25 results found
Hilton C, 2013, High Jinks and HIV: methamphetamine, novel psychoactive substances and sexual risk taking, AIDS Impact / SEISIDA
Catto A, Hilton C, 2013, Catching an NMDA-receptor encephalitis: clinical features to discriminate from other psychiatric syndromes, Royal College of Psychiatrists Neuropsychiatry Conference
Introduction:NMDA receptor encephalitis is a rare reversible cause of neuro-psychiatric disturbance. It frequently presents with characteristics which can resemble psychosis, catatonia and Neuroleptic Malignant Syndrome (NMS). We aim to highlight the difficulties of establishing a diagnosis of NMDAr encephalitis and how it might be distinguished from these other psychiatric syndromes. Methods:A recent case of a young woman is described with particular focus on neuropsychiatric symptomatology. We then report the results of targeted systematic literature review between 2005-2013 of papers comparing clinical features of catatonia or NMS to NMDA receptor encephalitis in an attempt to develop an aid for psychiatrists to differentiate these illnesses. Results:In the described case many of the key features of catatonia and NMS are displayed at various points during her illness before an eventual diagnosis of NMDAr encephalitis.The literature review reveals 10 papers and a total of 11 case reports linking NMS or catatonia to confirmed NMDAr encephalitis. Of 11 case reports of confirmed NMDAr encephalitis, 10/11 demonstrated psychotic features, 8/11 had concomitant catatonic features and 5/11 fever following exposure to antipsychotic medications suggesting NMS. Reported average time to diagnosis was 43 days. The features that might have raised early suspicion of NMDAr encephalitis included first episode of mental disturbance 11/11, acute deterioration 9/11, seizure-like movements (with or without epileptiform activity) 10/11, poor memory 7/11 and autonomic instability 6/11.Conclusion: NMDAr encephalitis can present with features suggestive of psychosis, psychiatric catatonia and NMS. A high index of suspicion is required for its diagnosis. We postulate that patients presenting with first episode psychosis who develop catatonic features, seizure-like movements or autonomic disturbance could be tested for NMDAr antibodies as part of their work up.
Sachar A, Hilton C, Tandy R, 2013, Integrated diabetes care: what's mental health got to do with it? The Inner North West London Integrated Care Pilot experience, Royal College of Psychiatrists, Liaison Faculty Conference
Hilton C, Oliver N, Sachar A, 2013, Beyond integrated care: learning from the use of higher trainee special interest sessions to develop a pathway of care for community patients with diabetes, Royal College of Psychiatrists, Liaison Faculty Conference
Hilton C, Ofori-Attah G, Bowden-Jones O, 2013, Club drugs and novel psychoactive substances: a call for more dedicated treatment services and education of health professionals, New trends in addiction: the challenge for treatment services, Publisher: Royal College of Psychiatrists
Hilton C, 2012, New generation, new drugs, Substance Misuse Management in General Practice Conference
Hilton C, 2012, Eating disorders and reproductive health, Margaret Pyke Trust: Current issues in reproductive health
NHS Confederation Mental Health Network, 2012, Investing in Emotional and Psychological Wellbeing for Patients with Long Term Conditions: a Guide for Service Design and Productivity Improvement for Commissioners, Clinicians and Managers in Primary Care, Secondary Care and Mental Health, Publisher: NHS Confederation
Hilton C, Patel I, Newton S, et al., 2012, Integrating physical and mental health: one year pilot of Liaison Psychiatry input into a Community Respiratory Service, Royal College of Psychiatrists, Liaison Faculty Conference
Hilton C, O'Driscoll W, Ruttley A, et al., 2012, Learning to lead: innovative higher trainee leadership development initiatives in a small Liaison Psychiatry team, Royal College of Psychiatrists, Liaison Faculty Conference
International Centre for Drug Policy, 2012, Substance misuse in the undergraduate medical curriculum project report, London, Publisher: ICDP
