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Biomedical subjects

V Anderson

Publications and source records attributed to V Anderson.

At least 73 records · Page 4Linked to original sources

Risk factors for intellectual and educational sequelae of cranial irradiation in childhood acute lymphoblastic leukaemia.

Long-term cognitive and educational sequelae have been inconsistently reported in children who received cranial irradiation (CRT) to prevent central nervous system (CNS) disease in acute lymphoblastic leukaemia (ALL). This study investigates a large and representative sample of survivors of ALL and compares them with non-irradiated survivors of cancer and healthy control children to determine the effect of CRT on cognitive and educational ability. Three groups of children were studied: Group 1 (n=100) survivors of ALL treated with chemotherapy and CRT, group 2 (n=50) children with a variety of malignancies treated with chemotherapy alone, group 3(n=100) healthy children. Cognitive and educational abilities of these groups were evaluated using standardised psychometric techniques. Significant differences in cognitive and educational abilities were found between the children in group 1 (chemotherapy + CRT) and the two control groups, with the children receiving CRT performing less well in a range of tests. Greatest differences were detected for tasks dependent on language function including verbal IQ, reading and spelling. Within group 1 a younger age at treatment (less than 5 years) and a higher dose of CRT (24 Gy vs 18 Gy) were predictive of poor long-term outcome for cognitive and education ability. In contrast, children who received chemotherapy alone, with or without intrathecal methotrexate, performed similarly to healthy controls. No gender differences were detected for these measures.

Adolescent↗

Intestinal perforation 14 years after abdominal irradiation and chemotherapy for Wilms tumor.

A 3-year-old girl underwent left nephrectomy and removal of a tumor thrombus from the inferior vena cava and right atrium in 1978 because of Wilms tumor. Her treatment consisted of tumor bed irradiation (4,000 cGy) and chemotherapy with actinomycin D, vincristine, and doxorubicin. The patient underwent laparotomy 2 months after completion of abdominal irradiation to relieve intestinal obstruction. Fourteen years later, she underwent another laparotomy because of an "acute abdomen" and was found to have perforation of the jejunum in the radiation field. Histopathological examination of resected intestine revealed evidence of severe chronic radiation enteritis, A diagnosis of chronic radiation enteritis should be considered in patients who had received abdominal irradiation and who manifest abdominal pain/vomiting even several years after irradiation.

Abdomen↗

Pharyngeal dermoids ("hairy polyps") as accessory auricles.

The purpose of this study is to clarify the origin and nature of so-called hairy polyps or dermoids of the pharynx, which are often thought to be a variant of pharyngeal teratoma. For this purpose, a case is reported of a dermoid polyp involving the middle ear of an infant, the features of multiple examples of pharyngeal dermoid polyps and teratomas received for consultation by the Armed Forces Institute of Pathology are examined, and selected pertinent reports from the literature are reviewed. All three means are used to support the conclusion that these lesions are choristomatous developmental anomalies arising from the first branchial cleft area and that they essentially represent heterotopic accessory "ears" (auricles) without the growth potential of a teratoma.

Branchioma↗

Diary of a rural organiser.

Although currently I do have responsibility for two city hospitals, for all intents and purposes, I am a rural Organiser. Those Organisers who service country areas need to be particularly resourceful, as they do not have the immediate support of other officers or extensive information resources on-hand. When faced with complex workplace issues or distressed members, you learn quickly to become particularly self-sufficient, but always confident that the Sydney office is only a phone call away.

Australia↗

Specific absorption rate levels measured in a phantom head exposed to radio frequency transmissions from analog hand-held mobile phones.

Electric fields (E-fields) induced within a phantom head from exposure to three different advanced mobile phone system (AMPS) hand-held telephones were measured using an implantable E-field probe. Measurements were taken in the eye nearest the phone and along a lateral scan through the brain from its centre to the side nearest the phone. During measurement, the phones were positioned alongside the phantom head as in typical use and were configured to transmit at maximum power (600 mW nominal). The specific absorption rate (SAR) was calculated from the in situ E-field measurements, which varied significantly between phone models and antenna configuration. The SARs induced in the eye ranged from 0.007 to 0.21 W/kg. Metal-framed spectacles enhanced SAR levels in the eye by 9-29%. In the brain, maximum levels were recorded at the measurement point closest to the phone and ranged from 0.12 to 0.83 W/kg. These SARs are below peak spatial limits recommended in the U.S. and Australian national standards [IEEE Standards Coordinating Committee 28 (1991): C95.1-1991 and Standards Australia (1990): AS2772.1-1990] and the IRPA guidelines for safe exposure to radio frequency (RF) electromagnetic fields [IRPA (1988): Health Phys 54:115-123]. Furthermore, a detailed thermal analysis of the eye indicated only a 0.022 degrees C maximum steady-state temperature rise in the eye from a uniform SAR loading of 0.21 W/kg. A more approximate thermal analysis in the brain also indicated only a small maximum temperature rise of 0.034 degrees C for a local SAR loading of 0.83 W/kg.

