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Biomedical subjects

J Brodie

Publications and source records attributed to J Brodie.

At least 19 recordsLinked to original sources

Cerebrovascular accident: relationship of demographic, diagnostic, and occupational therapy antecedents to rehabilitation outcomes.

OBJECTIVE: This study was conducted to identify factors that were significant in predicting occupational therapy treatment choices and discharge outcomes after inpatient rehabilitation for 112 patients who had experienced a cerebrovascular accident. METHOD: A retrospective descriptive study was conducted. RESULTS: According to discriminant function analysis, the cerebrovascular accident disability score (i.e., level of functional disability) during the initial evaluation period was the predictor of discharge outcomes with the most clinical significance. A greater proportion of occupational therapy assessment units was the most influential occupational therapy factor associated with a positive discharge outcome. In one inpatient rehabilitation setting, a greater proportion of occupational therapy intervention for all study subjects was directed at the level of impairment compared to the level of disability. CONCLUSION: Shorter inpatient stays, as well as shifts to outpatient rehabilitation, may require occupational therapists to examine whether intervention at the level of impairment or disability yields the best functional outcomes for patients who have sustained a cerebrovascular accident.

Adult

Firearm victims--who were they?

OBJECTIVE: To determine the characteristics of victims killed by firearms, whether they died by suicide, homicide or accident, and the types of firearms involved. DESIGN: A retrospective and descriptive study. SETTING AND SUBJECTS: Coronial autopsy data were obtained from the Brisbane Laboratory of Pathology and Microbiology. All 587 firearm deaths during the period 1980-1989 were included. MAIN OUTCOME MEASURES: The proportions of deaths by suicide, homicide, accident or undetermined cause. In cases of homicide, we sought to define the relationship of the perpetrator to the victim. RESULTS: The types of death were suicide 76%, homicide 18%, accidents 3% and undetermined 3%. Most homicides were of a domestic nature as opposed to crime. Small calibre rifles were the most common weapon; handguns were rarely used. CONCLUSIONS: Recent debate regarding firearm legislation has failed to recognise the predominance of interpersonal and psychological issues in the causation of firearm deaths. Crime is a motive for only a minority. Medical practitioners may reduce firearm deaths both by organisational representation and individual efforts in clinical practice. In particular, attention should be given to the identification of individuals or families at risk, the detection and treatment of psychological disorder and advice regarding firearm disposal.

Accidents

Effects of active and completed litigation on treatment results: workers' compensation patients compared with other litigation patients.

Outcomes of multidisciplinary pain treatment in workers' compensation claimants and in the claimants of other insurance companies were studied. Patients were also segregated as to state of completion of the litigation process. No differences were found between the groups in organic and psychologic pathology. Significant improvement in outcome measures was found for the total group, but the workers' compensation claimants with completed litigation failed to show any significant improvement in these measures. The system itself and legal factors can be obstacles to rehabilitation of the patient with chronic pain. Early intervention is recommended to improve treatment outcome.

Activities of Daily Living

Effects of amphetamine on local cerebral metabolism in normal and schizophrenic subjects as determined by positron emission tomography.

The effects of d-amphetamine (0.5 mg/kg PO) on regional cerebral glucose utilization were measured with Positron Emission Tomography (PET). Subjects included ten chronic schizophrenics and six controls who received amphetamine, and six chronic schizophrenics and nine controls who received placebo or no treatment. Amphetamine decreased glucose metabolism in all regions studied (frontal, temporal, and striatal) in normal and schizophrenic subjects. The metabolic effects of amphetamine were correlated with plasma level of the drug. Cortical atrophy was associated with a blunted metabolic response.

Adult

Putrescine metabolism in human brain tumors.

The metabolism of the polyamines, putrescine, spermidine and spermine, was studied in human brain and brain tumors. Samples of brain and tumors were incubated with 3H-putrescine and the amounts of labeled polyamines were measured. The amount of putrescine conversion was found to be greater in tumors that in normal brain samples. Furthermore, the metabolism of putrescine in brain tumors was related to tumor type and appeared to correlate with the degree of malignancy. The significance of these findings with regard to positron emission tomographic scanning and therapy of patients with malignant gliomas is discussed.

Astrocytoma

Positron emission tomography and computed tomography assessments of the aging human brain.

The relationship between alterations in brain structure and brain function was studied in vivo in both young and elderly human subjects. Computed tomography revealed significant age-related ventricular and cortical sulcal dilatation. The cortical changes were most closely related to age. Positron emission tomography failed to show regional changes in brain glucose metabolic rate. The results suggest that the normal aging brain undergoes structural atrophic changes without incurring regional metabolic changes. Examination of the correlations between the structural and the metabolic measures revealed no significant relationships. These data are discussed with respect to the significant structure-function relationships that have been reported in Alzheimer disease.

