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Biomedical subjects

A Scott

Publications and source records attributed to A Scott.

At least 217 records · Page 12Linked to original sources
PubMed1991

The effectiveness of labetalol in treating postoperative hypertension.

During the postanesthesia recovery period, surgical patients often exhibit an increased arterial blood pressure. Although these transient increases in blood pressure are usually benign, significant morbidity and mortality may result from complications of postoperative hypertension. The purpose of this study was twofold: to determine the frequency of postoperative hypertension in one particular recovery room, and to determine the efficacy of labetalol as an antihypertensive drug in this setting. This study included both a retrospective and prospective component. The retrospective portion involved review of 465 records of patients admitted to the recovery room at a large, private eastern medical college. Nearly 20% of patients admitted were found to have blood pressures in the range of our study's criteria for hypertension. Records were also reviewed for types of therapeutic interventions used to treat hypertension and determinations of their success or failure. The prospective portion of the study evaluated treatment protocols for postoperative hypertension with graduated intravenous injections of labetalol in 30 patients. Blood pressure was effectively controlled with an average of 25 minutes for all patients and remained effective for 24 hours postoperatively.

Adult↗
PubMed1990

Posterior labral tear as a block to reduction in an anterior hip dislocation.

The patient presented with an anterior dislocation of the hip that could not be centrically reduced by closed methods. Computed tomographic imaging after trial reduction revealed a posterior fragment that was limiting reduction. At the time of open reduction, a large posterior labral tear with a small avulsed posterior acetabular rim of bone was found to be blocking the reduction.

Adult↗
PubMed1990

The ethics of heroism in medieval and American Indian tales.

Oral-traditional stories detail their heroes' growth through a narrative pattern of exile and return that places the heroes in situations repeatedly challenging their strength and resolve. Through the motif of the quest, medieval and American Indian tales alike reaffirm general psychological truths that bear upon our understanding of human nature. Stories about heroes are stories about us: about our desires to grow up, to defeat death, to prove ourselves in difficult situations, and to achieve recognition or admiration among our peers (Becker, 1973, p. 4). In this way, medieval and American Indian tales are about self-actualization. They maintain that "one has within oneself proclivity toward growth and unity of personality ... and an automatic thrust toward expression" of these qualities (Yalom, 1980, p. 9). All forms of literature, however, reflect ideas peculiar to their cultures. The ways in which these basic human truths are represented in medieval and American Indian tales suggest the differing religious or social concerns that have informed these truths and have given them shape. To a large degree, the medieval knight's view of "self" and "other" encompasses the view that Western humanity has had (and continues to have) of itself. This is a view conditioned upon the superiority of the "self" as measured against the inferiority of the "other," reinforced through existing social (hierarchial) and religious (Judeo-Christian) codes of behavior. Such codes are not only inadequate to the task of interpreting American Indian perceptions of "self" and "other," they are inimical to the ethical foundation underlying them. Scott Momaday remarks that "you cannot understand how the Indian thinks of himself in relation to the world around him unless you understand his conception of what is appropriate; particularly what is morally appropriate within the context of that relationship" (Basso, 1984, p. 46). For the American Indian hero, self-actualization is self-transcendence. By "becoming a part of something greater" than himself, the American Indian hero sustains a moral vision that not only reveals his "latent nobility" but also protects, even strengthens, the relational fabric of his community. By reading these and other American Indian tales, Western healers may become more sensitive to the moral conflicts uniquely experienced by American Indians and to the needs of others who desire to revise or strengthen their own moral structures by including ideas of relatedness and relationship.

Ethics↗
PubMed1990

Pediatric AIDS: treatment and outcome of patients.

The treatment of pediatric patients with HIV infection/AIDS is structured according to the clinical classification of the disease by the Centers for Disease Control; it involves prophylaxis, therapy against the human immunodeficiency virus, and therapy for the opportunistic infections and non-infectious complications of this disease. In spite of all these forms of therapy, the universal outcome of HIV infection/AIDS is the death of the patients. Prevention remains the only effective means to curb this epidemic.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Pediatric AIDS: impact on health systems.

For 9 years we have recognized HIV infection/AIDS as an unstoppable epidemic affecting infants, children, and adolescents as well as adults. Now we see the tremendous impact of this disease on the health systems of this country. During these past 9 years, we have witnessed the transformation of the epidemic from one primarily affecting male homosexuals to one invading the average US family through heterosexual and vertical transmissions and through needle-sharing practices of intravenous drug abuse. It has been estimated that 2% to 3% of the HIV infection/AIDS cases involve the pediatric age group. If 1.5 million Americans have HIV infection by 1991, as predicted, we should anticipate 30,000 to 45,000 infected pediatric patients by the end of that year. What has been the impact of this epidemic on the health systems involved in care, prevention, and research of pediatric HIV infection/AIDS? This article investigates that question.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Pediatric AIDS: systematic approach to patient management.

In order to provide comprehensive care to infants, children, and adolescents with HIV infection/AIDS, a systematic approach to clinical management had to be developed. This approach involves "case management" by experienced health professionals, including initial evaluation and needs assessment, planning of services, brokerage of services, continuity of intervention until an outcome is reached. The care is delivered in hospitals, clinics, homes, residential facilities, respite care centers, and hospices. The care team needs to be multidisciplinary and well integrated.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Pediatric AIDS: psychosocial impact.

There is no question that the domain of the American family has been invaded by the HIV infection/AIDS epidemic. The disease, and particularly its form affecting children (pediatric AIDS), has had marked psychosocial impact on patients and families (intellectual/cognitive, emotional/behavioral, spiritual, and financial) and on our society in general (adverse or favorable). These impacts of pediatric AIDS are discussed in the present communication.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Pediatric AIDS: adolescence, delinquency, drug abuse, and AIDS.

