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Biomedical subjects

T Smith

Publications and source records attributed to T Smith.

At least 595 records · Page 33Linked to original sources
PubMed1990

Argon laser pretreatment in Nd: YAG iridotomy.

Argon laser pretreatment prior to Nd:YAG laser iridotomy may decrease the incidence of operative hemorrhage. In a prospective, randomized clinical trial involving 12 patients (24 eyes), one eye was randomly assigned treatment with the Nd:YAG laser alone, while the other eye was pretreated with argon laser photocoagulation immediately prior to Nd:YAG laser. Eight of the 12 eyes (67%) treated with Nd:YAG laser alone had operative hemorrhages; only 2 of the 12 (17%) pretreated eyes did. Thus, argon laser pretreatment significantly reduced the incidence of hemorrhage during Nd:YAG iridotomy (P = .012).

Aged↗
PubMed1990

Zidovudine disposition during hemodialysis in a patient with acquired immunodeficiency syndrome.

Zidovudine (azidothymidine, AZT) disposition was examined during a hemodialysis session in an HIV-infected male with mesangial proliferative glomerulonephritis. Serum concentrations of zidovudine and its glucuronidated inactive metabolite (G-ZDV) were measured by HPLC. Zidovudine pharmacokinetics were similar to previous reports in patients with normal renal function, however, G-ZDV concentrations were significantly elevated (23-440 times zidovudine concentration). Hemodialysis did not appreciably reduce zidovudine or G-ZDV levels. Significance of chronically elevated G-ZDV levels is unknown.

Acquired Immunodeficiency Syndrome↗
PubMed1989

The NHS bill.

Explore the source record for details and available documents.

Attitude of Health Personnel↗
PubMed1989

Serum cholinesterase isoenzymes and the WHHL rabbit: the relationship between the activity of cholinesterase not bound to low-density-lipoprotein and lipoprotein titer.

Serum cholinesterase has been previously shown to complex with beta-lipoprotein in the plasma. Since serum cholinesterase exists as isoenzymes in plasma, the relationship between the activity of these isoenzymes (unbound to beta-lipoprotein) and lipoprotein titer was investigated. The results indicated that the total of C2, C3, and C4 isoenzyme activities were expressed within a narrow range and independent of low density lipoprotein titer. These findings may indicate that unbound plasma cholinesterase may undergo autoregulation independent of cholinesterase bound to beta-lipoprotein.

Animals↗
PubMed1989

Progressive neurological dysfunction during latent HIV infection.

OBJECTIVE--To determine whether the delayed conduction through the spinal cord and peripheral nerves seen in patients with AIDS is related to infection with HIV or to the presence of an immunodeficient state. DESIGN--Two year prospective follow up study of electrophysiological measurements in subjects positive for HIV antibody but without AIDS. SETTING--HIV screening clinic and clinical departments in a university hospital in Copenhagen, Denmark. SUBJECTS--Twelve homosexual men positive for HIV antibody who had not developed AIDS. RESULTS--Eight latencies were measured: from the ankle to T12, the wrist to C7, T12 to the cerebral cortex, C7 to the cerebral cortex, the ankle to the gluteal crease (tibial nerve), the gluteal crease to T12, the wrist to Erb's point (median nerve), and Erb's point to C7. Spinal latencies increased in all subjects at C7 by a mean of 4.2% (SE 0.9%) and in all except one at T12 by a mean of 5.5% (1.0%). The conduction time from the gluteal crease to T12 was increased by a mean of 32.0% (5.0%) whereas that in the median and tibial nerves by only 5.6% (1.0%) and 2.2% (2.2%) respectively. CONCLUSIONS--A mild and slowly progressive peripheral neuropathy of the axonal type and a more severe progressive myelopathy or myeloradiculopathy occur concomitantly with early HIV infection, possibly as the result of a direct neurotropic action of HIV.

Denmark↗
PubMed1989

High serum levels of lactic dehydrogenase identify a high-grade lymphoma-like myeloma.

Although conferring a grave prognosis in patients with malignant lymphoma, high levels of serum lactic dehydrogenase (LDH) are usually not seen in patients with multiple myeloma, a more indolent tumor composed mainly of B cells in their terminal stage of differentiation. Thus, only 2 of 118 patients in earlier phases of myeloma showed marked LDH elevations to more than 500 U/L, whereas such abnormalities were present in 12 of 64 patients with advanced disease progressing despite treatment with vincristine, doxorubicin (Adriamycin), dexamethasone (VAD) (median LDH level, 700 U/L). High LDH levels were associated with high serum levels of beta-2-microglobulin, hypercalcemia, extraosseous disease features, a short preceding clinical course as well as a short subsequent survival time. A poor prognosis was also noted in patients with lower LDH in whom marked increments were induced by high-dose chemotherapy; thus, LDH elevations to greater than 300 U/L present before or found after high-dose cytotoxic therapy were observed in about 50% of patients with VAD-resistant myeloma and define a new clinical entity with features of extraosseous disease and an unusually aggressive course ("high-grade myeloma"). The shorter survival of newly diagnosed patients with high-normal compared with those with low-normal LDH levels (less than 200 U/L), regardless of tumor mass, suggests the presence in some patients of a tumor subpopulation with high LDH production that escapes growth control with standard treatment. Staging of multiple myeloma should therefore include measurements of serum LDH levels in addition to beta-2-microglobulin analysis and tumor mass estimation.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

Postpolio muscular atrophy. Diagnostic utility of macroelectromyography.

