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Biomedical subjects

B Taylor

Publications and source records attributed to B Taylor.

At least 217 records · Page 12Linked to original sources
PubMed1988

Family recovery after death of a child.

Children from a national birth cohort living in families in which a sibling had died or been stillborn were compared with children living in similarly structured families where no such tragedy had occurred by a number of health, developmental, and behavioural outcomes. Surprisingly little ill effect from a sibling death (occurring either before or after the birth of study children) was apparent at the age of 5 years. Families experiencing a stillbirth or death of a child were socially disadvantaged. Even allowing for this and other likely intervening factors, however, a child whose adjacent sibling had died was significantly more liable to bronchitis or wheezing during the first 5 years. Mothers who had experienced the death of a child since the study child's birth had high scores on a psychological screening test, and were more likely to be single parents. Mothers who had lost a child were more likely to smoke during the next pregnancy. No significant differences between cases and control subjects were detected on other health, behavioural, or developmental outcomes. Stillbirth or death of a child appears to have little measurable effect on siblings assessed at 5 years of age. This study does not exclude important longer term psychological effects from sibling death.

Bereavement↗
PubMed1988

Delayed reaction to "lead" pencil simulating melanoma.

A 74-year-old man had sustained a penetrating lead pencil injury to his right lower leg at the age of fifteen. A dark gray macule occurred that remained unchanged for fifty-eight years. An enlarging black nodule appeared in this area, simulating a melanoma, when the patient was seventy-three years old. Histologic examination revealed exogenous pigment and a foreign body reaction.

Aged↗
PubMed1987

Panic attacks in the natural environment.

Despite much recent research, there is still little systematic information about the phenomenology of panic attacks, and their possible causes remain obscure. We investigated panic attacks in the natural environment using an event sampling approach. Twenty-seven panic attack patients and 19 matched normal controls kept panic attack and self-exposure diaries for 6 days and wore an ambulatory heart rate/physical activity recorder for 3 days. Patients reported 175 attacks, generally of moderate severity. The most frequent symptoms were palpitations, dizziness/lightheadedness, dyspnea, nausea, sweating, and chest pain/discomfort. The results did not support the classification of panic attacks recently proposed by Sheehan and Sheehan, which requires three symptoms as a cutoff for panic attacks. Panic attacks classified by the patients as situational (i.e., occurring in feared situations) were more severe and occurred in situational contexts different from spontaneous attacks, but were otherwise phenomenologically similar. Heart rates did not change during spontaneous attacks and were only mildly elevated during situational attacks or during the 15 minutes preceding these attacks. These heart rate changes were interpretable as effects of anxiety, although physical activity showed a similar pattern of changes. Some normal control subjects reported on the panic diary primarily situational anxiety episodes that were phenomenologically similar to, albeit less severe than, the patients' episodes. Panic patients may sometimes fail to perceive environmental triggers for their attacks because many attacks classified as spontaneous occurred in classical "phobic" situations. Furthermore, the comparison of concurrent diary and retrospective interview and questionnaire descriptions showed that panic patients have a tendency toward retrospective exaggeration. Implications for the assessment, definition, and classification of panic attacks are discussed.

Activities of Daily Living↗
PubMed1987

Maternal smoking during pregnancy and lower respiratory tract illness in early life.

In a national study of 12,743 children maternal, but not paternal, smoking was confirmed as having a significant influence on the reported incidence of bronchitis and admission to hospital for lower respiratory tract illness during the first five years of life. Reported rates of admissions to hospital for lower respiratory tract diseases were found to be as high in children born to mothers who stopped smoking during pregnancy as in those whose mothers smoked continuously both during and after pregnancy. Rates of admissions to hospital for lower respiratory tract diseases in children whose mothers started smoking only postnatally were no higher than in those whose mothers remained non-smokers. Postnatal smoking seemed to exert a significant influence on the reported incidence of bronchitis, but less than smoking during pregnancy. These findings suggest that maternal smoking influences the incidence of respiratory illnesses in children mainly through a congenital effect, and only to a lesser extent through passive exposure after birth.

Child, Preschool↗
PubMed1987

Hepatic arterial infusion of mitoxantrone in the treatment of primary hepatocellular carcinoma.

