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Biomedical subjects

F C Powell

Publications and source records attributed to F C Powell.

At least 37 records · Page 2Linked to original sources
PubMed1996

Pyoderma gangrenosum: classification and management.

Pyoderma gangrenosum (PG) has four distinctive clinical and histologic variants. Some have morphologic and histologic overlapping features with other reactive neutrophilic skin conditions. PG often occurs in association with a systemic disease, and the specific clinical features of the skin lesion may provide a clue to the associated disease. Management of PG depends on its type and severity and usually requires aggressive local and systemic treatment.

Humans↗
PubMed1996

Undertakers' death anxiety.

A sample of 60 morticians completed the Revised Death Anxiety Scale. Their responses were compared with scores on that scale from 136 men from other occupations. The funeral directors' death anxiety scores were surprisingly high. Perhaps they are less able successfully to repress death fears because of constant occupational exposure to issues related to mortality.

Adult↗
PubMed1995

Symptomatic intracranial hemorrhage in full-term infants.

A retrospective analysis was undertaken in a consecutive series of 33 full-term infants (birth weight > 2500 g and a minimum of 37 weeks gestational age) with symptomatic intracranial hemorrhage (ICH) admitted to a regional neonatal intensive care unit from January 1986 to December 1992. Eleven infants were born in our institution; 17 were male. The estimated local incidence of symptomatic ICH for the inborn population was 4.9/10000 live births, with a regional incidence of 2.7/10000 live births. Twenty-four (72.3%) infants presented with seizures, apnea, or respiratory distress. Five (15.1%) children developed ICH associated with extracorporeal membrane oxygenation, ventriculoperitoneal shunting, and cardiac surgery. There were two deaths (6.1%) associated with a grade IV periventricular hemorrhage (PVH) and cardiac surgery. Nine infants (27.3%) showed PVH, while an additional nine children developed multifocal cortical hemorrhages. Eight infants (24.2%) showed extra-axial ICH, four children (12.1%) sustained lobar hemorrhages, and three children (9.1%) showed ICH associated with prenatal CNS abnormalities. Excluding five children with iatrogenic ICH, coagulopathies occurred in 9 of 28 infants (32.1%) and constituted a major determinant of the development of ICH. Neurosurgical intervention was limited to one infant with massive ICH and one child with hydrocephalus as a late sequela of ICH. Developmental follow-up was complete in 32 children with a mean and median duration of 3.4 years. Full-term infants with ICH associated with risk factors for hypoxic-ischemic injury showed a significantly greater risk of developmental delay compared to infants with uncomplicated ICH.

Cerebral Hemorrhage↗
PubMed1995

Lobar hemorrhages in full-term neonates.

A chart analysis for a 5-year period through December 1992 identified four full-term neonates with lobar hemorrhage. Prenatal and obstetrical histories were uncomplicated; all infants presented with seizures within 48 h following birth. Perinatal asphyxia and isoimmune thrombocytopenia were associated with lobar hemorrhage in two children. Although computed tomography was sufficient for diagnosis, magnetic resonance evaluation provided assessment of specific cortical injury and the age of the hemorrhage. No infant underwent surgical intervention; three children reached developmental milestones at a mean follow-up of 3.3 years.

Brain↗
PubMed1994

Reversal of insulin-dependent diabetes mellitus after percutaneous pancreatic pseudocyst drainage.

A 75-year-old man achieved complete reversal of insulin-dependent diabetes mellitus after percutaneous, computed tomography-guided, pancreatic pseudocyst drainage. This reversal is believed to have resulted from removal of physiologic stress after drainage. This and previously reported cases of new-onset diabetes following this procedure suggest close serum glucose monitoring in all patients undergoing percutaneous pancreatic pseudocyst drainage.

Aged↗
PubMed1994

Subcortical infarction in children.

