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Biomedical subjects

A Woolf

Publications and source records attributed to A Woolf.

At least 73 records · Page 4Linked to original sources
PubMed1989

Stimulation of testicular function during the nonbreeding season in the woodchuck (Marmota monax).

Treatment of male woodchucks with a series of s.c. injections of pregnant mare serum gonadotropin (PMSG) and human chorionic gonadotropin (hCG) induced testicular growth, sperm production and marked increase in serum testosterone levels in the fall, approximately 4 mo before the expected spontaneous onset of testicular activity. These results suggest that it may be possible to induce and/or maintain reproductive competence in this species outside of its normally brief breeding season.

Journal Article↗
PubMed1989

Serum osmolality in alcohol ingestions: differences in availability among laboratories of teaching hospital, nonteaching hospital, and commercial facilities.

Freezing point depression osmometry is preferred over vapor pressure with ingestions of volatile substances. Sixty-six laboratories nationwide (23 teaching hospital, 22 nonteaching hospital, and 21 commercial facilities) were surveyed to determine the availability and use of these techniques. Overall, 80% conducted serum osmometry (teaching, 100%; nonteaching, 82%; commercial, 57%). Freezing point depression was the most common method used by all laboratories; however, 33% of commercial laboratories and 11% of nonteaching laboratories used vapor pressure exclusively. One half of all laboratory supervisors did not identify why one method was preferred. Only 3% identified vapor pressure as a possible source of error in ingestions of volatile substances. Most laboratories estimated that they were aware of the patient diagnosis less than 50% of the time. Because vapor pressure osmometry is a potential source of false negative results when estimating serum concentrations of volatile substances, clinicians treating patients who have ingested ethanol, ethylene glycol, isopropanol, or methanol need to be aware of the methodology used in their reference laboratories.

Alcohols↗
PubMed1989

Hypermagnesemia associated with catharsis in a salicylate-intoxicated patient with anorexia nervosa.

While clinicians have raised concerns about giving multiple doses of a cathartic as a part of therapy for acute poisoning, fears of excessive magnesium absorption or fluid or electrolyte imbalances have been largely unrealized. We present the case of a 19-year-old woman with anorexia nervosa and long-term laxative abuse who, despite a normal baseline serum magnesium concentration, developed hypermagnesemia during treatment with multiple doses of activated charcoal-magnesium citrate for acute salicylate intoxication. The peak serum magnesium concentration, after two doses of magnesium citrate, reached 9.8 mg/dL (4.0 mmol/L). It fell to normal levels when sorbitol was substituted as a cathartic and after the patient had been hemodialyzed for symptoms of salicylate toxicity that continued despite conventional therapy. While disordered magnesium metabolism in one patient with a severe underlying medical condition should not interdict the use of repetitive doses of magnesium citrate as a cathartic, patients requiring such therapy should have serum magnesium concentrations measured serially to monitor for signs of magnesium loading.

Adult↗
PubMed1989

School functioning and disease severity in boys with hemophilia.

There have been few recent studies investigating the scholastic progress of children with hemophilia. The advent of PL94-142, which ensures an appropriate educational program based on a child's specific learning disabilities, and home Factor VIII therapy, which increases the hemophiliac's school attendance and sense of freedom and control, might have had a positive impact on the academic performance of these patients. We investigated past and current educational functioning of 26 boys with hemophilia, using both parental and teacher reports. Twenty-two of these children were administered reading and math achievement tests. Results indicate that school absenteeism is a continuing problem for these children, with the average hemophiliac missing 18 school days in an academic year (median = 11 school days missed); one child had missed 77% of the year. Although these boys had normal intelligence and made average grades in school, six of the 22 tested performed more than two grade levels below expectations in reading and 10 performed greater than two grade levels below expectations in math. School underachievement did not necessarily correlate with disease severity (as indicated by serum factor level), school absenteeism, or grade point average. Although eight parents indicated that their children had past or current school problems, and teachers reported that greater than 50% of the group received special tutoring or classes for learning disabled students, six out of 22 (27%) performed below expectations in either math or reading and yet had no current individual educational remediation plan.(ABSTRACT TRUNCATED AT 250 WORDS)

Absenteeism↗
PubMed1989

Cocaine exposure among children seen at a pediatric hospital.

