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Biomedical subjects

L W Brown

Publications and source records attributed to L W Brown.

At least 19 recordsLinked to original sources
PubMed1998

Periodic limb movement in sleep in children with Williams syndrome.

OBJECTIVE: Williams syndrome (WS) is associated with neurobehavioral abnormalities that include irritability and attention-deficit/hyperactivity disorder. Parents often report children having difficulties initiating and maintaining sleep because of restlessness and arousals. Therefore we evaluated a group of children with WS for the presence of a movement arousal sleep disorder. METHODS: Twenty-eight families of children with WS participated in a telephone survey aimed to screen for a movement arousal disorder. Of the 16 children identified as having such a disorder, 7 (mean age, 3.9 +/- 2.2 years) underwent polysomnography. Their studies were compared with those of 10 matched control subjects (mean age, 5.3 +/- 2.0 years). RESULTS: The 7 subjects with WS who were screened by the survey had sleep latency, total sleep time, arousals, and awakenings that were similar to those of control subjects. However, they presented with a disorder of periodic limb movement in sleep (PLMS). The PLMS index in the subjects with WS was 14.9 +/- 6.2 versus 2.8 +/- 1.9 in control subjects (P < .0001). In addition, arousal and awakening in subjects with WS were strongly associated with PLMS. Moreover, children with WS spend more time awake during sleep periods than control subjects (10.0% +/- 7.0% vs 4.4% +/- 4.7%; P < .05). Five children were treated with clonazepam, and in 4 a significant clinical response was noted. CONCLUSION: We report an association between WS and PLMS. Clonazepam may reduce the clinical symptoms of PLMS in some of these children.

Anticonvulsants↗
PubMed1994

Simultaneous quantification of ephedrines in urine by high-performance liquid chromatography.

A high-performance liquid chromatographic method for the simultaneous determination of ephedrine, pseudoephedrine, phenylpropanolamine, norpseudoephedrine and methylephedrine in urine is described. Samples were extracted at basic pH into diethyl ether and then back extracted into a small volume of acetic acid. These extracts were chromatographed on a Phase Sep Spherisorb ODS 1 column with tetraethylammoniumphosphate-methanol mobile phase and the analytes were detected by UV absorbance at 214nm. Calibration curves were linear over the range 0.5-100 microgram/ml for each analyte. The selectivity of the method was demonstrated for several drugs found with the ephedrines in pharmaceutical formulations. This method has an excellent accuracy, precision and recovery for all the ephedrine at the cut-off concentrations as set by the IOC for a positive doping case and can thus be used to quantify these ephedrines when present in the urine obtained from sportspersons.

Chromatography, High Pressure Liquid↗
PubMed1994

Culturally sensitive breast cancer screening programs for older black women.

Breast cancer is the leading cause of cancer mortality among black women. Elderly black women are particularly vulnerable and suffer the "double jeopardy" effect of older age and minority status. Older black women are not benefiting from the early detection provided through breast cancer screening. Factors that prevent this population from using breast cancer screening include cost, accessibility, availability, lack of knowledge, health care provider variables, and lack of community involvement. Breast cancer screening programs are needed that address cultural diversity to screen women who presently are not seen according to established guidelines. This article focuses on the need for primary care providers to offer culturally sensitive breast cancer screening programs designed for the older black woman. A model is presented based on Leininger's Culture Care Theory and the Health Belief Model. Specific strategies to increase the older black woman's participation in breast cancer screening practices are described.

Black or African American↗
PubMed1994

Bacterial meningitis: fluid balance and therapy.

Fluid administration in children with meningitis should be conservative in an attempt to minimize cerebral edema and electrolyte disturbances that frequently complicate the course of meningitis. Since these complications have been shown to correlate with poor neurologic outcome, it is believed that appropriate fluid management will minimize the morbidity and mortality associated with bacterial meningitis in children.

Animals↗
PubMed1994

Pediatricians and sleep disorders: training and practice.

OBJECTIVE: A series of studies were conducted to investigate pediatricians' training, knowledge, and practices regarding sleep and sleep disorders in children and adolescents. METHOD AND RESULTS: Study 1, a national survey of 156 pediatric residency programs, found that pediatricians receive a mean of 4.8 hours of instruction on sleep and sleep disorders, although the mode and median hours of instruction is 0 hours. In study 2, 88 pediatricians completing a questionnaire concerning general knowledge about sleep disorders in children and adolescents received a mean score of 71.8% (range, 40% to 93%). Pediatricians appear to know the most about developmental issues and sleep hygiene and the least about specific disorders such as narcolepsy and parasomnias. In the third study, 183 pediatricians were surveyed about their actual beliefs and practices regarding young children's sleep problems. Together, those surveyed reported that approximately 25% of their patients experience some type of sleep problem. Most pediatricians recommend behavioral interventions, although 14.8% of pediatricians report prescribing pharmacological treatments, and 48.9% inform parents that their child is likely to outgrow the problem. CONCLUSIONS: The results of these studies support the need for more education in sleep and sleep disorders in children and adolescents within medical schools, pediatric residency programs, and the practicing pediatric community.

