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Biomedical subjects

R Fitzpatrick

Publications and source records attributed to R Fitzpatrick.

At least 163 records · Page 9Linked to original sources
PubMed1989

A comparison of measures of health status in rheumatoid arthritis.

One hundred and five patients with rheumatoid arthritis were assessed on two occasions separated by 15 months, by means of the ARA functional scale, the Mallya and Mace index, the Health Assessment Questionnaire (HAQ) and the Functional Limitations Profile (FLP). Thirty three per cent of patients were assessed as clinically changed in terms of the ARA scale. On both occasions cross-sectional correlations were strongest between the health status measures (HAQ and FLP) and grip strength and the Ritchie articular index. The sensitivity and specificity of the two health status measures in relation to clinical change were calculated and overall the HAQ and FLP achieved similarly modest levels of sensitivity and specificity. The greater amount of precision and information provided by the FLP has to be weighed against the simpler measurement assumptions and shorter time required to administer the HAQ.

Arthritis, Rheumatoid↗
PubMed1989

Heterosexual sexual behaviour in a sample of homosexually active men.

Three hundred and fifty six homosexually active men were recruited in 1988 for a study by interview of sexual behaviour. Thirty two per cent had homosexual passive anal sex in the previous month and 60% in the year before interview. Anal sex and unprotected anal sex were more common with regular than non-regular partners. Heterosexual sex was reported by 4% of men in the last month and 10% for the last year. Sixteen per cent of heterosexually active men reported anal sex with a female partner. Fewer men described themselves as bisexual than would be expected from the sample's recent sexual histories. More attention is needed to the definition and measurement of "bisexuality" to understand its role in HIV transmission.

Adolescent↗
PubMed1989

The origins of depressed mood in rheumatoid arthritis.

Most studies that have considered depressed mood in patients with rheumatoid arthritis have failed to analyze the relative contribution of psychological, social and disease state variables. Using multivariate statistical analyses we identified the role played by demographic, disease related, disability and social variables. Together these variables accounted for 44% of the variation in depressed mood. Demographic factors, disability measures, disease duration, social isolation and economic deprivation all made significant contributions to the explanation of depressed mood. The results of our study underline the importance of examining a wide range of factors in order to consider their relative influence on psychological state.

Arthritis, Rheumatoid↗
PubMed1989

Ovarian cancer in a county hospital.

Forty two cases of ovarian cancer diagnosed and treated over a ten year period (1975-1985) are reviewed. The mean age at presentation was 59.3 years and mean parity 1.9. Abdominal pain and distension were the commonest clinical symptoms. Twenty three patients had total abdominal hysterectomy and bilateral salpingo-oophorectomy with or without partial omentectomy. All patients had at least diagnostic laparotomy. There were no post-operative deaths. Thirty two patients had adjuvant chemotherapy. Two patients had false negative "Second Look" procedures. Histology in all cases was of epithelial origin. Survival at one year was 52.4% and 35.3% in those patients followed for five years. Good prognosis was related to extent of disease and surgical excision. Cisplatinum post-operative chemotherapy replaced other cytotoxic drugs in the latter years and it's use was associated with less morbidity and longer survival in patients with extensive disease than earlier regimes. We feel that national co-ordination in gynaecological oncology surveillance and treatment would be beneficial.

Adult↗
PubMed1988

Factors influencing compliance with dietary restrictions in dialysis patients.

Dietary restrictions for dialysis patients are very demanding and compliance has been shown to be poor in many patients. A number of psychosocial variables were investigated in a sample of 41 dialysis patients for possible effects on dietary compliance. Clinical criteria of dietary abuse indicated problems in 58% of the sample. Self reported compliance was significantly associated with clinical abuse scores. The longer patients had been on dialysis, the less likely they were to report dietary compliance. Health locus of control and family support were significantly associated with specific items of self reported compliance, but not with overall compliance scores. Acceptance of the limitations imposed by illness was significantly associated with clinical dietary abuse scores. The process whereby positive adjustment and good dietary control may be achieved, is discussed.

Feeding Behavior↗
PubMed1988

The Nottingham Health Profile: an analysis of its sensitivity in differentiating illness groups.

