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Biomedical subjects

S Lewis

Publications and source records attributed to S Lewis.

At least 289 records · Page 16Linked to original sources
PubMed1993

Migraine madness: recurrent psychosis after migraine.

A 69 year old man with longstanding migraine with aura had four episodes of psychosis lasting 7-28 days during a 17 year period. During attacks he had formed visual hallucination and delusions, including reduplicative paramnesia. His mother was similarly affected. His EEG showed symmetrical frontal delta waves. The time course and EEG changes are similar to acute confusional migraine. The reduplicative paramnesia suggests a focal non-dominant hemisphere dysfunction.

Aged↗
PubMed1993

Delirium.

Explore the source record for details and available documents.

Delirium↗
PubMed1993

Computerised tomography and stroke.

To evaluate the utilisation of CT diagnostic imaging in patients admitted to hospital with a clinical diagnosis of stroke, and to identify factors which influence the use of CT imaging in stroke. Two hundred and fifty consecutive (155 females) stroke patients were assessed median age 76 years (range 39-95 y). Ninety-seven patients underwent CT scanning; median time to scan from admission was two days (range 0-43). The time to CT scanning was significantly shorter in patients aged < 65 years (p < 0.001), and in patients with a non-disabling stroke (p < 0.05). The factors (odds ratios and 95% confidence limits) significantly associated with CT scanning were male sex (2.21:1.31-3.74); normal Glasgow coma score (2.48:1.59-3.85); Rankin score 1-3 (6.40:1.74-23.56); age < 65 years (10.23:4.49-23.32) and no previous cerebrovascular event (1.97:1.10-3.51). In this study, those patients who would benefit most from medical intervention with antiplatelet agents to reduce the risk of recurrence were more likely to receive CT diagnostic imaging.

Adult↗
PubMed1993

Life events and psychosis. Initial results from the Camberwell Collaborative Psychosis Study.

Data from the Camberwell Collaborative Psychosis Study were used to examine the proposition that there is an excess of life events preceding the onset of psychoses of all types. Of 97 patients from the study who had episodes within the past year that were datable, 51 had developed psychotic symptoms from an essentially symptom-free state, 29 had been suffering only from neurotic symptoms, and 17 had experienced a marked exacerbation of psychotic symptoms. DSM-III diagnoses were collapsed into three major groups: 51 cases of schizophrenia; 31 cases of mania; and 14 cases of depressive psychosis. Life-event histories were taken for the six months before onset, and when these were compared with equivalent histories from a psychiatrically healthy sample from the local general population, there was a significant excess of life events, particularly in the three months before onset of psychosis. This was apparent in all groups, and remained even when events were restricted to the independent category. The excess of events began rather earlier than has been found in previous studies. In our view, this study provides some of the strongest evidence for a link between life events and the emergence of psychotic symptoms.

Adolescent↗
PubMed1993

Implant-retained overdentures.

While fixed implant-supported restorations were the most popular method of restoring edentulous mandibles during the development of osseointegrated implants, it soon became evident that removable overlay prostheses also were an excellent treatment choice. Lower cost and improved hygiene access were perhaps the main advantages of the removable overdenture in the mandible, although in some patients, the overdenture also provided necessary improved esthetics and more adequate lip support, compared to the fixed restoration.

Dental Implants↗
PubMed1993

Permeabilizing millions of cells with single pulses of an excimer laser.

Poration of millions of cells with single laser pulses of an argon fluoride excimer laser is developed and demonstrated on plant cells. The essence of the technique is to use the large beam size (10 x 25 mm) of the excimer laser and to split it using an appropriate mask into millions of micron- or submicron-sized beams of 193-nm radiation with enough energy to perforate cell membranes and walls. The extremely small depth of penetration of the 193-nm radiation in biological tissue (< 1 microns) is used to great advantage in this technique to provide for a gentle method that does not lead to cell death. This is the first laser-based method that has enough throughput to make it viable for biotechnological applications. Of considerable significance is that the method is applicable not only in the case of the single cells in suspension, but also for cells growing on the leaves of living plants.

Allium↗
PubMed1993

Bleeding oesophageal varices in alcoholic cirrhosis: long-term follow-up of endoscopic sclerotherapy.

