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Biomedical subjects

M Floyd

Publications and source records attributed to M Floyd.

At least 37 records · Page 2Linked to original sources
PubMed1991

Occupational aspects of epilepsy in the civil service.

Eighty five civil servants with epilepsy who were referred to the Civil Service Occupational Health Service over an 18 month period formed the study population. The reasons for these referrals and their outcomes have been analysed. The main reasons for referral were prolonged or frequent sickness absence, unsatisfactory work performance, epilepsy starting during employment, the discovery of undisclosed epilepsy, and for advice on working conditions. In 30 the outcome was medical retirement, although in only 15 was this due to epilepsy alone. Of the other 15, medical retirement was necessary in four because of the combination of epilepsy with another medical disorder, and in 11 because of a coincidental condition unrelated to their epilepsy. Only six out of 15 referred on account of epilepsy related sickness absence, and none of the 14 referrals due to epilepsy related unsatisfactory work performance resulted in early retirement. This reflected the invaluable role that the occupational physicians had in recognising where problems were due to poor control of the epilepsy or to the side effects of the antiepileptic medication and in arranging through general practitioners or hospital doctors for appropriate adjustment of the drug regimen. Nine of the 22 subjects who developed epilepsy during employment, however, were retired on medical grounds.

Absenteeism↗
PubMed1990

A quantitative approach to measuring the social effects of epilepsy.

This paper describes the construction of a postal questionnaire which has been used to investigate the social affects of epilepsy on a wide range of patients. The social profile was designed following extensive patient interviews at the National Hospital for Nervous Diseases and the Chalfont Centre for Epilepsy. The initial research revealed 21 areas of concern for the individual with epilepsy, which are described. Reliability was assessed on a test/retest procedure. Validity was tested via a criterion-related study based on the behaviour of the subject. Following reliability and validity studies 14 areas were eventually selected for the final questionnaire. Instruments have been adapted for both children and adults.

Attitude to Health↗
PubMed1988

The management of epilepsy at work.

This paper examines the way in which health problems, resulting from epilepsy, are managed in one large organisation, the British Civil Service. The part played by stress in precipitating epileptic seizures is first of all considered. This leads on to a discussion of the problems of finding a medical regime that, on the one hand, prevents epileptic attacks at work and, on the other, does not result in side effects that adversely affect work performance. The importance of social support is also stressed. The paper concludes by highlighting the need to improve the process whereby information on the requirements of a job are related to information on an individual's epilepsy, in order to determine the risk of their having, or causing, an accident at work.

Accidents, Occupational↗
PubMed1984

Potassium-wasting nephropathy secondary to chemotherapy simulating Bartter's syndrome.

A patient with a potassium wasting nephropathy secondary to chemotherapy simulating Bartter's syndrome is described. A 64-year-old woman with diffuse histiocytic lymphoma developed persistent hypokalemia following a course of Cytoxan (cyclophosphamide), Adriamycin (doxorubicin), vincristine, and prednisone (CHOP)-Bleo. The diagnosis of a functional Bartter's syndrome was concluded following evaluation of serial plasma renins, aldosterone levels, and urinary electrolytes. Evidence is suggestive that a subpopulation of patients receiving chemotherapy may develop a functional Bartter's syndrome, and it is important to consider this diagnosis in patients who develop hypokalemia subsequent to chemotherapy introduction.

Aldosterone↗
PubMed1981

Serial measurement of nonspecific immune parameters in chronically hemodialyzed renal failure patients.

Nonspecific immune monitoring of the percentage active T (A-T) rosette-forming cells (RFC) and spontaneous blastogenesis (SB) appear to be useful indexes of host reaction toward allografts. In order to assess the significance of the observed changes, renal failure patients were serially evaluated before and after hemodialysis for the percentage of total T (T-T) and A-T RFC and for peripheral blood leukocyte metabolic activity measured by a whole blood spontaneous blastogenesis (SB) assay. Renal failure patients had a significantly lower (P less than 0.05) percentage of T-T RFC than normal persons, while the percentage A-T RFC and SB remained stable. A hemodialysis treatment did not change the mean values of any of the three parameters. On the other hand, serial patient evaluation over 3 months revealed significant fluctuations in the percentage T-T RFC, but not the percentage A-T RFC and SB. Since the percentage A-T RFC and SB are relatively constant measures of immune status in ungrafted patients, significant changes in these nonspecific immune probes may reflect allograft rejection.

