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Biomedical subjects

R O'Carroll

Publications and source records attributed to R O'Carroll.

14 recordsLinked to original sources
PubMed1996

Chronic memory impairment after cardiac arrest outside hospital.

OBJECTIVES: To evaluate the nature, prevalence, and severity of chronic memory deficit in patients resuscitated after cardiac arrest outside hospital and to determine whether such deficits are related to duration of cardiac arrest. DESIGN: Case-control study. SUBJECTS: 35 survivors of cardiac arrest outside hospital and 35 controls matched for age and sex who had had acute myocardial infarction without cardiac arrest. MAIN OUTCOME MEASURES: Subjects assessed at least two months after index event for affective state (hospital anxiety and depression scale), premorbid intelligence (national adult reading test), short term recall (digit recall test), and episodic long term memory (Rivermead behavioural memory test). RESULTS: Cases and controls showed no difference in short term recall. Cases scored lower on Rivermead test than controls (mean (SD) score out of 24 points: 17.4 (5.4) v 21.8 (2.0), P < 0.001), particularly in subtests relating to verbal and spatial memory. Moderate or severe impairment was found in 37% of cases and in no controls. Severity of impairment of memory correlated significantly with measures of duration of cardiac arrest. This deficit was not significantly associated with subjects' age, interval from index event to assessment, occupation, measures of comorbidity, social deprivation, anxiety or depression scores, or estimated premorbid intelligence. CONCLUSIONS: Clinically important impairment of memory was common after cardiac arrest outside hospital. Improvement in response times of emergency services could reduce the severity of such deficits. With an increasing numbers of people expected to survive cardiac arrest outside hospital, rehabilitation of those with memory deficit merits specific attention.

Aged↗
PubMed1995

Cognitive estimation in neurological disorders.

The Cognitive Estimation Test (CET) was devised by Shallice & Evans (1978) in an attempt to quantify the tendency observed in some patients with frontal lobe lesions to produce bizarre estimates in response to questions to which people do not usually know exact answers (e.g. 'what is the height of a double-decker bus?'), despite performing normally on standard intelligence tests. In the present study, the CET performance of a large number of patients suffering from head injury, brain tumour, ruptured aneurysm (anterior communicating artery and other), multiple sclerosis, dementia, encephalitis, Korsakoff's syndrome and anxiety/depression were compared with CET scores from 150 healthy controls. Patients with Korsakoff syndrome demonstrated significantly impaired CET performance. A subgroup of patients with discrete frontal lesions was compared with a group with localized non-frontal lesions. No significant difference in CET performance was observed between anterior and posterior lesioned patients. The sensitivity of the CET to anterior brain dysfunction is called into question by the present findings.

Adult↗
PubMed1994

Memory impairment in schizophrenia--a comparison with that observed in the Alcoholic Korsakoff syndrome.

Until very recently, memory impairment was not considered to be a central feature of schizophrenia, except in chronic, deteriorated patients. In this study of a heterogeneous sample of 40 patients with DSM-III-R schizophrenia, episodic memory impairment was found to be prevalent, and in some cases, severe. The degree of memory impairment was not attributable to neuroleptic or anticholinergic medication, or to poor motivation or cooperation. These results, therefore, replicate those reported by McKenna et al. (1990) and Tamlyn et al. (1992), who suggested that the pattern of memory impairment in schizophrenia may conform in important respects to that of the classic amnesic syndrome. However, in a direct comparison of the schizophrenic sample with 18 patients suffering from the Alcoholic Korsakoff Syndrome (AKS), both quantitative and qualitative differences were found to exist between the two groups of patients. In particular, the level of long-term episodic memory impairment was found in the AKS sample to be far greater than that in the schizophrenic group. An interesting possible double-dissociation emerged between the two groups; although demonstrating superior episodic memory functioning, the schizophrenic sample were found to perform significantly more poorly than the AKS sample on a test of semantic memory.

