PubMed Health⌕ Search

Biomedical subjects

T Judd

Publications and source records attributed to T Judd.

7 recordsLinked to original sources

Improvement in catheter sepsis rate in burned children.

Routine frequent central venous catheter (CVC) changes in burned patients (either change in insertion site or change over guidewires) has been advocated to decrease catheter-related sepsis. The need for this management has not been verified for children with burns. We reviewed our pediatric burn population with regard to CVC sepsis rate and individual CVC longevity to confirm this traditional policy. From 1978 to 1988, 70 children admitted to the Children's Hospital of Oklahoma Burn Unit required central venous access. Patients in whom CVCs were changed frequently (FC), (n = 10; no. of CVC, 46) were compared with those in whom CVCs were changed only for mechanical complications or sepsis (NFC), (n = 60; no. of CVC, 74). There were 10 septic CVCs in each group. The difference in mean length of individual CVC use between FC and NFC was significant (4.6 v 17.7 days; P less than .01). The difference in the number of septic CVCs per total number of catheter days in each group was highly significant (FC: 10 CVC/212 d. = 0.05; NFC: 10 CVC/1,112 d = 0.009; P less than .001). This study demonstrates a significant decrease in catheter-related sepsis when CVCs are not changed on a routine frequent basis.

Bacterial Infections↗

Sources of difficulty in the solution of verbal arithmetic problems by mentally retarded and nonretarded individuals.

Effects of several logical (i.e., operation type and amount of extraneous information), memory (i.e., availability of memory aids and number of problem presentations), and semantic variables (i.e., problem text type) on verbal math problem-solving performance were assessed. Results revealed that the overall problem-solving performance of mildly mentally retarded adolescents was inferior to that of nonretarded fourth graders in spite of comparable performance on a computational screening test. Although the retarded individuals experienced particular difficulty with subtraction and static problem texts, the two groups responded similarly to the other experimental variables. The possibly important role of comprehension in problem-solving was discussed.

Adolescent↗

Alexia without agraphia in a composer.

A 77-year-old composer had a left occipital lobe haemorrhagic infarct giving a severe reading disturbance with well-preserved writing and without appreciable aphasia. He continued to read music and to compose. His text- and music-reading performance under different conditions suggests that this unusual dissociation was primarily due to four factors. (1) He was unusually talented musically and inferred a great deal about the music he was reading. (2) The symbols of staff music notation are more visually distinctive than the symbols of phonetic language writing systems. (3) In staff music notation, pitch is represented ordinally, and other symbols are also distinguishable by their relative positions and sizes. (4) Music notation can be usefully read by interpreting it acoustically, kinaesthetically or in terms of formal musical concepts; in contrast to written language, it need not be interpreted referentially or in terms of auditory-verbal images. His disorder fits the classic visual-verbal disconnection account of alexia without agraphia and the contemporary view that music involves a family of related but distinct skills probably involving many brain areas in both hemispheres, although different cortical areas make characteristic contributions to different musical behaviours.

Aged↗

Visual agnosia in an artist.

This report describes a 73 year old left-handed male artist who presented with agnosic symptoms following an occipital cerebral vascular accident. Against a background of a memory disturbance, but otherwise essentially intact linguistic and cognitive capacities, the patient was generally unable to identify single objects on visual presentation, and displayed marked difficulty in interpreting complex objects, depicted scenes, and partially occluded figures. The patient's preserved ability to recognize geometric forms, to perceive optical illusions, and to copy designs, and objects with considerable accuracy suggested the clinical picture of visual agnosia. An examination was undertaken of the effects of this recognition disorder on the artist's capacity to draw. Despite an inability to recognize an object or scene, the patient retained various techniques (perspective, shadowing, designation of texture) which allowed him to copy the display in a veridical fashion. When displays were recognized, or when the patient was given only the name of the object and asked to draw it, he adopted a less slavish approach, characteristic of his pre-morbid artwork. While his post-morbid drawings bore a strong similarity to his earlier works, such features as insufficient differentiation of figure from ground, over-elaboration of detail, and areas of neglect revealed the debilitating effects of the recognition disorder. Moreover, an examination of the patient's strategies revealed numerous compensatory verbal and motor procedures which guided his drawing. Acknowledgments. We wish to acknowledge Dr. Prather Palmer, J.R.'s neurologist, for his cooperation and for making available his very thorough examination notes. Thanks also to Dr. Kent Stevens for providing the stereograms, and to Dr. Frank Benson and Dr. Edgar Zurif for their helpful comments on the manuscript.

Aged↗