Transient vasopressin-resistant diabetes insipidus of pregnancy.
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Biomedical subjects
Publications and source records attributed to G Robertson.
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Weekly respiratory symptom information was obtained on a random population of 3800 whites in Tucson. We asked weekly about 14 symptoms representing acute respiratory illnesses (ARI), rhinitis (Rh), and other conditions. The denominator for each week was about 80 randomly chosen subjects from the study population. Interactions of the air pollutants total suspended particulate, oxidants, carbon monoxide, nitrogen oxides for the basin, meteorological information, and aero-allergens were examined. The temporal and spatial interactions between the weekly symptoms and the environmental factors were tested utilizing multivariate methods such as Fourier analyses, multiple regression, and the stimulus-response method, adjusting for lags and controlling for season. Multiple regressions with a smoothing function (using fourier or other methods) yield significant correlations between symptoms and the environmental factors, and separate the ARI's from the Rh's and the miscellaneous symptoms.
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All men receiving hospital orders (Section 60) in the UK in the year 1963-64 (excluding those receiving restriction orders (Section 60/65)) were followed up over 15 years with regard to (1) subsequent offences and convictions, (2) hospital admissions, and (3) death. Nine per cent of the patients involved could not be traced. Sixteen per cent had died by 1978, a quarter of them by suicide. Of the mentally ill only 4 per cent subsequently committed serious offences (manslaughter, wounding, GBH, robbery, rape or arson), although a further 4 per cent committed assaults repeatedly. Sex crimes were uncommon. Among the mentally subnormal, 7 per cent committed serious sex crimes subsequent to committal. A further 9 per cent were considered to be persistent sex offenders and another 9 per cent were judged to be persistently violent. In general the mentally subnormal were much younger and were detained for much longer than the mentally ill. Since 1964 the use of hospital orders for the detention of such people has become much less frequent. The best predictor of subsequent offences was found by multiple regression analysis to be the number of previous offences: this was especially true for acquisitive offences committed by the young. The mentally ill were less often reconvicted than the mentally subnormal.
The offenders committed to local hospitals in 1962 and 1964 under a hospital order with restriction of discharge were followed up for 15 years with regard to subsequent court appearances, hospital admissions, and death. One hundred and forty-six were traced. Of these, 49 per cent had been diagnosed as mentally ill: most of this group were committed for violent offences. Thirty-five per cent were mentally subnormal: they were frequently committed for sexual offences, arson and property offences. Twelve per cent were diagnosed psychopathic: this group had a wide variety of committal offences. Fourteen per cent of the mentally ill and 17 per cent of the mentally subnormal were still in hospital after 15 years, but 51 per cent of the mentally ill and 36 per cent of the psychopaths were released within two years. Few of the subsequent offences were serious in any of the diagnostic groups. Since 1973 there has been a dramatic fall in restriction orders, especially for mentally subnormal patients.
1-Nitroso-2-naphthol reacts with various 5-hydroxyindoles as well as para-substituted phenols and guaiacols. Consequently, this reaction has long been used to measure tyrosine in tyrosinosis and tyrosinemia, homovanillic acid in neuroblastoma, and 5-hydroxy-3-indoleacetic acid in the carcinoid tumor. We report here on the specificity of this reaction, as well as our early observations with respect to the chemical basis of the reaction.
The effects of hypoxia upon renal and endocrine function are unclear. Normal water-loaded subjects were exposed to hypoxia for 1 h (inspired PO2 = 74 Torr) in a decompression chamber (5,100 m, n = 8) or by breathing 10.5% oxygen at ambient pressure (n = 4). In four of eight subjects exposed to hypobaric hypoxia: urine flows (V) decreased (mean = 56%), urine osmolality increased (340%), plasma arginine vasopressin (AVP) increased (2,700%), plasma cortisol increased (256%), and mean blood pressure (BP) decreased (18%). V correlated inversely with AVP (r = 0.71, P less than 0.01) while AVP increases correlated with falls in mean BP (r = 0.72, P less than 0.05). Similar results were observed in the subjects exposed to normobaric hypoxia. Plasma aldosterone fell in the four subjects who maintained V on exposure to hypobaric hypoxia, but plasma renin activity did not change. In both groups prolactin levels were variable and solute and creatinine excretion were unchanged. No changes were observed in controls or in subjects exposed to hypobaria alone. Acute hypoxic exposure may produce significant hypotension with consequent increased AVP secretion resulting in diminished V.
