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Biomedical subjects

M Black

Publications and source records attributed to M Black.

At least 19 recordsLinked to original sources
PubMed1992

The diagnosis of child sexual abuse.

OBJECTIVE: To examine how the history, psychological evaluation, medical examination, and child's response to the examination contributed to a diagnosis of child sexual abuse by an interdisciplinary team. DESIGN: Patient series. SETTING: Subspecialty clinic for evaluating prepubertal children alleged to have been sexually abused. PARTICIPANTS: One hundred thirty-two children alleged to have been sexually abused and their parents or guardian, evaluated consecutively in a subspecialty clinic between September 1989 and June 1990. MEASUREMENTS/MAIN RESULTS: A social worker interviewed the parents, a psychologist interviewed the child, and a pediatrician obtained a medical history and examined the child. Parents completed a Child Behavior Check list and the child's response to the physical examination was noted. Both a disclosure by the child and abnormal physical findings were significantly and independently associated with the team's diagnosis of sexual abuse, whereas the presence of sexualized behavior, somatic problems, and the child's response to the examination did not make an additional contribution to the diagnosis. CONCLUSIONS: The findings support the need for a skilled psychological interview and a medical examination of a child alleged to have been sexually abused to make the diagnosis of sexual abuse. An interdisciplinary team appears to be a valuable approach for evaluating these children and their families.

Baltimore↗
PubMed1991

Split skin grafting and bullous pemphigoid.

We present a case of a 73-year-old Caucasian female with known recent mild generalized bullous pemphigoid who underwent a forearm-to-palm split skin graft as part of a fasciectomy for Dupuytren's contracture. Histologically confirmed bullous pemphigoid blistering occurred extensively around the donor site 5 weeks post-operatively and required systemic corticosteroids for adequate control.

Aged↗
PubMed1991

Spatial correlation between thyroid epithelial cells expressing class II MHC molecules and interferon-gamma-containing lymphocytes in human thyroid autoimmune disease.

In this immunohistochemical study we addressed the question whether aberrant class II MHC expression by thyroid epithelial cells (thyrocytes) in established thyroid autoimmune disease is the result of release of interferon-gamma (IFN-gamma) by adjacent lymphocytes. Thyroids from eight cases of Hashimoto's thyroiditis, 13 cases of Graves' disease and 10 cases of focal thyroiditis were studied. Both thyrocytes expressing class II MHC and lymphocytes containing immunoreactive IFN-gamma were found in all 31 autoimmune thyroids. In a serial section study of these thyroids, IFN-gamma-expressing lymphocytes were found within 50 microns of class II MHC-positive thyrocytes in 89% of 282 randomly selected fields. Conversely, class II MHC-positive thyrocytes were found within 50 micron of aggregates of IFN-gamma-positive lymphocytes in 82% of 272 randomly selected fields. These findings support the view that in established thyroid autoimmune disease expression of class II MHC by thyrocytes is the result of local release of IFN-gamma.

Autoimmune Diseases↗
PubMed1991

Paradoxic air embolism in the absence of an intracardiac defect.

A 58-year-old man experienced paradoxic air embolism with passage of air from the systemic venous to the systemic arterial circulation with subsequent stroke and death. No intracardiac shunt was present. Pulmonary fibrosis concomitant with severe pulmonary arterial hypertension appears to have been responsible for the air traversing the pulmonary capillary bed. This unusual outcome of a complicated central venous catheterization must be borne in mind and guarded against in similar patients.

Catheterization, Swan-Ganz↗
PubMed1991

Sentence processing deficits: a replication of therapy.

This paper describes the replication of a therapeutic programme originally used by one of the authors, Byng (Cognitive Neuropsychology, 1988, 5, 629-676) to remediate a specific sentence processing deficit. Our patient is shown to have similar although not identical deficits to those of one of the patients (JG) described in that programme. Sentence comprehension and production both improved as a result of therapy. The pattern of results observed gave further insights into both the nature of the patient's deficit and the mechanism of therapy.

Aged↗
PubMed1991

Failure-to-thrive: lessons from animal models and developing countries.

