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Biomedical subjects

J L Alexander

Publications and source records attributed to J L Alexander.

At least 19 recordsLinked to original sources
PubMed1990

Prenatal diagnosis of a double bisatellited marker with an unusual copy number ratio.

Prenatal diagnosis, by amniocentesis, revealed mosaicism with respect to a bisatellited, apparently dicentric, DA/DAPI positive, de novo marker. The following cell lines were observed in decreasing order of frequency: 46,XX greater than 48,XX,+mar,+mar much greater than 47,XX,+mar. The pregnancy was terminated and post-mortem examination revealed an apparently normal fetus. Cytogenetic studies of fetal and placental tissues revealed approximately the same level of mosaicism together with the unusual copy number ratio seen in the amniotic fluid cultures. Non-disjunction at the first post-zygotic mitotic division giving rise to a mosaic: 46,XX/48,XX,+mar,+mar followed by subsequent mitotic instability of the marker could account for the unusual copy number ratio.

Adult↗
PubMed1986

Team care: an analysis of verbal behavior during patient rounds in a rehabilitation hospital.

Patient rounds are an important aspect of multidisciplinary team care. Team perceptions of ideally functioning rounds were compared with the actual communication patterns in rounds in a physical rehabilitation hospital. Perceptions of the patients' needs in the content areas of physical, psychosocial, and support systems were also compared with the actual distribution of content in rounds. Physicians spoke more (41%) and made more authoritative statements (62%) than did staff from any other discipline. The physicians participated far more than was perceived as ideal in all areas but the physical. Patients contributed only 9% of the discussion and less than 1% of authoritative statements. The physical content area was overemphasized (65%) and the psychosocial area was underemphasized (14%) when compared with the perceived needs of the patients. Interpretations of these findings and implications for investigation of the impact of team care are discussed.

Authoritarianism↗
PubMed1984

Membership issues within the American Congress of Rehabilitation Medicine: results of a survey.

A questionnaire survey of the membership of the American Congress of Rehabilitation Medicine ( ACRM ) was conducted in early 1983. Results relating to membership issues indicate that the organization should not return to physician-only membership. The issue of opening membership to baccalaureate-level rehabilitation professionals polarized the membership. The dimension of polarization is not between physicians/non-physicians. The membership is uncertain whether the current size of the organization is too small. The data suggest that appeals for new members should be primarily based on aspects of professionalism. Secondary reasons for joining differ for subgroups of members. The recommendation of a current ACRM member may be a decisive influence in a potential new member's decision to join. It is suggested that a major discriminating factor among members relates to belief in interdisciplinary rehabilitation as the ultimate concern of the ACRM .

Allied Health Personnel↗
PubMed1982

The "limiting proximal gastric pouch": the evolving solution of morbid obesity.

Seventy-five patients received the "limiting proximal gastric pouch." The technique used is the complete transverse gastric stapling with Roux-en-Y reconstruction of gastrointestinal continuity. There was one death, 13 patients required rehospitalization, and five patients required reoperation because of complications. Both the weight loss and percentage of excess weight loss were satisfactory. The patients' acceptance was very high. The limiting proximal gastric pouch is evolving as the procedure of choice for morbid obesity.

Adult↗
PubMed1981

Exteriorized repair in the management of colon injuries.

In an attempt to reduce septic complications following colonic injury in penetrating abdominal trauma, we tested the efficacy of the exteriorized repair, also known as primary repair and exteriorization of the injured colonic segment. From June 1973 to August 1979, 50 patients with colonic injuries suitable for exteriorized repair were entered into this study. Their ages ranged from 4 to 47 years; 42 were male, eight, female. Thirty-eight had gunshot wounds, 12 had stab wounds. The majority had various associated injuries, but only five were in shock. In 33 patients (66%) the colonic wounds successfully healed and the exteriorized loop was returned into the peritoneal cavity within 14 days. In 17 patients (34%), fecal leakage developed at the repair site and the exteriorized loops were converted into colostomies without sepsis. There was no mortality and a low complication rare (18%). This method of management for selected patients has a special merit in combining the safety of exteriorization with the economy of primary repair.

Abdominal Injuries↗
PubMed1981

Quality of life: some measurement requirements.

The current view of quality of life as subjective responses is briefly reviewed. A new view emphasizing quality of life as the reciprocal relationships between persons and their environments is presented conceptually. This ecological view of quality of life is illustrated by summarizing 2 analyses conducted on a large archive of detailed data descriptive of the actual functional performance of 15 patients with spinal cord injury during 1st hospitalization for comprehensive rehabilitation. The 1st analysis identifies generic dimensions of patients' behavior during hospitalization. These behavioral vital signs represent the minimum requirements for measuring quality of life. The 2nd analysis demonstrates that the measures of performance during hospitalization have an extremely high level of predictive validity in the community or postdischarge environment. Thus, the minimum requirements for measuring quality of life should include measures of actual functioning along the generic dimensions.

