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Biomedical subjects

J M Freeman

Publications and source records attributed to J M Freeman.

At least 109 records · Page 6Linked to original sources
PubMed1981

Biofeedback treatment of fecal incontinence in patients with myelomeningocele.

Approximately six hours of biofeedback training was given to eight fecally incontinent children with myelomeningocele in order to establish bowel control. Their ages ranged from five to 15 years. The patients were shown a polygraph tracing of the external anal sphincter while they were being encouraged voluntarily to contract the sphincter when the rectum was distended with progressively larger volumes of air in a balloon. Seven of the eight patients showed normal sensation for rectal distension. Following this training period, five of the children had no incontinent periods, and two of these had discontinued enemas or suppositories. A sixth patient had an 80 per cent reduction in the frequency of incontinence. The remaining two did not benefit. At follow-up between 13 and 24 months later, four children were incontinent once a month or less often; two others were incontinent once per day, a considerable decrease from the pretraining period. The two children who failed to learn were still incontinent at follow-up. These results show that fecally incontinent patients with myelomeningocele can learn to evacuate normally or to reduce soiling after a relatively short period of biofeedback training.

Adolescent↗
PubMed1980

A new look at peripheral vascular disease in blacks: a two-year update.

A comprehensive overview of 66 patients-the majority of whom were black-undergoing distal lower extremity revascularization for severe atherosclerotic ischemia with impending limb loss is presented. Twenty-five patients are presently two-years postoperative, 19 are one-year post revascularization, and 22 are new additions having undergone revascularization within the last year.Patients in the study group are presented according to race, sex, and age. Their histories and pre-operative clinical conditions, along with angiographic and operative findings lead to the identification of a previously undescribed atherosclerotic phenomenon present among blacks. The impact of an aggressive program for limb salvage is reported and the prospect of avoiding needless limb loss is discussed.

Black or African American↗
PubMed1979

Valproate sodium in refractory seizures: a study of efficacy.

Sodium valproate (N-dipropylacetic acid) is a newly released anticonvulsant drug with a broad spectrum of activity. Twenty-seven children with uncontrolled seizures, predominantly akinetic and myoclonic, were treated with this drug. Encouraging results were noted in those with head-nodding spells, body drops, and myoclonic jerks ("minor motor" seizures). Side effects included occasional gastrointestinal disturbance. No important hepatotoxic complications were noted. Two persons displayed transient neurologic side effects. Of particular interest was the noticeable improvements in mental status noted in 17 of the 27 patients. Some variations in blood level of other anticonvulsant drugs were noted, emphasizing the importance of monitoring these drugs. Valproate sodium provides important improvement in our ability to manage minor motor seizures.

Adolescent↗
PubMed1979

A behavior analysis approach to high-rate myoclonic seizures.

Epilepsy represents a serious medical and social problem. In the majority of cases, seizures are successfully managed by a variety of anticonvulsant medications, even though these drugs may potentiate significant physical and developmental side effects. A small group of studies to date have offered evidence that behavioral procedures can successfully manage some seizure disorders and are particularly desirable treatment choices when seizure disorders are intractable to drug management or when drug side effects are to be avoided. The present case adds to this small but growing group of studies in that it demonstrates the use of behavioral procedures in the analysis and treatment of high-rate myoclonic seizures. Seizures were evaluated on a hospital ward and in a controlled experimental setting. The data indicated a variable rate of seizures across days and activities and a reduction of seizure frequency in the controlled setting when time-out was made contingent on seizures. A program of contingent rest' was then applied on the hospital ward that demonstrated a reduction in myoclonic seizure frequency and the apparent prevention of several grand mal episodes. An observer calibration procedure showed high correspondence between behaviorally and physiologically recorded seizures. A discussion of issues in behavioral medicine research follows.

Behavior Therapy↗
PubMed1979

Carbamazepine levels in pregnancy and lactation.

An epileptic patient whose seizures were controlled with carbamazepine and primidone was followed throughout pregnancy and lactation. Blood levels of primidone decreased during pregnancy and rose postpartum requiring dosage adjustments. Pharmacologically insignificant amounts of the drug were detected in breast milk. A review of the literature revealed 94 infants exposed to carbamazepine in utero and no evidence to date that this drug carries a teratogenic risk.

Adult↗
PubMed1978

Rehabilitation and the client with epilepsy: a survey of the client's view of the rehabilitation process and its results.

A survey of epileptic clients of the Maryland State Department of Vocational Rehabilitation was conducted to evaluate the success of the rehabilitation process from the client's point of view. Less than half had become employed, 70% had continuing seizures, most had psychosocial problems. Recommendations are made as to how the rehabilitation process could better serve persons with epilepsy.

Adolescent↗