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Biomedical subjects

G Hanson

Publications and source records attributed to G Hanson.

At least 109 records · Page 6Linked to original sources

Intervention with sexually abused children. The Child and Adolescent Sexual Abuse Resource Center at San Francisco.

Child victims of sexual abuse are being identified in increasing numbers. An appropriate and therapeutic intervention requires a trained multidisciplinary staff. This article describes the San Francisco Child and Adolescent Sexual Abuse Resource Center (CASARC), a 24-hour crisis intervention program for sexually abused children based in a pediatric setting. The training needs of medical professionals as well as community agencies serving children are discussed. Areas for new research are also presented.

California↗

Malignant histiocytosis resistant to anthracycline. Response to intensive treatment with etoposide and amsacrine.

A 36-year-old woman, presenting with fever, pancytopenia, hepatosplenomegaly, and striking effacement of the bone marrow by true malignant histiocytes, was found to have no benefit from the systemic administration of cyclophosphamide, vincristine sulfate, doxorubicin, prednisone, and high-dose methotrexate with calcium leucovorin rescue. Striking histologic and clinical improvement was noted after the administration of two cycles of etoposide and amsacrine, each cycle consisting of 100 mg/sq m/day of each agent for five days. We believe that this therapy should be considered for future patients demonstrating aggressive presentations of malignant histiocytosis.

Adult↗

Failure to suspect and diagnose thalassemic syndromes. Interpretation of RBC indices by the nonhematologist.

A three-year review of the medical records of 76 patients with apparent thalassemic syndromes (mean corpuscular volume, greater than 75 cu micron; RBC count, greater than 5 X 10(6)/cu mm) was performed to assess overall physician response to this information at a midwestern teaching institution. Abnormal indices were recognized in only 50% of the cases; in only 32% of cases was a thalassemic syndrome considered in the differential diagnosis. Residents in internal medicine failed to recognize microcytic indices and to consider thalassemic syndromes 42% and 59% of the time, respectively. Even though hemoglobin electrophoresis was performed in 25 patients, in only 15 (56%) of the 25 cases was beta-thalassemia proved or alpha-thalassemia presumptively diagnosed. In 17% of all cases, the patients were treated with iron without diagnostic findings on iron studies and/or in spite of data suggesting a thalassemic syndrome. The RBC indices are an underused portion of the complete blood cell count, and readily apparent thalassemic syndromes are often not considered.

Erythrocyte Indices↗

Fc gamma bearing T cells in non-Hodgkin lymphoma.

T-cell subpopulations have been implicated in the regulation of normal human B-cell reactivity. As the non-Hodgkin lymphomas (NHL) represent predominantly clonal B-cell malignancies, we examined the relationship of total T-cell [Sheep Red Blood Cell (SRBC) binding] and Fc gamma bearing T-cell populations in these disorders. Peripheral blood from seven low-grade (Rai stage 0), six high-grade (Rai stage 3 or 4) CLL patients, lymph node specimens from five patients with WDLL, seven patients with PDLL-D, three patients with MC-D, and eight patients with DHL were studied. All values were compared to normal controls. The percentage of total T cells in each disease category was decreased compared to controls. In addition, there was a reproducible correlation between the percentage of Fc gamma bearing T cells and the histopathologic diagnosis. The percentage of Fc gamma bearing T cells was highest in low-grade CLL and decreased incremently from high-grade CLL and WDLL, to MC-D, and PDLL-D. In DHL, we found no Fc gamma bearing T cells. Finally, the percentage of Fc gamma bearing T cells in each disease category was decreased compared to controls. These findings suggest a correlation between Fc gamma bearing T cells and the clinical aggressiveness of disease in NHL. In addition, they may raise important questions about therapy. Finally, they may offer a useful clinical test as an adjunct to histopathology although this will need to be confirmed in larger series.

Humans↗

Borderline syndromes in childhood: criteria for diagnosis.

There is currently a great deal of confusion regarding the diagnostic status of children with borderline disorders and a tendency to apply criteria for borderline adults to the diagnosis of these children without allowing for developmental differences. On the basis of their experience with 24 latency-age children, the authors propose diagnostic criteria in an effort to establish a uniformity in the diagnosis of these children. Major areas of psychopathology include fluctuation of functioning, nature and extent of anxiety, thought content and processes, relationships to others, and lack of control. The authors also found a high frequency of organic impairment, physical abuse, and familial disturbance.

Anxiety Disorders↗

Aspects of the treatment of borderline children.

The authors review the history of the concept of borderline children and the criteria for diagnosis. They then outline the various stages of the treatment of these children, paying particular attention to the vicissitudes of the psychotherapeutic relationship and the multifaceted treatment approach, which is essential to their growth and development.

Borderline Personality Disorder↗

Bronchocentric granulomatosis: a complication of allergic bronchopulmonary aspergillosis.

Hypersensitivity to the fungal antigens of Aspergillus fumigatus may result in a spectrum of immune injury collectively known as allergic bronchopulmonary aspergillosis (ABPA). This report describes a 14-yr-old boy who presented clinical findings consistent with ABPA,including a history of asthma, blood eosinophilia, serum precipitins, and IgE antibodies to Aspergillus fumigatus. Sputum Aspergillus, pulmonary infiltrates, and dual types I and III skin reactions to Aspergillus fumigatus were observed also. Pathology of the resected right upper lobe revealed severe bronchial destruction with the findings of bronchocentric granulomatosis. Noninvasive septate fungal hyphae compatible with Aspergillus were identified. Cultures from sputum and surgical specimens grew Aspergillus and Mycobacterium intracellulare avium. The PPD-B (purified protein derivative-Batty) intradermal skin test produced a 6 mm induration (PPD-S was negative). The patient's condition has been well controlled with prednisone and several antituberculous drugs. In addition, inflammatory and immunologic parameters have begun to return to normal. The relationship between ABa and the atypical mycobacterial infection is not clear. The association of ABPA with the severe bronchial destruction seen in bronchocentric granulomatosis is emphasized to alert physicans to this serious sequelae of ABa seen in the asthmatic.

Adolescent↗