Biomedical subjects
K Wood
Publications and source records attributed to K Wood.
Resource management in action on the ward.
The implementation of resource management at the Radcliffe Infirmary made clinical managers responsible for their ward budgets. This article describes how a nursing system was developed to facilitate the planning and management of resources at ward level.
Oncology. Protective isolation.
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Abnormal eating attitudes in London schoolgirls--a prospective epidemiological study: factors associated with abnormal response on screening questionnaires.
One thousand and ten unselected London state schoolgirls were screened by questionnaire to identify an 'at risk' cohort displaying abnormal eating attitudes and two control cohorts, one with probable general psychiatric morbidity, one without. Members of all cohorts were assessed at interview for the presence of eating disorder and for putative risk factors implicated in the development of anorexia nervosa. A prevalence rate of 0.99% was detected for clinical eating disorder and 1.78% for the partial syndrome of eating disorder. Factors specifically associated with abnormal eating attitudes were identified, in particular, current or past overweight, history of amenorrhoea and perceived stress in school and social life. Some commonly accepted risk factors for eating disorders were discovered to be associations with general psychiatric morbidity. These were perceived parental pressure to eat more, taking exercise to lose weight, perceived stress at home and reporting a family history of anxiety or depression. Other well reported putative risk factors for eating disorder, including social class, birth order, age at menarche, obsessional personality and weight related career choice were not associated specifically with abnormal eating attitudes in schoolgirls. These findings represent cross-sectional data at entry into a prospective epidemiological study.
Benign hereditary chorea. A case report.
A case of benign hereditary chorea is reported, along with a brief review of the condition. It is a rare and little known autosomal dominant disorder which may be confused with Huntington's chorea, which has a more serious prognosis. The case described shows some characteristic features. It is difficult to decide how many of the patient's psychiatric difficulties are a reaction to his disabilities and how many have an organic substrate.
Regulation of tyrosine hydroxylase gene expression during differentiation of neuroblastoma cells.
Differentiation of N1E-115 neuroblastoma cells into neuron-like cells, with extension of neurites and acquisition of excitable membranes, can be induced by dimethyl sulfoxide (DMSO). We have found this differentiation to be accompanied by an increase in tyrosine hydroxylase (TH) mRNA, an increase disproportionate to changes in mRNAs for other measured, non-neuron-specific genes. The mRNA increases slowly over several days and falls gradually after removal of DMSO. Nuclear run-on studies suggest that a change in the rate of transcription cannot explain the increase in steady-state mRNA levels. TH mRNA half-life does, however, increase. This suggests that regulation is exerted in this case not at the level of transcription but rather at that of mRNA stability.
Inherited haemoglobin variants in a South African population.
We present the findings of a survey to determine the prevalence of inherited haemoglobin disorders in the Coloured (mixed ethnic origin) population of South Africa. A variety of haemoglobins was found. Of the structural variants, Hb E and Hb S were the most common, the former probably originating from South-East Asia and the latter from East Africa and possibly Madagascar. The alpha+ (-alpha) thalassaemia haplotype is particularly common with an observed frequency of 0.023. Beta thalassaemia was rather less common, while hereditary persistence of fetal haemoglobin was found for the first time in this population group, occurring in two subjects.
Depressive disorder in primary care.
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Physical illness. A risk factor in anorexia nervosa.
Reports have appeared in the literature suggesting an association between physical illness and the later development of anorexia nervosa. The histories of 326 patients with anorexia nervosa were examined for physical illness. A higher rate of severe physical illness was found in this group when compared with controls suggesting that it should be regarded as a risk factor for anorexia nervosa. No statistically significant differences were found when illness was examined by time in relation to onset of anorexia, system involved, or when subjects were stratified by age. Possible explanations for the observed association are discussed.
Platelet alpha-adrenergic receptors in depression: ligand binding and aggregation studies.
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Does the dexamethasone suppression test predict antidepressant treatment success?
The 1 mg dexamethasone suppression test (DST) was carried out in patients with a major depressive illness in order to establish whether the results of this test, given before antidepressant or ECT treatment, could predict eventual therapeutic outcome. No significant difference could be detected in overall therapeutic improvement between those patients with a normal or abnormal DST response respectively, based on the 50 ng/ml cortisol cut-off point. However, using 100 ng/ml as a cut-off point it was found that patients with an abnormal DST response (i.e. a post-DST plasma cortisol concentration greater than or equal to 100 ng/ml) responded significantly better than those who had a normal DST response. These observations were statistically significant for those patients receiving antidepressants and in the combined treatment groups of those patients receiving either antidepressants or ECT.
Plasma immunoglobulins in depressed and lithium-treated patients.
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Institutional care of the elderly: a comparison of the cities of New York, London and Mannheim.
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Platelet accumulation of histamine in controls, depressed and lithium-treated patients.
The accumulation of histamine into blood platelets of depressed patients, lithium-treated patients and controls was determined using radio-labelled histamine. All groups had significantly different mean accumulation rates: the depressives had the lowest, the controls had the highest while the lithium-treated patients had intermediate rates. No significant difference in histamine accumulation rates was detected between drug-free depressed patients or depressed patients receiving psychotropic medication apart from lithium. Histamine accumulation rates of depressed patients did not appear to have been influenced by their age or severity or endogenicity of their illness; no difference in histamine accumulation was detected between those patients who had an abnormal or normal dexamethasone suppression test response. We have concluded that while the biological significance of these results is unclear it would appear to be a very sensitive test for depression, especially in women. It would appear that prophylactic lithium treatment increased the rate of histamine accumulation: this result is discussed with reference to histamine's association with allergic disorders.
Peripheral serotonergic receptor sensitivity in depressive illness.
Platelet aggregation induced by 5-HT was used as a measure of the functional responsiveness of peripheral 5-HT receptors in controls and drug-free depressed patients. No significantly different aggregatory response (5-HT/ADP ratio) was noted between the controls and drug-free depressed patients. If the receptor mediating this response is a 5-HT2 receptor, there is no overwhelming evidence to suggest that the functional activity of this system is abnormal during a depressive illness. The results are discussed with reference to reported abnormalities of 5-HT2 receptors during a depressive illness and to their change during antidepressant treatment.
Haemoglobin E variants: a clinical, haematological and biosynthetic study of 4 South African families.
The clinical, haematological and biosynthetic features of subjects with Hb E variants are described. An association with red cell hypochromia and microcytosis was confirmed, although this was not invariable in Hb E trait. Imbalanced globin chain synthesis was found in the majority of Hb E carriers. A patient doubly heterozygous for Hb E and Hb S, a condition we have not previously seen reported, had a benign clinical course with minor haematological changes, despite a relatively large amount of Hb S (67%).
The role of diagnosis in a psychiatric emergency setting.
A sample of 253 psychiatric emergency patients consecutively evaluated in a general hospital was studied to determine the role of psychiatric diagnosis in disposition decisions and the possible influences of patient and staff variables on diagnoses. Except for patients with organic brain syndrome, age and sex were not significantly associated with diagnostic grouping; some racial differences were found. Diagnosis was strongly associated with disposition decisions: schizophrenic and manic patients were more frequently hospitalized, while patients with substance abuse disorders, adjustment and neurotic disorders were more often referred to outpatient treatment. The authors stress the importance of a reliable diagnostic system and the recruitment of diagnosis-oriented staff in improving the quality of psychiatric emergency care.