Search PubMed⌕ Search

Biomedical subjects

M A Roberts

Publications and source records attributed to M A Roberts.

At least 91 records · Page 5Linked to original sources
PubMed1982

Epileptic seizures in the elderly: II. Diagnostic problems.

Three principal diagnostic problems were encountered in a group of 81 elderly patients with epileptic seizures: Post-ictal paresis (Todd's palsy) occurred in 13 patients (16%), of whom seven had evidence of past or present cerebral infarction, and six no such evidence. The paresis lasted up to 4 days, and could be confused with recurrent infarction or a transient ischaemic episode. Ictal and post-ictal confusional states of 24 h or more duration (up to 7-8 days) were noted in 11 patients (14%). They occurred in association with normal intellectual function as well as with pre-existing dementia, and required to be distinguished from other causes of delirium. Two patients presented paroxysmal sensory phenomena of ictal type. The differential diagnosis of episodic pain in hemiplegic limbs is discussed.

Aged↗
PubMed1982

Lead absorption in children of employees in a lead-related industry.

Children can be exposed to lead from a variety of environmental sources. It has been repeatedly reported that children of employees in a lead-related industry are at increased risk of lead absorption because of the high levels of lead found in the household dust of these workers. A case-control study was done in Oklahoma in 1978 to determine whether children of employees in battery manufacturing plant had a higher prevalence of high levels of blood lead than children whose parents were not employed in a lead-related industry. The data obtained indicated that the blood lead levels of the study children were significantly greater than those of the control children. None of the control children had blood lead levels greater than 30 micrograms/dl, while 53% of the exposed children had blood lead levels of greater than 30 micrograms/dl. Trends indicated that the children whose fathers had higher lead exposure at work also had higher blood lead levels. However, the study children whose fathers had good personal hygiene had blood lead levels comparable to the control children. It appeared that only good personal hygiene, i.e., showering, shampooing and changing clothes and shoes before leaving work, was effective for lead containment. The mere changing of clothes and shoes appeared to be inadequate for lead containment.

Child, Preschool↗
PubMed1981

A multitrait-multimethod analysis of variance of teachers' ratings of aggression, hyperactivity, and inattention.

The convergent and discriminant validities of three teacher rating scale measures of the traits of hyperactivity, aggression, and inattention were explored, using the multitrait-multimethod matrix approach of Campbell and Fiske (1959), as well as an analysis of variance procedure (Stanley, 1961). In the present study teachers rated children from their elementary school classrooms on the above traits. The results provided strong evidence for convergent validity. Data also indicated that these traits can be reliable differentiated by teachers, suggesting that research aimed at better understanding the unique contributions of hyperactivity, aggression, and inattention is warranted. The respective benefits of analyzing multitrait-multimethod matrices by employing the ANOVA procedure or by using the Campbell and Fiske (1959) criteria were discussed.

Aggression↗
PubMed1980

Relative resistance to penicillin in the pneumococcus. A prevalence and case-control study.

Isolates of Streptococcus pneumoniae from 103 patients were submitted for serotyping and determination of the minimum inhibitory concentration (MIC) for penicillin. Isolates from 16 patients were relatively resistant to penicillin (MIC, 0.1 to 0.5 micrograms/mL). In a study to determine if the patients with relatively resistant pneumococci (RRP) differed from patients with normally susceptible pneumococci, 18 patients with RRP showed no significant difference from their matched controls in antibiotic use during the two months prior to isolation of the pneumococcus. Other variables that showed no significant difference between the two groups were (1) antibiotic use in household contacts in the previous six months, (2) presence of chronic infection in the case or control patients, and (3) recurrence of pneumococcal infection following therapy. The high rate of relative resistance to penicillin is heretofore unknown in a general, unconfined population in this country. The case-control study suggests that no strong relationship exists between isolating RRP and prior penicillin administration. More extensive surveys in the United States are needed.

Adolescent↗
PubMed1978

Endogenous prostaglandin synthesis inhibitor in the renal cortex. Effects on production of prostacyclin by renal blood vessels.

