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Biomedical subjects

A Thomas

Publications and source records attributed to A Thomas.

At least 451 records · Page 25Linked to original sources
PubMed1988

A longitudinal study of negative emotional states and adjustment from early childhood through adolescence.

The relations among various negative emotional and behavioral characteristics (e.g., aggression, anxiety, undercompliance, depressive mood) and adjustment were examined through use of data from the 31-year-old New York Longitudinal Study. 75 white, middle-class children were rated on these negative characteristics from infancy to adolescence. Measures of family, peer, and personal adjustment were also obtained. Because of the longitudinal nature of the data, we were able to use structural equation models to address the following questions: (1) How stable are these negative behaviors from early life through adolescence? (2) What is the degree of relation between these emotional characteristics and adjustment in childhood and adolescence? and (3) To what degree do these emotional characteristics differentially predict multiple adjustment dimensions in adolescence? 2 factors of negative emotional behavior, labeled as Aggression and Affect, respectively, were identified in early and late childhood and were found to have relatively high stability of individual differences. Aggression significantly predicted adolescent maladjustment, whereas Affect had no independent prediction of maladjustment. Moreover, emotional problems provided better prediction of adolescent adjustment problems than did earlier childhood adjustment ratings.

Adolescent↗
PubMed1988

Blood lead, ethnic origin, and lead exposure.

A survey of blood lead concentrations is reported in a group of 199 young Walsall children (3-6 years of age). The geometric mean blood lead concentration was 0.47 mumol/l (range 0.2-1.6 mumol/l). There were no significant differences in blood lead concentrations between groups of children with different ages, sex, ethnic origin, or environment.

Child↗
PubMed1988

Cystosarcoma phyllodes tumors.

Of 106 females treated surgically for cystosarcoma phyllodes, 20 had one or more local recurrences, while seven other patients had "pseudorecurrences" in that the histologic findings showed benign disease of the breast. Histologic transformation into a histologically more aggressive lesion was noted in three patients. There was a higher incidence of recurrence among the younger patients (those less than 20 years of age) and in those with the larger tumors (greater than 5 centimeters diameter). The reasons for these findings are discussed. The phenomenon of recurrence was reviewed with regard to age of the patient, size of the lesion, histologic features of the tumor and extent of the operation.

Adult↗
PubMed1988

Cystosarcoma phyllodes--Asian variations.

Cystosarcoma phyllodes afflicting 106 female patients in a multiracial Asian society is reviewed and some interesting variations are noted when compared with Western patients. The incidence of phyllodes tumour is 3.83% of surgically removed breast tumours compared with 0.5-2.5% in Western series. This lends weight to the belief that non-Caucasians are more prone to this enigmatic breast disease than the Caucasian population. The profile of the Asian phyllodes patient is that of a young female, aged 25-30 years, whereas her Western counterpart is in her 40s. As a result, she is liable to be mistaken clinically as having fibro-adenoma. The disease is notably rare among the females below 20 years of age but in the Asian context, as much as one-quarter-one-third may be in the adolescent group. There were only three malignant and six borderline phyllodes tumours out of 106 cases, and this incidence is far below that of many other studies in which the malignant cases are believed to constitute 23-27%. However, this may not be a racial variation but explicable by the fact that the present study is an unselected cohort from a general surgical unit. The presence of associated benign breast disease in 25.5% cases helps to reinforce the widely held belief that fibro-adenoma and phyllodes tumour are related to some degree.

Adult↗
PubMed1988

[Hepatic manifestations in Still's disease].

In children, as in adults, Still's disease usually presents with a hectic fever, a characteristic rash and arthralgia or arthritis. Visceral involvement is however classical; the hepatic manifestations were studied with respect to two cases. Biochemical changes are common, often mild: the commonest abnormality is cytolysis. Jaundice is less frequent and hepatic involvement may in exceptional cases be life threatening, usually in cases of serious polyvisceral disease often with disseminated intravascular coagulation. These manifestations may be spontaneous or secondary to salicylate therapy; the anatomical changes are the same; the salicylate would therefore seem rather to unmask and aggravate an underlying hepatic abnormality.

Adolescent↗
PubMed1988

A double-blind controlled clinical trial to assess the role of anti-histamines in the treatment of multi-bacillary leprosy.

A double blind controlled clinical trial to assess the role of anti-histamines as a supplement in the treatment of leprosy was conducted in multi-bacillary cases of leprosy. In all, 120 patients with lepromatous or borderline leprosy were randomly allocated to a regimen of clofazimine and dapsone for 12 months with or without a supplement of pheniramine maleate for the first 3 months. During the 12-month period, 92% of the patients who received the supplement and 86% of the patients who had not received it had moderate or marked clinical improvement. The BI values decreased from 4.1 to 3.4 and 4.2 to 3.3, respectively. The results over the 12-month period showed that the addition of the antihistamine had not enhanced the efficacy of the regimen as evidenced by clinical and bacteriological findings.

Adolescent↗
PubMed1988

Solitary thyroid nodules for surgery--the role of fine-needle aspiration biopsy cytology.

The diagnostic accuracy of fine needle aspiration biopsy cytology (FNAC) was assessed in 46 patients, all of whom had histological verification. In the group of patients with microscopic foci of carcinomas excluded, diagnostic sensitivity was 75% and specificity 100%. No false positives were recorded, the false negative rate was 5.0% and the overall accuracy, 95%. Although 6 of the 10 carcinomas were correctly diagnosed by cytology, the correct morphological type of tumor was only identified in three of them. Using clinical suspicion of malignancy alone as a criterion for surgery, 13% of patients would have required surgery with 50% of malignancies still remaining undetected. However using FNAC, clinical suspicion and patients above 50 years of age as combined criteria, 40% of patients would have been subjected to surgery with a resulting yield of malignancy of 100%. These promising results from a initial experience with FNAC confirm its usefulness in the appropriate selection of patients for surgery.