Between 1977 and 1984, 53 consecutive unselected patients with bleeding oesophageal varices and alcoholic cirrhosis were treated by endoscopic sclerotherapy. Ten died during their index bleed, and 10 died within the following year due to hepatic failure (five), non-liver related causes (three), bleeding varices (one) and hepatocellular carcinoma (one). After the first year, a further three patients died of bleeding varices, eight died of hepatic failure (including one hepatocellular carcinoma) and six died of unrelated problems. Patients with hepatic disease of Childs-Pugh grade C died earlier than those of grade A and B grade (p < 0.01). There were 24 variceal recurrences within 1 year of completing sclerotherapy and seven recurrences later. Abstemious alcoholics rarely rebled and none developed recurrent varices after 18 months without recurrence. The size of the original varices, the number of sessions required to obliterate them, and the total volume of sclerosant used did not correlate with duration of remission. Continuing drinkers were more likely to present with bleeding varices (six of nine) than asymptomatic recurrences (one of 23) (p < 0.0001). In this study endoscopic sclerotherapy prevented deaths from variceal bleeds but there was a continued risk of death from hepatic failure and other unrelated causes.

Adult↗
PubMed1993

Acute syphilitic meningitis in a patient with systemic lupus erythematosus.

A man with systemic lupus erythematosus receiving chronic steroid therapy presented with headache, fever and panophthalmitis. Cerebrospinal fluid analysis was consistent with syphilitic meningitis. This represents the first reported case of syphilitic meningitis in a lupus patient. Our case report highlights the need to remain alert for unusual manifestations of syphilis in immunosuppressed patients.

Acute Disease↗
PubMed1993

A busy urban geriatric day hospital: analysis of one year's activity.

Lightburn Geriatric Day Hospital is a 30-place unit sited adjacent to Geriatric Assessment and Rehabilitation wards and three miles from the local district general hospital in east Glasgow. The service serves an urban population of 25,000 persons aged 65 or more. During 1991 a data capture form was used to prospectively record Day Hospital referral patterns and activity. There were 731 new patient referrals, accounting for a total of 5,780 patient attendances. Thirty-eight per cent of new patients attended without prior screening (unscreened General Practitioner (GP) referrals). Booked occupancy was 85.5%, actual occupancy 76%. The average period of attendance was three weeks (median number of attendances: 7) and 18% of attenders required in-patient care. Specific after-care arrangements were made for 85% of patients on discharge from day hospital. Low rates for re-attendance (within three months of day hospital discharge) and chronic attendance (more than three months) as well as favourable responses from surveys of both GPs and patients suggest effective use of the Day Hospital resource, but more direct measures of Day Hospital effectiveness are required.

Aged↗
PubMed1992

Treatment of edentulous maxillae with osseointegrated implants.

Edentulous maxillae can be restored with implant supported fixed restorations containing denture teeth on a metal framework, implant-retained removable overlay prostheses, or porcelain fused-to-metal fixed prostheses. Esthetics and hygiene access are two important factors in determining the restoration best suited for each patient. Treatment planning considerations and treatment procedures for the various techniques are discussed.

Dental Implants↗
PubMed1992

Arginase is a major pathway of L-arginine metabolism in nephritic glomeruli.

L-arginine can be metabolized to nitric oxide (NO) by nitric oxide synthase (NOS) and to urea and L-ornithine by arginase. Competition between these pathways for L-arginine in inflammatory sites has been suggested. In experimental glomerulonephritis glomeruli produce nitrite; a major source is macrophages. We hypothesized that arginase is present in glomeruli and may compete for substrate with NOS in glomerulonephritis. Therefore we examined both pathways in isolated nephritic glomeruli and peritoneal macrophages. Arginase activity was present in glomeruli, increased by > 500% in nephritic glomeruli compared to controls, and was predominant over NOS. Activity increased with L-NMMA (a NOS inhibitor), but this trend did not reach statistical significance. In macrophages both pathways were present; NOS predominated basally but this was reversed by L-NMMA. In contrast with glomeruli macrophage arginase activity increased after LPS stimulation. Levels of macrophage arginase activity could not account for activity in nephritic glomeruli, suggesting another source of arginase. This is the first demonstration of high arginase activity of nephritic glomeruli. Competition between arginase and NOS pathways suggests a regulatory mechanism of L-arginine metabolism within the glomerulus, with implications for the pathogenesis of injury and scarring in glomerulonephritis.

Amino Acid Oxidoreductases↗