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Biomedical subjects

J F Fitzgerald

Publications and source records attributed to J F Fitzgerald.

At least 19 recordsLinked to original sources
PubMed1992

Chronic constipation with encopresis persisting beyond 15 years of age.

Childhood constipation with encopresis is a common malady. Previous reports suggest that essentially all patients either respond to standard treatments or have spontaneous recovery before 16 years of age. In this paper, we describe the results of anorectal function studies and treatment outcome in four patients in whom constipation and encopresis persisted beyond 15 years of age. Abnormalities in the ability to defecate water-filled balloons, in external sphincter relaxation with straining, in rectal sensation and development of the urge to defecate, and in maximum anal resting pressure were seen in some or all of these patients. In addition, two patients had impaired voluntary squeeze strength. Two patients responded to standard therapy; a colostomy was needed in one; and one failed therapy and has become a recluse.

Adolescent↗
PubMed1992

The risk of nursing home placement and subsequent death among older adults.

This article examines the effects of the characteristics specified in the behavioral model of health services utilization and measured at baseline on the subsequent risk of nursing home placement and death within four years. Analyses of the 5,151 respondents in the Longitudinal Study on Aging indicate that the risk for nursing home placement is greater for older adults, Whites, those who lived alone, persons with telephones, those with fewer nonkin social supports, those who did not feel that they had much control over their future health, those with more household ADL or lower body limitations, and those who had been in the hospital during the year prior to baseline, or in a nursing home at any time before baseline. Among the 549 respondents placed in nursing homes, the risk of dying there was greater for older adults, men, those who had not lived in multigenerational households, persons who did not worry about their health, individuals with more upper body limitations, and respondents having a history of valvular heart disease or cancer. The odds of dying were 2.74 times greater among the 549 respondents placed in nursing homes than among the 4,602 respondents who remained in the community.

Aged↗
PubMed1992

Falling, health status, and the use of health services by older adults. A prospective study.

In this study, data from the Longitudinal Study on Aging were used to prospectively assess the relationship between repetitive falling or falling only once in the year before baseline and changes in health status and the use of health services. Multiple and logistic regression were used to control for a variety of known covariates, in addition to the baseline values of the target outcomes. Repetitive falling was associated with decreased health status, measured by various activities of daily living and disability indices, at both 2- and 4-year follow-ups. One fall, however, was never associated with deteriorating health status. Similarly, repetitive falling was related to a decreased likelihood of visiting a physician (at the first follow-up, only), but to an increased likelihood of hospitalization, nursing home placement, and death (at both follow-ups). Falling just one time, however, was only associated with an increased likelihood of nursing home placement. Based on outcome trajectories, two subpopulations of repetitive fallers were identified. One subpopulation was consistent with the rapid deterioration hypothesized by the "spiral" response to falling, and includes about 35% of the repetitive fallers (i.e., those who die within 4 years of baseline). The other subpopulation was consistent with the initial decline and subsequent stabilization hypothesized by the "drop-stabilization" response.

Accidental Falls↗
PubMed1979

Gastroesophageal reflux in infants and children. Diagnosis and management.

Eighty-three infants and children underwent surgical correction of gastroesophageal reflux (GER) from 1973 to 1978. Fifty-four patients had coexistent brain damage (most commonly due to cerebral palsy), eight were previously treated for esophageal atresia, and four had gastroschisis or omphalocele repair. Clinical presentation included failure to thrive in 64 patients, vomiting in 59, and recurrent bouts of aspiration pneumonitis in 43. Barium roentgenography showed GER in 61 patients, whereas additional tests (particularly pH monitoring) were required for detection of GER in 22 patients. After failure of medical management, transabdominal Nissen fundoplication was performed in 80 cases and a Hill repair in three cases. The surgical mortality was zero, but there were five late deaths. Results were considered excellent in 54 patients, good in 22 patients, and poor in seven. Ten of 12 patients with preoperative stricture responded to dilation after fundoplication. Nissen fundoplication was a safe and effective antireflux procedure in 76 of the 83 cases.

Adolescent↗
PubMed1979

Chronic diarrhea in infants and children.

A useful clinical classification of chronic diarrhea is based on the character of the stool--watery, fatty or bloody. Pathophysiologic mechanisms include osmotic and secretory diarrheas, bacterial overgrowth leading to excess colonic bile acids and fatty acids, defective anion exchange systems, mucosal damage and abnormal motility and transit. Evaluation may require hospitalization. Antidiarrheal agents are not used. Antibiotics are generally not indicated. Parenteral hydration and feedings of special formulas are carefully monitored.

Bile Acids and Salts↗
PubMed1978

Determination of disaccharides in feces by permethylation and gas chromatography: rapid screening for carbohydrate intolerance in children.

