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Biomedical subjects

B Oliver

Publications and source records attributed to B Oliver.

At least 73 records · Page 4Linked to original sources

Surgical management of aortic coarctation associated with ruptured cerebral artery aneurysm.

We report two patients with coarctation of the aorta who were admitted to the hospital with ruptured cerebral artery aneurysms. In both patients, we surgically treated the coarctation and later repaired the intracranial lesion. One patient, a 34-year-old woman, is alive and well after 3 years; whereas, the other, a 19-year-old man, did not survive. We discuss the sequence for surgery, which continues to be subjected to debate.

Journal Article↗

Prolonged outbreak of Norwalk gastroenteritis in an isolated guest house.

During November and December 1982, a persistent outbreak of gastroenteritis took place in an isolated guest house. An estimated 26% of the changing population of guests and staff developed symptoms. Laboratory studies implicated Norwalk agent as the cause of illness, although the original source of the outbreak could not be established. Information on clinical features of the illness, its mode of spread, and eventual control is presented.

Adolescent↗

Spontaneous thrombosis of an intracranial aneurysm.

A case of spontaneous thrombosis of a previously ruptured anterior communicating artery aneurysm is reported. The patient was referred by another hospital to our service 4 months after the bleeding episode. He had developed a symptomatic normal pressure hydrocephalus, successfully treated by ventriculoperitoneal shunt. Follow-up angiographies, the first performed 4 months and the second 1 year after the bleeding, did not show the aneurysm. Furthermore, the parent artery was not occluded. The literature relative to the subject is reviewed and the possible mechanisms of spontaneous thrombosis are discussed.

Humans↗

Improving communication: a practical programme for teaching trainees about communication issues in the general practice consultation.

This paper describes a teaching programme, for use in general practice vocational training, which provides a theoretical and practical framework for exploring key aspects of the consultation with trainees. A particular emphasis is on the educational or 'cognitive' outcomes of the consultation and skills for improving them. The five stages of the programme are described and an example of experience of each stage is given. The paper concludes with an evaluation of the programme by the trainers, trainees and social scientist involved.

Communication↗

Computed tomography of intraperitoneal malignancy.

A review of 205 abdominal computed tomographic (CT) scans in 83 patients with gastric or ovarian neoplasms was performed in order to assess their contribution to management. Assessment of scan accuracy was based on results of invasive procedures, clinical data, and double-blind re-reporting. Scans appeared to be of greater value in patients with ovarian rather than gastric neoplasms (p less than 0.001), and in patients undergoing clinically-indicated rather than routine scans (p less than 0.001). No clinical benefit accrued from the use of pre-treatment scans. Overall accuracy of scanning was judged to be significantly greater for the ovarian than the gastric group (p less than 0.001), while concordance of scan reports with re-reporting was also greater in the ovarian group (p less than 0.001). The data indicate the inherent limitations of the CT scan and the high degree of subjectivity in its interpretation, particularly when used in the follow-up of patients with known or suspected recurrent gastric cancer. CT scanning remains a potentially useful adjunct to clinical assessment of patients with intraperitoneal malignancy, but should not be regarded as obviating the need for clinical judgement in management decisions.

Adolescent↗

Calcified cerebral hydatid cyst.

A case of calcified cerebral hydatid cyst recently treated in our neurosurgical service is reported. The frequency of calcified cerebral hydatid cyst (CCHC) is less than 1% of cerebral hydatid cysts. A review of the literature disclosed 13 cases of calcified cerebral hydatid cysts. The clinical presentation and radiological findings are discussed. The present case is, to the best of our knowledge, the first case studied by computerized tomography.

Adult↗

Pineal region meningiomas without dural attachment.

A rare case of meningioma in the pineal region without dural attachment, which was successfully removed through an infratentorial supracerebellar approach, is presented. The preoperative diagnosis was made by means of computed tomography together with histographic analysis. We review similar cases reported in the literature and discuss the clinical feature, diagnostic aspects, and surgical management.

Brain Neoplasms↗

Cancer of the anterior floor of the mouth. Selective choice of treatment and analysis of failures.

From 1971 through 1975, 104 patients with squamous carcinoma of the anterior and anterolateral floor of the mouth underwent surgery, irradiation therapy or a combination of both with the purpose of eliminating their tumors. No patient had received treatment before, and this effort was considered primary and definitive. Fifty-five patients were free of cancer at the time of this analysis, 21 had died of intercurrent disease or new primary tumors, 1 patient was alive although suffering from another primary cancer, and in 27 patients the treatment failed and they died of recurrent carcinoma of the head and neck or with distant metastases. The ultimate determinate rate of control for all stages of disease was 66 percent. A rational approach to the problem of selecting a particular form of treatment for patients with cancer of the anterior floor of the mouth in different clinical manifestations is presented.

