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Biomedical subjects

S Whitman

Publications and source records attributed to S Whitman.

At least 37 records · Page 2Linked to original sources
PubMed1988

The neurological, psychosocial and demographic correlates of hypergraphia in patients with epilepsy.

The multiaetiological determinants and correlates of interictal hypergraphia in patients with epilepsy were studied. A variety of neurological, psychosocial and demographic variables were examined in order to determine their relationship to experimental and clinically derived measures of hypergraphia in a sample of 50 patients with epilepsy. The results indicate that hypergraphia is of multifactorial origin in general, with especially strong relationships with measures of psychopathology. These results are related to the larger literature concerned with interictal behavioural change in patients with epilepsy.

Adult↗
PubMed1988

Ideology and violence prevention.

Interpersonal violence is a major problem in US society in terms of the death and destruction it causes, the fear it generates, and the attention it receives. A recent trend has been to regard the problem of violence as an epidemic and to shape ideas of violence prevention according to public-health formulations. This process does not take into account the ideological nature of the proposed violence-prevention measures. Problems arise because this ideology is relevant to the potential effectiveness of violence prevention.This paper delineates several ideological issues involved in violence prevention and discusses how they interact with frequently employed public-health prevention strategies. Based upon this discussion, a general perspective for violence prevention is proposed and guiding principles that emerge from this perspective are presented.

Adult↗
PubMed1986

Transfers to a public hospital. A prospective study of 467 patients.

In recent years there has been a dramatic increase in the number of patients transferred to public hospitals in the United States. We prospectively studied 467 medical and surgical patients who were transferred from the emergency departments of other hospitals in the Chicago area to Cook County Hospital and subsequently admitted. Eighty-nine percent of the transferred patients were black or Hispanic, and 81 percent were unemployed. Most (87 percent) were transferred because they lacked adequate medical insurance. Only 6 percent of the patients had given written informed consent for transfer. Twenty-two percent required admission to an intensive care unit, usually within 24 hours of arrival. Twenty-four percent were in an unstable clinical condition at the transferring hospital. The proportion of transferred medical-service patients who died was 9.4 percent, which was significantly higher than the proportion of medical-service patients who were not transferred (3.8 percent, P less than 0.01). There was no significant difference in the proportion of deaths on the surgical service between patients who were transferred and those who were not (1.5 vs. 2.4 percent). We conclude that patients are transferred to public hospitals predominantly for economic reasons, in spite of the fact that many of them are in an unstable condition at the time of transfer.

Adult↗
PubMed1986

Stereomicroangiography in embryologic and teratologic investigation.

Vascular dysmorphogenesis is usually investigated by invasive microdissection or time-consuming reconstruction of serial sections. Stereomicroangiography (SMA) was used for detection and analysis of vascular abnormalities in a murine trisomy 13 model demonstrating pulmonary atresia. Twenty-two litters from doubly heterozygous Robertsonian translocation Rb(6.13)3Rma/Rb(5.13)70Lub male matings to NMRI females were studied. Embryos (13-17 days gestation) were prepared by umbilical vein perfusion with buffered fixative and umbilical artery perfusion with 5% AgNO3. After immersion fixation specimens were infiltrated with paraffin, mounted on stubs, and stereoradiographed at multiple angles. Transverse serial sections were prepared of the thoracic area. Thoracic vascular morphology was satisfactorily imaged and trisomy 13 embryos were correctly distinguished from normals in 105 of 120 embryos (87.5%). When independent SMA and histologic interpretations were compared anomalous vasculature was correctly identified in all 27 trisomic embryos and one control, and falsely interpreted in one normal embryo. Normal vascular morphology was demonstrated in the remaining 76 normal embryos. Separate SEM evaluation of five microdissected hearts from nontrisomic embryos following this perfusion schedule showed normal distension of the ventricular cavity and metallic silver deposition on the surface and at junctions of endocardial cells. Light microscopy revealed silver staining at the endothelial surface and within the endocardial cushions. SMA accurately records embryonic vascular morphology for rapid screening of viable embryos.

Angiography↗
PubMed1985

Ideology and injury prevention.

