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Biomedical subjects

L Watt

Publications and source records attributed to L Watt.

At least 19 recordsLinked to original sources
PubMed2005

Atypical anti-psychotics in the real world--a naturalistic comparative outcome study.

BACKGROUND: There are few real life independent comparative studies of atypical antipsychotics. We prospectively examined five commonly used atypical antipychotics in the UK, without support from the pharmaceutical industry. METHOD: Prospective naturalistic systematic clinical evaluation. Patients being newly prescribed atypical anti-psychotics over a one year period were assessed by psychiatrists at initiation and after six months treatment using five outcome measures: clinical global impression; positive and negative psychotic symptoms; drug related side effects; and quality of life. RESULTS: 373 patients participated in total. Olanzapine and risperidone produced statistically significant reductions in all ratings at six months. Amisulpride, clozapine, and quetiapine were also studied. There was limited variance between the different drugs, although some sample sizes were small. CONCLUSION: Atypical anti-psychotics were found to be clinically effective, and produced similar outcomes. Routine monitoring of outcomes in psychiatry is feasible.

Adolescent↗
PubMed2004

Faecal egg counts provide a reliable measure of Trichostrongylus tenuis intensities in free-living red grouse Lagopus lagopus scoticus.

The reliability of different egg counting methods for estimating the intensity of Trichostrongylus tenuis infections in red grouse, Lagopus lagopus scoticus, was investigated in the autumn, when grouse may harbour high parasite intensities. Possible limitations to the use of these methods were also examined. Faecal egg counts were found to accurately estimate T. tenuis worm intensities, at least up to an observed maximum of c. 8000 worms. Two egg counting methods (smear and McMaster) gave consistent results, although the exact relationship with worm intensity differed according to the method used. Faecal egg counts significantly decreased with increasing length of sample storage time, but egg counts were reliable for estimating worm intensity for three weeks. The concentration of eggs in the caecum was also found to reliably estimate worm intensity. However, egg counts from frozen gut samples cannot be used to estimate worm intensities. These results conclude that, despite some limitations, faecal and caecum egg counts provide useful and reliable ways of measuring T. tenuis intensities in red grouse.

Animals↗
PubMed2000

The interview with the donor's family before postmortem cornea procurement.

PURPOSE: Asking the family of a deceased patient to consider eye donation is one of the most difficult aspects of the donation process. The aim of this prospective study was to describe the content of interviews with the families of potential donors and to analyze their reactions to improve the process of eye donation. METHODS: We consecutively met with 151 families of suitable corneal donors at the Rouen University Hospital. All interviews with donor families were analyzed using a preestablished questionnaire. RESULTS: In only 17.9% of cases was the family aware of the potential donor's last will. In 77.7% of these cases, the patient wished to donate. Procurement rate was 71.5%. This acceptance was mostly facilitated by the awareness and motivation of the hospital staff, the experience of the physician, and the 13.3-h period of time allowed after the donor's death. The commitment on the part of the ophthalmologist to carry out optimal anatomical restoration was a very important point for 32% of families who accepted donation. Twenty-one percent of families asked for a delay for reflection. This delay helped to obtain a positive response in 72.7% of cases and even sometimes helped families to reconsider a previously negative position (14% of initial refusals). CONCLUSION: We demonstrate that a high positive response (71.5%) can be obtained from the donor's family when a trained and motivated group manages the post-mortem cornea donation request.

Adult↗
PubMed2000

Skin-to-skin contact is analgesic in healthy newborns.

OBJECTIVES: To determine whether skin-to-skin contact between mothers and their newborns will reduce the pain experienced by the infant during heel lance. DESIGN: A prospective, randomized, controlled trial. SETTING: Boston Medical Center, Boston, Massachusetts. PARTICIPANTS: A total of 30 newborn infants were studied. INTERVENTIONS: Infants were assigned randomly to either being held by their mothers in whole body, skin-to-skin contact or to no intervention (swaddled in crib) during a standard heel lance procedure. OUTCOME MEASURES: The effectiveness of the intervention was determined by comparing crying, grimacing, and heart rate differences between contact and control infants during and after blood collection. RESULTS: Crying and grimacing were reduced by 82% and 65%, respectively, from control infant levels during the heel lance procedure. Heart rate also was reduced substantially by contact. CONCLUSION: Skin-to-skin contact is a remarkably potent intervention against the pain experienced during heel stick in newborns.

Blood Specimen Collection↗
PubMed2000

[Limbal autograft transplantation, eight consecutive cases].

