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Biomedical subjects

M Marshall

Publications and source records attributed to M Marshall.

At least 19 recordsLinked to original sources
PubMed1992

What happens to homeless mentally ill people? Follow up of residents of Oxford hostels for the homeless.

OBJECTIVES: To follow up severely mentally ill residents of hostels for the homeless to determine their social and psychiatric outcome. DESIGN: Follow up at 18 months of hostel residents previously assessed with psychiatric and behavioural measures. SETTING: Two Oxford hostels for the homeless. SUBJECTS: 48 hostel residents previously identified as disabled by mental illness. MAIN OUTCOME MEASURES: Current housing, admissions to psychiatric hospital, violent or antisocial behaviour, and score on standardised behavioural rating. RESULTS: 45 of the 48 residents were traced. 27 had remained in the hostels; only 10 had been rehoused, mainly in bedsits or with their families. 16 had a poor outcome as judged by death (four subjects), lengthy hospital readmission (two), marked deterioration in behaviour (six), sleeping rough (one), or disappearance (three). CONCLUSION: More effort is needed to provide suitable housing for homeless mentally ill people.

Adult↗
PubMed1992

Pneumocystis carinii infection in the middle ear.

Pneumocystis carinii is the opportunistic pathogen frequently causing pneumonitis in the acquired immunodeficiency syndrome. Extrapulmonic manifestation of P carinii is unusual and is commonly associated with severe systemic illness, other immune deficiency status, malignancy, or immune suppression. We describe a case of acquired immunodeficiency syndrome with manifestations of P carinii otitis media with severe otalgia and conductive hearing loss.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Can we measure need in the homeless mentally ill? Using the MRC Needs for Care Assessment in hostels for the homeless.

Hostels for the homeless contain many who are disabled by chronic mental illness but have little access to rehabilitation services. One approach to solving this problem might be to measure the needs of hostel residents in a standardized way and use this information as a basis for planning interventions. This study attempted to use the MRC Needs for Care Assessment Schedule to measure the needs of 46 mentally ill residents of Oxford hostels. It aimed to determine if a standardized assessment could be used in these difficult settings and if the needs it identified could form a useful basis for planning future interventions. Although it was possible to use the schedule, and although the pattern of need identified appeared broadly to reflect conditions in the hostels, it was not felt that the information produced was of sufficient quality to assist in planning services. The authors postulate that underlying this deficiency is the failure of the schedule to take sufficient account of the views of staff and residents.

Adaptation, Psychological↗
PubMed1992

A comparison of psychosocial functioning and personality in amputee and chronic pain populations.

OBJECTIVE: To compare two populations with disabling conditions, amputation and chronic pain, in terms of psychosocial functioning and personality factors. We hypothesized that the degree of disability of amputees would resemble that of patients with chronic musculoskeletal pain. We also examined the prevalence of personality characteristics stereotypic of chronic pain in the two samples. DESIGN: Survey. SETTING: Outpatients at the pain and amputee clinics of a teaching hospital. PATIENTS: Ninety-four patients (47.7% of the number approached) were selected in consecutive samples taken from records and clinics. MAIN OUTCOME MEASURES: Sickness Impact Profile (SIP) and the Millon Clinical Multiaxial Inventory (MCMI). RESULTS: The two groups did not differ on the SIP total score. Sixteen of 47 amputees reported significant pain, and this group showed higher levels of overall disability than did patients with chronic musculoskeletal pain (n = 47) and significantly greater disability than the 31 amputees reporting low levels of pain. Contrary to common perceptions of chronic pain patients, 25% showed no significant evidence of psychopathology. Only anxiety and dysthymia levels were clinically elevated in more than 50% of chronic pain patients. CONCLUSIONS: Results are discussed in terms of the dual disability of amputees with chronic pain and of the hazards of attributing common characteristics to heterogenous patient groups.

Adult↗
PubMed1992

Glucose repression of pigment production in atypical isolates of Aeromonas salmonicida responsible for goldfish ulcer disease.

The effect of glucose and other carbohydrates on the pigmentation of three atypical isolates of Aeromonas salmonicida indicated that the addition of D-glucose at a concentration of 0.1% (w/v) or more, inhibited pigment production and caused a reduction in the size of colonies. The addition of cAMP reversed the inhibitory effects of D-glucose on pigment production.

