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Biomedical subjects

J G Walker

Publications and source records attributed to J G Walker.

At least 19 recordsLinked to original sources
PubMed1992

Measuring marital distress in couples with chronically ill children: the Dyadic Adjustment Scale.

The idea that couples with chronically ill children are particularly at risk for marital distress has been supported by clinical observation and empirical research. Three recent controlled studies, however, did not find evidence for this increased risk. A possible explanation for the discrepant findings is that these three studies employed Spanier's Dyadic Adjustment Scale (DAS) as a unidimensional measure of marital adjustment. To develop a better understanding of the discrepant findings of risk for marital distress in couples with chronically ill children, the present study examined both the appropriateness of the DAS's published norms as well as the criterion validity of the DAS for use in this population of couples. Three hundred and sixteen parents (158 couples) from a large urban pediatric health care setting completed a survey investigating interest and need to participate in an intervention program for marital distress. Results indicated that this instrument can reliably predict marital distress in this population of couples, however, mean DAS scores are higher than those established by Spanier.

Adaptation, Psychological↗
PubMed1989

Differences in the nature and kinetics of the ethanol-related circulating cytotoxic proteins in normal subjects and patients with alcohol-induced cirrhosis.

The kinetics and nature of the nondialyzable cytotoxic activity which appeared in the serum after the consumption of 1.2 g ethyl alcohol per kilogram body weight over 45 min was studied in six healthy volunteers and eight patients with histologically proven alcohol-related cirrhosis of the liver. Whereas the cytotoxic activity in the dialyzed serum showed a single peak with a maximum value 8 hr after the start of ethanol consumption in the healthy volunteers, it showed two peaks with maximum values at 2 and 8 hr in the patients with cirrhosis. Studies of the fractions obtained by Sephacryl-S-300 gel filtration of the 2-hr postalcohol serum samples revealed substantial cytotoxic activity in the fractions containing both the albumin peak and the IgG peak in the patients with cirrhosis and only in the fractions containing the albumin peak in the healthy volunteers. Experiments with pure IgG preparations obtained from prealcohol and 2-hr postalcohol sera by chromatography on Q-Sepharose Fast Flow anion-exchange resin showed considerable cytotoxic activity in the preparations from the patients with cirrhosis and little or no cytotoxic activity in those from the healthy volunteers. Thus, the early peak of the biphasic serum cytotoxicity curve seen after ethanol consumption by patients with cirrhosis appeared to be caused by the development of a substantial cytotoxic activity in the IgG molecules during the first 2 hr.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetaldehyde↗
PubMed1988

Upper gastrointestinal Kaposi's sarcoma in patients positive for HIV antibody without cutaneous disease.

Six patients with antibodies to the human immunodeficiency virus (HIV) and with persistent gastrointestinal symptoms of HIV infection but without cutaneous lesions of Kaposi's sarcoma underwent endoscopy. Four also underwent barium meal examination. In all six cases small lesions were seen in the stomach at endoscopy, and histological examination of biopsy specimens taken from the lesions confirmed the diagnosis of Kaposi's sarcoma. The barium meal examinations were reported as normal in three patients and showed oesophageal candidiasis in the fourth. These findings suggest that Kaposi's sarcoma of the upper gastrointestinal tract is common in patients positive for HIV antibody, even those without cutaneous lesions. Endoscopy, with biopsy of suspicious lesions, is necessary to make the diagnosis and is recommended in all HIV antibody positive patients with persistent upper gastrointestinal symptoms.

Adult↗
PubMed1988

Balsalazide in the maintenance treatment of patients with ulcerative colitis, a double-blind comparison with sulphasalazine.

Balsalazide (BSZ) is a pro-drug which releases 5-aminosalicylic acid (5ASA) and 4-aminobenzoyl-beta-alanine (an inert carrier) in the colon of various species including man. BSZ was compared with sulphasalazine (SASP) (both 1 g b.d. orally) in the maintenance of remission in patients with ulcerative colitis (UC). Seventy-nine patients (53 male, 26 female), mean age 49 years (range 19-79 years), with UC were randomly allocated to either treatment (41 BSZ, 38 SASP) for 6 months. The groups were similar in respect of age, sex, duration and extent of disease. Seven patients defaulted (3 BSZ, 4 SASP) leaving 38 on BSZ and 34 on SASP. Two male patients, both receiving SASP, were withdrawn because of severe side-effects. One of these patients, with an exfoliative rash, was maintained satisfactorily on open BSZ. Remission rates at 6 months (51% BSZ, 63% SASP) were not significantly different (life-table analysis P less than 0.1). Twelve patients (15%) reported troublesome side-effects (2 BSZ 5%, 10 SASP 26%, P = 0.017 Fisher Exact Test). Mean haemoglobin concentrations, similar on entry, increased after 6 months with BSZ (0.2 g/dl) but decreased with SASP (0.5 g/dl) (P less than 0.0002). BSZ was not significantly different from SASP in maintaining remission in patients with UC but had fewer side-effects.

Adult↗
PubMed1983

Eradication of scabies with a single treatment schedule.

