Search PubMed⌕ Search

Biomedical subjects

J Marshall

Publications and source records attributed to J Marshall.

At least 487 records · Page 27Linked to original sources
PubMed1982

Pediatric health care in family practice.

This paper describes the 32,926 health care problems of 9,117 pediatric patients visiting 12 Colorado family practices (4 rural, 3 urban, and 5 residency practices) over a one-year period. All 12 practices utilize the Family Medicine Information System (FMIS), a selectively automated system for storing and analyzing medical, family, and billing data. Age-sex distribution, visiting patterns, and morbidity are described for patients under 18 years of age. The 25 most frequent pediatric diagnoses account for 77 percent of visits, and 121 diagnoses account for 94 percent of pediatric visits. All diagnostic categories are explored in detail, and comparisons are made among urban, rural, and residency practices.

Adolescent↗
PubMed1981

Effect of haematocrit on carotid stenosis and cerebral infarction.

Carotid angiograms in 187 patients presenting with transient ischaemic attacks and minor completed strokes were reviewed. A haematocrit of 50% or more was encountered more frequently in those found to have carotid occlusion. The severity of vessel-wall disease showed no relationship to the level of haematocrit. Computerised axial tomographic to the level of haematocrit. Computerized axial tomographic measurements of the volume of the cerebral infarct seen in 23 patients with carotid occlusion and completed strokes showed a correlation between the size of the infarct and the height of the haematocrit. It is suggested that reduced blood flow resulting from increase blood viscosity associated with a high haematocrit adversely affects collateral flow, thereby increasing the size of the infarct.

Arterial Occlusive Diseases↗
PubMed1981

Diet and cancer of the esophagus.

The reported dietary, alcohol consumption and smoking habits of 147 Roswell Park Memorial Institute white male patients diagnosed with cancer of the esophagus were compared with the reports of 264 white males of comparable ages with diagnoses other than cancer. Overall frequency of vegetable an fruit consumption was associated with lower risk; persons reporting fruit and/or vegetable consumption 31-40 times a month had significantly greater risk than those who reported consumption 81 times a month or more. Calculated indexes of vitamin A and vitamin C intake were similarly related to reduction in risk. Dose-response gradients were observed for frequency of vegetable and/or fruit consumption, as well as for vitamin A and C intake. The putative protective effect of vegetable and fruit intake remained evident after controlling for its possible association with smoking and drinking. Previously reported associations of smoking, alcohol use and social class, as measured by type of occupation, were replicated in these data. The findings of this investigation in instances of colon, lung, bladder, oral, and laryngeal cancers, and with evidence of tumor inhibition by vegetable properties in animals. Interpretation of the findings is limited by the difficulties of retrospective assessment of dietary intake and by possible confounding by other factors known to be related to esophageal cancer.

Alcohol Drinking↗
PubMed1981

Regional cerebral oxygen supply and utilization in dementia. A clinical and physiological study with oxygen-15 and positron tomography.

The cerebral blood flow, oxygen extraction and oxygen utilization has been measured regionally in 22 dements, and 14 aged normal volunteers. Ten demented patients were studied twice at a six-month interval from initial measurements. The use of a steady-state 15O technique and positron tomography for measuring regional cerebral blood flow, regional oxygen extraction fraction and mean cerebral oxygen utilization is discussed. The limitations of measurements are reviewed in the light of the present results and the current state of technological development in positron emission tomography is discussed. A decline in cerebral blood flow and mean cerebral oxygen utilization was correlated with increasing severity of dementia in both degenerative and vascular dements. The decline was coupled, both for the cerebral hemisphere as a whole and regionally. There was no increase in oxygen extraction ratio globally, and therefore no evidence to support the existence of a chronic ischaemic brain syndrome. Focal abnormalities in oxygen utilization were observed for both vascular and degenerative groups. In the vascular group, parietal defects were the most pronounced. Individual derangements of the regional pattern varied, reflecting the different unique patterns of ischaemic damage in these patients. In the degenerative group, parietal and temporal defects were seen in the less severe group, but a profound depression in the frontal regions with relative sparing of occipital area characterized the severe degenerative dements.

