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Biomedical subjects

R House

Publications and source records attributed to R House.

At least 19 recordsLinked to original sources
PubMed2004

Rounded atelectasis in an asbestos exposed worker.

The case history is presented of a 51-year-old electrical power worker with a history of asbestos exposure presenting with rounded atelectasis. No other radiological markers of asbestos exposure were present. A documented history of asbestos exposure and exclusion of other causes of rounded atelectasis led to the diagnosis of asbestos related rounded atelectasis. It is important to understand that rounded atelectasis can be an isolated finding due to asbestos exposure. This facilitates investigation of lung masses of unknown etiology and initiation of appropriate follow up of patients at risk for future development of more debilitating asbestos related pathology.

Asbestos↗
PubMed2001

Hand-arm vibration syndrome from exposure to high-pressure hoses.

Hand-arm vibration syndrome has been reported in the literature to occur following exposure to vibration from the use of many tools, but to date there have been no case reports of its occurrence in workers who have used high-pressure hoses, alone or with other tools. To remedy this, the case histories of nine subjects (two without mixed exposure) examined in the UK and Canada are presented, together with their severity classified according to the Stockholm scales. Attention is drawn to the need to use multiple diagnostic tests to establish the diagnosis and the need to implement vibration isolation and damping methodologies, as and when feasible, with respect to hose nozzles in order to minimize the hazard. The ultimate goal for tool manufacturers, hygienists and engineers should be to reduce workplace vibration levels to meet national and international guidelines and legislation, including UK Health & Safety Executive guidelines and European Economic Community directives. The respective risk levels are presented, together with vibration measurements on hoses used by some of the cases.

Canada↗
PubMed2000

Sentinel lymph node biopsy is accurate after neoadjuvant chemotherapy for breast cancer.

PURPOSE: Sentinel lymph node (SLN) biopsy has proved to be an accurate method for detecting nodal micrometastases in previously untreated patients with early-stage breast cancer. We investigated the accuracy of this technique for patients with more advanced breast cancer after neoadjuvant chemotherapy. PATIENTS AND METHODS: Patients with stage II or III breast cancer who had undergone doxorubicin-based neoadjuvant chemotherapy before breast surgery were eligible. Intraoperative lymphatic mapping was performed with peritumoral injections of blue dye alone or in combination with technetium-labeled sulfur colloid. All patients were offered axillary lymph node dissection. Negative sentinel and axillary nodes were subjected to additional processing with serial step sectioning and immunohistochemical staining with an anticytokeratin antibody to detect micrometastases. RESULTS: Fifty-one patients underwent SLN biopsy after neoadjuvant chemotherapy from 1994 to 1999. The SLN identification rate improved from 64.7% to 94.1%. Twenty-two (51.2%) of the 43 successfully mapped patients had positive SLNs, and in 10 of those 22 patients (45.5%), the SLN was the only positive node. Three patients had false-negative SLN biopsy; that is, the sentinel node was negative, but at least one nonsentinel node contained metastases. Additional processing revealed occult micrometastases in four patients (three in sentinel nodes and one in a nonsentinel node). CONCLUSION: SLN biopsy is accurate after neoadjuvant chemotherapy. The SLN identification improved with experience. False-negative findings occurred at a low rate throughout the series. This technique is a potential way to guide the axillary treatment of patients who are clinically node negative after neoadjuvant chemotherapy.

Adult↗
PubMed2000

A pilot study of the relationship between problem-solving skills and outcome in major depressive disorder.

Three methods of assessing problem-solving skills are described in the literature: questionnaires, self-report inventories and verbal assessment of the resolution of problem scenarios. These three approaches were used to assess problem-solving ability in a sample of 20 patients with unipolar major depressive disorder, who were treated with antidepressant medication alone at a hospital out-patient clinic. It was found that baseline deficits in problem-solving skills were significantly associated with prognosis at 3- and 6-month follow-up. Self-ratings of perceived self-control and confidence rather than subjective problem-solving effectiveness were important predictors of final outcome. Differences in perceived and actual problem-solving ability emerged over time. The reasons for these differences in subjective and observer assessments are unclear. The data appear to demonstrate that problem-solving deficits in depression represent both state and trait phenomena.

Adolescent↗
PubMed1999

Agriculture sector resource and environmental policy analysis: an economic and biophysical approach.

