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Biomedical subjects

S Foreman

Publications and source records attributed to S Foreman.

At least 19 recordsLinked to original sources
PubMed2001

Children with organic growth hormone deficiency have elevated cortisol responses to stimuli.

The aim of this study was to investigate hypothalamic-pituitary-adrenal (HPA) function in children with GH deficiency. Ninety-four patients were evaluated for GH deficiency and cortisol (F) deficiency using clinical criteria and L-dopa and insulin-induced hypoglycemia stimulation tests. They were assigned to three diagnostic groups: organic GH deficient (OGHD), idiopathic GH deficient (IGHD), and not GH-deficient (NGHD). Time series, cross-sectional, regression analysis revealed statistically significantly elevated F [>828 nmol/L (30 microg/dL)] in the OGHD group vs. the NGHD group. The value for F in the IGHD group was not different from the NGHD group. This finding suggests that dysregulation of the HPA axis is present in most children with OGH deficiency and significantly less often in children with IGH deficiency or without GH deficiency. Anatomical disruption of the control pathways for the HPA axis or stress may cause the dysregulation.

Blood Glucose↗
PubMed2001

Concurrent validity of the Functional Independence Measure for Children (WeeFIM) and the Pediatric Evaluation of Disabilities Inventory in children with developmental disabilities and acquired brain injuries.

The Functional Independence Measure for Children (WeeFIM) and the Pediatric Evaluation of Disability Inventory (PEDI) are the most commonly used measures of functional performance in children. The purpose of this study was to determine the concurrent validity of the instruments when used with children with developmental disabilities and acquired brain injury. The subjects were 41 children, age 1.3 to 9.5 years, who were receiving inpatient or outpatient services at a pediatric rehabilitation unit in Brisbane, Australia. Spearman correlation coefficients between the two tests were greater than 0.88 for self care, transportation/locomotion, and communication/social function. The high correlations indicate that the two tests measure similar constructs. Choosing between the tests depends on situational requirements and depth of information required.

Brain Injuries↗
PubMed1999

Legal issues associated with sexual activity between adults and minors in Texas: a review.

Recent research on adolescent mothers and the age of their sexual partners has stimulated discussion of whether legal action should be taken against adult men who engage in sexual intercourse with minors. A nonrandom poll that started as casual questions but extended over 6 months to 52 doctors initiated this review. It became apparent that the primary care physicians (pediatrics, family medicine, and internal medicine) had little, if any, understanding of some key legal facts in Texas associated with adolescent sexuality and pregnancy, especially when adult partners are involved. This article provides a legislative overview for practitioners in an attempt to clarify the law, remediate any deficiency of knowledge, and remind physicians of their role in reporting sexual abuse of minors.

Adolescent↗
PubMed1994

Social responsibility and the academic medical center: building community-based systems for the nation's health.

Academic medical centers have fulfilled several of their missions with immense success but have failed to fulfill others. They have responded only modestly to the needs of the nation's underserved rural and urban communities. The author calls on academic medical centers to take an aggressively active role in building the medical infrastructure now missing in these communities and outlines a multi-part agenda for institutional commitment. It includes developing community-based systems of primary care, outreach programs, and social supports; training professionals committed to serving isolated and poor communities; and performing research that will extend the knowledge base to include the health and social issues of the disadvantaged. (Examples are given of institutions that have pioneered these kinds of community-based activities.) To build the new infrastructure, financing must be secured (various sources are discussed), a community-based faculty must be developed, and each institution's leadership--the medical school dean, the hospital executive, and the department chairmen--must come together around a new agenda and support it materially and psychologically, making whatever changes are needed in the corporate culture. The author warns that if centers do not undertake this responsibility for the health of the underserved, a critical job will go undone, a huge opportunity will have been missed, and American society will be the poorer.

Academic Medical Centers↗
PubMed1994

Recurrent benign intracranial hypertension due to iron deficiency anemia. Case report and review of the literature.

