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Biomedical subjects

L C Gray

Publications and source records attributed to L C Gray.

8 recordsLinked to original sources
PubMed1992

A population-based study of assessed applicants to long-term nursing home care.

OBJECTIVE: To examine the characteristics of all individuals assessed as requiring nursing home care arising from a population living within a defined geographical region and to study the manner in which they presented for assessment. DESIGN: Clinical assessment by a physician in geriatric medicine with the assistance of other disciplines. SETTING: Regional Geriatric Assessment Service. SUBJECTS: All persons recommended for nursing home care within the study period. RESULTS: The major diseases contributing to the need for nursing home care were organic brain disorders (60%) and stroke (32%). Dementia was present in 64% of cases; significant behavioral disturbance in 18%; severe communication disorders were frequent. The majority (86%) had been ill for greater than 1 year. The mode of presentation was acute in 9%, acute-on-chronic in 46%, and chronic in 45%. It was associated with significant differences in case characteristics including the location at the time of assessment, diagnoses, duration of illness, physical dependency, communication disorders, behavioral disturbance, and skilled nursing care requirements. CONCLUSIONS: These observations suggest that progression to nursing home care varies considerably. Strategies directed toward the prevention of institutionalization should be organized in recognition of these variations.

Aged↗
PubMed1992

Grading system for the selection of patients with congenital aural atresia.

It is generally recognized that surgery for congenital aural atresia is difficult. In an effort to select those patients who have the greatest chance of success, we have developed a grading scheme based on the preoperative temporal bone CT scan and the appearance of the external ear. Patients are graded on a possible best score of 10. The stapes is assigned the highest rating (2 points), while all other entrees on the scale are 1 point. The grade assigned preoperatively has been shown to correlate well with the patient's chance of success, herein defined as a postoperative speech reception threshold of 15 to 25 dB. A patient with a preoperative grade of 8/10 would, therefore, have a 80 percent chance of achieving this threshold. Patients with scores of 5/10, or less, are not considered surgical candidates, because the risk of the operation would outweigh the potential benefits. We have found that the grading system allows us to avoid impossible surgical cases while allowing for a reasonable prediction of the hearing outcome.

Abnormalities, Multiple↗
PubMed1985

High-resolution CT scanning and auditory brain stem response in congenital aural atresia: patient selection and surgical correlation.

Thirty patients with congenital aural atresia underwent CT scanning and/or auditory brain stem response (ABR) testing in a 20-month period. Eighteen patients had unilateral atresia and 12 had bilateral atresia. Twelve patients subsequently had surgery for repair of their atresia. CT scanning was not electively done until the patient was at least 2 years of age, while ABR testing was often performed in the first few months of life. Nineteen patients had CT scanning and 27 had ABR testing. The CT technique was found to offer specific advantages not previously observed in other methods of radiographic evaluation: (1) the course of the facial nerve was more easily traced and (2) the presence (or absence) of a stapes was more easily noted. The ABR was measured for monaural air-conduction as well as mastoid-placement bone conduction click stimuli; simultaneous multielectrode two- or four-channel recordings were employed. With this measuring technique it was not only possible to enhance wave I detection but, more important, the laterality of ABR wave I could be noted.

Acoustic Stimulation↗
PubMed1984

Should a paediatrician be present at non-rotational forceps deliveries?

In a series of 500 consecutive deliveries there were 35 non-rotational forceps deliveries for delay in the second stage of labour. There was no statistically significant difference in the frequency of resuscitations in this group compared with that in 329 spontaneous vertex deliveries. It is concluded that a paediatrician need not be called routinely to these forceps deliveries when there is no evidence of fetal distress.

Female↗
PubMed1977

The geographic and functional distribution of black physicians: some research and policy considerations.

Studies of the geographic and functional distribution of physicians rarely include race of the physicians as a study variable. For black physicians, there are some rather strong justifications for doing just that: 1) their services are directed almost exclusively to black and often medically underserved communities; 2) recent efforts to reduce constraints to medical education based on race, sex, ethnicity, and income have resulted in a substantial increase in the proportion of black medical students; 3) inferring about black physicians from information on the general population of physicians given the differences in biographical and experimental characteristics is tenuous at best. Hence, an adequate information base and focused conceptualization on the educational and career patterns of black physicians are indicated. At the policy level there is a need to clarify the relationship between equity in educational (and career) opportunity and efforts to redistribute physicians.

Black or African American↗