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Biomedical subjects

P L Adams

Publications and source records attributed to P L Adams.

At least 37 records · Page 2Linked to original sources
PubMed1990

The effect of the American Heart Association step one diet on hyperlipidemia following renal transplantation.

Cardiovascular disease is a frequent cause of morbidity and mortality following renal transplantation. The percentage of deaths due to ischemic cardiovascular disease and cerebrovascular accidents nearly equals that caused by infection among patients receiving their first transplant, according to data from the European Dialysis and Transplant Association Registry. Hypercholesterolemia is a risk factor for cardiovascular disease frequently identified following renal transplantation, and diets low in fat and cholesterol have been suggested as treatment. Previous studies have not reported the response of LDL cholesterol to dietary treatment, and it is this form of cholesterol that is most closely related to cardiovascular disease. The American Heart Association has provided nutritionists with guidelines for the treatment of hyperlipidemic patients which include the Step One Diet. Previous dietary studies of renal transplant recipients have allowed a slightly higher intake of fat than that currently recommended by the AHA. We wondered if an easily reproducible diet well known to nutritionists such as the AHA Step One Diet would be effective in lowering cholesterol levels in hyperlipidemic renal transplant recipients. The purpose of our study was not to define the mechanisms of posttransplant hyperlipidemia, but rather to assess the effectiveness of dietary intervention on hyperlipidemia following renal transplantation.

Adult↗
PubMed1989

Psychopathology and economic status in mother-only and mother-father families.

This paper reports evidence on the link between economic resources and psychiatric disorder in female-headed families with children. It has been assumed that a father's absence leads to augmented psychopathology in children and their mother through the disruption of roles, relationships, socialization and development. This study suggests that the absence of father/husband compounds the stress of family separation by diminishing household income, often to the point of poverty.

Adult↗
PubMed1987

The mother not the father.

Otto Rank pioneered in regarding the mother's place as paramount in the emotional life of the child, even when he was enveloped in Freudian orthodoxy, but expanded his viewpoint after he had left the Freudian ranks. His more mature views were to stress separation and individuation as lifelong dilemmas because they were in tension with our urges to seek oneness and to merge with others and not to regard that struggle as a dialectic that got worked through or transcended in an early, pre-Oedipal stage. He believed that fusing and individuating were lifetime issues for all, in or out of their psychoanalyses. Rank showed radical feminist attitudes far ahead of his time, contending that the female is central and superior to male existence, and that women need a psychology that is not warmed-over male biases but truly a "female psychology." He foreshadowed later writers who emphasized the motherly warmth and caregiving of psychotherapists. He regarded many of his technical innovations as ways to heighten the reexperiencing of early child-and-mother interactions and thought of the analytic setting itself as being akin to the mother-child relationship. Among psychoanalysts of all colorations respecting their Freudian orthodoxy, there is a special mystique and nostalgia around the Oedipus complex and paramountcy of the father in a child's mental life; but Otto Rank took a militant, yet reasoned, stand against such patriarchal biases.

Austria↗
PubMed1985

The obsessive child: a therapy update.

Literature on treatment of childhood obsessive-compulsive disorder (OCD) is reviewed and evaluated in order to present a therapy update of the disorder since 1973. Sixteen treatment reports show a move toward eclecticism that blends biologic as well as group "psychosocial" therapies with the individual psychosocial therapies oriented to emotion, thinking and behavior in OCD.

Combined Modality Therapy↗
PubMed1984

Focal neurologic signs associated with hyperkalemia.

A patient with end-stage renal disease had a flaccid hemiparesis in conjunction with severe hyperkalemia. The hemiparesis resolved with treatment of the hyperkalemia. The patient was later found to have extracranial vascular disease, and we propose that a severe metabolic abnormality associated with an area of relative cerebral ischemia caused the reversible neurologic deficit.

Aged↗
PubMed1984

Fathers absent and present.

