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Biomedical subjects

W Mitchell

Publications and source records attributed to W Mitchell.

At least 37 records · Page 2Linked to original sources
PubMed1990

Malignant fibrous histiocytoma arising from descending thoracic aorta.

Cases of malignant fibrous histiocytoma arising from the aorta are rare and have a dismal outlook despite treatment. The longest reported survival period following resection is only 28 months. A patient with malignant fibrous histiocytoma of the descending thoracic aorta was successfully treated with resection and reconstruction with a prosthetic graft. The patient developed metastatic disease eight months postoperatively. With aggressive triple regimen chemotherapy, complete remission has been obtained. The patient is alive and free of disease six years postoperatively.

Aged↗
PubMed1990

Horizontal and vertical integration in hospital laboratories and the laboratory information system.

An understanding of horizontal and vertical integration and their quasi-integration variants is important for pathologists to formulate a competitive strategy for hospital clinical laboratories. These basic organizational concepts, in turn, are based on the need to establish control over critical laboratory inputs and outputs. The pathologist seeks greater control of mission-critical system inputs and outputs to increase the quality and efficiency of the laboratory operations. The LIS produces horizontal integration of the various hospital laboratories by integrating them vertically. Forward vertical quasi-integration of the laboratories is mediated primarily by the LIS through front-end valued-added features such as reporting of results and creating a long-term on-line test result archive. These features increase the value of the information product of pathology for clinicians and increase the cost of switching to another system. The LIS can also serve as a means for customizing the information product of the laboratories to appeal to new market segments such as hospital administrators.

Clinical Laboratory Information Systems↗
PubMed1989

Treatment of hypertension in the elderly with a new calcium channel blocking drug, nitrendipine.

PURPOSE: Treatment of hypertension in the elderly decreases cardiovascular morbidity and mortality. We hypothesized that nitrendipine would be efficacious in the treatment of hypertension in the elderly. We evaluated potential differences between nitrendipine and the commonly used drug hydrochlorothiazide (HCTZ). PATIENTS AND METHODS: The study was conducted as a double-blind randomized clinical trial of nitrendipine or HCTZ. Thirty hypertensive subjects over age 60 with a median sitting blood pressure greater than or equal to 95 mm of Hg were recruited into the study. A diastolic blood pressure with treatment of less than 95 mm Hg with a 5 mm Hg or greater decrease from baseline was considered a successful response. RESULTS: Nitrendipine decreased mean (+/- SEM) blood pressure from 163 +/- 3/102 +/- 1 to 142 +/- 2/89 +/- 2 mm Hg, and HCTZ decreased it from 164 +/- 4/102 +/- 1 to 143 +/- 5/91 +/- 2 mm Hg. A greater proportion of patients had a successful response with nitrendipine (81 percent) than with HCTZ (64 percent). The antihypertensive effect of nitrendipine twice daily appeared to be sustained for 24 hours. Blood pressure response to exercise was attenuated with both drugs. HCTZ caused gout, leg pains, muscle aches, hypokalemia, increased uric acid levels, and increased total cholesterol and triglyceride levels. Nitrendipine caused edema and tachycardia. CONCLUSION: Nitrendipine significantly reduces blood pressure with few side effects and no adverse metabolic effects, and offers a reasonable alternative for treating hypertension in the elderly.

Aged↗
PubMed1987

Social skills training of Prader-Willi staff.

Over the past 30 years, research interest in PWS has focused on questions related to the identification of syndrome features, determination of etiology and incidence, and effectiveness of both medical and nutritional management strategies. Residential and day treatment facilities have emphasized control of food and of inappropriate behaviors. The present training program developed techniques and materials to encourage positive behaviors and minimize inappropriate behaviors, supplementing earlier techniques. Activities from social skills training curricula were adapted to the needs of PWS persons. Training sessions were held with staff in residential settings to field test the techniques. This paper summarizes the training program and describes effective techniques and materials.

