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Biomedical subjects

N Brooks

Publications and source records attributed to N Brooks.

At least 19 recordsLinked to original sources
PubMed1992

Psychosocial assessment after traumatic brain injury.

Psychosocial outcome has been difficult to define, but nevertheless widely reported. More recent studies have demonstrated not only that the long term emotional costs of head injury are enormous for survivor and family members, but the functional consequences in terms of changes in family life, recreational and vocational activities, are great and prolonged. These consequences have more recently become the focus of rehabilitation, with studies demonstrating dramatic improvements in many aspects of productive living, and consequent lifetime cost savings of an enormous amount. The psychosocial deficits matter, they can be the focus of treatment, and the treatment can be successful and cost effective.

Activities of Daily Living↗
PubMed1991

Adolescent health behaviour and similarity-attraction: friends share smoking habits (really), but much else besides.

Smoking habits and related attitudes were assessed in a sample of 4059 11- to 16-year-olds who also identified their best friends from among their fellow respondents. Subjects' responses were directly collated with those of their friends and indicated a clear covariation of smoking status (controlling for sex and age) as anticipated from previous research in which adolescents have been asked to report on the smoking habits of their friends. Such covariation, however, was not specific to smoking habits, but generalized to related measures of attitude and normative beliefs, alcohol use, health locus of control, school performance, spending habits and socio-economic status. Similarities on these other attributes were much the same, whether or not friends shared each others' smoking habits. It is concluded that these data argue against a simplistic view of unidirectional 'peer group influence' and invite an interpretation of friendship choice based on multiple dimensions of similarity.

Adolescent↗
PubMed1990

The effects of muscle tension on cerebral circulation in blood-phobic and non-phobic subjects.

This study aimed to assess whether (1) a muscle tensing procedure which has been found to be useful in the treatment of blood-phobic patients produces an increase in heart rate and cerebral blood flow and (2) whether this increase is greater than that produced by mental effort alone. Subjects were 17 volunteers with a history of fainting in response to blood-injury stimuli, (12 were phobic) and 8 volunteers with no fainting history. They were required to (a) rest, (b) do mental arithmetic, and (c) repeatedly tense and release their arm and leg muscles. It was found that Ss, heart rate and cerebral blood flow velocity were significantly greater during the muscle tensing procedure than during mental arithmetic or resting conditions. The increased cerebral blood flow produced by muscle tensing may enable blood phobic patients to prevent fainting during exposure treatment.

Adolescent↗
PubMed1990

New chronic schizophrenic patients: a comparison of daypatients and inpatients.

A group of 24 "new chronic" schizophrenic inpatients was compared with a group of 19 daypatients matched for duration of current care; both had spent between 1 and 6 years in continuous inpatient or daypatient care. The groups were compared on a variety of clinical, demographic, and social variables to identify specific variables that might distinguish the new chronic inpatient group. Despite a few nonsignificant trends in the data, the groups were found not to differ significantly on any variables. Both groups had long psychiatric histories with many previous hospital admissions, presented many negative symptoms of schizophrenia at interview, were quite disabled in terms of self-care and speech skills, had a low incidence of behavioural disturbance and had few contacts outside of the hospital. The majority of both groups expressed a clear preference for community care. The results therefore highlight the urgent need for more comprehensive and detailed assessment of patients in relation to decisions about retention in or discharge from inpatient hospital care and also the need to identify objective predictors of the success of such decisions.

Adult↗
PubMed1988

Personality change after severe head injury.

Personality change is widely reported after head injury, but rarely investigated quantitatively. This Paper summarises recent quantitative studies concerned with the natural history of personality change after severe head injury; its nature; its prediction; and its consequences. Reports of personality change increase with increasing time after injury, and the changes reflect a variety of phenomena including changes in affect, behaviour, maturity, and responsibility. Although there is a relationship between injury severity and personality change, other features such as premorbid personality and lifestyle are important. A severe personality change has important functional consequences. Families become heavily burdened, and patients with severe personality change are very unlikely to return to work.

Brain Damage, Chronic↗
PubMed1988

Behavioural abnormalities in head injured patients.