Disaccharides can be identified and determined quantitatively in fecal specimens by permethylation of the components in crude supernatants followed by isothermal gas chromatographic separation on OV-17 columns. The method provides a rapid screening procedure for detecting patients suspected of having a carbohydrate intolerance secondary to intestinal disaccharidase deficiency.

Carbohydrate Metabolism, Inborn Errors↗
PubMed1978

Disseminated varicella complicating ulcerative colitis.

Disseminated varicella is an uncommon complication of ulcerative colitis, despite the frequent use of steroid therapy in this disorder. Fatal varicella infection occurred in a patient with ulcerative colitis who was receiving steroid therapy. This observation suggests that zoster-immunoglobulin should be administered to patients exposed to varicella with ulcerative colitis who are receiving steroid therapy.

Adolescent↗
PubMed1978

Competency evaluations in Connecticut.

New procedures for conducting competency evaluations were adopted in Connecticut in 1975 as a result of a change in the state law. The accused person is now evaluated in the setting in which he finds himself by virtue of his conflict with the criminal justice system, rather than automatically being remanded to the state hospital for evaluation. The criteria used are legal rather than medical-psychiatric, and the evaluations are conducted by a mental health team consisting of a psychiatric social worker, a psychiatrist, and a psychologist. The authors describe the procedures and discuss the benefits deriving from them, as well as some of the real and potential problems.

Adult↗
PubMed1978

Percutaneous cholangiography in infants.

Percutaneous transhepatic cholangiography was attempted in eight infants with normal-size bile ducts and was successful in four. The technique described is feasible in the infant age group, and is useful in the infant with obstructive jaundice.

Child, Preschool↗
PubMed1978

A suggested classification and reappraisal of mortality statistics for ruptured atherosclerotic infrarenal aortic aneurysms.

A retrospective review of 80 ruptured infrarenal abdominal aortic aneurysms with classification of the patients into clinical groups based upon the findings at laparotomy was undertaken. Patients with small hematomas confined to the area of rupture were uniformly salvaged. Those with free intraperitoneal blood almost invariably died. Intermediate groups had mortalities od 37.5 and 62.5 per cent. It is concluded that operative mortality is related to the clinical group to which the patient belongs. Attention must be focused upon the potentially salvageable intermediate groups, with regard to early laparotomy and prompt, effective proximal and distal control of the aorta before entering the retroperitoneal hematoma. Major improvements in survival have occurred with smaller ruptures but little has been achieved with larger ruptures during the past 25 years.

Aged↗
PubMed1977

Cosmetic excision of an isolated extracranial arteriovenous malformation using Gelfoam embolization.

Surgical excision of extracranial arteriovenous malformations may be indicated for cosmetic or urgent medical reasons, such as haemorrhage or high output cardiac failure. However, serious haemorrhage, incomplete removal and poor cosmetic results are well-known complications encountered after this operation. Preoperative embolization under angiographic control is recommended to reduce the incidence of these problems.

Arteriovenous Malformations↗
PubMed1977

Effect of maternal protein deprivation on the development of neonatal intestinal function in rats.

The developmental pattern of in vitro intracellular accumulation (IA) was studied in the small intestine of the offspring of females fed a 27% protein diet (normal) (NPD animals) and the offspring of females fed an 8% protein diet (low) (LPD animals). At 2 days of age, the IA of L-leucine (Leu) and D-galactose (Gal) was significantly reduced in the intestines of the LPD animals as compared to the NPD animals at initial velocities (75% and 81%) and under steady state conditions (82% and 84%). The IA of both compounds in the intestines of the LPD animals increased relative to the NPD animals until at weaning the IA of Leu and Gal under steady state conditions was significantly greater in the LPD animals (139% and 133%). After weaning, the IA of Leu was statistically increased (137%) and the IA of Gal was the same in the LPD animals as compared to the NPD animals at initial velocities. The variations in the developmental patterns of the IA of Leu and Gal in the intestines of LPD animals as compared to NPD animals appear to be related to animal age, which may reflect an improved caloric intake at weaning.

Animals↗
PubMed1977

Colonization of the gastrointestinal tract.

The alimentary tract is sterile at birth but colonic colonization is relatively complete by the end of the first week of life. The upper alimentary tract is colonized by microorganisms normally inhabiting the oral cavity. The colon on the other hand appears to be colonized by microorganisms originating in the maternallower alimentary tract. The colonic flora of infants is affected by diet (breast or formula feedings). The presence of a "fecal-type" flora in the proximal small bowel should be considered abnormal. Most authors agree on the need to define the role of the microflora in health and disease.

Adult↗