BACKGROUND: Limbal autograft transplantation is the procedure of choice in the management of ocular surface disorders secondary to stem cells deficiency. The aim of our study was to investigate the indications, results and limits of this infrequent surgery. METHODS: Limbal autograft transplantation was performed in 8 patients and the mean follow-up period was 11 months. Limbal stem cell deficiency was due to chemical burns in 4 patients, history of prior surgery extending to the limbus in 2 patients, chronic limbitis with dystichiasis in one patient and persistent corneal epithelial defect after keratoplasty in one case. RESULTS: In 6 out of 8 cases, the stability of the ocular surface normalized and comfort significantly improved. Four of these patients had increased visual acuity after surgery. Two patients who presented with severe alkali burn did not respond well to limbal autotransplantation. CONCLUSION: Limbal autograft transplantation is a reliable and effective procedure in limbal stem cells deficiencies. New associate procedures such as amniotic membrane transplantation will however be necessary to improve the prognosis of very severe corneal surface disorders.

Adolescent↗
PubMed1999

Peribulbar anaesthesia during keratoplasty: a prospective study of 100 cases.

AIMS: A prospective study was carried out in order to evaluate the efficacy and safety of peribulbar anaesthesia during keratoplasty and to describe surgical conditions. METHODS: Of 137 consecutive keratoplasties, 100 (73%) were performed under peribulbar anaesthesia. Patients received a mean volume of 16.5 (SD 4) ml (range 9-22 ml) of a mixture of etidocaine, bupivacaine, and hyaluronidase. Ocular compression duration was at least 20 minutes and intraocular pressure (IOP) was measured with a Tonopen after injection, compression, and before trephination. Degree of akinesia, pain scoring, complications, and surgical conditions were studied. RESULTS: Before trephination, IOP was 5.73 mm Hg below the preinjection value and was never above 21 mm Hg. Akinesia was complete in 80% of cases and 94% of patients found that surgery was painless. Two patients (2%) were very agitated during surgery. The last patient presented with an acute intraoperative suprachoroidal haemorrhage that did not result in a true expulsive haemorrhage despite an "open sky" situation. Surgical conditions were judged to be optimal by the patients in 92% of cases and by the surgeon in 98% of cases. CONCLUSION: These results demonstrate that peribulbar anaesthesia offers excellent anaesthesia and akinesia during keratoplasty and may be recommended for this type of surgery.

Adolescent↗
PubMed1996

Cognitive skills associated with estrogen replacement in women with Alzheimer's disease.

To delineate putative cognitive effects of estrogen in women with Alzheimer's disease, we compared neuropsychological performances in three groups of patients with clinically diagnosed Alzheimer's disease: women receiving estrogen replacement therapy (n = 9), women not receiving replacement therapy (n = 27), and men (n = 26). Untreated women and men were matched by age, education, and duration of dementia symptoms to women receiving estrogen replacement. We hypothesized that treated women would have better scores on neuropsychological tasks. Results showed that women receiving hormonal therapy performed significantly better than other women on some, but not all, tasks; on no task did women receiving estrogen score significantly worse. The largest group difference was on the Boston Naming Test, a semantic memory task previously shown to be more impaired in women with Alzheimer's disease than in men with this diagnosis. Of tests considered in a discriminant analysis, the naming task was the only neuropsychological variable to distinguish between the two women's groups. Mean differences between estrogen-treated women and men were small and were not statistically significant. Findings support the hypothesis that estrogen therapy for women with Alzheimer's disease is associated with better cognitive skills and that previously noted gender-associated differences in Alzheimer's disease may reflect a state of acquired estrogen deficiency among women with this disorder.

Aged↗
PubMed1996

Two years of school injuries in a Scottish education sub-division.

Injuries sustained in schools account for 20-30% of all accident and emergency attendances in school age children. Little information has been available on the epidemiology of school accidents in the United Kingdom. Two years of routine school incident reports were analysed from Renfrew Sub-Region, an area with a school roll of 55,521 children attending 135 schools. Schools returned 1,660 report forms in the two year period, of which 1,440 referred to injuries to school children. The peak incidence of injuries was in the 10-12 year age group. The male:female ratio was 1.37:1. Cuts/ laceration and fractures were the commonest diagnoses reported for both Primary and Secondary Schools. Injuries to face and features were commonest in Primary, and upper limb injuries in Secondary Schools. Uncontrolled areas, e.g. playgrounds, stairways and corridors were the most frequent places of occurrence in Primary Schools (Relative Risk 5.24, 95% C.I. 3.28-8.35). Report accuracy was assessed by comparing one year of school reports in a Local Government District to records in the local District General Hospital. This identified 156 children who had attended hospital as the result of a school accident. Schools overestimated the number of fractures by 27%, but where schools had not provided a diagnosis, 15.4% were identified as fractures in hospital records. Each child seen at the hospital received an average of 2.1 X-rays. Nine children underwent manipulations under general anaesthetic. Seventeen children were admitted to hospital, and the group required 103 outpatient follow-up appointments.

Adolescent↗
PubMed1995

Expression of airway secretory epithelial functions by lung carcinoma cells.

