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Biomedical subjects

E Dunn

Publications and source records attributed to E Dunn.

At least 73 records · Page 4Linked to original sources
PubMed1985

Scintigraphic differentiation of bone infarction from osteomyelitis in children with sickle cell disease.

Bone scans or bone marrow scans or both were obtained during 42 episodes of bone pain in 40 children with sickle cell disease, and the usefulness of these procedures was compared. On the basis of the subsequent clinical course, a diagnosis of bone infarction was made in 34 episodes, and osteomyelitis in eight. Among 22 patients with bone infarction, uptake on bone scan was increased in 14, decreased in three, and normal in five. Seven of eight patients with osteomyelitis had increased uptake on bone scan; one had normal uptake. In contrast, marrow scan uptake was markedly decreased in 15 of 16 patients with bone infarction, and was normal in five of five patients with osteomyelitis. Thus, decreased uptake on bone marrow scan in a patient with sickle cell disease and bone pain almost invariably indicates infarction, whereas normal uptake strongly suggests the diagnosis of osteomyelitis. We found marrow scans more useful than bone scans for this differential diagnosis.

Adolescent↗
PubMed1984

Diagnosis and management of hypertension: the stated practices of family physicians.

Hypertension is an important and common problem in family practice, but there is no general agreement on the systolic and diastolic pressures at which it should be diagnosed and treated. Responses from 273 family physicians surveyed by mail in Metropolitan Toronto showed a wide variation in the pressures used as cut-off points. The probability that in a given patient hypertension would be diagnosed or treated at different systolic and diastolic pressures varied considerably among the physicians, the variation increasing with the age of the patient. There was also wide variation in opinion among the surveyed physicians about how often patients should be screened for hypertension; depending on the patient's age, up to 35% of the physicians stated that the blood pressure should be measured at every visit. Only one third reported using any one or more methods to ensure that patients with hypertension were not lost to follow-up. The family physicians with an academic appointment used higher cut-off points for diagnosis and treatment, and they screened and scheduled follow-up visits less frequently than those without an academic appointment.

Adult↗
PubMed1982

Mechanical plethysmography and Doppler ultrasound. Diagnosis of deep-venous thrombosis.

Two hundred eighty-one patients were available for follow-up after undergoing bilateral lower-extremity venous laboratory evaluations for possible deep-venous thrombosis. Because of a recognized difficulty with such a clinical diagnosis, the use of Doppler ultrasound and mechanical plethysmography with air-filled cuffs was carefully studied. Eighty-three of the 281 patients had confirmatory results from venography or fibrinogen scan of the symptomatic or more-symptomatic leg, and these 83 patients were used to determine accuracy. The complete evaluation as performed was accurate in 70% of the patients with suspected deep-venous thrombosis. The Doppler examination alone was accurate in 71% of the patients, and the maximum venous outflow measurement was accurate in 67% of the patients. This study indicates a continuing need for venography or fibrinogen scanning for the diagnosis of deep-venous thrombosis.

Adolescent↗
PubMed1982

Urea and thiourea transport in Aspergillus nidulans.

Wild-type Aspergillus nidulans has an active transport system specific for urea which concentrates urea at least 50-fold relative to the extracellular concentration. It is substrate concentration dependent, with an apparent Km of 3 x 10-(5) M for urea. Competition studies and the properties of mutants indicate that thiourea is taken up by the same system as urea. Thiourea is toxic at 5mM to wild-type cells of Aspergillus nidulans. Mutants, designated ureA1 to ureA16, resistant to thiourea have been isolated, and transport assays and growth tests show that they are specifically impaired in urea transport. The mutant ureA1 has a higher Km value than the wild type for thiourea uptake. The ureA locus has been assigned to linkage group VIII. ureA1 is recessive for thiourea resistance while semidominant for the low uptake characteristic. The urea uptake system is under nitrogen regulation, with L-glutamine as the probable effector. The mutants, meaA8 and gdhA1, which are insensitive to ammonium control of many nitrogen-regulated metabolic systems, are also insensitive to ammonium control of urea uptake, but both are sensitive to L-glutamine regulation.

Aspergillus nidulans↗
PubMed1982

Specific but limited role of new imaging techniques in decision-making about intraabdominal abscesses.

