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Biomedical subjects

L Patterson

Publications and source records attributed to L Patterson.

45 records · Page 3Linked to original sources

Infantile hypertrophic pyloric stenosis after pertussis prophylaxis with erythromcyin: a case review and cohort study.

BACKGROUND: In February, 1999, a local US health department identified a cluster of pertussis cases among neonates born at a community hospital and recommended oral erythromycin for post-exposure prophylaxis for about 200 neonates born at that hospital between Feb 1 and Feb 24, 1999. We investigated a cluster of seven cases of infantile hypertrophic pyloric stenosis (IHPS) that occurred the following month among the neonates who had received erythromycin. METHODS: We obtained a masked, independent review of the IHPS ultrasonography diagnoses, calculated the monthly IHPS incidence, and compared index and historical (1998-99) IHPS cases with respect to several characteristics including erythromycin exposure. We used a retrospective cohort of infants born in January and February, 1999, to investigate further erythromycin exposure and development of IHPS. FINDINGS: An independent review confirmed the ultrasonographic diagnoses of all seven index IHPS cases. All index cases versus none of the historical IHPS cases had been given erythromycin for pertussis prophylaxis. The IHPS rate for infants born in the hospital in February, 1999, was 32.3 per 1000 liveborn infants, representing nearly a seven-fold increase over 1997-98 (relative risk 6.8 [95% CI 3.0-15.7]). Among infants born in January and February, 1999, erythromycin was associated with IHPS (absolute risk 4.5%, relative risk infinity [1.7-infinity]). INTERPRETATION: Neonates receiving oral erythromycin may have an increased risk of IHPS. The risks and benefits of erythromycin for neonatal pertussis prophylaxis should be re-evaluated, and caution should be used in defining risk groups for prophylaxis.

Administration, Oral↗

Bicaudate index on magnetic resonance imaging: effects of normal aging.

The bicaudate and bifrontal indices have been used in prior computed tomographic studies to investigate atrophy of the caudate nuclei in patients with Huntington's chorea and cerebral atrophy. However, the relationship between these indices and caudate volume has not been documented previously. In this study, we used high-field magnetic resonance imaging (MRI) to determine the effects of normal aging on the bicaudate and bifrontal indices and to study the relationship between these indices and caudate volume. The subjects were 49 normal volunteers, aged 22 to 82 years, who were without any significant neurologic or psychiatric disorders. Age was positively correlated with bicaudate index (r = .59; P < .0001) and bifrontal index (r = .40; P < .0047). Age was negatively correlated with caudate nuclei volume (r = -.47; P < .0005). Caudate volume was negatively correlated with bicaudate (r = -.27; P < .06) and bifrontal (r = -.31; P < .03) indices. These findings are consistent with prior reports of caudate nuclei degeneration with increasing age. Linear and volumetric caudate measurements with MRI may prove useful in the investigation of caudate nuclei function in the neuromotor decline with normal aging and in disorders such as Huntington's chorea.

Adult↗

Interuncal distance measurements in healthy volunteers and in patients with Alzheimer disease.

PURPOSE: To evaluate further the clinical utility of the interuncal distance (IUD) measured from axial MR scans as a reflection of hippocampal atrophy. METHODS: The IUD measured from the axial MR scans of 17 healthy control subjects was correlated with the volume of the amygdala hippocampal complex obtained from coronal MR images. The IUD was also measured on axial MR scans in 12 patients with possible or probable Alzheimer disease. RESULTS: The correlation between the total amygdala hippocampal volume and the IUD was insignificant for control subjects (r = -0.38, P = .13). When analysis of covariance was performed with the IUD as the dependent variable and age and diagnosis as the independent variables, overall R2 was 0.25. Age (F = 5.02, df = 1, P = .034), but not diagnosis (F = 0.02, df = 2, P = .88), had a significant effect. CONCLUSIONS: The IUD has no significant correlation with the amygdala hippocampal volume. The IUD appears to be a better measure of overall brain volume, which changes with age. In our patient population diagnosed with mild to moderate Alzheimer disease, the IUD measurement was not found to be useful in distinguishing their scans from those of the volunteers.

Adult↗

Interuncal distance as a measure of hippocampal atrophy: normative data on axial MR imaging.

PURPOSE: To assess the effects of age and gender on the interuncal distance measured from MR images. METHODS: High-field strength MR images (axial) of 75 volunteers, 21-82 years old and free of neurologic disorders, were used to measure the interuncal distance. RESULTS: The interuncal distance increased with age (r = 0.66, P < .0001). The mean (SD) interuncal distance for all subjects was 21.4 (4) mm with a range of 12 to 29 mm. CONCLUSIONS: The interuncal distance in healthy subjects is unlikely to exceed 30 mm. Our data may be of clinical significance in view of a previous report stating that the interuncal distance may be enlarged in pathologic hippocampal degeneration, such as in patients with Alzheimer disease.

Adult↗