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Biomedical subjects

B A Martin

Publications and source records attributed to B A Martin.

At least 91 records · Page 5Linked to original sources
PubMed1984

The Clarke Institute experience with electroconvulsive therapy: II. Treatment evaluation and standards of practice.

Contemporary standards of practice of electroconvulsive therapy with respect to the treatment procedure, clinical indications, and dosage (number of treatments per course) are summarized. The actual clinical practice at one psychiatric hospital over a 16-year period, comprising 22,647 treatments, was compared to those standards. The most significant findings in this series were the over-representation of patients with a diagnosis of schizophrenia and the absence of any clinically significant difference in the treatment dosage for schizophrenia and affective disorders. The significance of these findings is discussed with respect to their identification of patient subgroups that warrant case auditing. In addition, the results are used as a basis for a critical examination of the rationale for the presently recommended maximum treatment dosages.

Affective Disorders, Psychotic↗
PubMed1983

False assignment of familial antithrombin III deficiency with the von Kaulla assay.

As a serum assay, the von Kaulla assay for antithrombin III has been criticized on the grounds that consumption of antithrombin III during in vitro blood clotting may lead to falsely low assay values. Use of the assay to screen a Utah pedigree for familial antithrombin III deficiency lends support to this criticism. In all, the assay was performed on 150 persons. Low values on the assay were corroborated by performing an alternative coagulation assay, an amidolytic assay, and an immunoassay. While all persons with historic evidence for a diagnosis of familial antithrombin III deficiency had low assay values, eight of 23 persons with low values had normal values on the other assays.

Adolescent↗
PubMed1983

Factors which affect the amount of inorganic phosphate, phosphorylcholine, and phosphorylethanolamine in xylem exudate of tomato plants.

Phosphate in the xylem exudate of tomato (Lycopersicon esculentum) plants was 70 to 98% inorganic phosphate (Pi), 2 to 30% P-choline, and less than 1% P-ethanolamine. Upon adding (32)Pi to the nutrient, Pi in xylem exudate had the same specific activity within 4 hours. P-choline and P-ethanolamine reached the same specific activity only after 96 hours. The amount of Pi in xylem exudate was dependent on Pi concentration in the nutrient and decreased from 1700 to 170 micromolar when Pi in the nutrient decreased from 50 to 2 micromolar. The flux of 0.4 nmoles organic phosphate per minute per gram fresh weight root into the xylem exudate was not affected by the Pi concentration in the nutrient solution unless it was below 1 micromolar. During 7 days of Pi starvation, Pi in the xylem exudate decreased from 1400 to 130 micromolar while concentrations of the two phosphate esters remained unchanged.The concentration of phosphate esters in the xylem exudate was increased by addition of choline or ethanolamine to the nutrient solution, but Pi remained unchanged. Upon adding [(14)C]choline to the nutrient, 10 times more [(14)C]P-choline than [(14)C]choline was in the xylem exudate and 85 to 90% of the ester phosphate was P-choline. When [(14)C]ethanolamine was added, [(14)C]P-ethanolamine and [(14)C]ethanolamine in the xylem sap were equal in amount. P-choline and P-ethanolamine accumulated in leaves of whole plants at the same time and the same proportion as observed for their flux into the xylem exudate. No relationship between the transport of P-choline and Pi in the xylem was established. Rather, the amount of choline in xylem exudate and its incorporation into phosphatidylcholine in the leaf suggest that the root is a site of synthesis of P-choline and P-ethanolamine for phospholipid synthesis in tomato leaves.

Journal Article↗
PubMed1983

Polymyalgia rheumatica: an arthroscopic study of the shoulder joint.

A careful selection of 19 patients fitting the classical description of polymyalgia rheumatica have been examined by arthroscopy and thoroughly screened and followed up to exclude rheumatoid arthritis and other disease processes. Synovitis of the shoulder joint has been observed through the arthroscope in 17 and synovitis of varying degrees noted histologically, 4 of whom were studied by immunofluorescence. Five patients had radioactive joint scans.

Aged↗
PubMed1983

The clinical investigation of dementia.

The clinical investigation of 63 patients with a hospital discharge diagnosis of dementia was reviewed. The review focused on the completeness of ancillary investigations to detect treatable causes of dementia, and on the follow-up examination to confirm the diagnosis. Patients admitted to specialized geriatric psychiatry beds were compared to those admitted to other hospital services. The clinical investigation of the groups did not differ significantly with the respect to the search for treatable dementias, and in this series no treatable cases were detected. The non-selective use of a battery of ancillary diagnostic tests is questioned. The most notable finding was the almost uniform absence of follow-up examinations to document progressive deterioration of cognitive function. The indication for such follow-up is discussed in the context of previously reported diagnostic inaccuracy in this syndrome.

