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Biomedical subjects

D Savage

Publications and source records attributed to D Savage.

At least 55 records · Page 3Linked to original sources
PubMed1985

An investigation into the validity of the present classification of inflammatory bowel disease.

To assess the validity of the present subdivision of patients with inflammatory bowel disease into those with Crohn's disease of the small bowel or of the colon and those with ulcerative colitis, 252 patients with inflammatory bowel disease have been studied by questionnaire and case note review. One hundred and seventy-two variables concerning the nature and frequency of symptoms in remission and relapse, the incidence of complications and results of investigation have been analysed by computer. As expected, there were many highly significant variables between patients with ulcerative colitis and those with Crohn's disease of the small bowel. The latter showed evidence of a more severe disease course with more complications. There were similar, although less marked, differences between patients with Crohn's disease of the colon and those with Crohn's disease of the small bowel. There were very few differences in disease course between patients with Crohn's disease of the colon and those with ulcerative colitis. The results suggest that while separate classification of patients with Crohn's disease of the small bowel is justified on clinical grounds, the present separation of patients with disease confined to the colon into groups labelled ulcerative colitis or Crohn's disease of the colon is not. Alternative methods of classification should therefore be investigated.

Colitis, Ulcerative↗
PubMed1984

Race, poverty, and survival in multiple myeloma.

To identify possible interracial differences in the behavior of multiple myeloma, the records of 52 black myeloma patients at Harlem Hospital Center (HHC) and 46 black and 46 white patients at Columbia-Presbyterian Medical Center (CPMC) were reviewed. In addition to clinical variables such as tumor burden, azotemia, and hypoalbuminemia, the effect of poverty on prognosis was examined, using socioeconomic indices from the United States census block group data of each patient. The median survival of CPMC black and white patients was comparable (34 and 29 months, respectively) whereas that of the HHC group was 12 months (Breslow test, P less than 0.0001). Overcrowding and hypoalbuminemia were the most significant prognostic factors by multivariate regression analysis on all 144 patients (P = 0.001); for HHC patients, overcrowding was the single significant variable affecting survival (P = 0.004). By all socioeconomic indices, HHC patients were more impoverished than CPMC patients (P less than 0.001); they also presented with more advanced disease. Race is not a significant prognostic factor in myeloma, whereas the effect of socioeconomic status on survival appears to equal that of previously described clinical features.

Adult↗
PubMed1983

Relapses after interruption of cyanocobalamin therapy in patients with pernicious anemia.

One or more episodes of recurrent megaloblastic anemia occurred in 36 (10.8 percent) of 333 patients with pernicious anemia following interruption of therapy. Treatment had most commonly been discontinued by patients because they felt well, or by physicians due to error. Thirty-five episodes of recurrent cobalamin deficiency were analyzed in detail. In the 24 patients in whom the exact date of cessation of therapy was recorded, the mean interval before relapse was diagnosed was 64.5 months (range 21 to 123 months). Recurrence manifested as macrocytosis in the absence of anemia occurred earlier (mean, 49.2 months) than that associated with anemia (73.1 months). A weak correlation was apparent between the amount of previous cyanocobalamin treatment and time to relapse. One third of relapses were unrecognized and left untreated for more than two years, while usually slow hematologic progression occurred. Recurrences of cobalamin deficiency in individual patients exhibited mimetic features. Further study is necessary to establish the optimal dosage and frequency of maintenance therapy in pernicious anemia.

Adult↗
PubMed1979

The physician's duty to report the battered child syndrome.

All US jurisdictions require that physicians file formal reports of suspected cases of child abuse and/or child neglect. Most states expressly grant civil immunity from lawsuits to all reporting physicians. The physician who fails to file such a report will be exposed to civil liability for professional malpractice when failure to report leads to continued child abuse. At least 37 states provide for criminal penalties for physicians who fail to report battered children. This paper examines procedures for minimal compliance with any state's reporting statute and details the precise reporting procedure for each US jurisdiction.

Child↗
PubMed1978

Epileptic laughter with precocious puberty.

A child with associated epileptic laughter and precocious puberty is reported. The significance of epileptic laughter as a possible marker of hypothalamic disease is noted.

Brain Diseases↗
PubMed1972

Clinical, microbiological, and immunological studies in patients with immunoglobulin deficiencies and gastrointestinal disorders.

Seven patients with gastrointestinal disorders and deficiencies of serum and secretory immunoglobulins were evaluated clinically, microbiologically, and immunologically. Five patients had generalized deficiencies of immunoglobulins; two were selectively deficient. Diarrhoea and malabsorption in six of the seven patients were at least partially explained. Four of the five patients with generalized hypogammaglobulinaemia had intestinal infestation with Giardia lamblia; in three of the five, excessive numbers of anaerobic bacteria were cultured from small bowel fluids. Despite much variability in relative severity of patients' respiratory and gastrointestinal tract symptoms, deficiencies of mucosal immunocytes and immunoglobulins in nasopharyngeal and gastrointestinal tract tissues and secretions were similar. Except for one selectively IgA-deficient patient, all patients were deficient in IgE. The study characterizes in greater detail than heretofore the gastrointestinal disorders associated with immunoglobulin deficiency states.

Adolescent↗