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Biomedical subjects

B Joseph

Publications and source records attributed to B Joseph.

At least 73 records · Page 4Linked to original sources
PubMed1988

Object relations in clinical practice.

Analysts need to have a theory of object relations at the back of their minds while actually analyzing, but they also need to rediscover this theory constantly in their work with patients. This process of rediscovery depends, I suggest, upon analysts focusing attention not only on what is being communicated by words but on what is being lived out, however subtly, in the transference. This, in itself, can help in reconstructing dynamically something of the patient's history. These issues are discussed in relation to Melanie Klein's theory of object relations and are illustrated with clinical material.

Freudian Theory↗
PubMed1987

Pathomechanics of congenital and acquired hallux varus: a clinical and anatomical study.

Hallux varus was observed in 69 feet among patients from a rural Indian population. This included three types of congenital hallux varus. The congenital "primary" type was the commonest and was not associated with any other foot deformity. Among the acquired forms was idiopathic hallux varus of middle age, which developed spontaneously in unshod persons and progressed gradually. Hallux varus following chronic arthritis was part of a consistent pattern of foot deformities in which the first ray collapsed in a zig-zag manner in two planes. Although the development of hallux varus is often due to intrinsic muscle imbalance, hallux varus secondary to chronic arthritis seems to occur as a result of both intrinsic and extrinsic muscle imbalance associated with midtarsal and subtalar arthritis. Muscular factors contribute to progression of the deformity also. No anatomical basis for a racial predilection for the deformity was noted. Failure to use footwear could account for the higher incidence of hallux varus in India.

Adolescent↗
PubMed1986

Management of spinal cord injury in a general hospital in rural India.

Two hundred eighteen patients with spinal injury treated in a general hospital in rural India are analysed. One hundred and twenty-five of them had neurological deficit. The commonest cause for spinal injury was falling from trees (55.2%). Rescue and retrieval systems for these patients were inadequate and knowledge regarding precautions to be taken when transporting the patient was lacking. The frequency of decubitus ulceration and of urinary tract infections were unacceptably high. A high percentage of patients with cervical spine injury expired. The study highlights the necessity for appropriate preventive measures, and also reemphasizes the short-comings of treatment of spinal cord injury patients in general hospitals.

Accidental Falls↗
PubMed1986

Interleukin 1 increases the binding of human B and T lymphocytes to endothelial cell monolayers.

Lymphocyte binding to specialized high-endothelial venules (HEV) in lymph nodes and Peyer's patches is the first step in normal lymphocyte emigration and recirculation. The development and maintenance of HEV in these lymphoid organs are thought to be immunologically controlled. Because postcapillary venules in chronic inflammatory tissue often resemble the HEV of lymphoid tissue and may also be a site of lymphocyte emigration, examination of the effects of immunologic and inflammatory mediators on endothelial cells (EC) may provide important information about the physiology of both normal lymphocyte recirculation and chronic inflammation. It is reported here that treatment of human umbilical vein EC monolayers in vitro with affinity-purified human interleukin 1 (IL 1) markedly enhances the binding of both B and T lymphocytes. Increased binding was observed within 1 h of treatment of EC with as little as 0.04 U/ml IL 1. This effect of IL 1 was EC-specific, because pretreatment of T cells or human skin fibroblasts with IL 1 did not increase the binding of lymphocytes. Stimulation of binding required active EC metabolism because incubation of EC with IL 1 at 4 degrees C, or prior fixation of EC, prevented enhanced binding. The action of IL 1 was not associated with EC damage. The secretion of IL 1 by macrophages and perhaps other cells in inflammatory lesions may exert a positive feedback signal on EC to enhance further emigration of lymphocytes into the inflammatory focus.

Antigens, Surface↗
PubMed1986

Perthes' disease in South India.

One hundred sixty-five cases of Perthes' disease were observed during a 15-year period. The mean age at onset of symptoms was 9.89 years for boys and 8.71 years for girls. The overall male:female ratio was 2.58:1, with profound regional differences. Bilateral involvement was seen in ten children, and the right hip was more frequently affected in unilateral cases (R:L, 92:63). Fixed deformities were noted in 14 children. Profound restriction of hip movement was present in seven cases, and in three there was no movement at all. Seventy percent of the cases fell into Catterall's Group 3 or 4 and 20% could not be classified into any of the groups. Sixty percent of the children presented during the initial stage of the disease. One group of these children had features resembling tuberculosis, with fixed deformities, gross restriction of movement, and osteoporosis around the acetabulum. Their symptoms resolved without antitubercular treatment and their late radiologic features were those of healed Perthes' disease. Treatment planning was problematic because of the advanced age at onset, large proportion of girls, frequency of extensive involvement of the epiphysis, and socioeconomic factors.

Child↗
PubMed1985

Acro-osteolysis associated with hypertrophic pulmonary osteoarthropathy and pachydermoperiostosis.