The results of 1,680 consecutive urine and serum toxicologic screens from 1,120 patients, performed in a children's hospital during a 19-month period were surveyed. Among this sample, 52 (4.6%) patients had specimens that contained cocaine and/or metabolite. Fifteen specimens contained ethanol, a benzodiazepine, or a narcotic in addition to cocaine. Four patients were neonates, whereas three were infants from 1 to 7 months of age. The remaining 45 patients were adolescents with a mean age of 19 years. Among the adolescents, 11 had a significant chronic illness. In 19 patients (37%), cocaine exposure was unsuspected until the results of testing for toxic substances were known. The reasons for hospital evaluation included depression/attempted suicide in 19 patients, seizure in five, chest pain in 5, motor vehicle accident in three, syncope in three, abdominal pain in two, pneumomediastinum in two, accidental self-immolation in one, and apnea in one. Twenty patients required medical hospitalization for a total of 268 patient-days. One patient, a neonate, died. There is a striking prevalence of cocaine exposure in the pediatric age group. Among adolescents, this exposure may occur despite the presence of chronic illness. Although the age distribution appears bimodal, infants and young children may also have unsuspected exposure to this toxin. Greater awareness of cocaine exposure in childhood will be needed by primary and tertiary care pediatricians to identify affected children and provide appropriate intervention.

Adolescent↗
PubMed1988

What residents know about child abuse. Implications of a survey of knowledge and attitudes.

Residency training programs are the appropriate milieu in which physicians should receive specialized training in the diagnosis and management of child abuse. The purposes of the present study were to assess and compare residents' knowledge of child abuse and their attitudes toward the propriety of different forms of childhood discipline. We surveyed 192 residents from seven different training programs with questionnaires probing their knowledge of child abuse and their attitudes toward childhood disciplinary measures; 161 (84%) of the questionnaires were satisfactorily completed by residents in pediatrics (n = 87), family medicine (n = 51), and surgery (n = 23). Both pediatric residents and family medicine residents outperformed surgery residents in one subscale and the total score on the test. Scores were not related to year of training or attitudes toward childhood discipline but were correlated with self-reports of previous child abuse teaching. Residents' performance on a childhood disciplinary measure demonstrated wide latitude in their rating of the acceptability of 23 different modes of childhood discipline. Our findings indicate a need for a more systematic approach to residents' education in childhood intentional injuries and some value clarification of their attitudes toward various forms of childhood discipline.

Attitude of Health Personnel↗
PubMed1988

Epizootiology of skunk rabies in North America.

Public health surveillance data from the United States and Canada (1961 to 1982) were analyzed to determine if consistent temporal and spatial patterns in skunk rabies could be identified. Enzootic/epizootic rabies was recognized in 18 states (enzootic states) based on the criteria of greater than or equal to 20 yr of reported skunk rabies and at least 1 yr with a minimum of 50 reported rabid skunks. In other wildlife species, epizootics have been demonstrated to expand along a wave-like front. We hypothesized: if skunk rabies behaved in a similar fashion, states reporting rabid skunks would change over time. No such change was noted. During epizootics the number of counties reporting increased but not the number of states. Within Illinois certain counties were demonstrated to have persistent rabies histories and likely served as enzootic foci. Enzootic states combined prevalence indicated a 6 to 8 yr cycle for epizootics. Data on monthly percent rabies positive (number rabid/total number tested) were available from six states and Canada. Mean distributions were bimodal with winter and spring peaks. The patterns identified for skunk rabies differ from those of other major wildlife vectors and have significance for potential vaccination control regimes.

