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Biomedical subjects

D Forbes

Publications and source records attributed to D Forbes.

At least 55 records · Page 3Linked to original sources

Conservative management of temporomandibular disorders: a posttreatment comparison between patients from a university clinic and from private practice.

Long-term (1 to 7.5 years) follow-up evaluations of 110 adult patients who were seen for diagnosis and treatment of symptoms related to myofascial problems (MP), internal derangement (ID), or both were conducted by means of telephone interview. One half of the patients were seen at the Northwestern University Dental School TMJ Clinic, while the other half were seen in the private office of one author (H. T. P.). The purpose of this study was to evaluate patient response to conservative therapy combined with advice about self-management, as compared with the response to advice only. Further, we desired to compare treatment outcomes among (1) diagnostic categories ID, MP, and ID plus MP, (2) clinic patients and private patients, and (3) patients with acute disease and those with chronic disease. Chronic disease was identified as that in which pretreatment symptoms had persisted for more than 4 months. The ridit analysis was used to assess differences in outcomes for patients in the three diagnostic categories and for clinic patients compared with private patients. The results revealed no significant differences. There was a trend for patients with acute conditions to improve more than those with chronic problems; however, further research is needed to determine whether a correlation exists between symptom duration and treatment outcome. At the time of the follow-up evaluation, 88% of all patients reported substantial or total improvement in their symptoms of pain and dysfunction. Therefore, conservative therapy, including advice about self-management, was found to be both adequate and appropriate for most of these patients.

Acute Disease↗

Intestinal anaphylaxis: in vivo and in vitro studies of the rat proximal colon.

The response of the rat proximal colon to an immunoglobulin E (IgE)-mediated hypersensitivity reaction was examined. Rats were sensitized to egg albumin (EA) by intraperitoneal injection, and serum titers of specific anti-EA IgE were measured at 14 days. Sensitized animals had titers of greater than or equal to 1:64, whereas no anti-EA IgE antibodies were detected in controls. Water and electrolyte absorption in the proximal colon, before and during antigen challenge, was measured by in vivo marker perfusion. Antigen challenge resulted in significant inhibition of water, Na+, Cl-, and K+ absorption in vivo. Proximal colonic tissue from sensitized and control animals was studied in Ussing chambers under short-circuited conditions. Antigen challenge of sensitized tissue resulted in significant increases in short-circuit current due to the induction of active Cl- secretion. No such changes were seen in control tissue. The abnormalities induced by antigen challenge in tissue from sensitized animals was blocked by doxantrazole (10(-3) M), a mast cell stabilizer. The findings indicate that IgE-mediated reactions in rat proximal colon to a food protein cause pertubations in water and electrolyte transport secondary to active Cl- secretion and these abnormalities appear to be due to mast cell degranulation.

Anaphylaxis↗

Supplemental calories improve essential fatty acid deficiency in cystic fibrosis patients.

Fatty acid composition of plasma lipids was analyzed in malnourished cystic fibrosis patients undergoing 6 months of nutritional rehabilitation. There were three males and five females (mean age 15.1 yr); five patients had pancreatic insufficiency. Nutritional rehabilitation in seven of eight patients was accomplished by nocturnal nasogastric infusion of a high-carbohydrate semisynthetic diet, in addition to daily meals. One patient received high-energy food supplements as snacks in addition to regular meals. All patients were moderately to severely malnourished on entry to the study and showed significant improvement over the 6 months in (means +/- SE) energy intake (96 +/- 8.0 to 126 +/- 11% recommended daily allowance) and body composition (80 +/- 4 to 90 +/- 4% ideal body weight). Daily intakes of linoleic acid were not significantly different before or during nutritional rehabilitation either as an absolute amount (383 +/- 45 to 557 +/- 124 mg/kg/day) or as a percentage of total calories (4.50 +/- 0.40 to 4.73 +/- 0.14%). In comparison to the controls, the relative percentage of plasma cholesterol ester fatty acids of the CF patients on entry into the study showed a marked decrease of linoleic acid (52.7 +/- 1.0 versus 42.3 +/- 2.7%) with elevated palmitoleic (2.34 +/- 0.2 versus 5.64 +/- 0.7%) and oleic (18.7 +/- 1.0 versus 25.2 +/- 1.4%) acids; a pattern consistent with essential fatty acid deficiency. However, this pattern is not truly characteristic of a pure linoleic acid deficiency as the metabolites of linoleic acid were not decreased.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Familial polyposis coli in childhood.

