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Biomedical subjects

P Robinson

Publications and source records attributed to P Robinson.

At least 109 records · Page 6Linked to original sources
PubMed1998

Impact of improved depression treatment in primary care on daily functioning and disability.

BACKGROUND: Few data are available regarding the impact of improved depression treatment on daily functioning and disability. METHODS: In two studies of more intensive depression treatment in primary care, patients initiating antidepressant treatment were randomly assigned to either usual care or to a collaborative management programme including patient education, on-site mental health treatment, adjustment of antidepressant medication, behavioural activation and monitoring of medication adherence. Assessments at baseline as well as 4 and 7 months included several measures of impairment, daily functioning and disability: self-rated overall health, number of bodily pains, number of somatization symptoms, changes in work due to health, reduction in leisure activities due to health, number of disability days and number of restricted activity days. RESULTS: Average data from the 4- and 7-month assessments in both studies, intervention patients reported fewer somatic symptoms (OR 0.68, 95% CI 0.46, 0.99) and more favourable overall health (OR 0.50, 95% CI 0.28, 0.91). While intervention patients fared better on other measures of functional impairment and disability, none of these differences reached statistical significance. CONCLUSIONS: More effective acute-phase depression treatment reduced somatic distress and improved self-rated overall health. The absence of a significant intervention effect on other disability measures may reflect the brief treatment and follow-up period and the influence of other individual and environmental factors on disability.

Absenteeism↗
PubMed1998

Executive function in treated phenylketonuria as measured by the one-back and two-back versions of the continuous performance test.

The executive dysfunction hypothesis in treated phenylketonuria was investigated by means of the one-back and two-back versions of the continuous performance test. Eleven non-retarded, primary school-age children with classical phenylketonuria who had been treated early and continuously were indistinguishable from healthy, matched controls on the measures and test performance was not predicted by historical or concurrent plasma phenylalanine concentrations. Mean lifetime phenylalanine concentrations for the phenylketonuric subjects were within ranges currently recommended as dietary optima in the United Kingdom. The negative neuropsychological test findings add weight to the rationale for this policy.

Child, Preschool↗
PubMed1998

ATM mutations and phenotypes in ataxia-telangiectasia families in the British Isles: expression of mutant ATM and the risk of leukemia, lymphoma, and breast cancer.

We report the spectrum of 59 ATM mutations observed in ataxia-telangiectasia (A-T) patients in the British Isles. Of 51 ATM mutations identified in families native to the British Isles, 11 were founder mutations, and 2 of these 11 conferred a milder clinical phenotype with respect to both cerebellar degeneration and cellular features. We report, in two A-T families, an ATM mutation (7271T-->G) that may be associated with an increased risk of breast cancer in both homozygotes and heterozygotes (relative risk 12.7; P=. 0025), although there is a less severe A-T phenotype in terms of the degree of cerebellar degeneration. This mutation (7271T-->G) also allows expression of full-length ATM protein at a level comparable with that in unaffected individuals. In addition, we have studied 18 A-T patients, in 15 families, who developed leukemia, lymphoma, preleukemic T-cell proliferation, or Hodgkin lymphoma, mostly in childhood. A wide variety of ATM mutation types, including missense mutations and in-frame deletions, were seen in these patients. We also show that 25% of all A-T patients carried in-frame deletions or missense mutations, many of which were also associated with expression of mutant ATM protein.

Adolescent↗
PubMed1998

Hepatitis C--role of perinatal transmission.

To evaluate the role of perinatal transmission in the spread of hepatitis C virus (HCV), we screened a cohort of pregnant intravenous drug using (IVDU) women for HCV antibody detection; where seropositive HCV RNA detection by polymerase chain reaction (PCR) was found we followed the infants longitudinally for HCV antibody and HCV RNA. Serum prevalence for HCV for this population was 80% with HCV RNA detected in 50%. Recruitment and follow-up over a 3-year period of a cohort of 83 seropositive women, their 91 newborns and 16 siblings of newborns, showed that there had been a 3% perinatal transmission rate with 1 sibling also infected. These positive cases were defined as transient in 1 case (HCV RNA positive by PCR at 1 month, but seronegative and HCV RNA negative at 10 months of age), 2 unevaluable (HCV RNA positive at 2 months of age, but patients lost to follow-up), and 1 chronic infection in a child at 34 months (positive HCV RNA and seropositive 34-month sibling). Maternal HCV RNA levels for those with infected infants was a mean 40-fold greater than those whose babies were uninfected, although this did not reach statistical significance. Of the remaining infants, the majority (93%) had lost passively acquired maternal antibodies by 9 months of age and all by 12 months. Of 18 women who were HCV seropositive and breast feeding (66% of whom were HCV RNA positive in their sera), none had detectable HCV RNA in breast milk. Hence we conclude that transmission of HCV from mother to infant appears to be of low frequency and positivity appears to correlate with maternal circulating viral load.

