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Biomedical subjects

R Rhodes

Publications and source records attributed to R Rhodes.

At least 55 records · Page 3Linked to original sources
PubMed1991

Chronic illness and the physician-patient relationship: a response to the Hastings Center's "ethical challenges of chronic illness".

The following article is a response to the position paper of the Hastings Center, "Ethical Challenges of Chronic Illness", a product of their three year project on Ethics and Chronic Care. The authors of this paper, three prominent bioethicists, Daniel Callahan, Arthur Caplan, and Bruce Jennings, argue that there should be a different ethic for acute and chronic care. In pressing this distinction they provide philosophical grounds for limiting medical care for the elderly and chronically ill. We give a critical survey of their position and reject it as well as any attempt to characterize the physician-patient relationship as a commercial contract. We emphasize, as central features of good medical practice, a commitment to be the patient's agent and a determination to acquire and be guided by knowledge. These commitments may sometimes conflict with efforts to have the physician serve as an instrument of social and economic policies limiting medical care.

Attitude to Health↗
PubMed1990

MRI evaluation of AIDS-related encephalopathy: toxoplasmosis vs. lymphoma.

The spectrum of cranial MRI findings was evaluated in 113 patients with the acquired immunodeficiency syndrome, assessing lesion number, size, location, and configuration in association with the autopsy and/or biopsy results. Correlation of cranial MRI and CT was performed in 32 patients. MRI was shown to be superior in sensitivity of lesion detection demonstrating more lesions than CT in 14 studies (44%) and equivalent information in 18 studies (56%). In no case did CT demonstrate lesions not detected on MRI. We conclude that MRI should be the study of choice in evaluating AIDS-related encephalopathy. Multiple lesions that involve both deep gray matter and white matter suggest the possibility of CNS lymphoma. The "target" appearance on MRI is not helpful in distinguishing toxoplasmosis from lymphoma.

AIDS Dementia Complex↗
PubMed1988

Autopsy findings in AIDS-related lymphoma.

Autopsies in 20 patients with the acquired immune deficiency syndrome (AIDS)-related lymphoma were studied retrospectively to ascertain the precise cause of death and the extent of lymphomatous disease. Eight patients had primary central nervous system (CNS) lymphoma: two of them were diagnosed antemortem; CNS lymphoma was suspected in three others by computerized tomographic (CT) scan and was confirmed at autopsy. The remaining three were diagnosed incidentally at autopsy. All had concurrent infections at autopsy, including opportunistic infection in six and pyogenic infections in two. Opportunistic infections at autopsy in these patients outnumbered those diagnosed clinically. Twelve patients had systemic lymphoma. Three were diagnosed only at autopsy, two of whom had extensive Kaposi's sarcoma (KS) as well. Eight patients were treated with chemotherapy, but died with disseminated disease. Opportunistic infections were found at autopsy in five patients. Secondary involvement of the CNS by lymphoma was frequent (66%) and was not related to previous bone marrow involvement. The authors conclude that the incidence of lymphoma occurring in AIDS may be more frequent than diagnosed clinically. Similarly, multiple opportunistic infections occur in these patients which are not diagnosed premortem and may contribute to early death.

Acquired Immunodeficiency Syndrome↗
PubMed1982

Periaortic fluid aspiration for recognition of infected graft: preliminary report.

Diagnostic aspiration of a periaortic fluid collection was performed four times on three patients suspected of aortic graft infection. One aspiration was positive for Staphylococcus epidermidis and the others were sterile. The results of aspiration were critical in determining if radical surgical treatment should be performed. CT guidance is well suited for this type of aspiration because it results in accurate needle placement without inadvertent puncture of bowel or the graft.

Abscess↗
PubMed1978

Short-term memory and the EEG: effects of instructions to rehearse.

Transoccipital EEG was analyzed during the performance of a task involving the presentation and recall of auditorily presented nine-digit strings. Three strategies of processing were imposed by instruction: (i) passive listening without recall; (ii) passive listening followed by attempted recall; (iii) active rehersal followed by attempted recall. Phasic EEG arousal (8.5-12.5 Hz), inferred from the decline in abundance during string presentation, was found to be a function of the level of 'engagement' in the task. This finding was viewed as supporting an earlier phenomenological description of the task demands involved in recall. Tonic levels of arousal were found to be frequency dependent. At low frequencies (8.5-10.5 Hz) EEG abundance was inversely related to engagement but at higher frequencies (10.5-12.5 Hz) abundance was directly related to the level of engagement. The results are discussed in terms of a possible functional dissociation of EEG arousal within the alpha frequency band.

Brain↗
PubMed1975

Minimal increases in pulmonary wedge pressure associated with improved PaO2s in dogs.

To determine the relationship between minimal increases in pulmonary wedge pressure (PWP), arterial PO2s, single breath diffusing capacity (DLCO), and lung perfusion pattern (as determined by semiupright lung scans), we elevated PWP by 61.8+/-4.1% from baseline values of 5.5+/-0.4 mm Hg. At the end of 30 min PaO2 increased by 13.2+/-1.4% (p less than 0.001) from baseline values of 81.7+/-3.1 mm Hg; DLCO decreased by 15.5+/-1.2% (p less than 0.01) to 0.98+/-0.10 ml/min/mm Hg/kg. Lung perfusion changes in the right lung apical zone increased by 28.0+/-4.2% (p less than 0.001) and decreased in the basal zone by 6.2+/-0.8% (NS). In the left lung the apical perfusion increased by 14.9+/-1.1% (p less than 0.01) and basal perfusion decreased by 8.6/+-1.4% (NS). We conclude that minimal elevation of PWP in dogs leads to improvement in PaO2s through alterations in the lungs perfusion pattern.

Animals↗