Assertiveness↗
PubMed1987

Segmental renal artery infarction: a case report with computerized tomography scan and angiographic correlation.

Segmental renal artery infarction results in a clinical syndrome that generally involves transient hematuria, leukocytosis, fever and flank or abdominal pain, and generally occurs in patients with a history of atherosclerotic, cardiac or thromboembolic diseases. We present a case that demonstrates the characteristic appearance of this lesion on a computerized tomography scan. Angiographic correlation is provided.

Aged↗
PubMed1983

Laceration of the inferior vena cava of angiographic demonstration.

Laceration of the inferior vena cava (IVC) often presents as an acute surgical emergency requiring immediate operative intervention. We show that when the patient's clinical condition permits, angiography may delineate the site of caval laceration and active hemorrhage, and identify associated arterial injuries. Contrast extravasation from the IVC also is reported for the first time.

Adult↗
PubMed1983

Selectivity in response to L-tryptophan among insomniac subjects: a preliminary report.

The hypnotic effects of l-tryptophan (1 g), secobarbital (100 mg), and flurazepam (30 mg), relative to placebo, were evaluated in a sample of 54 outpatient chronic insomniacs with a major complaint of sleep maintenance insomnia. Three mutually exclusive complaints about sleep maintenance were identified. Analysis of the data from the tryptophan condition indicated that the single factor type of sleep maintenance complaint accounted for 100% of the variance in a measure reflecting a single overall assessment of tryptophan's hypnotic effect, and 52% of variance in a second, repeated measure assessing subjects' day-to-day experience with the treatment. It is concluded that the distinctions in sleep maintenance insomnia identified are likely to be clinically meaningful. The distinct profiles of the tryptophan responders and nonresponders are described, and the utility of the distinctions in understanding the differential effects of flurazepam and secobarbital discussed. The implications of the finding for a number of sleep disorder-related issues were addressed.

Adolescent↗
PubMed1983

Granular cell schwannoma of the extrahepatic biliary system.

We report the case of a woman who presented with a typical picture of cholelithiasis and choledocholithiasis. A percutaneous transhepatic cholangiogram revealed instead a concentric narrowing of the common bile duct and at operation she was found to have a rare, benign tumor of the extrahepatic biliary tree, a granular cell schwannoma.

Bile Duct Neoplasms↗
PubMed1982

Choroid plexus, brain and kidney Na+,K+-ATPase: comparative activities in fetal, newborn and young adult rabbits.

We have studied maturation of brain barrier systems in fetal, newborn, juvenile and adult rabbits. We have compared choroid plexus and brain Na+,K+-ATPase levels in each age group, as well as serum and CSF Na+ concentration as a measure of the ability of the choroid plexus to generate a gradient from blood to CSF. The choroid plexus appears functionally mature at all ages studied, both in ability to produce a Na+ gradient and in ATPase levels. In contrast, brain ATPase levels rose markedly with age. Kidney ATPase measured for comparison showed a pattern similar to brain.

Aging↗
PubMed1980

Cerebral intraventricular hemorrhages in infants: a widening age spectrum.

Cerebral intraventricular hemorrhage (IVH), a problem widely recognized in premature infants, was found in six older infants, ages 2 weeks to 3 months. IVH was often initially misdiagnosed as subarachnoid hemorrhage or meningits with a traumatic lumbar tap. IVH occurred primarily in infants with hypoxemia, acidosis, ischemia, and/or hypernatremia, conditions found in association with IVH in premature infants, but also occurred spontaneously. Computerized tomography scans were the most valuable diagnostic procedure for detection of IVH.

Age Factors↗
PubMed1977

Colonic necrosis complicating pancreatitis.

Bowel necrosis is an uncommon complication of pancreatitis. Two patients are reported who developed ileocecal and descending colon changes as a result of ischemia following severe pancreatitis. Arteriography in one patient confirmed the presence of intraluminal thrombi.

Acute Disease↗