A recent criticism of the Nottingham Health Profile (NHP) claimed it was an insensitive instrument for use in population surveys, because its modal response was zero, and domains measured by the instrument are insufficiently distinct. It is argued here that the NHP was designed specifically to uncover the chronically ill in populations and, further, research undertaken here indicates that the instrument is sufficiently sensitive to be successful in permitting variations within and between illness groups to be determined. However, the domains of mobility and pain, as measured by the instrument, are found to be confounded.

Adult↗
PubMed1988

Social relationships and psychological well-being in rheumatoid arthritis.

This study examines the social relationships of a sample of 158 patients attending a hospital rheumatology clinic with rheumatoid arthritis (RA). Scores of the sample were compared with those of other samples on the Interview Schedule for Social Interaction (ISSI). In addition the effects of severity of disease activity and of disability upon social relationships were examined. Diffuse social relationships such as with friends and acquaintances, rather than more intimate ones appear to be more affected in individuals with RA. Psychological well-being was assessed by means of two measures. The more favourably patients scored for social relationships, the more favourable were their scores for psychological well-being using both scores. More diffuse social relationships were more strongly correlated with psychological well-being than were the scores for more intimate relationships. Despite the strong effects of social relationships upon well-being, no buffering action on the effects of disability upon well-being were found.

Activities of Daily Living↗
PubMed1988

The relationship between plasma ibuprofen concentrations and toxicity in acute ibuprofen overdose.

1. The information available from the literature and from a prospective survey of ibuprofen overdose being undertaken by the London centre of the National Poisons Information Service (NPIS) was examined utilizing the Generalized Linear Interactive Modelling (GLIM) statistical computing package. 2. This confirmed that timed ibuprofen plasma concentrations were related to the symptoms of tachycardia, dizziness, tinnitus, ocular symptoms and coma/stupor as well as to reversible renal impairment and plasma hepatic enzyme elevation. 3. The best model of the relationship between symptomatic toxicity and timed ibuprofen plasma concentrations, was an exponential equation in time. Because of the lack of specificity or sensitivity in this model, and absence of demonstrable clinical advantages from its application, we do not recommend its use as a guide to predict toxicity. 4. However analysis of a larger information base utilizing similar methodology could, by increasing the statistical power of the resultant model, provide a useful means of predicting ibuprofen toxicity. 5. A previously postulated relationship between post-ingestion ibuprofen plasma concentrations and toxicity was not confirmed.

Humans↗
PubMed1987

The assessment of patients' distress in genito-urinary medicine clinics.

A sample of patients attending the clinic of a Department of Genito-Urinary Medicine in London completed The General Health Questionnaire, The Illness Behaviour Questionnaire and The Illness Concern Questionnaire. The doctor whom they consulted was also asked to complete rating scales regarding each patient's level of psychological disturbance. Thirty-eight percent of patients scored highly on the GHQ, indicating possible psychological disturbance. However, only one in five of such 'cases' were also rated by the doctor as possibly psychologically disturbed. A number of social variables are examined that may facilitate or limit the communication of psychological distress. No evidence of labelling of deviant groups is found. However, both the sample in general and specific sub-groups in particular scored highly on scales of hypochondriasis and distress in relation to health and such characteristics appeared relevant to doctors' judgements of patients' psychological states.

Adult↗
PubMed1987

Psychological disturbance and illness behaviour in a clinic for sexually transmitted diseases.

Patients attending a sexually transmitted diseases (STD) clinic were asked to complete the General Health Questionnaire and the Illness Behaviour Questionnaire. Data were collected from 852 patients. One-third of the sample were found to score positively on the GHQ, indicating possible psychological disturbance. Women were more likely than men to score positively on the GHQ. On the General Hypochondriasis scale of the IBQ the sample's scores were higher than any other normative data except those obtained from psychiatric in-patients. On this scale homosexual and bisexual males scored significantly higher than heterosexual males. It is argued that the IBQ draws attention to important dimensions of psychological distress in STD clinics.

