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Biomedical subjects

T Ferguson

Publications and source records attributed to T Ferguson.

At least 73 records · Page 4Linked to original sources
PubMed1997

Health online and the empowered medical consumer.

BACKGROUND: Lay health care consumers' emergence as active participants in online health care networks is a powerful new technological pattern that promises to take the American health care system through all stages of cultural adaptation--substitution, innovation, and transformation. Soon everyone will recognize the fundamental changes online health has produced in the way we think and act about health care. A NEW ACADEMIC SUBSPECIALTY: A new subspecialty--consumer health informatics (CHI)--is covering two domains: (1) community CHI resources--the online networks, forums, databases, and World Wide Web sites that anyone with a home computer can access, and (2) clinical CHI resources--programs or systems developed by clinicians, system developers, or health maintenance organizations and provided to selected membership groups or patients. EXHIBITS: Sample communications among online self-helpers within their chat groups, e-mail exchanges, bulletin boards, and USENET newsgroups for chosen health topics show what is on their mind, how they get information, how they use it, and how they correct it. Sometimes, clinicians have observed, lay care offers higher quality than professional care. Lay self-helpers, such as the originator of the Brain Tumor Mailing List, have observed several potential benefits in linking online self-helpers and providers and at a very modest cost. FUTURE DIRECTIONS: In a coming six-level system of information-age health care, patient-consumers may seek what they need in the following order: individual self-care, family and friends, informal self-help networks, the professional as coach, the professional as partner, and the professional as authority.

Adult↗
PubMed1997

Covert poisoning with difenacoum: clinical and toxicological observations.

1. The coumarin anticoagulant difenacoum was detected by high performance liquid chromatography (HPLC) with multi-wavelength UV detection in plasma from a 41 years old man who presented with a severe deficiency of vitamin K-dependent clotting factors of unknown aetiology. A longitudinal toxicological study of the consequent coagulopathy is described. 2. Plasma concentrations of difenacoum declined from 0.97 to 0.11 mgl-1 in 47 days with a terminal half life of 11.7 days. Rifampacin (300 mg bd) had no apparent effect on the terminal half life of the drug. Subsequently plasma concentrations of difenacoum and descarboxyprothrombin (DCP) unexpectedly increased. 3. Seven months after exposure clotting times were prolonged. The patient continued to have episodes of epistaxis, haematoma, purpurae and bruising and he required frequent treatment with Fresh Frozen Plasma in additional to oral phylloquinone (200 mg day-1). 4. Intermittent and unexpected increases in plasma concentrations of difenacoum and descarboxypro-thrombin suggested that covert, repeated ingestion of the anticoagulant was the most likely cause of the poisoning. The measurement of low concentrations of plasma phylloquinone except following supervised ingestion of the vitamin indicated that as an outpatient, the subject was not compliant with treatment despite his protestations to the contrary. He continued to deny this even when confronted by laboratory findings and at no time did he ever admit to self-poisoning.

4-Hydroxycoumarins↗
PubMed1995

Cortisol excretion in essential hypertension.

A number of factors suggest that abnormalities of the adrenal cortex are present in essential hypertension. To determine whether altered cortisol excretion exists in essential hypertension, we have measured urinary free cortisol and cortisol to creatinine ratios in early morning urine specimens for 14 consecutive days. We have established a reference range for these parameters in 26 normotensive subjects. We have also compared these values in nine normotensive subjects and nine patients with essential hypertension closely matched for age, sex and body mass index. In the 26 normotensive subjects, urinary free cortisol was 240 +/- 13 nmol/l (mean +/- s.e.m) and cortisol to creatinine ratio was 22 +/- l. In the nine hypertensive subjects, urinary free cortisol was 238 +/- 48 nmol/l and cortisol to creatinine ratio was 20 +/- 3. We have not demonstrated an abnormality of cortisol excretion in essential hypertension.

Adult↗
PubMed1991

Hydronephrosis of pregnancy.

During pregnancy, up to 90 percent of women have some degree of asymptomatic dilatation of the renal calyces, the renal pelves and the upper two-thirds of the ureters. Such changes occur in the face of increased renal blood flow and are well tolerated. However, the dilatation may be responsible for the increased propensity of asymptomatic bacteriuria to progress to symptomatic infection during pregnancy. Pathologic hydronephrosis manifested by acute pain, refractory urosepsis or even renal failure has been reported. A case of spontaneous extravasation of urine in a 19-year-old primigravida during the 28th week of gestation is reported. The ureteral obstruction in this patient required percutaneous nephrostomy drainage until delivery of the fetus.

Adult↗