Search PubMed⌕ Search

Biomedical subjects

W H Reid

Publications and source records attributed to W H Reid.

17 recordsLinked to original sources
PubMed1992

The use and reliability of psychiatric diagnosis in forensic settings.

The clinical professional encounters conflict whenever he or she enters the courtroom. The psychiatrist's approach must not be simply diagnostic or simply legal. We cannot shed our clinical identity; indeed, the court depends on our clinical identity and expertise in its search for the truth. The psychiatric expert must be able to translate his or her findings for the court, but these findings must come from clinical experience, not some solely legal perspective. The legal system needs our knowledge about the interfaces of mental illness, function, and behavior. After we provide our opinions, however, the legal issues must be left to the lawyers and the final determinations left to the judge or jury.

Criminal Law↗
PubMed1991

Increased airways reactivity after smoke inhalation.

13 fire victims who required treatment after smoke inhalation underwent lung function assessment within 3 days of injury and 3 months later. Initial airways hyperreactivity improved over this period, but FEV1 and airways specific conductance did not change significantly. There was a strong correlation between exposure carboxyhaemoglobin concentration (an indicator of smoke exposure) and initial airways specific conductance (r + 0.79; p = 0.006). Airways obstruction after smoke inhalation in house fires may be more common and more persistent than is generally recognised. Early lung function tests would allow the incidence of pulmonary complications after smoke inhalation and the potential benefits of early use of inhaled antiinflammatory drugs to be assessed.

Adult↗
PubMed1991

Alveolar macrophage chemotaxis in fire victims with smoke inhalation and burns injury.

In vitro migration of alveolar macrophages was studied in 24 fire victims and 19 controls; all subjects were cigarette smokers. Unstimulated (P = 0.01) and stimulated migration towards casein-(P = 0.01) and zymosan-activated serum (P = 0.002) of macrophages from smoke inhalation patients (SI) (n = 19) was increased when compared to control subjects (CS). Migration of alveolar macrophages from patients with burns without smoke inhalation (burns only, BO) was not increased. Patients with smoke inhalation and no burns (smoke only, SO) (n = 9) had increased migration when compared to controls but this was not statistically significant. Patients with smoke inhalation and burns (SB) (n = 10) had increased unstimulated migration (P = 0.01) and increased migration towards casein (P less than 0.005), ZAS (P less than 0.002) and F-met-leu-phe (P less than 0.05) when compared to controls (CS). Lavage fluid from the fire victims displayed chemotactic activity towards normal human neutrophils and its analysis for the components of the complement cascade proved positive (Clq, Clr, Factor B and C3). These data suggest that activation of alveolar macrophages may contribute to the development of pathophysiological changes in patients with smoke inhalation (SI) and particularly those with smoke inhalation and burns (SB).

Burns↗
PubMed1990

Q-switched ruby laser treatment of tattoos; a 9-year experience.

Nine years of clinical experience of the application of the Q-switched ruby laser to the removal of tattoos is presented. This laser achieves optimal removal of blue/black amateur tattoos by its selective interaction with the dermal suspensions of pigment which constitute the tattoos. The scar free cosmesis thus achieved is a considerable improvement on non-specific laser techniques whereby the laser is absorbed to a comparable degree in both pigmented and non-pigmented tissue. Long-term results are analysed and it is noted that a variety of professional tattoos may also respond to treatment. The mechanisms and appearance are discussed and correlated with short-term healing processes. It is found that power densities in the range 1200-2800 GW/m2 are most suitable. Appropriate dosimetry can be witnessed by the appearance of opaque intradermal vacuoles corresponding to the vaporization of the tissue water surrounding the pigment suspensions. Treatment by Q-switched ruby laser offers a viable scar-free option for a wide range of dark tattoos, leading to a more acceptable clinical outcome in most cases than other current therapies.

Dermatologic Surgical Procedures↗
PubMed1990

Changes in alveolar macrophage, monocyte, and neutrophil cell profiles after smoke inhalation injury.

Thirty two fire victims with smoke inhalation, with or without burns, and 26 control subjects had bronchoalveolar lavage performed. Cell yields and differential cell counts were assessed. All patients and controls were cigarette smokers. Patients with smoke inhalation (SI) injury generally showed higher total bronchoalveolar lavage (BAL) cell yields, and this was significant on repeat lavage from 12 patients. The increase was almost entirely due to an increase in the proportion of neutrophils in patients with smoke inhalation alone (S) and those with cutaneous burns as well as smoke inhalation (S + B). On sequential lavage of 12 patients with smoke inhalation (SI) the proportion of neutrophils had increased; this was significantly higher than on initial lavage. Using various macrophage markers, the proportions of macrophage subgroups were determined. There was an increase in UCHM1 and RFD9 positive cells in each subgroup: the increase in UCHM1 positive cells was significant in patients with burns as well as smoke inhalation, and the increase in RFD9 positive cells was significant in patients with smoke inhalation alone. Assessment of the role of such cells in the development of acute lung injury (such as adult respiratory distress syndrome) may be important in our understanding of the mechanisms entailed.