Despite the very high accuracy rate of imaging studies (ultrasound, computed tomography, liver-lung-spleen scans and gallium-67 scans) in detecting intraabdominal abscesses, our experience with 80 recent cases indicate that these techniques have not significantly altered traditional methods of decision-making about when and where to drain such abscesses. In only 12.5 percent of cases were such decisions based on special imaging techniques alone, and most of these cases subphrenic abscesses were diagnosed late after surgery. In the remainder, physical examination and routine radiologic studies sufficed, with special imaging techniques primarily corroborating clinical evidence based on these methods. We conclude that the use of special imaging techniques alone in a search for the cause of fever early after abdominal surgery does not provide evidence upon which clinical decisions can be based unless there are already physical signs of an abscess.

Abdomen↗
PubMed1981

Mother-child separation: a study in a remote health care setting.

The literature indicates that the birth of a sibling and the consequent temporary separation from the mother is usually a stressful experience for a child. It was hypothesized that this stress would result in an increased number of visits by the child to health care facilities because of new health problems. In a controlled study of 89 matched pairs of Indian families in a remote region of northwestern Ontario this hypothesis was not supported. During the intervals studied - the anticipatory period before delivery, the separation itself and the period immediately following the mother's return home - the number of diagnoses of new medical problems was significantly less for the children who were separated from their mothers for the birth of a sibling. As well, the number of diagnoses of new medical problems in the children separated form their mothers decreased over the three intervals. The fathers' reluctance to seek health care probably played a major role in this decrease.

Age Factors↗
PubMed1981

Primary carcinoma of the gallbladder: a review of a 16-year experience at the Waterbury Hospital Health Center.

The charts of 48 cases of primary carcinoma of the gallbladder seen at the Waterbury Hospital Health Center over the past 16 years were reviewed. In 47 patients, the diagnosis was confirmed pathologically. In one patient, the diagnosis was made only on clinical and radiologic grounds. This condition is more common in females and in the elderly (mean 71.7 years). Symptoms and signs were nonspecific, and duration of symptoms was extremely variable (range: one day to 21 years). There were 16.6% patients who had an associated primary tumor elsewhere. In 89.3% of the carcinomas of the gallbladder, the histologic type was adenocarcinoma. Two thirds of the patients had associated cholelithiasis. Overall five-year survival rate was 12.5%. In more than 80% of the patients, resection was made impossible by local invasion of liver, biliary ducts, and adjacent structures. Patients were divided into three groups according to the degree of invasion of the tumor. Group A had a survival rate of 66.6% at five years. There were no survivors in Group B and Group C. The different factors in each group are compared and discussed. Chemotherapy appeared to have no beneficial effect in the management of carcinoma of the gallbladder. Only one patient survived more than 12 months when tumor invaded the liver or the nodes along the biliary ducts. The postoperative complications and causes of death are also discussed.

Adenocarcinoma↗
PubMed1981

Percutaneous transhepatic pancreatic vein catheterization in localization of insulinoma.

Localization of pancreatic insulinomas can present considerable operative difficulty. Blind pancreatic resections are likely to miss the tumor and are associated with the concomitant morbidity and mortality of repeated explorations and resections. While arteriography is often very helpful in locating the tumor preoperatively, there are some patients in whom a tumor blush cannot be seen. The use of percutaneous transhepatic pancreatic vein sampling for radioimmune insulin assay is reviewed, with particular emphasis on its usefulness in locating a small insulinoma. The technique is readily adaptable to other endocrine-secreting tumors of the pancreas.

Adenoma, Islet Cell↗
PubMed1979

Appendicitis in the elderly: learn to discern the untypical picture.

Symptoms and signs of appendicitis in the elderly may be vague and referable to other abdominal diseases. Diagnosis is often delayed or missed, leading to a prolonged preoperative period and increased morbidity and mortality. In this study of elderly appendicitis patients, we noted a high incidence of ruptured appendixes. At least 80% of these patients could have been operated on earlier.

Aged↗
PubMed1978

Fetal- and uterine-specific antigens in human amniotic fluid.

Removal of the major maternal serum proteins from second trimester amniotic fluid by antibody affinity chromatography revealed various soluble tissue antigens, of which two were fetal-specific skin proteins and another, of alpha2-mobility, was specific to the uterus, and was therefore designated alpha-uterine protein (AUP). These proteins could not be detected in maternal serum by antibody-antigen crossed electrophoresis. The concentration of AUP in amniotic fluid reached a maximum between 10 and 20 weeks of gestation, suggesting that there is an influx of uterine protein into the amniotic fluid at this stage of pregnancy.

Amniotic Fluid↗