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Biomedical subjects

H G Taylor

Publications and source records attributed to H G Taylor.

At least 73 records · Page 4Linked to original sources
PubMed1990

The sequelae of Haemophilus influenzae meningitis in school-age children.

BACKGROUND: Previous data on the consequences of Haemophilus influenzae type b meningitis for school-age children have been inconsistent, and much of the information on risk factors has been inconclusive. The present study was designed to evaluate the sequelae of this disease with a protocol for the comprehensive assessment of neuropsychological function. METHODS: Ninety-seven school-age children (mean age, 9.6 years), each of whom had a school-age sibling, were recruited from a survey of the medical records of 519 children treated for H. influenzae type b meningitis between 1972 and 1984 (at a mean age of 17 months) at the children's hospitals of Toronto, Ottawa, and Montreal. Of the 97 children, 41 had had an acute neurologic complication. Sequelae were assessed by comparing the index children with their nearest siblings on the basis of standardized measures of cognitive, academic, and behavioral status. RESULTS: Only 14 children (14 percent) had persisting neurologic sequelae: sensorineural hearing loss in 11 (unilateral in 6 and bilateral in 5), seizure disorder in 2, and hemiplegia and mental retardation in 1. Although the total sample of index children scored slightly below the siblings in reading ability, the 56 children without acute-phase neurologic complications (58 percent) were indistinguishable from their siblings on all measures. The differences between the groups were small even for the 41 pairs in which the index child had had an acute neurologic complication (mean full-scale IQ, 102 for the index children vs. 109 for the siblings). Sequelae were also associated with lower socioeconomic status and a lower ratio of glucose in cerebrospinal fluid to that in blood at the time of the meningitis. Behavioral problems were more prominent in index boys than index girls and in those who were older at the time of testing, but sex and age were not related to cognitive or academic sequelae. CONCLUSIONS: We find a favorable prognosis for the majority of children who are treated for meningitis caused by H. influenzae type b.

Adolescent↗
PubMed1990

An unusual pleural effusion.

Transudative pleural effusions usually result from systemic disorders such as congestive heart failure, hypoproteinaemic states and pneumonia. We report a patient who illustrates a rarely considered local mechanism of transudate formation.

Aged↗
PubMed1989

American practitioners and the global primary care movement.

In conclusion, comparative studies of primary health care in various parts of the world can lead to new solutions for underserved communities in Maryland and other parts of the US. Careful review of how similar principles work under different circumstances will open new approaches. Current international experience shows that each country must evolve its own health care system. We have much to learn from those who are poorer than we, where limited resources stimulate local innovation and less waste.

Community Health Services↗
PubMed1988

Salvage therapy in metastatic adult Wilms' tumor.

Adult Wilms' tumor is a rare and aggressive malignancy. Despite multimodality therapy for all stages of disease, the majority of patients develop fatal metastases. Little information is available on effective salvage therapy. The current report describes a 38-year-old man who had Stage I disease. Pulmonary metastases developed after radical nephrectomy and tumor bed irradiation while receiving adjuvant chemotherapy. He achieved a complete remission lasting 8 months with a combination chemotherapy regimen of cyclophosphamide, vinblastine, dactinomycin, and cisplatin. After isolated pulmonary relapse, he received whole-lung irradiation and remained disease-free 4.5 years after diagnosis. The previously reported results of therapy in metastatic or unresectable adult Wilms' tumor are reviewed, and the current case of effective salvage therapy is documented.

Adult↗
PubMed1988

Clinical effect of admission chest X-rays in Zimbabwe.

The independent effect of admission chest X-rays on clinical management of 432 consecutive patients admitted to general medical wards was prospectively evaluated. Diagnosis, investigations, and treatment were recorded on the basis of clinical findings alone. A chest X-ray was then taken and clinical effect measured by the resultant changes. Although 226 (53%) admission chest X-rays were abnormal, only 9% changed management. In patients with no clinical evidence of cardiorespiratory disease ("routine" X-rays, n = 214) the clinical effect was slight; management was changed in 5% and patient benefit resulted in 1.4%. Clinical effect was greatest in patients (n = 172) with definite signs of new cardiorespiratory illness (altered management 14%, patient benefit 6%) and patients (n = 34) with "possible" chest disease (altered management 9%, patient benefit 9%). Omission of admission chest X-rays in patients with no clinical evidence of chest disease, those with clinically stable, known chest disease, and those with isolated cardiomegaly or hyperinflated lungs would result in a 60% reduction in the number of admission chest X-rays.

Adult↗
PubMed1988

Extragonadal germ cell tumors. Clinicopathologic findings and treatment experience in 12 patients.

In patients with primary germ cell tumors, treatment with combination chemotherapy followed by surgical debulking of residual tissue usually produces favorable results. The best treatment for patients with extragonadal germ cell tumors (EGCT) remains a problem. In our series of 12 patients, important clinical features were related to the site of bulky tumor, and all patients exhibited sharply elevated levels of lactate dehydrogenase (LDH), beta subunit human chorionic gonadotropin (beta-HCG), and/or alpha-fetoprotein (AFP). Each patient was treated with systemic chemotherapy, and ten were treated with the same combination chemotherapy--cyclophosphamide, actinomycin, vinblastine, bleomycin, and cisplatin (VAB) alternating with VP-16 and vincristine (VV). Of these ten patients, five died of progressive disease, three of whom had brain metastases. The other five are alive and clinically free of disease. The addition of VP-16 and vincristine did not improve responses. Advanced disease at presentation contributes to the poorer prognosis for these patients. Earlier diagnosis and surgical debulking may improve the long-term survival of patients with this disease.

