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Biomedical subjects

R S Jackson

Publications and source records attributed to R S Jackson.

34 records · Page 2Linked to original sources
PubMed1991

Are patients with low serum thyroid stimulating hormone and normal total thyroxine hyperthyroid? Usefulness of 99mTc pertechnetate uptake.

The records of 107 patients who had had thyroid 99m Tc pertechnetate uptake measured, were reviewed. In patients with normal serum thyroxine (T4) and thyroid stimulating hormone (TSH), 35 of 36 with normal uptake and three with high uptake were clinically euthyroid. In patients with high serum T4 and low TSH, seven had normal and 29 had high uptake and all were clinically hyperthyroid. In patients with normal serum T4 and low TSH, 10 of 11 with high uptake were clinically hyperthyroid whereas only two of 18 with normal uptake were. The sensitivity, specificity and positive predictive value of pertechnetate uptake measurements were 83%, 94%, and 91%, respectively. The measurement of pertechnetate uptake is a rapid investigation and may help in the interpretation of patients with undetectable serum TSH found in the presence of normal serum T4.

Adult↗
PubMed1987

Acute rupture of myxomatous mitral valve presenting as refractory cardiopulmonary arrest.

A 59 year old white woman had an out of hospital sudden cardiac arrest. Resuscitation at the scene restored spontaneous pulse, blood pressure and respiration but cardiovascular collapse recurred within 30 minutes of hospital arrival. Medically refractory cardiogenic shock of unclear origin prompted the placement of an intraaortic balloon pump, and hemodynamic stabilization was achieved over several hours. Acute rupture of the chordae tendineae of myxomatous mitral valve was diagnosed as the cause of the cardiac arrest. Mitral valve replacement was performed and the patient made an uneventful recovery. This report describes the first known case of rupture of a myxomatous mitral valve presenting as sudden cardiac death. The differential diagnosis of sudden death in this disorder is reviewed, the role of mechanical circulatory assistance in refractory cardiac arrest is discussed and several interesting hemodynamic aspects of the case are considered.

Female↗
PubMed1986

High-frequency ventilation in the management of tracheal trauma.

Two cases of rupture of the trachea were treated by surgical repair. Intraoperative and postoperative ventilation was managed with high-frequency ventilation. This mode of ventilation afforded good intraoperative exposure and support as well as good postoperative ventilation despite pulmonary contusion without requiring inflation of the endotracheal tube cuff against tracheal suture lines. We recommend high-frequency ventilation in the management of tracheobronchial trauma intraoperatively and postoperatively, because it allows good ventilation despite pulmonary contusion without high positive airway pressures and without the necessity for inflation of the endotracheal tube cuff against a tracheal suture line.

Adult↗
PubMed1979

Development of a statewide program for surveillance and reporting of hospital-acquired infections.

In 1974, a statewide program was begun to improve surveillance of nosocomial infection in Virginia hospitals. Infection control practitioners were trained at the University of Virginia Hospital, Charlottesville, and were encouraged to submit monthly surveillance reports for analysis. In the first three years of the project, 141 students from 65 hospitals within the state attended a two-week basic course, with eight to 10 students per class. Of the 98 Virginia hospitals that sent students, 75 (73%) submitted monthly reports. The consistency of reporting (number of monthly reports received divided by the number of possible reporting months) was 83%. The sensitivity of reported data was estimated in comparative daily prospective surveys to be 69% for participating hospitals, and the specificity was 99%. The crude infection rate for the first 1.1 million patients at risk was 3.3%.

Cross Infection↗
PubMed1978

Epidemic kepone poisoning in chemical workers.

From March 1974 through July 1975, 76 (56%) of 133 persons who had worked at a pesticide plant that produced Kepone, a chlorinated hydrocarbon insecticide, contracted a previously unrecognized clinical illness characterized by nervousness, tremor, weight loss, opsoclonus, pleuritic and joint pain, and oligospermia. Illness incidence rates for production workers (64%) were significantly higher than for nonproduction personnel (16%). The mean blood Kepone level for workers with illness was 2.53 ppm and for those without disease 0.60 ppm (p less than 0.001). Blood Kepone levels in current workers (mean, 3.12 ppm) were higher than those in former employees (1.22 ppm). Blood Kepone levels for workers in nearby businesses and for residents of a community within 1.6 km of the plant ranged from undetectable to 32.5 ppb. Illness attributable to Kepone was found in two wives of Kepone workers; there was no apparent association between frequency of symptoms and proximity to the plant in the survey of the community population.

Chemical Industry↗
PubMed1976

Tickborne oculoglandular tularemia: case report and review of seasonal and vectorial associations in 106 cases.

A patient acquired tickborne oculoglandular tularemia in early summer in rural Virginia. Tick exposure may be a clue to the diagnosis of tularemia in the eastern as well as the western United States, especially in summer months. A review of the experience with tularemia in Virginia for the last 13 years shows a bimodal seasonal incidence of tularemia with an associated vector exposure in 77.4% of 106 cases. The majority of cases occurring during winter months have been associated with rabbit exposure, while those in summer months are often associated with tick exposure.

Aged↗
PubMed1976

Serologic response to revaccination with two rubella vaccines.

Three years after receiving rubella vaccine, 1,060 elementary school children living on the island of Maui, Hawaii, were revaccinated with either HPV-77 DE-5 or RA 27/3 rubella vaccine given subcutaneously or intranasally in order to compare the effectiveness of these two vaccines in raising antibody titers. RA 27/3 was the more effective booster vaccine, producing fourfold or greater titer rises in 20.1% of recipients, including 80% of children with hemagglutination-inhibiting antibody titers less than or equal to 1:40 at the time of revaccination, intranasal revaccination was not significantly more effective than subcutaneous revaccination, although it did elicit higher titers in children who responded. Responses differed according to the vaccine that children had received three years earlier. Because antibody titers have persisted in vaccinated children, routine administration of a second dose of rubella vaccine is not currently recommended.

Administration, Intranasal↗
PubMed1975

Rubella vaccination: fertility control in a large-scale vaccination program for postpubertal women.

Despite nationwide immunization programs, rubella infections during pregnancy continue. To solve this serious health problem direct immunization of women of reproductive age may be required. On a clinic basis, using nonphysician personnel, we vaccinated 404 susceptible women, ages 18 to 33; half were sexually active. Since pregnancy is proscribed for 2 to 3 months following rubella vaccination, a full range of family-planning services and a variety of contraceptive methods were used to ensure sustained fertility control. Sixteen vaccinees presented with possible conceptions in a 3 month follow-up. Of these, only five required treatment: two received diethylstilbestrol, two had menstrual inductions, and one an abortion. Administration of vaccine during a menstrual period was effective in preventing inadvertent vaccination of pregnant women. It was concluded that contraceptive counseling with adequate pregnancy termination backup makes it feasible to give rubella vaccine to highly motivated women.

Contraception↗