Adolescent↗
PubMed1994

Assessing cognitive estimation.

The Cognitive Estimation Test (CET) was devised in an attempt to quantify the tendency observed in patients with frontal lobe lesions to produce bizarre estimations in response to fairly simple questions, despite performing normally on standard intelligence tests. Several studies have been published where CET performance in patient groups has been examined. However, there is a paucity of adequate normative data. In the present study, representative normative data are provided from 150 healthy controls. CET performance was found to be moderately related to general intellectual ability, with females performing more poorly than males. The scale was examined psychometrically, and was found to be factorially impure, with poor internal reliability but adequate inter-rater reliability. Further revision of the CET is required in order to render it a psychometrically acceptable instrument.

Adolescent↗
PubMed1993

Neuropsychological and neuroimaging aspects of latent hepatic encephalopathy (LHE).

It has become increasingly clear that many cirrhotic patients who do not display overt clinical encephalopathy, on closer examination, do demonstrate significant cognitive impairment, which often goes unrecognised. This "latent" hepatic encephalopathy (LHE) is usually characterised by memory impairment and psychomotor slowing, and is not simply attributable to the effects of alcohol. Structural neuroimaging studies (CT and MRI) have produced conflicting results. Functional neuroimaging studies (PET and SPECT) which have measured regional cerebral blood flow, however, have found evidence of increased regional cerebral activity in sub-cortical areas in LHE patients, with the degree of sub-cortical activity correlated with the severity of neuropsychological impairment.

Cognition Disorders↗
PubMed1992

Selecting controls for schizophrenia research studies: the use of the National Adult Reading Test (NART) is a measure of premorbid ability.

The National Adult Reading Test (NART) has achieved popularity as a measure of pre-morbid intellectual ability, based on the premises that pronunciation of irregular words is unaffected in many clinical disorders and that performance is highly correlated with general intellectual ability. Recently, schizophrenia research studies have begun to appear in the literature, where the NART has been used to estimate pre-morbid ability. However, this use has preceded the basic required demonstration that, in fact, NART performance is unaffected by the schizophrenic process. In the present study, NART performance was compared across three groups; 20 acutely ill unmedicated DSM-IIIR schizophrenics, 10 other unmedicated acute psychotics, and 20 control subjects. When demographic variability between the groups was controlled for, there were no group differences in terms of NART performance. NART performance was not correlated with Brief Psychiatric Rating Scale scores, and in all three groups, no significant differences emerged when demographically predicted intelligence quotients were compared with NART estimated intelligence quotients. NART performance (predicted on the basis of demographic variables) was not significantly different from observed NART performance in any of the three experimental groups. However, within the sample with schizophrenia, NART estimated pre-morbid IQ was significantly higher than currently measured intellectual abilities. These results suggest that the National Adult Reading Test provides a reasonable estimate of pre-morbid ability in acutely ill, unmedicated schizophrenic patients.

Acute Disease↗
PubMed1991

Estimating premorbid intellectual level in dementia using the National Adult Reading Test: a Canadian study.

Twenty elderly demented subjects were compared with 20 elderly controls using a neuropsychological test battery which included the National Adult Reading Test (NART) and the WAIS-R. Significant differences emerged between the two groups on all of the cognitive measures administered, with the exception of the NART and the Verbal-Performance IQ discrepancy. Models were constructed using the normal controls as subjects where NART errors and WAIS-R Vocabulary age scaled scores were regressed against WAIS-R FSIQ and WAIS-R VIQ. These regression equations were then used to estimate premorbid intelligence levels in the demented sample, and these estimates were compared with the 'current' measures (WAIS-R FSIQ and WAIS-R VIQ). NART estimated IQs were significantly higher than Vocabulary estimated IQs, which in turn were significantly higher than WAIS-R FSIQ and WAIS-R VIQ. These results confirm that the ability to pronounce irregular words correctly remains relatively unimpaired in dementia.