Aeromonas↗
PubMed1992

Intensive follow-up does not decrease the risk of repeat suicide attempts.

We carried out a randomized controlled trial to determine whether an intensive intervention after a suicide attempt could decrease by half the risk of a repeat attempt in the following two years. After initial assessment and randomization, experimental subjects attended 18 therapy appointments over one year, including one home visit, and measures to improve attendance. Control subjects received the usual care. Of 63 experimental subjects, 35% made a repeat attempt, and so did 30% of 63 control subjects. The study had a 99% power to detect the desired decrease of risk (30% to 15%). Clearly, the intervention did not achieve its objective.

Adult↗
PubMed1991

Resolution of a low molecular weight G protein in neutrophil cytosol required for NADPH oxidase activation and reconstitution by recombinant Krev-1 protein.

Activation of the membrane-associated NADPH oxidase in intact human neutrophils requires a receptor-associated heterotrimeric GTP-binding protein that is sensitive to pertussis toxin. Activation of this NADPH oxidase by arachidonate in a cell-free system requires an additional downstream pertussis toxin-insensitive G protein (Gabig, T. G., English, D., Akard, L. P., and Schell, M. J. (1987) (J. Biol. Chem. 262, 1685-1690) that is located in the cytosolic fraction of unstimulated cells (Gabig, T. G., Eklund, E. A., Potter, G. B., and Dykes, J. R. (1990) J. Immunol. 145, 945-951). In the present study, immunodepletion of G proteins from the cytosolic fraction of unstimulated neutrophils resulted in a loss of the ability to activate NADPH oxidase in the membrane fraction. The activity in immunodepleted cytosol was fully reconstituted by a partially purified fraction from neutrophil cytosol that contained a 21-kDa GTP-binding protein. Purified human recombinant Krev-1 p21 also completely reconstituted immunodepleted cytosol whereas recombinant human H-ras p21 or yeast RAS GTP-binding proteins had no reconstitutive activity. Rabbit antisera raised against a synthetic peptide corresponding to the effector region of Krev-1 (amino acids 31-43) completely inhibited cell-free NADPH oxidase activation, and this inhibition was blocked by the synthetic 31-43 peptide. An inhibitory monoclonal antibody specific for ras p21 amino acids 60-77 (Y13-259) had no effect on cell-free NADPH oxidase activation. Activation of the NADPH oxidase in intact neutrophils by stimulation with phorbol myristate acetate caused a marked increase in the amount of membrane-associated antigen recognized by 151 antiserum on Western blot. Thus a G protein in the cytosol of unstimulated neutrophils antigenically and functionally related to Krev-1 may be the downstream effector G protein for NADPH oxidase activation. This system represents a unique model to study molecular interactions of a ras-like G protein.

Cell-Free System↗
PubMed1991

The GTPase stimulatory activities of the neurofibromatosis type 1 and the yeast IRA2 proteins are inhibited by arachidonic acid.

Three proteins, GTPase activating protein (GAP), neurofibromatosis 1 (NF1) and the yeast inhibitory regulator of the RAS-cAMP pathway (IRA2), have the ability to stimulate the GTPase activity of Ras proteins from higher animals or yeast. Previous studies indicate that certain lipids are able to inhibit this activity associated with the mammalian GAP protein. Inhibition of GAP would be expected to biologically activate Ras protein. In these studies arachidonic acid is shown also to inhibit the activity of the catalytic fragments of the other two proteins, mammalian NF1 and the yeast IRA2 proteins. In addition, phosphatidic acid (containing arachidonic and stearic acid) was inhibitory for the catalytic fragment of NF1 protein, but did not inhibit the catalytic fragments of GAP or IRA2 proteins. These observations emphasize the biochemical similarity of these proteins and provide support for the suggestion that lipids might play an important role in their biological control, and therefore also in the control of Ras activity and cellular proliferation.

Arachidonic Acid↗
PubMed1991

The second fatal impact: cigarette smoking, chronic disease, and the epidemiological transition in Oceania.