Adult

Antibodies and the Aberdeen typhoid outbreak of 1964. I. The Widal reaction.

The outbreak of typhoid fever in Aberdeen during 1964 (Walker, 1965) presented an opportunity to study the antibody titres of typhoid fever patients and of TAB immunized individuals to obtain further knowledge concerning the behaviour of these titres with the passage of time.This paper gives an abbreviated version of part of a research programme which followed the Aberdeen typhoid outbreak of 1964.The antibody titres of patients were followed up for a period of 2 years after discharge from hospital and the findings have been compared with those in TAB immunized healthy individuals. The following points emerged:(1) The value of the Widal test as an aid to diagnosis was limited;(2) the flagellar antibody titre in patients' sera provided a more reliable aid towards diagnosis than did the somatic antibody titre;(3) the response of immunized and non-immunized patients to the somatic antigens was poor and often delayed well into the period following discharge from hospital;(4) titres of 1/40 and over for Vi agglutinins were present in immunized and non-immunized patients for at least 12 months after discharge without their being S. typhi excretors;(5) Vi agglutinin titres as high as 1/40 were present in TAB immunized healthy individuals and also in members of the general public;(6) the presence of S. typhi septicaemia need not result in a high antibody titre;(7) patients who relapse, may do so without enhancement of previous antibody titres and may relapse even in the presence of earlier appreciable titres.

Agglutinins

Antibodies and the Aberdeen typhoid outbreak of 1964. II. Coombs', complement fixation and fimbrial agglutination tests.

In a previous paper (Brodie, 1977) the value of the Widal test in the diagnosis of typhoid fever was shown to be limited. Evaluation of possible alternative tests showed that: (1) the sensitivity of the anti-human globulin (Coombs') test appeared greater than that of the agglutination test but the length of time (48 h) before results were available rendered it of little value in rapid diagnosis: (2) the complement fixation test offered no particular help towards diagnosis; (3) immunized and non-immunized typhoid fever patients developed fimbrial antibodies, as also did immunized healthy individuals. In this latter group, however, those immunized with alcoholized TAB vaccine had higher antibody titres to fimbrial antigen than those immunized with heat-killed phenolized vaccine.

Agglutination Tests

Antibiotics and the Aberdeen typhoid outbreak in 1964.

This paper gives an abbreviated account of part of a research programme which followed the Aberdeen typhoid outbreak in 1964. Chloramphenicol, the main antibiotic used in treatment, was shown to have a minimum inhibitory concentration (MIC) of between 5 and 2-5 mug./ml. for the S. typhi phage type 34 of the outbreak. The MIC for methacycline was between 5 and 2-5 and 2 mug./ml. Whereas the deep and shallow broth techniques used gave similar results with these antibiotics, the MIC for ampicillin, and also cephaloridine, was less in the deep than in the shallow broths. Serum assays in patients given ampicillin or cephaloridine yielded abnormally high concentrations of both antiboitics when S. typhi phage type 34 was the test organism whereas, with other test organisms, the concentrations were within expectation. These abnormally high values fell within expected values when the sera under investigation had first been heated to 56 degrees C. for 30 min. before assay against the S. typhi of the outbreak. The findings with ampicillin suggested that dosages given were satisfactory. With cephaloridine the concentrations found in patients' sera seemed to show that twice daily doses of 0-5 g. fell short of adequacy.

Adult

Use of bacteriological investigations by general practitioners.

The numbers of vaginal swabs, faecal specimens, throat swabs, and urine specimens submitted by 104 city general practitioners to the bacteriology laboratory at Aberdeen differed widely. The doctors who made most use of the laboratory service rarely did so equally for all four investigations but usually for only one or two. Similarly, those who used the service least often made frequent use of one particular investigation. Further studies are needed to identify and evaluate the reasons for the apparently substantial disagreement among general practitioners concerning the value of these diffferent bacteriological investigations in general practice.

Bacteriological Techniques

Fluid and solid media for isolation of Brucella abortus.

The use of a fluid-enrichment technique increased by 10-16% the recovery rate of Brucella abortus from milks of herds positive to a milk ring test. Three solid media for direct cultural techniques were also tested on the same milks. Combinations of these techniques produced a recovery rate of ca. 88% from MRT-positive-herd milks using a mixture of the centrifuged deposit and cream layer as the inoculum as against a recovery rate of ca. 75% using the MRT cream layer as inoculum. B. abortus biotypes 1-5 and 9 were isolated and growth of all the biotypes was supported by all media used.

Animals