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Biomedical subjects

P Freeman

Publications and source records attributed to P Freeman.

10 recordsLinked to original sources
PubMed1992

Clinical research and statistical analysis of a visual field awareness system.

This article discusses the clinical research and applications of the statistical analysis of a system called "The Visual Field Awareness System." This medical lens system allows patients with a visual field loss to 1) scan toward area of the loss, to see objects sooner and more clearly, and 2) demonstrate increased function and safety. Seventy-nine percent (27 of 34) of the patients in the sample received and accepted the prism treatment. Of this group, a minimum of 70 percent (19 of 27) continue to benefit from this treatment strategy. Statistically significant predictors of success are discussed. This study demonstrates that patients suffering visual field loss may show functional benefit by the utilization of this prism treatment along with vision rehabilitation.

Adult↗
PubMed1991

Recombinant human erythropoietin in the anemia of prematurity: results of a placebo-controlled pilot study.

Experimental and clinical data implicate inadequate erythropoietin production as an important reason that infants acquire this anemia and suggest that recombinant human erythropoietin (r-HuEPO) might be used to treat or prevent it. We therefore randomly assigned 20 small premature infants (birth weight less than or equal to 1250 gm) who were highly likely to require erythrocyte transfusions for anemia of prematurity to receive 6 weeks of treatment with either intravenously administered r-HuEPO (at a dose of 100 units/kg twice each week) or a placebo. Hematologic measurements, transfusion requirements, and growth were followed during therapy and for 6 months thereafter. Treated (EPO) and control babies did not differ with respect to weight, hematocrit, overall mean absolute reticulocyte count, calculated erythrocyte mass, or rate of growth. However, reticulocyte counts increased earlier in patients given r-HuEPO. Six of ten babies in the EPO group, and 8 of 10 assigned to the control group, received at least one erythrocyte transfusion during treatment. For all infants the amount of blood sampled for laboratory tests was strongly predictive of the volume of packed erythrocytes transfused (r = 0.890; p = 0.0001). Of nine infants who had less than 20 ml packed erythrocytes removed for laboratory tests, none of four given r-HuEPO received a transfusion, whereas three of five infants assigned to the placebo group received one. No toxic effects were attributable to r-HuEPO, and no significant changes in leukocyte or platelet counts occurred during treatment. Reticulocyte counts were correlated with simultaneous platelet counts and were inversely related to absolute neutrophil counts in both study groups. We conclude that r-HuEPO administration is safe and feasible at the dose studied. Additional controlled trials utilizing higher doses of r-HuEPO and larger numbers of patients are justified.

Anemia, Neonatal↗
PubMed1991

Some factors affecting acceptance of family planning in Manus.

This paper examines selected factors affecting the acceptance and delivery of modern family planning from health centres in Manus. A survey was carried out of mothers attending Maternal and Child Health clinics and a written questionnaire was given to health workers. The survey of mothers demonstrated the importance of the husband's approval for contraceptive practice and showed that knowledge about traditional methods of family planning is widespread. The health workers' questionnaire demonstrated a high level of dissatisfaction with the current family planning program delivered by health clinics: 45% found the program ineffective; 68% wrote that health workers' attitudes discouraged mothers from attending for family planning. The perceived and actual benefits and costs of children and the role of men should be assessed locally before planning future family planning programs. Widespread retraining and motivating of health workers is essential if improved coverage is to be achieved through health services. The efficacy of alternative methods of delivery of family planning such as local community-based and social marketing programs should also be investigated.

Age Factors↗
PubMed1978

The effects of damage to the renal tubular cell population in growing rats.

Intraperitoneal injection of mercuric chloride in the rat was used to study the effect of tubular injury on renal growth in intact and in unilaterally nephrectomised animals. If a reduction in the size of the tubular cell pool was effected, hypertrophy of surviving cells, rather than hyperplasia, would be the dominant response in treated animals. The remaining kidney in animals which had undergone nephrectomy showed hyperplasia without hypertrophy. However, unilaterally nephrectomised animals treated with mercuric chloride showed evidence of hypertrophy only, with no hyperplasia.

Acute Kidney Injury↗
PubMed1978

Fistula of the lateral semicircular canal.

The principles enunciated by Adam Politzer concerning the management of fistula of the lateral semicircular canal are as true today as they were during his time, in spite of the advances made in otologic surgery during the past 25 years or more. If a fistula of the lateral semicircular canal is suspected or proven, the patient's hearing has a greater chance of being preserved if the fistula is left undisturbed. Several illustrative cases are presented.

Adult↗
PubMed1978

Rupture of the round window membrane.

The mechanism of development of rupture of the round window membrane appears to be an increase in pressure in the cerebrospinal fluid transmitted to the inner ear via the cochlear aqueduct. Two cases of rupture of the round window membrane in divers are described in detail. One diver had ruptures of both round window membranes following difficulty in autoinflating when diving, and the other had a rupture of one round window membrane, having presented with acute prostating vertigo and normal hearing. Surgical repair restored the hearing in the former case and preserved normal hearing in the latter. The similarity between ruptures of the round window membrane and poststapedectomy fistula is emphasized, and it is suggested that spontaneous healing of ruptures may well occur. A case history supporting this hypothesis is presented. The technique of repair of ruptures of the round window membrane is described as well as postoperative management. Normal nasal function in divers is essential if inner ear barotrauma and ruptures of the round window membranes are to be avoided.

Adult↗
PubMed1975

Childhood urinary infection associated with vesico-ureteric reflux.

Among 222 children investigated in hospital for urinary infection 98 had vesicoureteric reflux only, and of these a group of 59 has been followed at a special clinic for from three to 14 years (mean 5.4 years). Children with reflux had an earlier age of onset and a greater likelihood of a family history of urinary infection than those with other diagnoses. Fifty-five were conservatively treated, and more than half of these still had reflux at the end of the study. Children with severe grades of reflux and an early onset of symptoms had least chance of reacting favourably to medical treatment. Evidence of renal deterioration was exceptional and virtually confined to the pre-school age group. It is argued that severe grades of reflux in pre-school children should be treated surgically, and that voiding cystograms need only be part of routine investigation in two circumstances, namely when the patient is under five, and on the very rare occasion when an older child shows progressive renal damage in serial pyelograms.

Age Factors↗
PubMed1975

Rupture of the round window membrane.

Considerable interest has been displayed in sudden sensori-neural deafness in recent years, and especially since Blair Simmons postulated that this could be caused by mechanical disruption of the membranes in the inner ear. The literature concerning such reports is reviewed briefly and two cases of rupture of the round window membrane resulting from inner ear barotrauma are reported in detail. Both these cases were experienced divers who had had little difficulty in auto-inflation whilst diving. The first case had progressive sensori-neural deafness with mild vertigo, and tympanotomy revealed rupture of the round window membrane in both ears. These ruptures were repaired with plugs of fat, following which his hearing was restored. The second case developed marked vertigo following a dive and was thought to be suffering from decompression sickness. When the appropriate treatment did not help him, tympanotomy was performed and a rupture of the round membrane was found. This was plugged with fat with a most satisfactory result. Both of these cases had difficulty with autoinflation, and had been aware of such difficulties for some time. Nasal problems were responsible for this, and it is strongly recommended that all divers should have normal nasal function and that they should be educated in the technique of autoinflation, and, in particular, in the importance of avoiding forceful autoinflation at all times. A third case of rupture of the round membrane following an injury to the head is also reported.

Adult↗