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Biomedical subjects

P Chadwick

Publications and source records attributed to P Chadwick.

At least 37 records · Page 2Linked to original sources
PubMed1995

The omnipotence of voices. II: The Beliefs About Voices Questionnaire (BAVQ).

BACKGROUND: We describe the development and psychometric investigation of the Beliefs About Voices Questionnaire (BAVQ), a self-report measure of how people understand and respond to their voices. The measure is unique in being driven by and gathering data essential to a cognitive formulation of voices. METHOD: Sixty subjects with chronic hallucinatory voices took part. RESULTS: Psychometric properties of the scales were established, including test-retest reliability (mean = 0.89), internal reliability (mean Cronbach's alpha = 0.85), and construct validity using factor analysis and the criterion group method. CONCLUSIONS: The BAVQ was found to be easy to complete and the scale may aid clinical assessment of voices, not least because of the possible value of cognitive therapy as a treatment approach.

Adult↗
PubMed1994

The omnipotence of voices. A cognitive approach to auditory hallucinations.

We offer provisional support for a new cognitive approach to understanding and treating drug-resistant auditory hallucinations in people with a diagnosis of schizophrenia. Study 1 emphasises the relevance of the cognitive model by detailing the behavioural, cognitive and affective responses to persistent voices in 26 patients, demonstrating that highly disparate relationships with voices-fear, reassurance, engagement and resistance-reflect vital differences in beliefs about the voices. All patients viewed their voices as omnipotent and omniscient. However, beliefs about the voice's identity and meaning led to voices being construed as either 'benevolent' or 'malevolent'. Patients provided cogent reasons (evidence) for these beliefs which were not always linked to voice content; indeed in 31% of cases beliefs were incongruous with content, as would be anticipated by a cognitive model. Without fail, voices believed to be malevolent provoked fear and were resisted and those perceived as benevolent were courted. However, in the case of imperative voices, the primary influence on whether commands were obeyed was the severity of the command. Study 2 illustrates how these core beliefs about voices may become a new target for treatment. We describe the application of an adapted version of cognitive therapy (CT) to the treatment of four patients' drug-resistant voices. Where patients were on medication, this was held constant while beliefs about the voices' omnipotence, identity, and purpose were systematically disputed and tested. Large and stable reductions in conviction in these beliefs were reported, and these were associated with reduced distress, increased adaptive behaviour, and unexpectedly, a fall in voice activity. These changes were corroborated by the responsible psychiatrists. Collectively, the cases attest to the promise of CT as a treatment for auditory hallucinations.

Adult↗
PubMed1990

Detection of rhinovirus RNA in nasal epithelial cells by in situ hybridization.

This paper describes the development and evaluation of in situ hybridization (ISH) for the detection of rhinovirus in cells obtained from nasal washings of volunteers infected with human rhinovirus 14 (HRV-14). Twenty-five (66%) and 27 (71%) of 38 volunteers inoculated with HRV-14 had evidence of infection by virus isolation and ISH, respectively, on at least one of 4 days investigated after virus challenge. In contrast, only 14 of 38 (37%) volunteers had significant antibody rises as detected by the neutralization test. Of the 38 volunteers inoculated with HRV-14, only 13 (34%) had symptoms of colds. Of these, 12 (92%) and 10 (77%) were positive by virus isolation or ISH, respectively, on at least one day. Six (46%) had significant antibody rises by neutralization. Similarly, of the 38 volunteers challenged, 22 (58%) were asymptomatic and of these 10 (45.5%) and 12 (54.5%) were positive by virus isolation and ISH, respectively, on at least one day. Only 8 (36.4%) of these asymptomatic volunteers showed significant antibody rises by neutralization. There were significant associations between the detection of rhinoviruses by ISH and virus isolation on the third day (P less than 0.025) after virus challenge in the group as a whole and in the symptomatic group. These results show that generally rhinovirus detection by ISH compares well with virus isolation and both tests are clearly more sensitive than the neutralization test in detecting evidence of infection. It is concluded that ISH is an interesting new technique that may play an important role in the study of rhinovirus infection and pathogenesis.

Adult↗
PubMed1989

Rhinovirus detection using probes from the 5' and 3' end of the genome.

