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Biomedical subjects

T Burns

Publications and source records attributed to T Burns.

At least 127 records · Page 7Linked to original sources
PubMed1986

Contact of parasuicide patients with the accident and emergency department.

In a group of 82 consecutive parasuicide patients attending the St George's Hospital Accident and Emergency Department, London, England, 15 had attended the same department within the preceding 6 months. Thirteen of these 15 had also consulted their general practitioner during this time, as had a further 51 parasuicide patients. Only two out of the 82 patients, therefore, had had sole medical contact with the Accident and Emergency Department in the 6 months prior to their suicide attempt. This is the first such report from an accident and emergency department. It demonstrates that very few patients seek help from, or visit in isolation, this facility prior to a parasuicide episode as opposed to visiting their general practitioner whose importance is reaffirmed. The problems of identifying 'somatising' patients in an accident and emergency department are discussed.

Adolescent↗
PubMed1986

Localization of the gene for X-linked spinal muscular atrophy.

We used probes for DNA polymorphisms on the X chromosome to study genetic linkage in seven families with X-linked adult-onset spinal muscular atrophy. We found significant linkage to the marker DXYS1 on the proximal X chromosome long arm and loose linkage or nonlinkage to markers elsewhere. Our analysis localizes the gene defect for this form of anterior horn cell disease.

Adult↗
PubMed1986

Use of the term "borderline patient" by Swedish psychiatrists.

Four hundred and sixty seven Swedish psychiatrists (response rate = 52.5%) returned a questionnaire on their understanding of the term "borderline patient". Virtually all had heard of it and 75.2% regularly used it as a diagnosis. Its use was positively associated with female sex, psychotherapy interest and training. 38.8% of the respondents aligned themselves with a predominantly constitutional, and 57.8% with a psychodynamic, understanding of the term. This difference was strongly associated with those diagnoses to which the term was considered equivalent, the symptoms most characteristic of it and with various aspects of the responding psychiatrists' training and work. Swedish psychiatrists emphasized the subjective aspects of the patients' disorder rather than the lability and socially disruptive behaviour which are so prominent in the DSM-III diagnosis. The results of this study underline the urgent need for the establishment of simpler and more practical criteria for the diagnosis.

Borderline Personality Disorder↗
PubMed1985

Factors affecting prognosis in male anorexics.

Twenty-seven male anorexics have been followed up over 2-20 yr (mean 8 yr) and their outcome assessed. This has been compared with outcome in female patients with similar pictures at presentation (Burns and Crisp, 1984). Features of the family and personal history and clinical aspects of the disease at presentation were compared with outcome and a number found to be significantly associated with it. Poor relationship with parents during childhood and the absence of normal adolescent sexual behavior and fantasy premorbidly were strongly predictive of a poor outcome. Long duration of illness, previous treatment and greater weight loss during illness were also associated with poor outcome, although no specific dietary behaviour was predictive. The remarkable similarity in outcome pattern between the male and female prompts re-evaluation of some theories of the nature of the role of sexual conflicts in anorexia nervosa.

Adult↗
PubMed1985

Food-induced changes in theophylline absorption from controlled-release formulations. Part I. Substantial increased and decreased absorption with Uniphyl tablets and Theo-Dur Sprinkle.

Food-induced changes in absorption from two controlled-release formulations of theophylline (Uniphyl tablets [Purdue Frederick Co.] and Theo-Dur Sprinkle [Key Pharmaceuticals, Inc.]) were studied in healthy male nonsmokers. Although the two forms exhibited a theophylline in vitro dissolution rate that was independent of changes in pH from 1 to 8, they showed substantial but opposite food-induced absorption changes. In a 12-subject, three-way, single-dose, randomized, crossover study the bioavailability of theophylline relative to immediate-release aminophylline tablets increased from 53% +/- 23% (means +/- SD) to 96% +/- 46% when Uniphyl (two 400 mg tablets) was taken under fasting and nonfasting (high fat content meal) conditions, respectively. On the other hand, in a separate six-subject, two-way, randomized, crossover study, food reduced the bioavailability of theophylline from Theo-Dur Sprinkle: Theophylline bioavailability in the nonfasting state was only 53% +/- 9% that in the fasting state.

Absorption↗
PubMed1985

Food-induced changes in theophylline absorption from controlled-release formulations. Part II. Importance of meal composition and dosing time relative to meal intake in assessing changes in absorption.

Theo-24 (G. D. Searle & Co.) is an ultra-slow-absorbing formulation of theophylline suitable for once-a-day dosing in slow and normal metabolizers of theophylline. Relative to fasting conditions, increased rate and extent of theophylline absorption occur when this product is administered immediately after a breakfast with a high fat content. Our study demonstrated that factors such as meal composition (fat content) or dosing time relative to meal intake can modify the high fat-induced changes in absorption. For consistent, slow absorption, patients taking high doses (greater than or equal to 900 mg) of Theo-24 once a day should take this product in the morning under fasting conditions or with a breakfast containing less than or equal to 10 gm fat. If a high-fat breakfast (greater than 55 gm fat) is taken, then Theo-24 should be administered at least 1 hour before the meal.

Absorption↗
PubMed1984

Outcome of anorexia nervosa in males.

