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Biomedical subjects

R Bell

Publications and source records attributed to R Bell.

At least 217 records · Page 12Linked to original sources
PubMed1991

Observations on the effect of chimeric anti-CD4 monoclonal antibody in patients with mycosis fungoides.

Chimeric (murine/human) anti-CD4 monoclonal antibody was infused into seven patients with mycosis fungoides. Successive patients received doses of 10, 20, 40, and 80 mg of antibody twice a week for 3 consecutive weeks. All patients had some clinical improvement, but responses were of relatively short duration. Serum levels of chimeric antibody varied as a function of dose. At the 80-mg dose level, antibody was readily observed in biopsied skin lesions. Although there was coating by antibody of most CD4 positive cells in the blood, there was no significant depletion of CD4 positive cells. Low-level antibody responses against the mouse Ig variable region and human Ig allotypic constant region determinants were observed in several patients, but none were of clinical significance. All but two patients made primary antibody and T-cell proliferative responses to a simultaneously administered foreign protein test antigen. However, there was marked suppression of the mixed lymphocyte reaction. We conclude that at the dose levels studied, a chimeric anti-CD4 monoclonal antibody (1) had some clinical efficacy against mycosis fungoides; (2) was well tolerated; (3) had a low level of immunogenicity; (4) had immediate immunosuppressive effects; and (5) did not induce tolerance to a co-injected antigen.

Adult↗
PubMed1991

Diagnosing personality disorders in psychiatric inpatients.

This study investigated assumptions made by DSM-III and DSM-III-R regarding Axis I-Axis II associations and sex differences for the 11 personality disorders (PD). A total of 112 patients formed 4 Axis I diagnostic groups: recent-onset schizophrenia (n = 35); recent-onset mania (n = 26); unipolar affective disorder (n = 30); and a mixed diagnostic group (n = 21). The prevalence of PD was determined using the Structured Interview for DSM-III Personality Disorders (SIDP). Schizophrenia was associated with antisocial PD and schizotypal PD; manic disorder was associated with histrionic PD; and unipolar affective disorder was associated with borderline, dependent and avoidant PD. Some of these results were consistent with DSM-III/DSM-III-R postulates. However, there was little support for the DSM-III/DSM-III-R statements on sex differences in the prevalence of PD, except for antisocial PD. The implications of the results for DSM-III/DSM-III-R assumptions are discussed.

Adult↗
PubMed1991

Elevated intracranial pressure and computed tomography of the brain in fulminant hepatocellular failure.

Cerebral herniation is a leading cause of death in patients with fulminant hepatocellular failure. Classical signs of elevated intracranial pressure are often absent in these patients. A reliable noninvasive method by which the presence of cerebral edema could be determined is much needed. To assess the efficacy of computed tomography of the brain in this setting, we compared the radiographic findings to the intracranial pressure measured by an epidural monitor in patients with fulminant hepatic failure. Unfortunately, a considerable difference existed between the presence of cerebral edema diagnosed by computed tomography of the brain and elevation of the intracranial pressure. Our observations suggest that in patients with fulminant hepatic failure and advanced hepatic encephalopathy, computed tomography of the brain is of little value in detecting cerebral edema. Pressure monitoring is most important to establish the presence and guide the therapy of intracranial hypertension.

Brain↗
PubMed1991

Effect of different pump mechanisms on transfusion of blood.

Sometimes infusion pumps are used to deliver whole blood to patients. However, in doing so there is a potential for damage to red cells from mechanical stresses in the pump, resulting in haemolysis. In order to investigate the degree of haemolysis caused by different pumps and therefore their suitability for whole blood infusion, we compared the performances of commonly used volumetric pumps (AVI 400; IVAC 560; IVAC 631 and IMED 927) with different pumping mechanisms. Our results show that the maximum haemolysis (3.9 mg/100g) was caused by the IVAC 560 and the least (1.08 mg/100g) by the AVI 400.

Blood Transfusion↗
PubMed1990

A comparative trial of three agents in the treatment of acute migraine headache.

STUDY OBJECTIVES: A study was conducted to evaluate the relative efficacy of three non-narcotic agents, chloropromazine, lidocaine, and dihydroergotamine, in the treatment of migraine headache in an emergency department setting. DESIGN: The trial was randomized and single blinded. SETTING: The study was conducted in two university-affiliated EDs. TYPE OF PARTICIPANTS: All patients had an isolated diagnosis of common or classic migraine. INTERVENTIONS: Patients were pretreated with 500 mL (IV) normal saline before randomization. Study drugs as administered were dihydroergotamine 1 mg IV repeated after 30 minutes if the initial response was inadequate; lidocaine 50 mg IV at 20-minute intervals to a maximum total dose of 150 mg as required; or chloropromazine 12.5 mg IV repeated at 20-minute intervals to a total maximum dose of 37.5 mg as required. Patients were asked to grade headache severity on a ten-point scale before and one hour after the initiation of therapy. Follow-up by phone was sought the following day. MEASUREMENTS AND MAIN RESULTS: Of 76 patients completing the trial, 24 were randomized to receive chloropromazine, 26 to receive dihydroergotamine, and 26 to receive lidocaine. Reduction in mean headache intensity was significantly better among those treated with chloropromazine (P less than .005). Persistent headache relief was experienced by 16 of the chloropromazine-treated patients (88.9%) contacted at 12 to 24 hours follow-up compared with ten of the dihydroergotamine-treated patients (52.6%) and five of the lidocaine-treated group (29.4%). CONCLUSION: The relative effectiveness of these three antimigraine therapies appears to favor chloropromazine in measures of headache relief, incidence of headache rebound, and patient satisfaction with therapy.

