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Articles by M Dewey
Total Records ( 4 ) for M Dewey
  M Dewey , E Zimmermann , F Deissenrieder , M Laule , H. P Dubel , P Schlattmann , F Knebel , W Rutsch and B. Hamm
 

Background— Noninvasive coronary angiography with the use of multislice computed tomography (CT) scanners is feasible with high sensitivity and negative predictive value; however, the radiation exposure associated with this technique is rather high. We evaluated coronary angiography using whole-heart 320-row CT, which avoids exposure-intensive overscanning and overranging.

Methods and Results— A total of 30 consecutive patients with suspected coronary artery disease referred for clinically indicated conventional coronary angiography (CCA) were included in this prospective intention-to-diagnose study. CT was performed with the use of up to 320 simultaneous detector rows before same-day CCA, which, together with quantitative analysis, served as the reference standard. The per-patient sensitivity and specificity for CT compared with CCA were 100% (95% confidence interval [CI], 72 to 100) and 94% (95% CI, 73 to 100), respectively. Per-vessel versus per-segment sensitivity and specificity were 89% (95% CI, 62 to 98) and 96% (95% CI, 90 to 99) versus 78% (95% CI, 56 to 91) and 98% (95% CI, 96 to 99), respectively. Interobserver agreement between the 2 readers was significantly better for CCA (97% of 121 coronary arteries) than for CT (90%; P=0.04). Percent diameter stenosis determined with the use of CT showed good correlation with CCA (P<0.001, R=0.81) without significant underestimation or overestimation (–3.1±24.4%; P=0.08). Intraindividual comparison of CT with CCA revealed a significantly smaller effective radiation dose (median, 4.2 versus 8.5 mSv; P<0.05) and amount of contrast agent required (median, 80 versus 111 mL; P<0.001) for 320-row CT. The majority of patients (87%) indicated that they would prefer CT over CCA for future diagnostic imaging (P<0.001).

Conclusions— CT with the use of emerging technology has the potential to significantly reduce the radiation dose and amount of contrast agent required compared with CCA while maintaining high diagnostic accuracy.

  A Mykletun , O Bjerkeset , S Overland , M Prince , M Dewey and R. Stewart
 

Background

Depression is reported to be associated with increased mortality, although underlying mechanisms are uncertain. Associations between anxiety and mortality are also uncertain.

Aims

To investigate associations between individual and combined anxiety/depression symptom loads (using the Hospital Anxiety and Depression Scale (HADS)) and mortality over a 3–6 year period.

Method

We utilised a unique link between a large population survey (HUNT–2, n = 61 349) and a comprehensive mortality database.

Results

Case-level depression was associated with increased mortality (hazard ratio (HR) = 1.52, 95% CI 1.35–1.72) comparable with that of smoking (HR = 1.59, 95% CI 1.44–1.75), and which was only partly explained by somatic symptoms/conditions. Anxiety comorbid with depression lowered mortality compared with depression alone (anxiety depression interaction P = 0.017). The association between anxiety symptom load and mortality was U-shaped.

Conclusions

Depression as a risk factor for mortality was comparable in strength to smoking. Comorbid anxiety reduced mortality compared with depression alone. The relationship between anxiety symptoms and mortality was more complex with a U-shape and highest mortality in those with the lowest anxiety symptom loads.

  V. C. H Chen , H. K. L Tan , A. T. A Cheng , C. Y Chen , L. R Liao , R Stewart , M Dewey and M. Prince
 

Background

Repeated self-harm is relatively common and is linked with an elevated risk of eventual suicide. There has been no study of this involving a large sample from the Far East.

Aims

To estimate the risk over the medium term of non-fatal repetition of self-harm and identify predictive factors in those carrying out self-harm.

Method

A total of 970 individuals who had self-harmed were recruited from a community-based suicide behaviour register system in Nantou, Taiwan from July 2000 to February 2003. Information regarding demography and suicide methods was collected. Individuals were followed-up until December 2005 to examine the risk of repeated self-harm and independent predictive factors.

Results

Ninety cohort members had repeated self-harm during the follow-up period (accounting for 131 repeated self-harm episodes in all). The cumulative risks were 5.7% for the first year, 7.8% for the second year and 9.5% for the fourth year. The risk was highest within the first year after the self-harm event. Independent risk factors included female gender and self-cutting as well as self-poisoning with drugs. Effect of younger age was mediated through the choice of methods.

Conclusions

Individuals with self-harm have a high risk of repetition, especially within the first year. Suicide prevention strategies need to focus on intervening with this population to reduce their repetition.

  C Hanlon , G Medhin , A Alem , M Araya , A Abdulahi , M Tomlinson , M Hughes , V Patel , M Dewey and M. Prince
 

Background

Traditional perinatal practices may protect against postnatal common mental disorders (CMD) in non-Western societies.

Aims

To evaluate the association between perinatal practices and postnatal CMD in rural Ethiopia.

Method

A population-based sample of 1065 women was followed up from pregnancy until 2 months postpartum. Qualitative investigation informed the development of scales measuring attitudes towards and adherence to perinatal practices. Postnatal CMD was measured using the Self-Reporting Questionnaire.

Results

Endorsement of sociocultural perinatal practices was associated with lower odds of antenatal CMD persisting into the postnatal period (adjusted odds ratio (OR) = 0.66, 95% CI 0.45–0.95). Women who endorsed protective and celebratory perinatal practices but were unable to complete them had increased odds of incident (adjusted OR = 7.26, 95% CI 1.38–38.04) and persistent postnatal CMD (adjusted OR = 2.16, 95% CI 1.11–4.23) respectively.

Conclusions

There is evidence for an independent role of sociocultural practices in maintaining perinatal mental health in this Ethiopian community.

 
 
 
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