Absorption↗

Neuropsychological deficit and academic performance in children and adolescents following traumatic brain injury.

Evaluated the utility of neuropsychological testing in predicting academic outcome in children 1 year following traumatic brain injury (TBI). Fifty-one school age children who were admitted to hospital after TBI were assessed with a battery of neuropsychological measures at 3 months postinjury. Academic achievement was assessed at 3 and 12 months postinjury. The neuropsychological battery included intelligence testing and measures of memory, learning, and speed of information processing. Academic outcome was assessed in terms of post-TBI changes in reading, spelling, and arithmetic; changes in teacher ratings of school performance; and change in school placement. According to logistic regression analysis, change in placement from regular to special education at 1-year post-TBI was predicted by injury severity and by neuropsychological performance at 3 months post-TBI. Findings suggest that neuropsychological testing is useful in identifying children with special educational needs subsequent to TBI.

Achievement↗

Intellectual, educational, and behavioural sequelae after cranial irradiation and chemotherapy.

Cognitive and educational sequelae are inconsistently reported in children treated with cranial irradiation for acute lymphoblastic leukaemia. This study investigated differences in these skills after cranial irradiation, controlling the effects of chemotherapy and psychosocial factors. Three groups were evaluated: 100 children diagnosed with acute lymphoblastic leukaemia and treated with cranial irradiation and chemotherapy; 50 children diagnosed with acute lymphoblastic leukaemia or other cancers and treated with chemotherapy alone; and a healthy control group of 100 children. Children in the clinical groups stopped treatment at least two years before evaluation and had no history of relapse. Children were aged between 7 and 16 at the time of assessment. Evaluation included cognitive, educational, and behavioural measures. Analyses found that children receiving cranial irradiation and chemotherapy performed more poorly than non-irradiated groups on intellectual and educational tests, with verbal and attentional deficits most pronounced. Children receiving chemotherapy alone performed similarly to controls, suggesting such treatment is not associated with adverse neurobehavioural sequelae.

Adolescent↗

Neuropsychological functioning in adolescents with diabetes.

Investigated the relationship between disease variables, neuropsychological performance, and psychosocial status in adolescents with Insulin Dependent Diabetes Mellitus (IDDM). The study group consisted of 85 adolescents, aged 14 to 16.5 years who had been diabetic for longer than 12 months. Parameters of both recent and long-term metabolic control were determined, including diabetic incidents such as severe hypoglycemia or ketoacidosis. The mothers completed standardised measures of adolescent adjustment, and the adolescents provided self-reports of psychosocial status. Neuropsychological functioning was evaluated with standardised tests of verbal and nonverbal intelligence, memory and new learning, visuo-graphic skills, mental flexibility, and problem-solving ability. Using retrospective accounts of disease history, there was no relationship between neuropsychological functioning and variables such as age of onset, chronic poor control, or major metabolic crises. The findings emphasise the need for a long-term, prospective study of a cohort of diabetic children from the time of diagnosis to clarify causal relationships, if any, between illness variables, neuropsychological performance, and psychosocial factors.

Adolescent↗

An inner-city community's perspective on infant mortality and prenatal care.

Neither expanded Medicaid eligibility nor case-finding approaches have significantly increased use of early prenatal care. Failure to improve use points to the importance of further study of the broader community's perspectives on prenatal care and perinatal health issues. A convenience sample of 380 low-income, inner-city, black adults were interviewed with respect to their understanding of infant mortality, perceived barriers to and importance of prenatal care, and recommended numbers of prenatal visits. All respondents reside in a community with negative indexes of perinatal health as measured by infant mortality, low birthweight, and average number of prenatal visits. Fifty percent of the sample could correctly define the term infant mortality. The majority believed that prenatal care is very important and should begin in the first trimester of pregnancy. Respondents recommending the least number of prenatal visits (0-6) perceived financial, institutional, and attitudinal factors as barriers to care. Pregnant women's fear of detection of drug use was the most salient barrier regardless of the recommended number of prenatal visits, age, sex, employment status, or number of children. Changing health problems mandate continued monitoring of community perceptions and expectations of services such as prenatal care. Public health nursing is ideally positioned to articulate community values to policy makers and health care professionals concerned with perinatal health.

Adult↗

Hepatic pathology in pediatric acquired immunodeficiency syndrome.