This paper reviews the psychological deficits found after head injury. The deficits are very broadly of two types involving cognitive and behaviour disturbances. The main features of the two types of disturbances are described; and the natural history, prediction, functional impact, and rehabilitation of the disturbances are reviewed. Key features of good clinical evaluation of patients are identified.

Behavior↗
PubMed1987

Clinical neurological examination, neuropsychology, electroencephalography and computed tomographic head scanning in active amateur boxers.

Twenty active amateur boxers were studied seeking evidence of neurological dysfunction and, if present, the best method for detecting it. Seven of these boxers had an abnormal clinical neurological examination, eight an abnormal EEG and nine of 15 examined had abnormal neuropsychometry. The CT scan was abnormal in only one. An abnormal clinical examination correlated significantly (p less than 0.05) with an increasing number of fights, and an abnormal EEG with decreasing age (p less than 0.05). In several of the neuropsychometric tests, the boxers were significantly worse than controls (p less than 0.05). Neuropsychometry was the best method for detecting neurological dysfunction.

Adolescent↗
PubMed1987

A neuropsychological study of active amateur boxers.

Neuropsychological examinations were carried out on 29 amateur boxers and 19 controls matched for age, ethnicity, and education. There was no evidence of significantly impaired performance in the boxers. Within the boxing group, a variety of features of boxing history were examined as possible predictors of cognitive performance (such as number of knockouts, duration of boxing). No feature was a significant predictor of lower cognitive performance.

Adolescent↗
PubMed1986

Infection of cardiac mural thrombus associated with left ventricular aneurysm.

Infection is a rare complication of cardiac mural thrombus and may prove difficult to diagnose and treat. We describe a patient with infected thrombus associated with a left ventricular aneurysm, involving Salmonella typhimurium. Cross-sectional echocardiography proved helpful in establishing the diagnosis.

Echocardiography↗
PubMed1986

Dissecting aneurysm of the thoracic aorta presenting as right atrial obstruction.

A patient with a dissecting thoracic aortic aneurysm presented with acute low output cardiac failure due to right atrial obstruction. Five years earlier she had had her aortic valve replaced because of aortic regurgitation. Obstruction of the superior vena cava and pulmonary artery has been reported elsewhere as a complication of compression by thoracic aortic dissecting aneurysm. This case was unusual in presenting as right atrial obstruction.

Aortic Dissection↗
PubMed1986

Exercise capacity and spontaneous heart rhythm after transvenous fulguration of atrioventricular conduction.

Twenty nine patients who had had refractory supraventricular tachycardia were studied 4-36 (mean 16) months after transvenous fulguration of the atrioventricular junction. Twenty two had complete atrioventricular block, five partial atrioventricular block, and two had atrioventricular conduction via an accessory atrioventricular pathway. Though all patients were free of palpitation after the procedure, exertional dyspnoea had developed in 13 and in two patients pre-existing dyspnoea had worsened. During ventricular demand pacing, exercise time was reduced to 43% of the predicted value for their age and sex. The 16 patients with rate responsive pacemakers demonstrated a significantly better but still impaired exercise capacity during "physiological" pacing as compared with their performance during constant rate pacing. In patients with complete atrioventricular block there was an increase in spontaneous ventricular rate during exercise in seven patients and in response to the Valsalva manoeuvre in eight patients. This suggests that the intrinsic ventricular pacemaker is influenced by autonomic nervous system activity in some patients. It is concluded that though transvenous fulguration is successful in controlling tachycardia it may reduce exercise capacity. Most patients remain in complete atrioventricular block after the procedure and, in contrast with the practice as described in early reports, would benefit from "physiological" pacing--though even with this mode exercise capacity is likely to be abnormal.

Adult↗
PubMed1986

The five year outcome of severe blunt head injury: a relative's view.

A close relative of each of 42 severely head injured patients was interviewed at 5 years after injury, following initial study at 3, 6, and 12 months. Persisting severe deficits, in some cases worse than at 1 year, were primarily psychological and behavioural, although minor physical deficits, for example in vision, were also common. Relatives were under great strain; significantly more so than at 1 year. The best predictor of strain in the relative was the magnitude of behavioural and personality change in the patient.