Adult↗
PubMed1986

Survey of psychological disturbance in patients attending a sexually transmitted diseases clinic.

A survey of psychological disturbance was conducted in a sexually transmitted disease (STD) clinic, using the general health questionnaire, the Crown-Crisp experiential index, and the illness concern questionnaire. Of 381 patients who completed the questionnaire, 158 (43%) had general health questionnaire scores indicating that they were psychiatric cases. Psychological disturbance was more common in women. The association between general health questionnaire caseness and patients' reports of concerns and worries about illness in relation to their presenting complaint was significant. The Crown-Crisp experiential index scores of cases were lower than those characteristic of patients attending psychiatric clinics, and much of the psychological disturbance found by this and other surveys of STD clinics may therefore represent distress in relation to the presenting problem. Of the 381 patients, 14 (4%) appeared to have an abnormal or unwarranted level of distress in relation to their presenting complaint.

Adult↗
PubMed1985

The recognition of psychological disturbance in a sexually transmitted diseases clinic.

This study examined the rate of psychological disturbance in a series of new patients attending a clinic for sexually transmitted diseases. Forty three per cent of patients were identified as probable psychiatric cases by the General Health Questionnaire. Medical staff in the clinic were asked to assess patients' level of psychological disturbance. Disagreement between GHQ and doctors' ratings occurred in 41% of patients. Some patient and doctor characteristics were examined that might be associated with disagreement, and the results are discussed in terms of possible social--psychological influences upon doctors' recognition of psychological disturbance.

Adult↗
PubMed1983

Problems in the conceptual framework of patient satisfaction research: an empirical exploration.

Survey research into patient satisfaction has been responsible for developing a number of related concepts concerning the ways in which patients evaluate the health care that they receive. Recently doubts have been expressed as to the adequacy of this approach for understanding how patients anticipate and respond to medical encounters. This paper reports a study of patients attending neurological outpatient clinics. The results suggest that the conceptual framework deriving from patient satisfaction research provides only partial and sometimes misleading insights into the perspectives of the patients studied. The paper concludes that patients' varying concerns with regard to their illness need to be more directly considered in explaining different responses to medical consultations. This approach enables a more sensitive evaluation of health care from the patient's point of view.

Consumer Behavior↗
PubMed1981

Psychogenic purpura (autoerythrocyte sensitization).

A 41-year-old woman has had a long history of repeated episodes of recurrent painful ecchymotic lesions. Results of coagulation tests were normal other than a slight decrease in antithrombin III. Skin tests were positive in response to the patient's own washed red cells. Light and electron microscopy of both the spontaneous and the induced lesions showed nonspecific changes but failed to reveal immunologic vasculitis. Psychologic evaluation showed hysterical and masochistic traits, depression, anxiety, and inability to deal appropriately with hostile impulses. Placebo was successful on several occasions in controlling or modifying the severity of the ecchymotic lesions.

Adult↗
PubMed1981

Referrals to neurologists for headaches not due to structural disease.

Patients attending neurological clinics with headaches that proved not to be due to clearly defined structural disease were interviewed before and after the consultation and approximately one year later. Their expectations of the consultation were ill-formed. About two-thirds of the patients had fears about organic disease although few had psychiatric morbidity. These fears were generally dispelled by the consultation. About one-third of the patients were dissatisfied by the consultation, nearly all by what the neurologist said rather than by what technical procedures he did or did not undertake. Women with a long history of migraine, with significant psychiatric morbidity, and who had initiated the referral themselves were particularly likely to be dissatisfied. Although most patients were still having headaches one year later, visits to the general practitioner for this symptom had greatly declined.

Adolescent↗
PubMed1981

Histiocytosis X.

A patient with histiocytosis X had nonhealing mouth lesions. Evaluation revealed diabetes insipidus and numerous bony lesions. Electron microscopy of the mouth lesions and lymph nodes did not indicate Langerhans cells, which have frequently been described as occurring in histiocytosis X. A survey of 59 patients examined during a 20-year period at UCLA reported the presence of oral lesions in 42% of the cases and confirmed the occurrence of a wide range of clinical patterns and variations in the course of the disease.

Adolescent↗