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Biomedical subjects

L Turner

Publications and source records attributed to L Turner.

At least 145 records · Page 8Linked to original sources
PubMed1988

Injection therapy for impotence.

Injection of vasoactive drugs is an effective form of treatment for selected patients with impotence from virtually all causes. The two most commonly employed drugs in the United States are either papaverine alone or various combinations of papaverine and phentolamine. Patients with organic and mixed impotence are best suited for injection treatment, but selected patients with psychogenic impotence also benefit from therapy. After the patient is selected for injection therapy, he undergoes a series of trial injections in the physician's office. The incidence of priapism will be minimized if the initially administered doses are low and the patient is titrated to an appropriate dose level. Uncontrolled trials have revealed that injection treatment produces a satisfactory erection in 65 to 100 per cent of patients for a follow-up period of as long as 2 years with minimal side effects, but the dropout rate is high. If priapism does occur, it almost always responds readily to treatment with aspiration, low doses of an alpha-adrenergic agent, or both. The other common side effects are bruising or ecchymosis and nodule formation at the injection site. This latter complication has not been noted to cause significant abnormal penile curavature necessitating cessation of the program.

Clinical Trials as Topic↗
PubMed1986

The physician's actions and the outcome of illness in family practice.

The outcome of new episodes of common nonrespiratory tract symptoms was studied in 193 patients attending family physicians. After controlling for demographic, psychological, and social variables, the only element of the process of care that was related to resolution of the patient's symptom at one month was physician-patient agreement about the nature of the problem. Patients with unresolved symptoms were followed for an additional two months. Late resolution was associated with the physician's recording of attention to psychosocial problems. These results have implications both for the provision and audit of primary care.

Adolescent↗
PubMed1985

The prevalence of antibodies to Rickettsia rickettsii in an area endemic for Rocky Mountain spotted fever.

A study of Rickettsia rickettsii was conducted in Rowan, Cabarrus, and Granville counties, North Carolina in an attempt to define the prevalence of endemic infection in this area. Serum samples were obtained from 1,976 healthy persons and tested by indirect hemagglutination for detectable antibodies to R. rickettsii. Of this group, 568 (28.7%) had detectable antibody (greater than or equal to 1:8), 80 (4%) had titers greater than or equal to 1:64, and 1,408 (70%) had no detectable antibody (less than or equal 1:8). Indirect immunofluorescence testing for antibody was also performed for 315 (15%) of the serum samples, of which 301 (95%) had undetectable titers and 14 (5%) had detectable titers ranging from 1:8 to greater than or equal to 1:64. Serological reactivity by indirect hemagglutination was detected in persons in the absence of known Rocky Mountain spotted fever. The study failed to show a good correlation of either the height of the geometric mean titer or percentage of seropositive persons with the previously determined age-related rates of acquisition of the disease. These data suggest that the antibodies measured may not be specific for R. rickettsii or that the antibody levels wane with time or both. It is probable that unrecognized infection occurs, but the true incidence or prevalence cannot be determined by available serological tests.

Adolescent↗
PubMed1985

Cassava is not a goitrogen in mice.

To examine the effect of cassava on the thyroid function of mice, we fed fresh cassava root to mice and compared this diet with low iodine diet and Purina. Cassava provided a low iodine intake and increased urine thiocyanate excretion and serum thiocyanate levels. Mice on cassava lost weight. The thyroid glands of mice on cassava were not enlarged, even when normalized for body weight. The 4- and 24-hr thyroid uptakes of mice on cassava were similar to those of mice on low iodine diets. Protein-bound [125I]iodine at 24 hr was high in mice on either the cassava or low iodine diets. The thyroid iodide trap (T/M) was similar in mice on cassava and low iodine diets. When thiocyanate was added in vitro to the incubation medium, T/M was reduced in all groups of mice; under these conditions, thiocyanate caused a dose-related inhibition of T/M. The serum thyroxine (T4) and triiodothyronine (T3) concentrations of mice on cassava were reduced compared with mice on Purina diet. Thyroid T4 and T3 contents of mice on cassava were relatively low compared with mice on Purina diet. Hepatic T3 content and T4 5'-monodeiodination in liver homogenates were reduced in mice on cassava compared with other groups. The data show that cassava does not cause goiter in mice. The thiocyanate formed from ingestation of cassava is insufficient to inhibit thyroid iodide transport or organification of iodide. The cassava diet leads to rapid turnover of hormonal iodine because it is a low iodine diet. It also impairs 5'-monodeiodination of T4 which may be related to nutritional deficiency. These data in mice do not support the concept that cassava per se has goitrogenic action in man.

Animals↗
PubMed1984

Attrition in maintenance therapy for recurrent depression. A preliminary report.

