PubMed Health⌕ Search

Biomedical subjects

F Wilson

Publications and source records attributed to F Wilson.

At least 19 recordsLinked to original sources

Sudden onset bilateral sensorineural hearing loss: a manifestation of occult breast carcinoma.

Diffuse infiltration of the meninges by metastatic carcinoma (meningeal carcinomastosis) is a potential complication of systemic malignancy. It may present with a variety of neurological symptoms as any aspect of the neuraxis can be affected. Often there is a history of pre-existing malignancy. The authors describe a case with an initial presentation of sudden onset profound bilateral sensorineural hearing loss. The underlying pathology was found to be an occult breast carcinoma, a previously unreported finding. The role of cerebrospinal fluid cytology and radio-imaging in diagnosis is discussed. All previously reported cases of sudden hearing loss and meningeal carcinomatosis are reviewed.

Adenocarcinoma↗

Protection afforded by sickle-cell trait (Hb AS): what happens when malarial selection pressures are alleviated?

A study of reproductive outcome in Mobile, AL was conducted among a large maternal cohort with sickle-cell disease (Hb SS), sickle-cell trait (Hb AS), and no hemoglobinopathies (Hb AA). It was found that mean gravidity and live births among Hb AS women were significantly higher than among Hb AA women. These findings were surprising since it is generally held that once malarial pressure is alleviated, any reproductive advantage that might be conferred by Hb AS would disappear and fertility levels would reach levels similar to or slightly less than that of Hb AA women. A search of the literature was subsequently conducted and a large cohort study of an African-derived population was found in the United Kingdom. Results from this study also showed that parity was significantly higher among Hb AS women compared to Hb AA women. If survivorship is similar among Hb AS and Hb SS women, findings from these two studies raise doubts whether directional selection is occurring against the Rb S allele in nonmalarial environments. Balancing selection may still be occurring.

Africa↗

The 1993-94 patterns of care process survey for breast irradiation after breast-conserving surgery-comparison with the 1992 standard for breast conservation treatment. The Patterns of Care Study, American College of Radiology.

PURPOSE: To determine the patterns of evaluation and treatment in the U.S. of women with early breast cancer treated with breast-conserving surgery and irradiation in 1993-94, and to compare these with a similar survey in 1983 and with the 1992 Standard for Breast Conservation Treatment. METHODS AND MATERIALS: In 1995-96, 727 randomly selected records of eligible patients treated from 1993-94 at 62 facilities representative of 3 practice types were reviewed. RESULTS: Compared with the Process Survey (PS) in 1983, patients in the 1993-94 study had an older age distribution. In the current study, 70% of patients were > or = 50 years of age, and 69% were post-menopausal, compared with 59% > or = 50 years of age and 49% post-menopausal in 1983 (p = 0.0087 and < 0.001, respectively). Work-up and evaluation in the 1993-94 PS were closely aligned with the standard and were considerably improved compared with 1983. In the 1983 study, 77% of patients underwent mammography, as compared to 97% in the 1993-94 study. In 1983, pathological size documentation was performed in 83% of patients; in 1993-94, this was performed in 95% of patients. An estrogen receptor evaluation was performed in 36% of patients in 1983; in 1993-94, that increased to 76%. In 1983, 28% of patients underwent progesterone receptor evaluation; in 1993-94, this increased to 72%. Only 3% of patients in 1993-94 were enrolled in a clinical trial. Radiation treatment parameters closely adhered to standard recommendations, improving substantially from 1983. In 1983, wedge or compensator use was recommended for 64% of patients; in 1993-94, for 95% of patients. In 1983, 4-8 MV photons were recommended for breast treatment in 67% of patients; in 1993-94, 90%. In 1983, bolus was avoided in 75% of patients; in 1993-94, in 94%. In 1983, the recommended breast dose for 89% of patients was 45-50 Gy (44-51 Gy in PS); in 1993-94 this had increased to 99% of patients. In 1983, electrons were recommended for primary site boost in 70% of patients; in 1993-94, for 94% of patients. CONCLUSION: There was an extensive shift to adherence to the 1992 standard in 1993-94, compared with the 1983 PS, although there is room for improvement in some areas.

Adult↗

Two-year outcome of preschool children with autism or Asperger's syndrome.