The island countries of Oceania are now experiencing the epidemiological transition which has shifted patterns of morbidity and mortality from primarily infectious to mainly noncommunicable diseases. Prominent among these are many ailments known to be linked to or caused by tobacco smoking--especially to smoking of flue-cured, commercially made cigarettes. Cigarette manufacture by major tobacco transnational corporations began in the Pacific during the mid-1950s and production has grown rapidly since then. Cigarettes have been marketed aggressively, with a result that they have increasingly replaced the smoking of home-grown and twist tobacco. The history of tobacco production and marketing is sketched, and the literature on chronic diseases related to smoking is summarized for the Pacific region. The rise of anti-smoking movements in Oceania is then discussed, with particular attention to the PNG case during the 1980s.

Advertising↗
PubMed1991

[Terminology of ultrasound vascular diagnosis].

There is at present no accepted nomenclature regarding diagnostic vascular ultrasound. At two scientific meetings, the Study Group for Vascular Diagnosis of the German Society of Ultrasound in Medicine (DEGUM) developed a terminology for Doppler and duplex sonography of the arteries and veins supplying the brain and of peripheral vessels. The most important of these sonographic terms and their synonyms are presented. Recommendations as to which of the presently employed terms should be avoided, are given.

Blood Flow Velocity↗
PubMed1990

[Iloprost in the treatment of ischemic tissue lesions in diabetics. Results of a placebo-controlled multicenter study with a stable prostacyclin derivative].

The efficacy of iloprost, a stable prostacyclin analog, was investigated in a placebo-controlled trial in 109 diabetics with ischemic lesions. 56 patients were randomly allocated to iloprost and 53 patients to placebo. Iloprost was intravenously applied for 6 hours daily on 28 consecutive days at an individually tolerated dose up to 2 ng/kg/min. The control group received identical solvent volumes. In addition all patients had an intensive basic, mainly local, therapy. At the end of the treatment in the iloprost group 31 of 50 patients (62%) showed partial (greater than 30%) or total healing of the lesion(s). In the placebo group this was the case in 12 of 51 patients (22.5%). The difference of 38.5% was statistically significant (p less than 0.05, chi 2-test, alpha = 0.05, beta = 0.1). The percentage of patients who were free of pain increased from 23% to 42% (+19%) in the iloprost group and from 38% to 48% (+10%) in the placebo group. After dose-titration iloprost was well tolerated. Flush, headache and abdominal complaints were the most frequent side effects. Heart rate and blood pressure were not influenced and the control of diabetes was not altered.

Adult↗
PubMed1990

"Problem deflation" and the ethnographic record: interpretation and introspection in anthropological studies of alcohol.

A controversy that has continued over the past 5 years concerning whether ethnographic studies of alcohol systematically "deflate" alcohol-related problems is discussed and critiqued. This debate harbors some fundamentally significant matters that have important implications for the future of alcohol and culture studies. These matters concern the epistemological basis of ethnography, and the reliability of ethnographic research methods. Drawing upon data from Truk, Federated States of Micronesia, these issues are explored in detail. It is suggested that the presence or absence of "alcohol problems" in ethnographic accounts is largely a result of particular interpretations made at specific historical moments in the changing, open-ended systems that anthropologists study. It is concluded that by alerting us to likely biases in the ethnographic record, Room has performed a signal service to the anthropology of alcohol.

Alcohol Drinking↗
PubMed1990

[Terminology of ultrasonic vascular diagnosis].

There is at present no accepted nomenclature regarding diagnostic vascular ultrasound. At two scientific meetings, the Study Group for Vascular Diagnosis of the German Society of Ultrasound in Medicine (DEGUM) developed a terminology for Doppler and duplex sonography of the arteries and veins supplying the brain and of peripheral vessels. The most important of these sonographic terms and their synonyms are presented. Recommendations as to which of the presently employed terms should be avoided, are given.

Brain↗
PubMed1990

Studies of aerosol distributions in a small laboratory containing a heated phantom.

In order to provide information to assist in the design and planning of workplace air-sampling facilities, we have studied the variations in time and space of aerosol concentrations in a small room containing a glove-box and a heated phantom. Aerosol concentrations are reduced by factors of 10(2)-10(3) between the source and the phantom and walls of the room. Time-series plots of concentration show large departures from mean concentrations and fluctuations measured at the mouth and chest of the phantom are frequently uncorrelated. Both the average concentration around the phantom and the fluctuations in concentration tend to increase when the phantom is heated.

