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Biomedical subjects

C Elliott

Publications and source records attributed to C Elliott.

18 recordsLinked to original sources

Audiological, vestibular and radiological abnormalities in Kallman's syndrome.

Kallman's syndrome is a multifaceted congenital disorder with predominantly endocrine abnormalities. We have characterized the associated mixed hearing loss and identified consistent radiological evidence of abnormal temporal bone anatomy. Abnormal labyrinthine morphology is accompanied by a complete absence of response to vestibular stimulation with caloric or rotational chair testing. The endocrine abnormalities are correctable and Kallman's syndrome is a diagnosis worthy of consideration when assessing children with congenital hearing loss.

Adult

Diagnosing blame: responsibility and the psychopath.

The diagnosis of psychopathy is controversial largely because of two notions: first, that because of their defects, psychopaths cannot understand morality, and second, that these defects should thus excuse psychopaths from moral responsibility for their actions. However, it is not clear just what is involved in understanding morality. The argument that the psychopath is ignorant of morality in the same way that one might be ignorant of facts is difficult to sustain. However, a closer examination of the psychopath's peculiar deficiencies reveals that the psychopath's understanding of mortality might be impaired in other ways.

Antisocial Personality Disorder

Ketorolac as a preoperative nonnarcotic analgesic to enhance anesthesia and postanesthesia recovery.

The benefits of using ketorolac as a preoperative intramuscular (IM) non-narcotic analgesic are described and illustrated by the presentation of two case reports. Case Summary--Patient 1: A 53-year-old female who had experienced refractory nausea and vomiting after six previous exposures to anesthesia presented for outpatient ureteroscopy and dilatation of strictures. Instead of using an opiate narcotic, ketorolac 60 mg IM was given 1 hour before induction as the analgesic portion of anesthesia. Case Summary--Patient 2: A 65-year-old male with mild chronic obstructive lung disease presented for extracorporeal shock wave lithotripsy (ESWL). To avoid the respiratory depression associated with opioid narcotics, ketorolac 60 mg IM was given as an analgesic 1 hour before the ESWL procedure.

Aged

Role of plasma non-esterified fatty acids during and after exercise.

1. The importance of circulating non-esterified fatty acids as a substrate during and after low-grade exercise has been examined by using a nicotinic acid analogue to inhibit lipolysis. Seven healthy men received acipimox or placebo on separate occasions. After 90 min, bicycle exercise was performed for 45 min (40% of pre-determined maximum oxygen uptake), followed by a 60 min recovery period. 2. The plasma concentration of non-esterified fatty acids increased during exercise after placebo (320 +/- 80 to 630 +/- 110 mumol/l) and remained elevated in the post-exercise period. Basal concentrations were lower after acipimox (100 +/- 10 mumol/l; P less than 0.05); they declined to 60 +/- 10 mumol/l during exercise and remained at this level for the rest of the study. 3. Lipid oxidation increased from 0.8 +/- 0.1 to 4.2 +/- 0.5 mg min-1 kg-1 during exercise after placebo (P less than 0.001) and remained elevated in the post-exercise period (1.2 +/- 0.1 mg min-1 kg-1). It was lower after acipimox, but still increased from 0.3 +/- 0.1 to 2.3 +/- 0.2 mg min-1 kg-1 with exercise. Carbohydrate oxidation was increased after acipimox compared with after placebo, but only reached significance during the post-exercise period (P less than 0.05). 4. Although acipimox abolished the rise in the plasma concentration of non-esterified fatty acids during exercise, there was only a 50% decrease in the rate of lipid oxidation. This suggests that an alternative source of non-esterified fatty acids makes an important contribution to the supply of lipid for oxidation during exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

The rules of insanity: commentary on: psychopathic disorder: a category mistake?

This paper addresses Colin Holmes's suggestion that the psychopathic disorder is best regarded not as a psychiatric concept, but as an ethical one. The paper argues that the concept of psychopathy, like many other concepts, can span both psychiatry and ethics, and that it is not clear what removing if from the realm of psychiatry would entail. Also, the question of whether the concept of psychopathy is useful for psychiatrists must be separated from the question of whether psychopaths should be exonerated from the moral and legal responsibility for their actions.

Antisocial Personality Disorder

From the patient's point of view: medical ethics and the moral imagination.

