Search PubMed⌕ Search

Biomedical subjects

E Brown

Publications and source records attributed to E Brown.

At least 145 records · Page 8Linked to original sources
PubMed1993

[Differences in mortality in the Dogon of Boni].

Mortality has been analyzed at the level of a small population of approximately 5000 persons, part of the Dogon of Mali. They are separated into four distinct groups, each composed of from three to four villages. Adjusted life tables are estimated for two periods of five years: 1977-81 and 1982-86. First these tables were calculated for the entire population and then for two of the most densely populated massifs. Mortality is very high. However, it is different in the two areas. This difference, already notable in 1977-81, increased during the period 1982-86. Possible causal factors could be linked to the presence of primary health care in the Tabi region. Although very limited, the care changed elementary rules of hygiene. Moreover, comparison between villages point to the important role of the quality and quantity of available water in relation to child mortality levels.

Adolescent↗
PubMed1993

The emergent problem of ambulance misuse.

STUDY OBJECTIVE: The primary objective was to determine whether rates of ambulance misuse varied systematically by type of health insurance. The secondary objective was to determine whether the level of service provided in the ambulance varied by ambulance company ownership. DESIGN: Survey. SETTING: A 175-bed community hospital in central Connecticut. PARTICIPANTS: One hundred forty-five records were selected randomly for study from the records of the 488 patients presenting to the hospital emergency department within a 45-day period. OUTCOME MEASURES: The urgency of presenting complaint and the use of life support measures within the ambulance were obtained from each ambulance run form. Type of health insurance, clinical data, and disposition were obtained from ED records. Ambulance use was deemed unnecessary if the patient's presenting complaint was nonurgent, the patient was ambulatory, and the patient was not ultimately hospitalized. Advanced life support measures were deemed unnecessary if they were applied to patients with nonurgent complaints. RESULTS: Patients with private insurance made appropriate use of ambulances in 77.8% of cases, patients with Medicare did so in 65.8% of cases, and patients with Medicaid did so in 14.7% of cases. These results were statistically significant at P < .001. Among patients with Medicare, ambulance misuse was more common among nursing home residents. Approximately 20% of the observed misuse was related to alcohol intoxication. Although it did not reach statistical significance, we noted a higher frequency of inappropriate use of advanced life support measures in patients brought to the ED by a private ambulance service than for those brought by a municipal service. CONCLUSION: Ambulance misuse is common in the studied community and may be related to the broader problem of the provision of care to the poor or otherwise underserved. Our results raise several interesting questions for further research.

Ambulances↗
PubMed1993

Renal failure and severe hypokalemia associated with acute myelomonocytic leukemia.

The leukemias have long been associated, albeit rarely, with the development of renal failure and several metabolic perturbations. While renal insufficiency may result from a variety of mechanisms in the setting of leukemia, severe leukostasis with microvascular insufficiency and renal parenchymal infiltration by blast cells are rare and infrequently described etiologies. In addition, hypokalemia can occur from lysozyme-induced renal tubular injury with inappropriate kaliuresis. We present a case of acute myelomonocytic leukemia that was complicated by renal failure and severe hypokalemia and discuss the probable mechanisms.

Aged↗
PubMed1993

Acute aluminum toxicity and alum bladder irrigation in patients with renal failure.

Intravesical alum instillation is an increasingly common treatment for hemorrhagic cystitis. It has been claimed that this therapy is safe in patients with renal failure. We report the case of a patient with renal failure following a bone marrow transplantation who developed an acute encephalopathy from apparent aluminum intoxication following intravesical alum. In a review of the literature, we have found two similar cases of acute aluminum intoxication from alum in patients with renal failure who have received multiagent chemotherapy. We suggest that alternate therapies be selected for hemorrhagic cystitis in such patients.

Acute Disease↗
PubMed1993

Peritonitis associated with disseminated Mycobacterium avium complex in an acquired immunodeficiency syndrome patient on chronic ambulatory peritoneal dialysis.

