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Biomedical subjects

P Marriott

Publications and source records attributed to P Marriott.

At least 19 recordsLinked to original sources
PubMed2004

Conscious sedation for endoscopic and non-endoscopic interventional gastrointestinal procedures: meeting patients' expectations, missing the standard.

AIM: To assess the level of sedation, patient satisfaction and frequency of unplanned events with conscious sedation for interventional procedures. MATERIALS AND METHODS: One hundred and seventeen patients were assessed prospectively before, during and after procedures. Blood pressure, pulse, oxygen saturation and sedation level were monitored and patients followed up after 24 h. Sedation was scored after drugs were given in accordance with an established protocol. Doses were recorded, as were patients' weight, age and ASA grade and any unplanned events and their management. RESULTS: Seventy-six of the 117 patients (65%) had no unplanned event, 20 (17.1%) became agitated, 15 (12.8%) hypotensive, three (2.6%) hypoxic and three (2.6%) had more than one response. Twelve patients required active management. Fifty-two (44.4%) had a sedation level of </=3 (responsive to verbal commands), but 39 (33.3%) reached level 6. Median doses were midazolam 6 mg (1-20 mg) and pethidine 50 mg (12.5-100 mg). Ninety-three percent were satisfied with their sedation. No adverse effects were observed after 24 h. CONCLUSION: Despite using a sedation protocol, unplanned events occurred in 35% (95% CI=27-44%) of patients, although not all required active management. The sedation levels reached in some exceeded guidelines. Unplanned events were commoner with increased sedation level. Patient satisfaction was high and no permanent damage was observed.

Adjuvants, Anesthesia↗
PubMed2003

Metabolism of bisphenol A in zebrafish (Danio rerio) and rainbow trout (Oncorhynchus mykiss) in relation to estrogenic response.

The kinetics of bisphenol A (BPA) were investigated in zebrafish (Danio rerio) exposed to 100 microg BPA/l. BPA uptake was measured during a 7-day period followed by an elimination phase of similar duration. After 2, 6, 12, 24, 48, 72, 120 and 168 h of uptake/elimination, fish were analysed for their content of BPA, bisphenol A glucuronic acid (BPAGA) and bisphenol A sulfate (BPAS). Within the first 24 h steady state levels of BPA, BPAGA and BPAS were reached and the total body concentrations were calculated to be 569, 12,600 and 39.9 ng/g fish, respectively. Elimination rates of the three compounds in zebrafish were estimated by fitting the data to a compartment model. An initial rapid elimination phase was observed for BPA and BPAS with total body half lives (T(1/2)) of <1.1 h and 30 min, followed by a slower second elimination phase with T(1/2) values of 139 and 71 h, respectively. Excretion of BPAGA occurred from a single compartment with a T(1/2) of 35 h. The steady state concentration of BPA and its metabolites were investigated in rainbow trout (Oncorhynchus mykiss) exposed to 100 microg BPA/l. The toxicokinetic parameters from zebrafish and rainbow trout were compared; including previously published data on the rainbow trout. The data indicate that the smaller estrogenic sensitivity observed for the zebrafish may be caused by a more rapid metabolism of BPA in the zebrafish liver.

Animals↗
PubMed1996

Diazepam versus alprazolam for the treatment of panic disorder.

BACKGROUND: Alprazolam has proven efficacy as a treatment for panic disorder, but the place of other benzodiazepines is less well established. METHOD: To compare the efficacy and tolerability of diazepam and alprazolam for the disorder, a placebo-controlled, double-blind trial was undertaken in two sites. Two hundred forty-one subjects with panic disorder or agoraphobia with panic attacks were randomly assigned to flexible doses of diazepam, alprazolam, or placebo for 8 weeks. RESULTS: At the end of the trial, over 60% of subjects taking either diazepam or alprazolam were at least moderately improved compared with less than 30% of those taking placebo. On all measures of efficacy, subjects taking diazepam and alprazolam showed an equally favorable response. Despite some sedation early in the trial, both drugs were tolerated well. More severely ill subjects responded less well to either benzodiazepine. CONCLUSION: The results indicate that diazepam is an effective alternative to alprazolam for the treatment of panic disorder.

Adult↗
PubMed1993

The elderly agoraphobic: a hidden problem.

This is a fascinating history of an untreated and undiagnosed patient with agoraphobia. The limitations to her lifestyle have been extreme. Improvement has been impressive and Mrs B is now enjoying her life considerably. The cognitive behavioural strategies have been useful and her improvement maintained at follow up. Asking elderly patients routine questions to elicit evidence of anxiety, phobias, and panic attacks will enable the physician to detect similar cases.

Aged↗
PubMed1990

Panic and phobic disorders. Current cognitive behavioural strategies.

The past 5 years have seen the development of a number of treatment strategies suitable for panic and phobic disorders. At this stage, a combined drug and psychological approach is appropriate. Not all patients will accept medication. A number of cognitive-behavioural techniques can be used with hope of success. Sessions must include positive statements such as 'you can do it', 'be persistent', 'look forward to this activity' and 'I am achieving'.

Behavior Therapy↗
PubMed1984

Intervals between long acting neuroleptics: outcome and re-admission variables.

A drug monitoring programme has evaluated flexibility in the use of treatment intervals with Depot Fluphenazine. In this large group of schizophrenics over 30% receive injections at intervals of over 3 weeks or longer, with an overall relapse rate of 24%. Analysis of the intervals reveals in those who relapse, that 20% of cases increased their interval by an average of 7 weeks. Generally, there was an increase in intervals by the patients in the second year of treatment.

Age Factors↗
PubMed1981

Multicentre evaluation of mianserin in depressive illness.

A multicentre evaluation of the effectivensss of mianserin in depressive illness was carried out. A total of 130 patients were treated with the drug, but useful data were collected on 55 patients; of these 36 responded to mianserin. A number of unwanted side effects were recorded. They were generally of mild to moderate severity, but occasionally were severe enough to warrant withdrawal of mianserin therapy. Mianserin was considered to be an effective antidepressant.

Adult↗
PubMed1978

Drug monitoring at an Australia depot phenothiazine clinic.

Three aspects of treatment with injectable neuroleptics, are presented. An individualized approach to the dosage of Fluphenazine decanoate must be practiced in conjunction with, and taking into account the time spent in treatment and the sex and age variables reported. Our flexible approach to the interval between injections, indicated a large group could be maintained at intervals of 5 to 8 weeks. Complex and challenging problems can be found with antiparkinsonian drugs; 30% of nearly 400 outpatients still require these drugs.

Adult↗
PubMed1976

A mirror image Out-patient study at a depot phenothiazine clinic.

This Mirror Image Study, at a specialised clinic, has shown a significant reduction in days spent in Hospital. Individual features of the sample include sex and age difference in the sub-groups for dosage, duration of treatment and anti-Parkinsonian medication. Preliminary cost-effectiveness analysis has been reported.

Adolescent↗