This paper concerns the difficulties of imagining the subjective point of view of another human being, and the relevance of these difficulties to medical decisions. It explores especially the difficulties of imagining the experience of the mentally impaired, and examines several standards for decision-making: the 'prior expressed wishes standard', the 'substituted judgement standard', and the 'best interests standard'.

Beginning of Human Life

The clinical nurse anesthetist as diagnostic sleuth.

Two cases are presented where observations made during anesthetic management led to appropriate diagnoses that otherwise might not have occurred in a timely fashion. In the first case, an early diagnosis of myasthenia gravis was facilitated; while in the second case, an improbable response led to rethinking of the initial diagnosis. The role of the nurse anesthetist in being alert to the consequences of unusual clinical and theoretical responses on behalf of the patient is depicted.

Adult

"How am I doing?".

Explore the source record for details and available documents.

Chronic Disease

Combined hyperlipidemia and hypertriglyceridemia in renal allograft recipients. Comparison with non-renal combined hyperlipidemic or hypertriglyceridemic patients and normal subjects.

In order to investigate the degree of similarity between renal transplant and non-renal combined hyperlipidemic and hypertriglyceridemic patients, serum and lipoprotein lipid compositions were compared in transplant and non-renal combined hyperlipidemic and in transplant and non-renal hypertriglyceridemic patients, and normal subjects. Although certain similarities were demonstrated, combined hyperlipidemia in transplants differed from that in non-renal patients in a number of respects: (1) LDL-triglyceride levels were increased to a greater extent in transplant than in non-renal patients in females, while LDL-phospholipid was elevated in male transplants only; (2) HDL-cholesterol levels were raised in transplants relative to non-renal patients in females, and relative to both non-renal patients and normal subjects in males; (3) a number of differences in lipoprotein-lipid ratios between transplant and non-renal patients were demonstrated for all three lipoprotein fractions. In hypertriglyceridemia, changes in lipoprotein-lipid levels were similar in transplant and non-renal patients with the exception of HDL-cholesterol levels, which were decreased in non-renal patients only. Furthermore, the ratio of esterified to free cholesterol in LDL and HDL was decreased in non-renal but not in transplant patients. The data presented demonstrate that, despite certain similarities, a number of the lipoprotein-lipid changes observed in transplant combined hyperlipidemia and in transplant hypertriglyceridemia differ from those observed in non-renal patients with similarly elevated serum lipids.

Adult

Hypercholesterolemia in renal allograft recipients. Comparison with non-renal hypercholesterolemia and normal subjects.

In order to investigate the degree of similarity between renal transplant and non-renal hypercholesterolemia, serum and lipoprotein lipid compositions were compared in female transplant hypercholesterolemic patients (serum cholesterol greater than 240 mg/100 ml, serum triglyceride less than 150 mg/100 ml) and female non-renal hypercholesterolemic and normal subjects. A number of lipid abnormalities were demonstrated: (1) Serum and LDL cholesterol and phospholipid levels were significantly elevated in both transplant and non-renal hypercholesterolemic patients; (2) Serum triglyceride, VLDL choelsterol, triglyceride and phospholipid, and LDL and HDL triglyceride were significantly increased in transplant hypercholesterolemic patients. Changes of this nature are usually found in hypertriglyceridemia, and were not observed in non-renal hypercholesterolemic subjects. Finally, a number of changes in the ratio of esterified to free cholesterol and in the ratios of other lipoprotein-lipids, most of which did not correspond to any changes found in the common non-renal hyperlipidemias, were also demonstrated.

Cholesterol

Factors influencing the response latencies of subnormal children in naming pictures.

The times taken to name 56 drawings of objects on five separate occasions were analysed for 21 ESN(M) and 21 ESN(S) children, matched for picture-naming vocabulary. The ESN(S) group not only had a higher mean response latency but also showed greater inter- and intra-subject variance. Nine objects were selected whose names have a Thorndike-Lorge language frequency of 50 words per million or greater, and nine others were selected with a frequency of less than 50 words per million. Each object was drawn in two ways, one giving a two-dimensional outline with the addition of important detail, the other drawing also incorporating cues indicating the depth of the object. An analysis of variance of the children's latencies in naming the selected 36 pictures of 18 objects over five trials indicated that the method of drawing had no effect upon naming latencies. Pictures with high-frequency names were named faster than those with lower frequency names, the ESN(S) group showing a greater rate of increase in naming latency for the lower frequency words than the ESN(M) children. Results were discussed in terms of the Oldfield and Lachman models of lexical memory storage and of the search processes required for the retrieval of names.

Adolescent