Animals↗
PubMed1988

Disseminated intravascular coagulation in a case of fatal lindane poisoning.

After an accidental or intentional ingestion of lindane, clinical manifestations of poisoning may include rapid onset of nausea and vomiting, coma, seizures, respiratory failure, and death. While rhabdomyolysis, secondary renal failure, and aplastic anemia have also been reported, coagulopathies have not been observed following poisoning with this pesticide. In this case report we describe a 43-year-old female who intentionally ingested 8 oz of a 20% lindane solution. Her serum lindane concentration reached 1.3 mcg/ml and her clinical manifestations included seizures, coma, rhabdomyolysis, secondary renal failure, and disseminated intravascular coagulation. The coagulopathy presented early in her clinical course and resolved when serum lindane levels fell. The patient died 11 days after the ingestion.

Adult↗
PubMed1987

Carcinoid tumour of stomach and primary hyperparathyroidism: a new association.

Three cases of carcinoid tumour of the stomach associated with primary hyperparathyroidism had the clinical and pathological features of a pluriglandular syndrome. Two of the patients showed multiple small polypoid carcinoids in the non-antral stomach, in conjunction with a parathyroid adenoma in one and parathyroid hyperplasia in the other case. One of these patients was also suffering from pernicious anaemia. A third patient had a large metastasising carcinoid arising in the gastric body and a parathyroid adenoma. Immunohistochemical stains for PGP 9.5 were positive in the carcinoids of all three cases. In all cases the carcinoids showed immunoreactivity for gastrin. A positive family history of endocrine hyperplasia and neoplasia was established in one case. It is suggested that patients with gastrointestinal carcinoids and their families should be evaluated for hyperparathyroidism, and patients with hyperparathyroidism presenting with upper gastrointestinal symptoms should undergo endoscopy to rule out gastric carcinoid tumours.

Adult↗
PubMed1987

Prostatic involvement in Wegener's granulomatosis.

Prostatic involvement is an unusual complication of Wegener's granulomatosis. We report two cases with this complication and emphasize the importance of recognizing this manifestation in diagnosis and management of the disease condition.

Adult↗
PubMed1987

Prevention of childhood poisoning: efficacy of an educational program carried out in an emergency clinic.

For many inner-city families, the emergency clinic is the most frequent and sometimes the only point of contact with medical services. We hypothesized that this setting could serve as an opportunity to direct a health promotion at a population that might not receive such a message elsewhere. The objectives of the program were (1) to remind parents of the telephone number of the Massachusetts Poison Center, (2) to ensure that parents have ipecac for use in an emergency, and (3) to counsel parents on how to use ipecac. Of 403 families recruited from the emergency clinic and divided randomly into intervention and nonintervention groups, 262 families completed the follow-up interview 6 months later (65%). Results showed that 68% of intervention families compared with 42% of control families reported ipecac storage at follow-up (chi 2 = 7.65, P = .005) and that 40% of intervention families v 25% of control families reported familiarity with the use of ipecac (chi 2 = 4.04, P = .04). Accessibility to the poison center's telephone number was reported by 62% of intervention families and by 49% of control families (chi 2 = 4.60, P = .13). Finally, 42% of intervention families v 25% of control families reported that they had a sticker on their phone with the number of the poison center on it (chi 2 = 4.60, P = .03). Our results suggest that a brief intervention, even in an emergency clinic, can introduce the topic of poisoning prevention to families and can encourage the storage of syrup of ipecac in the home.

Child, Preschool↗
PubMed1986

Evidence of canine distemper virus infection in skunks negative for antibody against rabies virus.

