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Biomedical subjects

J T Brown

Publications and source records attributed to J T Brown.

At least 73 records · Page 4Linked to original sources
PubMed1984

The anxiety disorders.

Anxiety commonly accompanies serious illness. However, in some patients anxiety is the primary manifestation of illness. Diagnostic criteria for these "primary" anxiety disorders have been redefined in the most recent revision of the American Psychiatric Association's Diagnostic and Statistical Manual. We discuss these new diagnostic categories; review the theoretical basis for the psychodynamic, behavioral, and physiologic manifestations of each of these disorders; and critically examine the treatments offered for each.

Anxiety Disorders↗
PubMed1984

Propranolol and depression: a reevaluation based on a pilot clinical trial.

A wide range of neuropsychiatric side effects are attributed to propranolol including visual hallucinations, somnulence, memory impairment, decrease in response time, dizziness, confusional states, insomnia, nightmares, fatigue, sedation and depression. Benson et al., in a summary review of several clinical studies of 5,846 patients being treated with a variety of beta adrenergic blocking agents, listed depression as a rare side effect of propranolol that was usually reported only after long term treatment at high doses. Despite the widely circulated attribution that depression is a side effect of propranolol, there is a paucity of evidence to directly link this drug with clinically significant mood disturbance. For example, the most widely quoted reference attributing propranolol as a depressogenic agent was a "letter to the editor" which was a retrospective, uncontrolled, unblinded study that did not use a standardized depression rating scale. Most of the evidence linking propranolol to depressive symptoms have derived from scattered case reports in which the onset of depressive symptoms were attributed to this agent. Given the well known cyclic onset and remissions of affective disorders, and the prevalence of depression in the general medical population as a whole, the role of propranolol in these cases is debatable.

Aged↗
PubMed1983

Normal and pathological grief.

Physicians are often called on to care for patients and members of patients' families during the period of bereavement. The grief process serves a psychologically adaptive function and usually progresses in a predictable manner. Under certain unusual circumstances, however, the grieving process may become pathologically delayed or distorted, with serious consequences for the survivor's emotional and physical health. There are three phases of the normal grief process and particular guidelines for physician recognition and management of pathological grief reactions.

Adaptation, Psychological↗
PubMed1983

Herpetic whitlow.

Explore the source record for details and available documents.

Acyclovir↗
PubMed1983

Fetal surgery for hydrocephalus: successful in utero ventriculoamniotic shunt for Dandy-Walker syndrome.

The diagnosis of fetal hydrocephalus based on dilation of the ventricular system presents a broad range of management decisions. The options are presented and a case of Dandy-Walker syndrome managed by fetal ventriculoamniotic shunt placement is presented as an example. Under ultrasonic guidance, a shunt was placed at 30 weeks' gestation by later newborn Dubowitz examination. Delivery was delayed for five weeks, one to two weeks following probable shunt malfunction, after achieving fetal lung maturation. Follow-up six months after definitive neonatal ventricular shunting and three weeks after shunt revision revealed a socially active male infant with a motor development index of 87 and a psychomotor development index of 95. Potential advantages of fetal surgery including achievement of term gestation are presented. Proposed guidelines for determining the benefit of such procedures are also presented.

Adult↗
PubMed1976

Subcapital fractures of the femur. A prospective review.

This abridged account of a report to the British Medical Research Council describes a long-term investigation of 1,503 subcapital fractures of the femur, almost all of which were treated by reduction and internal fixation. With three exceptions, union occurred in all Garden Stage I and Stage II fractures and in 67% of Stage III and Stage IV fractures, of which only 14-5% were united at six months. In women, late segmental collapse was seen after union had occurred in 16% of Stage I and in 27-6% of Stage III and Stage IV fractures. Delay of up to one week before operation had no significant effect on the incidence of non-union or of late segmental collapse. The incidence of union followed by late segmental collapse was higher in women with normal bone density than in those with osteoporosis. Smith-Petersen nailing was found to be the least effective form of fixation in displaced fractures. The age and physical state of the patient, the accuracy of reduction, and the security of fixation had the greatest influence on union.

Age Factors↗
PubMed1975

Necrotic stomatitis in a dolphin.

Necrotic stomatitis of undetermined etiology was found in an Atlantic bottlenosed dolphin, Tursiops truncatus. The case history, treatment and hematologic findings are described. The animal remained anorectic throughout the course of the illness, and was force fed on a daily basis for approximately 5 weeks.

Animals↗
PubMedDate not supplied

Screening mammography in the elderly: a case-control study.

This case-control study tested the hypothesis that elderly women with metastatic breast cancer were previously screened less than controls. Cases included women over 60 years old who had metastatic breast cancer; the tumor registry provided controls. Identical criteria yielded comparable groups (cases = 109, controls = 211) receiving primary care at this tertiary center. Radiology and medical records were examined for mammograms; these were blindly categorized "diagnostic," "screening," or "indeterminant." The major, unexpected finding was that less than 6% of controls had ever had screening mammography. The associations between screening and metastatic cancer (odds ratios) suggest a beneficial effect of screening: OR/0.73 for ever screened and OR/0.71 if screened within the year of cancer diagnosis. All confidence intervals include one; however, low screening participation leaves this study with little power. The major implication is that despite the current recommendations, the elderly are not being included in screening mammography programs.

Aged↗