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Biomedical subjects

R Joseph

Publications and source records attributed to R Joseph.

At least 163 records · Page 9Linked to original sources
PubMed1986

Solitary colonic ulcer in a spinal cord injured patient.

Bleeding from the lower gastrointestinal tract is rarely reported in spinal cord injured patients. A case is reported of such bleeding in a quadriplegic man with a solitary colonic ulcer diagnosed by flexible sigmoidoscopy and biopsy. The diagnosis of solitary colonic ulcers is difficult to make in spinal cord injured persons because presenting features may be masked by the neurologic deficits caused by the injury or may be falsely attributed to problems associated with the injury or to iatrogenic trauma. Solitary colonic ulcer should be included in the differential diagnosis of gastrointestinal bleeding in persons with spinal cord injury. Flexible sigmoidoscopy or colonoscopy is recommended for visualization and biopsy of the bleeding lesion.

Adult↗
PubMed1986

Reversal of cerebral dominance for language and emotion in a corpus callosotomy patient.

A case study of a right-handed individual with epilepsy and brain dysfunction of early onset is described who was found, following callosotomy (sparing the rostrum of the callosum) to be left hemisphere "dominant" for processing and/or expressing emotional and somesthetic information, and right hemisphere "dominant" in regard to the expression and comprehension of language and linguistic stimuli. Hence, a significant reversal in functional representation, due presumably to an injury suffered early in life, was observed. Moreover, following callosotomy the patient demonstrated severe disconnection syndromes in regard to right hand usage, the recognition of emotion, and the production and comprehension of linguistically related information. The left cerebrum appeared to be almost completely without linguistic representation except in regard to emotional language. The possible mechanisms involved in functional sparing and reversed representation are briefly discussed, and the effects of partial disconnection on the expression of these capacities is presented.

Adult↗
PubMed1986

Neurological manifestations of the hyperventilation syndrome.

Seventy-eight patients with the hyperventilation syndrome are described, none of whom had been diagnosed prior to referral for neurological assessment. There is a constellation of symptoms associated with this condition, and attacks need to be reproduced by hyperventilation in order for the diagnosis to be established. Loss of consciousness and paraesthesiae were more frequent than in previously published series.

Adolescent↗
PubMed1985

Interhemispheric transfer and the completion of reversible operations in non-conserving children.

Evidence that concerns interhemispheric transfer deficits in young children is reviewed, and it is suggested that the late maturation of the corpus callosum may prevent the transfer and thus verbal expression of knowledge concerning equivalence relationships in non-conservers - operations normally performed by the right hemisphere. Because previous findings with "split-brain" patients indicate that interhemispheric transfer can be achieved when questions are phrased in the context of a reward (e.g., "preference"), questions concerning the conservation of a non-equivalent volume were posed to 65 non-conservers in terms of an imagined reward (preference condition). Questions also were phrased so as to require comparative-relational determinations as well as expectation of an empirical reversal of the stimulus conditions so as to determine differences/similarities in the reasoning process. Significantly more non-conservers demonstrated an awareness of empirical reversal or performed the preference relational operation correctly as compared to conditions that required comparative-relational judgments. The evidence also suggests the presence of two fundamentally distinct cognitive approaches to the problem, which appear to resist integration in children of this age group.

Child Development↗
PubMed1985

Parental age and birth order effects in children with febrile convulsions.

This is a study of the parental age and birth order of 100 Chinese children with febrile convulsions compared with 100 controls. The birth order of children with febrile convulsions (1.6 +/- 0.8) was found to be lower than that of the controls (2.1 +/- 1.0), a difference significant at P less than 0.001, whereas there was no significant difference for both paternal and maternal age. Using multiple regression analysis, it was found that the birth order effect was significant at P less than 0.0001. This finding suggests that perinatal factors may play a role in the pathogenesis of febrile convulsions.

Adult↗
PubMed1985

Combined team management of diabetes mellitus in pregnancy.

225 women with diabetes in pregnancy were managed by a team of obstetricians, physicians (endocrinologists) and paediatricians from the National University of Singapore. A protocol of management was formulated and followed. The incidence of 1.1% or 1 in 90 pregnancies was found, with significantly higher incidence in Indians and lower in Malays. There were 37 established diabetics and 188 diagnosed during pregnancy. Of these (188), 74 were gestational diabetics. All the women were treated with Insulin and Diet or Diet alone. 177 (79%) were treated with Insulin and Diet. Blood sugar profiles were done for monitoring diabetic control. 72.8% of the women were between para 0 and 1 and 85.2% between the ages of 20 and 34. 72.5% of the women delivered at 38 weeks gestation or later. 48.9% went into spontaneous labour, 32.4% were induced and 18.7% had elective caesarean section. 62.2% of the women had labour of less than 12 hours. The overall caesarean section rate was 41.7%. There were 3 stillbirths and 2 neonatal deaths. The perinatal mortality rate was 2.2%. Thirteen babies had congenital malformations (5.8%). 77.8% of the babies had Apgar score of 7 or more at 5 minutes after delivery. 79.1% of the babies weighed between 2.5 kgm and 3.9 kgm. Pre-eclamptic toxaemia was the commonest complication in pregnancy followed by Urinary Tract Infection and Polyhydramnios. Postpartum complications in the mother were confined to 14 women (6.2%), and wound infection or breakdown was the commonest cause.

Adult↗
PubMed1985

Extremes of foetal birthweight for gestation in infants of diabetic mothers.

100 patients were registered at the Diabetic Clinic in 1981, where they were managed by a team of physician, obstetrician and paediatrician, based on a preset protocol. Only 92 patients were eventually analysed. The study showed a 1.3% incidence of pregnancies complicated by diabetes mellitus. The mean birthweights of infants of both gestational and established diabetics were heavier than that of the general population by race and gestation. 25% of the 92 infants of diabetic mothers have birthweight exceeding the 90th centile of population. Further division of the 92 patients into the "true gestational" diabetics, as shown by an oral glucose tolerance test performed 6 weeks post-natally, also showed a 25% incidence of macrosomia. Late antenatal booking, delayed detection of abnormal glucose tolerance and treatment attributed to the high incidence of macrosomia. Only one infant had birthweight below the tenth centile. There were no perinatal mortality in the 92 patients studied. Macrosomia is a common complication in infants of diabetic mothers despite a physician-obstetrician joint-care system. Also, the risk of having macrosomia amongst gestational diabetics is high.

Birth Weight↗
PubMed1985

Thrombotic complication of umbilical arterial catheterization and its sequelae.

Umbilical arterial catheterization caused major complications including 5 deaths in 25 of 230 infants who underwent autopsy at the Kandang Kerbau Hospital in a two-and-a-half year period beginning May 1982. Arterial thrombosis developed in 25 of 129 (19.3%) autopsies with a history of umbilical arterial catheterization. Pathological sequelae of thrombosis occurred in 14 cases (peripheral gangrene 1, renal 6, gastrointestinal 3 and both renal and gastro-intestinal 4). The sequelae were clinically unsuspected in the majority. Early deaths were uncommon in the group with thrombosis. Comparison of neonatal factors revealed no significant differences between the group with sequelae and those without. Infants with indwelling umbilical arterial catheter should be actively monitored for complications.

Aorta, Abdominal↗