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Biomedical subjects

M Thomas

Publications and source records attributed to M Thomas.

At least 721 records · Page 40Linked to original sources

Vitamin D deficiency and low osteocalcin concentrations in anorexia nervosa.

The calcium, vitamin D, and osteocalcin concentrations were investigated in 17 patients with anorexia nervosa. Serum 25-hydroxyvitamin D (25 OHD) concentrations below normal were observed in 15 (88%); only two patients has serum 1,25 dihydroxycholecalciferol (1,25(OH)2D) concentrations below normal. Serum parathyroid hormone (PTH) concentration was also normal in all except these two patients. Serum osteocalcin concentration was below normal in seven of 14 patients. Although a low concentration of serum 25 OHD is common in patients with anorexia nervosa in the United Kingdom, 1,25(OH)2D concentrations are usually normal. Hypovitaminosis D with secondary hyperparathyroidism is relatively uncommon. The subnormal osteocalcin concentrations observed in these patients probably reflect diminished osteoblastic activity, which may contribute to their osteopenia.

1-Carboxyglutamic Acid↗

Vitamin D and parathyroid hormone and bone mineralisation in adults with cystic fibrosis.

Vitamin D and parathyroid hormone concentrations were assessed in 31 adults with cystic fibrosis (mean age 24, range 17-52 years), in 28 of whom the bone mineral index in the forearm was also determined. Serum 25-hydroxyvitamin D was subnormal in eight patients, of whom five were receiving vitamin D supplements in standard doses. 1,25-dihydroxyvitamin D and parathyroid hormone concentrations showed no consistent abnormalities. The bone mineral index was lower in patients with cystic fibrosis (p less than 0.02) than in controls. Five patients with unequivocally reduced bone mineral index had a subnormal mean serum 25-hydroxyvitamin D and significantly worse lung function than the other patients. There was a positive correlation between age and bone mineral index (r = 0.68, p less than 0.001). Thus a significant proportion of patients with cystic fibrosis living in a temperate climate are at risk of vitamin D deficiency. Osteopenia is common and is probably related to a combination of hypovitaminosis D, delay in puberty, hypo-oestrogenism in women, and reduced physical activity, rather than to secondary hyperparathyroidism. Since most patients with deficiency of 25-hydroxyvitamin D were receiving oral supplements, parenteral vitamin D supplementation may be appropriate for selected patients who are unable to maintain adequate 25-hydroxyvitamin D concentrations despite oral vitamin D supplements.

Adolescent↗

Acupuncture for the alleviation of tinnitus.

The present study describes the effect of acupuncture in 12 patients with tinnitus. The patients were referred from the Department of Audiology, Karolinska Hospital, where their hearing and tinnitus were assessed. None of the patients had benefited from previous treatment for tinnitus. The selection of acupuncture points depended on the individual and was, to a limited extent, based on traditional Chinese medicine (TCM). Local points such as Si 19, Sj 17, and Sj 21 were fairly standard; distal points took into account associated problems of the patient, but were also points recommended in TCM for tinnitus. Ten treatments were attempted within a 6- to 12-week period. The treatments were carried out weekly or biweekly depending on the availability of patient and acupuncturist. Six patients had transient effects and noise reduction. However, no positive long-term results were obtained. Similarities between the experience of tinnitus and of pain are discussed in light of these findings.

Acupuncture Therapy↗

Traumatic atlanto-axial subluxation.

Traumatic atlanto-axial subluxation is a rare injury which may not be revealed on routine radiographs, especially when there is muscle spasm. We report on seven patients with atlanto-axial subluxation as a result of neck injury; only two of them had significant head injuries. Three patients presented with a neurological deficit attributable to the injury, one immediate and two with delayed onset. Traumatic atlanto-axial instability, occurring in an otherwise healthy patient, has a potential for neurological disaster; early consideration of operative treatment is indicated.

Adult↗

Cervical spine instability in rheumatoid arthritis.

