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Biomedical subjects

J Dempsey

Publications and source records attributed to J Dempsey.

67 records · Page 4Linked to original sources

Malignant islet-cell tumour of the pancreas presenting with non-bacterial thrombotic endocarditis and eosinophilia.

A case of severe persistent eosinophilia and non-bacterial thrombotic endocarditis complicating a malignant islet-cell tumour of the pancreas is documented. Although these are well recognized complications of malignant tumours, they do not appear to have been previously documented from the same patient. These complications probably reflect ectopic synthesis and are unlikely to be causally interrelated.

Adenoma, Islet Cell↗

Percutaneous needle biopsy in the management of solitary lesions of bone.

Needle biopsies were performed in 12 patients with solitary bone lesions, employing a simple 18 gauge cutting needle. Material sufficient for reliable diagnosis was obtained from eight of our 12 cases, thereby avoiding exploratory surgery. It is concluded that percutaneous needle biopsy of bone is a safe and simple procedure of value in the management of solitary lesions of bone.

Adult↗

A first-year follow-up of high-risk infants: formulating a cumulative risk index.

Multiple developmental assessments were made at 4-month intervals over the first year of life for 2 groups of infants born at risk and 1 normal group. The groups included 46 preterm respiratory distress syndrome infants, 46 postterm postmaturity syndrome, and 59 term normal infants. The mothers were white, multiparous, middle-class, high school graduates averaging 25 years of age. Analyses of group differences revealed that the preterm respiratory distress syndrome (RDS) infants continued to exhibit delays in motor and mental development and the postmature infants in mental development. Discriminant function analyses suggesting that the most efficient predictors and accurate discriminators of continuing risk were as follows: the Parmelee obstetric and postnatal complications scores and the Brazelton interactive and motoric process scores at birth; the Denver rating, mother-infant interaction and Carey temperament ratings at 4 months; and the Bayley mental and motor scores at 8 months. On the basis of their weighted assessment scores, infants were assigned a cumulative risk index at each assessment period.

Age Factors↗

A modified forced oscillation technique for measurements of respiratory resistance.

We present a modification of forced oscillation technique for automated determination of total respiratory resistance during inspiration. The modifications consist of a computerized signal averaging and an optimization technique in the assessment of the resistance value. Thereby a favorable signal-to-noise ratio is obtained, allowing very low superimposed pressure oscillations. The method is validated by comparison with a conventional esophageal balloon method, by estimating added mechanical resistances in healthy subjects and by measuring the effect of bronchodilation in asthmatic children. The coefficient of variation as obtained from day-to-day measurements was about 7%. Mechanical resistances, estimated as the difference in total resistance with and without external resistance, were within 7% of their values determined for the resistances alone. A significant decrease in resistance was obtained in each of the asthmatic children following bronchodilation.

Adolescent↗

Effects of shape changes of the chest wall on distribution of inspired gas.

The configuration of the chest wall was measured with magnetometers applied at various levels of the rib cage and abdomen. Distribution of ventilation was measured in the supine position using a bolus of xenon-133 inspired at a flow rate of 0.1 liter per sec. Measurements were made during spontaneous breathing, during augmented abdominal breathing, after manual lateral compression of the lower part of the rib cage followed by a predominantly abdominal motion, and after similar compression followed only by increase of the lateral basal rib cage diameter. Basal compression gave a decrease in lateral diameter of 5 to 7 per cent. During spontaneous breathing, apical ventilation exceeded basal ventilation. During an inspiration with an increase of the lateral basal rib cage diameter after compression, the ventilation of basal peripheral regions increased somewhat. No other systematic effects of the changes in either chest wall diameter at the start of inspiration or the type of inspiration were found on distribution of inspired boli.

Humans↗

Visual decentration: from stereometric points to planeometric forms.

19 3-yr.-olds chose to put blocks together to produce good continuation across stereometric edges. 4 mo. later they began to produce good continuation across planeometric edges. A group of 15 4-yr.-olds chose to produce symmetrical forms rather than simply to align edges. Symmetrical form was produced across planeometric surfaces but not across stereometric contours. These data suggest that visual decentration is first a shift from looking at single points touched to single points displaced from touch and, at a still later age, a shift to the organization of many points. The failure of the older group to produce a symmetrical form across stereometric contours could have resulted from the cultural press to attend to planeometric information.

Age Factors↗

Transjugular core liver biopsy with a 19-gauge spring-loaded cutting needle.

One hundred and five sequential transjugular core liver biopsies (TJLBx) were performed in 101 patients with coagulopathy and/or ascites using the 19-gauge Quick-Core Biopsy (QCB) needle. Two-hundred and seventy-three cores were obtained in 295 passes (92. 5%). One-hundred and two of the 105 procedures (97.1%) led to a histopathologic diagnosis. One of the three nondiagnostic biopsies was done because of severe autolysis of the liver. There was one subcapsular hematoma, one hepatic arteriovenous fistula, and one liver capsular puncture. Two minor neck hematomas occurred. One death was reported (unrelated to the procedure). QCB needle TJLBx is an effective and relatively safe way to obtain core liver samples.

Adolescent↗

The appropriateness of admissions and the influences on a decision to admit.

Within health services there is concern that escalating costs may reflect an inappropriate use of services and that services should avoid admitting patients who do not require acute care. The problem is, if these patients exist, how may they be identified and is this the sole consideration in patient management? This triangulated study examines the appropriateness of admissions, factors that influence that admission, and the potential to develop alternate models of care for medical patients. A utilization review, auditing 521 medical patients, provided a percentage of appropriateness of admission and stay, identified the barriers to discharge and those patients suitable for programs such as hospital in the home. Complementing the review, interviews with eight physicians explored how they decided to admit patients, what factors influenced that decision and their attitude to the development of these models of care.

Decision Making↗