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Biomedical subjects

O James

Publications and source records attributed to O James.

At least 55 records · Page 3Linked to original sources
PubMed1982

Delivery of the second twin.

A retrospective chart review of all twin deliveries between April 1, 1977, and March 20, 1980, at the Boston City Hospital and the Brigham and Women's Hospital revealed corrected neonatal mortality rates of 0 for 74 twins in nonvertex presentation delivered by cesarean section and 0 for 76 second-born twins extracted vaginally. Breech extraction of 76 second-born twins weighing more than 1499 g at birth was not associated with a statistically significant increase in the incidence of 5-minute Apgar scores of 7 or less when compared to 74 similarly asymptomatic twins in nonvertex presentation delivered by cesarean section. Vaginal delivery may be considered when the second twin, weighing more than 1500 to 2000 g, is in breech presentation.

Apgar Score↗
PubMed1981

Primary biliary cirrhosis--a revised clinical spectrum.

The presentation or method of detection of 93 patients with primary biliary cirrhosis (PBC) from Northern England is reported. Almost half (45/93) the patients had no symptoms of liver disease when PBC was diagnosed; in many of them serum antimitochondrial activity (AMA) was detected during immunological screening for other diseases. 13 patients with normal liver function tests had symptomless PBC. Liver histology in 6 of these was diagnostic for PBC, and 7 had histology suggestive of PBC; all had a positive AMA titre greater than or equal to 1/40. The mortality of the symptom-free AMA-positive patients over a mean follow-up of 4-5 years did not differ from that of the general population. Only 1 out of 45 initially symptom-free patients died in the follow-up period (8 months-12 years). 37 patients had disorders which may be associated with PBC--including 16 with thyroid disease, 9 with rheumatoid arthritis, and 5 with mixed connective tissue disease. It is suggest that, as with autoimmune thyroid disease, overt organ damage never develops in many patients with symptomless PBC.

Adult↗
PubMed1981

Fat embolism syndrome: incidence, significance and early features.

During the period 1968 to 1978 a total of 447 patients were treated in the Royal Newcastle Hospital for acute respiratory failure after injury. In 321 patients respiratory failure occurred after thoracic and/or long bone injury. In only 17 of these could a diagnosis of fat embolism syndrome (FES) as a sole cause of respiratory failure be substantiated when strict diagnostic criteria were applied. In a further 15 patients FES may have coexisted with other causes of respiratory failure. The outstanding features of patients with FES were: (I) all were in the younger age groups; (II) all developed respiratory symptoms within 48 hours of admission to hospital; (III) most had multiple limb fractures; (IV) more than half had been transferred from other hospitals; and (V) three were pregnant and had sustained in comparison with the others, less severe long bone injuries.

Adolescent↗
PubMed1981

Guillain-Barré Syndrome: incidence, management and outcome of major complications.

From October 1970 to March 1980, 33 patients with Guillain-Barré Syndrome (GBS) were treated at the Royal Newcastle Hospital (RNH). One patient died and 2 made incomplete neurological recoveries. This study shows that although GBS is an uncommon disease, a significant number (28%) of patients have a severe form of the illness that results in acute respiratory failure and frequently requires artificial ventilation (AV). This latter group of patients have a high incidence of major complications. Methods of reducing the incidence of these complications are suggested.

Adolescent↗
PubMed1980

Kupffer cell phagocytosis in relation to BSP clearance in liver and inflammatory bowel diseases.

Experience using microaggregated human serum albumin for a Kupffer cell phagocytic capacity "stress test" in patients with liver and inflammatory bowel diseases is described. Each result has been related to a 1-hr BSP clearance in order to account for variations in liver blood flow. Kupffer cell clearances are reduced in proportion to BSP clearance in obstructive jaundice and in secondary biliary cirrhosis but are increased in patients with chronic hepatocellular inflmmation. Conversely Kupffer cell phagocytosis is often depressed in patients with alcoholic hepatitis. In Crohn's disease or ulcerative colitis RES function is normal unless patients are receiving corticosteroid suppression.

Colitis, Ulcerative↗
PubMed1980

The effect of age on the pharmacokinetics of diazepam.

1. After intravenous administration to 19 subjects, aged 18-95 years, plasma diazepam concentrations were measured over 160 h. Plasma protein binding of diazepam was also measured in each subject. 2. The terminal plasma half-life of diazepam ranged from 15.0 to 125 h and was positively correlated with age (r = 0.797). Total plasma diazepam clearance was not correlated with age (r = -0.017). 3. The free fraction of diazepam ranged from 0.0137 to 0.0386 and was significantly correlated with age (r = +0.863). Free diazepam clearance, which ranged from 432 to 1870 ml/min, was also correlated with age (r = -0.717). 4. It is concluded that the increased sensitivity of the elderly to diazepam is, at least in part, due to pharmacokinetic factors.

