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Biomedical subjects

M R Phillips

Publications and source records attributed to M R Phillips.

At least 55 records · Page 3Linked to original sources
PubMed1991

Changes in the positive and negative symptoms of schizophrenic in-patients in China.

Positive and negative symptoms at admission and discharge of 401 unselected schizophrenic patients from four psychiatric hospitals around China were studied. On admission 58% of patients had prominent negative symptoms and the overall severity of negative symptoms was similar to that of positive symptoms; at discharge, negative symptoms were more prevalent and more severe. The severity of negative symptoms was not significantly correlated with duration of illness or with dosage of medication; 48% of first-episode, drug-naive patients had prominent negative symptoms on admission. Negative symptoms responded to standard neuroleptic treatment, but the improvement was less marked than that in positive symptoms (47% v. 80%). The proportion of patients classified as positive type, negative type, and mixed type schizophrenia altered dramatically with treatment. These findings highlight the importance of negative symptoms in the assessment and treatment of both acute and chronic schizophrenia.

Adolescent↗
PubMed1990

Witch doctors and mental illness in mainland China: a preliminary study.

This study, the first report on witch doctors in the People's Republic of China, found that most witch doctors are poorly educated peasants who perform healing rituals as a part-time occupation. Despite being officially illegal, folk healing practices are flourishing in the countryside: 73.9% (N = 286 of 387) of psychiatric outpatients from rural areas and 70.5% (N = 43 of 61) of mentally ill persons identified in a rural community admitted to consulting witch doctors. These findings indicate an urgent need to systematically assess the beneficial and detrimental effects of these practices on China's health care system.

Adolescent↗
PubMed1990

Neuroleptic malignant syndrome in 12 of 9,792 Chinese inpatients exposed to neuroleptics: a prospective study.

In a prospective study of an estimated 9,792 inpatients treated with neuroleptic medication at a large Chinese psychiatric hospital, 12 patients developed neuroleptic malignant syndrome. The estimated prevalence of neuroleptic malignant syndrome in these psychiatric inpatients was 1.23/1,000 (95% confidence interval = 0.63/1,000 to 2.14/1,000). Unlike other investigators, the authors found that young adulthood, nonschizophrenic illness, oral high-potency neuroleptics, and concurrent use of lithium were not important risk factors for neuroleptic malignant syndrome. However, depot fluphenazine decanoate, particularly if used without an antiparkinsonian agent, was a risk factor.

Adult↗
PubMed1989

Intrapleural regional analgesia for pain management in cholecystectomy.

Fifty patients undergoing cholecystectomy either electively or urgently were treated in the postoperative period with the intrapleural injection of 30 mL of 0.75% bupivacaine hydrochloride with epinephrine (1:200,000). The frequency of narcotic administration and the postoperative stay were compared with those of 50 historical controls. The group receiving intrapleural regional analgesia had significant, prolonged pain relief requiring minimal narcotic analgesics in the first 24 hours postoperatively and had a significantly shortened hospital stay. There were no complications related to catheter insertion or bupivacaine toxic effects. This technique is safe and effective in controlling perioperative pain.

Analgesia↗
PubMed1989

Patterns of pesticide usage by cereal crop farmers in Western Australia.

In Western Australia there has been an increase in the use of herbicides in recent years due to a change in farming practices. This change, together with more general public concern over exposure to chemicals, has resulted in farmers expressing concern over the possible long term health effects from exposure to herbicides. As part of a long term study of the possible health effects from such exposure, a survey was carried out to establish the extent of pesticide use within the cereal farming community of Western Australia. Of the 9,408 properties surveyed, 2,921 responses were received which represents a 32.2% response rate. The results indicate that a wide range of chemicals are used as insecticides, fumigants, seed dressings, seed pickles, herbicides, and rodent poisons. At the time of the survey in 1985, products containing prespruf and 1,1,1-trichloro-2,2-bis (p-chlorophenyl)ethane (DDT) were the most popular insecticide, and products containing diquat, diclofop-methyl, chlorsulfuron and glyphosate as active ingredients represented the four most popular herbicides.

Agriculture↗
PubMed1988

Reliability and validity of a Chinese computerized diagnostic instrument.

This paper reports on the development and testing of a new Chinese diagnostic instrument--the Adult Diagnostic Interview Schedule-Present (ADIS-P). This instrument uses a selection of items adapted from DIS and SADS. It is administered within approximately 25 min by a trained clinician using a small portable computer that provides an immediate diagnosis. The instrument was tested on 1,331 patients from six large mental hospitals across the country. The concurrent validity was good: compared to the concensus diagnosis of two senior clinicians (who were blinded to the ADIS-P result), the overall diagnostic accuracy was 83% and the weighted Kappa value was 0.60. The 1 month test-retest reliability was satisfactory (weighted Kappa = 0.55). We conclude that ADIS-P is a convenient, reliable and valid diagnostic instrument.

