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Biomedical subjects

J G Brooks

Publications and source records attributed to J G Brooks.

At least 37 records · Page 2Linked to original sources
PubMed1993

Unraveling the mysteries of sudden infant death syndrome.

The major contributions to the understanding of sudden infant death syndrome (SIDS) from the 1992 literature are in the area of epidemiology. The SIDS incidence, both in the overall population and in the Native American population, is decreasing. There was an additional report identifying overwrapping as a risk factor for SIDS, and several models of infant hyperthermia have been developed and studied. New data from New Zealand and England lend further support to the association between prone sleeping and SIDS, a relationship that has prompted a sleeping position recommendation from the American Academy of Pediatrics. Several studies suggest an association between SIDS and toxigenic bacteria in the upper respiratory tract, but no significant association was found between SIDS and positive viral cultures. Two studies report that medium-chain acyl-coenzyme A dehydrogenase deficiency is not significantly associated with SIDS. Of particular interest in the near future will be additional data about the effect of changing sleeping position on the incidence of SIDS in the United States.

Animals↗
PubMed1993

Non-ulcerative fungal keratitis diagnosed by posterior lamellar biopsy.

We report a case of Fusarium solani keratitis which highlights the difficulties often associated with management of fungal corneal infections. This case demonstrates several unusual and interesting features: the occurrence of deep fungal pathology after superficial injury, the difficulties encountered in attempting to isolate and identify the causative organism, and the protracted course taken by an organism often noted to be rapidly destructive. These features necessitated an individual approach to therapy, employing unconventional medical and surgical techniques to achieve a satisfactory outcome.

Adult↗
PubMed1993

Fracture of the femoral component in cementless total knee arthroplasty.

Records of sales revealed that 6172 Ortholoc II cementless total knee femoral components with double bead layers were sold between January 1986 and December 1987. Sixteen thousand two hundred thirty Ortholoc II femoral implants with single bead layers were sold between December 1986 and January 1990. Fractures of the femoral components were reported in 32 knees; all but one occurred in femoral components with porous surfaces consisting of two layers of sintered beads. The overall minimum rate of failure for all sizes with double bead layers was 0.42%. The rate varied with the size of the implant and was much greater in smaller implants. The rate of failure was 0.82% in 852 small components, 0.37% in 2416 medium components, 0.29% in 1729 large components, and 0.09% in 1175 extra-large components. The differences in failure rates were statistically significant for all sizes of implants when compared with other sizes. Sixteen thousand two hundred thirty Ortholoc II components with a single layer of beads were sold worldwide between December 1986 and January 1989. One implant (medium size) failed 18 months after surgery. The minimum rate of failure in the single bead layer implants is 0.006%. This failure rate is statistically significantly less than that of the double bead layer implants. All failures occurred at the junction between one of the bevel surfaces and the distal surface of the implant. In all cases, crack propagation was initiated at the inner surface. This suggests that bending stresses had developed and had opened (straightened) the femoral component.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Weight↗
PubMed1992

General practitioners' attitudes to computer-generated surgical discharge letters. Members of the Department of General Surgery, Fremantle Hospital.

OBJECTIVE: To assess general practitioners' attitudes to a computed-generated general surgical discharge letter. To identify the six most important items of information in an ideal discharge letter. DESIGN: One hundred and thirty general practitioners who had received at least six computer-generated surgical discharge letters in one year were circulated with a questionnaire. RESULTS: Most general practitioners approved of the computer-generated discharge letter which included all six of the most important items of information they requested. Eighty-four per cent wished to see a similar computer-generated discharge system extended into other areas of hospital practice.

Attitude of Health Personnel↗
PubMed1992

Evaluation of the Oxford and Sheffield SIDS risk prediction scores.

STUDY OBJECTIVE: To evaluate the clinical usefulness (sensitivity and specificity) of the Oxford and Sheffield birth scores for prospective identification of infants at high risk of SIDS. DESIGN: Retrospective medical record reviews of prospectively identified, autopsy-validated SIDS and living control infants. STUDY SUBJECTS: Consecutive sample of 140 infants, born between 1/1/83 and 12/31/87, who died suddenly and unexpectedly in the Avon Area Health Authority in southwest England between 1/1/84 and 12/31/88. Seventeen of the cases were excluded: 6 because they lacked adequate clinical records, 11 because they were not SIDS. The 637 control infants were comprised of every 80th delivery between 1/1/83 and 12/31/87 in the three major hospitals in the area. RESULTS: SIDS incidence was 2.85/1,000 live births. Using standard cut scores to define high SIDS risk (2.0 for Oxford and 500 for Sheffield), sensitivities were 0.55 and 0.35 and specificities were 0.78 and 0.89 for the Oxford and Sheffield scores, respectively. SIDS risk for infants in the high risk group was 7.3/1,000 (Oxford) and 9.3/1,000 (Sheffield). CONCLUSIONS: Since there is no intervention with proven efficacy for SIDS prevention, and since approximately one half of SIDS cases occur in low risk groups, clinical use of these scoring systems for allocation of health care resources or personnel for the sole purpose of SIDS prevention is not justified.

Cohort Studies↗
PubMed1992

How accurate is a computerized surgical audit when resident medical staff collect the data?