Adult↗
PubMed1998

Precision and reliability for measurement of change in MRI lesion volume in multiple sclerosis: a comparison of two computer assisted techniques.

OBJECTIVE: The serial quantification of MRI lesion load in multiple sclerosis provides an effective tool for monitoring disease progression and this has led to its increasing use as an outcome measure in treatment trials. Segmentation techniques must display a high degree of precision and reliability if they are to be responsive to small changes over time. This study has evaluated the performance of two such techniques, the manual outlining and contour methods, in serial lesion load quantification. METHODS: Sixteen patients with clinically definite multiple sclerosis were scanned at baseline and after two years. Scan analysis was performed twice, independently by three observers using each technique. RESULTS: For the absolute lesion volumes the median intrarater coefficient of variation (CV) was 3.2% for the contour technique and 7.6% for the manual outlining method (p < 0.005), the interrater CVs were 3.8% and 6.1% respectively (p < 0.01) and the reliability of both techniques was very high. For the change in lesion volume the intrarater and interrater repeatability coefficients were respectively 2.6 cm3 and 2.8 cm3 for the contour technique, and 3.3 cm3 and 3.7 cm3 for the manual outlining method (lower values reflect higher precision). The values for intrarater and interrater reliability for measuring change in lesion volume were respectively, 0.945 and 0.944 for the contour technique, and 0.939 and 0.921 for the manual outline method (perfect reliability = 1.0). CONCLUSIONS: With such high values for reliability, the impact of measurement error in lesion segmentation on sample size requirements in multiple sclerosis treatment trials is minor. This study shows that a change in lesion volume can be measured with a higher level of precision and reliability with the contour technique and this supports its further application in serial studies.

Adjuvants, Immunologic↗
PubMed1998

Maternal cigarette smoking is associated with increased inner airway wall thickness in children who die from sudden infant death syndrome.

The harmful effects of passive cigarette smoke exposure to infants include an increased frequency of asthma exacerbations, lower respiratory viral infections, and the sudden infant death syndrome (SIDS). Because of a difficulty in obtaining airway tissue from infants, little information is available on the effects of passive cigarette smoke exposure on the structure of the infant airway wall. We examined airway dimensions in 19 children who died from SIDS whose mothers smoked more than 20 cigarettes a day prenatally and postnatally, and compared these data with those from 19 infants who died from SIDS and had nonsmoking mothers. Total inner and outer wall areas were calculated for each airway and expressed in terms of the basement membrane perimeter (Pbm). Inner airway wall thickness was greater in the larger airways of those infants whose mothers had smoked more than 20 cigarettes a day. These findings suggest that infants exposed to a high level of passive cigarette smoke develop significant structural changes in their airways. Increased airway wall thickness may contribute to exaggerated airway narrowing and may help explain the previously observed abnormalities in neonatal lung function that have been described in infants of smoking mothers.

Airway Obstruction↗
PubMed1998

Hanging stones.

Explore the source record for details and available documents.

Adenocarcinoma↗
PubMed1998

Unsettled, uncertain and striving to understand: toward an understanding of the situation of persons with suspected dementia.

The main purpose of this study was to understand the part played by clinical diagnosis in relation to persons with suspected dementia. Interviews were held with eight persons who had been evaluated clinically because of suspected dementia. A phenomenological-hermeneutic analysis inspired by Ricoeur's philosophy was performed. The findings revealed the overall meaning of "making sense" of early experiences of memory loss in terms of a clinical diagnosis by which participants are provided with a means of interpreting and ascribing some meanings to the changes in themselves. When a meaning cannot be established and the future is unknown, these experiences are found to pose an existential threat that projects into future existence. The study suggests that understanding how an informed diagnosis is comprehended by the client becomes essential when evaluating persons due to suspected dementia.