Bronchoalveolar Lavage Fluid↗
PubMed1990

Access to care: clozapine in the public sector.

Clozapine holds great clinical promise for some chronic schizophrenic patients. However, limitations on access to the drug by the largest subgroup who need it, the indigent, are causing frustration for patients, their families, physicians, and public-sector mental health systems. The drug is available only through the manufacturer's proprietary monitoring system; many public-sector professionals and agencies feel that the system is overpriced, is unfairly exclusive, and has thus far kept the drug out of reach of most patients who need it. Arguments that patient improvement will lead to dollar savings in the long run seem overly optimistic. The ethical issue of access to treatment remains. The author discusses these and related issues and reports early experience from several public mental health systems.

Agranulocytosis↗
PubMed1990

Management of congenital arteriovenous malformations.

Over a 6-year period, 12 patients with 14 congenital arteriovenous malformations were considered for a staged approach to include afferent vessel ligation (AVL) and/or intra-arterial embolization (IAE) and surgical excision where possible. Patients were followed for a period ranging from 3 to 60 months. Two patients had localized lesions which were completely excised. Five patients were treated by IAE followed by excision with a successful outcome in four. One patient had a transmetatarsal amputation for failed IAE. Two patients had both IAE and AVL before excision of the lesion. In one patient AVL alone was followed by a recurrence. Two patients with multiple lesions were kept under observation. It would appear that IAE and excision of an arteriovenous malformation can achieve cure or excellent palliation in most patients.

Adolescent↗
PubMed1985

The antisocial personality: a review.

Definition, understanding, and treatment of antisocial personality disorder continue to present difficulties, but there have been several encouraging developments. Recently published data on antisocial syndromes from several different disciplines have been strikingly consistent and have raised hopes for an integrated understanding of the disorder. In addition, many of the sources of antisocial symptoms have been identified, and certain highly structured therapeutic programs have been effective in modifying antisocial behavior. The paper reviews the latest issues related to diagnosis, symptom presentation, and treatment, as well as pathologic, sociologic, and epidemiologic aspects of the disorder.

Adolescent↗
PubMed1978

The sadness of the psychopath.

In this introduction to the study and treatment of antisocial disorders, pain and loss to, as well as from, the sociopath are explored in an effort to establish and update an overview of sociopathy for the therapist or social scientist who is asked to work with such patients.

Antisocial Personality Disorder↗
PubMed1976

A review of psychotropic medications and the glaucomas.

Four general groups of psychotropic drugs are examined with respect to possible adverse effects upon intraocular pressure. After a brief discussion of the various mechanisms of the glaucomas, both general and specific information is provided and discussed concerning antipsychotic, antidepressant, antiparkinsonian and antianxiety preparations of a variety of chemical structures and utilities. The consensus of the authors is that with certain basic safeguards virtually all of the medications studied are acceptably safe to prescribe even in patients with diagnosed glaucoma.

Anti-Anxiety Agents↗
PubMed1975

Treatment of somnambulism in military trainees.

Of 12 otherwise health individuals facing honorable discharge from the military because of intractable sleepwalking, six chose to participate in a short-term treatment program involving hypnosis. Four of these reported total alleviation of symptoms. Therapeutic design and treatment implications are discussed and a brief review of the literature is presented.

Adolescent↗
PubMed1975

Sleepwalking.

Explore the source record for details and available documents.

Humans↗
PubMedDate not supplied

Treatment of portwine stains using the pulsed dye laser.

Five years of clinical experience of the treatment of portwine stains using the flashlamp-pumped dye laser is presented. The dye laser, when turned to a wavelength of 577 nanometres with a short pulsewidth of the order of 340 microseconds, may be used to target selectively the dilated vasculature constituting the lesion. Patients with ages ranging from 5-45 years were treated under general anaesthetic using a computer controlled scanning system developed by the authors. Several repeat treatments were found to be necessary. Results are presented ranging from total eradication of the lesion to marginal lightening only. No scarring of the treated sites was evident.

Adolescent↗