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Biomedical subjects

R Brown

Publications and source records attributed to R Brown.

At least 559 records · Page 31Linked to original sources
PubMed1989

Autoimmune haemolytic anaemia associated with malignant peritoneal mesothelioma.

A 57-year-old man with a history of pulmonary asbestosis was incidentally found to have benign mesothelial hyperplasia of the peritoneum at hernia repair. Five months later he developed a Coombs positive haemolytic anaemia of the IgG-C3d type caused by non specific IgG antibodies. At that time no underlying cause for the anaemia was found. The anaemia responded to steroids, but remained steroid dependent. Six months after the diagnosis of the anaemia, a malignant peritoneal mesothelioma was found at laparotomy. The association between malignant mesothelioma and autoimmune haemolytic anaemia has been reported on one previous occasion. The description of a second case suggests that the association is not purely coincidental and that malignant mesothelioma should be added to the list of solid tumours that can be associated with autoimmune haemolytic anaemia. The finding of red blood cells coated with IgG and C3d in this as well as in other cases adds further evidence to the hypothesis that a quinidine type mechanism of haemolysis might be responsible for Coombs positive haemolytic anaemia associated with solid tumours.

Anemia, Hemolytic, Autoimmune↗
PubMed1989

The value of the Glasgow Coma Scale and Injury Severity Score: predicting outcome in multiple trauma patients with head injury.

This retrospective study of multiple trauma patients requiring SICU admission was undertaken to determine to what extent, if any, head injury affected patient outcome. One hundred seventy such patients with head injuries had further analysis. Glasgow Coma Scale (GCS) values at approximately 5 hours postinjury were evaluated, and the Glasgow Outcome Scale was determined 1 month postinjury. A good recovery was seen in 99% of the 87 patients with GCS 15-13. This fell to 71% of the 24 patients with GCS 12-9. Among 59 patients having a GCS below 9, 41% died and an additional 17% had a poor recovery, leaving only 35% with an eventual good outcome. By using both Injury Severity Score and GCS at 6 hours postinjury, physicians will be more accurate in assessing outcome of multiple trauma patients with head injuries.

Adolescent↗
PubMed1989

Immunochemistry of the cell surfaces of Bacteroides bivius and Bacteroides disiens.

Outer membranes were extracted from seven strains of Bacteroides bivius and six strains of B. disiens by the Sarkosyl method. Lipopolysaccharides (LPS) were extracted from the same strains by the Proteinase K method, and from three strains of each species by an aqueous phenol method. Analysis of the outer-membrane proteins by SDS-PAGE demonstrated that, within a species, very similar patterns with many shared or common bands were produced, but there were sufficient differences between species to allow separation. Immunoblotting with antisera raised against whole cells of each of the type strains showed that many antigens were shared between species. Smooth LPS was present in both species. By immunoblotting, the O-antigen of B. disiens was shown to be common to all six strains, and there was no cross-reaction between the B. disiens antiserum and B. bivius LPS. The O-antigen of B. bivius was not detected by immunoblotting with homologous antiserum, but antiserum to B. bivius reacted with a series of common low molecular mass antigens that were present in LPS preparations from strains of both species.

Bacterial Outer Membrane Proteins↗
PubMed1989

Psychosocial factors in Parkinson's disease.

Self-report measures were administered to 136 patients with Parkinson's disease in order to explore the relationships between aspects of psychological adjustment (depression, positive affect and acceptance of illness) and physical illness (duration of the illness, stage of illness and functional disability). Many psychosocial variables which, it was hypothesized, might intervene in the relationship between physical and psychological status were also measured. These were coping style, social support, self-esteem, attributions about the onset and course of the illness, perceived control and previous psychiatric history. A variable pattern of relationships between the different indices of psychological adjustment and physical illness emerged. Self-esteem, coping style and practical support contributed significantly to the variance in psychological adjustment. It was concluded that well-being in Parkinsonian patients is not exclusively dependent on a simple relationship between disability and depression, and that other factors should be taken into account in the clinical management of the illness.

Adaptation, Psychological↗
PubMed1989

Intrathoracic pressures and left ventricular configuration with respiratory maneuvers.

In 12 dogs, we examined the correspondence between esophageal (Pes) and pericardial pressures over the anterior, lateral, and inferior left ventricular (LV) surfaces. Pleural pressure was decreased by spontaneous inspiration, Mueller maneuver, and phrenic stimulation and increased by intermittent positive pressure ventilation (IPPV) and positive end-expiratory pressure (PEEP). To separate effects due to blood flow, we analyzed beating and nonbeating hearts. In beating hearts, there were no significant differences between changes in Pes and pericardial pressures. In arrested hearts, increasing LV pressure by 8 Torr increased pericardial pressures by only 3.6 Torr. With IPPV and PEEP, increases in Pes and pericardial pressures were equal in live hearts and in low-volume arrested hearts (LV pressure = 4 Torr). In high-volume arrested hearts (LV pressure = 12 Torr), the increase in pericardial pressure over the anterior LV surface was less than Pes, whereas that over the lateral and inferior LV surfaces was the same as Pes. At high LV volume, in arrested hearts pericardial pressures decreased less than Pes during negative pressure maneuvers. In another six dogs, external LV configuration and volume were measured. In beating hearts during spontaneous inspiration, Mueller maneuver, and phrenic stimulation (endotracheal tube open), septal-lateral dimension and LV volume decreased by approximately 3% (P less than 0.05). This was also true for PEEP. In arrested hearts, septal-lateral dimension and LV volume decreased only with PEEP. We conclude that 1) the relationship between Pes and pericardial pressures is complex and depends on LV volume, local pericardial compliance, and the means by which Pes is changed, 2) changes in measured pericardial pressures did not completely explain changes in LV configuration, and 3) during different respiratory maneuvers, different forces account for the same observed changes in LV volume and configuration.