Chronic ambulatory peritoneal dialysis (CAPD) is a commonly used form of renal replacement therapy in patients with end-stage renal disease (ESRD) infected with the human immunodeficiency virus (HIV). An increased incidence of peritonitis, as well as an increased rate of infections with unusual and serious organisms, has been reported in these patients. We report the first case of an HIV-infected patient who developed clinical peritonitis associated with Mycobacterium avium-intracellulare (MAI) infection. We suggest that the diagnosis of MAI peritonitis be suspected in HIV-infected patients with clinical CAPD peritonitis, negative cultures for bacteria or fungi, and a CD4 count less than 100 cells/microL. Therapy with a two-drug regimen for disseminated MAI infection without removal of the peritoneal dialysis (PD) catheter appears to provide symptomatic improvement while allowing ongoing PD.

AIDS-Related Opportunistic Infections↗
PubMed1993

What gives a face its gender?

An experiment is reported in which the attribution of gender to isolated facial features and to faces whose features have been interchanged with those of a face of the opposite gender has been examined. Sixteen male faces were averaged to create a prototype male face and sixteen female faces averaged to create a prototype female face. The prototypes were then masked to exclude ears, neck, hair, and hairline. Individual features (brows, eyes, nose, mouth, and chin) and pairs of features (brows & eyes, eyes & nose, nose & mouth, mouth & chin) from the prototypes were then presented in isolation for classification according to their perceived gender. The results showed that, for the faces used, the brows & eyes, brows alone, eyes alone, the whole jaw, the chin, the nose & mouth, the mouth alone (in descending order), ie all the features except the nose, carried some information about gender when they were seen in isolation. In the second part of the experiment different features from one prototype face were grafted into the prototype of the opposite gender and the resulting composite faces classified by their perceived gender. The results of this feature substitution showed the jaw, brows & eyes, chin, and brows (in descending order) effecting significant change in perceived gender. The difference in gender information carried by feature(s) when they were viewed in isolation from that when they were substituted for each other is attributed to the role of configuration in the perception of the gender of a face.

Adolescent↗
PubMed1993

Laparoscopic cholecystectomy: morbidity and mortality in a community teaching institution.

From November 1989 to December 1990, 474 elective laparoscopic cholecystectomies were performed. This study analyzes the first year's experience with regard to complications, postoperative response in terms of pain and nausea, and time back to activity and work. There were 369 females and 105 males in the group. The average age was 51.5 years. Of these, 394 were discharged within 23 h and 80 required admission postoperatively. Of the group requiring hospitalization, there were 10 (2.1%) major complications, 37 (7.8%) minor complications, 14 (3.0%) aborted laparoscopic cholecystectomies, and 19 (4.0%) others. Major complications occurred early in the surgeon's experience, all but two within the surgeons' first 25 cases. Patients in the short stay group were followed-up with a phone questionnaire. In this group, most patients experienced minimal abdominal pain following surgery, with an average score of 2.4 (SD = 1.38) on a scale of 1 (absent) to 5 (extreme). At home, 48.6% of patients experienced some form of postoperative discomfort. Of these, 38.2% experienced abdominal pain, 18.7% shoulder pain, and 32.7% nausea. The average postoperative time to resume normal daily activity was 7.9 days (SD = 8.2) and to return to work was 11.6 days (SD = 9.9).

Adolescent↗
PubMed1993

Black male college students and hypertension: a qualitative investigation.

Qualitative research was used to determine what young black male college students do and believe in the hypertension related areas of nutrition, stress and exercise. Black female college students also were asked about their perception of the men's beliefs and behaviors in regard to the above mentioned areas. The study identified stress, especially the stress of being a black male in the US, as the most important concern of both male and female students. There was also agreement in both gender groups that relatives and close friends, especially females, had more influence on men's health behavior than professionals or celebrities. The study discusses the implications of these findings for hypertension prevention programs targeted at young black male college students.

Adult↗
PubMed1993

Comparing medical school graduates who perform poorly in residency with graduates who perform well.

