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Biomedical subjects

S Dixon

Publications and source records attributed to S Dixon.

82 records · Page 5Linked to original sources
PubMed1982

Natural history of nonstenotic, asymptomatic ulcerative lesions of the carotid artery. A further analysis.

The natural history of 153 asymptomatic, nonstenotic ulcerative lesions of the carotid bifurcation in 141 patients was reviewed. A technique for quantitatively defining small (A), large (B), and compound (C) ulcers was developed. During the course of study, extending up to ten years, 3% of patients with A ulcers, 21% with B ulcers, and 19% with C ulcers had hemispheric strokes without antecedent transient ischemic attacks (TIAs), on the side appropriate to the lesion. The interval annual stroke rate was 4.5% for B ulcers and 7.5% for C ulcers. Because these interval stroke rates are comparable to the 6% annual stroke rate occurring in patients with TIAs, a well-accepted indication for operation, we recommend prophylactic operation for these lesions in good surgical candidates, to be performed by surgeons who have demonstrably low operative stroke rates.

Actuarial Analysis↗
PubMed1982

Familial erythroleukemia: four cases of the Diguglielmo syndrome in close relatives.

Erythroleukemia was diagnosed in three brothers during a 6-month period in 1976. A son of one leukemic had died 5 years earlier with erythroleukemia. First-degree relatives of these men were evaluated in an attempt to identify contributing factors. Twenty-four relatives have been studied. Immunoglobulin M was elevated in 14 of 16 persons (mean, 352.8 mg/dl; normal, less than 145 mg/dl; P less than .001). This was neither a monoclonal protein nor rheumatoid factor. Age-dependent red cell enzymes were increased. Erythrocyte hexokinase was markedly increased in 23 of 24 persons (mean, 35.05 units/100 ml RBC; normal, less than 18 units; P less than .001). Evidence for a hemolytic state was absent. Bone marrow samples in 8 first-degree relatives were normal. Cytogenetics were normal in 18 relatives. One leukemic exhibited hypoploidy and a marker chromosome. The association of an immunoglobulin abnormality and enzymopathy in the leukemics and relatives alike suggests a hereditary susceptibility to the development of erythroleukemia. The exact link is not identified.

Adolescent↗
PubMed1982

Specific differences in motor performance between Gusii and American newborns and a modification of the Neonatal Behavioral Assessment Scale.

Brazelton Neonatal Behavioral Assessment Scale (NBAS) exams were performed on 24 Gusii (Kenya) newborns during their first 10 days of life. Their scores were compared to those of a low-risk white American sample. The Gusii showed unique motor tone requiring an expansion of the NBAS General Tone Scale. There were few significant differences between the Gusii and American samples. The Gusii scored better on motor maturity and had fewer tremors and startles. There were trends indicating better visual orienting and better habituation to light in the American sample, and better habituation to pinprick and more state changes but less irritability and better self-consoling by the Gusii sample. Both groups performed well and had relatively flat recovery curves. The results are discussed with regard to the influences of newborn behavior on caregiving activities and later development, and the genetic, intrauterine, and perinatal influences on newborn behavior. The need for culture-specific models of development is stated.

Child Behavior↗
PubMed1980

Pulsatile lavage in the management of postoperative wound infections.

High-pressure pulsatile lavage is more effective than conventional irrigation in cleansing recently contaminated wounds. This method of irrigation was applied to postoperative infections in an attempt to lower wound bacterial counts to 10(5) or fewer organisms per gram of tissue, a level predictive of safe primary reclosure. Sequential wound biopsies for quantitative bacterial analysis demonstrated that high-pressure lavage is more effective than conventional irrigation in lowering bacterial counts in postoperative staphylococcal wound infections in guinea pigs. However, reductions were transient and did not lower counts sufficiently to permit safe reclosure. In contrast to results in newly contaminated wounds, pulsatile lavage of postoperative infections did not have therapeutic benefit. Reclosure of wounds with greater than 10(5) organisms per gram of tissue is unsafe even after five days of therapy.

Animals↗
PubMedDate not supplied

The use of condition specific outcome measures in economic appraisal.

Despite growing concern over the use of health utility measures in economic evaluations of health care programmes, economists have been reluctant to use the wealth of knowledge contained within studies using condition specific outcome measures (CSOMs). Problems with the measurement properties of many CSOMs means that the scope for their use in economic appraisal is extremely limited. This paper examines the potential uses of CSOMs in economics, namely: to provide valid descriptive material, to provide scales for comparing the effectiveness of interventions and to 'validate' the descriptive accuracy of economic measures of benefit. It is argued that valid descriptive information is essential for economic appraisal, no matter which method of evaluation is used. Generic measures have been criticised for being too narrow and insensitive to the consequences of specific conditions. CSOMs offer a rich source of information to produce quality adjusted life years (QALYs) but two potential methods, one of mapping health states from one scale to a QALY classification (such as Rosser), and the other, developing 'exchange rates' between scales are unsatisfactory. A more rigorous approach would necessitate a major research programme of revaluing existing CSOMs using preference based methods. Another interesting avenue of research would be to use the information from CSOMs to construct health scenarios for valuation. Given the current state of development of outcome measures, it seems advisable to use CSOMs alongside economic measures in trials. Such a strategy would help demonstrate the usefulness of economic measures to clinicians and to reconcile the two measures.

Cost of Illness↗