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Biomedical subjects

P Graham

Publications and source records attributed to P Graham.

At least 19 recordsLinked to original sources
PubMed1992

Young spinal cord injured patients in nursing homes: rehospitalization issues and outcomes.

Most spinal cord injured (SCI) patients are discharged to their homes and families after they complete their initial rehabilitation program. Nursing homes, however, were the discharge destinations for 3.9% of all SCI patients nationally. When a nursing home is the only discharge option for a young SCI adult, certain economic, medical and psychosocial incongruencies make this placement potentially stressful for both the nursing home staff and the young patient. This study of the rehospitalization of 12 SCI patients under the age of 50 who were discharged to nursing homes explores the issues of cost, care and outcome during their first year following nursing home admission. Nine of the 12 patients were rehospitalized a total of 21 times, mainly for urinary tract infections and decubiti. Charges for 18 of these 21 rehospitalizations amounted to over $423,110 for 599 days of care. Four of these 9 patients died before the end of the first year. Although this is a retrospective study of the medical records and follow up data for a small key group of SCI patients, it calls attention to the need for continued investigation into the outcomes of a minimally visible population that lacks advocacy for change.

Adult↗
PubMed1992

The effect of hypotonicity on the mean platelet volume of patients with thrombo-embolism.

When dipotassium EDTA anticoagulated platelet rich plasma was incubated against a range of hypotonic saline concentrations, platelet volume was seen to change in a particular and reproducible fashion. When platelets taken from patients suffering a thromboembolic episode were tested in the same manner, a different pattern of response was observed the platelets being far less tolerant to osmotic stress. Similar changes occurred in platelets from ante-natal subjects. Platelets from both groups regained their tolerance to hypotonicity following either the thromboembolic incident or parturition respectively.

Adolescent↗
PubMed1992

Biochemical diagnosis of pheochromocytoma by simultaneous measurement of urinary excretion of epinephrine and norepinephrine.

The utility of specific assay of urinary catechols in pheochromocytoma diagnosis was examined by reviewing our data on the investigation of pheochromocytoma in a population of 2476 patients investigated over a six-year period. We used specific gas-chromatographic/mass-spectrometric (GC/MS) analysis for the simultaneous measurement of norepinephrine, dopamine, and the neuronal metabolites 3,4-dihydroxyphenylglycol (DHPG) and 3,4-dihydroxyphenylacetic acid (DOPAC) in all samples; the last two years of data collection (from 1101 patients) also included the specific GC/MS assay of epinephrine. The importance of assaying epinephrine as well as norepinephrine was shown by these latter data. During this latter period, 19 of 1101 patients were found to have pheochromocytoma; of these, nine had tumors that exclusively secreted norepinephrine, six had tumors that exclusively secreted epinephrine, and four exhibited excess production of both norepinephrine and epinephrine. Neither dopamine nor DOPAC was useful in the diagnosis of pheochromocytoma. A substantial proportion of patients may have uniquely epinephrine-secreting pheochromocytomas, previously considered a rarity. Thus we recommend that the biochemical testing for pheochromocytoma include the specific measurement of both norepinephrine and epinephrine.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1991

The link between fluid intake and weight gain in psychosis.

Diurnal weight gain was found to be abnormal among 44 of 77 institutionalized chronically psychotic patients. All patients were weighed and urine samples obtained weekly for 3 weeks at 7 A.M. and 4 P.M. Diurnal weight gain was normalized as a percentage by subtracting the 7 A.M. weight from the 4 P.M. weight, multiplying the difference by 100, and then dividing the result by the 7 A.M. weight. Normalized diurnal weight gain (NDWG) was 2.504 +/- 1.266% for the 44 study patients with abnormal findings, .631 +/- .405% for the 16 acutely psychotic controls, and .511 +/- .351% for 29 normals. Urine excretion was related (r = .476, p = .001) to NDWG in the subgroup of study patients with abnormal NDWG, consistent with the observation that their fluid intake exceeded fluid excretion in the afternoon.

Adult↗
PubMed1991

Rhizobium tropici, a novel species nodulating Phaseolus vulgaris L. beans and Leucaena sp. trees.

A new Rhizobium species that nodulates Phaseolus vulgaris L. and Leucaena spp. is proposed on the basis of the results of multilocus enzyme electrophoresis, DNA-DNA hybridization, an analysis of ribosomal DNA organization, a sequence analysis of 16S rDNA, and an analysis of phenotypic characteristics. This taxon, Rhizobium tropici sp. nov., was previously named Rhizobium leguminosarum biovar phaseoli (type II strains) and was recognized by its host range (which includes Leucaena spp.) and nif gene organization. In contrast to R. leguminosarum biovar phaseoli, R. tropici strains tolerate high temperatures and high levels of acidity in culture and are symbiotically more stable. We identified two subgroups within R. tropici and describe them in this paper.

Base Sequence↗
PubMed1990

Primary lung cancer.

Explore the source record for details and available documents.

Carcinoma, Non-Small-Cell Lung↗
PubMed1990

Previous pet ownership and Paget's disease.

