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Biomedical subjects

B Gilbert

Publications and source records attributed to B Gilbert.

At least 73 records · Page 4Linked to original sources
PubMed1994

Employee assistance programs: history and program description.

1. The history and development of Employee Assistance Programs (EAPs) can be traced back to the 1800s. There are currently over 10,000 EAPs in the United States. 2. Standards for program accreditation and counselor certification have been established for EAPs. The "core technology of Employee Assistance Programs" includes identification of behavioural problems based on job performance issues, expert consultation with supervisors, appropriate use of constructive confrontation, microlinkages with treatment providers and resources, macrolinkages between providers, resources, and work organizations, focus on substance abuse, and evaluation of employee success based on job performance. 3. Some EAPs take a broad brush approach, and incorporate health promotion and managed care functions.

Accreditation↗
PubMed1994

[Megaloblastic anemia in children].

Megaloblastic anemia in children is mainly due to folic acid or vitamin B12 deficiencies. However dosages of these two vitamins must be performed before any vitamin supplementation or blood transfusions are given in order to establish precisely the etiologic diagnosis. A disorder in the metabolism of these vitamins must be considered in any infants in whom the onset of neurological abnormalities is associated with the characteristic hematological abnormalities. Imerslund's syndrome is a specific vitamin B12 malabsorption defect that warrants consideration as it is easy to recognize on the basis of the association of megaloblastic anemia and proteinuria. A possible drug-induced etiology must also be looked for. In the absence of vitamin deficiency, several rare etiologies must be considered. A macrocytosis, occasionally with megaloblastosis reflecting an abnormal erythropoiesis, may accompany an hemopathy, eventually malignant.

Anemia, Megaloblastic↗
PubMed1993

[Excessive water intake with intoxication as a manifestation of anorexia nervosa].

A case of anorexia nervosa revealed by water intoxication with severe hyponatremia is reported after a search of the literature demonstrated the rarity of such cases. Pathophysiological mechanisms involved are discussed. Hospitalization in a unit for adolescents in which pediatricians and psychiatrists work together allowed both prompt treatment of metabolic disorders and early management of anorexia nervosa, which is associated with improved prognosis.

Adolescent↗
PubMed1992

Perspective for the production of antimalarial drugs in Brazil.

There appears to be no chemical manufacture of antimalarial drugs in Brazil. Technology at the laboratory process level has been developed for chloroquine, mefloquine, pyrimethamine and cycloguanil, but not perfected nor scaled-up, largely for economic reasons and market uncertainty. Development of primaquine has been contracted but it will run into the same difficulty. Manufacturing capacity for sulfadoxine was registered in the SDI by Roche. A project to produce artemisinine and its derivatives is under way at UNICAMP-CPQBA but is hampered by low content in the plant. Proguanil could be produced easily, but apparently no attempt has been made to do so. Quinine is imported on a large scale mostly for soft-drink production. Since malarial treatment falls largely within the responsibility of the Government health authorities, manufacture of drugs in Brazil will depend on an assured medium-term purchase order made to a potential local manufacturer, since competition in the world market is scarcely viable at the present moment.

Antimalarials↗
PubMed1992

[24 cases of human parvovirus B19 infection in children].

From January 1, 1987 through December 31, 1990, twenty-four pediatric patients with human parvovirus B19 (HPV B19) infection were seen. In every case the diagnosis was established by a positive capture immunoassay for IgM antibodies against the HPV B19. Four patients had hematologic manifestations, including one case of transient bone marrow aplasia revealing hereditary spherocytosis, one case of autoimmune hemolytic anemia with beta-thalassemia, and two cases of peripheral thrombocytopenia. Eight patients had skin lesions, with a morbilliform rash in six cases, erythema nodosum in one case, and Gianotti-Crosti syndrome in one case. No patients had erythema infectiosum. Seven patients developed joint manifestations: Henoch-Schönlein purpura in two cases, arthralgia in four cases, and polyarticular disease progressing to severe rheumatoid arthritis in a thirteen-year-old girl. Unremarkable symptoms of viral disease were seen in three patients. A five-month-old infant developed severe acute myocarditis. One patient with hepatitis A had acute liver failure. This study confirms the broad spectrum of clinical manifestations of HPV B19 infection. There were a number of unusual findings, including the high rate of joint manifestations (29%) and the severe course of some hematologic and myocardial manifestations. These results raise the question of whether the HPV B19 may be involved in the genesis of chronic juvenile arthritis.

Adolescent↗
PubMed1991

[The efficacy of smectite in acute infantile diarrhea, compared to a placebo and loperamide].

Fifty-six infants (aged 2 months to two years) with moderate to severe diarrhea were entered in a comparative therapeutic trial of smectite versus placebo or loperamide. Results showed that diarrhea resolved faster under smectite than under placebo and at least as fast under smectite as under loperamide. Tolerance of smectite is excellent as a result of the lack of any effect on intestinal motility.

Dehydration↗
PubMed1989

Color discrimination testing reveals early printshop solvent neurotoxicity better than a neuropsychological test battery.

