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Biomedical subjects

E Martin

Publications and source records attributed to E Martin.

At least 595 records · Page 33Linked to original sources
PubMed1985

[Aspergillosis with involvement of the central nervous system].

Clinical and pathological findings in a patient with central nervous system lesions due to a disseminated aspergillosis are reported. Symptoms and signs were suggestive of a meningoencephalitis with onset two years after nephrectomy for cancer and four months after a corticotherapy was started for post-radiation digestive disorders. A review of the literature shows that C.N.S. is rarely involved in this disease, that the diagnosis is difficult in immunodepressed patients and that the prognosis is poor in the absence of a specific treatment.

Aspergillosis↗
PubMed1984

Health of prisoners admitted to and discharged from Bedford Prison.

The age, smoking and drinking habits, active health problems, and occupational fitness of prisoners entering Bedford prison, and the health and willingness of prisoners being discharged from prison to take a letter to their general practitioner were surveyed. This group of men had a high level of illness, neglected their health, and had a high alcohol intake. Fewer problems were found than in a survey in New York City. Many prisoners with active medical problems on discharge from prison were unwilling to take a letter to their own general practitioner.

Adult↗
PubMed1984

Comparison of medical care in prison and in general practice.

The medical care of prisoners "declaring sick" to the medical officer and hospital officers in Bedford Prison was surveyed and compared with the medical care given to the medical officer's patients in general practice. The consultation rate of prisoners was higher than that of patients in the practice. Part of this increase was because household remedies were not available to prisoners except through the prison medical service and part may also have been due to the stresses of life in prison. Few psychoactive drugs were prescribed in prison. The problems that prisoners presented reflected the problems of violence and poor hygiene in prison. Some problems that more commonly present in prison than in general practice may be related to stress.

Drug Prescriptions↗
PubMed1984

Problems and pitfalls in estimating average pharmacokinetic parameters.

The problems of obtaining optimal average parameter estimates (APE) from experimental pharmacokinetic data are considered. Four different approaches, three parametric and one non-parametric tests, are compared, using selected individual alcohol concentration data. Pooling the raw data for estimating APE can obscure individual pharmacokinetic characteristics, whereas averaging individual parameter estimates (IPE) exposes unique statistical problems. Furthermore, careful consideration should be given to weighting procedures. The advantages and shortcomings of all four methods are discussed. It is concluded that none can be considered as a universally applicable statistical method in view of the purpose for which the information, derived from a set of data, e.g. an alcohol-kinetic study, is required.

Computers↗
PubMed1984

The pharmacokinetics of alcohol in human breath, venous and arterial blood after oral ingestion.

The concentration-time profile of ethanol in breath air (AAC), arterial (ABAC) and venous blood (VBAC) of human volunteers was studied after four different oral doses of absolute alcohol--0.5, 0.75, 1.0, and 1.25 g/kg body weight. Seventy-eight single dose experiments were carried out in 42 subjects. In all 78 studies AAC was measured and VBAC was estimated simultaneously in blood collected from a cubital vein of 36 volunteers. Arterial blood, too, was collected from 8 subjects from a catheter in a brachial artery. All blood alcohol concentrations were analysed independently by gas chromatography (GLC) and an enzymatic (ADH) method. A one-compartment open model with first order absorption and pseudo-zero-order elimination was employed to calculate the pharmacokinetic parameters. The average values for the first order absorption rate constant (ka) ranged from 2.2 to 3.1, from 2.4 to 2.6 and from 1.0 to 1.7 h-1 for ACC, ABAC and VBAC, respectively. The pseudo-zero-order elimination rate constant (beta) was 0.17 to 0.18, 0.21 to 0.22 and 0.26 to 0.27 g X 1(-1) X h-1, respectively. During absorption ABAC tended to be higher than VBAC, peaking at a higher level (Cmax) and with a shorter time to peak (tmax) until an arterio-venous concentration equilibrium was reached, whereafter VBAC remained above ABAC. Although there was a close relationship between AAC, ABAC and VBAC during elimination, AAC closely followed the pattern of ABAC during absorption and tended to deviate from VBAC. AAC, therefore, is a much better predictor of ABAC during absorption than VBAC.

Absorption↗
PubMed1984

Survival of frog striated muscle after pressure cooling.