This study investigated the abilities of cDNA probes from the 5' and 3' ends of the genome of human rhinoviruses (HRV-) 14, 9, and 1B to detect RNA from 59 rhinovirus serotypes. The results show that probes from the 5' end of the genomes of HRV-14, 9, and 1 B detected a large number of serotypes but the detection rate was variable and depended on the degree of homology with the particular probe. In contrast, all the 3' end probes were specific for the homologous virus. However, a long HRV-9 probe detected a large number of serotypes. It was concluded that such cDNA probes would not detect all serotypes with equal efficiency. Synthetic oligonucleotides corresponding to short but highly conserved regions in the 5' non coding region may overcome this problem.

DNA Probes↗
PubMed1983

Adherence of gram-negative uropathogens to human uroepithelial cells.

The adherence of several gram-negative uropathogens to human uroepithelial cells was examined with scanning and transmission electron microscopy, and in vitro adhesion assays. The bacteria studied demonstrated different extracellular structures: fimbria and glycocalyx. Human uroepithelial cells were obtained from a bladder tumor cell line (T-24) and from different groups of patients, including those with no history of urinary tract infection (controls), recurrent urinary tract infection, acute cystitis and bladder tumors before and after bacillus Calmette-Guerin therapy. Results from these comparative studies showed that bacteria with extracellular structures adhered better than those bacteria without extracellular structures. It also was shown that uroepithelial cells obtained from patients with recurrent urinary tract infection and with acute cystitis were more susceptible to bacterial adherence than the uroepithelial cells of the controls (there were significant increases of 2 to 5-fold in mean adherence in the former 2 groups, p equals 0.015 and 0.002). There was no significant difference in bacterial adherence between the T-24 cells and the bladder tumor cells before bacillus Calmette-Guerin treatment. However, in both groups after treatment with bacillus Calmette-Guerin the mean adherence increased 2 to 4-fold (p equals 3 times 10(-5)). A survey of 29 bladder tumor patients also showed a 5-fold increase in the incidence of acquired urinary tract infection after bacillus Calmette-Guerin therapy. These results reveal a correlation between bacterial adherence and urinary tract infection, and suggest that bacterial adherence to uroepithelial cells depends upon the bacterial extracellular structures and the source of the uroepithelial cells.

BCG Vaccine↗
PubMed1983

Three to eight weeks of therapy with netilmicin: toxicity in normal and diabetic patients.

Twenty-eight patients, 24 men and 4 women, aged between 17 and 72 years old, and suffering from chronic osteomyelitis (19), mastoiditis (5), or serious wound infections (4) were treated for an average of 35 days with netilmicin at doses of 2.4 to 6.9 mg/kg/day. The total dose of netilmicin given to each patient ranged from 3700 to 23 220 mg. Although the renal function was initially normal in all patients and stayed normal throughout therapy in all patients with no underlying disease, netilmicin nephrotoxicity was detected in two diabetic patients (7.6%). Vestibular toxicity developed in two (7.6%) but no change in audiograms was noted. Long-term therapy was associated with a significant increase (P less than 0.001) in half-life, from 1.5 to 1.9 h, and AUC 7.9 to 13.1 mg/l/h.

Adult↗
PubMed1981

Acute pancreatitis associated with campylobacter infection.

We report a case of acute pancreatitis associated with campylobacter infection. The patient presented with clinical symptoms and signs which suggested acute appendicitis. However, she was found to have acute pancreatitis with an acute campylobacter infection. Recent reports have shown that campylobacter is pathogenic in the biliary tract, and we suggest that it may also be responsible for some cases of acute pancreatitis in the absence of biliary disease.

Acute Disease↗
PubMed1981

The role of chlamydiae in genitourinary disease.

The incidence of chlamydial organisms in early morning urine specimens obtained from 53 men and 50 women without evidence of urinary tract pathology was 2 per cent in both groups. Early morning urine specimens and/or prostatic fluid or semen was examined in 50 patients with chronic prostatitis and 39 (56 per cent) yielded this organism. Of 31 patients with epididymo-orchitis the early morning urine specimens yielded chlamydiae in 12 (39 per cent) and in those with the acute form of disease the incidence was 56 per cent. The chlamydia recovery rate was 27 per cent in 119 women with cystourethritis. Within these groups of patients approximately 50 per cent of sexual partners had urine cultures positive for chlamydia. The importance of reinfection and the need for careful treatment of patients and consort should be stressed. An appropriate transport medium is necessary for specimen collection and adequate culture facilities are required to achieve effective chlamydial recovery. Trimethoprim-sulfamethoxazole and tetracycline were used effectively in the study for primary and secondary drug therapy.

Adolescent↗
PubMed1980

Frequency of micturition and urinary tract infection.