OBJECTIVE: DSM-IV specifies that Asperger's disorder is a type of pervasive developmental disorder without clinically significant cognitive or language delay. There are no data, however, on the outcome of children with Asperger's disorder or on whether their outcome differs from that of children with autism. The objectives of this study were to compare the outcome of groups of children with these disorders over a period of 2 years on variables independent of the defining criteria and to identify variables that might account for these differences. METHOD: All children 4-6 years of age who came for assessment or were currently in treatment at a pervasive developmental disorder service of one of several centers in a large geographic region were identified. Children who received a diagnosis of autism (N=46) or Asperger's syndrome (N=20) on the basis of a diagnostic interview and had an IQ in the nonretarded range were given a battery of cognitive, language, and behavioral tests. Families were contacted roughly 2 years after the date of their enrollment in the study, and many of the tests were readministered. RESULTS: Children with Asperger's syndrome had better social skills and fewer autistic symptoms 2 years after study enrollment than the children with autism. The differences in outcome could not be explained by initial differences in IQ and language abilities. Children with autism who had developed verbal fluency at follow-up were very similar to the children with Asperger's syndrome at study enrollment. CONCLUSIONS: Although the exact mechanism for the differences in outcome remain to be determined, it appears that Asperger's disorder and autism represent parallel but potentially overlapping developmental trajectories.

Asperger Syndrome↗

Primary care groups. Supra troupers.

Research in Birmingham involving GPs, the health authority and the local medical committee found support for umbrella arrangements for some primary care group functions. Clinical governance and strategic city-wide planning emerged as particularly suitable for these arrangements. A range of support arrangements are likely to emerge as PCGs develop.

Governing Board↗

House dust mite and cat allergen levels in domestic dwellings in Christchurch.

AIMS: To quantify the levels of Dermatophagoides pteronyssinus allergen (Der p I) and Felis domesticus allergen (Fel d I) in domestic dwellings in Christchurch and to assess possible relationships with housing characteristics. METHODS: Domestic dwellings (n = 93) were randomly selected and housing characteristics documented during the summer of 1994/95. Dust samples were obtained from the floor of the living room (LR) and bedroom (BR) and from the bed by standard vacuuming methods. The predominant mite species were determined and D pteronyssinus and F domesticus levels quantified. RESULTS: D pteronyssinus was the predominant (95%) species. D pteronyssinus allergen levels [geomean (95% confidence intervals) were 3.5(2.5-4.8) micrograms/g in LR, 10.1(7.5-13.7) micrograms/g in BR and 5.7(4.3-7.6) micrograms/g in the bed. F domesticus allergen levels were significantly higher (p < 0.001) in houses with cats than without cats [median (range) 93.2 (3.3-1227.2) micrograms/g and 2.9 (0.4-214.8) micrograms/g respectively]. Higher LR D pteronyssinus allergen levels were found in houses classified as having high indoor humidity and in houses situated in geographically damp locations. CONCLUSIONS: Domestic D pteronyssinus and F domesticus allergen levels in Christchurch are comparable with those found in other climatically similar locations. D pteronyssinus allergen levels are associated with both indoor and outdoor humidity factors.

Adult↗

Sensory dysfunction associated with repetitive strain injuries of tendinitis and focal hand dystonia: a comparative study.

Repetitive strain injuries are reaching epidemic levels among workers who perform heavy schedules of rapid alternating movements (eg., computer programmers, data entry workers) or repetitive, sustained, coordinated movements (eg., editors, writers, salespeople). The purpose of this study was to determine if patients with repetitive strain injury demonstrated degraded sensory motor performance with their hands. Sixty age-matched adults were recruited, with 15 each assigned to a healthy adult control group, a healthy musician control group, a tendinitis group, or a focal dystonia group. Four sensory motor subtests from the Sensory Integration and Praxis Test were given to the subjects according to a standardized protocol. Using multiple one-factor analyses of variance in the parametric or nonparametric mode followed by post hoc pairwise testing, no significant differences were found between the healthy controls and the musician controls. On the test of kinesthesia, using the left hand, subjects with tendinitis performed significantly worse than controls and subjects with focal dystonia. Compared with controls, subjects with focal dystonia did significantly worse on graphesthesia and manual form perception (part 1 and part 2). Subjects with focal dystonia also did significantly worse than subjects with tendinitis when using the left hand on graphesthesia and manual form perception (part 2). When treating patients with repetitive strain injury, discriminative sensory motor skills must be carefully assessed and may need to be addressed as part of an effective treatment program.

Adult↗

Immunological parameters associated with susceptibility or resistance to alveolar hydatid disease in Yupiks/Inupiats.

