Biomedical subjects
Publications and source records attributed to J Barr.
This paper describes the work of a marriage guidance cousellor in a group-practice centre. The considerable advantages to patient, doctor, and counsellor of her close association with the primary medical care team are discussed.
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The overall incidence in gonorrhoea of septic gonococcal dermatitis was found to be 1.9% (3% for the females and 0.7% for the males). In 23 patients the common presenting symptoms were arthritis or arthralgia and bouts of fever, but the characteristic skin lesions served as an early clue to the diagnosis, and Neisseria gonorrhoeae was isolated from the genitourinary tract or from the blood. With the use of immunofluorescent techniques gonococci were also found in smears prepared from the skin lesions. An immune response to gonococci was found with the complement fixation technique in 90% of the patients. The response to treatment with penicillin was prompt, with complete relief from joint pains and fever, usually within two to seven days. The skin lesions faded within a few days, but scars could be observed for up to four weeks.
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A retrospective review of the records of 3886 patients with non-Hodgkin's lymphoma registered at the Princess Margaret Hospital between 1970 and 1985 was undertaken to determine the incidence of second malignant tumours. Three thousand and twenty-one patients with a minimum documented follow-up of 6 months from referral were identified for analysis. The overall observed/expected ratio for all cancers in patients with malignant lymphoma was 1, suggesting no increased risk of developing a second malignant neoplasm compared to the general population. When the data were analyzed independently for each tumour site, statistically significant increased risk of developing acute non lymphocytic leukemia (ANLL) (p less than 0.001) and carcinoma of the tongue (p less than 0.05) were found. An increased risk of lung cancer following lymphoma was detected but was not statistically significant. Survival following diagnosis of ANLL and lung cancer was similar and significantly shorter than that following the diagnosis of other second malignancies. The risk of developing a second primary cancer was significantly related to increasing patient age.
OBJECTIVE: Patients treated with intravenous antibiotics were seen to have increased attenuation of the renal collecting system on CT scan of the abdomen. To detect whether this was related to certain antibiotics, we undertook a prospective study on patients being treated for sepsis while receiving intravenous antibiotics. In addition, we also tested antibiotics administered to rabbits. MATERIALS AND METHODS: Fourteen patients were tested with cefazolin, gentamicin, cefotaxime, vancomycin, amoxicillin and clavulanic acid (Augmentin), and metronidazole. Ten groups of rabbits received these drugs by intravenous injection. Computed tomography scan of the kidneys was performed prior to and 2 h after intravenous injection of antibiotics. Fourteen patients who underwent CT scan of the abdomen and were treated by intravenous antibiotics were scanned without contrast agent injection. RESULTS: According to our results, cefazolin, cefotaxime, and gentamicin seemed to be the most potent antibiotics in inducing increased attenuation of the collecting system. This effect was synergistic when a combination of drugs was used. CONCLUSION: The elucidation of the potential increase in attenuation of the collecting system by antibiotics in normally functioning kidneys should help to eliminate confusion with other pathologies such as medullary sponge kidney.
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