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Biomedical subjects

J How

Publications and source records attributed to J How.

At least 19 recordsLinked to original sources
PubMed1992

Retinal artery occlusion in a diver.

The clinical manifestation of decompression disorders is highly variable, ranging from mild rashes or joint pains to central nervous system symptoms like scotomata, paralysis and death. The diagnosis is easily overlooked, especially if an occupational history is not obtained. Recompression treatment with hyperbaric oxygen is the specific treatment for decompression sickness and air embolism. Prompt recognition and treatment are vital to recovery. However, there is a place for treatment of decompression disorders and embolism even when significant delay of up to 14 days has occurred. This case report discusses decompression disorders in relation to an unskilled fisherman diver who present with retinal artery occlusion. Decompression disorder leading to retinal artery occlusion is a very rare presentation. The difficulty of diagnosis is discussed as well as the result of delayed hyperbaric treatment.

Adult↗
PubMed1991

The application of disposable contact lenses in the Navy.

With the recent advent of disposable contact lenses, many of the problems which have been hindering the military application of contact lenses have been overcome. Fifty-five myopic naval personnel with no previous contact lens experience were put through a three-week study using these contact lenses. The aim was to test the feasibility of supplying bespectacled myopic seamen with contact lenses at the outset of operational missions. Seven developed conjunctival injection which caused them to discontinue contact lens wear. Of the remaining 48, however, a vast majority showed preference for contact lenses when compared to spectacles in the work environments that they were exposed to. With contact lenses, 95.8% had comparable or better vision during the day and 85.4% during the night. No serious ocular complications were noted and only minor findings were detected in the 96 eyes at the end of three weeks of contact lens wear.

Contact Lenses↗
PubMed1990

Decompression sickness in the Singapore Mass Rapid Transit Project.

In the Singapore Mass Rapid Transit Project (MRT), 11 km of underground tunnels were built using compressed air. 1,737 compressed air workers (CAWs) were employed in the project. They underwent 188,538 man decompressions at the various compressed air worksites. 160 CAWs developed Type I decompression sickness (DCS) and 4 developed Type II DCS. This gave an overall incidence of 0.087%. The adoption of strict medical selection, strict adherence to decompression procedures and the provision for acclimatization of newstarters contributed greatly to this low incidence. Prompt treatment of DCS accounted for the low relapse rate. The clinical presentation of DCS is discussed here. Prevention of DCS by worksite environmental and work-practice monitoring are advocated.

Decompression Sickness↗
PubMed1990

Acute decompression sickness in compressed air workers exposed to pressures below 1 bar in the Singapore Mass Rapid Transit project.

The Singapore Mass Rapid Transit (MRT) project started compressed air work in Oct 1984. Eleven km of underground tunnels out of 20 km were built using this method. Cases of decompression sickness (DCS) arising from compressed air work are rare with working pressures less than 1 bar gauge. However, there were 10 cases of DCS in the MRT project who were exposed to less than 1 bar pressure. The authors present their clinical features and attempt to explain the observations in relation to theories of bubble nuclei formation, gas loading and rate of decompression. The formation of bubble micronuclei are correlated with physical factors like heavy exertion, and the use of vibrating tools. The concept of extremely long tissue half-times in the absorption of nitrogen in the body is discussed as a contributory factor to the development of DCS under 1 bar.

Acute Disease↗
PubMed1979

Comparison of propranolol and metoprolol in the management of hyperthyroidism.

1 Propranolol and metoprolol were both effective in controlling the symptoms and signs of hyperthyroidism. 2 Propranolol caused a highly significant increase in serum reverse T3 concentrations with lesser changes in other serum thyroid hormone levels, whereas metoprolol did not have this effect. 3 Steady-state plasma propranolol and metoprolol levels showed marked inter-individual variation. Metoprolol concentrations showed relatively little intra-individual variability, and could be related to the clinical efficacy of the drug, whereas no such relationship was demonstrated for propranolol.

Adult↗
PubMed1979

Red cell changes in hyperthyroidism.

The Coulter 'S' red cell profile was studied prospectively in 100 untreated non-anaemic hyperthyroid patients and followed up in 52 of them until they had become euthyroid with radio-iodine or carbimazole treatment. Serial haematological data were also obtained in 23 hyperthyroid patients during treatment with beta-adrenoreceptor blocking drug alone. The most significant finding was a low mean corpuscular volume (MCV) which was invariably present throughout the hyperthyroid state. Treatment with beta-adrenoreceptor blocking drugs did not significantly alter any of the red cell parameters. On the other hand, the MCV increased and was restored to normal with radio-iodine or carbimazole treatment although there was a lag period of about 6--8 weeks between achieving the euthyroid state and the normalisation of this red cell index. While none of the patients were aneaemic, the haemoglobin level rose significantly following effective anti-thyroid treatment. It is suggested that measurement of the MCV may have a useful role in the diagnosis of hyperthyroidism. 2 possible mechanisms leading to the observed red cell changes in hyperthyroidism are postulated.

Adolescent↗
PubMed1978

Aortic regurgitation as a manifestation of giant cell arteritis.

The detailed clinical findings of a 65-year-old woman who developed aortic regurgitation caused by giant cell aortitis are presented. The initial phase of the disease was dominated by severe non-specific constitutional symptomatology suggesting infective endocarditis or a malignancy. Aortic regurgitation as a manifestation of giant cell arteritis has hitherto recieved scant attention in the published reports. The clinical and therapeutic relevance of this masquerade is discussed.

Aged↗
PubMed1977

Acquired stomatocytosis: its prevalence of significance in routine haematology.

100 patients showing a significant number of stomatocytes were identified from the microscopic examination of 4291 peripheral blood films. The distinctive red cell appearance was most commonly found in patients with neoplastic, cardiovascular or hepatobiliary disease including acute alcoholism and during therapy with certain drugs some of which are known to be stomatocytogenic in vitro.

Adolescent↗
PubMed1977

Chlorpromazine-induced haemolytic anaemia in anorexia nervosa.

Two patients with anorexia nervosa who developed progressive haemolytic anaemia during chlorpromazine therapy are presented. In each case, withdrawal of the drug alone led to a prompt haematological response. Drug-induced oxidant damage is proposed as being the underlying haemolytic mechanism.

Adult↗