Surgical removal of a gigantic abdominal mass: a multidisciplinary approach.

Background: Ovarian cystadenomas are common benign ovarian neoplasms that rarely present as gigantic abdominal masses. A variety of intraoperative and postoperative challenges may be encountered in the removal of these masses.

Case: We review the case of a 45-year-old woman who presented with massive abdominal swelling that was later identified as two distinct bilateral serous cystadenomas with a combined weight of approximately 107 kg.

Post-traumatic stress disorder and illness perceptions over time following myocardial infarction and subarachnoid haemorrhage.

Objectives: This study investigated post-traumatic stress disorder (PTSD) symptoms and illness perceptions in people who suffered the acute medical trauma of a myocardial infarction (MI) or a subarachnoid haemorrhage (SAH). The study tested hypotheses regarding changes in PTSD symptoms and illness perceptions over time, associations between PTSD and illness perceptions and cognitive predictors of PTSD.

Design And Method: The study employed a longitudinal design and measured the illness perceptions and PTSD symptoms of an MI group (N=17) and a SAH group (N=27).

Differences between out-patients with physical disease and those with medically unexplained symptoms with respect to patient satisfaction, emotional distress and illness perception.

Objectives: This study aimed to assess whether patients with medically unexplained symptoms (MUS) attending cardiology and neurology out-patient clinics were less satisfied with their consultation than patients whose presenting symptoms were explained by an organic diagnosis. The multidimensional nature of satisfaction and its relationships with emotional distress and illness perception were also assessed within the two groups.

Design And Setting: A prospective cohort study was carried out at a large inner city teaching hospital.

Predictors of outcome for orofacial pain in the general population: a four-year follow-up study.

Orofacial pain is often persistent, but it is not clear why it lasts in some patients but not in others. We aimed to describe the natural course of orofacial pain in a general population sample over a four-year period and to identify factors that would predict the persistence of pain. A cross-sectional population-based survey was conducted in the United Kingdom, involving 2504 participants (participation rate 74%), of whom 646 (26%) reported orofacial pain.

Patient communication during cataract surgery.

Purpose: Most cataract surgery is now performed under local anaesthesia on a day-case basis. As patients are fully conscious during the procedure, it is important that they remain still. There are a variety of reasons why patients may need to move, and it is important that the surgeon is made aware that this may happen.

Factors associated with health care seeking behaviour for orofacial pain in the general population.

Objective: To describe the health care seeking behaviour associated with orofacial pain (OFP) and determine factors associated with such behaviour.

Design: Cross-sectional population-based study using postal questionnaires.

Participants: Adults aged 18-64 years from a general medical practice in south-east Cheshire, UK (participation rate 74%).

The association between psychological factors and oro-facial pain: a community-based study.

Objective: To examine the hypothesis that psychological factors of psychological distress, maladaptive response to illness and perception of happiness in childhood, are associated with self-reported oro-facial pain (OFP).

Method: A cross-sectional population-based study was conducted in South-East Cheshire, UK. The adjusted participation rate was 74%, and 2504 adults aged 18-65 years participated in the study.

Association between female hormonal factors and oro-facial pain: study in the community.

The aim of this study was to determine the relationship between the prevalence of oro-facial pain (OFP) in the population and female hormonal factors. The cross-sectional population study was conducted in a general medical practice in the north-west of England. A random sample of 4000 adults aged 18-65 years were mailed questionnaires, of whom 2504 responded (adjusted participation rate 74%).

Oro-facial pain in the community: prevalence and associated impact.

Study Objective: To determine the prevalence of oro-facial pain (OFP) in the population and within-population subgroups and to describe the associated disability.

Design: Cross-sectional population study.

Setting: General medical practice in South East Cheshire, United Kingdom.

Factors associated with the temporomandibular disorder, pain dysfunction syndrome (PDS): Manchester case-control study.

Objectives: To determine the individual and combined effects of potential risk factors in relation to the temporomandibular disorder, Pain Dysfunction Syndrome (PDS).

Design: Case-control study.

Material And Methods: Cases were new referrals to the temporomandibular disorder clinic of the University Dental Hospital of Manchester, diagnosed with PDS.

Low-dose midazolam infusion for oculoplastic surgery under local anesthesia.

Purpose: Oculoplastic surgery with infiltration of local anaesthesia at the operative site performed as a day-case procedure is both efficient and cost-effective. Patients considered unsuitable for this because of fear or apprehension may, however, benefit from per-operative conscious sedation. We sought to study the efficacy and safety of this using midazolam, a water-soluble benzodiazepine.

Anxiety levels, patient satisfaction and failed appointment rate in anxious patients referred by general practitioners to a dental hospital unit.