Adolescent↗
PubMed1985

Randomised placebo controlled trial of aspirin and dipyridamole in the prevention of coronary vein graft occlusion.

Treatment with the combination of aspirin and dipyridamole is believed to reduce the incidence of coronary vein graft occlusion. A double blind randomised controlled trial was carried out in which aspirin 990 mg and dipyridamole 225 mg daily or placebo were added to the routine postoperative management (warfarin for three months) of 320 patients undergoing coronary bypass grafting. The trial treatment was given for 12 months, after which the results were assessed by coronary and graft angiography. The two randomised groups, each of 160 patients, were comparable in age, sex, symptomatic state, angiographic findings, and operative procedure. Repeat coronary arteriography was carried out on 266 patients, 133 in each group. All grafts and distal anastomoses were patent in 68% (91/133) of the placebo patients and in 75% (100/133) of those receiving active treatment. Overall graft patency was 87% (306/352) and 89% (342/385) respectively. Retrospective subgroup analysis showed patency rates of 72% (26/36) and 78% (39/50) of grafts to vessels requiring preliminary endarterectomy, and 80% (36/45) and 91% (40/44) of distal anastomoses to vessels measured at operation to have a diameter of less than or equal to 1 mm. None of these differences was significant at the 5% level. Thus in this group of patients with high graft patency rates, treatment with aspirin and dipyridamole conferred no appreciable advantage.

Adult↗
PubMed1985

Myocardial infarction with normal coronary arteries and factor XII deficiency.

A 17 year old girl had a myocardial infarction. Three days later coronary angiography showed an occlusive thrombus in the circumflex and anterior descending arteries. The coronary arteries themselves appeared to be normal, and this was confirmed at repeat angiography three months later. Tests of haemostasis showed a deficiency of factor XII.

Adolescent↗
PubMed1985

Reoperation for angina after previous aortocoronary bypass surgery.

A retrospective study was carried out of the outcome of 102 patients who underwent a second operation for myocardial revascularisation, necessitated by persistence or recurrence of intractable angina after their first coronary bypass procedures. Operative mortality was 2%. During follow up of the survivors (mean interval 36.4 months) five died, two after further operation, and five underwent further surgery. Sixty eight patients reported an improvement in their symptoms, 57 of whom claimed to have little or no angina. Less favourable results were recorded for those patients reviewed with longer follow up. No useful indicators of prognosis were identified. The problem of angina in patients who have already received bypass grafts is likely to increase as more revascularisation surgery is performed. Reoperation offers a reasonable prospect of helping some of these patients, but not all will be suitable. Their long term prognosis remains uncertain.

Adult↗
PubMed1985

Bypass grafting to the right coronary artery with and without endarterectomy: patency at one year.

Between January 1979 and December 1981, 142 patients undergoing surgery to the right coronary artery agreed to have repeat coronary arteriography one year later. Thirty patients underwent combined endarterectomy and bypass grafting to the right coronary artery. The patency of these grafts was compared with that of grafts in 69 patients undergoing direct grafting to the right coronary artery and in 43 with grafting to the posterior descending coronary artery. There were two hospital deaths and one late death. No patients developed new inferior Q waves on the electrocardiogram. Repeat coronary arteriography at one year showed that 21 (72%) of the 29 grafts were patent after combined endarterectomy and bypass grafting to the right coronary artery. Sixty three (94%) grafts to the right coronary artery and 40 (93%) grafts to the posterior descending coronary artery were patent at one year. Direct grafts to the right coronary artery or its posterior descending branch had a significantly higher patency rate at one year than grafts to the endarterectomised right coronary artery. Graft patency after the combined procedure correlated with the extent of atherosclerosis in the posterior descending coronary artery. It was not influenced by treatment with platelet antagonists. Endarterectomy of the right coronary artery was most successful when it allowed a single graft to perfuse both the large posterior descending and left ventricular branches.

Adult↗