Hindering and obfuscating psychiatric scholarship about the father's role, whether he is present or absent, are several widespread notions and practices--including conceptual, assumptive, attitudinal, methodologic and technical matters. Discussed are eleven barriers to research: patriarchal ideology, preference for studying individual and dyad instead of family systems, preference for considering adults not children, overly rigid definition of parental roles, choosing not longitudinal but one-time cross-sectional study, reasoning about linear cause and effect, focus on attitudes not overt behavior, failure to control for adequate number of variables, neglect of adequate sampling procedures, confusing correlation with causation and an overemphasis on obvious pathology. The father, present or absent, may be salient or insignificant in the life of a child. If salient, the father's role may promote health and growth or may be largely pathogenic. The conclusion holds that an irreducible family unit may consist of only one pair: caretaker/child.

Child↗
PubMed1983

Endometrial carcinoma diagnosed by examination of peritoneal dialysate.

Well-differentiated adenocarcinoma of the endometrium was diagnosed by cytologic examination of peritoneal dialysate during continuous ambulatory peritoneal dialysis in a 70-year-old woman. The patient had undergone estrogen therapy for 16 years. The carcinoma was localized, noninvasive, and apparently at an early stage of development. Surgical removal was followed by megestrol acetate chemotherapy and the patient currently remains on peritoneal dialysis, free of recurrence, at 14 months. This case suggests that cellular material from the endometrium can be retrieved from intraperitoneal dialysate in patients undergoing peritoneal dialysis. Therefore, cytologic examination should be performed on peritoneal fluid with elevated counts associated with sterile cultures or atypical features.

Adenocarcinoma↗
PubMed1982

Lower gastrointestinal tract dysfunction in patients receiving long-term hemodialysis.

Severe bowel dysfunction developed in 25 of 945 patients receiving long-term hemodialysis during a ten-year period. Colonic perforation occurred in 12 patients, six of whom died due to peritonitis. In seven instances, the perforation occurred spontaneously. Ten other individuals exhibited prolonged, severe adynamic ileus that progressed to colonic pseudo-obstruction in eight patients. Medical decompression (eight patients) and surgical bowel decompression (two patients) resulted in recovery in nine. Aluminum hydroxide gel, which was taken regularly by all patients, was associated with notable chronic constipation prior to the occurrence of bowel perforation or protracted adynamic ileus in 78% of these individuals.

Adult↗
PubMed1981

Language patterns of opponents to a child protection program.

A community effort was made to help sexually abused girls and a "pro-incest lobby" was uncovered. This report focuses on the language used to deny or obscure the occurrence of father-daughter incest. As children's rights advocates, the authors attempted to provide a lexicon, a dictionary for the clinician, so that efforts to condone incest will not be overlooked but refuted. Both in the past and the present, instances of incest have been rationalized away by health care professionals, members of the legal profession and the community at large. The incidence of incest is higher than the increasing number of actual cases reported. The vocabulary that systematically drives certain resistances and defenses to the surface, in opposition to child protection in such cases, is analyzed by the authors. The "dynamics" involved in the realization of incest as a psychologically damaging situation for the child are complex. The social influences on the individual and the married couple, that serve to make incest a closely kept secret, are examined. The authors express hope that their linguistic analysis will help to alert all persons who work in the broad field of child abuse and child protection.

Adolescent↗
PubMed1981

Treatment of secondary hyperparathyroidism in patients with chronic renal failure by total parathyroidectomy and parathyroid autograft.

Sixty-one patients with chronic renal failure and secondary hyperparathyroidism underwent total parathyroidectomy and parathyroid autograft. Symptoms relieved by parathyroidectomy included bone pain, pruritus, soft tissue calcification, muscle weakness and healing of fractures. Serum parathormone levels measured before and after operation in 48 patients returned to normal in all but two patients. Serum alkaline phosphatase levels also returned toward normal after operation, except in one patient with a retained parathyroid gland. Complete radiographic studies before and after operation were available in 30 of 61 patients. Twenty-three of 24 patients with osteitis fibrosa had evidence of healing, and in one patient no change occurred. Osteosclerosis noticed in 23 patients improved slightly in eight patients, did not change in 14 and became worse in one. Pathologic examinations revealed 45 patients to have diffuse hyperplasia and 16 nodular hyperplasia. There were two early postoperative deaths, in the first 30 days, and 16 late postoperative deaths, from four months to four years afterward. In no case did the operation contribute to death. Some patients required the administration of supplemental calcium after operation, but in no instance did profound hypocalcemia occur. No patient developed recurrent hyperparathyroidism.