Adolescent↗
PubMed1992

Automated high-performance liquid chromatographic method for the determination of mianserin in plasma using electrochemical detection.

An automated high-performance liquid chromatographic method for the determination of mianserin in plasma is described. Extraction and injection of the samples were automatically done by the Gilson ASPEC system using C8, 100-mg Supelclean solid-phase extraction columns. The extracts were chromatographed on a reversed-phase C18 column (150 mm x 3.9 mm I.D.) with a phosphate buffer-acetonitrile-methanol mobile phase and the analytes detected electrochemically. Calibration curves were linear to at least 53.7 ng/ml at which the between-day relative standard deviation was 5% and the recovery 101%. The limit of quantification was 1.67 ng/ml at which the between-day relative standard deviation was 9% and the recovery 92% using a sample volume of 0.5 ml. The method was applied to the determination of mianserin in the plasma of normal human volunteers participating in a comparative bioavailability study.

Biological Availability↗
PubMed1985

Clinical, laboratory, and environmental features of infant botulism in Southeastern Pennsylvania.

Forty-four cases of botulism occurred in infants in Southeastern Pennsylvania between 1976 and 1983. Forty-three were caused by Clostridium botulinum type B. Progressive weakness necessitated ventilatory support in 39 infants. Complications during hospitalization included otitis media in 13 patients and aspiration pneumonia in 11. Eight infants developed the syndrome of inappropriate secretion of antidiuretic hormone and two developed adult respiratory distress syndrome. One infant died of progressive bradycardia despite adequate control of ventilation. Manifestations of autonomic nervous system dysfunction recognized on admission to the hospital were constipation, distention of the urinary bladder, and decreased salivation and tearing. During hospitalization, some infants had unexpected fluctuations of skin color, blood pressure, and heart rate. Infants' strength improved despite persistent intestinal elaboration of toxin. C botulinum was isolated from seven of nine home or work environments sampled. All 44 infants were white and were receiving breast milk at the time of onset of symptoms. The majority had first feedings of nonhuman food substances within 4 weeks prior to onset of symptoms. Delineation of fecal flora in seven infants revealed predominance of enterobacteriaceae. Perturbations of intestinal flora during infancy, especially at weaning, may cause transient permissiveness to colonization by C botulinum.

Botulinum Toxins↗
PubMed1984

Case 4. The first fatal Baylisascaris infection in humans: an infant with eosinophilic meningoencephalitis.

Baylisascaris procyonis, the ascarid of raccoons, causes a characteristic, rapidly fatal eosinophilic meningoencephalitis with ocular involvement in many naturally and experimentally infected aberrant hosts, including monkeys. Warnings that humans are potentially susceptible to the devastating infection have been issued, but an instance in humans has not been recognized. This report describes a boy who died from an eosinophilic meningoencephalitis, which mimicked B. procyonis infection in monkeys. The causative agent was not identified during life. Autopsy showed a systemic larval ascarid infection with massive involvement of the brain. The size and anatomy of the larvae in histologic sections were identical to those recorded for B. procyonis. The larvae were indistinguishable from the B. procyonis larvae observed in histologic sections of experimentally infected monkeys. An indirect immunofluorescence test was positive for B. procyonis. Exposure to raccoon feces was highly likely. The evidence suggests that this is the first recognized B. procyonis infection in humans. Prudent avoidance of exposure to raccoon feces is indicated.

Animals↗
PubMed1984

Infant botulism.

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Botulism↗
PubMed1982

The hemostatic system in children undergoing intensive plasma exchange.

We report the effects on the hemostatic system of intensive plasma exchange therapy using replacement fluids devoid of plasma coagulation proteins. Five children were studied during ten exchanges. There were no hemorrhagic episodes clearly attributable to the plasma exchange, but one patient developed recurrent thrombosis of the vascular access used for the procedure. Plasma values of the various coagulation factors (II to XII) were decreased by 35 to 67% immediately following the plasmapheresis. The mean decrease in levels of antithrombin III antigen and activity and of plasminogen were 58, 60, and 66%, respectively. The recurrent thrombosis of the vascular access in one of the patients, and the decrease in antithrombin III and plasminogen values in plasma following plasmapheresis in all patients, suggest that there is increased potential for thrombosis in patients undergoing intensive plasmapheresis, despite the depletion of coagulation factors. At 24 hours following plasmapheresis the values for all factors were within normal limits, attesting to the ability of the synthetic mechanisms in children to replenish hemostatic factors rapidly.

Adolescent↗
PubMed1981

Infant botulism.

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Action Potentials↗
PubMed1980

Trends in assertion training research and practice: a content analysis of the published literature.

Investigated historical trends in the assertion training literature by content analyzing 344 documents published between January 1942 and December 1977. Documents were collected through standard literature and search procedures and were content-coded according to their primary methods (e.g., case study, experimental research) and major foci (e.g., assessment, treatment). The results of four separate descriptive analyses performed on the coded reports revealed that although the assertion training literature has shown a very rapid acceleration of growth over the past five years, empirical documentation of the effects of a few important parameters of training and treatment is lacking. Future research needs that clearly emerged from the analyses were discussed.

Assertiveness↗