Biomedical subjects
Publications and source records attributed to J Farrell.
Spinal motor evoked potentials (SMEP) were recorded from tibialis anterior muscle after epidural stimulation of the spinal cord at the low cervical or high thoracic level during scoliosis surgery. By using a double stimulus pulse to produce temporal summation within the spinal cord a maximal CMAP response was readily achieved despite good surgical anaesthesia.
The purpose of this study was to examine the stages of drug use acquisition among college students, and the relationship between stage status and motivation to avoid drugs and the frequency of drug use. Six hundred and sixty-nine students from a mid-size public university were selected to participate in the survey. College students were found to differ with regard to their stage of habit acquisition across five drugs. Stage status for a particular drug was associated with motivation to avoid that drug, with less motivation generally being related to greater stage advancement. Stage of acquisition for certain drugs was also found to be related to the frequency of use of other drugs, with alcohol and marijuana stage status being associated with the consumption of the greatest number of drugs. These results suggest that an acquisition stage heuristic holds promise in increasing our understanding of important developmental stages of drug use.
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In a double-blind study a non-invasive method of examining the stability of the precorneal tear film was used to record tear thinning time on a population of 34 independently diagnosed dry eye patients. The results were compared with those for tear output, as inferred from the standard Schirmer tear test, and a correlation coefficient of 0.20 determined. The mean tear thinning time and Schirmer results for the population sample were 6.87 +/- 2.97 sec, and 5.62 +/- 5.69 mm wetting in 5 min, respectively. From a plot of tear thinning time against Schirmer a simple classification for dry eyes can be made. A Type A with normal tear stability and low output accounting for 14.70% of the dry eyes. A Type B with low tear stability and normal output, also accounting for 14.70% of the dry eyes. A Type C with low stability (less than 9.84 sec), and low output (less than 11.31 mm wetting in 5 min) accounting for 70.60% of the dry eyes.
During an 8-week period in the winter of 1986-87, there were 11 deaths from an adenovirus infection (case fatality rate = 39%, 11/28) in a long-term care paediatric facility in southern New Jersey. Among the 61 resident children, all with severe congenital and/or acquired disabilities, 28 developed a febrile respiratory illness compatible with adenovirus infection [attack rate (AR) = 46%]. Patients with tracheostomies were three times as likely to become ill [relative risk (RR) = 3.2, 95% confidence intervals (CI) = 1.8-5.6]. Twenty-three members of the staff had a similar febrile illness (AR = 22%, 23/106); nurses were more likely to be ill than other staff (RR = 3.0, 95% CI = 1.1-11.4). Adenovirus 7 was isolated from four of the case patients and adenovirus 1 from one. The findings suggest prolonged transmission between patients and nursing staff with lack of cohorting of ill patients probably contributing to the prolongation of the outbreak. This investigation indicates that adenoviral outbreaks, although rare, can have a high mortality in severely disabled children, and that future outbreak investigations should examine the use of vaccines or antiviral agents to reduce mortality and for outbreak control.
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Granulomatous orchitis is a rare lesion of the testis which can clinically simulate malignancy. The clinical, radiological and pathological features of 15 patients are presented and discussed.
We describe a case of non-functioning adrenal cortical carcinoma, which recurred 16 years after surgical adrenalectomy. In addition, the patient was successfully treated for two anatomically separate and histologically different, primary malignant tumours. This case highlights the importance of lifelong follow-up after apparently curative surgical excision of an adrenal tumour.
Pulmonary function tests were carried out in 20 consecutive patients with pulmonary embolism (PE), diagnosed on the basis of a positive ventilation-perfusion lung scan carried out within 72 h of admission. Changes in forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and arterial blood gas tensions were too variable to be helpful diagnostically. In contrast, transfer factor (diffusing capacity) of the lung (TLCO) was significantly reduced in all cases and, in spite of a period of anticoagulation, tended to remain subnormal during a follow-up period of up to 3 years. Lung scans, however, tended to return to normal within 3 months of the incident. Thus, a reduction of TLCO to below 75% of the predicted normal was found in all cases with abnormal lung scans and such measurements provide a useful and simple screening test for PE; a normal TLCO would effectively exclude such a diagnosis. The failure of TLCO to return to normal in the majority of cases suggests persistence of the underlying physiological defect, in spite of normalization of symptoms and lung scans following anticoagulation.
The clinically diagnosed dry eye generally has an unstable tear film and changes in the corneal epithelium but, not necessarily, hyposecretion of tears. In normal asymptomatic eyes we found, using a noninvasive technique, a significant relation between precorneal tear film stability and tear production rates (TPR's).
Inexperienced group leaders can benefit from using a system to process groups. A system or model can help to reduce anxiety. It can help group leaders make connections between group behavior and theoretical concepts, and move the group toward its goal. The author presents such a system. This one provides a specific recording format and step-by-step guidelines for organizing and interpreting the collected data.
In order for replication of cancerous cells to develop, a number of processes must operate: 1. Increased uncontrolled provision of nutrient material (carbohydrates oxygen, etc...) which the new cells need to develop; 2. Stimulation of the cellular nuclei to divide and transform cells, using the nutrient material, i.e. the "trigger" mechanism. 3. Reduction of the cytoplasmic viscosity, thereby permitting a greater rate of diffusion of nutrients throughout the matter of the cell. 4. Increase in porosity of the cell membrane allowing more material to enter the cell. Each of these processes may operate separately and contribute to the development of cancer.
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The frequency of abnormal glucose tolerance in the first 12 months after gestational diabetes was found to be 33.3%, which is much higher than previously accepted. Women with gestational diabetes (Group 1 = 54 requiring insulin, Group 2 = 32 treated with diet alone) attending a metropolitan teaching hospital over a 3 1/2 year period were followed-up after delivery to determine their subsequent glucose tolerance. Of 86 seen 3 months after delivery, 2 had developed insulin-dependent diabetes mellitus (IDDM) and 2 noninsulin dependent diabetes mellitus (NIDDM), diagnosed by glucose tolerance testing. Another 38 returned for follow-up glucose tolerance testing at 12 months; of these 3 had impaired glucose tolerance (IGT), 7 had NIDDM, and one who had had NIDDM at 3 months now showed IGT after 9 months dietary treatment. Thus, 12 months after delivery, the cumulative prevalence of abnormal glucose tolerance was 14/42 (33.3%), 10 of the 42 being frankly diabetic (26%). Of the remaining 44 patients, 21 have not yet reached 12 months or were pregnant again, and 23 did not attend for glucose tolerance testing. Although the trend was for gestational diabetes mellitus (GDM) to recur earlier and more severely in subsequent pregnancies, in 3 instances the diabetes did not recur. Major congenital malformations occurred in 4 of the 86 babies (4.7%); minor malformations were found in a further 13 (15%) with no difference in frequency between Group 1 and Group 2.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.