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Biomedical subjects

N Walsh

Publications and source records attributed to N Walsh.

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

The use of transdermal scopolamine to control drooling. A case report.

Drooling is a serious social handicap experienced by some neurologically impaired patients. No one method has been identified to control drooling for all patients, however, anticholinergic drugs recently have been utilized. In the case study described, transdermal scopolamine patches were found to be effective for controlling drooling in a traumatic brain-injured patient for whom more conservative methods failed. From a baseline saliva flow rate, saliva flow decreased an average of 30% with one-patch and 59% with two-patch dosing. No significant side effects were observed with treatment, and the decrease in drooling was maintained for a 4-month period. Although transdermal scopolamine may represent one acceptable facet of long-term treatment, it must be stressed that efficacy is variable across patient populations and that treatment approaches must be individualized.

Administration, Cutaneous↗
PubMed1990

Intravenous regional sympatholysis: a double-blind comparison of guanethidine, reserpine, and normal saline.

This double-blind, randomized study was designed to compare the effectiveness of intravenous regional sympatholysis using guanethidine, reserpine and normal saline. Twenty-one patients with reflex sympathetic dystrophy of an upper or lower extremity were enrolled and received intravenous regional blockade (IVRB) with one of the three medications. There was significant pain relief in all three groups at 30 min. There were no significant differences among the three groups in the degree of pain relief, the number of patients obtaining pain relief in the 30 min after the block, or the number of patients reporting more than 50% pain relief for more than 24 hr. The saline group's high rate of pain relief could be partially due to a mechanism of tourniquet-induced analgesia.

Adult↗
PubMed1990

Infundibulocystic basal cell carcinoma: a newly described variant.

A report by Tozawa and Ackerman (Am J Dermatopathol 9(6):474, 1987) upon a distinctive type of basal cell carcinoma with a particular type of follicular differentiation has stimulated lively correspondence in the literature of dermatopathology. The lesion in question presents itself clinically as a basal cell carcinoma on the face and histopathologically as a neoplasm typified by small size, sharp circumscription, and a unique combination of kinds of follicular differentiation, namely, follicular germs and infundibula. The principal point of contention concerning this neoplasm has been whether it is truly a special variant of basal cell carcinoma or whether it is actually a trichoepithelioma. More extensive studies of this singular neoplasm, including its occurrence in patients with nevoid basal cell carcinoma syndrome, and review of the very few portrayals of it in the literature, have consolidated our view that it is indeed a special variant of basal cell carcinoma. We now present (a) new information about an early stage in the evolution of the neoplasm in point, (b) evidence to validate classification of it as a basal cell carcinoma, and (c) a critical appraisal of other lesions that might pose problems in differential diagnosis. Finally, justification is provided for the designation "infundibulocystic basal cell carcinoma."

Aged↗
PubMed1988

Congenital hemihypertrophy associated with posterior interosseous nerve entrapment.

An entrapment of the posterior interosseous nerve (PIN) associated with congenital hemihypertrophy has not been reported previously. A 63-year-old man noted that since birth his right arm had been considerably larger than his left. Fifteen years before our initial examination, however, he first noted weakness of his right wrist and finger extensors without sensory loss. Physical examination revealed atrophy and weakness of the musculature innervated by the PIN distal to the supinator and the first dorsal interosseous (FDI). Sensation was intact throughout the entire right arm. Electromyographic examination demonstrated membrane instability and decreased activation of voluntary motor units in the radial nerve musculature distal to the supinator and in the FDI. Electrophysiologic evidence suggested an anomalous innervation of the FDI by the PIN. Surgical exploration revealed hypertrophy of the brachioradialis, extensor carpi radialis longus and brevis, and supinator muscles, with atrophy of all muscles distal to the supinator. The supinator muscle appeared to be constricting the PIN and was sectioned. Clinical and electrodiagnostic follow-up at six months and again at four years revealed no further deterioration.

Arm↗
PubMed1987

Biliary neoplasia in Gardner's syndrome.