Twenty-three patients (16 male, seven female) with hepatocellular carcinoma (HCC) were treated by hepatic arterial infusion (HAI) of mitoxantrone every 4 weeks. At each treatment, a catheter was inserted percutaneously into the main hepatic artery via the femoral artery under image intensification. Treatment consisted of a 24-hour continuous HAI of mitoxantrone, 6 mg/m2/d X 3 (eight patients) or 10 mg/m2/d X 3 (14 patients) without heparin. Eight patients had only one infusion, nine patients four infusions, five patients three infusions, two patients two infusions, and one patient five infusions. A partial response was seen in six patients, with a median duration of 20 weeks (range, 18 to 38 weeks). Five patients achieved stable disease, with a median duration of 20 weeks (range, 11 to 42 weeks). The median survival of the overall group was 22 weeks. Survivals of responding, stable, and nonresponding patients were 32 weeks, 24 weeks, and 9 weeks, respectively. Complications of catheter placement included asymptomatic dissection of the hepatic artery (one patient), and asymptomatic thrombosis of the hepatic artery (five patients). Three patients experienced mild nausea and vomiting, and six patients had mild to moderate alopecia. Granulocytopenia was frequent at both dose schedules. The granulocyte nadir was greater than 1,000/microL in 34% of evaluable courses, 500 to 1,000/microL in 32%, and less than 500/microL in 34% of courses. Two patients developed neutropenia-associated fever. A platelet nadir below 100,000/microL was seen after only 10% of courses, and only two patients had platelets below 50,000/microL. Seven patients received doxorubicin after progression on mitoxantrone. Four received systemic doxorubicin, 50 mg/m2, and three HAI of doxorubicin, 25 mg/m2, for three days. Two patients achieved partial response (18 weeks and 32 weeks) to HAI doxorubicin. Mitoxantrone has activity in HCC and is well tolerated when administered by HAI. It is not entirely cross-resistant with doxorubicin.

Adult↗
PubMed1987

Transjugular intrahepatic portosystemic shunt: a nonoperative approach to life-threatening variceal bleeding.

Portosystemic venous shunts may be created nonoperatively with a Grüntzig balloon dilatation catheter using the transjugular route. The authors achieved technical success with this shunt in 15 of 20 patients with life-threatening gastrointestinal bleeding from variceal hemorrhage. All patients but one were considered at high risk for surgery because of end-stage liver disease; the exception was a patient in whom two previous operative portosystemic shunts had failed. An average decrease of 5.9 mm Hg in portal vein pressure was measured in 11 patients for whom sequential pressures could be obtained. Two patients survived longer than 12 months without subsequent operative procedures, and the shunt helped temporize in three other patients who later underwent operation. Nine patients with successful shunts died within 30 days of the procedure, comparing favourably with reported operative death rates of 40% to 80% in emergency shunt procedures. Follow-up portal venograms demonstrated shunt patency in six of nine patients, in one after 8 months. Tract patency was determined in four of seven patients on whom autopsy was performed, up to 6 months after the transjugular intrahepatic portosystemic shunt was created.

Adult↗
PubMed1986

Intussusception and intestinal malrotation in infants: Waugh's syndrome.

The position of the duodenojejunal flexure was determined in 37 out of a group of 49 consecutive infants presenting with intussusception. The flexure was in a normal position in 19, at the midline in 3, and in an abnormal position in 15. The caecum was unfixed in all of the 41 infants subjected to operation. It is concluded that lack of normal rotation and fixation of the intestine is an important factor in the aetiology of idiopathic intussusception of infants.

Cecum↗
PubMed1986

Percutaneous transhepatic sphincterotomy in the management of biliary tract disease.

This report describes a novel modification of existing transhepatic techniques and illustrates successful relief of mechanical obstructive jaundice in 2 patients in whom surgical or endoscopic intervention was contraindicated or impossible. In each, percutaneous transhepatic cholangiogram (PTC) was performed in the usual manner. A standard endoscopic papillotome was then advanced across the stricture into the duodenum. Sphincterotomy was performed at the 11 to 1 o'clock position using blended current for 3-4 seconds. Repeat cholangiography showed successful decompression of the biliary tree in both patients. No morbidity or mortality was directly attributable to percutaneous transhepatic sphincterotomy in these patients. This technique offers a safe and therapeutic alternative to biliary tract obstruction, and should be considered in selected patients who are not candidates for surgery or endoscopy.

Aged↗
PubMed1986

Dietary lead increases ethanol consumption in the rat.

Rats fed either a diet containing 500 ppm (parts per million) Pb (as lead acetate) or an unadulterated control diet for 50 days were offered a 15% ethanol (ETOH) solution in a nonchoice (one-bottle) test situation. The results from this test indicated that Pb-diet animals consumed greater amounts of the ETOH solution than did controls. In a subsequent choice (three-bottle, two-fluid) test situation offering a nonpreferred ETOH solution or tap water as alternatives, Pb-diet animals once again ingested greater amounts of the ETOH solution. These findings are discussed in terms of possible Pb-induced increases in emotionality and the potential stress-reduction properties of ETOH.

