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Biomedical subjects

C S Mitchell

Publications and source records attributed to C S Mitchell.

35 records · Page 2Linked to original sources
PubMed1996

Clinical evaluation of 58 organolead manufacturing workers.

Fifty-eight workers were evaluated at a university-based occupational health clinic for potential health effects related to organic and inorganic lead exposures. The clinical evaluation included a history, physical, and laboratory examination, and in a subset of workers, neurobehavioral tests and nerve conduction studies. Workers reported symptoms that predominantly involved the central and peripheral nervous systems. Findings for which no alternative medical explanations could be found included neurobehavioral abnormalities (18 of 39 workers) and sensorimotor polyneuropathies (11 of 31 workers). The clinical presentation and evaluation of workers exposed to organic lead are discussed.

Adult↗
PubMed1993

Gorham's disease involving the thoracic skeleton. Plain films and CT in two cases.

Two cases of Gorham's disease (massive osteolysis, idiopathic osteolysis, vanishing bone disease) involving the thoracic skeleton are reported. Both patients were adolescent females with involvement of multiple ribs. Involvement of the thoracic spine and pleural effusions--unusual manifestations carrying a poor prognosis--were also present. The radiographic and computed tomographic appearances are included with discussion and review of this disease entity.

Adolescent↗
PubMed1993

Orofacial abscesses of odontogenic origin in the pediatric patient. Report of two cases.

Odontogenic infections rarely spread beyond the periapical space. Occasionally spread of infection into contiguous anatomic areas occurs through bone, fascial or muscular barriers. Two cases of orofacial abscess of odontogenic origin in the pediatric patient are presented, one imaged with CT and the other with MRI. Both abscesses involved the deep and superficial tissues of the face. Additionally, one of the abscesses extended into the orbit and the other involved the preseptal soft tissue. The pathogenesis, mechanism of spread and management of the disease are discussed.

Abscess↗
PubMed1993

Application of an injury surveillance system to injuries at an industrial facility.

We developed a computerized surveillance database employing the Abbreviated Injury Scale (AIS) and sampled three months of nonfatal injuries at a large industrial facility. Data from 197 injury visits to the plant medical department were collected. With the addition of some new AIS codes for injuries specific to the workplace, most injuries could be coded and severity scores calculated with good interrater reliability. Neither Maximum AIS nor Injury Severity Score (ISS) predicted restricted or lost work time. Because of its ease of automation and reliability, the AIS can serve as a useful tool for occupational injury surveillance, but its current severity scoring system is not predictive of disability.

Abbreviated Injury Scale↗
PubMed1993

Computed tomography in the headache patient: is routine evaluation really necessary?

OBJECTIVE: To determine the likelihood ratio of a positive computed tomogram of the brain in the routine evaluation of headache patients. DESIGN: Consecutive patients with a chief complaint of headache were prospectively evaluated with computed tomography of the brain. Patients with headaches complicating other clinical disorders such as trauma, postictal state or known intracranial neoplasm were excluded. SETTING: Military tertiary care center. PATIENTS: Consecutive sample of 350 patients with a chief complaint of headache, regardless of the presence or absence of physical or neurologic signs, were referred for computed tomography of the brain. The patients were referred from a variety of inpatient and outpatient settings. RESULTS: Seven (2%) of the 350 patients had computed tomographic findings that were clinically significant. An additional 25 (7%) had positive computed tomographic findings, which were clinically insignificant for findings. All of the patients with significant computed tomographic findings had an abnormal physical or neurologic exam or unusual clinical symptoms. CONCLUSION: Routine computed tomography of the brain in headache patients with normal physical and neurologic exams and no unusual clinical symptoms has a low likelihood ratio for discovering significant intracranial disease.

Adolescent↗
PubMed1992

Lyme disease in Maryland: 1987-1990.

We describe the epidemiology of Lyme disease in Maryland for 1987 to 1990 when the number of cases reported grew from 23 to 448 and the number of cases meeting the CDC case definition grew from 23 to 238, as well as discuss the implications of increased reporting and diagnosis of Lyme disease.

Adolescent↗
PubMed1987

Cimetidine therapy in nonsteroidal anti-inflammatory drug gastropathy. Double-blind long-term evaluation.