Adult↗
PubMed1983

The mental status examination for dementia: a review of practice in a psychiatric hospital.

The mental status examinations of 63 patients with a hospital discharge diagnosis of dementia were reviewed. The examination and documentation of most areas of cognitive function were found to be incomplete in the majority of cases. The need for a complete examination of cognitive function is discussed in relation to the natural history of dementia and in the context of recent developments in the classification of organic mental disorders.

Adult↗
PubMed1983

Electroconvulsive therapy and the stimulus waveform.

The amount of electrical energy transmitted to the patient while inducing a seizure during electroconvulsive therapy (ECT) may vary considerably depending on the waveform of the electrical stimulus. The majority of ECT equipment used in the past employed a sinusoidal waveform for the stimulus. Advances in waveform technology have led to the development of pulsatile waveforms which are effective convulsants requiring a fraction of the electrical energy transmitted by the sinusoidal waveform. This paper summarizes the clinically relevant advances in waveform technology. The therapeutic principle of using the minimum effective dosage is emphasized.

Electric Conductivity↗
PubMed1983

Electroconvulsive therapy and the seizure threshold.

The use of a pulsatile square wave stimulus for a large series of electroconvulsive treatments under conditions of routine clinical practice is compared to the equivalent experience with a sine wave stimulus. The literature indicates that both waveforms are equally effective convulsants. However, in this series, the induction of a convulsion was found to be much more difficult with the pulsatile square wave such that the rate of failure to convulse was four times that compared to sine wave stimulation. A number of variables that may affect the seizure threshold during ECT were examined. It is concluded that the benefit obtained by reducing the electrical energy transmitted to the patient with the pulsatile stimulus offsets the difficulty encountered in reaching the seizure threshold.

Adolescent↗
PubMed1983

A method for collecting detailed data on direct and indirect medical expenses of cancer patients.

A complex data collection system involving seven community based practices and a university affiliated hospital has been developed. Four types of data are being collected: 1) medical status, 2) billings for a six month period, 3) patient reports of direct and indirect costs for a six month period and how they affected family finances and 4) diaries of direct and indirect costs for a week in which treatment was received and a week in which treatment was not received. Three groups are involved in collecting these data: physicians, their office staff and a central project telephone interviewer. Office staff are paid overtime rates for their work which is in addition to their regular responsibilities. Telephone follow-up interviews have contributed to compliance and have helped insure consistency in the data. Two hundred and fifteen patients have provided complete information to date. Refusal rate has been approximately 26% and drop out rate among persons enrolled in the study has been 21%. Patients most difficult to recruit and hold in the study have been very sick, elderly or on welfare. Total direct costs of data collection are estimated to be $48.00 per patient.

Data Collection↗
PubMed1982

Effect of pulmonary blood flow on the exchange between the circulating and marginating pool of polymorphonuclear leukocytes in dog lungs.

The effect of pulmonary blood flow on the exchange between the circulating was marginating pool of polymorphonuclear leukocytes (PMN) was examined in three sets of experiments. In the first we used the double indicator dilution technique with labeled PMN and erythrocytes (RBC) to calculate the percent extraction and percent recovery of PMN at different levels of cardiac output (CO). In the second group of experiments we took advantage of the wide range of blood flow in the lung to determine the effect of regional blood flow on regional PMN retention, and in the third set we measured total leukocyte (WBC) and PMN counts in simultaneous samples from the pulmonary artery and aorta over a wide range of cardiac output. The studies showed that 80-90% of the labeled PMN were removed in a single pass through the lung and that regional retention of labeled PMN and A-V differences for unlabeled PMN increased with decreasing blood flow. The data for regional retention of labeled PMN and the A-V differences observed for unlabeled cells both fit the equation Y = A + Be-cx (where A + B = 100), which showed that PMN accumulate in the lung as blood flow is reduced. We conclude that a dynamic equilibrium exists between the circulating and marginating pools of leukocytes in the lung and that blood flow primarily effects the reentry of cells into the circulating pool so that the marginating pool of PMN within the lung accumulates cells when blood flow is reduced below 7 ml/min per g.

Animals↗
PubMed1982

Clinical significance of the interaction between lithium and a neuromuscular blocker.

