosis was confirmed by laparotomy, necropsy, or liver biopsy. There were no significant complications. Laparotomy, when indicated, was performed earlier in the course of the jaundice and it was avoided in seven patients. Precise knowledge of the site of the obstruction was of great help to the surgeon. We believe that this technique represents an important advance in the management of the jaundiced patient.

Adult↗