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Biomedical subjects

D B Paul

Publications and source records attributed to D B Paul.

13 recordsLinked to original sources
PubMed1995

The hidden science of eugenics.

The early eugenicists were not stupid, but they did not share our social values. The rise and fall of the eugenics movement is a history that modern medical geneticists would do well to heed.

Animals↗
PubMed1995

Short-term stability of HIV provirus levels in the peripheral blood of HIV-infected individuals.

Changes in viral load have been reported to reflect disease progression or response to therapy; however, the stability of HIV DNA levels in HIV-infected individuals has not been extensively studied. Cellular HIV DNA levels in infected individuals were evaluated over a short time period to determine degree of variability as well as any correlation with other measurements of virus load or immune status. Peripheral blood mononuclear cells (PBMC) were obtained several times over 1 month from 32 asymptomatic or symptomatic non-AIDS, HIV-infected individuals currently on AZT therapy. PCR amplification of the HIV gag region was performed with DNA from PBMC lysates and the PCR amplified products quantitated by liquid phase hybridization. HIV DNA levels in the majority of the patients were relatively stable, with 26 of 32 persons having less than threefold change. Changes over the study period were both positive and negative, and the median change in HIV DNA levels was 68.6%. These changes were found to positively correlate with fluctuations in plasma p24 levels. In contrast, no correlations were found with other measurements of immune system activity, including changes in CD4 number, CD4 percent, and beta 2-microglobulin when compared with provirus changes. This study shows that levels of HIV DNA can be relatively stable over short periods in most non-AIDS, HIV-infected persons.

Base Sequence↗
PubMed1994

Blunt vascular injury associated with closed mid-shaft femur fracture: a plea for concern.

During a period of six years, 765 consecutive patients were treated by the trauma service at Allegheny General Hospital for closed mid-shaft femur fractures that were a component of their injury complex. Thirty-one patients underwent angiography of the involved extremity for indications including loss of pulses in eleven and large hematomas or deformities of the thigh in the remainder. Ten patients (1.3%) were found to have acute vascular injuries. In nine patients there was an intimal flap of the superficial femoral artery (SFA), and in one, a pseudoaneurysm. Two patients had injuries of the femoral nerve. Three patients had no other associated major injuries (Injury Severity Score range, 10-19). Twelve months after the initial injury, one patient developed an arteriovenous fistula of the SFA. Detailed, repeated physical examinations, early utilization of angiography, and intensive follow-up by the trauma surgeon or orthopedic surgeon of patients with closed mid-shaft femur fractures should lead to early recognition of this potentially serious association.

Adolescent↗
PubMed1994

Enhanced rim around infarcted, traumatized spleen on computed tomographic scans: case report.

Computed tomography is considered a reliable imaging technique when determining the extent of splenic injury. We present the case of a patient with a traumatic infarct of the spleen detected by computed tomographic scanning of the abdomen. During laparotomy there was an infarction of the spleen from a hilar injury in addition to bleeding from the splenic vein. We conclude that ongoing bleeding from the splenic hilar vessel can lead to a rim of enhancement around the spleen from contrast material. This should be taken into account when a decision is made for nonsurgical management.

Abdominal Injuries↗
PubMed1994

Diving injuries: a preventable catastrophe.

During a 5-year period from January 1987 through January 1992, 58 patients were admitted to the Allegheny General Hospital trauma center for non-scuba, non-suicidal diving injuries. There were 46 men and 12 women (mean age, 23 years). Forty-five patients were injured in swimming pools. Twenty-two patients had blood alcohol levels > 100 mg/dL. Cervical spine injury was the most common pathologic entity encountered in this group of patients. Closed head injury, pelvic fracture, thoracic vertebral fracture, and rib fractures were other injuries identified. Some patients had multiple organ failure syndrome. Aquatic recreational activities carry a risk for injury that is preventable. The mechanism, clinical data, and complications of 58 patients are presented and the importance of prevention is discussed.

Adolescent↗
PubMed1994

Delayed rupture of the spleen--myths, facts, and their importance: case reports and literature review.

Over a 1-year period, three patients were seen in our trauma service with delayed bleeding (> or = 7 days) from an initially inapparent splenic injury. This entity was defined as a late occurrence of signs and symptoms attributed to splenic injury not detected by diagnostic computed tomographic (CT) scanning during the initial examination. We believe that this represents an "injury in evolution" minor enough to go undetected on initial CT scans of the abdomen. A high index of suspicion and liberal utilization of imaging techniques are essential for the identification of delayed splenic rupture. Further multicenter studies are required to delineate the true incidence of its occurrence and its clinical significance. We conclude that "delayed rupture" of the spleen is a true clinical entity. The occurrence of a delayed rupture may prove hazardous to patients discharged early from the hospital after blunt abdominal injury. A classification system to assess this type of injury is suggested.

Accidents, Traffic↗
PubMed1985

Pelvic lymphadenectomy for carcinoma of prostate.

Pelvic lymphadenectomy was performed in 187 patients as a staging procedure for carcinoma of the prostate. Clinical impression of lymph nodes during dissection appears to be inaccurate in a large number of patients. We therefore believe that if radical surgery is planned for clinically localized tumor, the histologic status of the removed nodes should be confirmed before surgical extirpation of the tumor.

Adenocarcinoma↗
PubMed1985

Textbook treatments of the genetics of intelligence.

Genetics textbooks have been remarkably unaffected by the discovery of fraud in the work of British psychologist Sir Cyril Burt or by the resulting critical review of other classic studies on the genetics of intelligence. Although Burt's name has nearly vanished from current textbooks, his results continue to be cited in textbook discussions of the heritability of intelligence, as do the results of other studies now recognized as methodologically inadequate. Moreover, genetics textbooks consistently employ confused or misleading definitions of the concept of heritability that, together with the reporting of discredited data, perpetuate a fundamentally inaccurate understanding of the genetics of intelligence. This situation is largely attributable to the practice--generic to textbook writing but in this case taken to an extreme--of authors' liberal borrowing from one another or from a few apparently authoritative works (including earlier textbooks). The extent to which authors rely on these sources for their discussions of the genetics of intelligence is apparently a function both of the controversiality of the subject and of authors' technical insecurity, perhaps reinforced by prior assumptions about the influence of genes on variations in intellectual performance.

Genetics, Behavioral↗
PubMed1983

Morbidity from pelvic lymphadenectomy in staging carcinoma of the prostate.

A retrospective review of 150 patients with adenocarcinoma of the prostate was done to determine the morbidity associated with lymphadenectomy performed as an independent procedure. A total of 77 complications, 17 of which were considered major, was noted in 50 patients. Wound drainage and transection of the spermatic cord were associated with increased morbidity. Systemic antibiotic therapy afforded no protection against wound infections, while intraoperative irrigation was protective. Lymphoceles and lower extremity edema occurred infrequently in our series, although only a few patients underwent postoperative pelvic irradiation therapy.

Adenocarcinoma↗