Adult↗
PubMed1990

An unusual pleural effusion.

Transudative pleural effusions usually result from systemic disorders such as congestive heart failure, hypoproteinaemic states and pneumonia. We report a patient who illustrates a rarely considered local mechanism of transudate formation.

Aged↗
PubMed1990

Vascular complications following orthotopic liver transplantation.

During the first 3 years of the Australian National Liver Transplantation Programme, 51 liver grafts were performed in 46 patients. There were 11 major vascular complications encountered following 10 liver transplants in eight (17%) patients. They caused death in three patients and the need for retransplantation in two others. Hepatic artery thrombosis (HAT) occurred five (10%) times, producing a spectrum of clinical illness ranging from death to an asymptomatic event. Other vascular complications included hepatic artery stenosis not complicated by thrombosis (two), primary (one) and secondary (one) haemorrhage, thrombosis of a mesoportal venous graft (one) and inferior vena caval stenosis (one). Vascular complications are a significant cause of morbidity and mortality following liver transplantation. Predisposing and precipitating factors should be recognized and minimized.

Adult↗
PubMed1989

Perceptual and motor factors in the imitation of simple temporal patterns.

This study investigated the relative importance of perceptual and motor factors in the imitation of simple temporal patterns. Previous research in which subjects tap out interval sequences using one finger has suggested that perceptual factors play an important role in response timing. Studies of bimanual tapping, in contrast, stress the importance of motor interactions between the two hands. In this experiment we compared the ability of subjects to tap out two-interval sequences using one finger, two fingers on one hand, and two fingers on opposite hands. The results showed almost identical performance under the three response conditions. It is suggested that the perceptual relations between intervals in a pattern were the main determinant of performance in this experiment.

Adult↗
PubMed1989

Group psychotherapy with preadolescent sexual abuse victims: literature review and description of an inner-city group.

The demand for therapy groups for child sexual assault victims has risen as detection of abuse has increased, but little has been published about conducting and evaluating such groups. The authors present a comprehensive review of the literature and describe their sixteen-week therapy group with seven eleven- and twelve-year-old girls. Treatment themes, activities, group process issues, and psychometric findings on the Piers-Harris Children's Self Concept Scale and the Child Behavior Checklist are discussed. Suggestions for future groups and research are offered.

Child↗
PubMed1989

The dynamic nature of ethnic identity among Greek-Australian adolescents.

The dynamic nature of ethnic identity was explored by exposing Greek-Australian adolescents to one of three experimental conditions: positive (highlighting the advantages of their ethnic group membership), negative (the disadvantages), or a neutral control condition. Sensitizing respondents to their ethnic group membership resulted in an increase in the salience of Greek identity. Multi-dimensional scaling yielded two dimensions that best represented the interrelationships among items describing ethnic reference groups: an ethnicity dimension and a multi-cultural-segregated dimension. There was no discrimination among the three groups on the latter, but the two experimental groups differentiated between the Australian and Greek items significantly more than did the controls. Respondents in the negative condition had significantly less positive attitudes to their ethnic origins than the other two groups.

Acculturation↗
PubMed1989

Redistribution of crossed cerebellar diaschisis.

Crossed cerebellar diaschisis refers to a functional decrease in blood flow to the cerebellar hemisphere contralateral to the infarcted or ischemic cerebral hemisphere. This phenomenon can be depicted using PET as well as using SPECT. This condition, seen on early I-123 IMP brain scans, can show redistribution on the three hour delayed scan, presumably due to normal non-specific amine receptor sites of the affected cerebellum. One such case is reported.

Amphetamines↗
PubMed1989

Somatosensory evoked potentials predict neuromotor outcome after periventricular hemorrhage.

Thirty-nine very low-birthweight (VLBW) preterm infants with periventricular hemorrhage (PVH) were studied with short-latency median nerve somatosensory evoked potentials (SEP) at two, four and/or six months corrected age, and subsequently were followed to a mean age of 22 months. All 12 infants with a single SEP showing unilateral absence or prolonged latency of the early cerebral (N1) response had motor abnormalities at follow-up. A single normal SEP predicted normal motor development in 19 of 36 infants; two normal SEPs did so in 15 of 26 infants, and three normal SEPs in 12 of 14 infants. These results demonstrate that SEPs play a useful rôle in predicting neuromotor outcome for VLBW preterm infants with PVH.

Cerebral Hemorrhage↗
PubMed1989

Alcohol consumption, cigarette smoking and fetal outcome in Victoria, 1985.

The aims of this study were to document the extent of cigarette smoking and alcohol consumption by Victorian women during pregnancy and relate the use of cigarettes and alcohol to various measures of pregnancy outcome. The study found that 24 per cent of women smoked during pregnancy and smoking was more common amongst younger women; 99.5 per cent of women drank, on average, less than two standard drinks per day and older women were more likely to be drinkers than younger women; 3.6 per cent of women reported at least one episode of binge drinking during pregnancy. There was an increasing trend in the proportion of low birthweight (less than 2500 g) infants with increasing use of tobacco and a dose-dependent reduction in mean birthweight. Drinkers were less likely to have a pre-term or low birthweight infant than abstainers and babies born to drinkers had a higher mean birthweight than babies born to abstainers. The results of our study did not suggest that drinkers were at increased risk of delivering an infant with a congenital malformation, however heavy drinking was very uncommon in the studied population.

Adult↗