Objective: To reduce the high failed appointment rate and anxiety levels among previously identified anxious new patients referred by general practitioners to a unit of restorative dentistry. A letter was drawn up which contained more explanatory information about the purpose and content of the initial dental appointment.

Design: The study was a single centre, double blind trial.

Familial Incidence and Influence on the Development of Obesity.

BACKGROUND: The prevalence of obesity in families of patients seeking surgical treatment for their severe obesity was investigated. METHODS: Patients listed for surgery (vertical gastroplasty) for severe obesity (BMI > 35) were interviewed and asked for details of the numbers of members of the immediate family who were at least 6.5 kg overweight.

Psychological status of diabetic people with or without lower limb disability.

The aim of this study was to compare the quality of life between diabetic people with chronic foot ulceration or lower limb amputation and diabetic controls. Each participant was interviewed using the Psychosocial Adjustment to Illness Scale, the Hospital Anxiety and Depression (HAD) scale, a specifically designed foot questionnaire and a quality of life ladder. Thirteen diabetic unilateral lower limb amputees (DA) were matched for age and sex with 13 unilateral diabetic patients with chronic foot ulceration (DU).

Reversal of Hair Loss following Vertical Gastroplasty when Treated with Zinc Sulphate.

BACKGROUND: Nutritional complications following surgery for morbid obesity include both vitamin and mineral deficiency. Severe cases of zinc deficiency can lead to alopecia, diarrhea, emotional disorders, weight loss, intercurrent infection, bullous-pustular dermatitis and hypogonadism in males. Hair loss may occur after vertical gastroplasty (VG).

Biochemical Changes after Vertical Banded Gastroplasty.

A prospective study of biochemical changes after vertical banded gastroplasty for morbid obesity, in 94 patients (10 males and 84 females, ages ranging from 18 to 59 years) has been carried out. Liver function tests and electrolyte estimations were performed preoperatively, during hospitalization for surgery, at 6 weeks and at 6 months postoperatively, and demonstrated no significant changes in liver function in these patients 6 months after surgery. The study concludes that there is no increase in the risk of liver damage or electrolyte disturbance after vertical gastroplasty, but that there may be subtle hepatic changes present as gall bladder disease developed in 18 patients postoperation (19%).

Resolution of Diabetes Following Vertical Gastroplasty in Morbidly Obese Patients.

Case reports are presented in three patients treated for morbid obesity by vertical gastroplasty. Prior to surgery, the patients had diabetes which required insulin, up to 200 units per day, or oral hypoglycemics for its control. Six months after surgery the diabetes had been resolved in all three patients, and they were no longer dependent on medication.

General practitioner referral rates to district psychiatry and psychology services.

The number of referrals made to a district psychiatry service by each of the local general practitioners over a five year period was counted and a large variation in general practitioner referral rate was found. Ten referral letters from each of the general practitioners were independently assessed for the amount of detail included and a mean score for each general practitioner obtained. A significant negative correlation was found between referral rate and amount of detail in referral letters, that is low referrers wrote very detailed letters.

The Oxford-Manchester study of dialysis patients. Age, risk factors and treatment method in relation to quality of life.

A retrospective study of 159 patients who started Haemodialysis (HD) or Continuous Ambulatory Peritoneal Dialysis (CAPD), between 1981 and 1984 was carried out in two UK Renal Units. An extension of the study was carried out in one unit during 1985, gathering data on 30 patients aged greater than 65. The aim was to assess whether age, medical or social risk factors, or treatment method, affected perceived quality of life.

Psychological factors in recovery from myocardial infarction: preliminary communication.

A small consecutive series of 27 myocardial infarction patients were interviewed at approximately 10 and 40 weeks after infarction to obtain data concerning the psychological aspects of rehabilitation. The results emphasized the need for consistency in imparting information and advice, and suggested the value of joint cardiological and clinical psychological assessment where patients fail to make expected progress. They pointed to a simple framework for intervention which is capable of further development and evaluation.

Does prostacyclin prevent cognitive deficits after open heart surgery?

Two groups of open heart surgery patients, one receiving prostacyclin and one placebo, were assessed one week pre-operatively and 3 months post-operatively, using a battery of clinical tests measuring a variety of cognitive functions. No significant differences between the groups were detected, apart from a visual retention deficit at 3 months in the prostacyclin group. The results cast doubt on previous findings suggesting that prostacyclin reduces cognitive deficits following open heart surgery.

Locus of control and cognitive behaviour therapy with mastectomy patients: a pilot study.

A cognitive behaviour therapy programme was designed for use with mastectomy patients, and a pilot study performed to test the efficacy of the programme. This article reports the locus of control data collected during the pilot study and the relationship between these data and the clinical assessment measures. Lower chance scores at pre-treatment are associated with greater clinical improvement as predicted.