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Biomedical subjects

S Moss

Publications and source records attributed to S Moss.

At least 91 records · Page 5Linked to original sources
PubMed1996

Respondent and informant accounts of psychiatric symptoms in a sample of patients with learning disability.

This paper investigates differences in the nature and frequency of psychiatric symptoms reported by patients with learning disability and key informants. The study involved psychiatric assessment of 100 patients with learning disabilities and key informants using the Psychiatric Assessment Schedule for Adults with a Developmental Disability (PAS-ADD), a semi-structured psychiatric interview developed specifically for people who have a learning disability. There was considerable disagreement between respondent and informant interviews: only 40.7% of cases were detected by both interviews. Respondents were more likely to report on autonomic symptoms and certain psychotic phenomena. Other anxiety and depression symptoms were more frequently reported by informants. The results indicate that it is crucial for sensitive case detection to complete both interviews where possible. If the respondent cannot be interviewed, panic disorder or phobias may be particularly difficult to detect.

Adolescent↗
PubMed1995

A comparison of the study populations in the Diabetes Control and Complications Trial and the Wisconsin Epidemiologic Study of Diabetic Retinopathy.

BACKGROUND: We compared the Diabetes Control and Complications Trial (DCCT) cohort with patients who had insulin-dependent diabetes mellitus (IDDM) in the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) to determine whether the DCCT cohort was similar to the patients with IDDM in the general population and whether the DCCT results are generalizable to a nonresearch population. METHODS: Demographic and clinical characteristics were compared between the DCCT study cohort and the WESDR cohort of patients with IDDM with age at onset of diabetes at younger than 30 years and followed up from 1980 to 1986. The DCCT eligibility criteria were applied to the WESDR cohort, and patients were identified who fulfilled the major criteria of the DCCT primary prevention and secondary intervention cohorts. Conventionally treated subjects in the DCCT primary prevention and secondary intervention cohorts were compared with their respective WESDR groups with regard to clinical characteristics, progression of retinopathy, and development of gross proteinuria. RESULTS: Comparison of the DCCT primary prevention and secondary intervention cohorts at baseline with the respective WESDR groups revealed an older age and an older age at diagnosis, a lower hemoglobin A1c (HbA1c) level, and more frequent injections and monitoring in the DCCT cohorts, but there were few other substantive differences. The progression of retinopathy and the association with baseline HbA1c level were similar for the conventionally treated DCCT and WESDR cohorts, except for a lower rate of progression in the DCCT secondary intervention cohort compared with that of the WESDR cohort, perhaps because of the lower HbA1c level. CONCLUSIONS: At baseline, patients in the DCCT cohort were generally similar to patients with IDDM in the population-based WESDR cohort, except for differences in the levels of HbA1c that diminished over time as the HbA1c levels in the WESDR cohort decreased. The demographic similarities between the DCCT and WESDR cohorts, the similar rates of progression of retinopathy in conventionally treated patients, and the similar associations between the HbA1c levels and progression of retinopathy in the DCCT and WESDR cohorts support the validity of generalizing the DCCT results to patients with IDDM in the general population.

Adolescent↗
PubMed1995

The applicability of the Kaufman Assessment Battery for Children (K-ABC) with older adults (50+ years) with moderate, severe and profound intellectual impairment.

To define the intellectual characteristics of a population of older people (50+ years) with severe intellectual impairment who were the focus of a wider demographic study, participants were assessed on the Kaufman Assessment Battery for Children (K-ABC). Test material was modified to make it age-appropriate and culturally suitable. Of the 122 people in the population [chronological age (CA) = 63.5 years; range 50-90 years], 61 were successfully tested on the K-ABC (CA = 60.9 years; range 51-81 years). Factor analysis closely replicated the factorial structure demonstrated for younger children. Separate Sequential and Simultaneous Mental Processing factors were identified, with subtests from the Achievement Scale loading on these factors and not constituting a separate factor. Application of hierarchical cluster analysis confirmed the factor structures. Inferences in relation to cognitive development from a Piagetian perspective are drawn, and the utility of information on mental processing for educational intervention with older persons with severe intellectual impairment is noted.