To assess the efficacy of cimetidine in treating and preventing gastric mucosal lesions associated with nonsteroidal anti-inflammatory drug (NSAID) therapy (NSAID gastropathy), we endoscopically studied 104 patients taking NSAIDs for a variety of rheumatic diseases. Fifty-six percent (22/43) of patients randomized to cimetidine 300 mg four times a day and 52% (22/42) of those randomized to placebo showed progression of endoscopic lesions during the eight-week short-term phase. Thirty-nine patients whose endoscopic lesions improved were then randomized to a ten-month maintenance regimen of either cimetidine 400 mg at bedtime or placebo. Fifty percent (7/14) of placebo-treated and 42% (5/12) of cimetidine-treated patients showed progression of lesions during the maintenance phase. The failure of cimetidine to offer any significant benefit under these protocol conditions reflects the fundamental difference in pathophysiologic features between classic acid-mediated ulcer disease and NSAID gastropathy.

Adolescent↗
PubMed1977

Augmented histamine test--diagnostic and prognostic values.

The results of the augmented histamine test in 107 controls, 48 patients with gastric ulcer and 141 patients with duodenal ulcer are presented. The mean basal acid secretion and maximal acid output (MAO) were significantly higher in duodenal ulcer patients than in normal subjects. Ulcers of the body of the stomach were associated with lower than normal levels of secretion, whereas ulcers of the prepyloric region were associated with higher than normal levels. In this study of 141 patients with duodenal ulcer, 101 patients or 72% had an MAO above the upper limit of normal (20.4 mEq./hr.). Conversely, a patient with an MAO of less than 12.4 mEq./hr. is unlikely to have duodenal ulcer disease. The use of the ratio of MAO to actual body weight did not increase the diagnostic discrimination between normal subjects and those with duodenal ulcer. Duodenal ulcer patients with complications had a significantly higher MAO to histamine than those without complication. The finding of an MAO greater than 40 mEq./hr. is highly suggestive of the presence or the imminence of a complication.

Adult↗
PubMedDate not supplied

Artificial intelligence and Bayesian decision theory in the prediction of chemical carcinogens.

Two procedures for predicting the carcinogenicity of chemicals are described. One of these (CASE) is a self-learning artificial intelligence system that automatically recognizes activating and/or deactivating structural subunits of candidate chemicals and uses this to determine the probability that the test chemical is or is not a carcinogen. If the chemical is predicted to be carcinogen, CASE also projects its probable potency. The second procedure (CPBS) uses Bayesian decision theory to predict the potential carcinogenicity of chemicals based upon the results of batteries of short-term assays. CPBS is useful even if the test results are mixed (i.e. both positive and negative responses are obtained in different genotoxic assays). CPBS can also be used to identify highly predictive as well as cost-effective batteries of assays. For illustrative purposes the ability of CASE and CPBS to predict the carcinogenicity of a carcinogenic and a non-carcinogenic polycyclic aromatic hydrocarbon is shown. The potential for using the two methods in tandem to increase reliability and decrease cost is presented.

Animals↗
PubMedDate not supplied

Immunologic parameters of multiple chemical sensitivity.

Immunologic abnormalities have long been advanced as a potential mechanism for multiple chemical sensitivity (MCS). An immunologic mechanism is supported in part by the systemic nature of the symptoms reported, the complex interactions known to exist between the immune system and other systems, and limited experimental evidence. However, there are both theoretical grounds for doubting an immunologic mechanism in MCS and methodological constraints in many of the studies that have been conducted in humans. The authors discuss the structure and function of the immune system as it potentially applies to MCS, the uses and limitations of immunologic testing, and the evidence for immunologic theories of MCS. They describe recent work to validate some of the immunologic tests used in MCS and consider opportunities for further research.

Humans↗
PubMedDate not supplied

MR imaging of the brain in patients with migraine headaches.

Forty-one patients with migraine headaches were referred for MR imaging of the brain. Intermediate and T2-weighted images were obtained to determine the frequency of areas of high intensity within the white matter. The average age of these patients was 29.8 years; only five were over 40 years old. Each patient was evaluated in the axial plane with long TR/short and long TE images. Twenty-three patients also had T1-weighted short TR/short TE MR scans; enhancement with gadopentetate dimeglumine was used in three patients. Intracranial abnormalities were seen in only six patients: foci or white matter high intensity on intermediate and T2-weighted images in five and a venous angioma in one. Prior studies have indicated that parenchymal brain abnormalities may be found in up to 46% of patients with migraines. The current study demonstrated parenchymal brain lesions in only 12%. This study suggests that the frequency of foci of high intensity seen on long TR sequences in the migraine patient is much lower than previously reported, especially in patients under 40 years old (5.5% in our series).

Adult↗