All maintenance treatment programs are complicated by the issue of patient noncompliance. This report investigates factors contributing to noncompliance during a 2-year study designed to evaluate the efficacy of long-term antidepressant medication in patients with recurrent unipolar depression. Only 21 of 51 patients (49%) who entered maintenance treatment successfully completed this phase of the study. Fifteen patients (8 completers and 7 dropouts) were randomly selected for an interview which focused on their previous psychiatric treatment history and attitudes towards the maintenance treatment program. In addition, these patients also completed a comprehensive personality battery. Results indicate that, while both groups had similar attitudes about the treatment program, they differed significantly along personality and psychiatric treatment history variables. Dropouts scored higher than completers on a measure of hysterical personality style. They were also more likely to have received psychotherapy in previous treatment experiences and to rate it as beneficial, while completers consistently rated prior treatment, which did not include antidepressant medication, as being of no benefit whatsoever. In order to enhance patient compliance, it is important to obtain information early in treatment about patients' treatment histories and their expectations about effective treatment for depression.

Adult↗
PubMed1984

Epidemiology of Rocky Mountain spotted fever as determined by active surveillance.

Prospective, active surveillance for Rocky Mountain Spotted fever (RMSF) was undertaken in two North Carolina counties for the years 1979-1981. Appropriate age, sex, and geographically matched controls were compared with the serologically confirmed cases of disease. Patients who were suspected of having infection, but were shown not to have RMSF, were also compared with the serologically proven cases. Ninety-eight cases were identified, and three of these patients died. The mean annual incidence of RMSF in these two counties was 14.59 cases/100,000 population. Identified cases occurred between the months of March and September. The overall mean annual incidence for men was 19.65/100,000 and for women 10.3/100,000. The study suggests that persons contracting RMSF are exposed to the vectors at their residences, which tend to be detached dwellings in woody, brushy areas. Children are more likely than adults both to be seen by physicians early in the illness and to be checked for ticks. Eighty-four percent of patients with serologically confirmed cases developed a rash. The epidemiology of RMSF in these two endemic counties is described.

Adolescent↗
PubMed1984

Gastric sarcoidosis.

Two cases of gastric sarcoidosis are reported. Both patients presented with a history suggestive of peptic ulceration and the diagnosis of sarcoidosis was made after operation.

Adolescent↗
PubMed1983

Detection of Rickettsia rickettsii antibodies in human sera by crossed immunoelectrophoresis.

To identify Rickettsia rickettsii antigens of immunological importance, we examined sera from patients with serologically confirmed cases of Rocky Mountain spotted fever by crossed immunoelectrophoresis for antibodies to antigens extracted from the R strain of R. rickettsii with the detergent Triton X-100. Sixteen antigens were identified in the detergent extract by crossed immunoelectrophoresis with a hyperimmune rabbit serum raised against whole rickettsiae. When the rabbit antiserum was placed in the reference gel and patient sera were placed in the intermediate gel, antibodies to one or more antigens were detected in 61 of 71 North Carolina sera, all of 7 Oklahoma sera, and 9 of 10 Montana sera obtained from 1 day to 40 years after onset of Rocky Mountain spotted fever. Antibodies to antigens 1 and 16 were found as early as 1 day after onset of illness, and antibody to 16 was found in 20 of 29 sera obtained within the first 7 days of illness. Antibodies to antigens 2 and 3 generally did not appear until the third week of illness but were found in six of seven serum samples collected 4 to 40 years after onset of Rocky Mountain spotted fever. Antibodies to R. rickettsii antigens 1, 7, 8, and 16 were found in sera from patients with illnesses caused by other etiological agents. Four of the Oklahoma and Montana sera from Rocky Mountain spotted fever patients, but none of the North Carolina sera, had antibodies to antigen 12. Sera containing antibodies against antigens 3 and 14 prevented death of mice challenged with two 50% lethal doses of R. rickettsii.

Animals↗
PubMed1981

Complications of anterior resection of the rectum using the EEA stapling device.

Fifty patients had anterior resection of the rectum performed with end-to-end anastomosis using the EEA stapling device. The instrument certainly facilitated low anastomoses, but anastomotic dehiscence occurred in 3 cases, stenosis in 2, wound sepsis in 10, some degree os incontinence (usually only temporary) in 7 and anal fissure in 4 cases.

Adult↗
PubMed1981

Acute pancreatitis associated with campylobacter infection.

We report a case of acute pancreatitis associated with campylobacter infection. The patient presented with clinical symptoms and signs which suggested acute appendicitis. However, she was found to have acute pancreatitis with an acute campylobacter infection. Recent reports have shown that campylobacter is pathogenic in the biliary tract, and we suggest that it may also be responsible for some cases of acute pancreatitis in the absence of biliary disease.

Acute Disease↗
PubMed1981

Radical versus modified radical mastectomy for breast cancer.

A prospective randomised trial (534 patients, 1969-75) was designed to determine whether radical mastectomy conferred advantages over modified radical mastectomy for breast cancer in terms of total survival, local recurrence, distant metastasis, and disease-free interval. The results showed no significant difference in outcome as regards these variables between the two treatments.

Breast Neoplasms↗