Female↗
PubMed1981

Anterior extraperitoneal donor nephrectomy.

The anterior extraperitoneal approach was compared to the flank approach for living donor nephrectomy in a series of 36 familial donors. The former procedure (23 cases) not only afforded superior visualization of renal vessels but also was probably at least as safe as the latter (13 cases) for donors with risk factors of obesity, age more than 45 years and pulmonary disease. Anterior extraperitoneal nephrectomy appears to be indicated for donors with multiple renal arteries and skeletal deformities, including thoracolumbar arthritis.

Adolescent↗
PubMed1981

Correlation of nonspecific immune monitoring with rejection or impaired function of renal allografts.

Two nonspecific immunological assays were combined with radionuclide scanning to monitor 113 patients thrice weekly following allotransplantation. The nonspecific immune assays included measurement of the percentage of active T rosette-forming cells (% A-T RFCs) and spontaneous blastogenesis (SB). An increase in SB and decrease in % A-T RFCs (greater than 1 sd of normal controls) constituted an immune event. The immune parameters were correlated with thrice weekly radionuclide studies which were computer analyzed for glomerular and tubular function. Alteration of the immunological and radionuclide parameters significantly correlated (P less than 0.001) with 90 rejection episodes displayed by 72 nonantithymocyte globulin (ATG)-treated renal allograft recipients during the first 30 postoperative days. In the absence of clinically defined rejection, changes in immune parameters correlated with (1) decline of radionuclide parameters and (2) alterations in weight, temperature, creatinine clearance, and serum creatinine, suggesting subclinical events. As a result of the effects of ATG on lymphocytes, a similar comparison could not be made for 41 other patients treated with this immunosuppressive drug. The incidence of false positive tests was 12.7%. Thus, the combination of two nonspecific immune parameters, % A-T RFCs and SB, with computerized analysis of radionuclide scans may afford a reliable index to diagnose early rejection or impaired function of renal allografts.

Diagnosis, Differential↗
PubMed1981

Tissue and glomerular deposition of globulin aggregates.

We studied the behavior of AgGG, a model of iCs, in the rat. The clearance of radiolabeled AgGG from the circulation was found to follow first-order kinetics. The t1/2 of the AgGG increased markedly with increases in dose administered, whereas the absolute rate of removal appeared to approach a maximum. The bulk of the AgGG cleared was found in the liver, and less than 1% was found in spleen, lung, or kidney. All these features are typical of the behavior of macromolecules removed from the circulation by the RES. Specific glomerular deposition was studied at various dosages by isolating glomeruli and measuring the fraction of injected aggregate that was trapped. This fraction represented less than 10% of total renal deposits. Moreover, when animals were sacrificed at an interval of 1 t1/2 after the injection of the corresponding dose, the fraction deposited in glomeruli remained constant. The significance of this finding is discussed in relation to the pathogenesis of glomerulonephritis.

Animals↗
PubMed1981

Albumin and beta 2-microglobulin radioimmunoassays applied to monitoring of renal-allograft function and in differentiating glomerular and tubular diseases.

Blood and urine were samples daily from 11 renal-allograft recipients from one to six weeks after the transplant. Clearances of both albumin (Calb) and beta2-microglobulin (C beta 2 mu) were significantly increased in all 11 patients. Five patients (Group I) with acute allograft rejection showed markedly increased Calb and moderately increased C beta 2 mu, concurrent with decreased creatinine clearance (CCr). Five other patients (Group II) with no evidence of rejection demonstrated episodes of grossly increased C beta 2 mu with minimally increased but stable Calb and normal CCr. One patient had no evidence of rejection nor indications of glomerular or tubular proteinuria. While changes in serum beta 2-microglobulin concentration closely paralleled those of serum creatinine in the Group II patients, the results diverged in the Group I patients because the increase in serum beta 2-microglobulin exceeded that of serum creatinine and preceded the increased in creatinine by one to five days, suggesting that measurement of serum beta 2-microglobulin might afford earlier indication of the nature and extent of renal damage in the allograft recipients.

Beta-Globulins↗