The relationship between pet ownership and Paget's disease (PD) of bone was investigated in 112 patients with PD who were matched with a similar number of community-based controls. There was a significantly increased frequency of dog ownership by patients with PD aged less than 60 years. Multivariate logistic regression analysis revealed that there was a significant age-related increase in risk of PD associated with past or present ownership of either dogs or cats, with younger patients having the greatest risk. These results suggest that slow virus infection of osteoclasts by paramyxoviruses acquired from pets may contribute to the development of Paget's disease in the younger patient.

Age Factors↗
PubMed1990

From ICU to rehabilitation: a checklist to ease the transition for the spinal cord injured.

Spinal cord injuries are devastating. The injured person faces many unknowns including surgical procedures, hospitalization and rehabilitation. Frequently, the transition from acute care to rehabilitation is frightening. In the intensive care unit (ICU), the patient receives one-to-one nursing care and develops trust, but then may feel abandoned when faced with rehabilitation. In order to facilitate readiness for rehabilitation, coordinators of the Southeastern Michigan Spinal Cord Injury System proposed a checklist of activities designed to meet individual patient and family needs. Coordinators assess the patient within 24 hours of admission to the spinal ICU. The physiatrist is notified of the admission and recommends initial therapies as appropriate. The patient is followed through the acute phase and preparations are made for rehabilitation. A checklist format has been developed to coordinate the transfer. This article describes the checklist and its use at our institution.

Adaptation, Psychological↗
PubMed1990

Life expectancy free of disability: a composite measure of population health status.

Access to disability data from a nationwide survey of New Zealanders provides the opportunity to estimate Life Expectancy Free of Disability (LEFD) for the non-institutional adult population. This measure of population health status combines mortality and morbidity data into a single index. The analysis is restricted to the 15-64 age range and results on partial life expectancy free of disability are presented for the key sociodemographic groups. The results conform to the international evidence and highlight the potential impact of disability as a component in a composite measure of population health status: although women live longer than men, almost all this apparent advantage in longevity is spent in some state of disablement; Maori are disadvantaged in comparison with non-Maori both in terms of longevity and in the proportion of the life span spent disability-free; and, social class comparisons show a decline in LEFD with declining social class that is steeper than the corresponding mortality gradient. Despite some technical difficulties and the strong requirements of the data, the LEFD measure has many potential applications in public health research and planning. In particular, it has the potential to direct research and policy towards the enhancement of the active years of life rather than just the postponement of mortality.

Adolescent↗
PubMed1990

Abnormal diurnal weight gain among institutionalized patients with manic-depressive spectrum disorders.

We found diurnal weight gain to be abnormal among 41 institutionalized patients with manic-depressive spectrum disorders. They were weighed at 7 AM and 4 PM weekly for three weeks. We normalized the diurnal weight gain (NDWG) as a percentage by subtracting the 7 AM weight from the 4 PM weight, multiplying the difference by 100, and then dividing the result by the 7 AM weight. NDWG was 2.216 +/- 1.513 percent for the study population, .631 +/- .405 percent for 16 young, newly admitted controls, and .511 +/- .351 percent for 29 normals. Abnormal NDWG may be an additional feature of manic-depressive spectrum disorders.

Adult↗
PubMed1989

The validity of Maori mortality statistics.

Data from an Auckland coronary heart disease register have been used to assess the validity of Maori mortality statistics produced by the National Health Statistics Centre. During the period 1983-4, 804 people aged 35-64 years and resident in the Auckland statistical region, were identified by both the register and death registration data as having died of coronary heart disease. The coronary heart disease register failed to classify the ethnicity of thirteen of these people. Of the remaining 791 cases, the register classified 80 as Maori while only 44 were classified as Maori in the national death registration data; over the period 1983-4 Maori mortality due to coronary heart disease in the Auckland statistical region was understated by 82% (80-44/44). Although some of this discrepancy may be due to differences in classification of ethnicity, the major reason for the understatement is missing information on the death registration form. Simple changes in the documentation of ethnicity could markedly reduce the degree of underreporting.

Adult↗
PubMed1989

Diurnal weight gain in chronic psychosis.

We found diurnal weight gain to be abnormal among 93 chronically psychotic patients, most of whom had schizophrenia. They were weighed at 7 a.m. and 4 p.m. weekly for 3 weeks. We normalized the diurnal weight gain (NDWG) as a percentage by subtracting the 7 a.m. weight from the 4 p.m. weight, multiplying the difference by 100, and dividing the result by the 7 a.m. weight. NDWG was 1.7 +/- 1.0 percent for the study sample, 0.6 +/- 0.4 percent for 16 acutely psychotic controls, and 0.5 +/- 0.4 percent for 29 normals. More than 60 percent of the study sample had abnormal NDWG values. NDWG related to antipsychotic drug dose (r = 0.290, p = 0.005) with variability in drug dose accounting for 8 percent of the variability in NDWG. This report provides yet another piece of evidence that disordered water balance is common in chronic psychiatric patients. The etiology is unknown, but it may relate to subtle brain abnormalities in the regulation of fluid intake and excretion.

Adult↗