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Biomedical subjects

K Clark

Publications and source records attributed to K Clark.

At least 37 records · Page 2Linked to original sources
PubMed1989

Testicular ischemia and infarction following herniorrhaphy or varicocelectomy: evaluation by radionuclide imaging.

The postoperative use of testicular imaging to evaluate the preservation of testicular circulation has been reported after orchiopexy, excision of a hematocele, and repair of a traumatized tunica albuginea. The authors discuss the previously unreported use of testicular imaging in patients who have undergone recent herniorrhaphy or varicocelectomy. The scan of a patient with intact testicular perfusion following herniorrhaphy is compared to the scans of two patients with absence of perfusion of a testicle five to seven days following respective herniorrhaphy and varicocelectomy surgeries.

Adult↗
PubMed1989

Intra-abdominal compartment syndrome as a complication of ruptured abdominal aortic aneurysm repair.

In four patients with ruptured abdominal aortic aneurysms increased intra-abdominal pressure developed after repair. It was manifested by increased ventilatory pressure, increased central venous pressure, and decreased urinary output associated with massive abdominal distension not due to bleeding. This set of findings constitutes an intra-abdominal compartment syndrome caused by massive interstitial and retroperitoneal swelling. The purpose of this report is to establish criteria for this syndrome and suggest a method of treatment. The syndrome developed within 24 hours; in one patient within 5 hours postoperatively. All four patients received more than 25 liters of fluid resuscitation (electrolyte and blood) during and within 16 hours after operation and had massive abdominal distension. Decompressive laparotomies were performed in the Intensive Care Unit with placement of Marlex (Bard Corp., Billerica, MA) mesh. In two additional patients, at the completion of the aneurysmectomy the abdominal incision was left open with interposition Marlex mesh. Opening the abdominal incision was associated with dramatic improvements in central venous pressure, urinary output, ventilatory pressure, arterial carbon dioxide tension, and oxygenation. The authors conclude that some patients with ruptured abdominal aortic aneurysm do not tolerate the closure of the abdominal wall, as manifested by increased ventilatory pressures, decreased oxygenation, and decreased urinary output. Opening the abdominal wound or delayed closure may reverse the oliguria and improve oxygenation. Recognition and treatment of this condition by opening the abdominal wound or delayed closure may affect outcome in some cases.

Abdomen↗
PubMed1989

Aspects of women's health care in Finland.

The article is drawn from experience gained on a management study trip to Finland, and begins with a general explanation of the Finnish health care system, which is based on local government. Planning progress over the last fifty years is outlined, culminating in the present emphasis on primary care. There is a short section on family planning, followed by a description of abortion legislation and its effects on the birth rate. Antenatal care is also considered, particularly the important role of public health nurses and the lack of contact during pregnancy with the hospital staff who will attend the delivery. Finally the generous Finnish system of maternity leave is described.

Female↗
PubMed1988

Pharmacological treatments of tardive dyskinesia in the 1980s.

The studies of tardive dyskinesia treatment published in the 1980s were generally superior to earlier work in terms of methods (more double-blind trials using standardized rating scales), but relatively small sample sizes and short durations of studies were still the main deficiencies. The results continue to suggest an absence of an overall satisfactory treatment. Individual patients seem to respond to different drugs such as noradrenergic antagonists and GABAergic agents. Withdrawal of neuroleptics and antiparkinsonian agents is a useful strategy. Future work should concentrate on defining clinicopharmacological subtypes of tardive dyskinesia.

Dyskinesia, Drug-Induced↗
PubMed1987

Prevalence of major depressive disorder in patients receiving beta-blocker therapy versus other medications.

Depression is believed to be a common side effect in patients receiving beta-blocker therapy. However, diagnoses of depression defined by current diagnostic criteria may not be more common in patients receiving beta-blockers than in patients with the same medical disorder receiving other medications. Seventy-seven patients undergoing elective cardiac catheterization for evaluation of chest pain received a semi-structured diagnostic psychiatric interview. Twenty-one percent of the patients receiving beta-blockers and 33 percent of the patients receiving medications other than beta-blockers met the current American Psychiatric Association criteria for major depressive disorder (DSM-III) (p = NS). The mean heart rate and state anxiety scores for patients taking beta-blockers were significantly lower than those measured in patients taking medications other than beta-blockers. No other medical or demographic differences were observed between the two groups. Despite the methodologic limitations of the study, there does not appear to be a difference in the point prevalence of depression between patients receiving beta-blockers and those receiving other medications.

Adrenergic beta-Antagonists↗
PubMed1986

Demonstration of antigenic variation among rabies virus isolates by using monoclonal antibodies to nucleocapsid proteins.