Adolescent↗
PubMed1979

Shotgun wounds of the abodomen: revisited.

A review of one hundred and sixty-seven patients with penetrating abdominal injuries caused by firearms showed that 17 patients (11%) had shotgun wounds. Nine patients were treated nonoperatively, whereas eight patients had immediate exploratory laporotomy. An analysis of shotgun wounds of the abdomen is presented to outline the principles in management. Factors influencing conservative versus operative treatment are discussed. Magnitude of the clinical problems have been illustrated by means of 4 cases.

Abdominal Injuries↗
PubMed1978

Experience in selective operations in the management of penetrating wounds of the neck.

Experience with 100 patients demonstrated that a selective approach to penetrating injuries of the neck can be accomplished without increasing morbidity and mortality. However, this selective approach must be done in a setting in which there are adequate nursing and house staffs. Facilities and personnel to perform arteriography and other diagnostic tests must also be available. Otherwise, observation would be unsafe, and it would be in the best interest of the patient to choose immediate operative intervention.

Adolescent↗
PubMed1978

Role of antibiotics in penetrating abdominal trauma.

The effectiveness of antibiotics in the management of penetrating abdominal injuries was studied retrospectively in two non-controlled, non-randomized groups of patients. The uncontrolled group (107 patients) received a variety of antibiotic(s) mainly intra- and postoperatively. The protocol group (121 patients) received a combination of clindamycin and gentamicin preoperatively in the Emergency Room. The protocol group had a statistically significant reduction in the incidence of intraabdominal sepsis, 1.7% as compared to 8.3% in the uncontrolled group. Although the improved results cannot be attributed solely to the antibiotic regimen, the trend seems apparent. Therefore, to minimize septic complications in penetrating abdominal injuries, we advocate: 1. prompt resuscitation, 2. early and appropriate surgical intervention and 3. preoperative antibiotics that are effective against both the aerobic and anerobic resident flora of the gastrointestinal tract.

Abdominal Injuries↗
PubMed1977

Bacteriology of the human biliary tract and the duodenum.

Using the modern anaerobic transport media and meticulous culture techniques, 74 patients undergoing biliary tract surgery were studied. The biliary system was found to be sterile in 58 patients (78%). Fifteen patients had 35 isolates of aerobic and facultative bacteria. The most common ones were Klebsiella, Enterococcus, and Escherichia coli. The only anaerobe isolated was Clostridium perfringens. Eight of 17 patients (47%) with acute cholecystitis and five of 49 patients (10%) with chronic cholecystitis, harbored bacteria in the biliary system. This study suggests that anaerobes are rare in the human biliary system; therefore, if antibiotic therapy is considered, aerobic coverage should suffice.

Adolescent↗
PubMed1977

Transfer and expression of pseudomonas plasmid RP1 in Caulobacter.

This study demonstrates that the host range of Pseudomonas plasmid RP1 includes the genus Caulobacter. Caulobacter was shown to acquire three antibiotic resistance markers located in RP1. A fourth plasmid marker, susceptibility to an RNA bacteriophage, was not expressed, but could be transferred from Caulobacter to Escherichia coli. The lack of phenotypic expression of the phage marker was manifested by the inability of the phage to adsorb or to produce plaques on Caulobacter transcipients. Matings of Pseudomonas aeruginosa and Caulobacter vibrioides CV6 were carried out in the presence of bacteriophage phi6, a DNA phage that infects and kills only swarmer cells of Caulobacter. No decrease in plasmid transfer in the presence of phage phi6 was detected, suggesting that stalked cells, and not swarmer cells, serve as recipients. Our evidence suggests that transfer of chromosomal segments from Caulobacter may be mediated by plasmid RP1; such segments are not stably maintained.

Anti-Bacterial Agents↗
PubMed1976

The pros and cons of outpatient breast biopsy.

A review of the 130 breast biopsies performed on women during the past three years at the Martin Luther King, Jr, General Hospital showed that 90 were performed on outpatients and 40 on inpatients. Of the 90 outpatient procedures, 61 were under local anesthesia and 29 under general. Only three outpatient biopsy specimens were malignant and required subsequent patient admission to the hospital for mastectomy at an interval of 9 to 14 days. In all three, the axillary nodes were uninvolved. In two, no residual tumor was found in the mastectomy specimen.

Adenofibroma↗