Aged↗
PubMed1991

Parietal signs and sinister prognosis in dementia. A four-year follow-up study.

Thirty elderly demented subjects were assessed in 1985 using a neuropsychological test battery which included tests of parietal lobe function that are allegedly predictive of outcome. Four years later, 29 out of the 30 subjects were followed up. Twelve had died. There were no differences between survivors and deceased in terms of age, pre-morbid intelligence, years of full-time education, or scores on parietal tests. However, proportionally more of the women had died, and those subjects with more global cognitive impairment in 1985 were significantly more likely to have died by 1989. Those who scored lower on an aphasia measure in 1985 were more likely to have died. None of the variables differentiated between survivors and deceased Alzheimer subjects.

Aged↗
PubMed1987

Increasing circulating androgens with oral testosterone undecanoate in eugonadal men.

The effects of oral testosterone undecanoate (TU 80 mg; Organon) on plasma testosterone was assessed in 9 men (average age 55 yrs) complaining of loss of sexual interest. Absorption tests were carried out following the first dose of TU and again after 3 or 4 weeks of chronic administration. Absorption was variable in timing, peaks occurring from 30 min to 5 1/2 h after the oral dose. Increases in plasma testosterone of at least 50% of baseline levels occurred in 14 of the 18 tests. Apart from a slightly faster metabolic clearance on the second test, associated with a significant reduction in SHBG, there were no other significant differences between the first and second absorption tests. Variability of absorption may be related to dietary factors. If this can be reduced by dietary control, TU offers distinct advantages over injectable esters and implants in the short-term administration of testosterone to eugonadal men.

Absorption↗
PubMed1985

Androgens, behaviour and nocturnal erection in hypogonadal men: the effects of varying the replacement dose.

The behavioural effects of varying the replacement dose of the oral androgen testosterone undecanoate (TU, Restandol) were investigated in eight hypogonadal men. Each man was withdrawn from his previous androgen replacement regimen and after a period of no treatment was administered four doses of TU (40, 80, 120 and 160 mg/d) in four successive one-month treatment periods using a double-blind design. Throughout the study each man recorded his sexual interest, behaviour and mood state using a daily diary form. In addition, four hypogonadal subjects had sleep erections and sleep quality assessed in the laboratory during a state of androgen withdrawal and again after a minimum of 5 months of androgen treatment. A dose response relationship was demonstrated for frequency of sexual thoughts, arousal accompanying sexual thoughts and well-being. Sleep erections improved significantly during testosterone administration. In men, sexual interest and sleep erections are androgen-dependent.

Adult↗
PubMed1984

The effects of bromocriptine on the sexual behaviour of hyperprolactinaemic man: a controlled case study.

A 44-year old man presented with loss of sexual interest and erectile failure and together with his wife was treated successfully with sexual counselling. He was subsequently found to have been hyperprolactinaemic before and after sex therapy. Comparison of bromocriptine with placebo in two double blind studies showed a modest increase in sexual interest when his prolactin levels fell to normal. In this case, the principal effect of hyperprolactinaemia was on sexual interest. His main problems, erectile impotence and decline in sexual activity, resulted from his and his wife's psychological reaction to this modest hormonal effect. Hyperprolactinaemia appears to have a similar effect to testosterone deficiency in men.

Adult↗
PubMed1984

Testosterone therapy for low sexual interest and erectile dysfunction in men: a controlled study.

A double blind cross-over comparison of testosterone and placebo injection was carried out in two groups of men with normal circulating testosterone levels, 10 complaining principally of loss of sexual interest and 10 complaining principally of erectile failure. A significant increase in sexual interest was produced by testosterone in the first group. There was no effect on erectile function in either group. These results support previous findings from hypogonadal men that testosterone influences sexual interest but not erectile function, and indicate that increasing plasma testosterone can effect sexual interest even in men with pre-treatment testosterone levels within the normal range.

Adult↗