Adult↗
PubMed1987

Albumin lung/heart ratio change. A simple clinical means of documenting increased pulmonary endothelial permeability to protein.

We investigated a simple method that can be used at the bedside for documenting the net accumulation of albumin in the lung. The technique employs measurement with a computer-linked gamma camera of the activity ratio in an area of the right lung compared with the same-sized area in the heart at 20 minutes and three hours following intravenous injection of technetium Tc 99m albumin. We applied this measurement to three groups of patients: a control group and patients with roentgenographic evidence of edema classified according to clinically available criteria as either hydrostatic edema or permeability edema to see if we could document differences among these groups. In control patients this ratio did not increase by more than seven units between the 20-minute and three-hour measurements. Of 18 patients classified by other routine clinical means as having hydrostatic pulmonary edema, 89% showed no increase in lung albumin accumulation. In 29 patients with permeability edema associated with the so-called adult respiratory distress syndrome, 31% showed evidence of net pulmonary albumin accumulation. These findings suggest that some patients otherwise classified as having hydrostatic edema have concomitant permeability changes in the microvasculature and that permeability edema represents a spectrum of endothelial damage.

Capillary Permeability↗
PubMed1987

Multiple chromosome abnormalities in a drug resistant TdT positive B-cell leukemia.

A 17-year old caucasian male presented with B-cell acute leukemia which proved aggressive and refractory to treatment. Cytogenic investigation showed a single clone with a complex karyotype 49,XY,del(2)(p13),+4,del(4)(p11),-6,+i(6)(p),+7,+8, t(8;14), (q24;q32),del(17)(p11). This includes the Burkitt's translocation and a deletion at the site of the immunoglobulin kappa light chain gene. Clonal evolution included tetraploidy, duplication of the derived chromosomes and, terminally, trisomy 1q. Immunological investigation revealed a monoclonal population of B-cell blasts, expressing the kappa light chain, and with an extremely rare combination of SIg and TdT positivity. Immunoglobulin gene rearrangement confirmed monoclonalility. Tetraploidy of the clone and del(17)(p11) have been previously described only in a cell line or at end stage disease in B-ALL. It is suggested that the chromosomal abnormalities present at diagnosis were directly related to the refractory nature of this leukemia.

Acute Disease↗
PubMed1987

Contributions of in vitro fertilization to knowledge of the reproductive endocrinology of the menstrual cycle.

The administration of ovarian stimulants to endocrine-normal women in IVF programmes gives the clinical endocrinologist an opportunity to modify natural folliculogenesis. Use of antioestrogens and/or gonadotrophins at the correct time has demonstrated that follicular atresia can be prevented and that multiple pregnancy-potent haploid ova can be obtained. Scrutiny of spontaneous menstrual cycles in patients who show unsatisfactory IVF responses has identified two new syndromes, premature follicle selection and occult ovarian failure, in these patients. The incidence of these disorders in fertile women is still unclear. Early results suggest that endocrine manipulations may overcome premature follicle selection and induce codominant folliculogenesis. Inhibin is a recently characterized ovarian protein which is increased in peripheral blood during IVF treatment. Results from IVF cycles suggest that plasma inhibin may be a new index of follicular function. Other potential indices of ovarian function, such as the luteal protein relaxin, may also develop from the application of basic research to IVF and advance knowledge of the human ovarian and menstrual cycles.

Estradiol↗
PubMed1987

Effects of milrinone on systemic hemodynamics and regional circulations in dogs with congestive heart failure: comparison with dobutamine.

Milrinone is a new bipyridine inotropic agent with direct vasodilator properties. To determine the role of the vasodilator action in mediating systemic and regional hemodynamic responses to milrinone, we administered two equipotent inotropic doses of either milrinone or dobutamine to dogs with chronic congestive right heart failure produced by tricuspid avulsion and pulmonary artery stenosis. Similar increases in cardiac output, right and left ventricular dP/dt, and left ventricular dP/dt/P were produced by milrinone and dobutamine; however, heart rate increased and mean aortic pressure decreased only with milrinone infusion. In addition, while total peripheral vascular resistance decreased with both agents, the decrease was greater with milrinone. Regional blood flows were measured by a radioactive microsphere method. Milrinone and dobutamine produced similar increases in myocardial blood flow and left ventricular oxygen consumption. Dobutamine infusion decreased quadriceps muscle vascular resistance and had no effect on renal and splanchnic circulations. In contrast, milrinone infusion increased vascular resistance in quadriceps muscle and decreased it in renal and splanchnic beds. Thus, when milrinone was used in inotropic doses similar to those of dobutamine, the responses in systemic and regional hemodynamics in congestive heart failure differed. Milrinone produced a greater decline in total peripheral, renal, and splanchnic vascular resistances, probably resulting from its direct vasodilator action.

Animals↗
PubMed1987

School psychologist: an integral member of the school health team.

The primary responsibility of school psychologists is the application of psychological assessment, consultation, and intervention within public school settings. This article examines the role of the school psychologist as an individual and as a member of a school's child study team. The changing role of the school psychologist is noted as are the various organizations school psychologists may join, their educational requirements, and other facets of the school psychologist field.

Affective Symptoms↗