Data from a recently completed study of head injuries reveal that many of these injuries, and deaths from these injuries, result from interpersonal violence and automobile accidents. Such injuries are normally difficult to prevent. In this study it was found that much of the interpersonal violence involves family members and many of the vehicle accidents, especially those that result in death, happen to pedestrians. Prevention thus becomes even more difficult. Based upon these data and observations, five categories of prevention strategies are generated and evaluated. It is determined that the four strategies usually within the domain of traditional prevention (inaction, education, legislation, and design alterations) are not likely to prevent many head injuries or injuries in general. A fifth category is thus recommended. This category requires meaningful involvement of people into work that impacts on the social and political reality of their lives. The prevailing ideology of prevention offered by the health professions is considered and is found to be in opposition to our fifth prevention category. The implications of this opposition are examined and the search for improved health is considered in this context.

Craniocerebral Trauma↗
PubMed1984

Comparative head trauma experiences in two socioeconomically different Chicago-area communities: a population study.

Although a few epidemiologic studies of head injuries have appeared recently, none have examined the incidence, causes and risk factors for an inner city environment. To overcome this deficiency, the authors visited 35 hospitals and the Office of the Medical Examiner and abstracted data from every chart that described a head injury that had been sustained during a 12-month interval by residents of either of two Chicago-area communities: one located in the inner city, comprised almost entirely of blacks; the other the city of Evanston, a Chicago suburb, about 21% black and 75% white. Denominators came from the 1980 Census. Age-adjusted incidence rates, per 100,000 population, were 403 for the inner city community, 394 for Evanston blacks and 196 for Evanston whites. In each race-community category, males were about 2.5 times more likely than females to sustain a head injury. Mortality rates from head trauma were 32 for the inner city community, 19 for Evanston blacks and 11 for Evanston whites. The leading cause of head trauma and death from head trauma was interpersonal attacks for the inner city residents and vehicle accidents for Evanston residents. Community differences, revealed in this study, and in a comparison of this study with previous reports, are discussed. Finally, methodological differences among these studies are examined in an effort to determine which differences in results reflect actual differences in head trauma experience.

Accidents, Traffic↗
PubMed1984

Epilepsy in prison: elevated prevalence and no relationship to violence.

The epidemiologic, clinical, and social characteristics of epilepsy were investigated in men entering the Illinois prison system and compared with a matched control group of prisoners without epilepsy. The prevalence of epilepsy was 2.4%, four times higher than the prevalence among men aged 20 to 39 in Rochester, MN. Head trauma was the probable cause of epilepsy among 45% of the prisoners with epilepsy, a much higher percentage than that reported in studies of other populations. In comparison with an age- and race-matched group of prisoners without epilepsy, the epilepsy group was not convicted of more serious or more violent crimes.

Adolescent↗
PubMed1984

Sequelae associated with head injuries in patients who were not hospitalized: a follow-up survey.

Data about sequelae associated with head injuries in patients presenting at a suburban hospital but not hospitalized were collected from emergency department medical records and two follow-up telephone interviews. During the study period 669 patients with head injuries were discharged from the emergency department. Of these, 288 were asked to participate in the study, 275 (95%) agreed, and 262 (91%) were eventually contacted. Participants and nonparticipants were compared on six variables and differed significantly only on age--younger patients were more likely to be included. Forty-eight hours after trauma, 52% of the respondents suffered headaches, 14% complained of dizziness, and 13% complained of drowsiness. One week after trauma, the complaints were headaches in 27%, dizziness in 11%, and drowsiness in 9%. Twenty-seven per cent had not resumed normal activity at 48 hours after trauma, and 13% had not at 1 week. Sixty-six per cent of the patients followed the patient instructions regarding head injuries.

Adolescent↗
PubMed1984

Psychopathology in epilepsy: how great is the risk?

The relationship between epilepsy and psychiatric disorder in general and the relationship between epilepsy and psychosis in particular remain controversial issues of long standing. In order to reexamine these central issues concerned with epilepsy/psychopathology relationships, we utilized a Minnesota Multiphasic Personality Inventory (MMPI) sequential diagnostic system to reanalyze 87 published MMPI profiles of patients with epilepsy, other neurological disorders, and chronic physical illnesses encompassing a total of 2786 patients. We found that overall rates of psychopathology were not increased in epilepsy. However, when psychopathology was present, the level of psychosis was greatest in patients with epilepsy. The results are related to the larger literature concerned with the relationship between epilepsy and psychopathology.

Brain Damage, Chronic↗
PubMed1983

Seizures in relation to head injury.