BACKGROUND AND PURPOSE: This report examines the occurrence of subcortical infarction in 5 children, reviews the English literature, and discusses evaluation of this uncommon childhood illness. METHODS: Clinical characteristics and neurological follow-up were examined in children who presented with subcortical infarction within the past 7 years. The English literature over the previous 20 years was reviewed to identify similar patients with radiological documentation of subcortical infarction. RESULTS: Mean age of the patients in this series was 4.8 years (range, 4 months to 12 years); 3 children were female. Three patients presented with the sudden onset of hemiparesis, 1 with dystonia, and 1 with fever and focal seizures. Protein C deficiencies were demonstrated in 2 children; a cardiomyopathy was seen in 1 patient. Mean follow-up was 1.5 years. Two patients were neurologically normal, mild residual symptoms persisted in 2, and 1 patient showed severe dystonia. The literature analysis indicated that specific risk factors were described in 79 patients; complete clinical analysis was available for 51 patients. In the latter group, the mean age was 5.7 years; 26 children were female. Forty-six presented with hemiplegia, 4 with dystonia, and 1 with focal seizures. Follow-up greater than 5 months in 29 patients showed complete or good resolution of deficits in 23. Specific risk factors such as infection, trauma, hematologic disorders, or cardiac or vascular abnormalities were identified in 62 of 79 children. CONCLUSIONS: This analysis indicates that children with subcortical infarction usually presented with acute hemiparesis. Risk factors were identified in the majority of children, and follow-up demonstrated good or complete resolution of neurological deficits in 80% of the patients.

Cerebral Arteries↗
PubMed1994

Symptomatic interleukin-2-induced cholecystopathy in patients with HIV infection.

OBJECTIVE: This study reports the clinical and radiologic findings in seven patients infected with HIV who had 10 consecutive episodes of symptomatic cholecystopathy induced by infusion of interleukin-2. SUBJECTS AND METHODS: Ten episodes of right upper quadrant pain associated with gallbladder wall thickening were seen in seven of 29 HIV-infected patients who received IV interleukin-2. Patients received 6-18 million IU/day of continuous interleukin-2 infusion for 5 days. Patients with right upper quadrant pain underwent sonographic examinations, which were interpreted prospectively. Medical records and previous sonographic studies were reviewed retrospectively. Follow-up was obtained through outpatient visits and sonography. RESULTS: Right upper quadrant pain during these 10 episodes of cholecystopathy usually developed 4-5 days after starting infusion of interleukin-2. Sonography during that time showed gallbladder wall thickening (mean thickness, 12.4 mm; range, 5-18 mm) and a wide variety of sonographic appearances. Tenderness during sonography was focal in six episodes, diffuse in one, and absent in three. Sludge was identified in one episode; calculi were not seen. Findings on radionuclide biliary scans were normal in three cases. Symptoms abated rapidly in every case after infusion of interleukin-2 was reduced or stopped. No surgery was necessary. When treatment was repeated, three patients had recurrent episodes, with clinical courses and sonographic aberrations showing little variance from the initial episodes. Follow-up sonography in three episodes showed a maximal thickness of the gallbladder wall of 4 mm. No patient had a history or laboratory evidence of intrinsic biliary disease. CONCLUSION: Symptomatic thickening of the gallbladder wall during infusion of interleukin-2 can exactly mimic other forms of acalculous cholecystitis, except that when associated with interleukin-2 the thickening is rapidly reversible and surgery is not required. Radionuclide scans can be useful in clinical decision making. The process appears to be benign, and cessation of interleukin-2 therapy, along with close clinical observation, appears to be the appropriate treatment.

Abdominal Pain↗
PubMed1994

Epidemiology of gambling and depression in an adult sample.

As a relationship has been reported between pathological gambling and depression, the objective of this study was to explore whether there was a relationship between gambling and depression in a sample of 400 adults. No relationship was found.

Adolescent↗
PubMed1994

Depression and sense of humor.

This research note provides partial confirmation of a negative relationship between depression and sense of humor previously reported by Deaner and McConatha in 1993. Here, for 213 women and 134 men, r was -.18.

Adolescent↗
PubMed1993

Development and validation of a Multidimensional Sense of Humor Scale.

Personal sense of humor has been recognized as a coping mechanism. Sense of humor as a construct, however, is multidimensional. Existing efforts to assess overall sense of humor are, for a number of reasons, deficient. The present study reports the development and factor analysis of a new Multidimensional Sense of Humor Scale that may be useful in a variety of research and clinical applications.

Adaptation, Psychological↗
PubMed1993

Sense of humor and dimensions of personality.

Previous researchers have demonstrated relationships between sense of humor and personality. Most have viewed sense of humor from the perspective of humor appreciation. Others have taken the approach that sense of humor has two factors: appreciation and creativity. Our approach has been to look at sense of humor as made up of creativity and several additional elements. The present study reports on the factor analysis of a Multidimensional Sense of Humor Scale, as well as correlates of various elements of sense of humor with personality traits assessed by the Edwards Personal Preference Schedule. Relationships by humor scale factors are reported, as are differences between those high and low in sense of humor within a sample of 426 individuals, 18 through 90 years of age.

Adaptation, Psychological↗
PubMed1993

Labial melanotic macule: a clinical, histopathologic, and ultrastructural study.