Animals↗
PubMed1989

Diaphragm metabolism during supramaximal phrenic nerve stimulation.

The metabolic changes accompanying diaphragm fatigue caused by supramaximal stimulation of the phrenic nerves are incompletely described. In particular, we wished to determine whether the occurrence of anaerobic metabolism correlated with fatigue as defined by decline in force generation. In 10 anesthetized mechanically ventilated mongrel dogs we measured arterial pressure, transdiaphragmatic pressure (Pdi), phrenic arterial flow (Qdi-Doppler flow probe), arterial and phrenic venous blood gases, and lactate levels. From these we derived indexes of diaphragm O2 consumption (VO2) and lactate production. Bilateral phrenic nerve pacing was carried out (50 Hz, duty cycle 0.4, 24 contractions/min) for two 15-min pacing periods separated by a 45-min rest period. Over each pacing period Pdi decreased from approximately 16 to approximately 10 cmH2O (P less than 0.01, no significant difference between periods). Initially, during pacing, Qdi and VO2 each increased fivefold over prepacing base line. Qdi remained elevated at this level whereas VO2 decreased over the pacing period by approximately 25%. Hence, the change in VO2 over the pacing period was due primarily to changes in O2 extraction. During the first pacing period lactate production was observed early and declined throughout the pacing period. No lactate production was observed during the second pacing period, although Pdi, VO2, and Qdi responses were the same for both pacing periods. Phrenic venous PO2 remained greater than 30 Torr throughout both pacing periods.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

Fluorophotometric analysis of the blood retinal barrier: two techniques compared.

Methods of interpreting data obtained by vitreous fluorophotometry vary between institutions. One important difference in these methods is the use of total plasma fluorescein or only free fluorescein in the calculation of the plasma fluorescein curve used in the analysis of the blood retinal barrier. We examined 16 diabetic patients (32 eyes) with documented background retinopathy using vitreous fluorophotometry. We compared two methods of analysis: (1) using total plasma fluorescein, and (2) using plasma-'free' fluorescein. Both methods were equally efficient at detecting breakdown of the blood retinal barrier and were highly comparable (R = 0.84; p less than 0.001). 43.75% of eyes with documented background retinopathy had a normal blood retinal barrier as measured by these techniques.

Adolescent↗
PubMed1989

Respiratory mechanics in acute quadriplegia. Lung and chest wall compliance and dimensional changes during respiratory maneuvers.

We measured lung and chest wall compliance as well as rib cage and abdominal dimensions in the supine position in five acute C4-7 quadriplegics. Studies were performed serially from 1 to 12 months after injury. Results were compared with those of control groups of chronic (greater than 1 yr after injury) quadriplegics and normal volunteers. We found that lung compliance was lower in acute and chronic quadriplegics (0.129 +/- 0.023 and 0.176 +/- 0.043 L/mm Hg, respectively) than in normal subjects (0.278 +/- 0.086 L/mm Hg) and that these changes apparently occurred within 1 month of injury. Specific lung compliance appeared to be reduced to a lesser degree, suggesting that the changes in lung compliance were partly due to reduced lung volumes and partly to altered mechanical properties of the lung. During respiratory maneuvers, abdomen and rib cage dimensional changes demonstrated rib cage distortion. This distortion was less severe in chronic than in acute quadriplegics. The improvement in chest wall stability was likely due to increased strength of cervical accessory muscles of respiration and improved coupling of the various rib cage elements in chronic quadriplegics.

Acute Disease↗
PubMed1989

Predictors of suicide in borderline personality disorder.

One hundred patients with borderline personality disorder who were followed for a mean of 15 years were compared with 14 borderline patients who committed suicide. The most significant predictors of completed suicide were previous attempts and higher education.

Borderline Personality Disorder↗
PubMed1989

Agoraphobia with and without current panic attacks.

MMPI and SCL-90-R profiles of agoraphobics with and without current panic attacks are presented. Agoraphobics with current panic attacks were more elevated on Psychopathic Deviate (4), Psychasthenia (7), and Social Introversion (0) scales of the MMPI. On the SCL-90-R agoraphobics with current panic attacks had higher scores on Interpersonal Sensitivity, Anxiety, Phobic Anxiety, and Total/90.

Adult↗
PubMed1989

U.S. experience with valproate in manic depressive illness: a multicenter trial.

Valproic acid and its enteric-coated derivative, divalproex sodium, have been used extensively in a wide variety of seizure disorders. Recent preliminary research demonstrates the effectiveness of valproate in the treatment of manic-depressive illness, including acute mania, prevention of bipolar episodes, and schizoaffective disorder. In uncontrolled and controlled studies, treatment-resistant patients with these disorders have responded well to valproate. Preliminary results of an ongoing community-based open trial of valproate treatment of those affective illnesses reveal that valproate is frequently effective and has a favorable side effect profile. Overall, approximately two out of three patients with refractory bipolar disorder respond to acute therapy with valproate. Response in schizoaffective patients has been moderate, and valproate seems to be less effective in the treatment of depression. Experience suggests the importance of monitoring plasma drug levels to maximize efficacy and minimize potential toxicity.

Adult↗
PubMed1989

A twelve year follow-up of iodine deficiency in Bulape, Zaire.

In a defined population of Bulape, Zaire, the prevalence of simple goitre was 42.4 +/- 1.3%. Compared with studies in the same population done twelve years previously, the prevalence of simple goitre had increased by 13.9% (P less than 0.05). Urinary iodine determination remained approximately the same. We conclude that over the twelve year period, the prevalence of iodine deficiency has not improved in the Bulape population.

Adolescent↗