1. The capacity of various tissues of the porcine kidney to convert [1-14C]arachidonic acid into radiolabelled prostaglandins was studied. 2. Only after removal from the cortical matrix, were renal blood vessels able to convert arachidonic acid into prostaglandins (primarily prostacyclin). In contrast, convoluted tubules showed a low capacity to metabolize arachidonic acid. 3. The failure to demonstrate prostaglandin synthesis by renal cortical slices is related to the presence of an inhibitor of cyclo-oxygenase. Thus the addition of renal cortical incubate to isolated vascular tissues and ram seminal vesicles inhibited their ability to synthesize prostaglandins. 4. Slices of renal medulla metabolized arachidonic acid primarily to prostaglandin F2alpha; lesser amounts of prostaglandin E2 and prostacyclin were generated. 5. The large capacity of the renal vasculature to generate prostacyclin is consistent with an important role for this prostaglandin in regulation of renin release and renal haemodynamics.

Animals↗
PubMed1978

Electroencephalography and computerised tomography in vascular and non-vascular dementia in old age.

Nine normal elderly subjects and 81 patients with dementia have been studied by computerised tomography (CT) and electroencephalography (EEG). There was a broad relationship between slowing of the basic frequency of the EEG and the severity of mental impairment. Localised slow-wave activity was found in 19% of those with non-vascular dementia and 72% of those with dementia of vascular origin. The mean size of the ventricles, as determined from CT scans, was larger in the vascular than in the non-vascular group. Within the vascular group it was larger in those without than in those with visible infarcts. There was no relationship in either group between ventricular size and dominant EEG frequency.

Aged↗
PubMed1976

Steady-state kinetics of digoxin in the elderly.

Renal clearance of digoxin and creatinine was determined simultaneously on 30 occasions in 28 elderly in-patients on maintenance digoxin therapy. The mean ratio of digoxin to creatinine clearance was 1.04 (+/- S.E.M. 0.08). Multiple 24-hour urinary excretions of digoxin were measured in 10 patients on digoxin on a dose of 0.25 mg/day, four on 0.125 mg/day, and six on 0.0625 mg/day. Mean urinary excretion was 42% of dose per day. Calculated "net biliary clearance" averaged 18 ml/min. Knowledge of the magnitude of renal and net biliary clearance, together with assumed values for fractional absorption allows a relationship between serum digoxin levels and creatinine clearance to be calculated for each dose level. There was reasonable agreement between observed and expected serum digoxin levels in 41 elderly patients in whom creatinine clearance was measured, and in 106 in whom glomerular filtration rate was estimated from serum urea and creatinine concentrations. Quantitation of the kinetics of digoxin in the elderly can make maintenance therapy more rational and therefore safer and more effectove.

Age Factors↗
PubMed1976

Computerised tomography and intellectual impairment in the elderly.

Sixty-six elderly subjects (mean age 77 years) whose mental state was assessed clinically and by simple psychometric tests have been studied by computerised tomography. The mean maximum ventricular area in the 17 mentally normal subjects was above the upper limit of normal for younger subjects, and there was a broad relationship between increasing ventricular dilatation and increasing intellectual impairment. No such clear relationship was demonstrable for measures of cortical atrophy.

Aged↗
PubMed1976

Computerized tomography in the diagnosis of cerebral atrophy.

Computerized tomograms were studied of 67 adults whose lumbar pneumoencephalograms were normal or showed ventricular dilatation with or without widening of the sulci. The maximum ventricular area, measured from 80 x 80 matrix printouts, correlates well with measures of ventricular size on the pneumoencephalogram. An area of 10 cm2 is suggested as the upper limit of normal. The correlation between measures of sulcal width on computerized tomography and pneumoencephalography is less precise, but normal sulci and gross degrees of cortical atrophy can be identified.

Adolescent↗
PubMed1975

Skinfold thickness on the dorsum of the hand in the elderly.

The skinfold thickness on the dorsum of the right hand over the second metacarpal was measured with Harpenden calipers in 276 women and 152 men aged 65 and over living at home. Mean values were higher in men than women and declined with age in both sexes. Skinfold thickness was related to body size, as estimated from lean body mass, but was unrelated to the presence of osteoporosis as assessed from bone mass of the second metacarpal or the presence of vertebral fractures. The skinfold thickness was low in those subjects who had senile purpura and also in a small group of subjects on long-term steroid therapy.

Aged↗
PubMedDate not supplied

A developmental study of the Tinker Toy test: normative and clinical observations.