Adolescent↗
PubMed1981

Improved routine chest radiography with a trough filter.

Use of the aluminum trough filter for phototimed posteroanterior chest radiographs at 120 kVp provides excellent detail within the parenchyma of the lung as well as greatly enhanced visualization of mediastinal structures on a single exposure. An improvement in overall diagnostic value was noted by a panel of radiologists in 87% of 50 cases compared with conventional 120 kVp technique. Dosimetric measurements of the entrance exposure indicate a 12.5% reduction over the mediastinum and a 62% reduction over the lateral lung field compared with routine nonfilter examinations. The filter is inexpensive and readily adapted to any x-ray unit and is, therefore, an attractive alternative to costly high kVp sources. Furthermore, the attenuation coefficient for calcium in bone and parenchyma remains relatively high with preservation of calcium contrast. Repeat exposures have been minimized and the need for additional projections virtually eliminated.

Humans↗
PubMed1980

Psychopathology and fatherlessness in poor boys.

The study reported represents an effort to expand an earlier investigation of how psychopathology is related to fatherlessness. The sample (N=201), composed of U.S. blacks and Cuban refugees of white derivation, was controlled for the family's economic class position, ethnicity, place of residence, and for the children's age, gender, and ordinal position and matched with a control group of ""fathered'' children. Instruments used were a mini MMPI (76 items) and the Louisville Aggression Survey Schedule-1. All of the data obtained in the study were supplied by the mothers--both about themselves and their firstborn male child. No positive association between the boys' psychopathology and their fatherlessness was found. Moreover, the data seemingly indicate that poverty exerts a leveling influence that overrides the differentiating characteristics of ethnic and age grouping, family structure, father presence or absence, and liguistic and cultural heritages.

Adolescent↗
PubMed1980

Coping patterns of mothers of poor boys.

Using the same 201 impoverished, urban dwelling black and Cuban refugee mothers from their previous study ""Psychopathology & Fatherlessness in Poor Boys,'' Adams and Horovitz examine the coping sytles of these women. The differing groups of mothers were classified according to their firstborn son's ages, their ethnicity and the presence or absence of a father in their household. Scored according to scales L, F, K, 1--4, and 6--9 of the MMPI, the women were profiled and a descriptive comparison employed. In most instances the null hypothesis was confirmed: mothers of fathered boys did not differ in their coping strategies from mothers of fatherless boys regardless of the family's ethnicity and the boy's psychopathology or age. Of note was the high scores in the ""paranoia'' scale of MMPI, indicating that it may be functional and adaptive to use projection in an urban slum.

Adaptation, Psychological↗
PubMed1980

Impaired renal blood flow autoregulation in ischemic acute renal failure.

We used a model of ischemic acute renal failure featuring normal renal blood flow (RBF) to evaluate the autoregulatory capability in a preparation having a marked reduction of inulin clearance (GFR). In 10 dogs, we clamped the renal artery for 90 min (experimental); 6 dogs, 1 min only (sham). Approximately 18 hours later, we determined the autoregulatory ability from RBF responses to renal arterial constriction. GFR of the experimental dogs was 10 +/- 4 ml/min, significantly lower than GFR in the sham dogs (43 /+- 9 ml/min). RBF in the experimental dogs (189 +/- 17 ml/min) was not significantly different from that in the sham dogs (206 +/- 32). An autoregulation index, ranging from 0.49 to 1.09 (mean 0.690), was significantly larger than was that of sham dogs, which ranged from zero to 0.23 (mean 0.060). At control arterial pressures, vascular resistance was comparable in both groups; however, at reduced arterial pressures below the normal autoregulatory range, average resistance of the experimental dogs (0.62 +/- 0.12 mm Hg/[ml/min]) was significantly greater than was that of the sham dogs (0.38 +/- 0.06 mm Hg/[ml/min]). These studies indicate that a substantial loss of renal hemodynamic responsiveness follows ischemic injury to the dog even when RBF is maintained within the normal range. The loss of autoregulatory capacity associated with a severely attenuated GFR is consistent with a role for tubular flow in the normal mechanism of autoregulation.

Acute Kidney Injury↗