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Biomedical subjects

J M Thomas

Publications and source records attributed to J M Thomas.

At least 289 records · Page 16Linked to original sources
PubMed1988

Hypothesis: posture is one of the determinants of the circadian rhythm of urine flow and electrolyte excretion in elderly female patients.

In view of recent investigations suggesting that the circadian rhythm of urine output is reversed in the elderly, the present study was designed to see if increased urine flow at night may be related to change in posture. Urine flow, urea and electrolyte excretion were measured 4-hourly for 6 consecutive days and nights in four catheterized female patients, mean age 83 years. Two were nursed in chairs for 8 h daily for 3 days, followed by total bed-rest for 3 days, and the other two in reverse order. None of the patients showed the morning rise of water and electrolyte excretion which has been described in young people. On full bed-rest, there was no significant day-night difference in water, sodium, potassium, urea or creatinine excretion. Chair nursing produced a negative mean day-night difference in water excretion (-321 ml: P less than 0.001) and in sodium (-11.7 mmol: P less than 0.002), urea (-26.6 mmol: P = 0.005) and creatinine excretion (-0.6 mmol: P = 0.008), but had no significant effect on potassium excretion. These results suggest that sitting upright may have important effects on water and electrolyte balance in elderly patients and may contribute to nocturia and nocturnal incontinence.

Aged↗
PubMed1988

Basal and stimulated insulin levels rise with advancing puberty.

We studied the effect of pubertal development on insulin secretion. Intravenous glucose tolerance tests were performed on 47 islet-cell antibody negative siblings of diabetic children and on 16 normal adults. Puberty was staged using Tanner's criteria and subjects were grouped as follows: I, stage 1 (n = 16); II, stages 2 and 3 (n = 15); III, stages 4 and 5 (n = 16); IV, adults (n = 16). Fasting insulin increased with advancing puberty (p = 0.59, P less than 0.001). The stimulated insulin response also rose with increasing pubertal development: for the 0-10 min insulin area, p = 0.46, P less than 0.001 and for the 10-60 min area, p = 0.68, P less than 0.001. There was a low positive correlation between insulin and age to 16 years but multiple regression analysis showed that this could be accounted for by puberty alone. Indeed prepubertal children and adults did not differ. There was no correlation between glucose (fasting and 0-60 min area) and puberty or age. These findings suggest that insulin resistance increases during puberty, and this may contribute to the frequency of presentation or worsening control of insulin dependent diabetes at this time.

Adolescent↗
PubMed1988

Treatment of perichondritis with a quinolone derivative--norfloxacin.

Auricular perichondritis is an uncommon complication following surgery of the external ear. Pseudomonas aeruginosa is the most commonly associated pathogen. Presented is a patient with auricular perichondritis successfully treated with norfloxacin, a newly available, orally administered antibiotic with antipseudomonal activity.

Basal Cell Carcinoma↗
PubMed1988

Changing with the times to keep the meaning of mission.

In the fall of 1987, the Franciscan Sisters of the Poor Health System, Inc. (HSI), took over Madison Square Garden's Felt Forum to hold a fund-raiser. Called the Franciscan Health Care Games, the weekend-long event pitted employees from 14 HSI facilities against one another in basketball and volleyball tournaments; featured 40 stars of film, television, and the sports world in competition; and ended with a gala dinner for 950 people. The event, a first for the Franciscans, raised $800,000. Some of the programs the money will benefit include: The Young Fathers Project, a program in Cincinnati that helps fathers between the ages of 16 and 21 adjust to being a parent. Eldercare, which provides health services to some 5,000 elderly patients at 13 congregate housing sites throughout the Columbus, OH, area. The St. Elizabeth Medical Center in Dayton, OH, which helps support services at a hotel for the homeless sponsored by St. Vincent de Paul Society.

Anniversaries and Special Events↗
PubMed1987

Role of computed tomography in selecting patients for hindquarter amputation.