Agricultural pollution of the environment is jointly determined by economic decisions driving land use, production practices, and stochastic biophysical processes associated with agricultural production, land and climate characteristics. It follows that environmental and economic statistics, traditionally collected independently of each other, offer little insight into non-point pollutant loadings. We argue that effective policy development would be facilitated by integrating environmental and economic data gathering, combined with simulation modelling linking economic and biophysical components. Integrated data collection links economics, land use, production methods and environmental loadings. An integrated economic/biophysical modelling framework facilitates policy analysis because monetary incentives to reduce pollution can be evaluated in the context of market costs and returns that influence land use and production activity. This allows prediction of environmental and economic outcomes from alternative policies to solve environmental problems. We highlight steps taken to merge economic and biophysical modelling for policy analysis within the Economic Research Service of the United States Department of Agriculture. An example analysis of a policy to reduce agricultural nitrogen pollution is presented, with the economic and environmental results illustrating the value of linked economic and biophysical analysis.

Agriculture↗
PubMed1997

Individual risk factors for early repetition of deliberate self-harm.

This study investigated individual factors associated with repetition of deliberate self-harm (DSH) within three months of a first-ever episode. Individuals from an 'at risk' population who repeated DSH (N = 25) were compared with a socio-demographically matched group of 'at risk' individuals who did not engage in a further episode of DSH (N = 18). In comparison with the 'single DSH' individuals, those in the 'repeated DSH' group demonstrated significantly higher levels of depression and hopelessness, were significantly less skilled at problem solving, were significantly less likely to report the availability of a confidante and significantly more likely to identify that the reason for their DSH was to communicate their desperation. The implications of these findings for risk assessment and interventions are noted.

Adaptation, Psychological↗
PubMed1996

Basal and stimulated secretion of cytokines by peritoneal macrophages in women with endometriosis.

OBJECTIVE: To evaluate basal (constitutive) and stimulated synthesis of tumor necrosis factor alpha (TNF alpha), interleukin (IL)-8, IL-10 by peritoneal macrophages (PM) in women with endometriosis. DESIGN: Peritoneal macrophages were cultured in the presence or absence of lipopolysaccharide (LPS) for 24 hours. Peritoneal fluids (PF) and PM supernatants were assayed for cytokines using ELISA. SETTING: Institute for the Study and Treatment of Endometriosis and university-based research laboratories. SUBJECTS: Fertile controls undergoing tubal ligation (n = 8) and women with endometriosis (n = 17). INTERVENTION: Peritoneal fluid samples were obtained at the time of diagnostic laparoscopy (endometriosis group) or laparoscopy for tubal ligation; both were performed in the midluteal phase of the cycle. RESULTS: Both basal and LPS stimulated production of TNF alpha, IL-8, and IL-10 by the PM were elevated significantly in women with endometriosis as compared with the fertile controls. CONCLUSIONS: This study demonstrated that cytokines TNF alpha, IL-8, and IL-10 are synthesized at greater than normal levels by basal and stimulated PM from women with endometriosis. The levels of TNF alpha and IL-8 correlated with the levels in the PF, suggesting that PM are the principal source of these cytokines in the PF.

Ascitic Fluid↗
PubMed1996

Spontaneous and induced synthesis of cytokines by peripheral blood monocytes in patients with endometriosis.

OBJECTIVE: To investigate the capacity of peripheral blood monocytes (PBM) from women with endometriosis to secrete tumor necrosis factor-alpha (TNF-alpha), interleukin (IL) IL-6, IL-8, and IL-10. DESIGN: Peripheral blood monocytes were cultured in the presence and absence of lipopolysaccharide for 24 hours before assessment of cytokines in supernatants by enzyme immunoassay. SETTING: Institute for the Study and Treatment of Endometriosis and university-based research laboratories. PATIENTS AND PARTICIPANTS: Fertile controls, n - 10; women with endometriosis, n = 20. INTERVENTIONS: None. RESULTS: Basal synthesis of TNF-alpha, IL-6, and IL-8 and the lipopolysaccharide-stimulated synthesis of TNF-alpha by PBM from women with endometriosis was significantly greater in comparison to that of fertile controls. Endometriosis had no effect on the basal or stimulated synthesis of IL-10. CONCLUSIONS: These data show that endometriosis is associated with increased basal and stimulated synthesis and secretion of several different cytokines by PBM. Each of the cytokines found to be affected has the capacity to play a role in the symptomatology or pathogenesis of the disease.