Achievement↗
PubMed1995

Dysphagia in an HIV-positive man.

An HIV-positive man whose dysphagia was due to non-Hodgkin's lymphoma. The differential diagnosis of this symptom in the context of HIV infection is summarised in box 3.

Adult↗
PubMed1995

Effect of peptide YY on human renal function.

Peptide YY (PYY) is released from the intestine into the circulation in response to ingestion of food. As PYY/neuropeptide Y (NPY) receptors have recently been identified in the human kidney, we examined the effect of PYY on human renal function. Male subjects (6 per group) received control infusate or PYY at 0.4 or 1.2 pmol.kg-1.min-1 intravenously for 90 min with control periods before and after. Infusion of PYY at the lower dose reproduced normal postprandial plasma concentrations and caused significant decreases in glomerular filtration rate (10% reduction), plasma renin activity (30% reduction), and aldosterone levels while increasing sodium excretion by approximately 30% (all P < 0.01). Infusion of PYY at the higher dose, which reproduced plasma levels seen during a diarrheal illness, resulted in similar changes in renal function and also reduced renal plasma flow by approximately 10% (P < 0.05). Therefore, PYY may be an important mediator of the normal postprandial natriuretic response, and PYY agonists could provide a novel approach to the treatment of patients with sodium overload.

Adult↗
PubMed1995

Psychiatric symptoms associated with dementia in older people with learning disability.

BACKGROUND: This paper describes a study of non-cognitive features of dementia in a population of 105 people over 50 years of age, with learning disability. METHOD: The study involved psychiatric assessment using the Psychiatric Assessment Schedule for Adults with a Developmental Disability (PAS-ADD), a semi-structured psychiatric interview developed specifically for people who have learning disability. Dementia was diagnosed using a combination of informant interviewing and observation of cognitive change over a three year period. RESULTS: Sample members with definite dementia had higher levels of sleep difficulty, hypersomnia, irritability, inefficient thought, loss of interest and anhedonia. Discriminant function analysis showed that non-cognitive features could help discriminate between definite and probable cases. CONCLUSIONS: Results support the previously reported observation for the general population that cognitive and non-cognitive features are only weakly related. The study suggests that psychiatric symptom information may be useful in screening for dementia in people with learning disability.

Activities of Daily Living↗
PubMed1995

New Jersey radiology: the first decade.

Within months of Roentgen's discovery of x-rays, physicians were anxious to learn about the new technology. The Transactions of MSNJ kept practitioners informed about the applications and the dangers of medical radiology. The author looks back at the first decade of radiology in New Jersey.

History, 19th Century↗
PubMed1994

Treatment of bacterial vaginosis with a three day course of 2% clindamycin vaginal cream: a pilot study.

OBJECTIVE: To evaluate the efficacy and safety of a 3 day course of 2% clindamycin cream in the treatment of bacterial vaginosis. DESIGN: A prospective, randomised, double blind, placebo controlled study. SETTING: Department of Genitourinary Medicine, Royal Liverpool University Hospital. SUBJECTS: 55 female patients aged 18 years and over, and premenopausal, who spontaneously or after questioning complained of symptoms of bacterial vaginosis. RESULTS: 55 patients were enrolled. 44 patients were evaluable at Visit 1 when among the 23 who received clindamycin cream bacterial vaginosis was not present in 22 (95.6%) and only one failed treatment. Of the 21 patients in the placebo group only one (4.8%) patient was cured and 20 (95.2%) were failures. Of the 17 patients evaluable at Visit 2 in the clindamycin group, bacterial vaginosis was not present in 14 (82.4%) and had recurred in three. No serious adverse events were noted in either group. CONCLUSION: This pilot study provides encouraging evidence of the efficacy and safety of a 3 day course of 2% clindamycin cream in bacterial vaginosis.

Adolescent↗
PubMed1993

Physical morbidity in older people with moderate, severe and profound mental handicap, and its relation to psychiatric morbidity.