Tinker Toy test performance is presented for a normative group of 5- to 12-year-old children. Contrary to reported findings for some executive function tasks, developmental trends in Tinker Toy Test performance were not found. Results from a large group (N=55) of children who had sustained traumatic brain injury demonstrated that Tinker Toy Test performance was sensitive to the effects of traumatic brain injury and significantly associated with separate clinical ratings of functional or executive impairment. Present findings support the utility of the Tinker Toy Test as one component of the pediatric neuropsychological evaluation following traumatic brain injury.

Journal Article↗
PubMedDate not supplied

Protein energy supplements in unwell elderly patients--a randomized controlled trial.

BACKGROUND: To determine whether oral protein energy supplements, prescribed during hospitalization to elderly medical admissions, affect nutritional status and if baseline nutritional state influences this status. We also considered the effects on mortality, length of hospital stay, functional recovery, and institutionalization. METHODS: A prospective randomized controlled trial with no placebo. Consenting patients were stratified in 3 nutritional categories, and patients from each stratum were randomized into treatment or control. Observers were blinded to randomization. The participants were emergency admissions from home to a Medicine for the Elderly Unit in a Scottish hospital. The inclusion criteria were as follows: no known malignancy, the ability to swallow, and nonobesity (BMI < 75th percentile). The intervention was a prescription of 120 mL sip feed, 3 times daily (540 kcal, 22.5 g protein per day) throughout hospitalization, using the medicine prescription chart. The trial was powered to detect change in mean percentage weight. The following outcomes were also considered: anthropometry; mortality, length of hospital stay, functional recovery, and rates of institutionalization. RESULTS: Included in the trial were 381 patients. Nutritional supplementation was associated with significantly better energy intake (p = .001) and weight gain (p = .003) pooled across all nutritional categories. In the most poorly nourished patients, the intervention was associated with reduced mortality (5/34 versus 14/40, p < .05) and more patients improved functionally (17/25 versus 11/28, p < .04). Overall mortality results were 21/186 versus 33/195, odds ratio (OR) 0.62, 95% confidence interval (CI) 0.35, 1.13. CONCLUSIONS: Prescribing sip feed supplements in the medicine prescription chart during hospital stay reduces weight loss. Our data also support other evidence for a reduction in mortality noted in elderly patients on nutritional supplementation. There were suggestions of other clinical benefits.

Aged↗
PubMedDate not supplied

Multiple partial seizure-like symptoms following 'minor' closed head injury.

This report is a phenomenological study of 17 patients who developed multiple, partial seizure-like symptoms after sustaining relatively 'minor' closed head trauma. Unlike patients with classic complex partial seizure disorders, the symptoms of these head-injured patients did not tend to occur in stereotyped sequences. In contrast to meagre findings from neuroimaging and EEG evaluations, neuropsychological assessment of these patients often revealed evidence of static and episodic cognitive impairment. The majority of patients in this case series derived significant benefit from treatment with anticonvulsant medication; however, full return to premorbid levels of social and vocational competence was not typically observed. Recent findings from animal research on 'partial kindling' phenomena provide a hypothetical model for understanding how subclinical electrophysiological dysfunction may produce partial seizure-like symptoms and associated neurobehavioural dysfunction as longer-term sequelae of traumatic brain injury.

Adolescent↗
PubMedDate not supplied

A report of fluorosis in the United States secondary to drinking well water.

A 54-year-old female resident of Wellston, Okla, was found to have osteosclerosis on a routine chest roentgenogram. Subsequent investigation disclosed the cause of her osteosclerosis to be fluorosis secondary to the ingestion of well water containing 429 mumol/L of fluoride (recommended levels, 11 to 58 mumol/L). Water samples were also obtained from the 12 wells on properties adjacent to the index case. In three other wells, all at similar depths as the well of the index case, the fluoride concentration of the water was greater than 212 mumol/L. Urine samples from members of the four households who obtain their drinking water from these wells contained elevated urinary fluoride levels. Thus, fluorosis may develop in certain areas of the United States as a result of the natural occurrence of fluoride in the groundwater. Consequently, in known endemic areas, it would appear reasonable to measure the fluoride concentration of the well water at the time of drilling.

Female↗