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Biomedical subjects

N Gordon

Publications and source records attributed to N Gordon.

At least 19 recordsLinked to original sources
PubMed1992

The more unusual sleep disturbances of childhood.

The sleep patterns of children often cause anxiety to their parents. Some disturbances are unusual, and therefore may cause diagnostic difficulties. Sleep walking and night terrors can be confused with epileptic seizures. The sudden sleep of narcolepsy can lead to false accusations, when in fact the episodes are beyond the child's control. The associated phenomena of cataplexy, hypnogogic hallucinations and sleep paralysis can be particularly alarming, especially if they occur in the absence of narcolepsy. The overlap between narcolepsy and the Kleine-Levin syndrome is confirmed. Although of a different nature the sleep apnoea syndrome is equally important from the point of view of diagnosis and treatment.

Child↗
PubMed1992

Ethics rounds at the nursing home: an alternative to an ethics committee.

The increased attention in US medicine to medical ethics reflects in large part the "new" demography of a growing elderly population and the conflict of whether decisions regarding medical care should be based on cost-effectiveness or "human-effectiveness." Currently, about 40 percent of the nation's elderly end up in nursing homes where they confront ethical and legal dilemmas that would not arise in their own homes. In the nursing home, difficult medical-ethical decisions generally rely on two approaches: the often used but frequently invalid concept of informed consent and little used ethics committees. At The Jewish Home and Hospital for Aged in New York City we have developed a program of "ethics rounds" as an alternative to ethics committees. We conduct the rounds in the open style of a forum or clinical conference rather than with the aura of a decision-making group. We encourage the participation of patients and family and seek to educate the staff, any one of whom may choose to attend. The rounds consist of a multidisciplinary case presentation, an interview of patient and/or family, a discussion by the staff, and an overview by an ethicist. Staff response to the educational and interdisciplinary aspects of the rounds has been remarkably positive.

Ethical Review↗
PubMed1991

Specific learning disorders: the possible role of brain damage.

The causes of many of the more subtle disorders of cerebral function are often obscure. Are they due to impaired development of the brain or to damage to the brain? Particularly if there is no definite evidence of the latter, and when talking to parents, it is better to use such terms as "minimal cerebral dysfunction". However this must not lesson in any way the constant search for the etiology of these disorders. There is no doubt about their frequency, and in one form or another, about one in ten children have special educational needs. There is therefore a major medical contribution to be made to the problems of these children, especially in terms of prevention. A review of the literature shows, among other causes, how often episodes during pregnancy and birth can lead to learning problems during school life. In the future the development of new neuroradiological, and other techniques, will help to explain these common disabilities.

Abnormalities, Multiple↗
PubMed1990

Endoscopic and radiographic evaluation of the murine colon.

Endoscopic and radiographic techniques have not been widely applicable in the evaluation of chemically induced murine colon cancer. The authors investigated methods of cleansing the rat colon and refined endoscopic and radiographic techniques. They compared total colonoscopy (TC) and air-contrast (ACBE) and single-contrast barium enema (SCBE) findings with those obtained at necropsy in rats with 1,2-dimethylhydrazine (DMH)-induced colon cancer. Gastrograffin enemas with bisacodyl suppositiories showed complete evacuation of solid feces. Sprague-Dawley rats treated with DMH had their colons cleansed and then underwent TC (5.0-mm Olympus bronchoscope) and either SCBE or ACBE. Colonoscopy and ACBE were equally sensitive (81.5% and 76.3%, respectively), although SCBE was significantly insensitive in identifying lesions (P less than 0.001). This study demonstrates that: (1) mechanical cleansing of the rat colon is feasible, (2) TC and barium radiology can be done routinely after mechanical cleansing, and (3) TC and double-contrast BE are sensitive in identifying colon lesions. These techniques will provide a means for manipulation of murine tumors and in vivo surveillance.

1,2-Dimethylhydrazine↗
PubMed1990

Antibiotics in elective colon surgery. A randomized trial of oral, systemic, and oral/systemic antibiotics for prophylaxis.