We examined 12 non-small cell lung carcinoma cell lines for expression of airway goblet, serous, and mucous cell characteristics. The cells expressed some ultrastructural traits of secretory epithelial cells but none contained secretory granules typical of the airway secretory cells. Using immunocytochemistry and cell-specific monoclonal antibodies, we identified heterogeneous expression of goblet, mucous, and serous cell markers among the cell lines. After metabolic radiolabeling, cells incorporated isotope into high molecular weight material. Incubation of pulse-radiolabeled cells with a number of known mucus secretogogues revealed that 5 of the 12 cell lines released radiolabeled material in response to the agonists. However, in each cell line only one of the receptor-activated pathways tested was intact. Although we did not identify a single cell line expressing a phenotype similar to normal airway secretory cells, particular functions retained by some of these cell lines may make them useful for specific studies of mucus production or secretion.

Bronchi↗
PubMed1989

Protein meal-stimulated pancreatic polypeptide secretion in Prader-Willi syndrome of adults.

Children with Prader-Willi syndrome (PWS) are characterized by obesity, hyperphagia, hypogonadism, and mental retardation with underlying hypothalamic dysfunction and are known to have blunted or absent pancreatic polypeptide (PP) secretion in response to protein meals. In this communication, adults (26 +/- 3 years of age) with PWS were compared with age-matched normal obese and normal weight controls in regards to plasma glucose, insulin, PP, cholecystokinin (CCK), cholesterol, and triglyceride after a high protein meal. Compared with normal weight controls, adults with PWS showed a smaller and delayed rise in plasma insulin, and relatively smaller and delayed PP elevation whereas obese controls revealed hyperglycemia, markedly higher insulin, and moderately higher PP, cholesterol, and triglyceride levels than those with PWS. There was a small increment of CCK levels after a protein meal in all groups of adults. After a protein meal, the molar ratio of PP to CCK doubled in normal weight and PWS groups, and this ratio tripled in the normal obese group, suggesting no reduced PP secretion in PWS in response to CCK stimulation. PP hyposecretion in PWS thus appears to be a part of multiple endocrinopathy associated with hypothalamic dysfunction.

Adult↗
PubMed1989

Repeat self-harm: an 18-month follow-up.

An 18-month follow-up of cases of deliberate self-harm (DSH) revealed that 30% had repeated the act. Of a large number of items recorded at index DSH only one, a past history of self-harm, was associated with repetition. It is suggested that some factors not predictive of longer term repeat DSH may be important in the assessment of risk for immediate further self-harm.

Female↗
PubMed1988

Wegener's granulomatosis and autoantibodies to neutrophil antigens.

We report five cases of Wegener's granulomatosis all of whom had clinical and histological evidence of disease activity at presentation and in whom autoantibodies to neutrophil antigens were detected. This test may prove useful for the diagnosis of this serious condition and help to monitor disease activity during treatment.

Adult↗
PubMed1987

Deliberate self harm--correlates of suicidal intent and severity of depression.

In a study of 98 cases of deliberate self harm, a high correlation was obtained between a diagnosis of Major Depressive Disorder (M.D.D.) and scores on both the Hamilton Rating Scale for depression (HRS) and the Suicide Intent Scale (SIS). There was also a high correlation between HRS and SIS scores. A higher score on HRS and SIS correlated with increasing age, as also did a diagnosis of M.D.D.

Adolescent↗
PubMed1983

Esophageal acid perfusion in coronary artery disease. Induction of myocardial ischemia.

Although coronary artery disease and gastroesophageal reflux disease are common conditions which, therefore, may coexist, it is unknown whether or not the presence of one affects the other. We performed esophageal acid perfusion tests, with concurrent blood pressure, heart rate, and 12-lead electrocardiographic monitoring, in 37 patients, 25 with angiographically documented coronary disease and 12 with normal coronary arteries. Rate-pressure product, an index of myocardial work load, was calculated. In patients with coronary disease who developed chest pain during acid perfusion, rate-pressure product increased from 10.0 +/- 1.0 x 10(3) (mean +/- SEM) basally to 15.2 +/- 1.5 x 10(3) (p less than 0.001), and 3 of 9 patients showed concomitant electrocardiogram evidence of myocardial ischemia. In addition, in coronary disease, 64% of patients with infrequent or absent reflux symptoms by history had positive acid perfusion tests, and 56% of patients with coronary disease who developed pain during esophageal acid perfusion could not distinguish that pain from their usual angina. We conclude that in coronary disease, acid perfusion (and, presumably, gastroesophageal reflux) resulting in chest pain causes rate-pressure product elevation and can induce myocardial ischemia. The presence of esophageal acid sensitivity is not accurately predicted by clinical history in coronary disease, and pain of esophageal origin is often confused with angina.

Angina Pectoris↗