Carcinoma, Squamous Cell↗

[Intracranial teratomas of the newborn and childhood (author's transl)].

Two cases of intracranial teratomas are reported. Plain skull X ray is one of the principal procedures or diagnosis of these tumors, although CT scan usually showed the whole tumor. Cystic teratomas are low density masses and solid teratomas are high density masses. The behaviour of these tumors is different in the newborn and childhood. The former due to the size of these tumors usually has bad prognosis, but in childhood sometimes it is possible to achieve total removal. Regarding treatment, surgical approach is advised with postoperative radiotherapy in cystic teratomas and atypical teratomas.

Cerebral Ventricle Neoplasms↗

Pharmacological emptying of the stomach with metoclopramide.

This paper evaluates the use of metoclopramide (Maxolon) in emptying human stomach contents into the duodenum and beyond. A method of quantitative assessment of content by barium swallow radiography is used in the study, and the method is recommended as a diagnostic manoeuvre in patients presenting for emergency surgery in whom the stomach content is in doubt. Oral metoclopramide was found effective in emptying stomachs challenged by water load, and the intravenous route has been found effective in emptying semisolid contents in emergency clinical situations. A radiographic scan of the resting stomach was made on patients waiting for routine surgery who had received a variety of common premedication; it was shown that significant residues occur.We believe that metoclopramide deserves further investigation in order to exploit its potential in reducing the hazard of regurgitation and vomiting in patients requiring emergency anaesthesia and surgery.

Adolescent↗

A comparison of aspects of the maternal speech environment of retarded and non-retarded children.

This study was concerned to explore aspects of the maternal speech environment of mentally retarded children. Eight mothers were observed in interaction with their retarded children and compared with mothers on non-retarded infants who had been matched in terms of various socio-economic indices and language behaviour. The mothers of the retarded children were found to be significantly more stimulating vocally, more responsive and less directive than the controls. The findings are discussed in terms of possible reasons for such differences and the implications for the child.

Adult↗

The effect of enalapril on advanced diabetic nephropathy in African-American females.

This paper examines the effect of enalapril in African-American (AA) females with advanced type 2 diabetic nephropathy (DN)--the leading cause of end stage renal disease (ESRD) in this group. AA females followed in our university nephrology clinic with type 2 DN and a serum creatinine level (Cr) > or = 2.5 mg/dl were eligible. Historical controls who never received an ACE inhibitor were selected (matched for age and Cr) from a database of patients reaching ESRD between 1993 and 1998, with a primary diagnosis of DN. Patients enrolled (N = 6) were started on enalapril at 5 mg per day with the dose titrated upward to a blood pressure (BP) goal of 140/90 mm Hg. The enalapril group tended to be older than controls (58.8 vs 51.5 years of age, P = ns) and had had their diabetes longer (18.5 vs 13.2 years of age, P = ns). At baseline, there were no significant differences in blood pressure, blood, urea, nitrogen (BUN), Cr, or BMI between groups. One of the 6 treated with enalapril had the agent stopped due to hyperkalemia. Five of 6 in the enalapril group reached ESRD, but there was no significant difference between the groups in the time it took to reach this stage (69.5 +/- 13.8 weeks vs 92.0 +/- 21.4 weeks, enalapril group vs control group, P = ns). In the enalapril patient who did not reach ESRD, the Cr level increased from 2.9 to 3.8 mg/dl in approximately 3 years. From this small study, we conclude that, although enalapril is tolerated in AA females with advanced DN, the agent had no significant effect on renal survival.

Black or African American↗

[Hemangioblastoma associated with syringomyelia and syringobulbia in a patient with rheumatoid arthritis].

A 80-year-old woman with a 25-year history of seropositive, erosive rheumatoid arthritis (RA) presented with a neurological clinical picture consistent with cervical cord compression, secondary to a hemangioblastoma with medulla, cerebellum and spinal cord involvement, with associated syringomyelia and syringobulbia. We present a review of the literature remarking the low frequency of this tumor (1%-2% of all intracranial tumors) and its exceptional presentation over the age of 70. We have not been able to find no cases of hemangioblastoma associated with rheumatoid arthritis, thus, we think, this association may be casual. Nevertheless, it emphasizes the need for careful evaluation of patients with rheumatoid arthritis and neurological symptoms before ascribing them to complications due to the rheumatoid disease itself.

Aged↗