Adult↗
PubMed1988

Psychiatry and the criminal justice system: testing the myths.

Several states are changing legislation and treatment programs for mentally ill offenders without knowing how current laws and programs operate. To address this problem the authors linked data from police records, court reports, and clinical files for 2,735 psychiatric referrals from the criminal justice system of Alaska from 1977 through 1981. They found that only 0.2%-2.0% of all schizophrenic persons in the community were arrested for violent crimes each year, accounting for 1.1%-2.3% of all arrests for violent crimes; that psychiatrists agreed about competency and responsibility in 79% of the cases evaluated by more than one clinician; and that a successful insanity defense occurred in 0.1% or less of all criminal cases.

Adolescent↗
PubMed1986

The interaction of mental illness, criminal behavior and culture: native Alaskan mentally ill criminal offenders.

The rapid changes experienced by non-Western ethnic groups as they become "acculturated" to Western life-styles are frequently associated with disintegration of the traditional cultures and psychosocial dysfunction of the groups' members. How culture changes lead to maladaptation remains a mystery. As a first step in clarifying this relationship, this paper proposes a method for analyzing the interaction of cultural change and psychosocial maladjustment. It uses Native Alaskans as a paradigmatic example of a group that is undergoing rapid changes and describes in detail a maladjusted subgroup of Native Alaskans--mentally ill criminal offenders. It compares 567 Native Alaskan criminal offenders who were referred to mental health professionals (from 1977 thru 1981) to 939 White Alaskan offenders. We find that alcohol abuse, the dominant social problem for Native Alaskans, is not clearly associated with the degree of sociocultural change. Residence in larger communities and higher educational achievement are associated with greater psychosocial maladjustment. The region of residence (i.e., Native Corporation) has a stronger influence on the rate and type of maladjustment than the ethnic group (i.e., Eskimo, Indian, or Aleut) or the "ethnic density" of the community of residence (i.e., the proportion of Native Alaskans in the population). We emphasize the importance of using such quantitative findings to focus the questions that should be addressed by ethnographic research.

Acculturation↗
PubMed1983

Factitious mourning: painless patienthood.

Of 20 patients who falsely reported the deaths of loved ones in order to assume the patient role, most presented with depression and suicidal ideation secondary to reported multiple dramatic deaths for which there was no available verification, and many had histories of factitious physical symptoms, manipulative suicide attempts, substance abuse, and sociopathy. Diagnostic categories were of limited usefulness for these patients. Factitious symptoms can better be understood as one form of dysfunctional care-eliciting behavior. The authors recommend early and repeated confrontations in a firm but nonjudgmental manner combined with referral to outpatient psychotherapy focused on the underlying characterological problems.

Adolescent↗
PubMed1980

Perforation of the inferior vena cava by the Kim-Ray Greenfield filter.

Perforation of the inferior vena cava has been reported following insertion of the Kim-Ray Greenfield filter. This report describes this complication as a consequence of a preventable technical error. However, the clinical implications of such a malpositioned filter may extend beyond the possible obvious complications of retroperitoneal hemorrhage or paracaval organ injury. Inadequate protection against pulmonary embolism may result. A three-dimensional concept is presented to illustrate the loss of equal "compartmentalization" of the cava.

Humans↗
PubMed1979

Carotid endarterectomy in the presence of contralateral carotid occlusion: the role of EEG and intraluminal shunting.

Patients undergoing carotid endarterectomy in the presence of occlusion of the contralateral carotid artery appear at greater risk for operative-related stroke or death. We had experience with 37 such patients in a five-year period. Routine intraluminal shunting without EEG monitoring was used in nine patients. Twenty-eight patients had continuous EEG monitoring during surgery. Of this group, 12 patients required intraluminal shunting based on intraoperative EEG criteria. In the early postoperative period, there was one death, and there were no instances of new, fixed neurological deficits. Life table analysis shows that 80% of the patients are neurologically stable in the five-year follow-up period. Electroencephalographic monitoring proved valuable in the detection of patients requiring intraluminal shunting, in the occasional recognition of poorly functioning shunts, and in the determination of the importance of alterations in blood pressure or cardiac rhythm on cerebral blood flow.

Arterial Occlusive Diseases↗