To better understand the complex associations between undernutrition and poverty in determining behavioral outcome for infants with failure-to-thrive (FTT), we have reviewed findings from research in undernutrition among animal models and among children in developing countries, where rates of infant undernutrition are extremely high. The associations among undernutrition, poverty, and family functioning persist in both animal and human research, whether manipulated in laboratory settings or observed in natural settings. Although environmental support and stimulation appear to ameliorate many of the negative consequences associated with undernutrition, infants with a history of nutritional deprivation are at increased risk for behavioral and emotional problems. Recommendations for prevention and intervention follow an ecological framework and include adequate access to food, knowledge of nutritional requirements and feeding approaches, support for parents and families, and a nurturant environment for infants.

Child, Preschool↗
PubMed1991

Teaching pediatric residents about child maltreatment.

Child maltreatment is a growing problem faced by pediatricians; however, there are many deficiencies in pediatricians' relevant knowledge and skills. Residency programs typically have included limited teaching in the area of child maltreatment. Fifty pediatric residents participated in an evaluation of a model educational course in child maltreatment developed by an interdisciplinary faculty. The course resulted in significant short-term improvements in knowledge and skills as well as a greater sense of competence in managing cases of child maltreatment. The importance of teaching pediatric residents about the "new morbidity" is discussed.

Adult↗
PubMed1990

Hepatocellular carcinoma associated with erythrocytosis and hypoglycemia in a yearling filly.

A yearling Arabian-type filly with a history of poor growth, erythrocytosis, hypoglycemia, and high liver enzyme activities was admitted to the hospital for evaluation. Three days after admission, the filly collapsed, deteriorated rapidly despite treatment, and was euthanatized. A metastatic hepatocellular carcinoma with capsular rupture and hemoperitoneum were found at necropsy. Primary liver tumors are rare in horses, and hepatocellular carcinoma has been reported in only 1 other horse. The systemic manifestations of the tumor in this filly included weakness, weight loss, inappetence, erythrocytosis with tumor production of erythropoietin, persistent hypoglycemia with normal serum insulin concentrations, serum alpha-fetoprotein (normally present only during fetal life), and terminal massive hemoperitoneum, all features of the syndrome in man.

Animals↗
PubMed1990

Comparison of the 15q deletions in Prader-Willi and Angelman syndromes: specific regions, extent of deletions, parental origin, and clinical consequences.

It has recently been shown that apparently similar deletions of chromosome 15q occur commonly in the Prader-Willi and Angelman syndromes. The distinctness of the syndromes suggests that the deletions are not identical. To address this possibility, the specific bands involved and the sizes of the deletions were compared in seven patients with Prader-Willi syndrome and 10 patients with Angelman syndrome using high-resolution G-, Q-, and fluorescent R-banding techniques. The parental origin of the nine cases of Angelman syndrome for which parents were available for study was determined. The same proximal band was deleted (q11.2) in both syndromes. In general, the deletion in patients with Angelman syndrome was larger, though variable, and included bands q12 and part of q13. All of the studied deletions in patients with Angelman syndrome were of maternal origin. This contrasts with the predominant paternal origin of the deletion in patients with Prader-Willi syndrome. Two possible reasons for these observations are postulated: 1) the deleted regions are different at the cytologic and/or molecular level because of different exchange points in meiosis in males and females or to different mechanisms of breakage in males and females, resulting in differing breakpoints; 2) the deleted regions are essentially the same, but differential expression of the genes in the homologous chromosome 15 has occurred (imprinting).

Adolescent↗
PubMed1990

An epidemiological case-control study of breast cancer and alcohol consumption.

A case-control study of breast cancer and alcohol consumption was conducted with 1617 patients diagnosed with a primary cancer of the breast between 1982 and 1984 in 18 New York State counties. For each case, one control, matched for year of birth and county of residence, was selected from the driver's license files of the New York State Department of Motor Vehicles. Breast cancer risk was shown to increase as daily consumption of alcohol increased, with a risk of 1.37 (95% Cl = 1.07, 1.75) observed among women who consumed 15 or more grams of alcohol per day. Breast cancer risk did not appear to be related to the total number of years a woman drank or to be restricted to specific types of alcoholic beverages. The data suggest that this may be higher in women who began drinking at a later age. The increased risk associated with alcohol consumption, observed in the current study, persisted within strata of various breast cancer risk factors.

Adult↗