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Biomedical subjects

G L White

Publications and source records attributed to G L White.

At least 19 recordsLinked to original sources

Lethal Staphylococcus aureus-induced shock in primates: prevention of death with anti-TNF antibody.

A successful experimental treatment for gram-positive sepsis to our knowledge has not been achieved. The objectives of this study were to develop a nonhuman primate model of lethal gram-positive sepsis employing the micro-organism Staphylococcus aureus and to determine the efficacy of treatment using monoclonal antibody (MAb) to tumor necrosis factor alpha (TNF). The antibody was administered intravenously, 15 mg/kg, 30 minutes after the beginning of a 2-hour infusion of S. aureus, 4 x 10(10) colony forming units/kilogram. The baboons infused with S. aureus demonstrated the release of the cytokines TNF and interleukin-6 (IL-6), but endotoxin was not observed in the plasma at any time. Treatment with antibody to TNF abolished the rise in serum TNF levels and reduced the increased levels of IL-6. Treatment with MAb to TNF prevented multiple organ failure and achieved permanent (> 7 day) survival of all baboons.

Animals

Congenital anomalies of the optic nerve in one family.

We present three cases of congenital optic disc anomalies in one family who underwent an extensive diagnostic workup to exclude any intracranial pathology. One patient had elevated optic nerve heads and was hospitalized for multiple diagnostic tests including a lumbar puncture and magnetic resonance imaging scan. This patient had a sister with a previous history of having undergone head and orbital computed tomography to evaluate her symptoms of headaches with anomalous optic nerve heads. The third patient was the father of the other two patients who had previously undergone an extensive evaluation for elevated optic nerve heads and was treated for presumed pseudotumor cerebri with fenestration of the optic nerve sheath. These cases underscore the importance of a detailed family history and examination of family members to exclude congenital abnormalities of the optic nerve head before beginning an extensive workup.

Adolescent

Clinical comparison of ocular irrigation fluids following chemical injury.

This study tested the hypothesis that four ocular irrigating solutions were equally irritating during copious irrigation. We conducted a prospective, double-blind study of patients with chemical exposure to the eye. Each underwent cross-over irrigation with all of the following in random order: normal saline (NS), lactated Ringer's (LR), normal saline adjusted to pH 7.4 with sodium bicarbonate (NS + Bicarb), and Balanced Saline Solution Plus (BSS Plus, Alcon Laboratories, Fort Worth, TX). Compared with traditional NS and LR, NS + Bicarb tended to be more comfortable. BSS Plus was statistically superior (P less than .05) to NS and preferred over LR and NS + Bicarb. Three patients demanded discontinuance of NS or NS + Bicarb infusions. All solutions had comparable normalization of conjunctival pH and degree of injection. Alternate solutions including BSS Plus should be considered for use in those patients whose poor tolerance to normal saline threatens to delay or interrupt eye irrigation following a chemical injury.

Bicarbonates

Optical differences in multiple personality disorder. A second look.

The study was designed as a replication of a study reported in this Journal (Miller S [1989] Optical differences in cases of multiple personality disorder. J. Nerv Ment Dis 177:480-486) which found that subjects with multiple personality disorder (MPD) experienced significantly more changes in visual functioning between alter personalities than a control group simulating the disorder. In the present study, data from 20 patients diagnosed with MPD and 20 control subjects role playing MPD were analyzed for statistical and clinical significance. The findings from the present study appear to confirm results from the earlier study that individuals with MPD experience differences in some aspects of visual functioning between alter personalities. The results further confirm that MPD subjects experience more differences across visual measures than control subjects simulating the disorder. However, the findings from the present study are not entirely consistent across the various visual measures or with findings from previous studies.

Adult

Identification and treatment of retinopathy of prematurity: an update and review.

The risk of retinopathy of prematurity (ROP) is higher in infants with a birth weight less than 1501 g (3 lb 5 oz). Identification programs coupled with refined treatment procedures can reduce visual impairment in infants with ROP. Physicians providing in-hospital care to these infants should ensure that ophthalmologic referral has been established before hospital discharge. Physicians examining these infants for their 6-week checkups are also vital safeguards in the ROP screening and referral process.

Cryosurgery

Late-onset congenital syphilis. A retrospective look at University of Iowa Hospital admissions.