Alveolar hydatid disease (AHD) is a serious and often fatal disease with a relatively high prevalence among the Alaska native Yupik/Inupiat population. In a few patients, however, a spontaneous cure of the disease has been shown by demonstrating the presence of dead metacestode lesions. The present study shows a comparative analysis of the humoral (antibody activity to two different antigens: Em2-antigen and recombinant II/3-10-antigen) immune response and a respective immunogenetic background (HLA-DR typing) in (i) "susceptible" patients who had a still active intrahepatic metacestode and (ii) "resistant" patients who were shown to be spontaneously cured by presenting dead and calcified lesions. Control groups included relatives who were genetically closely related and less related cohabitants of the same villages. Antibody levels in the Em2- and the II/3-10-ELISA were high for patients who had still active lesions and low (Em2-ELISA) or negative (II/3-10-ELISA) for cured patients with dead lesions. Comparative HLA-DR analyses between infected and non-infected Yupiks/Inupiats revealed a slight tendency for susceptibility markers respective to the HLA-DRB1*0901 and HLA-DRB1*1601,02 genes.

Alaska↗

Safety implications of extending some Canadian Motor Vehicle Safety Standards to light trucks and vans.

The primary objective of this research was to evaluate the implications of extending specific Canadian Motor Vehicle Safety Standards (CMVSS) to light trucks and vans (LTVs). This was accomplished through the examination of the potential safety-related benefits of these standards comparing the injury frequencies and severities of the light trucks and vans and the passenger cars (PCs). The standards considered, which currently apply to passenger cars but not to LTVs, are the head restraint (CMVSS 202), side door strength (CMVSS 214), and roof crush strength (CMVSS 216) standards. The comparison was effected by means of logit models developed from multidimensional tables with injury frequency and severity as dependent variables. There are indications that installing head restraints in light trucks and vans could reduce or prevent minor neck injuries and that modest benefits could be achieved by extending the roof crush standard to the LTVs. It was also determined that the side door strength standard may not necessarily be as beneficial to LTVs in conditions in which the vehicle is struck on the side by another LTV. It is suggested that the general public be made aware of the differences in safety standards between LTVs and PCs.

Accidents, Traffic↗

Asperger's syndrome and autism: differences in behavior, cognition, and adaptive functioning.

OBJECTIVE: To determine whether subtypes of children with pervasive developmental disorder (PDD) differed on variables that were relatively independent of distinguishing criteria. METHOD: Higher-functioning children with PDD, 4 through 6 years of age, were differentiated into those with autism (n = 47) and those with Asperger's syndrome (n = 21) on the basis of delayed and deviant language development. The groups were then compared on a wide range of measures including PDD symptoms, adaptive behaviors in communication, socialization, and activities of daily living, and an assessment of verbal and nonverbal cognitive skills. RESULTS: Significant differences between the groups existed on many PDD symptoms, adaptive behaviors, and cognitive measures of language competence, but not on aspects of nonverbal communication, nonverbal cognition, or motor development. CONCLUSION: Subtypes of children with PDD can be identified that differ on variables relatively independent of defining characteristics. These findings should provide a firm foundation into research to determine whether children with autism and Asperger's syndrome also differ on outcome, etiology, and response to treatment.

Activities of Daily Living↗

Treatment of port-wine stains with the flashlamp-pumped pulsed dye laser: extended clinical experience in children and adults.

Seventy-six patients (51 females, 25 males) with port-wine stains (PWS) were treated with the flashlamp-pumped pulsed dye laser (585 nm, 450 microseconds). The patients ranged in age from 1 month to 71 years (average, 14 yr). Forty-nine percent of all patients under study had a 90% or better (average, 94.6%) lightening response after an average of 9.0 (range, 4-15) laser treatment. Overall, there was a 79% clinical improvement seen after an average of 9.1 (range, 2-19) laser treatments. In contrast to previous studies, the number of treatments necessary to obtain PWS clearing in older children (9-15 yr) and adults (> 16 yr) was not significantly greater than the number required to treat PWS in infants (0-2 yr) and younger children (3-8 yr). In fact, PWS in children aged 3 to 8 years required the greatest number of laser treatments, which may be due to continued abnormal growth of the ectatic blood vessels comprising the lesion during the growth of the child. In addition, there did not appear to be a significant difference in the number of laser treatments necessary to obtain clearing of PWS in different body locations. While the 585 nm pulsed dye laser continues to be the treatment of choice for removal of PWS in children and adults, the number of treatments necessary to obtain lesional clearing in all age groups in greater than previously reported.

Adolescent↗