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Biomedical subjects

M Freedman

Publications and source records attributed to M Freedman.

158 records · Page 9Linked to original sources
PubMed1976

Delayed lumen obstruction in endotracheal tubes.

Delayed onset of obstruction in the Oxford endotracheal tube during anaesthesia is described in five patients. The effects of intra-cuff voluem and pressure on the wall of the tube were investigated and discussed with special refernce to the ffects of body heat and repeated use on the consistency of the tube. It is concluded that inward collapse of the tube wall is caused by a combination of factors, namely: frequent use, softening of the tube wall by body heat, the gradual increasing of intra-cuff volume and pressure by diffusion of nitrous oxide into the cuff, replacing a damaged cuff by a new one and heat sterilization. Deflation and re-inflation of the cuff to minimal occlusive volume at hourly intervals is suggested as a precautionary measure in the prevention of inward collapse of the tube wall.

Airway Obstruction↗
PubMed1973

Monoribosomal attachment to messenger ribonucleic acid in sodium fluoride-treated rabbit reticulocytes.

Mild proteolysis with Pronase selectively dissociates ribosomes not attached to mRNA into subunits; ribosomes attached to mRNA remain intact. A portion of monoribosomes from reticulocytes incubated with NaF resisted proteolytic dissociation. Recovery of mRNA from monoribosomes of NaF-treated reticulocytes therefore may be explained by persistent attachment of some monoribosomes to mRNA.

Animals↗
PubMedDate not supplied

PACS clinical experience at Georgetown University.

Georgetown University Hospital has been operating an image management and communications system (IMACS or PACS) for three-and-a-half years. This work was initially funded under the Army Medical Research and Development Command Digital Imaging Network Systems (DINS) project. The system was taken from a research system supporting only radiology tasks to one extended to clinical use, and has been used in clinical work for two-and-a-half years. This paper will summarize our PACS clinical experience and will describe the operational features implemented and those still necessary.

Computer Systems↗
PubMedDate not supplied

The use of clock tests in schizophrenia.

Though clock drawing tests are well recognized as measures of cognitive function, there is little data on the performance of patients with schizophrenia. We compared 24 patients with schizophrenia to 24 healthy, age-matched controls on clock drawing, copying, and reading. Patients with schizophrenia performed significantly worse on clock drawing and copying despite the fact that the groups had similar scores on the MMSE. Worse performance was associated with higher scores on the BPRS. Clock drawing and copying may be useful for the assessment of cognition in schizophrenia, and the monitoring of cognitive changes associated with antipsychotic medication.

Adult↗
PubMedDate not supplied

Orbitofrontal function, object alternation and perseveration.

Object alternation (OA) is a well-established measure of perseveration and orbitofrontal function in non-human primates. Although several studies have used OA to examine orbitofrontal system dysfunction in humans with neurological and psychiatric disease, this task itself has not been validated as a bona fide measure of frontal dysfunction in humans. To address this issue, six patients with bilateral frontal lobe lesions documented by computerized tomography (CT) or magnetic resonance imaging (MRI) and 15 healthy controls were given OA, as well as other measures of frontal system dysfunction, delayed alternation (DA), delayed response (DR), and the Wisconsin Card Sorting Test (WCST). The CT and MRI scans were interpreted blindly. The patients with bilateral frontal lesions were significantly impaired on OA, DA, DR and the WCST. Analyses of the CT/MRI lesions suggest that the neuroanatomical regions involved in the deficits on OA include Brodmann areas 10, 24, 32 and 47, as well as possibly 11, and that OA is a sensitive measure of ventrolateral-orbitofrontal and medial frontal dysfunction in humans. Our findings lend further support for the use of experimental paradigms adopted from animal models to study the functional neuroanatomy and neuropsychological mechanisms underlying cognitive functions in humans with neurological and psychiatric disease.

Cognition↗
PubMedDate not supplied

The noisy elderly patient: prevalence, assessment, and response to the antidepressant doxepin.

To measure the prevalence of noisy behavior as a nursing problem, a survey of head nurses was done in a chronic care hospital to identify patients whose vocalizing was frequently disturbing to other patients, staff, or visitors. We found 17 patients among the total of 154. Subsequently, the medical records of 13 surviving subjects were reviewed more exhaustively, and 11 were described as disruptive, usually when they were left alone. Of these "lonely" patients, eight had a previously documented diagnosis of depression. All were demented. Antipsychotic medication had previously been given to all 11 "lonely" patients, but had failed to control their disruptive behavior. Empirically, six patients were treated with doxepin, and in five, all with a history of previous depression, agitation and noisiness diminished. These observations suggest that the prevalence rate of disturbingly noisy behavior among long-term institutionalized elderly patients is about 11% and that the disturbingly noisy patient is often demonstrating depression in conjunction with dementia.

Aged↗
PubMedDate not supplied

Office-based evaluation of renal function in elderly patients receiving nonsteroidal anti-inflammatory drugs.

Elderly patients with multiple diseases who are receiving diuretics are at risk for renal dysfunction from nonsteroidal anti-inflammatory drugs (NSAIDs). Fifty-two elderly patients (mean age = 72 years, range = 63-87 years) with degenerative joint disease and multiple concomitant illnesses were randomly selected to receive ibuprofen suspension (400 mg) or aspirin (650 mg) 4 times a day. Serum creatinine (Cr), blood urea nitrogen (BUN), weight, and blood pressure were measured at baseline and at weekly intervals for 6 weeks. There were no significant changes from baseline in any tests reflective of renal function, no significant differences between ibuprofen and aspirin, and no influence of concomitant diuretic therapy. Ibuprofen and aspirin administered in the doses examined for 6 weeks appear to have little effect on renal function as measured by serum Cr and BUN in a sample of elderly patients for whom these drugs are commonly employed. Concomitant diuretic therapy does not appear to increase the risk. While these drugs are contraindicated in patients with severe hemodynamic insult, they should not be withheld from elderly patients who require this therapy for analgesic/anti-inflammatory effects because of concern for renal impairment. Further prospective research should be undertaken to clarify levels of patient risk and to define appropriate monitoring in such patients.

Aged↗