Seizures have a two-fold relationship with head injury: they can cause a head injury, or they can be the result of a head injury. We compare these two groups in terms of cause, severity, likelihood of sequelae, outcome, radiological investigation, and surgical intervention. Of 702 patients admitted with a head injury to Cook County Hospital (CCH), 25 patients (3.6%) had seizures causing a head injury (Group 1). Another 29 patients (4.1%) experienced a head injury which caused a seizure (Group 2). The remaining 648 patients (Group 3) had no seizure involvement in relation to their injury. Group 1 and Group 3 were similar in terms of severity and sequelae. Group 2, in which a statistically significant increase in both was noted, was dramatically different. It thus appears that seizures indicate increased severity and sequelae in a head injury only when they result from that injury, and not when they cause it. The emergency physician must thus be prepared to distinguish these two situations, for patients in Group 2 have an increased need for neuroradiologic procedures and neurosurgical intervention.

Craniocerebral Trauma↗
PubMed1983

Seizures and civilian head injuries.

Although several studies have reported on the risk of "early seizures" (seizures occurring within 7 days following a head injury), the reported proportions of patients experiencing these seizures vary from 1.4 to 15%. This wide divergence may be due to problems with methodology such as case selection and definitions of head injury and early seizures. In a series of 702 patients admitted with a head injury to Cook County Hospital (CCH), Chicago, Illinois, 29 (4.1%) had early seizures. This proportion is twice as high as one previously reported in a comparable series. This may reflect an actual difference between the two series or a case selection bias serving to elevate the proportion of patients with early seizures at CCH.

Adolescent↗
PubMed1983

Hypergraphia in epilepsy: is there a specificity to temporal lobe epilepsy?

The purpose of this investigation was to determine the specificity of hypergraphia to temporal lobe epilepsy using the paradigm developed by Sachdev and Waxman (1981). One hundred and thirty-eight patients were sent a standard stimulus letter and the response rates were examined for the patient groups with temporal lobe epilepsy (N = 80), and without (N = 31), and mixed seizure types (N = 13). For those patients who responded, additional analyses involved the number of words per response and the presence/absence of any qualitative indices of the postulated interictal behavioural syndrome of temporal lobe epilepsy. The results were interpreted in the light of the contemporary definitions of hypergraphia and were related to the larger literature concerned with personality and behavioural change in temporal lobe epilepsy.

Adult↗
PubMed1983

Urban head injury: a clinical series.

Consecutive head-injured patients admitted to Cook County Hospital in Chicago, Illinois, over a 12-month period were examined upon admission and discharge. Information was collected about the nature of the injury, symptoms, signs, and sequelae for 702 patients. Detailed descriptions of the causes of these injuries, and their correlates, were also obtained.Approximately 80 percent of the patients had localized pain, loss of consciousness and/or posttraumatic amnesia, and associated injuries; 16 percent had a skull fracture, 7.0 percent had an intracranial hematoma, 4.1 percent had early seizures, and 2.4 percent died.Skull x-ray examinations were performed on 93.4 percent of the patients (16.9 percent were positive) and radiographic examination of the cervical spine was performed on 67.2 percent (1.7 percent were positive). Utilization of EEGs, computerized tomography scans, and arteriograms was also assessed.Falls were the leading cause of injury (45.8 percent) for patients under 16 years of age and interpersonal injuries accounted for the majority (55.7 percent) of the injuries to adults. About 15 percent of the adults sustained severe or fatal injuries, compared with only 7 percent of the children.It is concluded that although this set of data suggests new considerations for the prevention of head injuries, the lack of comparative data about the medical correlates of these injuries inhibits similar observations about medical care.

Adolescent↗
PubMed1982

Psychopathology and seizure type in children with epilepsy.

Previous investigations have reported an increased rate of behavioural disorder in children with epilepsy. The role, if any, played by temporal lobe epilepsy (TLE) in predisposing to psychopathology is unclear. In order to evaluate the relationship between seizure type and psychopathology, 35 children with TLE were compared with 48 children with primary generalized epilepsies (GE) on standardized measures of social competence, aggression and overall behavioural disorder via analyses of covariance. Additionally, Pearson correlations were computed in order to evaluate the relationships between psychopathology and several seizure and subject variables. It was found that the presence of TLE per se bore no relationship to aggression, social competence or overall behavioural disorder. Some specific subject- and seizure-related variables were found to be associated with increased aggression and behavioural dysfunction in children with TLE and the interpretation of these findings are related to the larger epilepsy/psychopathology literature. Finally, an alternative approach for studying the precursors of behavioural disorder in epilepsy is suggested.

Adolescent↗