Twenty standardized neuropsychological tests were compared to the Lanthony D-15 desaturated panel test of chromotopsia to determine which measures would most effectively discriminate solvent-exposed print workers from controls. All the workers of the printing services of Université du Québec a Montréal (N = 29) were assessed excepted one who refused to participate. Twenty-nine workers (employed on a full time basis) matched for occupation, age, sex, education, vocabulary, and written arithmetic (p >.13) with the print workers served as controls. Air samples revealed exposure to ethanol, perchloroethylene, methyl chloride, xylene, toluene, and stoddard solvent in the print shop. None of the 20 neuropsychological measures yielded a statistically significant decrement in the print workers. On the other hand, the Lanthony D-15 test revealed a significant group difference (p <.01) and a highly significant interaction between job category within the print shop and dyschromatopsia (p <.001) - the graphists, photocopiers, and printers/binders manifesting increasing severity of impairment as a function of increasing magnitude, and/or type, of dose. The results were interpreted to mean that in a cohort of printers with low seniority (10.42 years) such as this one, neuro-opthalmotoxic effects can be observed earlier than putative neuropsychotoxic effects with the tools at hand.

Journal Article↗
PubMed1988

Antiviral therapy with small particle aerosols.

The generation and use of small particle aqueous aerosols (1.23 microns aerodynamic mass median diameter, GSD = 2.0 microns) containing ribavirin is described. Administered via aerosol, ribavirin will be deposited rather uniformly on the surface of the nasopharynx, the tracheobronchial tree and in the pulmonary area. Examples of aerosol-delivered dosages found to be effective in the treatment of respiratory syncytial virus infection and influenza A and B virus infections are as follows: 12.8 mg of ribavirin/hour for a 6-month-old infant weighing 7.5 kg, and 56.2 kg of ribavirin/hour for a 25-year-old adult weighing 62.5 kg. Drugs which are relatively insoluble in aqueous solutions can also be administered in small particle aerosol by using liposomes as a vehicle. The preparation of enviroxime, a potent anti-rhinovirus drug, in liposomes for aerosol use is reported here. Its antiviral activity in liposomes was found to be undiminished, but its cellular toxicity was greatly reduced. It was well-tolerated by normal volunteers and studies are planned to determine its clinical efficacy.

Aerosols↗
PubMed1987

Activity of some naphthoquinones on blood stream forms of Trypanosoma cruzi.

Accidental transmission of Chagas disease to man by blood transfusion is a serious problem in Latin America. This paper describes the testing of several naphthoquinones, some of which were active against blood trypomastigotes in vitro at 4 degrees C and might therefore warrant further study for preventing transmission of Chagas disease by blood transfusion.

Animals↗
PubMed1986

[Value of continuous Doppler velocimetry for the diagnosis of patent ductus arteriosus].

A study of the curve of wave Doppler ultrasonography of 3 arterial axes (carotid, subclavian and femoral) was performed in 32 children in whom the diagnosis of patent ductus arteriosus was suspected. A continuous 8 MHz wave directional ultrasonic Doppler apparatus was used. At the level of subclavian and femoral arteries, patent ductus arteriosus is associated with a negative holodiastolic wave on the curve. At the carotid level, disappearance of the physiologic diastolic elevation may be the only change observed. Three groups were studied (1) 15 premature neonates with isolated murmur, (2) 15 premature neonates with respiratory distress and (3) 2 older children. In group 2, diagnosis of patent ductus arteriosus relies on clinical signs. A good correlation between Doppler and clinical data and/or TM ultrasonography was observed in 93% of cases.

Child↗
PubMed1984

The shared field: a precursor stage in the development of a psychotherapeutic alliance with the hospitalized chronic schizophrenic patient.

Psychotherapeutic work with chronic schizophrenic patients is difficult for both patient and therapist. Such patients lack many of the capacities necessary to participate in psychotherapy: motivation, observing ego, the ability to communicate verbally about thoughts and feelings, the capacity to sustain a relationship. Treatment of such patients may require phases in which such capacities are nurtured until the patient is able to form a therapeutic alliance of the ordinary kind. This paper discusses the ways in which hospitalization can be helpful during pre-alliance phases of psychotherapeutic work, through the provision of a protected setting and a team approach, in conjunction with individual psychotherapy. A perspective is offered for conceptualizing the early relationship between patient and hospital staff as a stage in the development of an alliance.

Adult↗
PubMed1983

Ventricular septal defect after myocardial infarction: diagnosis by two-dimensional contrast echocardiography.

Thirteen patients who had ventricular septal defects (VSDs) after myocardial infarction (MI) underwent two-dimensional echocardiography (2-D echo), with confirmation of the VSD by oximetry. Eight of the patients were male and five were female, ages 51-76 years. Five had anterior and eight inferior MIs. Two-dimensional echocardiography revealed akinesis or dyskinesis of the interventricular septum (IVS) in all 13 patients. In only six could a defect in the IVS be directly visualized. Two-dimensional echocardiographic left ventricular (LV) wall motion abnormalities correlated with ECG and angiographic site of infarction in all patients. Twelve patients had adequate saline contrast studies. Positive LV contrast (microbubbles entering the left ventricle through the VSD) was seen in 11 patients, and negative right ventricular (RV) contrast (washout of the RV bubbles by LV blood crossing the VSD) in five patients; at least one abnormality was present in every patient. The location of the VSD was determined by visualizing a VSD or by the site of the positive LV or negative RV contrast. Oximetry showed VSD shunts of 1.4:1 to 7:1, with no correlation between the degree of negative RV contrast and shunt size. Surgical or pathologic confirmation of VSD was obtained in 12 patients, with agreement of VSD location by 2-D echo in all. Four of the 11 patients who underwent surgical repair died, and two patients died before surgery could be attempted. We conclude tht 2-D echo is a sensitive, rapid and safe technique for diagnosing VSD after MI. Positive LV contrast, with or without negative RV contrast, is more sensitive in the diagnosis and localization of post-MI VSD than direct echocardiographic visualization of the defect.

Aged↗