Between January 1981 and October 1985, brain tissue specimens from 192 skunks that were negative for antibodies against rabies virus were obtained from 2 Illinois Public Health laboratories (A and B). Brain lesions were detected microscopically in specimens from 17 of the 91 (18.7%) skunks from laboratory B and in specimens from 30 of the 101 (29.7%) skunks from laboratory A. Lesions in 3 skunks (1 from laboratory A, 2 from B) were caused by cerebral parasitism. Lesions in the remaining 44 skunks were characterized by perivascular, nonsuppurative, mononuclear cell infiltrates and foci of glial cells of differing severity. The similarity of lesions and the finding of inclusions diagnostic of canine distemper virus (CDV) in some skunks indicated that CDV may be the main cause of neurologic disease in nonrabid skunks. Seventeen of 36 (47.2%) skunks evaluated for antibody against CDV, using an unlabeled antibody-enzyme method, were positive for CDV. Findings in skunks from the 2 laboratories indicated similar annual prevalences of brain lesions in 1982, 1983, and 1984. The highest percentage (40.5%) of nonrabid skunks with encephalitis was found in skunks submitted to laboratory B in 1981, which was concurrent with a rabies epizootic among skunks in Illinois in 1981. The number of skunks from both laboratories with CDV infection peaked during winter-spring. Importance of CDV in skunk population dynamics remains to be elucidated; however, infection with CDV appears to be enzootic and occasionally epizootic in skunks. Because enzootic/epizootic CDV may bias rabies surveillance data, caution in interpretation of surveillance data is necessary.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

Pathologic findings in rabies-suspect, random-source, and accidentally killed skunks.

To evaluate sampling biases, pathologic findings in accidentally killed skunks (ie, killed by motor vehicles) were compared with those in random-source skunks (live-trapped and euthanatized, or trap-killed during research) and skunks submitted to a public health laboratory as rabies-suspect. Presence or absence of microscopic lesions in the brain, kidneys, liver, and lungs were used to test the null hypothesis that prevalence of disease did not differ by source of collection. Brain lesions differed with the source; rabid and nonrabid skunks submitted to a public health laboratory had higher prevalences of lesions than did other skunks. Kidney, liver, and lung lesions did not differ among skunks by source of collection. Liver and lung lesions were attributed mainly to parasitism, were not severe, and did not cause debilitated condition. Lesions were seen more often in the kidneys than in other tissues. Usually, lesions were mild to severe, focal, chronic, nonsuppurative, interstitial nephritis (possibly a consequence of leptospirosis). Six of 177 skunks necropsied appeared cachectic. Aleutian disease was diagnosed in one skunk and histoplasmosis was diagnosed in another, but rabies and canine distemper virus infection were the only diseases found with the potential to cause the high population mortality. Public health surveillance cases were biased toward diseased animals (rabies and canine distemper virus infection), but random-source or accidentally killed animals provided unbiased data. Although other factors must be considered, accidentally killed skunks provided cost-effective and useful data for the evaluation of enzootic rabies.

Accidents, Traffic↗
PubMed1985

Epidemiology of trauma in a population of incarcerated youth.

This study assessed the types, circumstances, frequency, and health consequences of trauma suffered by juvenile delinquents at a secure residential training school. A review of 369 medical records of 387 teenagers, aged 10 to 17 years, admitted to one such facility between 1978 and 1982 was made. Of the 369 students, 191 students (52%) suffered 391 separate trauma incidents serious enough to require a health care provider's attention. Circumstances surrounding the injuries included sports (36%), fights (20%), self-inflicted injuries (13%), suicide attempts (9%), incidents related to vocational studies (8%), and horseplay (3%). The most common types of injuries were musculoskeletal trauma, scratches, bruises and lacerations, and fractures. The usual sites of injury were the extremities, head, or neck. More than 50% of trauma incidents required a physician's attention initially or in follow-up; 28% of the injured were referred to an off-campus facility; 21% necessitated radiologic or laboratory studies; 4% required hospitalization; and one student died. The average trauma rate for teenagers in this setting was 1.2 injuries per person per year; the average rate of hospitalizations for trauma was 0.04 hospitalizations per person per year. These data call for further studies of trauma morbidity among adolescents in this and other settings and for innovative trauma prevention strategies.

Adolescent↗