Biomedical subjects
Publications and source records attributed to D Graham.
Copper-bearing intrauterine devices are being increasingly used for contraception. A growing number of pregnancies, which may subsequently carry to term, are therefore being exposed to high levels of copper at the critical period of organogenesis, with risk of possible teratogenesis. Two cases of anencephaly occurring in association with these devices are reported.
This study concerns what is thought appropriate and what is being taught residents in family practice and pediatrics. University based training programs were selected for study and 63 family practice and 125 pediatric programs were surveyed by mail. The response rate for two mailings was 76 percent for pediatric and 81 percent for family practice programs. A larger proportion of pediatric than family practice programs teach diagnosis of mental retardation; educational placement of the mentally retarded; diagnosis of communication defects; trends in special education, and placement in special education; interdisciplinary teaming; and organization of the school system. Family practice programs focus more on the health problems of the school-aged athlete and the teaching of health education. School consultation and the implementation of clinical preventive medicine into care of the school-aged child are evident areas of weakness in current programs. The family physician must become more involved with the school placement of children and be aware of the relationship between school activities and health problems seen in the office setting.
Cyclopenta(cd)pyrene, a constituent of environmental emissions, has been found to mutate and transform mammalian cells in culture. Cyclopenta(cd)pyrene 3,4-oxide, a presumed metabolite, was found to be a direct-acting mutagen and to transform mammalian cells. These results suggest that cyclopenta(cd)pyrene 3,4-oxide may be an ultimate mutagenic form of the parent hydrocarbon.
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Preliminary findings of an open trial of cromolyn in hyperkinetic and psychotic children indicates that the medication is useful, safe and well tolerated. Further controlled studies are suggested to determine the efficacy and indications of cromolyn in child psychiatry. Positive findings could clarify the biochemical mechanisms of hyperkinesis.
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A method of the urodynamic investigation of paraplegic and quadriplegie patients is described. Serial measurements of the urethral pressure profile in patients with developing reflex micturition demonstrate a rising pressure at the external urethral sphincter with time following spinal trauma. Patterns of micturition with detrusor-sphincteric imbalance are described in patients with both early and well-established reflex micturition.
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Five interns joined in a collaborative study to assess their learning experiences during the internship year. A 3 times 5-inch data form was completed for each patient for whom the intern was responsible. Information was gathered on demongraphic characteristics of the patient, the teaching that involved this patient, and what skills were acquired. Nearly 30% of the patients were under 1 year of age; 55% were boys. More than one half of the contacts were in an outpatient or emergency department. Over 80% of the patients had not been seen before; continuity patients made up less than 9% of the contacts. Well-child care was the largest care category (19%), followed by respiratory problems (15%) and injuries (9%). About 40% of the contacts involved a teaching input, mainly from residents, attending physicians, and faculty. Care skills most frequently acquired were physical examination (49%), reading (15%), and interviewing (11%). Cross-tabulations showed that most learning was reported for inpatients, for patients with rare diseases, and when some teaching was involved.
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