Rabies virus isolates from terrestrial animals in six areas of the United States were examined with a panel of monoclonal antibodies to nucleocapsid proteins. Characteristic differences in immunofluorescence reactions permitted the formation of four antigenically distinct reaction groups from the 231 isolates tested. The geographic distribution of these groups corresponded well with separate rabies enzootic areas recognized by surveillance of sylvatic rabies in the United States. Distinctive reaction patterns were also identified for viral proteins from four infected bat species, and identical patterns were found in eight isolated cases of rabies in terrestrial animals. These findings suggest that monoclonal antibodies can be used to study the prevalence, distribution, and transmission of rabies among wildlife species.

Animals↗
PubMed1985

Clinical viral infections and multiple sclerosis.

Over an 8 year period, 170 patients with multiple sclerosis (MS) and 134 healthy controls were assessed at monthly intervals in order to ascertain environmental factors which might be important in producing exacerbation or progression of the illness, and to compare the frequency of common viral infections in the two groups. During cumulative periods designated "at risk" (2 weeks before the onset of infection until 5 weeks afterwards) annual exacerbation rates were almost 3-fold greater than those during periods not at risk. Approximately 9% of infections were temporally related to exacerbations, whereas 27% of exacerbations were related to infections. Frequency of common infections was approximately 20-50% less in MS patients than controls; it was progressively less in those with greater disability. Even in minimally disabled patients with similar potential for infectious contacts, the infection rate was significantly less than in controls, suggesting that MS patients could have superior immune defences against common viruses.

Adult↗
PubMed1978

Clinical studies of intrathecal autologous lymphocyte infusions in patients with malignant glioma: a toxicity study.

The feasibility and toxicity of intrathecal lymphoid cell infusions in patients with glioma were examined in this study. Blood rich in lymphoid cells was obtained using the Haemonetics Model 30 cell separator; the lymphoid cells extracted were further purified on Ficoll-Hypaque gradients. Four patients received a total of eighteen autologous lymphoid cell infusions, with between 1 X 10(6) and 5 X 10(9) lymphoid cells being infused on each occasion. No toxicity was observed, but the CSF glucose declined in 2 patients. In 1 patient examined at autopsy the lymphoid cells appeared to have gained access to the tumor bed as well as to the rest of the subarachnoid space.

Astrocytoma↗
PubMed1977

Transsphenoidal microsurgery for selective removal of functional pituitary microadenomas.

The transphenoidal approach to the pituitary gland is emerging as the safest and most efficacious procedure for the management of pituitary tumors. With the aid of the microscope large tumors producing visual symptoms can be removed and microadenomata producing only signs and symptoms of endocrinopathies can be safely and adequately approached. The procedure is described in this report. The results of its use in 29 patients with selected illustrative case reports are described.

Acromegaly↗
PubMed1977

Cerebral revascularization for transient ischemic attacks.

Thirty-one patients with cerebral transient ischemic, attacks and ipsilateral internal carotid artery occlusion without contralateral internal carotid artery occlusion or stenosis were treated with a surgical anastomosis between a superficial temporal artery and a cortical branch of the middle cerebral artery of the symptomatic hemisphere. The anastomosis was successful in 28 patients. Recurrent transient ischemic attacks were abolished in 23 patients and reduced in three. Two patients, one with a patent anastomosis, had strokes during the follow-up period. Of seven patients who refused the operation, two had strokes, two noted a reduction of transient ischemic attacks, two noted no change, and one became asymptomatic.

Adult↗
PubMed1977

Assessing adolescent mental health needs: the views of consumers, providers, and others.

The perceived mental health needs of adolescents were measured by questionnaire to groups of teenagers, parents, community child guidance personnel, self-help groups, police and court related people, school personnel, mental health administrators and area board members. Alcohol abuse and unemployment were seen as the first and second priority problems by most groups. Regarding specific services and facilities needed, residential facilities of various types were the most critical concern. Alcohol abuse programs, employment counseling, and family therapy and counseling were also major needs. There was considerable consensus as to needs among both consumers and providers. However, consumers tended to see as higher priority those problems affecting large numbers of adolescents while providers worried more about the seriously disturbed few.

Adolescent↗
PubMed1976

Electrical stimulation for anal sphincter control in barium enema examinations: an extended trial.

The routine use in 500 consecutive patients of a barium enema cannula incorporating stimulating electrodes is described. Barium retention was improved by the electrically maintained contraction of the anal sphincter. The cannula was connected to a battery-powered control unit which provided the stimulus; pulse width was 1 msec and frequency was 20 pulses/sec. The pulse amplitude, adjusted for each patient, was in the range of 5--17V. A standard procedure was adopted throughout the trial without the use of colonic relaxants (such as anticholinergic drugs). The barium suspension and water were in stilled at body temperature. A comparison with a control series of 200 patients showed a significant reduction in the failure rate from 20% to 4%. No unpleasant side effects were encountered apart from a tingling sensation in the anal region which was expected. The principal factors contributing to failure were fecal impaction and diverticular disease.

Adolescent↗