A single application (16 to 20 hours) of 1% gamma benzene hexachloride (GBH) lotion, when applied to a total island population of 178 persons in which seventy-four clinically had scabies, resulted in a cure rate of over 98%. Re-examination of the population at 10 and 21 weeks revealed only one remaining individual still having scabies. On a neighboring island, only those with clinical evidence of scabies were treated (140 persons). Applications of 1% GBH lotion were applied with the same methods used on the first island. When the population was re-examined at 10 weeks, the prevalence of scabies was reduced by only 50%. Successful eradication of scabies from a population should include treatment of all contacts, whether clinically infected or not. Treatment of the entire population at risk at one time is preferable. Coexistent pyoderma should be treated, and a second treatment for scabies may be needed when the pyoderma has cleared.

Administration, Topical↗
PubMed1983

A comparative trial of three treatment schedules for the eradication of scabies.

A trial of three treatment schedules, consisting of 1% gamma benzene hexachloride (GBH) lotion applied head to toe and left on the body for 2, 6, or 12 to 24 hours was conducted on an island of 2,076 persons, approximately 70% of whom had clinical evidence of scabies. The island is situated off the north coast of the Republic of Panama. Examination at 1 month after therapy showed that both the 6-hour and 12- to 24-hour cure rate was high (96% and 98%). There was a significantly lower cure rate in the 2-hour group, in which only 82% were cured. Eleven to twelve percent of the subjects became infested in all groups, presumably due to contact with untreated persons with scabies on the island. A single 6-hour application of 1% GBH lotion appears to be adequate therapy for scabies if properly applied. The entire population at risk should be treated at the same time if possible to reduce or eliminate the risk of infestation. No adverse reactions to 1% GBH lotion were observed.

Administration, Topical↗
PubMed1980

Program saves energy, fosters shared services.

The Tennessee Hospital Association offers consulting services to its members and promotes the sharing of automated systems as part of its energy management program.

Conservation of Energy Resources↗
PubMed1979

Dapsone and severe hypoalbuminaemia. A report of two cases.

Severe hypoalbuminaemia developed in two patients on long-term dapsone treatment for dermatitis herpetiformis. The patients had been treated with dapsone for 3 and 11 years before the syndrome developed and both recovered completely when dapsone was withdrawn. Albumin-turnover studies revealed a great increase in intravascular albumin catabolism and a modest decrease in synthesis.

Adult↗
PubMed1979

The effect of food and tablet formulation on plasma prednisolone levels following administration of enteric-coated tablets.

1 Plasma prednisolone levels have been compared following the administration of enteric-coated prednisolone to fasted and non-fasted subjects. The effect on plasma levels of altering the formulation of the enteric-coating has also been studied. 2 The presence of food in the stomach at the time of administration does not affect the absorption of enteric-coated prednisolone tablets. 3 There was considerable inter-subject variation in plasma prednisolone levels after administration of shellac based enteric-coated tablets. However, plasma levels were more consistent when a preparation whose formulation was based upon cellulose acetate phthalate (CAP) was given. 4 It is concluded that the pattern of absorption and plasma prednisolone levels depend on the formulation of the enteric coating. The bioavailability of the CAP based preparation is similar to that of plain prednisolone.

Adult↗
PubMed1974

Medical and social screening of patients aged 70 to 72 by an Urban General Practice Health Team.

A medico-social survey of 259 elderly patients aged 70-72 was carried out by three doctors, a health visitor and a nurse in an urban general practice. Seven hundred and ninety diseases or disabilities were identified-an average of 3.2 per patient-of which 20.5% were unknown to the doctors. Using a simple check list for symptom inquiry, the health visitor or nurse missed very little of the physical or psychological disease. In some respects their symptom inquiry was more revealing than that of the doctors but they had difficulty in eliciting evidence of malnutrition, masked depression, and incipient dementia. Initial health screening of the elderly for unreported disease in general practice can easily be done by a health visitor with training in geriatric problems and the recognition of psychiatric illness.Initial health screening can also be done by a nurse with community-nursing experience but she will require additional training in the techniques of social assessment. The doctor must examine those patients found to be suffering from alerting symptoms. A general practice of three or four doctors requires one health visitor for routine work and one additional health visitor or nurse for screening of the elderly. Unreported disease in the elderly indicates failure to make contact and failure to ask the right questions. Unknown disease may be due to inadequate records.

Aged↗
PubMed1974

Incidence and significance of faecal hydroxystearic acid in alimentary disease.

Three-day faecal collections were obtained from 87 patients with a variety of gastroenterological diagnoses and 12 control subjects while consuming normal diets. Faecal weight, total fatty acids, and the proportion of hydroxystearic (OHSA) acid were measured. All patients had some easily detectable hydroxystearic acid. It was found that in general the percentage of OHSA in the faecal fatty acids increased with increasing fat output. Thus most patients excreting less than 20 g of fat per day had less than 5% OHSA while those with greater steatorrhoea had levels of 6 to 23%. Exceptions were patients with mild steatorrhoea with ileal disease, ileal resections, or small intestinal bacterial colonization, who had more than 5% OHSA whilst patients with colonic resection had much lower levels of OHSA than otherwise found. It is impossible to determine whether OHSA had a specific cathartic action from this study since the data implicated total fatty acids to the same extent.

Adult↗