BACKGROUND: The labial melanotic macule (LMM) is a recently described pigmentary anomaly that may simulate malignant melanoma. OBJECTIVE: Our purpose was to define the LMM clinically, histologically, and immunohistochemically in a large group of patients. METHODS: We describe the clinical features of 36 LMMs in 29 patients (aged from 4 to 79 years, 4 male, 25 female) seen during the past 4 years. Histopathologic findings in 21 of these patients are discussed. Seventeen lesions were immunostained with HMB-45 monoclonal antibody, and electron microscopy was performed on eight lesions. RESULTS: The majority of patients were women and had solitary lesions on the lower lip with the mean age of onset of 30 years. Histologically prominent basilar hyperpigmentation accentuated at the tips of the rete ridges was present without atypia or nevoid formation. Immunohistochemical studies showed that all intralesional melanocytes were HMB-45 negative, supporting their benign nature. Ultrastructurally, numerous stage III and IV melanosomes clustered within basal keratinocytes and papillary dermal melanophages were found. CONCLUSION: The LMM is a clinically and histologically distinctive benign pigmentary anomaly.

Adolescent↗
PubMed1993

The Demodex mite population in rosacea.

BACKGROUND: The cause of rosacea is unknown; among other factors a causative role has been postulated for the hair follicle mites Demodex folliculorum and Demodex brevis. OBJECTIVE: Our purpose was to compare the population density of Demodex mites in facial skin of defined categories of patients with rosacea with control subjects. We also assessed the impact of tetracycline therapy on the mite population. METHODS: The population density and distribution of Demodex mites were studied in the facial skin of 42 patients with rosacea and 42 age- and sex-matched control subjects. Mites were counted in measured skin surface biopsy specimens obtained from six standard facial sites with cyanoacrylate glue. RESULTS: The mean mite count was 49.8 (range 2 to 158) in patients with rosacea and 10.8 (range up to 97) in control subjects (p < 0.001); the highest density of mites was found on the cheeks. A statistically significant increase in mites was found in all subgroups of rosacea, being most marked in those with steroid-induced rosacea. Mite counts in patients with rosacea before and after a 1-month course of oral tetracycline showed no significant difference. CONCLUSION: Increased mites may play a part in the pathogenesis of rosacea by provoking inflammatory or allergic reactions, by mechanical blockage of follicles, or by acting as vectors for microorganisms.

Adult↗
PubMed1993

Paraneoplastic pyoderma gangrenosum.

Pyoderma Gangrenosum (PG) is often associated with an underlying disease. PG as a paraneoplastic disease is illustrated by the presentation of four patients with malignancy of myeloproliferative origin and PG. An associated malignancy is found in approximately 7% of patients with PG, most commonly haematologic in nature and in particular leukaemia. Clinically the PG is often of the superficial bullous variant and is associated with a poor prognosis.

Aged↗
PubMed1993

A risk/benefit analysis of spinal manipulation therapy for relief of lumbar or cervical pain.

Approximately 12 million Americans undergo spinal manipulation therapy (SMT) every year. Renewed interest in this method requires an analysis of its reported risks and possible benefits. This review describes two patients with spinal cord injuries associated with SMT and establishes the risk/benefit ratios for patients with lumbar or cervical pain. The first case is a man who underwent SMT for recurrent sciatica 4 years after chemonucleolysis. During therapy, he developed bilateral sciatica with urinary hesitancy. After self-referral, myelography demonstrated a total block; he underwent urgent discectomy with an excellent result 3 months after surgery. The second patient with an indwelling Broviac catheter and a history of lumbar osteomyelitis underwent SMT for neck pain. Therapy continued for 3 weeks despite the development of severe quadriparesis. After self-referral, he underwent an urgent anterior cervical decompression and removal of necrotic bone and an epidural abscess with partial neurological recovery. An analysis of these cases and 138 cases reported in the literature demonstrates six risk factors associated with complications of SMT. These include misdiagnosis, failure to recognize the onset or progression of neurological signs or symptoms, improper technique, SMT performed in the presence of a coagulation disorder or herniated nucleus pulposus, and manipulation of the cervical spine. Clinical trials of SMT have been summarized in several recent articles.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Relationships of death anxiety and sense of humor.

The Multidimensional Sense of Humor Scale and the Revised Death Anxiety Scale were completed by a sample of 426 persons aged 18 to 90 years. Only slight relationships were found. The strongest correlation was between scores on death anxiety and on coping humor.

Adaptation, Psychological↗