Aged↗
PubMed1981

Dietary factors in the epidemiology of cancer of the larynx.

Interviews were carried out with 374 male patients at Roswell Park Memorial Institute with cancer of the larynx and 381 controls with diseases other than of the digestive or respiratory system and other than neoplasms. As have other investigators, the authors found a high risk associated with smoking as well as a risk associated with alcohol ingestion. In addition, the study found that males ingesting low amounts of vitamin A in their diet had approximately twice the risk of those ingesting large amounts. The same was true for vitamin C. All of these relationships were significant, and risk increased in dose-response fashion with decreases in ingestion of the above-mentioned dietary constituents. When the risks associated with vitamins A and C were examined controlling for smoking and drinking, the risk enhancement associated with low ingestion persisted. The findings on nutrients are consistent with results of studies on animals and tissue cultures. Nevertheless, the sparse epidemiologic replication, the difficulties with the methods, and the complexity of the field demand substantial further inquiry on these relationships.

Alcohol Drinking↗
PubMed1981

Fatal digoxin-quinidine interaction in an elderly woman.

The medical records of an elderly woman revealed strong evidence of a lethal digoxin-quinidine interaction. This case and several problems contributing to digitalis toxicity are presented. Physicians should be more aware of the potential toxicities involved in cardioactive drug therapy in the elderly. Current concepts of the quinidine-digoxin interaction are discussed.

Aged↗
PubMed1981

Subcortical arteriosclerotic encephalopathy: a clinical and radiological investigation.

Subcortical arteriosclerotic encephalopathy (Binswanger's type) was diagnosed in a group of patients with hypertension or arteriosclerosis, who showed acute and subacute neurological deficits, dementia, reduced cerebral blood flow, and white matter low attenuation with mild atrophy and infarcts as the predominant CT scan features. This set of clinical and radiological criteria could be used to make the diagnosis in life, as confirmed neuropathologically in one patient.

Acute Disease↗
PubMed1980

Cerebral tuberculomas developing during treatment of tuberculous meningitis.

Cerebral tuberculomas developed in two adult Asian immigrants during treatment for miliary tuberculosis and tuberculous meningitis. Both were infected by strains of Mycobacterium tuberculosis sensitive in vitro to all antituberculous drugs, and no evidence of immunodeficiency was detected. Focal neurological signs appeared and the lesions led to the death of one patient despite maximum treatment. The importance of systemic corticosteroids in controlling the raised intracranial pressure is discussed.

Adolescent↗
PubMed1980

Effect of high haematocrit on alertness.

Patients with high-normal or above-normal haematocrit were found to have impaired alertness when compared with a control group matched for age and occupation. On retesting the controls had improved alertness scores attributable to a practice effect; but the patients, when retested after reduction of haematocrit by venesection, had improved significantly more than the controls. Improvement in alertness correlated very well with the increase in cerebral blood flow which followed venesection. Levels of venous haematocrit that are generally accepted as normal may not necessarily be optimum.

Adult↗
PubMed1980

Thyroid, renal, and hepatic function tests following cholecystography with high-dose contrast agents.

Serum biochemical tests were observed for about three weeks following oral cholecystography with fractionated high doses (6 g) of iopanoic acid (Telepaque) or sodium ipodate (Biloptin) in 24 and 29 patients, respectively. Both agents produced similar effects. No significant changes were seen in renal or hepatic function except for a mild increase in bilirubin on day 22. Serum urate decreased 10% on day 4, but the change was not significant. On days 4 and 11, there were significant increases in thyroid-stimulating hormone, thyroxine and free thyroxine index, and a moderate fall in triiodothyronine. Reverse triiodothyronine increased sharply on day 4. The pattern of changes observed suggests that these contrasts interfere with the extrathyroidal deiodination of iodothyronines. The temporary rise in thyroxine and free thyroxine index exceeded reference ranges in about half of all subjects, but they remained clinically euthyroid. Thyroid function tests should be interpreted with caution within three weeks of cholecystography.

Adult↗