Familial adenomatous polyposis coli is now known to encompass a more complicated spectrum of anomalies than was initially suspected. The term Gardner's syndrome, broadened from its original definition, currently includes all cases of familial polyposis coli with extracolonic neoplasms. Small-bowel adenomata occur in approximately 12% of these patients, and sporadic instances of biliary neoplasia have also been reported. We describe multifocal adenomatous change with severe dysplasia of the gallbladder in a young woman known to have familial adenomatous polyposis coli. Review of this and other such cases in the literature leads us to conclude that neoplasms of the biliary tree constitute a new component of Gardner's syndrome.

Adenoma↗
PubMed1985

The prevalence of binge-eating and bulimia in 1063 college students.

We used a purpose-designed questionnaire to survey the prevalence of binge-eating and bulimia in a sample of 1063 Dublin third-level students aged 17-25 yr. There were 361 males and 701 females. The questionnaire was based on DSM-III, and included a written definition of a binge and cross-check questions. Although 17.7% of males and 37% of females claimed to have had an eating binge, cross-check items reduced this to 1.1% of males and 10.8% of females who met the DSM-III definition. No male and only 7.7% of females also met the behavioural criteria under item B of DSM-III, and only 5% of females reported dysphoric mood. Excluding those experiencing fewer than one episode per week gave a prevalence of 2.8% in females and 0% on males. Previously-reported prevalences using questionnaire may be inflated due to poor respondent understanding of the psychiatric terms being used.

Adult↗
PubMed1983

A comparison of characteristics in the families of patients with anorexia nervosa and normal controls.

The present study compared families of patients with anorexia nervosa with families of non-anorexic adolescent daughters of a similar social class. All anorexics and adolescent comparison girls and their parents were studied using a variety of psychometric measures. Body size estimation and physical anhedonia were also measured. Family characteristics were assessed using the Family Assessment Measure (FAM). Contrary to the hypotheses, no abnormalities were found in terms of parental attitudes to weight control or dieting. The mothers of anorexics displayed no increase in psychopathology on any of the measures. The fathers scored very similarly to controls but with higher degrees of conscientiousness. Neither fathers nor mothers displayed abnormalities of their own body size estimates or body satisfaction. On the FAM the anorexic families reported an increased pathology on several sub-scales. It is not possible to say whether these disturbances are part of the pathogenesis or are sequelae to the illness.

Achievement↗
PubMed1982

Social networks, attachments and support in minor affective disorders: a replication.

Significant deficiencies in personal social networks and social support in non-psychotic psychiatric out-patients have been reported by Henderson ad his colleagues. In a replication study, 50 non-psychotic psychiatric out-patients were compared with 50 matched controls. Patients reported spending less time in social interaction, but more time in unpleasant interaction during the previous week; they also had fewer attachment figures, close relatives and good friends and fewer social contacts than controls. However, the separate analysis of Neurotic and Retarded depressives (using the Present State Examination) failed to replicate all these findings in the Retarded depressives. It is concluded that these associations are confirmed in neurotic patients, but that the more severe depressive disorders require further investigation.

Adolescent↗
PubMedDate not supplied

The use of psychotropic medication in patients referred to a psycho-oncology service.

The purpose of this study was to investigate the use of psychotropic medication in patients referred to a psycho-oncology service. While depressive disorders and psychological difficulties are being increasingly recognised in oncology patients, the use of psychotropic medication has not been frequently studied, nor has it been studied in patients who are subsequently referred for psychiatric assessment. The use of psychotropic medication in all patients referred to a psycho-oncology service over a 6-month period was examined prospectively. Details recorded included class of psychotropic medication used and by whom it was prescribed. Demographic details and clinical diagnoses were also recorded. Sixty-three patients were referred over the initial 6 months of the service and the majority had advanced or metastatic disease (62%). Clinically, 44.5% had some form of major psychiatric disorder, and 40% had an adjustment disorder. Over half (55.5%) were already on psychotropic medication at referral; mainly minor tranquillisers (51%) and antidepressants (24%); 22% were on more than one drug. Of those medications prescribed pre-referral, 46% had been prescribed by the oncology team and 31% were from the GP. Following psychiatric review, further medication was prescribed in 30% of the subjects, leaving a total of 79% on some form of psychotropic drug. While the overall psychotropic prescribing and the use of minor tranquillisers appears to be similar to those found in earlier studies, the high rate of use of antidepressants suggests psychological distress is being increasingly recognised, and pharmacotherapy is a commonly used strategy in this group.

Adult↗