Hilton C, 2011, Diary Drawings: Mental Illness and Me Bobby Baker Profile Books, 2010, £15.00 pb, 232 pp. ISBN 9781846683749, The Psychiatrist, Vol: 35, Pages: 279-279, ISSN: 1758-3209
Hilton C, Thorley F, Williams E, et al., 2011, Crystal clear: prolonged psychosis in former methamphetamine users. Case reports and review of literature, Royal College of Psychiatrists, Addiction Faculty Conference
Hilton C, Catalan J, Davies G, et al., 2011, Assessment of psychiatric history and symptoms by non psychiatric doctors on an acute medical unit, Royal College of Psychiatrists, Liaison Faculty Conference
International Centre for Drug Policy, 2011, Substance misuse in the undergraduate medical curriculum: a toolkit for teaching and learning, Publisher: St George's, University of London
Institute of Psychoanalysis, 2010, Training to be a psychoanalyst at the Institute of Psychoanalysis, Publisher: Institute of Psychoanalysis
Hilton C, 2010, Methamphetamine addiction: biological foundations, psychological factors and social consequences, AIDS Care, Vol: 22, Pages: 1434-1435, ISSN: 0954-0121
Hilton C, Nelson L, Mure E, 2010, Watch with mother: bringing technology into the therapy room, Royal College of Psychiatrists Child Psychiatry Special Interest Group Annual Meeting
Hilton C, 2009, Raze out the written troubles of the brain, Royal College of Psychiatrists London Division Newsletter, Vol: 9
Owen D, Bicknell C, Hilton C, et al., 2007, Preoperative smoking cessation: a questionnaire study, International Journal of Clinical Practice, Vol: 61, Pages: 2002-2004, ISSN: 1368-5031
Owen D, Shiner T, Sivakumar R, et al., 2006, Pneumonia: Are we putting the CURB score into practice?, BMJ, Vol: 332, Pages: 1213-1213, ISSN: 0959-8138
Owen D, Shiner T, Hilton C, et al., 2006, Prescription of antibiotics for the treatment of community acquired pneumonia in a district general hospital in the UK, European Respiratory Journal, Vol: 28
Background: British Thoracic Society (BTS) guidelines recommend the CURB 65 score (new Confusion < 9/10, Urea >7, Respiratory rate > 30, Blood pressure < 90 systolic or 60 diastolic, age > 65) to assess the severity and treatment of community acquired pneumonia.Accordingly, oral antibiotics should always be prescribed when the CURB 65 score is 0-1 and intravenous antibiotics when the score is 3 or above.MethodsWe retrospectively reviewed 244 consecutive admissions for suspected pneumonia during 2005 at the QE II Hospital, Hertforshire. Only the case notes of those subsequently diagnosed with pneumonia were included. We calculated the CURB 65 score in all patients with a diagnosis of pneumonia. Subsequent prescription of oral or intravenous antibiotics was noted.Results: Of the 244 admissions with suspected pneumonia 106 were actually diagnosed and treated as pneumonia. In only 2 cases was the CURB 65 score recorded. 16 patients fulfilled the criteria for intravenous antibiotics (ie a CURB 65 score of 3 or above), and all of these were treated appropriately. However, of the 52 patients who fit the criteria for non-severe pneumonia (CURB 65 score of 0 or 1) 28 (54%) were given intravenous antibiotics contrary to current BTS guidelines.Conclusion: Inappropriate and unnecessary use of intravenous antibiotics is ex- pensive and promotes antibiotic resistance, as well as hospital acquired infections including Clostridium difficile and Methicillin Resistant Staphylococcus aureus (MRSA). Despite BTS guidelines, intravenous antibiotics are being inappropriately prescribed which may contribute to the morbidity and mortality of inpatients in UK hospitals.
Hilton C, 2005, La folie en dehors de l'asile, Annual Scientific Meeting of Association Medicale Franco-Britannique
Hilton C, 2002, Madness outside the asylum: a history of community care in Britain
Applin D, 2002, Key Science: Biology, Publisher: Nelson Thornes, ISBN: 9780748762415
Revised and updated to take account of the new co-ordinated syllabuses under the National Curriculum, this book offers a comprehensive and authoritative guide to biology.
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