Muscles recovered from previous poliomyelitis may exhibit new weakness and wasting years after the original infection (postpolio muscular atrophy). Routine electrophysiological and morphological techniques may not differentiate weakening muscles from previously affected but stable muscles. We used quantitative motor unit potential analysis, single-fiber electromyography, and macroelectromyography (macro-EMG) to determine if these techniques could identify weakening muscles. We classified 18 previously affected muscles according to strength from 12 patients who had had poliomyelitis 18 to 50 years earlier. Muscles of normal strength had large-amplitude macro-EMG signals (1000 to 4110 microV; normal level, less than 390 microV). Muscles with new weakness and atrophy had smaller than expected macro-EMG amplitude (130 to 450 microV). Two muscles with weakness and atrophy unchanged since the original childhood infection had markedly increased macro-EMG amplitude (1710 and 1860 microV), suggesting the increased macro-EMG amplitude is due to stable reinnervation not strength. Mean motor unit potential duration and amplitude were lower in newly weakened muscles, but jitter, fiber density, and blocking were similar in all muscles regardless of strength. We conclude that low-amplitude macro-EMG signals may be useful in the identification of muscles weakened by postpolio muscular atrophy.

Adult↗
PubMed1989

A comprehensive behavioral theory of autistic children: paradigm for research and treatment.

Although behavioral treatment is the most effective intervention currently available for autistic children, there have been no attempts to present a comprehensive behavioral theory of autistic children since Ferster (1961). The present paper is intended to fill this gap. Behavioral work is distinguished from traditional work with autistic children in three ways: (a) it focuses on specific behaviors rather than on the diagnostic entity of autism; (b) it emphasizes the immediate environment rather than etiology or early history; and (c) research is inductive rather than hypothetico-deductive. The behavioral theory derived from such work has four tenets: (a) autistic children's behaviors are consistent with laws of learning derived from the behavior of other organisms; (b) autistic children have many separate behavioral difficulties best described as a developmental delay; (c) despite their difficulties, many autistic children learn as much as other human beings in certain environments; and (d) their difficulties can be viewed as a mismatch between a deviant nervous system and average or typical environments rather than as a disease. A number of practical and theoretical problems remain that require further research and that would add to the present theory.

Autistic Disorder↗
PubMed1989

What sexual offenders tell us about prevention strategies.

A sample of 20 adult sexual offenders were interviewed about the process whereby they selected, recruited and maintained children in a sexual abuse situation. Offenders were selected if they were making "successful" progress in treatment in order that they might be less likely to distort their descriptions. Offenders were interviewed by their therapist in a community treatment program using a semistructured interview guide. Results suggest that this sample of offenders claim a special ability to identify vulnerable children, to use that vulnerability to sexually use a child that sexual abuse is inherently coercive, even though many offender statements minimize the level of coercion and violence, and that offenders systematically desensitize children to touch. Implications for prevention of sexual abuse are highlighted.

Adult↗
PubMed1989

Prostate cancer: a model of cancer in the elderly.

Prostate cancer is the most common malignancy in men over 70. Chronic course of the disease and multiple therapeutic options allow a customized management of the patient's individual problems. Prognostic factors are stage, size of primary tumors, serum acid phosphatase levels, number of metastases, ureteral obstruction and patient's age. In localized disease, surgery and radiation therapy are equally effective for patients with a life expectancy less than or equal to 10 years. Surgery may be superior to radiation if longer survival is expected. In locally advanced disease radiation therapy is preferred to surgery, due to a lower rate of complications. Management of metastatic disease requires offsetting androgen effects by castration or by antiandrogens. Orchiectomy, the safest way to produce castration, is unacceptable to 50% of patients. LHRH analogs are safer than estrogens, but more expensive; the risk of tumor flare up controindicates these compounds in life-threatening situations. The use of ketoconazole is limited by long-term toxicity, but may be life-saving in life-threatening situations, due to a rapid onset of action. Antiandrogens are as effective as castration, but are not commercially available in the USA. Alternative treatments include Estracyt, intermittent estrogentherapy, progesterone derivative and aminogluthetimide. Radical prostatectomy and radiation therapy to the prostate cause erectile impotence with persistence of orgasmic sensations. These patients are ideal candidates for erection-restoring interventions, such as intrapenile injections or penile implants.

Aged↗