To examine criteria to assess significant changes of measurements derived from the forced expiratory vital capacity (FVC), and to examine changes in the peak expiratory flow (PEF) maneuvers, ten subjects were tested on approximately 30 occasions. Since mini Wright peak flow meters are increasingly used for clinical and research purposes, peak flow intraindividual variability and relations to FVC peak flow were examined, each set of tests consisting of five FVC maneuvers and one peak flow. Measurements on a pneumotachograph included FVC, (FEV1), maximum mid-expiratory flow (MMF or FEF25-75%), and instantaneous maximum expiratory flow after 50 and 75 percent expiration of the FVC. PEF measurements were derived using the mini Wright peak flow meter and the pneumotachograph. The coefficients of variation for the FVC measurements were greatest for maximum expiratory flow measurements and least for the FVC and FEV1. Maximum values from each set of tests reduced the variability. From these values, criteria and estimates were derived to evaluate significant intraindividual change. The PEF measurements were evaluated also to determine intraindividual changes. The coefficients of variation were only 2 percent to 14 percent. The peak flows obtained were shown to correlate well with the PVC peak flow.
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One hundred and two admissions of VLBW babies to the Baby Unit at Raigmore Hospital were studied over a six-year period. The neonatal death rate was 53 per cent. Twenty three survivors weighing 1.36 kg. or less were examined at an average age of 3 years 11 months and 22 of these underwent cognitive assessment. All but one had normal or superior I.Q. assessments. Two were regarded as having significant or profound handicap. Possible reasons for the relatively low survival rate, but acceptable handicap rate are discussed.
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Theoretical and empirical studies in motor abilities were synthesized to construct an extensive range of tests items with auxiliary apparatus. These items were administered to 765 children between ages 4 1/2 and 14 1/2 yr. Results indicate that motor proficiency can be assessed safely and reliably in one testing period. The factor analysis of the 46 items supported the original subtest grouping of the items which employed a theoretical-rational strategy. Factor analysis of the subtests suggested the existence of two major dimensions, speed-precision-strength and balance-coordination.
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The varicoceles of 39 men of proven fertility and 57 husbands of infertile marriages were assessed by the Doppler technique and classified according to venous activity. Retrograde left renal venography in 17 subjects showed that Doppler grading was unable to distinguish between 7 patients with competent internal spermatic veins and 10 with internal spermatic vein reflux. Patients whose varicoceles were associated with internal spermatic vein reflux had a significant reduction in sperm density and these may be implicated as a cause of male infertility. The remaining varicoceles were probably the result of incompetence of other venous tributaries of the spermatic cord and were associated with higher sperm densities. The Doppler was able to identify accurately those varicoceles with significant elevation of scrotal temperature as determined by computer assisted infra-red scrotal thermography. The sperm densities of these patients were similar to the values found in patients with normal scrotal temperatures. The varicoceles of infertile men were found to have a greater incidence of spontaneous venous activity than the varicoceles of fertile men and this suggests that any reduction of fertility caused by elevation of scrotal temperature may be via an effect other than a reduction in sperm density.
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We studied 15 normal subjects and 15 patients with cystic fibrosis (CF), to determine the within-subject variability of spirometry, moment analysis, and slope ratios, and to calculate the per cent change for significance. Common sources of variability, such as patient and technician training, equipment errors, lung volume history, posture, and circadian variation, were controlled. Flow-time curves were analyzed with a digital computer. The coefficient of variations of spirometry were smallest for forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and peak flow (PF), and were largest for root moments (M) and slope ratios (SR) in both normal subjects and patients with CF. The coefficient of variations of all tests, except PF, were larger in patients with CF than in normal subjects. Significant change was calculated from the sample variance, mean, and the number of trials using a modified equation for sample size. This calculation estimated the degree of change for significance for each participant that was required in subsequent testing.
Nocturnal erections were studied in 30 diabetic patients who complained of impotence and in 11 healthy volunteers. The maximum increase in penile circumference was measured by a penile strain-gauge and recorded on a portable tape-recorder; an external oculogram was recorded simultaneously to identify periods of rapid-eye-movement sleep. The technique gave reproducible results, was acceptable to patients, and was suitable for use in an oridnary hospital ward. Only six diabetics showed a maximum increase in penile circumference of under 15 mm, whereas all but one of the healthy subjects showed maximum increases above this value. Of the six diabetics, five complained of total impotence and had other features of autonomic neuropathy that suggested an organic basis for their impotence. The other patient complained of partial importence, which was probably caused by psychological factors. These findings suggest that the prevalence of organic impotence among diabetics has been overestimated.
Erythema multiforme occurred in a 31-year-old woman as a complication of BCG immunotherapy administered by scarification for a Clark's level IV malignant melanoma. This is an unusual complication of the scarification technique.