Sexual promiscuity often is part of the lifestyle of teenagers who are delinquent and abuse drugs, and that behavior puts them at increased risk of contracting HIV infection/AIDS. Many of these juveniles are runaways or live in disorganized homes, and as a result they are hard to reach and it is extremely difficult to provide health and other services to them. Indeed, these youths at risk most frequently may be identified and helped when they run afoul of the law and enter the judicial system. With that in mind, concerned professionals in San Antonio have developed an innovative program to provide primary care, drug abuse treatment and rehabilitation, and AIDS prevention education to the youthful offenders admitted to the Juvenile Detention Center of Bexar County. They hope it will give some of these youngsters the help and the opportunity they need to grow up, become productive citizens, and stay alive.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Pediatric AIDS: prevention of HIV infection in infants and children.

The Centers for Disease Control reported that 109,167 cases of AIDS had been diagnosed since 1981 and that approximately 40,000 persons were living with AIDS at the time of this writing. These numbers, however, are the tip of an iceberg that consists of approximately 1.5 million Americans who are infected by the human immunodeficiency virus (HIV). As we described in earlier articles of this series, the HIV infection/AIDS epidemic has invaded the domain of the American family through heterosexual transmission, vertical transmission, drug abuse, and sexual abuse of children. Therefore, physicians for children are now facing the prospects of having to deal with this disease in their practices. If there is something unique about pediatrics and other specialties of the medical profession dealing with infants and children, it is that "prevention" of disease can be and has been used effectively. One only needs to remember the 1950s, when the poliomyelitis epidemic was causing the same, if not greater, concerns in the lives of the American families. The development and application of the "polio" vaccines has virtually eliminated the threat of poliomyelitis in our society. Similarly, the incidence of diphtheria, tetanus, and smallpox has decreased to the point that these diseases present practically no threat to the US population. Armed with these positive experiences, we need to examine what we can do today to curb the spread of the HIV infection/AIDS among infants and children, and by extension, among the general population of our country.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Results of external sphincter repair in Crohn's disease.

The results of anal sphincter repair in a group of six patients with anorectal Crohn's disease are reported. All patients had previously undergone anal surgery which was followed by faecal incontinence in five. The sixth patient became incontinent following obstetric injury. Of the six patients, five are completely continent and one has a permanent stoma (follow-up from 18 months to 16 years, mean 7.8 years). Anal sphincter repair in this highly selected group of patients with Crohn's disease has not been complicated by wound breakdown or fistula formation, and has given good results.

Adult↗
PubMed1989

Small-for-dates babies, gestational age, and developmental ability at 7 years.

One hundred sixteen small-for-dates (SFD) children, whose progress had been monitored prospectively from birth, completed a comprehensive developmental assessment at age 7 years. There was an inverse relationship between their developmental scores at 7 years and gestational age at birth. Further analyses showed that the negative associations were stronger when biological factors commonly associated with the birth of SFD babies were absent. SFD babies are often delivered electively before term because of their increased risks of intrauterine death. The infant's ability to withstand the perinatal metamorphosis is usually assured, prior to intervention. Our findings indicate that, among SFD children in general, prolongation of pregnancy beyond about 36 weeks is not associated with an improved long-term prognosis. When pathological factors are operant, delivery before term may enhance the chances of these babies achieving their full developmental potential in later childhood.

Child↗
PubMed1989

A double-blind assessment of additive intolerance in children using a 12 day challenge period at home.

Alleged food-additive intolerance (respiratory, dermatological, behavioural or abdominal) was assessed in 19 children using daily challenge drinks of either, base product alone, base product plus sunset yellow/tartrazine, or base product plus sodium metabisulphite/sodium benzoate. The same type of drink was given for 12 days, double-blind and in random order. During the trial the children were maintained on an additive-free diet under supervision. Diary cards were used to record symptoms and medication usage. If there was an apparent association between symptoms and drink ingredient the trial was repeated, again double-blind. Additive intolerance was confirmed by a consistent deterioration of symptoms in only three children. In one, urticaria was induced by the colourings, in another extremely abnormal behaviour was induced by the preservatives and a third child was only free of asthma and abdominal pain on placebo. This form of individual trial, using 12 daily drinks, overcomes some of the objections to a single challenge study. Despite this, intolerance to the additives was only confirmed in 3/19 children in whom it had been believed to occur.

Adolescent↗
PubMed1989

Fertility of Palestinian women between national perspective and social reality.

"This paper investigates the social content of fertility patterns in four Palestinian conglomerations, viz., the West Bank, Gaza Strip, Galilee and Jerusalem, on the basis of an analysis of fertility data derived from official sources and field work conducted by Palestinian demographers. It seeks to identify meaningful relationships between these data and variables related to the household's place of residence, social class, and vocational and educational background. The paper also reviews the demographic history of Arab citizens in the occupied territories since 1948 to determine the effect on fertility trends.... The paper finally touches on the impact of the Palestinian intifada...."

Asia↗
PubMed1989

Pediatric AIDS: a new health problem on the Texas horizon.

The current epidemic of HIV infection/AIDS initially limited to homosexual males appears to be spreading through heterosexual transmission and intravenous drug abuse. Infants, children, and adolescents are affected. We examine the modes of transmission of HIV infection in this population and the impact the spreading of this infection in the pediatric age group will have on Texas.

Acquired Immunodeficiency Syndrome↗