This report describes a study of physical health problems and their relation to psychiatric morbidity in a community sample of 105 people with severe mental handicap and over the age of 50 years from a Metropolitan Borough. An extensive outreach exercise ensured that almost 100% of people fulfilling the age and ability criteria were included in the study. All the physical and mental health assessments were carried out by a psychiatrist at senior registrar level. Physical assessments used a combination of physical examination and access to the subject's medical records. Results showed that, with minor exceptions, the physical health of the handicapped population was no worse than that of controls. Contrary to expectation, no relationship was demonstrated between physical and psychiatric morbidity. However, this may be due to the greater difficulty in identifying psychiatric morbidity in people who are more severely handicapped. Since physical health problems increase with level of handicap, the potential relation between physical and mental health is masked.

Aged↗
PubMed1993

Psychiatric morbidity in older people with moderate and severe learning disability. I: Development and reliability of the patient interview (PAS-ADD).

This paper describes the development of the PAS-ADD, a semistructured clinical interview for use specifically with patients with learning disabilities, based on items drawn from the PSE. The PAS-ADD includes a number of novel features including: parallel interviewing of patient and informant; a three-tier structure to provide a flexible interview appropriate to the patient's intellectual level; use of a memorable 'anchor event' in the patient's life to improve time focus; and simplified wording, improved organisation and lay out. Inter-rater reliability was investigated using an experimental design in which two raters viewed and re-rated videotaped PAS-ADD interviews which had been conducted by an experienced clinician. Reliability results compared favourably with those obtained in a major study of PSE reliability with a sample drawn from non-learning disabled individuals. Mean kappa for all items was 0.72. Other indexes of reliability were also good. In the current phase of development, the PAS-ADD is to be expanded to include further diagnostic categories, including schizophrenia and autism. The new version will be updated for use with ICD-10 criteria.

Aged↗
PubMed1993

Psychiatric morbidity in older people with moderate and severe learning disability. II: The prevalence study.

We present a prevalence study of psychiatric morbidity in people over 50 years of age with learning disability (LD), using a new semistructured clinical interview specifically for use with people who have LD (the 'PAS-ADD'). Assessment involved parallel interviewing of subject and informant, these two sets of information being combined to reach a final diagnosis using ICD-9 and DSM-III-R criteria. Detection of dementia involved interviews with informants, plus investigation of loss of cognitive function over a three-year period. The experimental sample was a mixed community and institutional group (n = 105), including, as far as possible, all people in a single administrative district (Oldham) matching the age and ability criteria. Prevalence of psychiatric disorder excluding dementia was 11.4% (n = 12), most of which were depression and anxiety. Seventy-five per cent of these cases were unknown to mental health services. However, immediate care staff were usually aware of the symptoms, although often unaware of their clinical significance. Prevalence of dementia was also 11.4% (n = 12), with a combined case prevalence of 21.0% (n = 22). The PAS-ADD proved a flexible interview, effective in use with people of varying linguistic level and intellectual ability: 61.9% (n = 65) of the sample were able to be interviewed, fully adequate clinical interviews being obtained with a group of 38 people whose mean IQ was only 39. In the remaining 38.1% (n = 40), diagnosis relied exclusively on informant data. Overall, the combination of subject and informant data was essential for sensitive case detection.

Aged↗
PubMed1992

Differential recognition of secretory vesicles by annexins. European Molecular Biology Organization Course "Advanced Techniques for Studying Secretion".

The interactions of synexin, calpactin, and p68 (annexins VII, II, and VI) with zymogen granules and adrenal medullary chromaffin granules were compared. Synexin promoted the aggregation and fusion of both types of organelles. Calpactin inhibited the action of synexin on zymogen granules but would aggregate only chromaffin granules. p68 inhibited aggregation of chromaffin granules by calpactin and fusion of zymogen granules by synexin. The results demonstrate that these annexins, all of which bind acidic phospholipids, interact differently with different biological membranes and therefore may play specific and non-overlapping roles in cells where they are co-expressed.

Adrenal Medulla↗