A prospective, randomized double-blind study was undertaken to compare the efficacy of three prophylactic regimens (oral neomycin and erythromycin, intravenous cefoxitin, and a combination of both oral and intravenous antibiotics) in patients undergoing elective colorectal surgery. One hundred sixty-nine patients were randomized and 146 patients were evaluable. Septic complications occurred in 11.4 per cent of patients receiving oral antibiotics only, in 11.7 per cent of patients receiving intravenous cefoxitin alone, and in 7.8 per cent of patients receiving both oral and intravenous antibiotics. These differences were not statistically different. The greatest number of septic complications occurred in those patients with anastomotic disruptions. Two patients died (1.3%), both of whom had major anastomotic failures. There was no advantage between any of the groups in the incidence of wound infection (3.9-6.8%). Thus, no advantage could be identified in this study in the combination of oral and intravenous antibiotics in elective colorectal surgery.

Administration, Oral↗
PubMed1989

An epidemiologic investigation of birth outcomes in relation to dibromochloropropane contamination in drinking water in Fresno County, California, USA.

This report describes an epidemiologic investigation of the relationship between dibromochloropropane (DBCP), contamination in drinking water and birth outcomes between 1978 and 1982 in Fresno County, California, USA. Census tracts in the county were categorized according to DBCP level in drinking water. A direct comparison between exposure categories was done by the use of the Mantel-Haenszel chi-square procedure to compute relative ratios or risks for low birth weight and birth defect, adjusting for age, race, percent Hispanic, and parity. No correlation between these birth outcomes and DBCP contamination was found. In addition, we did not find any difference in sex ratio in relation to DBCP contamination.

Adolescent↗
PubMed1989

Ecological analyses and case-control studies of gastric cancer and leukaemia in relation to DBCP in drinking water in Fresno County, California.

Through ecological analyses and case-control studies, the possible relation of gastric cancer and leukaemia to dibromochloropropane (DBCP) contamination of drinking water in Fresno County, California, has been examined. The ecological analyses examined the correlation between gastric cancer and leukaemia (including the lymphatic varieties), mortality rates, and DBCP concentrations in drinking water by census tract in Fresno County, 1960-83. No correlation was found between gastric cancer or leukaemia and DBCP. The gastric cancer case-control study consisted of 263 deaths from gastric cancer in the county, 1975 to mid-1984, and 1044 controls, using information on residential history and occupation of both cases and controls. Analyses were based on residence at death, as well as one and ten years before death. The case-control study did not find any relation between gastric cancer and DBCP in drinking water. Hispanics in the county were found to experience a relative risk of gastric cancer of 2.77, compared with non-Hispanics. A similar case-control study consisting of 259 cases of leukaemia and 1161 controls found no relation between all leukaemia or lymphatic leukaemia and DBCP in drinking water. Farm workers, however, do appear to have an increased risk of leukaemia.

Agricultural Workers' Diseases↗
PubMed1989

Metachromatic leukodystrophy (MLD) in hospitalized adult schizophrenic patients resistant to drug treatment.

Metachromatic leukodystrophy (MLD) is a rare inherited neurodegenerative disease associated with a defect in the catabolism of sulphatide (galactocerebroside-sulphate) which accumulates in the nervous system. MLD can be diagnosed biochemically by demonstrating deficiency in the activity of the enzyme arylsulphatase A (ASA) and an excess of sulphatide in urine and tissues. Clinically adult MLD may present as a schizophrenic-like psychosis, which typically develops years before the onset of neurologial signs which are not inevitable. Urinary ASA was investigated in 99 chronic hospitalized psychiatric patients (including 77 schizophrenics). Thirteen showed reduced ASA activity. Of the nine who were available for further study, only one evinced reduced ASA activity in other tissues (for example, leukocytes and cultured fibroblasts). However, there was no evidence of sulphatidurea with impaired sulphatide hydrolysis in his intact cultured fibroblasts. Therefore, he tested negative for MLD. This biochemical profile is known as pseudosulphatase deficiency. The possible relationship of pseudosulphatase deficiency to schizophrenic-like conditions is discussed.

Cerebroside-Sulfatase↗