A retrospective review of 766,742 hospital admissions was performed between 1966 and 1986 at the University of Iowa Hospital for the diagnosis of congenital syphilis. Although 88 individuals were identified with this diagnosis, adequate treatment was documented in only 33 (38%). Thirty-nine of the 88 individuals identified were initially seen for visual complaints by the ophthalmology department. We recommend that all physicians increase their index of suspicion for this disease, and institute appropriate therapy and follow-up if late congenital syphilis is diagnosed.

Adolescent

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Health Promotion

Hypothermia: threat to military operations.

Hypothermia has altered the course of military history. Military casualties tend to occur in epidemics, associated with cold weather combat or maneuvers, trauma, immobilization, improper clothing, exhaustion, and underlying illness. Symptoms of hypothermia begin subtly with fatigue and loss of concentration, but progress to stupor, coma, and resemble rigor mortis. Treatment of mild hypothermia is with body heat and warm clothes and fluids. Moderate and severe cases require gentle evacuation and active core rewarming method(s). Inhalation of warm (40 degrees C, 104 degrees F) humidified oxygen is safe, effective, and can be begun in the field. Recognition of risk factors and active measures can lessen the menance of cold weather for military personnel.

Body Temperature

Disposable contact lenses.

Disposable soft contact lenses are an alternative to conventional extended-wear lenses and provide an acceptable margin of safety and convenience for the wearer. The lenses are worn for one to two weeks and then discarded. Buildup of tear film deposits is minimized, and the need for cleaning and disinfecting solutions is eliminated. The long-term safety of disposable contact lenses is unknown.

Conjunctivitis

Essential health education for deployment in underdeveloped countries.

Educating personnel regarding issues related to health and foreign travel has always been an important deployment concern. This article provides general health education guidelines pertinent to any deployment, but especially foreign deployment. The report is intended as a vehicle for initiating the health education process of nonmedical personnel prior to deployment.

Developing Countries

Facial dystonia, essential blepharospasm and hemifacial spasm.

Movement disorders, or dyskinesias, in the facial region may be categorized in several ways. Dystonic movement disorders in the cranial-cervical region, including essential blepharospasm, Meige syndrome and spasmodic torticollis, are characterized by uncontrollable squeezing movements in the face and neck. These disorders typically present in the fifth and sixth decades of life. Essential blepharospasm is particularly debilitating, as the involuntary eyelid closure that accompanies this condition may result in functional blindness with an otherwise normal visual pathway. Hemifacial spasm is an intermittent, unilateral, spasmodic contraction of the muscles innervated by the facial nerve. This disorder usually presents in the third or fourth decade and has a different underlying pathophysiology than the dystonias. Botulinum A toxin therapy has largely supplanted surgical intervention in the treatment of essential blepharospasm and hemifacial spasm.

Blepharospasm

Body image in rheumatoid arthritis: the relevance of hand appearance to desire for surgery.

To investigate the importance of body image concerns relating to hand appearance in rheumatoid arthritis, a questionnaire was devised and administered to 80 female out-patients. Subjective judgements of hand attractiveness, feelings about hands, and behaviours relating to hand adornment and concealment were sought. Objective ratings of hand attractiveness were obtained from photographs taken at this time of the women's hands. Factor analysis indicated four principal orthogonal factors describe these body image items. Evaluative and affective elements were found to be independent of each other. The hypothesis that body image, thus rated, is relevant to desire for reparative hand surgery was tested using a two-stage general linear modelling procedure. Body image concerns, particularly negative feelings about hands, emerged as significant predictors of desire for surgery, and remained significant after the removal of variance accounted for by duration of arthritis, age, grip strength and objectively rated hand attractiveness. It is suggested that in rheumatoid arthritis, self-perception of hands and the associated emotional response, may be a covert agenda in women's decision to have surgery, and need specific clinical consideration.

Adult

Prevention and emergency field management of venomous snakebites during military exercises.

Summer exercises in the continental United States bring many military personnel in contact with our four types of indigenous venomous snakes. Personnel with a knowledge of these snakes, their habits, and habitat, and who exercise common sense are much less likely to fall victim to a venomous bite. When a bite does occur, timely and appropriate first aid can help to reduce the sequelae of an envenomation. Military medical personnel should be prepared to discuss snakebite prevention and field management with all personnel taking to the field this summer.

Humans