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Biomedical subjects

J Dickerson

Publications and source records attributed to J Dickerson.

At least 19 recordsLinked to original sources
PubMed2004

Sub-types of deep dyslexia: a case study of central deep dyslexia.

A case study is reported of a female patient (JAH), who following a left middle cerebral artery infarct, presented with the cardinal symptoms of deep dyslexia and deep dysphasia (semantic errors when reading and repeating words aloud, respectively). Detailed assessment revealed impaired performance across modalities for many tasks, but particularly those tasks that depend on an intact store of semantic knowledge. Her acquired dyslexia is best characterised as deep dyslexia of a central sub-type.

Adult↗
PubMed2001

Travoprost compared with latanoprost and timolol in patients with open-angle glaucoma or ocular hypertension.

PURPOSE: This study evaluated the safety and intraocular pressure-lowering efficacy of two concentrations of travoprost (0.0015% and 0.004%) compared with latanoprost 0.005% and timolol 0.5% in patients with open-angle glaucoma or ocular hypertension. METHODS: Eight hundred one patients with open-angle glaucoma or ocular hypertension were randomly assigned to travoprost 0.0015%, travoprost 0.004%, latanoprost 0.005%, or timolol 0.5%. The efficacy and safety of travoprost (0.0015% and 0.004%) daily was compared with latanoprost daily and timolol twice daily for a period of 12 months. RESULTS: Travoprost was equal or superior to latanoprost and superior to timolol with mean intraocular pressure over visits and time of day ranging from 17.9 to 19.1 mm Hg (travoprost 0.0015%), 17.7 to 19.1 mm Hg (travoprost 0.004%), 18.5 to 19.2 mm Hg (latanoprost), and 19.4 to 20.3 mm Hg (timolol). For all visits pooled, the mean intraocular pressure at 4 PM for travoprost was 0.7 mm Hg (0.0015%, P =.0502) and 0.8 mm Hg (0.004%, P =.0191) lower than for latanoprost. Travoprost 0.004% was more effective than latanoprost and timolol in reducing intraocular pressure in black patients by up to 2.4 mm Hg (versus latanoprost) and 4.6 mm Hg (versus timolol). Based on a criterion of 30% or greater intraocular pressure reduction from diurnal baseline or intraocular pressure 17 mm Hg or less, travoprost 0.0015% and 0.004% had an overall response to treatment of 49.3% and 54.7%, respectively, compared with 49.6% for latanoprost and 39.0% for timolol. Iris pigmentation change was observed in 10 of 201 of patients (5.0%) receiving travoprost 0.0015%, six of 196 of patients (3.1%) receiving travoprost 0.004%, 10 of 194 of patients (5.2%) receiving latanoprost, and none of the patients receiving timolol (0 of 196). The average ocular hyperemia score was less than 1 on a scale of 0 to 3, indicating that on average patients experienced between none/trace and mild for all treatment groups. There were no serious, unexpected, related adverse events reported for any therapy. CONCLUSIONS: Travoprost (0.0015% and 0.004%), a highly selective, potent prostaglandin F (FP) receptor agonist, is equal or superior to latanoprost and superior to timolol in lowering intraocular pressure in patients with open-angle glaucoma or ocular hypertension. In addition, travoprost 0.004% is significantly better than either latanoprost or timolol in lowering intraocular pressure in black patients. Travoprost is safe and generally well tolerated in the studied patient population.

Adult↗
PubMed2001

Subarachnoid-pleural fistula treated with noninvasive positive-pressure ventilation. Case report.

The authors describe the case of a 24-year-old man who underwent an L-1 corpectomy for spinal decompression and stabilization following an injury that caused an L-1 burst fracture. Postoperatively, an accumulation of spinal fluid developed in the pleural space, which was refractory to 1 week of thoracostomy tube drainage and lumbar cerebrospinal fluid (CSF) diversion. The authors then initiated a regimen of positive-pressure ventilation in which a bi-level positive airway pressure (PAP) mask was used. After 5 days, the CSF collection in the pleural space resolved. Use of a bi-level PAP mask represents a safe, noninvasive method of reducing the negative intrathoracic pressure that promotes CSF leakage into the pleural cavity and may be a useful adjunct in the treatment of subarachnoid-pleural fistula.

Adult↗
PubMed2000

Gait and postural stability in obese and nonobese prepubertal boys.

OBJECTIVE: To examine differences in gait and postural stability of obese and nonobese prepubertal boys. DESIGN: Percentage of gait cycle in double support was examined to determine significant differences. Postural stability was compared using temporal and frequency measures of the center of pressure in static stance. SETTING: Gait was examined using videography on a 30-meter walkway. Postural stability was examined using a measurement platform. PARTICIPANTS: Ten obese (>95th percentile in body mass index) and 10 nonobese (15th to 90th percentile in body mass index) prepubertal boys aged 8 to 10yrs. INTERVENTION: Participants were examined at three walking cadences as determined by preferred gait cadence. Full vision, darkness, and visually confused conditions were used to accentuate static postural stability differences. MAIN OUTCOME MEASURES: In the presence of dynamic stability differences (gait), static stability measures further investigated stability differences. RESULTS: Obese boys spent significantly (p < .02) greater percentage of gait cycle in dual stance. Obese boys showed significantly (p < .01) greater sway areas, energy, and variability primarily in the medial/lateral direction. CONCLUSIONS: Dual stance differences suggest diminished dynamic stability in obese boys. Greater sway areas in medial/lateral direction in obese boys and the absence of significant frequency measures suggest that the instability observed in obese boys is caused by excess weight rather than underlying postural instability.