Aerosols↗
PubMed1990

Combining insights from epidemiological and ethnographic data to investigate substance use in Truk, Federated States of Micronesia.

There has been a recent concern in medical anthropology to combine quantitative epidemiological survey methods with qualitative ethnographic fieldwork methods as a means for drawing on the strengths of both approaches. This article shows the advantages of doing this by examining data on substance use and abuse from Truk, Federated States of Micronesia. Ethnographic research in 1976 based solely on qualitative methods is compared with a second study by the same investigator on the same island 9 years later that combined ethnographic fieldwork with an epidemiological general population survey of substance use by 1000 adults. The survey data were found to support many of the ethnographic conclusions, provide some new information not revealed by use of the qualitative methods and call into question a few interpretations of Trukese drinking based on qualitative data alone. This buttresses the argument that these methods are complementary, provide a cross-check on one another and yield more information when used together than either does by itself.

Adolescent↗
PubMed1989

Collected and neglected: are Oxford hostels for the homeless filling up with disabled psychiatric patients?

OBJECTIVE: To assess the severity of psychiatric symptoms among residents of hostels for homeless people. DESIGN: Survey of residents in two hostels in Oxford, comprising three weeks of background fieldwork, a demographic questionnaire, and rating behaviour over two weeks with a behavioural rating scale (REHAB) and mental state with the brief psychiatric rating scale. SETTING: Two hostels for homeless people in Oxford. SUBJECTS: 146 Medium to long term residents, of whom 48 were selected by hostel workers by the following criteria: continuous residence for at least two months, signs of persistent severe mental disability, and difficulty in coping independently in the community. Two subjects died during the study; three (previously long term psychiatric inpatients) declined to be assessed on the psychiatric scale. MAIN OUTCOME MEASURE: Behavioural disturbance and mental state. RESULTS: Only a third of the total sample had been born in Oxfordshire. Subjects had been accepted into the hostel either by arrangement with the local psychiatric service (22) or straight off the streets (26); 43 had had a previous (non-drug related) psychiatric admission. Subjects were significantly more likely than other residents to have spent longer (greater than 80 weeks) in a hostel in the past three years (p less than 0.02). With reference to norms for deviant behaviour, the 46 subjects assessed showed considerable deviant behaviour (average weekly scores: 0 (11 subjects), 1 (14), 2-3 (16), and greater than or equal to 4 (5] not significantly different from that expected in moderately to severely handicapped psychiatric inpatients (chi 2 = 1.3, df = 3, p greater than 0.7); 22 had scores equivalent to those in most severely handicapped inpatients. Of the 43 subjects assessed with the psychiatric rating scale, 16 had symptoms of neurosis, 29 of florid psychosis, and 32 of a deficit state. Symptoms of deficit state were positively correlated with ratings of low social activity on the behavioural scale (Spearman's rank correlation coefficient 0.30, p = 0.03). CONCLUSIONS: Hostels are having to care for long term severely affected psychiatric patients discharged into the community. The suitability of the services offered to such subjects should be assessed.

Deinstitutionalization↗
PubMed1989

[Iloprost, a stable prostacyclin derivative, in stage 4 arterial occlusive disease. A placebo-controlled multicenter study].

The effectiveness of iloprost, a prostacyclin derivative, was assessed in a placebo-controlled multicentre trial on 101 patients with chronic arterial disease, stage IV. All patients were on a basic local treatment, 53 randomly being assigned to the iloprost group, 48 to the placebo one. Both groups received identical saline infusions, one with the other without iloprost. Infusions were given on 28 consecutive days, iloprost being added at a dose of up to 2 ng/kg.min over six hours. At the end of the treatment period, 32 of 52 patients (61.5%) of the iloprost group and eight of the 47 in the placebo group (17%) had partial or complete healing of ulcers (P less than 0.05), the treatment effect persisting in both groups for a mean duration of at least one year. Iloprost was well tolerated, once individual dosages had been appropriately adjusted. Facial flushes, headache and nausea were the most common side effects. Heart rate and blood-pressure variations did not differ between the two groups.

Adult↗