Biomedical subjects
Publications and source records attributed to N J Thompson.
We describe a rare variant of schwannoma characterized by a interconnecting multinodular growth mimicking a plexiform neurofibroma. The schwannoma recurred twice. The second recurrence was not excised and has not increased in size for 1 1/2 years. The patient is alive and well, 3 years and 4 months after the first excision with no clinical evidence of metastasis.
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Strains of Mycobacterium tuberculosis from various geographic areas within the continental United States were typed according to their susceptibility to 4 mycobacteriophages. Of 462 wild isolates studied, 34% were phage type 1 (previously designated A0), 42% were type 2 (A1), 2.6% were type 5 (A4), 13% were type 7 (A6), and 20.1% were type 8 (B). Distribution of types was essentially unaffected by geographic location, sex, age, or ethnic origin of the patient or by resistance of the isolate to antituberculosis drugs. Major types were further divided by susceptibility of the strains to lysis by 8 auxiliary phages, 2 of which were phages newly evaluated in this study. A new numbering system is proposed for designating major phage types of M. tuberculosis.
An 8-year retrospective study was conducted of the metropolitan Dayton, Ohio, area from January 1970 through December 1977. During this period of time there were 86,809 births and 721 tubal pregnancies. Thirty-three of the ectopic pregnancies were in patients who had previously undergone a tubal sterilization. The 7.4% rate (29 of 393) in the past 4 years indicates the increasing importance of previous sterilization as an etiologic agent in ectopic gestation.
To determine the frequency, magnitude, and causes of the booster phenomenon in tuberculin testing, a total of 1,478 employees from 10 hospitals throughout the United States received sequential intradermal tests using PPD-T. In addition, approximately 70 per cent were initially tested with PPD-G. Boosting was found in all age groups tested, but increased with age. It occurred as soon as one week after an initial tuberculin test, but rarely before that time. The boosted reactions were apparently caused either by remote tuberculous infection or recent or remote sensitization by one or more of the nontuberculous mycobacteria. In areas endemic for nontuberculous mycobacteria, they are the most likely cause of the sensitivity that may be boosted. On the basis of these findings, it is recommended that when repeated tuberculin testing is required as part of a hospital control program, a second identical tuberculin test be given one week after the first. When subsequent tests are given, this should permit separation of boosted reactions from reactions caused by new infections. Persons who do not boost when giben repeat tests at one week, but whose tuberuclin reactions change to positive after one year, should be considered to have newly acquired tuberculous infection and managed accordingly.
Tricuspid atresia is one of the rarest heart defects, and it is rarely associated with prolonged survival. This paper describes the third known case of pregnancy associated with tricuspid atresia. This is the first detailed report of the clinical course of a patient with this disorder. Complications included heart failure, multiple pulmonary emboli, cerebral embolization, and premature labor. Recommendations are made regarding patient care.
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Providers who referred patients to Reach to Recovery (Reach), an American Cancer Society breast cancer support group, were compared with those who did not to evaluate whether providers who identified problems with the program were less likely to make referrals. Also considered were contact with a Reach volunteer, having a Reach program in the area, years since residency or medical training, perceived value of the Reach program, belief that one's peers refer patients to Reach, urban or rural location of practice, and size of practice. When other variables were considered, physicians who identified problems with Reach were no less likely to refer patients to the program than those who did not. The factors most associated with referral (P < .001) were "having a Reach program in the area" and "having had contact with a Reach volunteer." Implications of these findings and the experience of conducting the evaluation through the Collaborative Evaluations Fellows Project are discussed.
OBJECTIVE: This study examined predictors of strategies used to cope with pain in children with sickle cell disease and their mothers. METHOD: Disease severity, socioeconomic status, child adjustment and adaptive behavior, maternal psychopathology, and family functioning were examined in 55 mother-child dyads to determine the predictive potential of these factors on engagement and disengagement coping. RESULTS: While controlling for socioeconomic status and psychopathology in the mothers, 15% of the variance in engagement coping was predicted by family adaptability. Disengagement coping was predicted by internalizing symptoms exhibited by the child, including a negative and pessimistic attributional style, which accounted for nearly one fifth of the variance. Finally, mothers who reported more active strategies for coping with their child's pain were more likely to endorse greater use of techniques to prevent and effectively manage pain in their children. CONCLUSIONS: Neither coping strategy was predicted by severity of disease presentation in the children, suggesting the importance of psychosocial factors in adapting to childhood chronic illness and that severity of disease may not necessarily be a marker for families at risk for adjustment difficulties. Findings were interpreted to support a systemic family model in promoting active and adaptive engagement coping in caretakers of children with sickle cell syndrome.
Although the likelihood of fire-related death in homes with smoke alarms is about one-half that in homes without alarms, alarm effectiveness is limited by behavior. Only 16% of residents of homes with alarms have developed and practiced plans for escape when the alarm sounds. We reviewed literature to identify behavioral constructs that influence smoke alarm use. We then convened experts in the behavioral aspects of smoke alarms who reviewed the constructs and determined that the appropriate areas for behavioral focus were formulating, practicing, and implementing escape plans should an alarm sound. They subsequently identified important behaviors to be addressed by burn-prevention programs and incorporated the constructs into a behavioral model for use in such programs. Finally, we organized the available literature to support this model and make programmatic recommendations. Many gaps remain in behavioral research to improve fire escape planning and practice. Future research must select the target behavior, apply behavioral theories, and distinguish between initiation and maintenance of behaviors associated with planning, practicing, and implementing home fire escape plans.
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