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Biomedical subjects

D Edwards

Publications and source records attributed to D Edwards.

At least 145 records · Page 8Linked to original sources

Experience with mebendazole in the treatment of inoperable hydatid disease in England.

Eleven heterogeneous patients with inoperable hydatid disease were treated with high doses of oral mebendazole, up to 200 mg/kg/day for 16 to 48 weeks. Toxicity was not encountered. Despite careful assessment it proved difficult critically to evaluate the efficacy of mebendazole. In four patients chemotherapy appeared to have been at least partially successful and success seems to have correlated with serum levels in excess of 100 ng/ml one to three hours after dosage. The problems of assessment are discussed and the need for controlled trials of mebendazole in hydatid disease are stressed.

Adolescent↗

Computed tomography of the thorax in the diagnosis and management of malignant disease.

The role of computed tomography (CT) scanning in the investigation of patients with intrathoracic malignancy has not yet been clearly defined. Current evidence suggests that it is the most sensitive diagnostic imaging technique for identifying the extent of primary lung cancers and their relationship to intrathoracic anatomy. It is an advance in the staging of intrathoracic malignancy as it identifies adenopathy in the paratracheal region and the mediastinum more readily. Discovery of small (less than 0.8 mm) pulmonary nodules is common in patients with some extrathoracic malignant conditions, but differentiating malignant deposits from benign nodules remains a problem. CT has a potential place in radiotherapy field planning and in identifying lung cancers in the occasional patient presenting with suspicious symptoms or positive cytology and a normal chest radiograph.

Carcinoma, Small Cell↗

Suspected malabsorption of aminophylline in pancreatis.

The case of a patient with pancreatitis in whom low theophylline concentrations were observed on oral aminophylline is presented. Therapeutic theophylline concentrations were obtained with intravenous aminophylline. However, serum levels following oral doses were only 20 to 40% of those observed with intravenous administration, suggesting malabsorption. The most reasonable explanation for this was the patient's pancreatic dysfunction, since adequate absorption of oral aminophylline had been demonstrated on a previous admission not associated with pancreatis, and other possible causes of malabsorption were ruled out.

Administration, Oral↗

Protein binding of valproic acid in the presence of elevated free fatty acids in patient and normal human serum.

Two recent reports indicate that free fatty acids (FFA) can decrease the binding of valproic acid (VPA) to plasma proteins. Since FFA can increase in several physiological and clinical situations, it becomes necessary to define the relationship between elevated FFA and VPA free fraction. This study was conducted in two phases. In the first phase, serum was obtained from nine patients who were receiving Intralipid. A base-line sample was taken when therapy was absent. A second sample was taken during or immediately after Intralipid therapy. Protein binding VPA (equilibrium dialysis) and FFA levels were determined on each sample. FFA increased in eight patients; the median increase was 80.1%. VPA free fractions increased in six of the eight patients showing an increase in FFA; the median increase in free fraction was 18.7%. Rank correlation between FFA differences and free fraction differences indicated a significant positive linear correlation (r = 0.800). In the second phase, oleic acid was added to normal serum in five different concentrations (500-5,000 microEq/liter) with VPA at 100 microgram/ml. Free fraction of VPA increased continuously from a blank value of 9.6% (+/- 1.4) to 44.1% (+/- 2.5) with increasing concentrations of oleic acid.

Fat Emulsions, Intravenous↗

A nutrient survey in elderly women with femoral neck fractures.

This survey was undertaken to study the nutrition of elderly women following surgical treatment for a femoral neck fracture. The voluntary food intake of 19 patients was measured 3, 7 and 14 days after operation. When the nutrient content was calculated and compared with DHSS recommended values for healthy women of the same age, only the intakes of vitamin A and calcium were adequate. The mean intake of protein, energy, vitamin D, riboflavin, vitamin C, thiamin and niacin fell short of the recommendation. The evidence suggests that whilst adequate food intake may be provided in hospital, the actual nutrient intake of elderly female patients recovering from a femoral neck fracture is often inadequate.

Aged↗

The effects of race and social class on clinical judgment.

Asked 61 male clinical psychologists (21 blacks and 40 whites) to assess case histories that were presented to them to determine whether racial or social class biases could be detected. In order to avoid the apparent artificial results or weak interpretations of past research, only cases with concurrently validated diagnoses and 4-year follow-up were used. An equal number of positive and negative clinical outcomes were included. Diagnosis, disposition, and rated severity were studied. The following results were found: (1) diagnosis for all psychologists was guided by case characteristics, not bias; (2) severity was related strongly to diagnosis; (3) disposition followed judgments of severity and diagnosis, not bias. The question was raised whether clinical investigators may not have overdramatized bias in psychodiagnosis and clinical judgment.

Alcoholism↗

Urinary MHPG and clinical response to amitriptyline in depressed patients.

The authors treated 18 rigorously diagnosed depressed patients with amitriptyline after baseline urine samples were collected for the measurement of 3-methoxy-4-hydroxphenylglycol (MHPG). Neither age nor severity of depression before treatment correlated with MHPG excretion. There was also no significant correlation between baseline MHPG excretion and clinical response at the end of at least 25 days' treatment with amitriptyline. The authors discuss the relevance of amitriptyline and nortriptyline plasma levels to MHPG and the noradrenergic/serotonergic theories of depression.

Adolescent↗

Positive results from outpatient mental health intervention.

Collected data on 3,342 outpatients over 2 years. A 4-year follow-up of successful outcomes was conducted on each of the cases. Hospitalized patients showed a 30% success rate. The success rate for the group that was recommended for no treatment was 60%. The success rate for patients who completed outpatient treatment increased to 78%. A patient's expectation of outcome, the clinician's assessment of reason for referral, the diagnosis, and age were the most powerful predictors of success. These findings demonstrate the following: (a) procedures for assessment and intervention can be successful; and (b) a significant portion of the population can be served by intervention with proper selection.

Adolescent↗

Effects of midterm integration on state and trait anxiety in black and white elementary school children.

This study investigated the effects of stress associated with school integration on state and trait anxiety for 637 Black and White fourth- fifth- and sixth-grade children. A court-ordered integration plan resulted in the transfer of children from all-White and all-Black schools into integrated schools 2 months before the end of the school year. The State-Trait Anxiety Inventory for Children (STAIC) was administered 1 week prior to the transfer and 6 weeks following transfer. Females who were transferred had higher state anxiety scores than nontransferred females, but there were no differences for males. Transferred Black and White children did not differ in state anxiety, but transferred Blacks were higher in trait anxiety than transferred Whites.

Black or African American↗

Patent ductus arteriosus treated with ligation or indomethacin: a follow-up study.

The course and complications of fifty-two infants with patent ductus arteriosus requiring closure were assessed prospectively. Twenty-six infants with a PDA received indomethacin for pharmacologic closure of the PDA, and 26 underwent ligation. The current study analyzes and compares the longitudinal follow-up with respect to somatic growth, neurologic function, psychomotor and mental development, and renal, ophthalmologic, and audiologic function in 21 infants in each group who entered the follow-up. No selective morbidity was attributable to PDA closure with indomethacin when compared to surgically treated infants.

Child Development↗