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Biomedical subjects

P Patterson

Publications and source records attributed to P Patterson.

At least 91 records · Page 5Linked to original sources
PubMed1996

Severe hemosiderosis post allogenic bone marrow transplantation.

Abnormal liver function persisting late after allogeneic BMT is usually attributed to chronic GvHD, viral hepatitis or drug toxicity. We describe a patient who had negative hepatitis serology, was on no hepatotoxic medication, had no evidence of GvHD but had abnormal liver function 15 months post MBT. She was diagnosed as having grade IV hemosiderosis of the liver. Her total red cell support had only been 52 units. We therefore postulate that in a proportion of patients receiving allogeneic BMT impaired intestinal iron absorption may be an important cause of hemosiderosis.

Bone Marrow Transplantation↗
PubMed1996

24-hour mother-infant discharge with a follow-up home health visit: results in a selected medicaid population.

OBJECTIVE: To determine safety and cost-effectiveness of 24-hour discharge in selected mothers and newborns. METHODS: Women delivering at University Hospital (the University of Alabama at Birmingham) were screened to determine their eligibility for 24-hour discharge. Mothers were eligible if they had no medical problems and no history of substance abuse, had an uncomplicated vaginal delivery and postpartum course, were 12 or more hours after postpartum bilateral tubal ligation, and had reached 24 hours after delivery by 6:00 PM on the day of discharge. Newborns were eligible if they were term (37 weeks or greater), weighted 2500 g or greater, and had a normal examination at 24 hours of age. At 48 hours after delivery, each mother and infant pair was examined by a home health nurse. Telephone consultations with a staff physician were noted and outcomes were entered into a data base linked to hospital financial data. RESULTS: Of 5621 deliveries from October 1, 1993 to September 30, 1995, 972 mothers (17%) and 856 (15%) newborns were discharged at 24 hours. One mother was lost to follow-up after discharge. Nine-hundred fifty-six of 971 mothers (98.5%) had a normal examination at the home visit. Fifteen of 971 mothers (1.5%) had problems that required obstetrician telephone consultation. Seven mothers (0.7%) required a physician visit; two of these women were readmitted for treatment of an infection. Seven-hundred ninety-five of 856 (93%) newborns had a normal examination. Sixty-one newborns (7%) had problems that required pediatrician telephone consultation, primarily for jaundice, infant care questions, and a cardiac murmur. Twelve infants (1.4%) required a pediatric clinic visit. No infant was readmitted to the hospital. Net cost savings to our hospital for 24-hour discharge in these selected patients was $ 506,139 during a 2-year period. CONCLUSION: In a selected, low-risk, low-income population, mother-infant discharge 24 hours after delivery with a home follow-up visit is safe and cost-effective.

Adolescent↗
PubMed1996

Verbal and non-verbal behavior immediately prior to aggression by mentally disordered people: enhancing the assessment of risk.

In this study we seek to enhance the assessment of imminent violence risk by providing empirical data on the types of verbal and non-verbal behaviour exhibited by 31 psychiatric inpatients immediately prior to assaulting a staff member, and 31 non-aggressive controls. Verbal abuse, high overall activity level and standing uncomfortably close to the intended victim were the most common behaviours immediately prior to the assault, but most preassault behaviours were also exhibited when patients were not assaulting staff. In the 3 days prior to the assault, aggressive patients differed from non-aggressors in terms of verbal abuse, abnormal activity level (P < 0.05), threatening gestures and threatening stance (P < 0.01). Only one patient was aggressive in the absence of any predictive behaviours. We conclude that most patients exhibit easily identifiable signs of imminent aggression, but that many of these signs occur in the absence of aggression.

Adult↗
PubMed1995

Pre-eclampsia is associated with an excess of proliferative immature intermediate trophoblast.

Pre-eclampsia/toxemia (PET) is an idiopathic hypertensive disorder of pregnancy elicited in susceptible mothers by exposure to placental trophoblast. Three facts regarding the placenta in PET are known: an association with large placentas (excessive trophoblast), a tendency for superficial implantation, and inappropriate trophoblastic immaturity, as assessed by ultrastructural and biochemical criteria. A unitary hypothesis is that PET is related to a maturation defect leading to excessive accumulation of inappropriately immature intermediate trophoblast in the placental implantation site. We studied the implantation site of PET and control placentas from three gestational age groups (25 to 30, 30 to 35, and 36 to 40 weeks old [five per group]) by morphometry and immunohistochemistry using antibodies to three phenotypic markers (cytokeratin, human placental lactogen (HPL), and beta 2-microglobulin) and two markers of cell dynamics (proliferating cell nuclear antigen [PCNA] and bcl-2]). Implantation sites in the PET group had increased amounts of intermediate trophoblast (cell number and longitudinal extent) with an increased proliferative index (percentage of PCNA positive) and evidence of phenotypic immaturity (HPL negative). Intermediate trophoblast from both groups was uniformly bcl-2 negative and beta 2-microglobulin positive. Based on these data and the findings of other investigators, we propose that the diagnostic term "atypical implantation site" be added to acute atherosis, villous infarction, and increased syncytial knotting as a characteristic of placentas from pre-eclamptic pregnancies.

Biomarkers↗