PURPOSE: Iron deficiency anemia (IDA) causes benign intracranial hypertension (BIH). PATIENTS AND METHODS: A case of an 11-year-old girl with severe IDA and benign intracranial hypertension is presented. RESULTS: Treatment of iron deficiency resulted in the resolution of BIH. Recurrence of BIH is observed with the recurrence of IDA. Chronic intermittent blood loss from the intestinal polyps was the etiology of recurrent IDA. CONCLUSIONS: A thorough search to determine the etiology of IDA is essential for proper treatment. Although BIH is a rare complication of IDA, its association with IDA should be recognized for prompt treatment before an extensive and costly workup for BIH is done.

Adolescent↗
PubMed1992

Rehabilitative management of injuries to the hand.

Athletic participation after injury may resume when cleared by a physician familiar with hand injuries. It is the role of the athletic trainer or therapist to implement appropriate rehabilitative measures and apply a protective device to lessen the chance of re-injury or delayed healing. The trainer must also educate coaches, athletes, and parents that hand and finger injuries are not inconsequential. Without proper diagnosis and treatment, there may be future pain, disability, and deformity.

Hand Injuries↗
PubMed1990

Graduate medical education: focus for change.

The author documents a significant broadening of the interest of both state and federal government in influencing graduate medical education. He states that the unwillingness of the academic medical community to address the issues of manpower supply and specialty distribution, the limited effectiveness of minority enhancement programs, and an ambiguous position on foreign medical graduates have invited government intervention. The author maintains that such intervention was inevitable because academic medical centers have focused only on the educational process and the quality of graduates but have not dealt with the need to shape the output of their training programs to meet national health needs. He challenges the academic medical community to seize the initiative in seeking the difficult-to-find solutions to major issues of medical training or be prepared to yield to the decisions of lawmakers and regulators.

Academic Medical Centers↗
PubMed1986

The changing medical care system: some implications for medical education.

In summary, the medical care system is undergoing the most widespread and significant changes in a generation. Individual hospitals, the basic delivery units of the past, may fast be disappearing as mergers, acquisitions, and a variety of multi-institutional arrangements become the dominant form and as a host of free-standing medical enterprises spread out into the community. Fee-for-service medicine and cost-based hospital reimbursement, each with its service-maximizing incentives, are being replaced--the former by prepaid capitation systems and the latter by discount pricing and all-inclusive admission charges. The hospital, until now a "farmer's market" of diverse programs and activities serving a broad patient population, increasingly has become a provider of intensive services to a narrowing and more ill patient base. The major teaching hospital, formerly a complete educational resource within itself, may soon become simply one of a number of educational settings, all of which are equally essential for providing a total medical education. Finally, after years of change driven by biomedical discoveries and centered in the academic medical centers, there is a new locus of innovation within the delivery system itself, and those in the forefront are not academicians. It is important, therefore, that just as in the past, when the academic medical center took the lead in bringing to the delivery system what it was learning in its laboratories, it must now take what is being learned in the marketplace and bring it back into the classroom.

Ambulatory Care↗
PubMed1984

Kaposi's sarcoma associated with hairy cell leukemia, immune thrombocytopenia, and opportunistic infection.

A 73-year-old man developed Kaposi's sarcoma 6 years after the diagnosis of hairy-cell leukemia, at which time a splenectomy was performed. He received no additional treatment. The Kaposi's sarcoma was complicated by the development of immune thrombocytopenia and Listeria monocytogenes meningitis. Evaluation during the course of his disease revealed lymphopenia, decreased OKT4 + subset, and increased OKT8 + subset. The clinical and immunologic findings in this patient have similarities to the acquired immunodeficiency syndrome.

Aged↗
PubMed1977

Cryopreservation of mouse peritoneal macrophages.

A method for the preservation of mouse peritoneal macrophages is described. Using 5% dimethylsulphoxide with either a cooling rate of 1 degree C/min or two-step cooling with 10 min interruption at -30 degrres C allows 80% survival as judged by pinocytic activity. An important finding was that the cells must be handled at 0 degrees C both before and after freezing.

Animals↗