In a retrospective study we assessed the hepatic changes in children with the acquired immunodeficiency syndrome by reviewing 12 biopsy specimens and 48 autopsy specimens from 54 children. Hepatopathology differed in biopsy and autopsy material. In biopsy specimens, chronic active hepatitis with predominantly T8 lymphocytes by tissue immunochemistry was common (five of 12 specimens). Fatty degeneration and hepatocellular necrosis were either absent, mild, or patchy. On the other hand, at autopsy, chronic active hepatitis was not observed. The most prominent changes were extensive fatty degeneration, nonspecific portal mononuclear infiltration, portal fibrosis, and confluent (ischemic) necrosis. Opportunistic infections such as Mycobacterium avium-intracellulare (MAI) were noted only at autopsy. In addition, three unusual morphologic characteristics were noted: nodular lymphoplasmacytic portal infiltrate, a pseudosarcomatous variant of Mycobacterium avium-intracellulare infection, and multinucleated giant cells (foreign both type and giant cell transformation of hepatocytes).

Acquired Immunodeficiency Syndrome↗

Ischemic injury to newborn rabbit ileum: protective role of human superoxide dismutase.

The effectiveness of human superoxide dismutase (hSOD) in the prevention of reperfusion injury was evaluated in a rabbit ileal loop model. Weanling white New Zealand rabbits, 6 weeks of age and weighing 500 to 1,000 g, were used. Intraluminal administration of SOD (5 mg/kg) was studied in 12 animals with each animal serving as its own control. In an additional 12 animals, parenteral SOD in a dose of 5 mg/kg in seven animals and 10 mg/kg in five animals was evaluated, while five additional control animals received parenteral saline. The effect of reperfusion injury was evaluated in each bowel loop by interruption of blood supply for five minutes, followed by reperfusion. Blood was drawn at 0, 16, 20, 24 hours in the parenteral group for measurement of hSOD levels by radioimmunoassay. The loops were studied pathologically for extent of mucosal damage. In the intraluminal group, nine of 12 loops without SOD v three of 12 loops with SOD showed necrosis when rendered ischemic (P = .0196). In the parenteral group 22 of 24 loops were normal when pretreated with SOD and subjected to ischemia v five of ten when no SOD was given (P = .0139). In the parenteral group, mean baseline level of hSOD was 0.42 +/- 0.26 micrograms/mL. Levels peaked at 16 hours (3.64 +/- 1.75 micrograms/mL) and progressively decreased at 20 hours (2.85 +/- 1.34 micrograms/mL) and 24 hours (1.82 +/- 1.15 micrograms/mL). This preliminary animal study suggests that hSOD may be an effective method for the prevention of postischemic bowel injury, adding to the literature on the protective effects of SOD in various models of intestinal ischemia.

Animals↗

Ambulatory care teams: the dehassling of Air Force medicine.

Lack of complete outpatient medical records is a chronic problem. Most facilities are only able to find 60% to 70% of records for appointments. Many records have incomplete laboratory and x-ray information. A program utilizing Ambulatory Care Teams (ACTS) was tested at the Air Force hospital at Carswell AFB. Records were pulled 48 hours prior to appointments, and the day prior to the appointment clinics endeavored to locate 100% of the records and reports. During a 1-year test period the staff at Carswell was able to produce or account for 98.2% of all medical records for more than 102,000 scheduled appointments.

Aerospace Medicine↗

Affect and nurturance: mechanisms mediating maternal behavior in two female mammals.

This review will discuss hormonal and psychological factors involved in the initiation and maintenance of maternal behavior during the postpartum period in rat and human mothers. Research on primiparous rats suggests that among the ways hormones act to promote maternal responsiveness are by increasing the mother's attraction to odors of young pups, decreasing her natural neophobia and fearfulness, and increasing the ease with which experiences obtained during initial mother-young contacts are retained. Long-term maintenance of elevated maternal responsiveness in the rat is not directly under hormonal control but instead depends on a minimal period of direct interaction with young during the early postpartum. In human first-time mothers, the onset of maternal responsiveness is also directly affected by their mood state as well as their attraction to infants; these factors are, in turn, influenced by the amount of prior experience women have had caring for young. While the role of hormones in mediating maternal behavior in women is still unclear, initial results indicate they may facilitate responsiveness during the puerperium.

Affect↗

Pancreatic heterotopia as a cause of an acute abdomen.

A 6-year-old boy with fever, vomiting, abdominal pain, and leucocytosis was found to have a small nodule of heterotopic pancreatic tissue in the wall of the jejunum. Leakage of pancreatic enzymes caused inflammation and hemorrhagic necrosis of adjacent smooth muscle. Excision of the lesion was followed by prompt and permanent relief of all signs and symptoms. Small intestinal pancreatic rests can cause acute and chronic abdominal complaints and should be carefully sought at laparotomy when no other etiology is encountered.

Abdomen, Acute↗