Nine patients with soft tissue sarcomas close to the pelvic girdle and one patient with a primary malignant bone tumour of the pelvis were referred for consideration of hindquarter amputation. Patients were considered unsuitable for hindquarter amputation on clinical grounds if malignant disease infiltrated into the perineum or across the sacro-iliac joint. If disease in the femoral triangle extended above the inguinal ligament the tumour's operability was seriously questioned. Buttock tumours which had passed through the greater sciatic notch to become palpable on pelvic examination were also considered likely to be inoperable. On computed tomographic (CT) examination, tumours were considered inoperable if the psoas muscle was involved above the inguinal ligament, or if malignant disease involved the sacro-iliac joint, sacrum or perineal structures. Soft tissue tumours of the buttock extending significantly through the greater sciatic notch were also considered likely to be inoperable. Five patients thought suitable for hindquarter amputation on clinical assessment had no excluding features on CT; four undergoing hindquarter amputation were proven on histological examination to have good clearance of their tumours. In another patient, considered suitable for hindquarter amputation on clinical grounds, CT suggested that en bloc wide excision of the tumour was feasible enabling the affected limb to be preserved. Four patients after clinical examination were considered unsuitable for hindquarter amputation and in all cases inoperability was confirmed by CT. CT complements clinical examination and provides an objective and reliable means of selecting patients for hindquarter amputation which should avoid unnecessary surgical exploration.

Adult↗
PubMed1987

Mycobacterium chelonei and abscess formation in soft tissues.

Mycobacterium chelonei was isolated from a breast abscess in a healthy 46-year-old non-lactating Caucasian woman. In-vitro testing showed the organism to be resistant to conventional anti-tuberculosis agents but sensitive to tetracycline and erythromycin. Treatment with isoniazid, pyrazinamide and rifampicin initially produced a good response but the subsequent development of multiple abscesses required the addition of tetracycline and finally a change to erythromycin and trimethoprim, on which recovery was complete.

Abscess↗
PubMed1987

Histamine and allergen induced changes in nasal airways resistance measured by anterior rhinomanometry: reproducibility of the technique and the effect of topically administered antihistaminic and anti-allergic drugs.

1. Changes in nasal airways resistance (NAR) following the topical application of histamine and allergen solutions were measured by passive anterior rhinomanometry. 2. The repeatability of five consecutive measurements of resting NAR prior to provocation with histamine or allergen (expressed as the coefficient of variation) was 32.8% and following instillation of saline control solution 37.2%. 3. The repeatability of five consecutive measurements of NAR during the nasal obstruction produced by histamine and allergen was similar to that recorded prior to provocation; the coefficients of variation (median values) being 39.6% and 33.1% respectively. The degree of variability was not related to the dose of agonist or the degree of nasal obstruction. 4. The reproducibility of histamine or allergen induced changes in NAR on four separate weekly occasions showed no significant intra-subject differences. 5. The effects of sodium cromoglycate (SCG), clemastine and ketotifen administered to the nasal mucosa 30 min before provocation with histamine and allergen were compared in a random order, double-blind, placebo controlled study. 6. Clemastine and SCG, but not ketotifen, significantly inhibited the nasal response to increasing concentrations of histamine. None of the drugs administered in the concentrations used in this study significantly inhibited the nasal response to allergen.

Administration, Topical↗
PubMed1987

Food-induced cortisol secretion is mediated by central alpha-1 adrenoceptor modulation of pituitary ACTH secretion.