Child↗
PubMed2000

Survival and functional outcome after prolonged intensive care unit stay.

OBJECTIVE: To examine the functional outcome and costs of a prolonged illness requiring a stay in the surgical intensive care unit (SICU) of 7 of more days. SUMMARY BACKGROUND DATA: The long-term benefits and costs after a prolonged SICU stay have not been well studied. METHODS: All patients with an SICU length of stay of 7 or more days from July 1, 1996, to June 30, 1997, were enrolled. One hundred twenty-eight patients met the entry criteria, and mortality status was known in 127. Functional outcome was determined at baseline and at 1, 3, 6, and 12 months using the Sickness Impact Profile score, which ranges from 0 to 100, with a score of 30 being severely disabled. Hospital costs for the index admission and for all readmissions to Johns Hopkins Hospital were obtained. All data are reported as median values. RESULTS: For the index admission, age was 57 and APACHE II score was 23. The initial length of stay in the ICU was 11 days; the hospital length of stay was 31 days. The Sickness Impact Profile score was 20.2 at baseline, 42.9 at 1 month, 36.2 at 3 months, and 20.3 at 6 months, and was lower than baseline at 1 year. The actual 1-year survival rate was 45.3%. The index admission median cost was $85,806, with 65 total subsequent admissions to this facility. The cost for a single 1-year survivor was $282,618 (1996). CONCLUSIONS: An acute surgical illness that results in a prolonged SICU stay has a substantial in-hospital death rate and is costly, but the functional outcome from both a physical and physiologic standpoint is compatible with a good quality of life.

APACHE↗
PubMed2000

Percutaneous retrogasserian glycerol rhizolysis for treatment of chronic intractable cluster headaches: long-term results.

OBJECTIVE: To analyze the long-term effectiveness and safety of percutaneous retrogasserian glycerol rhizolysis (PRGR) in the treatment of medically refractive chronic cluster headache (CH). The current mainstay of surgical intervention for these patients is percutaneous radiofrequency retrogasserian rhizotomy (PRFR). However, when performed for V1 distribution pathology, PRFR can lead to corneal anesthesia, which places the patient at risk for future visual loss. It also increases the risk of facial dysesthesia. METHODS: In a prospective, consecutive series, 18 patients with intractable CH were followed for a mean of 5.2 years (range, 40-78 mo) after they had undergone PRGR, performed using a standard technique. The significance of this technique as an alternative to PRFR is that it should result in a lower rate of both corneal and facial anesthesia and provide an acceptable degree of pain relief. RESULTS: Fifteen patients (83%) obtained immediate pain relief after one or two injections; the majority of them experienced relief after the first injection. CH recurred in seven patients (39%) over the course of the study. Two of these patients received a second injection, and both met with equal success. Two other patients underwent PRFR. Excluding those who underwent PRFR, the overall daily headache frequency decreased from 3.5 +/- 0.3 attacks per day preoperatively to 0.6 +/- 0.2 attacks per day at last follow-up. The severity of these headaches, as assessed by verbal pain scales, also decreased from 10 preoperatively to 4.4 +/- 1.4 at follow-up. None of the patients, including those who required a second procedure, experienced corneal anesthesia or facial dysesthesia. CONCLUSION: This study provides the first long-term evaluation of PRGR for the treatment of medically refractive chronic CH and lends support to both the safety and long-term efficacy of this procedure. Further investigations are needed to compare directly the relative efficacy and safety of PRGR and PRFR.

Adult↗
PubMed2000

Malignant melanoma of the foot and ankle.

Malignant melanoma is a serious and devastating skin disease that podiatrists may be called upon to treat. It is pertinent that delays in diagnosis and treatment of malignant melanoma be avoided. Some of the topics discussed in this article are causes, clinical features, classification, and treatment of malignant melanoma, focusing on the foot and ankle.

Aged↗
PubMed1998

Effects of damp and mould in the home on respiratory health: a review of the literature.