We present a study of 30 fusion operations in 26 rheumatoid arthritics with cervical spine instability. Atlanto-axial instability was present in 15, of whom 12 were fused; three had cord involvement and all made a partial or complete recovery following fusion. Cranial settling necessitated cranio-cervical fusion in four patients; all fused, and one with myelopathy was relieved. Subaxial instability required fusion in seven cases; two postoperative deaths followed the only two anterior interbody fusions. Posterior fusion was successful in the other five, with remission of neurological compromise in the three with myelopathy and one with radiculopathy. We conclude that neurological compromise in an unstable but mobile rheumatoid cervical spine can usually be brought to remission by immobilisation alone, so decompressive procedures are unnecessary in the first instance.

Arthritis, Rheumatoid↗

Internal fixation for occipito-cervical fusion.

We describe a method of internal fixation for occipito-cervical fusion utilising a standard "small fragment" T-plate bent and fixed to the skull with three screws. The lower end of the plate is screwed and wired firmly to the spine of the axis. Of 14 patients so treated, 12 fused, one died and one failed to unite to the skull. Of eight with cord signs, seven remitted or improved and one died.

Arthritis, Rheumatoid↗

[Serologic and clinical study of post-transfusion viral contamination after cardiac surgery. Excluding human immunodeficiency virus].

The incidence of post-transfusion viral contamination after cardiac surgery is variable but not negligible. The serological and clinical features of such contamination were determined in a series of 100 consecutive patients seen between June, 1983 and January, 1984. The ELISA technique was used for hepatitis A and B viruses and cytomegalovirus on three samples of blood taken before (S1), and 15 days (S2) and 2 to 3 months (S3) after surgery. In case of hepatitis further investigations were performed for heterophilic infectious mononucleosis antibodies and for hepatitis B virus DNA. The transient appearance at S2 of anti-cytomegalovirus antibodies brought by transfusion was observed in 40% of the cases; seroconversion occurred in 4% (cytomegalovirus 3, hepatitis B virus 1), and 5% of the patients developed clinical and biochemical hepatitis without serological markers.

Antibodies, Viral↗

[Chondrodysplasia punctata. Report of four cases in two sibships].

Chondrodysplasia punctata has very diverse clinical and radiological features. Its diagnosis may be suggested as early as in the neonatal period in front of an abnormal facial appearance, sometimes associated with bone and vertebrae defects. Radiological exams will assert it. Its subsequent course depends on the accompanying visceral abnormalities. Genetics advice is closely related to these. Ultrasonography is the only actual possibility of prenatal diagnosis. However our attitude must be guided by the clinical course (of the disease) of the initial case in the sibship.

Chondrodysplasia Punctata↗

[Activated thromboplastin time, plasma heparin and plasma fibrinogen using the Fibrintimer 10].

After a thorough study, and having chosen the machine that is to equip an average sized haemostasis laboratory, the installation then requires certain steps (the reorganisation of work, better adapted reagents, a change of normality, a fine tuning of the technics, the time to get used to the machine). In this perspective, this work describes the regulation of the technic to determine the heparin activity on the Fibrintimer 10 (F 10) by chronometry (thrombin clotting time with variable concentration), a study of the repeatability and reproducibility of activated partial thromboplastin time (APTT), plasma heparin (HEP) and fibrinogen on the Fibrintimer 10, a study of the correlation between the results we got with the F 10 and the thermostat water-bath for the APTT and the HEP and between those we got on the F 10 and the fibrometer for the fibrinogen. The F 10 has allowed us to save more time whilst keeping the same technics and reagents. The determination of the heparin activity, by thrombin clotting time with variable concentration, gives us a method which is quick, cheap and useful for the following-up of the patients undergoing a treatment with standard heparin. The reproducibility and repeatability prove to be good for the 3 tests in our operatory conditions as well as the correlations between the results we get with both methods.

Adult↗