Familial polyposis coli has generally been considered a disorder of adulthood that is rarely identified in children. We report 3 affected kindreds in which the disorder was diagnosed in 6 of 11 potentially affected children between 8 and 16 years of age. Experience with these kindreds demonstrates that polyps frequently develop during childhood in affected individuals. Colonoscopy was found to be preferable to the air-contrast barium enema, in that it was as sensitive a technique for detection of adenomas, and in that it also permitted collection of biopsies for histologic confirmation. We recommend that colonoscopy be performed late in the first decade of life before symptoms develop. Total colectomy, rectal mucosectomy, and ileo-anal anastomosis eliminated the risk of malignancy, preserved anal sphincter function by both clinical and manometric assessment, and was readily adapted to by these children.

Adenocarcinoma↗

Chronic pancreatitis associated with ulcerative colitis.

A twelve-year-old girl without apparent predisposing factors developed chronic pancreatitis, and 10 months later had fulminant onset of ulcerative colitis requiring a colectomy. This report strengthens the evidence for a relationship between pancreatitis and inflammatory bowel disease.

Child↗

Nutritional rehabilitation of malnourished patients with cystic fibrosis.

We examined the effect of nutritional rehabilitation in cystic fibrosis patients with severe disease. Thirteen malnourished patients (seven males, six females, age 7-27 yr) were studied over 7-16 mo. Oral supplementation was attempted initially in 12 patients (mean duration 6.7 mo); only 2 patients gained weight, 2 withdrew, and 1 died. The remaining 7 patients failed to achieve adequate weight gain and were commenced on nasogastric supplementation with a semisynthetic formula. An additional patient was entered without a prior period of oral supplementation because of the severity of malnutrition. Weight gain was achieved in 7 of 8 patients with nasogastric supplementation (mean duration 6.4 mo). Weight gain was associated with an increase in lean body mass, total body fat, and height velocity. While pulmonary function and biochemical parameters were unchanged, patient well-being improved and episodes of pneumonia decreased.

Adolescent↗

Delayed presentation of haemorrhagic disease of the newborn.

Six infants with delayed presentation of haemorrhagic disease of the newborn are described. All were full-term infants who had no underlying disease, but did not receive prophylactic doses of vitamin K at birth and were breast-fed. Two infants have been left with permanent handicaps as a result of this uncommon, but preventable, disorder.

Blood Coagulation Factors↗

Experimental Salmonella dublin infection in calves.

An experimental model of Salmonella dublin infection in calves for the purpose of evaluating antibacterial compounds was developed. Oral administration of the bacterium produced variable results and subsequently the organism was injected intravenously into one-week-old calves. Symptoms observed were consistent with those described in naturally occurring cases. An analysis of the mortality and clinical signs in both control and treated calves showed that the severity of the disease was exacerbated by the presence of specific antibody. It is argued that some symptoms presented were consistent with anaphylactic or Arthus-type hypersensitivity. Anaphylaxis was associated with antibody probably derived from maternal colostrum whereas Arthus hypersensitivity was probably due to antibody synthesised by the calf itself. There was an inverse relationship between low initial antibody titres and the survival period. Tests of antibacterial efficacy may best be done in colostrum deprived animals in which the symptoms will be dissociated from passively acquired antibody.

Administration, Oral↗