Biomedical subjects

M Chown

Publications and source records attributed to M Chown.

11 recordsLinked to original sources

PubMed1994

Comparison of neurologic changes in 'successfully aging' persons vs the total aging population.

OBJECTIVE: To determine age-related changes in neurologic function in the general population. DESIGN: To administer a neurologic examination to participants in such a way that it is possible to calculate the proportion of elderly persons in the population with each abnormal finding and the proportion of persons with each finding but without evidence of the medical and neurologic diseases likely to produce neurologic abnormalities (eg, stroke and diabetes). SETTING: Individuals were selected from a community-dwelling population. PARTICIPANTS: A stratified random sample of 467 persons aged 65 years and older were evaluated. RESULTS: Many neurologic abnormalities are increasingly common with advancing age and are present in a substantial portion of the elderly population. The prevalence of abnormal neurologic findings not attributable to disease, however, is substantially lower, typically one half to one third the total prevalence. Moreover, the increase with age in the prevalence of abnormal neurologic findings not attributable to major disease varies substantially among the different measures. CONCLUSIONS: Primitive reflexes and measures of gait show statistically significant increases with age in multiple measurement domains, suggesting a selective age-related vulnerability.

Aged↗

PubMed1993

A dose-ranging study of daily maintenance intravenous foscarnet therapy for cytomegalovirus retinitis in AIDS.

Thirty-two patients with AIDS and previously untreated cytomegalovirus retinitis completed an induction course of foscarnet, 60 mg/kg every 8 h for 14 days, had retinitis stabilize, and were then randomly assigned to receive foscarnet maintenance as either a 90- or 120-mg/kg/day infusion administered over 2 h. Median survival was 157 and 336 days for the 90- and 120-mg/kg/day groups, respectively (P < .001). In an independent, masked analysis of retinal photographs, median time to progression of retinitis was 31 versus 95 days (P = .13). Daily intravenous foscarnet at a dose of 120 mg/kg (adjusted for renal function) resulted in significantly longer survival and tended to increase time to retinitis progression compared to the standard 90-mg/kg/day maintenance dose. Although a substantial increase in the risk of serious toxicity at the 120-mg/kg/day dose was not observed, the small sample size in this trial limited the power to detect differences that might be clinically important.

AIDS-Related Opportunistic Infections↗

PubMed1992

Laparoscopic cholecystectomy in the rural setting.

Laparoscopic cholecystectomy was introduced into the United States in the last 2 years following a lengthy evolutionary process of laparoscopic techniques abroad. Work done in major centers in Nashville, Los Angeles, Salt Lake City, and Chicago has quickly extended to other areas of the country. This report attempts to evaluate the applicability of laparoscopic cholecystectomy to rural portions of the United States by analyzing the early experience of laparoscopic cholecystectomy by two rural surgeons. Seventy-three patients with cholecystitis were treated consecutively. Three of these were relatively emergent cases. In 69 patients, the Veress needle insufflation technique was used, and in 4 patients the Hasson open laparoscopic technique was used. Electrocautery dissection was employed in 55 of these patients, and in 15 patients the KTP-532 laser, set at 20 W, was used. Three patients required open surgery due to adhesions or inadequate scope visualization. Twenty-five patients underwent intraoperative cholangiography. Between 1 and 2 weeks postoperatively, 2 of the 73 patients developed retrograde bile leak and peritoneal bile soilage, leading to open common bile duct exploration. Three patients were discharged from the hospital in less than 24 h, 56 within 36 h, 9 within 48 h, and 2 patients went home after more than 48 h in the hospital. The 3 patients who had converted to open cholecystectomy required the usual hospitalization for that procedure. Over half the patients returned to full activity in less than 2 weeks. The surgeons noticed a gradual decrease in operative time as their experience increased. The rural experience of these two surgeons was consistent with statistics identified within the university setting.

Adult↗

PubMed1983

Aprindine therapy for refractory ventricular tachycardia.

Aprindine hydrochloride has been extensively used in Europe for the management of ventricular and supraventricular arrhythmias. Success has been achieved even in those cases that have proven refractory to standard antiarrhythmic agents. In this report, we describe our experience with aprindine therapy in seven patients with ventricular tachycardia in whom standard antiarrhythmic agents had proven either ineffective or had caused intolerable side effects. Aprindine was effective in five cases, and it failed in two. Neurologic side effects, although common, were easily controlled with adjustment of the dose. Agranulocytosis, a rare but serious side effect, was encountered in one of our patients. Relevant literature on aprindine is reviewed.

Agranulocytosis↗

PubMedDate not supplied