Biomedical subjects

R Wolfe

Publications and source records attributed to R Wolfe.

95 records · Page 6Linked to original sources

PubMedDate not supplied

Spinal aspergillus abscess in a patient with bronchocentric granulomatosis.

Aspergillus fumigatus hyphae is often found in the lung tissue of patients with bronchocentric granulomatosis (BCG). This organism is believed to be one agent responsible for inciting the hypersensitivity response and subsequent development of the characteristic pathology that defines BCG. The definitive etiology of this disease, however, remains conjectural. Corticosteroids represent the mainstay of therapy. The fungi recovered from patients with BCG are considered noninvasive; thus, the risk of fungal invasion secondary to steroid-induced immunosuppression is believed to be negligible. However, we report a case of spinal aspergillus abscess that developed in a patient with BCG subsequent to steroid therapy. This case also highlights the necessity for aggressive medical and neurosurgical intervention to avert the development of neurological sequelae.

Abscess↗

PubMedDate not supplied

Newborn screening for congenital hypothyroidism, Victoria, Australia, 1977-1997. Part 1: The screening programme, demography, baseline perinatal data and diagnostic classification.

Clinical, demographic and laboratory data from infants with congenital hypothyroidism (CH) born in the Australian state of Victoria from the commencement of neonatal screening in mid-1977 until December 1988 are reported. These provide a baseline for a 12-year prospective longitudinal study on physical and neuro-psychological outcome until mid-1997, the subject of a second paper. Infants with CH were detected using a primary TT4 screening test. Demographic data were collected prospectively using a clinical assessment protocol. Nearly all affected infants underwent 99mTc pertechnetate scanning at the initial assessment to determine the underlying aetiology of their hypothyroidism. 704,723 infants were screened and 199 with permanent primary hypothyroidism (one in 3,541) were identified. The most common aetiologies were thyroid ectopia (46%), thyroid aplasia (33%), and 'dyshormonogenesis' (11%). The clinical abnormalities classically described in CH were more evident in infants with aplasia, and the striking female preponderance in infants with thyroid dysplasia (syn. dysgenesis) was confirmed. Other features included increased frequencies of 'dyshormonogenesis' in infants of parents of Middle-Eastern origin and of labour induction in infants with dysplasia. A closed posterior fontanelle was not found in any infant with thyroid aplasia.

Age Determination by Skeleton↗

PubMedDate not supplied

Newborn screening for congenital hypothyroidism, Victoria, Australia, 1977-1997. Part 2: Treatment, progress and outcome.

A controlled longitudinal prospective study is reported of physical and neuropsychological progress up to 12 years in 152 children with congenital hypothyroidism (CH), detected by newborn screening in the Australian state of Victoria and born between the onset of screening in mid-1977 and December 1988. Linear growth of the CH children was normal. Throughout they were slightly heavier and the median head circumference was slightly larger compared with reference data. Those with thyroid aplasia required a marginally larger dose of thyroxine to achieve euthyroidism. Assessment of cognitive outcome in the children with permanent primary CH revealed the mean scores at 2, 5 and 8 years to be from 8.5 (p<0.001) to 10.2 (p<0.001) points lower than in a group of 60 euthyroid controls. However, there was large overlap and, of the affected children, only 10.1% at 2 years, 3.9% at 5 years and 6.8% at 8 years fell more than 2 SD below the means of the euthyroid controls. On univariate analysis, variables shown to have significant correlation with cognitive outcome at 8 years in the CH children were newborn activity, baseline TT4 and FTI, initial T4 dosage, socio-economic classification, maternal age, maternal education and presence of a serious accompanying disorder. On multiple regression analysis, significant variables were baseline bone age, maternal age and education, and presence of a serious accompanying disorder. No single thyroidal or extra-thyroidal variable could be identified to account for the discrepancy between the children with CH and the controls.

Age Determination by Skeleton↗

PubMedDate not supplied

Factors influencing the adoption and maintenance of Canadian, facility-based worksite health promotion programs.

PURPOSE: The purpose of this study was to determine senior management's rationale for adopting and maintaining worksite health promotion programs and the congruence of this rationale with the program objectives of health professionals who manage the programs. DESIGN: A multiple case study design was used. SETTING: Nine major Canadian organizations which had adopted facility-based health promotion programs were the settings for this study. DATA COLLECTION: Semi-structured interviews (22 conducted) and two questionnaires (36 completed) were the methods used to collect data. RESPONDENTS: Senior managers involved in program adoption, senior managers responsible for program budgets, and senior health professionals responded to the interviews and questionnaires. RESULTS: Impetus for health promotion program adoption in the organizations we studied had more to do with tangential issues such as an organization moving to a new facility or having access to unused space than with employee health or organizational performance considerations. The most common program adoption rationale was related to employee recruitment/retention. Program continuance was based on process issues such as participation rates and the quality of activity offerings rather than on health or organizational outcomes. While health professionals and senior management both considered human relations and morale more important than cost savings outcomes, health professionals considered cost savings outcomes more important than did senior management. CONCLUSIONS: It is important for health promotion professionals to develop program objectives which are shared by organizational management. Future program adoptions and maintenance will be influenced by closer analyses of the effect of these programs on organizational performance.

Canada↗

PubMedDate not supplied

Retrospective studies in scleroderma: skin response to potassium para-aminobenzoate therapy.

Analyses were made of University of Michigan Hospital records of 467 patients diagnosed during the period 1948 - July 1980 as having scleroderma (390) or scleroderma associated with manifestations of other collagen disease (77). In all, there were coded 4733 visits or admissions. Demographic characteristics are detailed for the 390 patients with clinical features of scleroderma alone. The principal focus of this report is on degree and extent of skin involvement and response to therapy with potassium para-aminobenzoate (Potaba, KPAB). Ninety percent of 224 patients treated with KPAB experienced mild, moderate, or marked skin softening. Among a parallel group of 96 evaluable patients who did not receive KPAB, less than 20% were noted to have mild or moderate skin improvement at the end of follow-up. The difference in skin softening attained by patients treated with KPAB compared to that of patients who did not receive this medication was significant (p less than 0.0001).

Aminobenzoates↗