Adolescent↗
PubMed1980

Prevalence of drug-induced immunologic changes in hypertensive Jamaicans.

Of 137 hypertensive black Jamaicans who took methyldopa for a mean period of 36 months, a positive ANA was found in 1.5% and a positive direct Coombs' test in 0.7%. In 36 patients in whom hydralazine was included in the therapeutic regimen, a positive ANA was seen in only 6%. These results suggest that in black populations, immunologic abnormalities induced by antihypertensive drugs are less common than has been reported in white patients.

Antibodies, Antinuclear↗
PubMed1979

Intestinal perforation in ascariasis--case reports.

Two cases of intestinal perforation in association with ascariasis are described. In both cases adult ascarids were found either in the gut or lying free in the peritoneal cavity. Neither patient had typhoid fever, one had Hodgkin's lymphoma. The authors believe that the perforation were directly caused by the ascarids. Both patients died.

Adult↗
PubMed1979

Clinical evaluation of computer processing of liver gamma camera scans.

A prospective study to assess the clinical usefulness of computer processing of liver scans has been carried out on 203 patients. All patients have had six months follow up to confirm the diagnostic accuracy of the scan results. Four presentations have been studied using ROC analysis: (i) original gamma-camera pictures; (ii) processed images obtained using a non-stationary filter; (iii) images processed using nine-point smoothing; (iv) images obtained by linear interpolation at 25 isocount levels of display. It is concluded that pictures obtained by use of a non-stationary filter at 25 isocount levels are superior to a conventional gamma-camera pictures and displays obtained by linear interpolation only. All three are considerably superior to the images obtained by nine-point smoothing in detection of focal space-occupying lesions. Based on the results obtained, a strategy for the rational use of computer processing of gamma-camera liver scans is proposed.

Computers↗
PubMed1978

The spectrum of paracetamol (acetaminophen) overdose: clinical and epidemiological studies.

In a regional survey of paracetamol overdose, 201 patients were admitted to hospital over 12 months. Chronic alcoholism was present in 10% of cases. Over 25% of patients were females aged 20 years or less. Initial blood paracetamol levels were in the toxic range in 16% and histologically severe liver damage eventually found in 20% of those biopsied. This finding corresponded to a serum aspartate aminotransferase of 600 i.u./l or more. Renal failure severe enough to require peritoneal dialysis developed in 1%. Elevated serum amylase was recorded in 22% of a 108-patient subset. Evidence of myocardial damage was found in 11.6% of an eighty-six patient subset. An unfavourable prognosis was indicated by a prothrombin ratio of 20% or less and hepatic coma, the overall mortality being 3.5%. The apparent safety of this useful analgesic is compromized by its widespread employment in parasuicide. This, the insidious and delayed onset of toxicity in overdose and ineffectiveness of late treatment argues for controlling availability to the general public.

Acetaminophen↗
PubMed1977

Bacterial overgrowth syndrome without "blind loop": A cause for malnutrition in the elderly.

Probable bacterial contamination of the small bowel without an anatomical sump occurred in 5 elderly patients (age 68--94). They presented with severe general deterioration in health rather than with obvious features of malabsorption. This syndrome has not been clearly described before. Bacterial deconjugation of bile salts was indentified by the 14C-glycocholic-acid breath test. Investigations for other causes of malabsorption, including small-bowel biopsy and pancreatic scan, revealed no abnormality. After prolonged ill-health despite an adequate diet in hospital, all 5 subjects made a striking recovery after treatment with antibiotics. This condition may be quite common, particularly in malnourished elderly people.

Age Factors↗
PubMed1977

Occupational vitiligo induced by p-tert-butylphenol, a systemic disease?

Vitiligo, morphologically indistinguishable from true vitiligo, was detected in 54 of 198 men exposed to p-tert-butylphenol (P.T.B.P.) during its manufacture. There is evidence that P.T.B.P. caused vitiligo by a systemic mechanism and that the severity of the disease was related to the intensity of exposure. No association with autoimmune disease was found. Screening for other possible associated disorders revealed mildly abnormal liver-function tests in 6 workers: liver biopsy confirmed liver damage. Of the 144 men exposed to P.T.B.P. who did not have vitiligo, only 2 had any abnormal liver-function tests. It seems possible that the liver damage is related to P.T.B.P.

Chemical Industry↗