Since July 1988 all eight general surgeons at Fremantle Hospital have used a computer-based surgical audit and discharge system. At the time of writing (September 1991) 10,919 computer-generated discharge letters have been produced by the system. This paper describes the system and reports a series of quality control assessments carried out between 1 July 1988 and 30 June 1990 during which 30 pre-registration surgical residents completed 5,716 data collection forms. It was found that: (1) data collection for 23 of 24 monthly surgical audits was at least 95% complete; (2) outstanding surgical discharge summaries were reduced by 89%; (3) the residents recorded 17/19 wound infections and identified 15 (79%) of these as a surgical complication; and (4) the residents tended to under-record complications in patients who had more than one complication during their hospital stay. It was concluded that the system was robust, and that resident staff collected data in such a way that good quality computer-generated discharge letters were produced in a timely manner. Closer attention to aspects of data collection will be required before the optimum surgical audits of the QX system can be generated.

Abstracting and Indexing↗
PubMed1992

Frequency of medium-chain acyl-CoA dehydrogenase deficiency G-985 mutation in sudden infant death syndrome.

A small percentage of apparent sudden infant death syndrome (SIDS) victims may have an unsuspected metabolic disorder. Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency is a disorder of fatty acid oxidation that has been the most common such metabolic disorder found in series of SIDS victims. A single mutation in MCAD deficiency has been recently described (G-985) that accounts for approximately 90% of MCAD deficiency mutations. We studied the hypothesis that heterozygosity or homozygosity for this specific MCAD deficiency mutation might be associated with SIDS. DNA was extracted from the paraffin-embedded autopsy tissues of 67 victims of SIDS in Monroe County, NY who died between 1984 and 1989. Using the polymerase chain reaction/NcoI digestion method, we found no G-985 homozygotes and three (4.5%) G-985 heterozygotes. In 70 newborn controls, there were no G-985 homozygotes and one (1.4%) heterozygote. Although the frequency of G-985 heterozygotes was slightly greater than in our control group, it was not statistically different. We conclude that the specific MCAD deficiency mutation G-985 is not strongly associated with SIDS and that MCAD deficiency probably does not make a significant contribution to the etiology of SIDS.

Acyl-CoA Dehydrogenase↗
PubMed1992

Apparent life-threatening events and apnea of infancy.

This article is a critical review of the literature relating to the incidence, causes, pathophysiology, and therapy of apparent life-threatening events in infants. The clinical characteristics at the time of presentation and follow-up of infants who experience apparent life-threatening events are also summarized.

Apnea↗
PubMed1988

Ventilatory chemosensitivity in parents of infants with sudden infant death syndrome.

We measured ventilatory responses to progressive isocapnic hypoxia and to hyperoxic hypercapnia (CO2) using rebreathing techniques in 16 parents of infants with autopsy-confirmed sudden infant death syndrome (SIDS) and 18 control parents matched for age, sex, and body size. Response to ventilatory loading was assessed by repeating the CO2 test with an inspiratory flow-resistive load (16 cm H2O/L/sec). During loaded and unloaded CO2 tests, respiratory effort was also assessed by measuring the pressure generated in the first 0.1 second (P0.1) of the subsequent inspiratory effort after brief manual occlusion of the inspiratory line. Ventilatory responses of the parents of victims of SIDS to chemical and mechanical stimulation were not significantly different from those of control parents. Responses in both groups were similar to previously reported normal values. There was a linear increase in ventilation (VE) in response to hypercapnia and hypoxia and in P0.1 in response to hypercapnia. We found expected increases in P0.1/PCO2 and decreases in VE/PCO2 slopes during loaded breathing in all subjects, but no difference between groups. We conclude that parents of SIDS victims have normal ventilatory chemosensitivity and respiratory drive.

Adult↗
PubMed1988

Near drowning.

Explore the source record for details and available documents.

Adolescent↗
PubMed1988

Infantile apnea and home monitoring.

Electronic cardiorespiratory monitors are appropriately used in the home for infants who are at high risk of sudden infant death syndrome (SIDS). A recent Consensus Panel, convened by several US federal agencies recommended that home monitors should not be used for infants at normal SIDS risk (less than 2/1,000 live births) or for asymptomatic premature infants. Those infants where home monitoring, despite its limitations and complications, is definitely indicated because of their very high risk, include survivors of severe apparent life-threatening events (occurring during sleep and 'requiring' CPR), siblings of two or more SIDS, and premature infants, still mildly or moderately symptomatic with apnea of prematurity who are otherwise ready for hospital discharge.

Humans↗
PubMed1985

Psychodynamics of four women with delayed cancer diagnosis.

Four young women from 28 to 35 years old were referred for psychiatric evaluation because of anxiety, depression, and rage following diagnosis and treatment (radical hysterectomy in all plus radiation therapy in two) of carcinoma of the cervix. Negligence and dishonesty on the part of the laboratory that reported their Pap smears as normal when actually they had been either carelessly examined or not read at all intensified their emotional reactions of shock, panic, and fury. Feelings of injustice and victimization and fantasies about the laboratory technicians, who were women in their age group, complicated the clinical picture. The depressions that ensued in all of the women were prolonged and the working-through processes were impaired despite the fact that three have apparently been cured of their malignant disease.

Adenocarcinoma↗