Adult↗
PubMed1998

Sharps injuries in dental practice.

Sharps injuries are common in dental practice and may allow transmission of blood-borne viruses. The transmission rates of hepatitis B (HBV) to non-vaccinated recipients, hepatitis C (HCV) and human immunodeficiency virus (HIV) after a needlestick injury are 6-30%, 2.7-10% and 0.1-0.3% respectively. Five strategies to prevent percutaneous injuries in dental surgeries are considered: a universal level of infection-control, surgery design, working practices, glove use and vaccinations. First-aid for sharps injuries and post-exposure management of those involving sources with HBV and HIV are described. Anticipation, planning and training can reduce the incidence of injuries and minimise their impact.

Accidents, Occupational↗
PubMed1998

Preparing kids for the new baby.

Sibling prenatal classes are a natural extension of nursing's interest and expertise in childbirth preparation for expectant couples. From parents' perspective, these classes have the potential to decrease sibling rivalry and facilitate parental coping with older children's concerns about a new baby. From a nurse educator's perspective, sibling prenatal classes offer a rich learning experience for students by providing an opportunity to integrate knowledge about pregnancy and birth with communication skills and child development knowledge.

Adaptation, Psychological↗
PubMed1998

Clinical comparison of dexketoprofen trometamol, ketoprofen, and placebo in postoperative dental pain.

The efficacy and tolerability of single doses of dexketoprofen trometamol 12.5 mg, 25 mg, and 50 mg and ketoprofen 50 mg were compared in this double-blind, randomized, placebo-controlled study of 210 patients with moderate to severe pain after removal of one mandibular impacted third molar tooth. Pain intensity and pain relief were monitored for 6 h after administration of medication using visual analogue and verbal rating scales. All four active treatments were significantly more effective than placebo (P < 0.001). Dexketoprofen 25 mg and 50 mg produced an analgesic effect within 30 min of administration and their effect persisted for 6 h. Ketoprofen 50 mg produced a level of analgesia similar to those of the higher doses of dexketoprofen trometamol, but it had a slower onset. The 12.5-mg dose of dexketoprofen trometamol was significantly superior to placebo but produced a lower level and shorter duration of analgesia compared to the other active treatments. There were no significant differences between 25 and 50 mg of dexketoprofen trometamol in any measure of analgesic efficacy. No serious adverse events were observed and there were no significant differences in the incidence of adverse events among treatment groups. These results demonstrate that dexketoprofen trometamol 25 mg is at least as effective as the racemic ketoprofen 50 mg in the treatment of postsurgical dental pain. The more rapid onset of action compared to ketoprofen suggests that dexketoprofen trometamol is more appropriate for treatment of acute pain.

Adult↗
PubMed1997

Paediatric slow-speed non-traffic fatalities: Victoria, Australia, 1985-1995.

An important group of fatal incidents are slow-speed pedestrian non-traffic incidents to children, which account for 14% of accidental deaths from all causes in Victorian children under 5 years of age between 1985 and 1995, and 12% of pedestrian deaths of all ages. In Victoria, Australia, the database of the state Consultative Council on Obstetric and Paediatric Morbidity and Mortality was utilised to identify paediatric slow-speed pedestrian non-traffic-accident deaths in the local population. Additional data relating to the car and its driver, the child, and the circumstances of the incident were abstracted from records kept by the State Coroner and the Victorian compulsory third party traffic injury insurance organisation. Twenty eight Victorian children were identified who had died in one of three types of incident (driverless cars, child interacting with the vehicle and driver, and drivers who were unaware of the child's proximity). These incidents were more common in rural areas compared with urban, usually occurring at the child's home. The child was with or near an adult on all occasions. The vehicle was usually being driven by a relative, and was reversing in a higher proportion of 'unaware' incidents compared with the 'interactive' type. The association of 'off-road' family vehicles and trucks with these incidents appears to be increasing, especially in recent years. These findings suggest some countermeasures, including the separation of vehicle driveways from children's play areas, and object vicinity ultrasonic warning devices for vehicles.

Accidents, Home↗