Alcohol Drinking↗
PubMed1986

Alpha thalassemia and the hematology of homozygous sickle cell disease in childhood.

alpha Thalassemia modifies the hematologic expression of homozygous sickle cell (SS) disease, resulting in increased total hemoglobin and HbA2 and decreased HbF, mean cell volume, reticulocytes, irreversibly sickled cells, and bilirubin levels. The age at which these changes develop in children with SS disease is unknown. Ascertainment of globin gene status in a large representative sample of children with SS disease has afforded an opportunity to study the hematologic indices in nine children homozygous for alpha thalassemia 2 (two-gene group), 90 children heterozygous for alpha thalassemia 2 (three-gene group), and 167 children with a normal alpha globin gene complement (four-gene group). The two-gene group had significantly lower mean cell volumes from birth, higher red cell counts from one month, lower reticulocytes from three months, and higher HbA2 levels from one year, as compared with the four-gene group. Children with three genes had intermediate indices but resembled more closely the four-gene group. Differences in total hemoglobin or in fetal hemoglobin between the groups were not apparent by eight years of age. The most characteristic differences of the two-gene group were the raised proportional HbA2 level and low mean cell volume, the latter having some predictive value for alpha thalassemia status at birth.

Age Factors↗
PubMed1986

Twenty-four-hour monitoring of esophagopharyngeal pH in outpatients. Use of four-channel pH probe and computerized system.

A 24 hour computerized four-channel esophagopharyngeal pH system is described. Using a 1.5 mm diameter esophageal probe containing four separate antimony-tipped electrodes and a small patient-worn digital recording computer, inpatient and outpatient studies are performed in the physiologic environment of the patient's workplace or home. Stored pH data in the computer are teletransmitted from satellite esophageal pH laboratories to a central esophageal pH laboratory for analysis, scoring, printout, and storage. Satellite laboratories located in hospitals, clinics, and physicians' offices use a minimum of equipment and obtain a quality computer-based printout. This preserves patient-physician relationships in the home environment and is cost-effective. Four case reports are presented identifying the advantages derived from the four-channel system localizing and quantifying the extent of cephalad transport of refluxed upper gastrointestinal content. The system has unique clinical and research potential in all age groups in such disparate problems as sleep apnea, laryngitis, bradycardia and cardiac irregularities, and aspiration pneumonia and pulmonary abscess.

Adolescent↗
PubMed1986

A time-comparison circuit in the electric fish midbrain. II. Functional morphology.

The weakly electric fish Eigenmannia is able to detect temporal disparities as small as 400 nsec between two signals from different parts of the body surface (Carr et al., 1986). The elements of this time-comparison circuit have been identified by EM reconstruction of its component cells. Information about the timing of the zero-crossing of signals on each area of the body surface is coded in phase-coder receptors, a subset of tuberous electroreceptors. Electroreceptors on the body surface are innervated by primary afferents with their central termination on the spherical cells of the medullary electrosensory lateral line lobe. These cells project to lamina VI of the midbrain torus, a structure similar to the inferior colliculus. Afferents entering lamina VI form a very restricted terminal arbor in which they synapse on the three cell types of this lamina. Each afferent makes gap-junction synapses on one or two giant cell somata and morphologically mixed synapses on the distal dendrites of two types of small cell. The afferent terminals thus encode the timing of the electric signal on a local patch of the body surface, forming a somatotopic map of the body surface in lamina VI. The giant cells are adendritic and their axonal arbor is such as to distribute timing information originating from one part of the body surface throughout lamina VI, so that each region of lamina VI receives information about the timing of zero-crossings from the entire body surface from giant cells, as well as information from a local portion of the body surface from the afferent terminals. The giant cells terminate exclusively on the cell bodies of the small cells of lamina VI, shown to be sensitive to small temporal disparities by Heiligenberg and Rose (1985). Thus, each small cell receives a single synapse on its soma from a giant cell that conveys phase-coding information from some portion of the body surface and receives local phase-coding input onto its dendrites from spherical cell afferents. The sensitivity of the small cells to temporal disparities appears to be conferred by their segregation of inputs from two different parts of the body surface onto dendrites and soma, respectively. We propose that the dendritic input acts as a delay line, and the small cell fires maximally when the inputs from the dendrites and the giant cell input onto the soma coincide.

Animals↗
PubMed1985

Staff perceptions of adolescent behaviour problems.

Staff in three residential units completed a 25 item behaviour problem questionnaire. From analysis of questionnaires a rank order of behaviours according to rated severity was made for each Unit. Comparisons of ranking were made between the Units and, from factor analysis, perceptions of these items of behaviour by staff in the three Units were studied. We were able to establish three hypotheses regarding the severity of problem behaviours and their perceptions by staff. We suggest that staff support has a major function in influencing them.

Adolescent↗