Electronmicroscopical studies and functional tests (isometric contractibility) were performed in frog biceps muscle after treatment with elevated hydrostatic pressure at room temperature and at various temperatures below 0 degrees C. 700 bar pressure for 15 min. at room temperature caused rigor and damage to the sarcomers and mitochondria. 500 bar pressure for 15 min. and cooling to -17 degrees C resulted in solid freezing connected with severe damage to the muscular tissue and loss of any function. 518 bar pressure and cooling to -7 degrees C allowed good preservation of the ultrastructure and survival of the muscular tissue.

Animals↗
PubMed1984

Pregnancy, labor and body image in the United States.

Although substantial research has been done showing how alienation (which in Ollman's terms means that "an essential tie has been cut in the middle") manifests itself in the domain of human labor, little has been done to discover how similar processes might operate in other domains. I examine women's images of their bodies while they are pregnant, using Lakoff and Johnson's method of looking for metaphors that are presupposed in our ordinary language. I uncover several central images, all of which display a marked sense of separation of self from the parts of the body, and a passive stance in which events are described as happening to rather than being brought about by the speaker. Turning to written texts, I find that the literature on childbirth (from opposite ends of the spectrum--popular literature advocating prepared childbirth on one end and obstetrical texts for medical students on the other) holds an assumption in common: that the uterus is an involuntary muscle. This is so despite evidence to the contrary cited in the texts themselves. I explore the implications of this imagery for obstetrical treatment of 'uterine inertia' and show the similarity between this imagery and ideas about women's physiology that were current in the 19th century.

Body Image↗
PubMed1984

Pharmacokinetics of ceftriaxone in neonates and infants with meningitis.

The pharmacokinetics of ceftriaxone was studied in the plasma, urine, and cerebrospinal fluid of seven neonates and seven infants with meningitis. In addition, plasma and urine data were obtained in five neonates and one infant receiving ceftriaxone for other serious infections. All neonates younger than 14 days received daily doses of 50 mg/kg ceftriaxone; all other patients but two received 100 mg/kg. The average weight-corrected values for total body clearance (ClT), volume of distribution (Vdss), and biologic half-life (t 1/2) were 0.37 ml/min/kg, 0.45 L/kg, and 16.2 hours in neonates younger than 1 week; 0.77 ml/min/kg, 0.48 L/kg, and 9.2 hours in neonates older than 1 week; and 1.03 ml/min/kg, 0.39 L/kg, and 7.1 hours in older infants, respectively. There was a significant difference in ClT and t 1/2 between the neonates younger and both neonates older than 1 week, and infants. The Vdss was not significantly different among the three age groups. The average renal clearance in neonates younger than 1 week (0.28 ml/min/kg was 70%, in neonates older than 1 week (0.54 ml/min/kg) was 77%, and in older infants (0.49 ml/min/kg) was 47% of ClT, indicating that nonrenal elimination was less developed in neonates. The quantitation of CSF diffusion of ceftriaxone was assessed by comparison of the areas under the CSF and plasma concentration-time curve. The mean ceftriaxone penetration into the CSF in neonates and infants with bacterial meningitis was 17%. On the other hand, penetration in patients with aseptic meningitis amounted to only 4%. Mean ceftriaxone concentrations in the CSF in patients with bacterial meningitis were 2.8 mg/L after 24 hours, exceeding by many times the minimum inhibitory concentration of the common meningitis pathogens at this time.

Cefotaxime↗
PubMed1984

Absence of the aortic valve: antenatal and postnatal two-dimensional and Doppler echocardiographic features.

Antenatal and postnatal two-dimensional and gated pulsed Doppler echocardiography, beginning at 32 weeks' gestation, were used to evaluate the cardiovascular contribution to nonimmunologic hydrops in a gravida 1, para 0 nineteen year old woman. Antenatal two-dimensional imaging demonstrated a hypoplastic left heart variant of complete common atrioventricular (AV) canal. Antenatal gated pulsed Doppler examination of the fetal thoracoabdominal aorta revealed atypical pandiastolic retrograde flow. Postnatal noninvasive examination at 36 weeks' gestational age was unchanged from the prenatal study. Postmortem examination confirmed the noninvasive anatomic findings and revealed polysplenia. The mechanism of pandiastolic retrograde flow was attributable to "absence of the aortic valve," a previously unreported congenital cardiac anomaly, which resulted in severe antenatal and postnatal aortic regurgitation.

Abnormalities, Multiple↗
PubMed1984

Symptoms of patients and escorts in a primary care department in Saudi Arabia.