Introital swabbing was done on each of 19 patients with a history of lower urinary tract infection. The swabs were collected during a 5-day period, with 2 swabs being collected each day. We found that 1) introital flora varied in nature and in number from hour to hour and from day to day, 2) repetitive qualitative swabbing was the most accurate method to determine the presence of pathogens in the introitus and 3) there was a relationship between the frequency of micturition and the presence of introital pathogens: a) normal controls became colonized with pathogens as frequency of voiding was increased and b) pathogen carriage was found more commonly in the patient group as compared to the controls and the patient group voided more frequently than the control group. The theoretical implications of this relationship are discussed.

Female↗
PubMed1978

Therapeutic experience with netilmicin.

Netilmicin, a new aminoglycoside antibiotic, was used to treat 19 patients with urinary tract infection and 5 with systemic infection. The causal organisms were Escherichia coli (in 2), Klebsiella pneumoniae (in 4), Serratia marcescens (in 12) and Pseudomonas aeruginosa (in 7); 1 patient was infected with two of these organisms. All the isolates of causal organisms except one of Serratia were initially sensitive to netilmicin but many were resistant to other aminoglycosides. Sixteen of the urinary tract infections responded to netilmicin therapy, although relapse occurred in three patients. Two of the three patients with musculoskeletal infection responded to combined therapy with surgery and netilmicin; the other patient responded to the same regimen but with carbenicillin added. Netilmicin cured pneumonia in one patient but failed in the other patient with pneumonia, who had leukemia. Superinfection occurred in five patients with urinary tract infection. Adverse reactions to netilmicin were minor. Netilmicin may prove to be a useful agent, particularly for infections due to multiresistant Klebsiella or Serratia, or when prolonged aminoglycoside therapy is required.

Adolescent↗
PubMed1977

Typhoid outbreak in Kingston, Ont: experience with high-dose oral ampicillin.

Twenty-four children contracted typhoid fever at a summer camp near Kingston, Ont. Six were treated with chloramphenicol alone and 15 with high doses of ampicillin (300 mg/kg-d) by mouth. Ampicillin in this dosage was well tolerated except in three children in whom severe urticarial rashes developed and two who had significant diarrhea. However, high-dose oral ampicillin therapy had no advantage over that with lower doses or over chloramphenicol as judged by the rate of defervescence after the start of treatment, the rate of clinical relapse and the frequency of excretion of Salmonella typhi during convalescence.

Adolescent↗
PubMed1977

Activity of netilmicin compared with those of gentamicin and tobramycin against enterobacteria and Pseudomonas aeruginosa.

The inhibitory activity of netilmicin against 500 isolates of gram-negative bacteria was compared with those of gentamicin and tobramycin. Netilmicin was considerably less active than tobramycin and slightly less inhibitory than gentamicin for Pseudomonas aeruginosa but was at least as active against Escherichia coli and Klebsiella pneumoniae as were the other two antibiotics. A few Klebsiella and Serratia isolates resistant to gentamicin and tobramycin were inhibited by netilmicin. All three antibiotics were strongly bactericidal for E. coli, K. pneumoniae and P. aeruginosa but had less lethal activity against the otherwise susceptible Serratia isolates tested. Some necessary precautions in reading minimal inhibitory concentrations on agar media are stressed, and some possible advantages of a 4-h bactericidal test, using a constant antibiotic concentration, are defined.

Anti-Bacterial Agents↗
PubMed1976

Urethral response to latex and Silastic catheters.

The reaction of the urethral mucosa to latex and Silastic catheters was compared in two groups of patients undergoing prostatectomy. The bacteriologic response in the two groups differed little; however, Silastic catheters produced less cellular reaction than latex catheters.

Catheters, Indwelling↗
PubMed1976

Introital bacterial flora - effect of increased frequency of micturition.

Introital swabbing was performed on each of 20 premenopausal female volunteers over a 5-day period, 2 swabs being collected each day. During the last 3 days of the 5-day period the volunteers were requested to void every 2 hours. Analysis of our data shows: 1. Perineal bacterial flora varies in number and type of organisms from hour to hour and day to day. 2. Quantitative culturing is of little help in distinguishing colonisation of the introitus with urinary pathogens from mere intermittent contamination of the introitus with the same pathogens. 3. Our results suggest that 4 or more consecutive isolates of the potential urinary pathogens from the introitus over a 48-hour period signify colonisation. 4. Frequency of micturition increases the risk of colonisation of the introitus with potential urinary pathogens. The significance of these findings is discussed, in relation to the previous work of other investigators.

Adult↗