Food ingestion stimulates cortisol secretion in man, but the mechanism of this effect is unknown. We have investigated the possible role of adrenoceptors in the mediation of this effect. Six normal males were given continuous 3 h i.v. infusions of normal saline, methoxamine (alpha-1 adrenoceptor agonist) and thymoxamine (alpha-1 adrenoceptor antagonist). Methoxamine enhanced and thymoxamine attenuated the ACTH and cortisol responses to a standard meal given 60 min after commencement of the infusion. The drugs had no effect on nutrient absorption. Four patients with recent onset of pituitary ACTH deficiency and normally responsive adrenal glands showed no ACTH or cortisol rises after the standard meal, demonstrating that postprandial cortisol secretion is mediated by pituitary rather than gut ACTH. Our previous investigations have demonstrated that alpha-1 adrenoceptors stimulate pituitary ACTH secretion in man by an action within the blood brain barrier. We therefore conclude that postprandial cortisol secretion is mediated by central stimulant alpha-1 adrenoceptors modulating pituitary ACTH secretion.

Adrenocorticotropic Hormone↗
PubMed1987

Effects of one year's treatment with ranitidine and of truncal vagotomy on gastric contents.

Fifteen patients with peptic ulcer underwent 24 hour studies of gastric contents: before and on completing six weeks' treatment with oral ranitidine 150 mg bd, twice on maintenance treatment for nine to 12 months and one month after stopping the drug. For comparison, 11 patients underwent identical 24 hour studies three to 38 months after truncal vagotomy for duodenal ulcer. During treatment with ranitidine median 24 hour intragastric pH, nitrate concentration, and counts of total and nitrate reducing bacteria increased significantly regardless of dietary nitrate content; there was no significant increase in the median day time concentration of N-nitroso compounds. Despite these changes, an acid tide at some point in each 24 hour study period prevented persistent bacterial colonisation of the stomach. There were no significant differences between the biochemical and microbiological changes recorded during one year of treatment with ranitidine, and the observations on patients after truncal vagotomy. One month after stopping one year's treatment with ranitidine all variables examined returned to pretreatment levels. Treatment with ranitidine or vagotomy was associated with significant positive correlations among pH, nitrate concentration and bacterial counts. Correlations between pH and N-nitroso compound concentration and between concentrations of nitrite and N-nitroso compounds were not significant.

Adult↗
PubMed1986

A simplified method for the routine determination of effective renal plasma flow.

Quantitative renal data (i.e., glomerular filtration rate or effective renal plasma flow) often would be useful ancillary information when radionuclide renography is carried out. The added time, and therefore cost, of obtaining quantitative information might be the main reason a department does not routinely perform a quantitative study, although there is no added radiation or risk to the patient. To simplify the procedure for determining effective renal plasma flow with I-123 orthoiodohippurate (OIH), the published methodology was modified to eliminate the repetitive preparation of a standard solution. This allows the routine incision of effective renal plasma flow (ERPF) determination in I-123 OIH renography with minimal impact on departmental operations.

Humans↗
PubMed1986

Rates of dissolution and biodegradation of water-insoluble organic compounds.

We conducted a study of the relationship between the dissolution rates of organic compounds that are sparingly soluble in water and the biodegradation of these compounds by mixed cultures of bacteria. The rates of dissolution of naphthalene and 4-chlorobiphenyl were directly related to their surface areas. The bacteria caused a decline in the concentration of the soluble substrate. The rate of bacterial growth fell abruptly when 4-chlorobiphenyl or naphthalene was no longer detectable in solution. The population continued to increase in media with different surface areas of insoluble 4-chlorobiphenyl, but the final counts were higher in media in which the surface areas of the substrate were larger. The rates of dissolution of palmitic acid, octadecane, di(2-ethylhexyl) phthalate, and 1-naphthyl N-methylcarbamate were determined in the absence of microorganisms. A mixed culture of microorganisms mineralized palmitic acid, di(2-ethylhexyl) phthalate, and Sevin (1-naphthyl N-methylcarbamate) at a logarithmic rate, but octadecane mineralization was linear. The rates of mineralization at the end of the active phase of the biodegradation were lower than the rate of dissolution of palmitic acid but higher than the rate of dissolution of octadecane in the uninoculated medium. We suggest that spontaneous dissolution rates are only one of the factors that govern the rates of biodegradation.

Alkanes↗