This review examines whether there is a direct or indirect relation between damp or mould in the home and respiratory health. Home dampness is thought to have health consequences because it has the potential to increase the proliferation of house-dust mites and moulds, both of which are allergenic. The results from the many studies conducted to investigate whether damp and mould are associated with health outcomes are difficult to compare because the methods of measuring exposures and health outcomes have not been standardized. However, the studies that have been conducted in children are probably the most reliable because the confounding effects of active smoking or occupational exposures are absent, and because the presence of symptoms of cough and wheeze have been consistently investigated in many studies. The increased risk of children having these symptoms if the home has damp or mould is fairly small with an odds ratio that is generally in the range 1.5-3.5, these estimates being statistically significant when the sample size has been large enough. This range is consistent with the measured effects of other environmental exposures which are considered important to health, such as environmental tobacco smoke or outdoor air pollutants. The potential benefits of reducing mould in the home have not been investigated, and the few studies that have investigated health improvements as a result of increasing ventilation or reducing damp in order to reduce house-dust mite levels suggest that this intervention is expensive, requires a large commitment, and is unlikely to be successful in the long term. This implies that houses need to be specifically designed for primary prevention of respiratory problems associated with indoor allergen proliferation rather than using post hoc procedures to improve indoor climate and reduce allergen load as a secondary or tertiary preventive strategy.

Animals↗
PubMed1997

Spectral characteristics of postural control in elderly individuals.

OBJECTIVE: To examine the feasibility of using spectral analysis techniques to identify potential biomarkers of diminished postural control in elderly individuals. DESIGN: Data from spectral signatures (derived from postural sway) of 21 young adults and 42 elderly individuals classified as "high" or "low" risk with regard to functional balance capacity were analyzed using Risk Category (3) x Sensory Condition (3) multivariate analyses of variance. Postural control was challenged by varying the visual conditions under which individuals stood on a measurement platform. RESULTS: Results indicated that measures of central tendency and dispersion of the spectral frequency distribution from medial-lateral components of sway (but not antero-posterior sway) clearly differentiated between "high" and "low" risk elderly. Low risk elderly were not different from young adults. High risk elderly exhibited greater dispersion and lower mean frequency than other groups. CONCLUSIONS: Differences in spectral characteristics of medial-lateral components of sway were more related to risk category than to age. Elderly persons with high functional balance capacity displayed characteristics similar to those of young adults. Thus, spectral frequency analysis techniques may be a clinically useful tool for identifying individuals potentially at risk of falling.

Accidental Falls↗
PubMed1994

Glomerular expression of monocyte chemoattractant protein-1 in experimental and human glomerulonephritis.

BACKGROUND: Glomerular monocytes are found in a variety of renal diseases and appear to be important in the pathogenesis of glomerular injury. The mediators responsible for recruiting monocytes to the glomerulus are not well characterized. We have recently established that cultured human mesangial cells produce the specific monocyte chemoattractant, monocyte chemoattractant protein-1 (MCP-1) in response to inflammatory cytokines commonly found in glomeruli during glomerulonephritis (GN). This suggested that MCP-1 may be involved in recruiting leukocytes to the glomerulus. To date however, there is little information regarding the expression of MCP-1 during renal disease. The present study was undertaken to investigate the in vivo expression of MCP-1 during experimental and human GN. EXPERIMENTAL DESIGN: A rodent model of anti-glomerular basement membrane GN was used to investigate glomerular MCP-1 mRNA regulation and protein expression. The presence of MCP-1 in human renal tissue was studied by immunostaining kidney biopsy material from patients with a variety of glomerulopathies. RESULTS: MCP-1 mRNA was transiently upregulated during the early stages of experimental GN. Message levels increased in association with the monocyte influx and correlated with expression of immunoreactive MCP-1 in the nephritic glomeruli. Glomerular MCP-1 was also found in human inflammatory glomerulopathies, but not in glomerular diseases lacking a prominent monocyte infiltrate. CONCLUSIONS: These data support a role for MCP-1 in the pathogenesis of glomerular inflammation.

Animals↗
PubMed1987

The quality of life: design and evaluation of a self-assessment instrument for use with cancer patients.

An attempt was made to define the concept of 'quality of life' and outline the development of a self-assessment instrument for detecting the changes in life as a whole which result from the presence and treatment of malignant disease. A comparison was made between three different scoring systems, familiar in psychometric assessment, although less familiar in nursing. The items selected for inclusion in the measurement instrument were based on an existing symptom distress scale and on the previously identified concerns of cancer patients. The relationship between such symptoms and the activities of daily living was explored. Each item, and the instrument as a whole, appeared to be reliable and to represent a valid means of assessing the impact of the disease on patient well-being. It was simple to use and straightforward to score and appeared accurately to reflect the patients' general condition.

Humans↗
PubMed1985

Babesiosis in Wisconsin. A new focus of disease transmission.

A confirmed case of human babesiosis was identified in August 1983 in a 54-year-old asplenic Wisconsin resident. Babesia microti was identified as the causative agent by blood smear morphology and hamster inoculation techniques. The patient's wife had clinically confirmed Lyme disease in 1981 and had serologic evidence (immunofluorescent antibody to a B microti titer of 1:1,024) of recent Babesia infection in August 1983. Mice (Peromyscus species) trapped on the patients' property and elsewhere in their Wisconsin county of residence were infected with B microti. Lyme disease and babesiosis have the same tick vector and animal reservoir; serum samples from 116 Wisconsin and Minnesota residents with clinically confirmed Lyme disease between 1980 and 1983 were tested, and none were found to have concurrent Babesia infection. This area of Wisconsin is identified as a new focus for babesiosis transmission, but the risk of transmission seems to be low.

Animals↗