The authors report two cases of marked acro-osteolysis. One patient, a 16-year-old boy, had hypertrophic pulmonary osteoarthropathy associated with bronchiectasis, clubbing of the digits, synovitis, and osseous changes. The other patient, a 55-year-old man, had pachydermoperiostosis as well as synovial hypertrophy, clubbing of the digits, blepharitis, and a cataract. While the association of acro-osteolysis and pachydermoperiostosis has been reported before, this appears to be the first verified case of acro-osteolysis combined with hypertrophic pulmonary osteoarthropathy.

Adolescent↗
PubMed1984

Do hospitals practice strategic planning? An empirical study.

A survey was conducted to determine the extent of strategic planning management and specific planning techniques used in hospitals today. Results indicate that approximately one-half of all hospitals use some sort of formalized strategic planning, although many of these are in the early stages of development. Data is also provided on other strategic planning issues such as budget allocations to planning, planning process participants, and aspects of planning needing improvement. A general discussion of the value of strategic planning to hospital management is offered.

Budgets↗
PubMed1983

Comparison of techniques for the estimation of the prevalence of poliomyelitis in developing countries.

Although reliable data on the prevalence and trends of paralytic poliomyelitis are necessary for health planning, they are often difficult to obtain in developing countries. Comparisons were made of the cost and the time taken to obtain prevalence rates of residual poliomyelitis paralysis in a single community by (1) a surveillance and reporting system using physicians and other practitioners, (2) a school survey covering grades 1 to 12, (3) annual surveys of grade 1 schoolchildren, and (4) a house-to-house questionnaire survey. These techniques gave poliomyelitis prevalence rates of 3-5 per 1000 school-age children, and poliomyelitis incidence rates of 12-29 per 100 000 population per year. The annual grade 1 school survey was the cheapest and easiest to carry out and appears reliable in areas with a high rate of school enrolment.

Adolescent↗
PubMed1983

On understanding and not understanding: some technical issues.

This paper discusses some technical problems arising from the diverse ways our patients have of making themselves understood or not understood. It aims to show how patients who have reached the depressive position are able to use understanding in a way that is very different from those in the paranoid-schizoid position. It describes particular methods that the latter patients have of avoiding understanding by splitting and projection and attempting unconsciously to draw the analyst into a type of acting out in the transference. It stresses the importance for the analyst, of listening to the patient in terms of the position from which he is operating, so that contact can be achieved and with it real understanding, as opposed to subtle acting out and pseudo-understanding.

Child, Preschool↗
PubMed1982

Addiction to near-death.

This paper describes a very malignant type of self-destructiveness seen in a small group of patients. It is active in the way that they run their lives and it emerges in a deadly way in the transference. This type of self-destructiveness is, I suggest, in the nature of an addiction of a particular sado-masochistic type, which these patients feel unable to resist. It seems to be like a constant pull towards despair and near-death, so that the patient is fascinated and unconsciously excited by the whole process. Examples are given to show how such addictions dominate the way in which the patient communicates with the analyst and internally, with himself, and thus how they affect his thinking processes. It is clearly extremely difficult for such patients to move towards more real and object-related enjoyments, which would mean giving up the all-consuming addictive gratifications.

Attitude to Death↗
PubMed1980

Hemoglobinopathies observed in the population of the Southeastern United States (SE-USA).

A survey of nearly 250,000 citizens of Georgia and South Carolina conducted during the past twenty years has led to the detection of over 40 abnormal hemoglobins and several additional hemoglobinopathies. The presence of some of these hemoglobin abnormalities cause (severe) clinical symptoms but others remain undetected unless a specific search is initiated. The incidence of Hb S varies slightly among the populations of different areas, and appears to be the highest in the coastal counties of Georgia and South Carolina. A survey of over 17,000 persons of mainly high school and college age has shown that a significant number of cases with clinically significant hemoglobinopathies will remain undetected unless such surveys are actively promoted.

Adolescent↗
PubMed1979

Renal failure owing to oxalate nephrosis after jejunoileal bypass.

Oxalate nephrosis resulted in progressive renal failure in 4 patients after jejunoileal bypass for morbid obesity. In general, increased levels of oxalates in the blood and urine of such patients result from enhanced absorption of exogenous oxalates. Urinary calculous formation is determined further by concomitant deficiency of inhibitor substances, whereas oxalate nephrosis probably occurs as a result of oxalate deposition in renal interstitium via the blood stream. Clinical manifestations of oxalate nephrosis include pain, infection, hematuria and renal failure. Routine postoperative renal function studies and early renal biopsy in suspicious cases are urged to establish early diagnosis. Continued deterioration of renal function, despite therapy with oxalate restruction and oxalate binding agents, indicates a reversal of the bypass to preserve unaffected renal substance.

Adult↗