Reports of delayed recovery from anesthesia by patients concurrently receiving lithium carbonate and a neuromuscular blocker have been followed by a recommendation to avoid such a combination and, hence, concurrent treatment with lithium and electroconvulsive therapy (ECT). The authors review the literature and their clinical experience with such a drug combination at one psychiatric hospital. They conclude that the clinical and experimental findings to date are insufficient to warrant proscribing the combination of lithium and ECT on the basis of possible potentiation of neuromuscular blockade by lithium.

Adult↗
PubMed1981

Platelet sequestration in lung with hemorrhagic shock and reinfusion in dogs.

We compared red blood cell (RBC) and platelet transit through the pulmonary vascular bed under control conditions (n = 8) and during hemorrhagic shock (n = 8) in anesthetized spontaneously breathing dogs, using a modification of the indicator-dilutor technique. Platelets and RBCs from each animal were labeled with 51Cr and 99mTc, respectively, and were rapidly injected into the right atrium while blood was sampled from the ascending aorta. The mean transit time (MTT), volume of distribution, and percent recovery for RBCs and platelets were calculated, as was the percent extraction of platelets. We found 1) the the difference between RBC and platelet MTT increased (p less than 0.01), 2) that the percent extraction of platelets increased (p less than 0.001), and 3) that the percent recovery of platelets fell (p less than 0.01) during the shock period. These values all returned to control levels after reinfusion of the shed blood. The relationship between a transient reduction in blood flow and platelet extraction was then studied in a third group of dogs (n = 5) where inflation of a balloon in the inferior vena cava was used to reduce cardiac output (CO). These studies showed that platelet extraction was inversely related to CO. We conclude that the increased platelet sequestration seen in the lung during hemorrhagic shock is primarily related to decreased blood flow.

Animals↗
PubMed1980

Angiosarcoma, metastatic to the mandible and maxilla.

A case of metastatic angiosarcoma, which was diagnosed from a biopsy of the presenting oral lesions, is reported and discussed. The case illustrates the aggressive nature of the tumour with its widespread metastasis and its brief course to fatality.

Hemangiosarcoma↗
PubMed1980

Pulmonary leukostasis and its relationship to pulmonary dysfunction in sheep and rabbits.

Pulmonary leukostasis, as a result of complement activation, has been invoked as a cause of pulmonary dysfunction. To investigate this phenomenon, we studied the pulmonary response to infusion of autologous complement-activated plasma in sheep and rabbits. Complement activation was produced by plasma incubation with zymosan. Leukopenia, with selective loss of polymorphonuclear leukocytes into the lungs, occurred in all animals immediately after the onset of plasma infusion. Complement-activated plasma infusion in sheep produced a significant fall in the arterial PO2 and a marked rise in pulmonary vascular resistance, whereas no such effects were observed in rabbits. Pretreatment of the sheep with sulfinpyrazone eliminated the pulmonary response to complement-activated plasma without altering the leukopenic response. Pulmonary histology in rabbits and sheep confirmed the presence of intracapillary leukostasis after the plasma infusions, whether or not sulfinpyrazone had been administered previously. The pulmonary response to complement activation is associated with pulmonary capillary leukostasis, but leukostasis alone is not an adequate explanation of the phenomenon.

Animals↗
PubMed1980

The confidentiality of medical records: the right to privacy versus the public interest.

The confidentiality of medical records is discussed in the context of the individual's right to privacy, as yet undefinable in degree, and the often conflicting demands for access to these records for purposes considered to be in the interests of society. The proposed use of a unique personal identifying number for medical records which facilitates linkage to administrative data systems is critically examined.

Confidentiality↗
PubMed1979

Changes in Activity of Ribulose-1,5-Bisphosphate Carboxylase/Oxygenase and Three Peroxisomal Enzymes during Tomato Fruit Development and Ripening.

Ribulose-1,5-bisphosphate carboxylase/oxygenase, catalase, glycolate oxidase, and hydroxypyruvate reductase activities on a protein and fresh weight basis were measured over seven stages of tomato fruit development and ripening. Ribulose-1,5-bisphosphate carboxylase decreased steadily during fruit development from 23 +/- 8 nmoles per minute per milligram protein at the mature green stage to 13.4 +/- 2 at the table ripe stage. There was no change in partially purified preparations of the enzyme in the ratio of carboxylase to oxygenase activity, which was about 10. Catalase activity reached a maximum during the climacteric, simultaneously with increased ethylene and CO(2) formation. Glycolate oxidase activity decreased during early stages of development and was barely detectable at the climacteric. Hydroxypyruvate reductase, associated with serine formation by the glycerate pathway, increased in specific activity during early stages of tomato fruit ripening. In the fruit of the rin tomato mutant, which does not ripen normally, none of these changes in enzyme activity occurred.

Journal Article↗