Cytokines↗
PubMed1991

Coronary artery bypass grafting within thirty days of acute myocardial infarction. Early and late results in 406 patients.

Between 1981 and 1987, 1726 coronary artery bypass operations were performed by a single group of surgeons at a community hospital. Overall hospital mortality in this group was 2.4% (41/1726). Of these patients 406 were operated on within 30 days of an acute myocardial infarction. The hospital mortality rate in this group was 6.7% (27/406) versus 1.1% (14/1320) in patients operated on without evidence of recent acute myocardial infarction (p less than 0.0001). In these 406 patients, sex, location of acute myocardial infarction, type of infarction, coronary anatomy, presence of postinfarction angina, technique of myocardial preservation, and the time from infarction to operation were not associated with hospital mortality. Univariate and multivariate analyses showed that three factors were significantly associated with increased hospital death: poor ejection fraction, less than 30% (p less than 0.0001), preoperative shock (p = 0.0005), and age greater than 70 years (p = 0.004). Follow-up was 90% complete (365/406 patients) at a mean time of 35 +/- 21 months. Of these patients 80% (292/365) were in New York Heart Association functional class I, and 10% (36/365) were in functional class II. Of all patients 88% were alive at 3 years, and 84% were alive at 5 years after operation. Multivariate comparison of survival curves showed that ejection fraction less than 30% was associated with decreased survival (p = 0.0002), followed by age (p = 0.0009). Patients younger than 70 years with an ejection fraction greater than 30% and not in cardiogenic shock can be operated on at any time after acute myocardial infarction without increased risk. Long-term survival and freedom from symptoms can be expected in these patients.

Adult↗
PubMed1985

Subependymal germinal matrix hemorrhage in full-term neonates.

A population of healthy, full-term newborn infants was studied in order to obtain documentation of the prevalence of intracranial hemorrhage. Cerebral ultrasonography was performed within 72 hours of birth on 505 healthy newborn infants, 37 weeks of gestation or greater. Sonographic abnormalities were detected in 23 (4.6%) neonates. Bilateral subependymal germinal matrix hemorrhage occurred in 14 and unilateral hemorrhage in five infants. Other abnormalities detected included agenesis of the corpus callosum in two infants, a cyst involving the subependymal germinal matrix in one (presumably the result of a previous subependymal hemorrhage), and mild ventricular dilation of unknown etiology in one. Newborns with subependymal hemorrhage were compared with newborns without hemorrhage in order to determine whether any significant differences existed between the two populations. No significant differences existed between infants with and without subependymal hemorrhage with regard to gender, obstetrical presentation, use of forceps, birth trauma, Apgar scores, need for resuscitation, maternal age and parity, and neonatal clinical problems. Infants with subependymal hemorrhage were of significantly lower gestational age and birth weight; the overall difference in weight was attributable to lower weight in female infants with subependymal hemorrhage. Significantly more infants with subependymal hemorrhage were small for gestational age, vaginally delivered, and black.

Birth Weight↗
PubMed1983

Psychiatric aspects of hepatic transplantation.

We conducted formal psychiatric evaluations and extensive chart reviews in a series of 34 patients surviving an average of 5 1/4 years after hepatic transplantation. Seven of 14 children and 19 of 20 adults exhibited obvious psychiatric disturbances before the operation. (There was not time to evaluate another 5 children and a sixth was an infant; one adult arrived in hepatic coma.) All patients experienced psychiatric problems postoperatively. Organic brain syndromes and apprehensiveness were the most common preoperative problems in pediatric patients, and problems in relationships with family members, anxiety, regression, and helplessness were most common after surgery. In adults, organic brain syndromes, anxiety, and depression were the most common preoperative and postoperative problems. While psychosocial disturbances in liver transplant recipients were similar in many respects to those of the more well-studied kidney homograft patients, a number of important differences emerged: organic brain syndromes, fear of death, severe regression (psychological functioning appropriate to a younger age), worries that a suitable donor would not be found in time, and insomnia were more common, and concerns about the origin of the homograft and about changes in body image were relatively rare postoperatively. These differences seem to be related to the severity of liver disease requiring transplantation, the effects of the illness on the brain, the lack of an alternative means of life support resulting in greater prominence of concerns about survival, the exclusive use of cadaver rather than living donors, and the greater effect of the illness than of its treatment on physical appearance.

Adolescent↗