Biomedical subjects
Publications and source records attributed to R A Banks.
We present the magnetic resonance imaging (MRI) findings in a young patient with histological proven solid and papillary epithelial neoplasm of the pancreas. Although the appearance of this tumor at MRI can be useful in making a correct preoperative diagnosis, only few cases describing its MRI features have been reported in the radiological literature.
OBJECTIVE: To examine the relationship between disordered eating attitudes and behaviors, BMI, and glycemic control in adolescents with type 1 diabetes. RESEARCH DESIGN AND METHODS: In a cross-sectional design, 152 adolescents (ages 11-19 years) completed three scales from the Eating Disorders Inventory (EDI): Body Dissatisfaction, Drive for Thinness, and Bulimia. All subjects had diabetes for > 1 year. Glycemic control was assessed by glycosylated hemoglobin (HbA1c). Height and weight were measured to assess BMI. RESULTS: Adolescents with type 1 diabetes did not report more disordered eating attitudes and behaviors than the normative comparison sample. Male subjects with type 1 diabetes reported fewer symptoms of bulimia and female subjects with type 1 diabetes reported greater body satisfaction than the normative group. A higher BMI was a significant predictor of greater body dissatisfaction, more so for female than male subjects. Symptoms of bulimia were associated with older adolescence and female sex. Those with more symptoms of bulimia were also more likely to have a higher BMI. Sex (female) and body dissatisfaction (more dissatisfied) predicted a stronger desire to be thin. Longer duration of disease, more symptoms of bulimia, and obesity all predicted poorer glycemic control. CONCLUSIONS: Female patients aged 13-14 years seem to be at greatest risk for developing disordered eating patterns. Using the clinical cutoff score (> or = 5) of the EDI Bulimia subscale as a screener in diabetes clinics may help identify adolescents whose disordered eating patterns are likely to compromise their glycemic control.
BACKGROUND: Sepsis as a consequence of central venous hemodialysis catheter colonization is a major cause of morbidity in the hemodialysis population. We have previously shown that the majority of catheters become colonized and that this is associated with peripheral bacteremia. The time period over which this colonization occurs is unknown. METHOD: A prospective study of 31 central venous hemodialysis catheters was performed. Central venous blood cultures were taken from the catheter weekly after insertion. When the central cultures became positive, indicating catheter colonization, peripheral venous blood cultures were taken during dialysis to detect peripheral bacteremia. RESULTS: Twenty-one catheters (68%) became colonized before their removal for reasons other than infection (mean time to colonization 27 days, range 5-115 days). Eleven patients (35%) developed peripheral bacteremia with the same organisms (mean time from colonization to bacteremia 32 days, range 5-26 days). Bacteremia only occurred when blood drawn from the catheter cultured more than 3000 colony forming units per ml. CONCLUSIONS: Bacterial colonization of central venous catheters often leads to bacteremia. The time between insertion and colonization is very variable, but is universally present after 16 weeks. The risk of subsequent bacteremia is related not only to time left in situ, but also the degree of colonization. Surveillance cultures would allow clinicians to detect colonization before bacteremia occurs and take preventative measures.
IgA nephropathy (IgAN) and Henoch-Schoenlein purpura (HSP) are clinically distinct conditions indistinguishable on renal biopsy. However, progression from IgAN to HSP has rarely been reported, particularly in adults. We report such a case: a young man with biopsy-proven IgAN and no systemic features of HSP who six years later developed classical HSP. This supports suggestions that the two conditions are different manifestations of the same disease.
Tompkins-McCaw Library of Virginia Commonwealth University has planned and implemented four one-year outreach service projects during the past two years. These projects were funded by the National Library of Medicine and the National Network of Libraries of Medicine Southeastern/Atlantic Region. The projects focus on information access for public health nurses, HIV/AIDS information access, and circuit librarian services in rural Southern Virginia. This article documents issues and challenges which have been identified from these projects and suggests ways to resolve them.
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A programme of Continuous Ambulatory Peritoneal Dialysis has been in progress at the Gloucester Royal Hospital since January 1988. After 2 years patient and technique survival was 81% and 73% respectively, very similar to that in established British Renal Units. Management of end stage renal failure at the local District General Hospital has meant that patients no longer have to travel long distances to the Regional Renal Unit.
The steady state diffusing capacity of the lung for carbon monoxide (DLCO) was studied in 18 splenectomized adult ewes. Seven animals were anemic when studied. Weight (Wt) and, to a lesser extent, hemoglobin (Hb) level were the key predictive variables of DLCO. Sheep DLCO can be expected to range between 15 and 28 ml/min/mmHg in adult ewes which are not anemic. When DLCO measurements were repeated up to three times on the same day no significant decreases occurred. Thus, the data demonstrated no CO back-pressure caused by preceding DLCO determinations. This paper's importance is in defining a normal predictive range for this sensitive parameter of pulmonary function.
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The mean corpuscular volume (MCV) of urinary erythrocytes was measured by a Coulter Counter in 42 patients with asymptomatic haematuria. All patients had the source of haematuria established by a renal biopsy, cystoscopy or radiology. The mean urine MCV was significantly less in those with glomerular disease (n = 21) than in those with non-glomerular haematuria (n = 21). In every patient with glomerulonephritis, urinary erythrocytes were smaller than those in their own venous blood. Conversely, urinary red cells larger than venous blood were confined to patients with a non-glomerular source. Coulter analysis of urine provides a simple and objective aid to the diagnosis of haematuria.
Haematuria, whether overt or microscopic has a wide range of causes and patients may present to a variety of clinicians. This article describes the modern approach to the investigation of haematuria and emphasizes the importance of cooperation between physicians and surgeons.
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The pharmacokinetics of a single intravenous dose of cefotetan were studied in 17 volunteer patients with end-stage renal failure, requiring intermittent haemodialysis in 12 cases or undergoing continuous ambulatory peritoneal dialysis in 5 cases. Between haemodialysis the mean plasma elimination half life was 20.4 h (S.E.M. +/- 2.1). This decreased to 7.5 h (S.E.M. +/- 0.6) during haemodialysis. In patients treated by continuous ambulatory peritoneal dialysis the mean plasma elimination half life was 15.5 h (S.E.M. +/- 1.9). Small amounts of cefotetan (5-9% of the administered dose) were recovered in the peritoneal dialysates removed over the 24 h following the dose.
Intraperitoneal absorption of human insulin (crb) and porcine insulin was examined in 9 diabetic patients with renal failure, and on Continuous Ambulatory Peritoneal Dialysis (CAPD). Serial blood sampling was performed to determine the characteristics of insulin absorption and glycaemic control. Four patients received successive equal doses of human and porcine insulins, 2 received different doses and 3 received human insulin only. Glycaemic control was similar after both insulins. Mean insulin levels were consistently higher after human insulin with significant differences at 90, 300 and 360 min. It is concluded that, if required, patients may be transferred from i.p. purified porcine to i.p. human insulin without a change in insulin dose.
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