Adult↗
PubMed1988

Drug use before hospital admission in Zimbabwe.

Drug use before hospital admission was studied prospectively in 284 consecutive patients admitted to general medical wards in Zimbabwe. Drugs were used by 84% of patients. Self-medication was used by 143 (50%) patients, aspirin (54%) and chloroquine (17%) being the most commonly used drugs. Traditional medicines were used by 55 (19%) patients. Drugs dispensed from orthodox medical sources were taken by 128 (45%) patients. Analgesics (22%), antibiotics (18%), and chloroquine (13%) were the commonest drugs dispensed. Urine screening tests were performed and were positive for aspirin in 37% of cases, chloroquine (33%), and antibiotics (20%). Adverse drug reactions requiring hospital admission occurred in 14 patients (10 orthodox medicines, 4 traditional medicines). Drug use before hospital admission, which is often poorly documented, is a source of potential drug toxicity and may obscure a diagnosis of infective illness.

Analgesics↗
PubMed1987

Outcome in children with enteroviral meningitis during the first year of life.

The neurologic, psychologic, language, and academic skills were evaluated and compared in children who had had enteroviral meningitis in infancy and their siblings. The study population consisted of 45 children in whom enteroviral meningitis developed between the ages of 4 days and 12 months. Three died of heart failure caused by viral myocarditis. Thirty-three survivors and 31 siblings were comprehensively evaluated with physical and neurologic examinations; hearing, vision, and achievement tests; and tests of cognitive, perceptual-motor, language, memory, and emotional-behavioral functions. The remaining nine survivors of meningitis and eight of their siblings were assessed by telephone interviews and analysis of school and medical records. None of the survivors had major adverse neurologic sequelae. In addition, they performed as well as their siblings on all tests administered. Our study did not demonstrate either overt or covert impairments of neurologic function or development in survivors of infantile enteroviral meningitis.

Child↗
PubMed1986

Neurologic toxicity associated with hepatic artery infusion HAI of FUdR.

A 66-year-old man with hepatic metastases from gastric adenocarcinoma was treated on two occasions with 5-fluoro-2-deoxyuridine (FUdR) via hepatic artery infusion (HAI). The patient developed neurologic signs and symptoms including disorientation, oculomotor defects, ataxia and multifocal myoclonus during both attempts at HAI. Systemic drug toxicity is unusual when FUdR is given via HAI, and neurologic toxicity has not previously been reported. We postulate individual hypersensitivity to FUdR or selective concentration of FUdR in brainstem structures to explain the toxicity in this case.

Adenocarcinoma↗
PubMed1986

Acute leukemia in patients with breast cancer.

Symptoms related to pancytopenia were the earliest signs of acute myelogenous leukemia (AML) in two patients with breast cancer. Although some patients with breast cancer may be predisposed to AML, prolonged treatment with alkylating agents may be leukemogenic.

Aged↗
PubMed1986

Systemic lupus erythematosus in Zimbabwe.

Systemic lupus erythematosus (SLE) was diagnosed in 31 black Zimbabweans over a six year period. Renal involvement (71%) was more common and photosensitivity (16%) and serositis (23%) less common than in the United States. Lymphopenia (48%) was the commonest haematological abnormality. Unusual complications included subarachnoid haemorrhage, cardiac rhythm disturbance, portal and superior mesenteric vein thrombosis, and a non-Hodgkin lymphoma. Tuberculosis was a common differential diagnosis that was difficult to exclude. Nine patients (29%) died within one year of diagnosis. SLE is being recognised more commonly in Zimbabwe.

Adolescent↗
PubMed1986

Long-term outcome of group B streptococcal meningitis.

Group B Streptococcus is a common cause of neonatal sepsis and meningitis. The purpose of this study was to evaluate the neurologic, psychologic, and academic status of children who had group B streptococcal meningitis and to compare these children with their siblings. Seventy-four children who acquired group B streptococcal meningitis between one day and 6 months of life formed the study population. Survivors were 3 to 18 years old at the time of their follow-up evaluations. Twenty children (27%) died, two were institutionalized, one severely affected child died at age 2 years, 15 were assessed by phone interview, and two were lost to follow-up. Thirty-four children and 21 siblings were comprehensively evaluated with physical and neurologic examinations, hearing tests, and tests of intellectual, perceptual-motor, and behavioral-adaptive functions. Of the total population, nine children (12%) had major neurologic sequelae (spastic quadraplegia, profound mental retardation, hemiparesis, deafness, or blindness). Six children had acute hydrocephalus; two were doing well after shunt placement. In general, those children surviving group B streptococcal meningitis without major sequelae appeared to be functioning normally or comparably to their sibling in intellectual, social, and academic matters.

Achievement↗