BACKGROUND: Most medical school graduates perform well as residents. However, the authors' annual surveys have shown that a few graduates from each class at their school fail to meet residency directors' expectations. METHOD: The medical school records of the 20 of the 153 graduates from the class of 1983 at the University of California, San Francisco, School of Medicine who received poor evaluations from their residency directors in the first and/or second year of residency were compared with the records of 20 of their best-received classmates. The poorly received graduates did not necessarily receive poor numerical ratings of their knowledge, skills, or overall performances, but they did receive negative or ambivalent responses to the following question: "Knowing what you now know about this resident, would select him or her again? Please explain." The two groups of graduates were matched for sex, racial-ethnic identification, and residency discipline. RESULTS: The groups were quite similar with respect to qualifications for admission to medical school, overall academic achievement, and performance on standardized national examinations. There were minor differences in performances on clinical clerkships. CONCLUSION: As indicated by residency directors' ratings and comments, most of the poorly received graduates' problems during residency appear to have been personal and motivational rather than skills- or knowledge-related. With but few exceptions, the medical school records contained little evidence that might have predicted the graduates' poor reception as residents.

Adult↗
PubMed1993

Weekly KT/V urea and selected outcome criteria in 56 randomly selected CAPD patients.

The optimal way to objectively measure the adequacy of continuous ambulatory peritoneal dialysis (CAPD) therapy remains controversial. It has been suggested that one-third or more of all CAPD patients are presently receiving "inadequate dialysis" when dialysis prescriptions are not carefully calculated. To better define the therapy being delivered in a large, freestanding CAPD center, weekly KT/V urea and creatinine clearance per 1.73 m2 body surface area were measured in 56 of 180 patients randomly selected from our unit in whom dialysis prescriptions were arbitrarily determined by nurses and physicians. In addition, protein catabolic rates and selected clinical outcome criteria were assessed. Weekly KT/V urea correlated with weekly creatinine clearance (r = 0.50) as well as with the protein catabolic rate (r = 0.45). Patients were arbitrarily divided into three groups based on KT/V urea measurements. Thirty percent of the patients had weekly KT/Vs < or = 1.4, 41% had KT/Vs between 1.5 and 1.8, and 29% had weekly KT/Vs > or = 1.9. Significant differences were not noted in hospitalization rates, erythropoietin doses, or serum albumin concentrations in patients with KT/Vs < or = 1.4 and in patients with KT/Vs > or = 1.9. Peritonitis rates were highest in the patients with KT/V > or = 1.9. Therefore, in patients randomly selected from our large CAPD center, 30% of the patients had weekly KT/V urea measurements < or = 1.4. The clinical significance of this finding remains uncertain.

Adult↗
PubMed1993

Gastrointestinal absorption of aluminum in rats using 26Al and accelerator mass spectrometry.

Using the technique of Accelerator Mass Spectrometry (AMS), 26Al has been measured in plasma, liver, urine and bone of normal rats at 8, 24 and 48 hours after ingestion of trace amounts of Al (3.8 ng of 26Al and 63 ng of stable 27Al), both in citrate-free and citrate-containing solutions. Our data show that under physiological conditions, namely at normal levels of dietary intake, intestinal Al absorption is approximately 0.04%, and is not significantly enhanced by the presence of citrate. Interestingly, the amount of Al retained by bone (0.02%) is comparable to that excreted in urine during 48 h (0.02%). Our estimate of gastrointestinal absorption is more than two orders of magnitude smaller than that estimated by Day et al. [1991], also using 26Al, for a single human subject.

Aluminum↗
PubMed1992

Compact and trabecular components of the spine using quantitative computed tomography.

A computer algorithm was employed to quantify separately cortical and trabecular bone mineral density (BMD) from single energy computed tomography (CT) scans of 139 vertebrae (L1-L3) of 50 normal female subjects. In addition, the trabecular-to-integral and cortical-to-integral mass ratios were determined using digital image segmentation techniques. They showed that for the central 8-mm vertebral slice, the mass of integral bone consists of about one-fifth trabecular and four-fifth cortical bone. The trabecular-to-integral volume ratios were 0.37 +/- 0.08 and 0.63 +/- 0.08, respectively. Based on cross-sectional data from this subject group, the average annual loss was -2.21 +/- 0.15 mg/cm3 or -1.84 +/- 0.12% for trabecular bone, -3.15 +/- 0.25 mg/cm3 or -1.01 +/- 0.08% for cortical bone, and -2.60 +/- 0.20 mg/cm3 or -1.09 +/- 0.09% for the integral bone. The proportions of the age-related loss of BMD from the integral bone which originated from trabecular and cortical bone were 29.5 and 70.5%, respectively.

Adult↗