In a survey of symptoms experienced by 1000 patients and 1000 patient escorts attending a primary care department in Saudi Arabia, pain was found to be the most frequent cause of a medical consultation. Abdominal pain was the symptom most frequently presented by patients, and the third most frequent symptom experienced by escorts of patients. Thirty-two per cent of escorts of patients had experienced symptoms of illness over the previous three days and 11% had consulted a doctor. Patients presented with an average of three symptoms each and 91% of patients were able to identify the most important symptom triggering a consultation. This was not always the first symptom presented. The nature of symptoms experienced by both patients and patient escorts was found to influence the action they took. The possibility of patients presenting abdominal pain as a symptom signaling problems-of-living was raised.

Adolescent↗
PubMed1984

Cimetidine usage for unlabeled conditions in an ambulatory care service.

With the intent of cost containment, we conducted a survey of cimetidine usage in the Ambulatory Care Service of our Veterans Administration Medical Center. During a period of six months, this drug was prescribed for 132 patients. Only about 20% received cimetidine for FDA approved conditions. Treated conditions not approved by the FDA (unlabeled) included undiagnosed abdominal pain, past peptic ulcer disease, reflux esophagitis, and a variety of other conditions. Fourteen percent of the patients had demanded the drug. Irrespective of whether a confirmed diagnosis was present or not, most patients taking cimetidine had symptomatic relief. It is unclear whether more regulations or improved physician education would be the better method to control improper and unnecessary use of a drug that is generally safe but has potentially serious side effects.

Cimetidine↗
PubMed1984

Primary care in two cultures.

Differences were found between primary care as practised by the same doctor in Saudi Arabia and England within a twelve-month period. Many of these differences reflect demographic and cultural divergence between the two communities. Other factors suggested to explain areas of divergence were the administrative differences, systems of audit, language and empathy problems.

Adolescent↗
PubMed1984

High dose glucocorticoids in the management of severe head injury.

Eighty-eight patients with a Glasgow coma score of 8 or less 6 hours after nonpenetrating head trauma were given either high dose methylprednisolone sodium succinate (30 mg/kg q6h X2, then 250 mg q6h X6, then tapering over 8 days), low dose methylprednisolone (1.5 mg/kg q6h X2, then 25 mg q6h X6, then tapering over 8 days), or placebo. Standard care including the removal of traumatic hematomas, assisted ventilation, and intracranial pressure monitoring and control was carried out. Follow-up assessments were performed on all surviving patients at 6 months and were graded according to the Glascow outcome scale. No statistically significant difference in outcome was seen between the low dose group and the placebo group. The high dose group experienced a mortality of 39% as compared to a 52% mortality in the low dose and placebo groups (P less than 0.05). Mortality differences were most marked in patients less than 40 years old, with the high dose group experiencing a mortality of 6% as compared to a 43% mortality for the low dose and placebo groups (P less than 0.05). For patients under 50 years old, the incidence of recovery of speech was 62% compared to 36% in the low dose and placebo groups (P less than 0.5). The increased survival in those treated with high dose corticoids, however, was associated with an increase in the poorer outcome categories.

Age Factors↗
PubMed1984

Analysis of a rural family-practice-based evening clinic staffed by a PA.

A family practice in rural Breckenridge, Colorado began an evening clinic during the winter months of 1981-82 to serve the extra 1,000 to 2,000 residents that that community accommodated each year during the ski season. The clinic was staffed by a PA, who was aided by an office assistant, on weekdays from 5 P.M. to 10 P.M.; after 10 P.M., the PA took calls at home until the office again opened at 9 A.M. The pilot program was successful enough to warrant continuation. This article analyzes the Breckenridge Medical Center's experience during that first year with a PA-staffed evening clinic, in terms of morbidity profile of the after-hours cases, the amount of physician involvement required, the economic aspects of maintaining evening hours, and the ratio of day to evening patients that can be expected. The authors conclude that their extended office hours have proven to be an effective, affordable solution to their practice's after-hours medical care problem.

Ambulatory Care Facilities↗
PubMed1984

The reactions of patients to a video camera in the consulting room.

In a general practice survey of reactions to the presence of a video camera in the consulting room 13 per cent of patients refused to be filmed, and 11 per cent of those who did consent disapproved of recording. Patients were more willing to express their reservations about video recording if asked to fill in a questionnaire later at home rather than immediately at the surgery. Patients with anxiety, depression, or problems relating to the breasts or reproductive system were more likely to withhold consent. Patients were less likely to refuse video recording of their consultation if they were asked by the doctor for their verbal permission as they entered the consulting room rather then if they were asked to sign a consent form. Only a small minority of the patients who refused to be filmed felt that this refusal had affected their consultation with the doctor.

England↗