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Biomedical subjects

T M Roy

Publications and source records attributed to T M Roy.

142 records · Page 8Linked to original sources
PubMed1987

Variability in the evaluation of the Federal black lung benefits claimant.

A critical review of the medical data accumulated on 100 consecutive miners referred for evaluation for disability under the Federal Coal Mine Health and Safety Act documented the generation of an excess of unreliable data at an unacceptable cost, even though the evaluations had been performed by physicians who regularly perform this service. Physician training appears to have an impact on the accuracy and reproducibility of historical inquiry regarding items that would identify other causes of activity-limiting dyspnea. Physicians with pulmonary training are statistically more likely to include the cigarette smoking history, as well as history for the presence or absence of exertional chest pain and paroxysmal nocturnal dyspnea. Spirometric pulmonary functions that are supervised and interpreted by physicians with pulmonary training are less likely to show wide variation between the forced expiratory volume in 1 sec, and the direct maximum voluntary ventilation. Regardless of the source, the direct MVV measurement does not contribute additional useful information about a claimant's pulmonary impairment. Arterial blood gas analysis does not add to the discriminatory value of spirometry and should be dropped from the routine claimant's evaluation. Electrocardiography identifies cardiovascular disease in a sufficient number of applicants to make this test worthwhile. The presence or absence of pneumonconiosis on chest radiograph does not vary significantly when interpreted by the examining physician regardless of pulmonary training.(ABSTRACT TRUNCATED AT 250 WORDS)

Coal Mining↗
PubMedDate not supplied

The effect of an aldose reductase inhibitor on cardiovascular performance in patients with diabetes mellitus.

Because some aldose reductase inhibitor studies have demonstrated clinical improvement in scored neurological signs and symptoms of diabetic neuropathy, a prospective study of the effect on cardiovascular performance of sorbinil 250 mg/day for 12 months was conducted on patients with diabetic autonomic neuropathy who were free of atherosclerotic coronary artery disease and/or cardiomyopathy. After 1 year of treatment, the study group (n = 14) demonstrated significant improvement in both the resting cardiac output (P = 0.02), and the maximal cardiac output (P = 0.03). This observation suggests that the use of an aldose reductase inhibitor may be useful in treating suboptimal cardiovascular performance in patients with diabetic cardiac autonomic neuropathy.

Adult↗
PubMedDate not supplied

Upper airway obstruction from AIDS-related Kaposi's sarcoma.

Kaposi's sarcoma occurs in the head and neck region, commonly in patients with the acquired immunodeficiency syndrome. This tumor may also involve oromucosal surfaces, but only rarely leads to upper airway obstruction. When such obstruction develops, the emergency physician must be aware of the attendant problems of surgical manipulation and radiotherapy.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Cardiac mucormycosis complicating diabetes mellitus.

Fewer than 25 cases of myocardial involvement with the Mucoraceae have been reported. We present a diabetic patient with recurrent ketoacidosis and staphylococcal septicemia whose demise was accelerated by unsuspected left atrial mural endocardial mucormycosis.

Adult↗
PubMedDate not supplied

Paecilomyces varioti pneumonia in a patient with diabetes mellitus.

Paecilomyces is a saprophytic soil fungus that is an uncommon human pathogen. We report a diabetic patient who developed an upper lobe pulmonary infection due to Paecilomyces varioti. This pneumonia responded poorly to oral imidazole therapy with ketoconazole. Eventual treatment of the chronic infiltrating process required administration of intravenous amphotericin B. This experience emphasizes the potential pathologic nature of this fungus when immunity is compromised by poorly controlled diabetes.

Adult↗
PubMedDate not supplied

Use of residual volume as a marker for enteral feeding intolerance: prospective blinded comparison with physical examination and radiographic findings.

High gastric residual volumes (RVs) are a frequent cause for cessation of total enteral nutrition (TEN). This study was designed to determine the RV that indicates intolerance or inadequate gastric emptying and to compare the RV findings in a blinded fashion with those findings obtained on physical examination and radiography. Twenty healthy normal volunteers (HNV), 8 stable patients with gastrostomy tubes (GTP), and 10 critically ill patients (CIP) were evaluated prospectively for 8 hours while receiving TEN. No subjects were clearly intolerant (ie, vomiting, aspiration). Of the total RVs recorded, 13.1% were greater than or equal to 150 mL in the CIP group, whereas only 2.4% of the RVs were greater than or equal to 150 mL in the HNV group. None of the RVs in the GTP group were greater than or equal to 150 mL. Objective scores on physical examination failed to correlate with RV (p = .397), as did objective scores on radiography (p = .742). However, objective scores on physical examination were significantly related to scores on radiography (p = .016). Abnormal physical examination findings were found in 4 out of 11 patients (GTP + CIP) with RVs less than 100 mL and in 6 out of 7 with RVs greater than or equal to 100 mL. Abnormal radiographic results were found in 6 out of 11 patients with RVs less than 100 mL, in 7 out of 7 patients with RVs greater than or equal to 100 mL, and in 4 out of 20 HNVs. There was no difference in RVs obtained from the supine or right lateral decubitus positions.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMedDate not supplied

Multisystem autoimmune dysfunction with early onset of bullous emphysema.

We report a patient with alopecia universalis, autoimmune dysfunction, and rapidly progressing bullous emphysema. These disorders have neither been reported together previously nor classified within a syndrome. To explain early-onset bullous emphysema associated with autoimmune disturbance requires further study; we encourage reporting of similar patients.

Adult↗