Twenty-seven consecutive male patients suffering from anorexia nervosa were followed-up 2-20 years after presentation; 20 had been treated with an in-patient refeeding/psychotherapy regime. The outcome of the series compared very closely with a similar group of female anorectics: 12 (44%) had a good outcome, stable weight restoration and normal sexual functioning; seven (26%) had an intermediate outcome, and eight (30%) poor (weight more than 15% below normal, and poor or no sexual activity). No patient had died. Good outcome in terms of weight was associated with good psychological and social functioning, while poor outcome was clearly associated with a longer duration of illness, previous treatment, and greater weight-loss during illness, although not with any specific dietary behaviour. Poor relationship with parents during childhood and the absence of normal adolescent sexual behaviour premorbidly were also strongly predictive of poor outcome.

Adolescent↗
PubMed1984

Familial aggregation of Reiter's syndrome and ankylosing spondylitis: a comparative study.

To determine the nature and prevalence of spondyloarthropathy (SpA) among the 1st degree relatives of probands with either Reiter's syndrome (RS) or ankylosing spondylitis (AS), 599 relatives of 223 consecutive probands (110 RS and 113 AS) were blindly evaluated in a controlled study. Analysis was by questionnaire, radiographic examination without knowledge of proband or relative status and, where relevant, by chart review. No cases of RS were found among the 277 relatives of probands with AS. In contrast, 11 of 322 relatives of probands with RS did have RS which was neither temporally related in onset nor due to a common epidemic source (p less than 0.01). There were 18 cases of AS among the relatives of the probands with AS compared to only 7 cases among the relatives of the patients with RS (p less than 0.05). Two probands with AS each had 2 relatives with AS. Thus, the degree of familial aggregation in RS (11/110; 10%) approaches that seen in AS (16/113; 14%) and the 2 diseases tend to breed true within families. These data suggest that there may be different genetic backgrounds in patients with RS and AS, despite the fact that both conditions are typically associated with HLA-B27.

Adult↗
PubMed1983

Genetic differences between B27 positive patients with ankylosing spondylitis and B27 positive healthy controls.

In a controlled study of the 499 available first degree relatives of 79 consecutive HLA-B27 positive patients with ankylosing spondylitis and 69 HLA-B27 positive healthy blood donors, 19 cases of ankylosing spondylitis were found: 16 (15 B27 positive) among the 282 relatives of the patients with ankylosing spondylitis, and 3 (1 B27 positive, 1 B27 negative, 1 unknown) among the 217 relatives of healthy donors (chi c2 = 5.11; P less than 0.025). However, if all cases of possible spondylarthritis are included, 48 cases of ankylosing spondylitis were found: 37 of 282 relatives of patients with ankylosing spondylitis and 11 of 217 relatives of healthy donors (chi c2 = 8.29; P less than 0.01). Assuming that 50% of relatives of B27 positive individuals carry this antigen, 15 of 142 (10.6%) B27 positive relatives of patients and 2 of 108 (1.9%) B27 positive relatives of healthy subjects (chi c2 = 5.91; P less than 0.025) have ankylosing spondylitis. The relative risk of spondylarthropathy for B27 positive relatives of B27 positive patients compared with relatives of B27 positive healthy subjects is 5.6. Assuming all subjects were evaluated in a similar manner, analysis of these data suggests genetic differences between B27 positive diseased individuals and B27 positive healthy subjects.

Adult↗
PubMed1979

Acute colitis and bacteremia due to Campylobacter fetus.

An acute febrile illness with dysentery and colitis developed in a 26-year-old man following a wilderness outing. Campylobacter fetus ssp. jejuni was subsequently grown on blood cultures drawn during the acute illness and 9 days later when the patient was asymptomatic. Proctosigmoidoscopic and histopathologic evidence of acute colitis was present on admission and resolved on follow-up examination. Campylobacter fetus spp. jejuni infection should be considered in the etiology of acute infectious colitis.

Adult↗
PubMed1975

Serum calcitonin-lowering effect of magnesium in patients with medullary carcinoma of the thyroid.

The effect of magnesium chloride or magnesium sulfate infusion on circulating levels of immunoreactive calcitonin (iCT) was evaluated on nine occasions in three patients with metastatic medullary carcinoma of the thyroid. One patient was normocalcemic and had normal circulating levels of immunoreactive parathyroid hormone (iPTH), one patient was hypocalcemic and had surgical hypoparathyroidism, and one patient had mild to moderate hypercalcemia associated with bone metastases. The basal serum iPTH levels were undetectable in the latter two patients. In every instance magnesium administration produced a rapid and striking fall in circulating iCT and usually a detectable fall in serum calcium. During the hypermagnesemic state, serum iPTH fell from normal to undetectable in the patient with normal parathyroid function, while serum iPTH levels remained undetectable in the hypoparathyroid patient and in the patient with hypercalcemia associated with bone metastases. The results of these studies indicate that: (a) contrary to what has been reported in normal experimental animals, magnesium administration lowers circulating iCT in human subjects with thyroid medullary carcinoma and (b) the calcium-lowering effect produced by magnesium in patients with medullary carcinoma may, in part at least, be due to a redistribution of body calcium that is not mediated by the actions of either parathyroid hormone or clacitonin.

Aged↗