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Transcutaneous Bilirubinometry In Pakistani Newborns: A Preliminary Report, Z A. Bhutta, K Yusuf

Department of Paediatrics and Child Health

Neonatal hyperbilirubinemia is a frequently encountered problem in the neonatal period and carries a potential risk of encephalopathy. Early detection and quantification is important, and transcutaneous bilirubinometry (TcB) has been recommended as a non-invasive method for rapid screening. We prospectively compared the efficacy of TcB in 65 normal Pakistani jaundiced newborns undergoing simultaneous serum bilirubin measurements. Although the correlation between the two methods was significant (r = 0.66, P less than 0.01), the scatter was wide and the specificity only 53%. Although the technique offers the potential for non-invasive early screening of neonatal hyperbilirubinemia, it requires further validation in a …

Department Of Radiology-Annual Report-July 1, 1990 To June 30, 1991, David C. Levin

Department of Radiology Administrative Documents and Reports

Department of Radiology Annual Report, July 1, 1990 to June 30, 1991. Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States. 84 pages.

Predicting Survival In The Advanced Cancer Patient, Robert J. Miller

Henry Ford Hospital Medical Journal

No abstract provided.

Caring For The Terminally Ill: Communicating With Patients And Family, Dana G. Cable

Henry Ford Hospital Medical Journal

Caring for terminally ill patients requires effective communication skills. It is important that medical personnel understand appropriate ways to communicate with the patient in order to inform him about his illness, throughout its duration. Physicians must develop an understanding of how patients communicate and ways to respond to that communication. Furthermore, the physician needs to communicate with the family of the terminally ill patient. Effective communication must become a regular part of the treatment.

Assessment Of Methylprednisolone Purging Efficacy On Daudi Burkitt Lymphoma Cells From Normal Bone Marrow, Nalini Janakiraman, Loreen M. Niewenhuis

Henry Ford Hospital Medical Journal

Studies on normal bone marrow and Daudi Burkitt lymphoma cells were performed to determine the efficacy of selective, in vitro chemopurging with methylprednisolone (MP). We found that MP reduces the numher of lymphoma cells without significant damage to bone marrow cells. This information is important because we need to improve the existing in vitro purging regimens used to cleanse autologous marrows of metastatic disease before transplantation into cancer patients who have received high-dose chemotherapy. Normal human bone marrow (NBM) and Daudi lymphoma cells were trealed in parallel with various purging regimens. NBM death was evaluated using soft-agar culture, while Daudi …

Peripheral Blood Stem Cell Transplantation As An Alternative To Bone Marrow Transplantation: An Overview, Nalini Janakiraman

Henry Ford Hospital Medical Journal

Stem cells capable of restoring hematopoiesis following lethal bone marrow injury circulate in the blood of many animals, including humans. When collected through leukapheresis and reinfused following high-dose chemotherapy, stem cells offer a treatment option not currently open to some patients who are unable to undergo autologous bone marrow transplantation because of tumor involvement in the pelvis, prior pelvic radiation, or intolerance to general anesthesia. After stem cell infusion, hematologic and immunologic recovery are rapid in comparison to that after autologous hone marrow reinfusion: however, in some cases platelet engraftment is slower. There is some evidence that tumor contamination in …

The Accuracy Of Sonographic Imaging (Dolphintm Digigraph) And Standard Lateral Cephalometric Radiographs : A Comparative Study, Michael D. Teichman

Loma Linda University Electronic Theses, Dissertations & Projects

Radiation due to x-ray exposure is a concern, and the development of the Dolphin™ DigiGraph represents an attempt to limit this exposure. The purpose of this paper was to compare measurements (using Ricketts analysis) obtained from conventional radiographic cephalometric tracings with those obtained by computerized digitizing with the DigiGraph. Forty-six patients from the Loma Linda University School of Dentistry graduate orthodontic clinic were digitized, and the results were compared to the x-ray tracings of these patients. The results showed that seven of the twenty-one variables examined exhibited a statistical similarity between the two methods (DigiGraph and x-ray tracing). An examination …

The Use Of Corrected Occlusal X-Ray For Determination Of Ald : A Comparative Study, Merlin D. Ekvall

Loma Linda University Electronic Theses, Dissertations & Projects

In this study arch length discrepancy or ALD was studied in 50 untreated patients. The measurements obtained from Hilgers' corrected occlusal x-ray using his Occlusal Paralleling Instrument or O.P.I, were compared with those derived by four conventional methods, - "Eye balling," digital caliper determination, conventional mandibular x-ray, and the Rocky Mountain Data Systems computer analysis (31 cases). When using the OPI, results give a higher negative ALD as it takes into consideration the space required to level a curve of Spee.

Measurements were made by the author and 3 faculty members using the above methods. Statistical analysis of the means …

Regulation Vs. The Market: The Case Of Bicycle Safety (Part Ii), Ross D. Petty

RISK: Health, Safety & Environment (1990-2002)

In this part, Professor Petty examines bicycle Risk in detail, comparing the accomplishments of the CPSC's bicycle standard with market forces resulting in, e.g., the development and use of hardshell bicycle helmets. Moreover, he briefly discusses the role of tort liability in managing Risk. Ultimately he concludes that, in the case of bicycle safety, regulation has failed to be as effective as other forces tending to reduce bicycle injuries. [Part I appears at 77.]

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

A Thyroid Testing Algorithm: Results Of A Pilot Study, Hossam Ibrahim, Malachi J. Mckenna, Carolyn S. Feldkamp

Henry Ford Hospital Medical Journal

We conducted a pilot study to evaluate an algorithm for thyroid function testing consisting of initial serum thyrotropin values, measured by a sensitive immunoradiometric assay (TSH-IRMA) followed by a computer-directed decision to order further studies. We divided 216 outpatients according to their serum TSH-IRMA values as follows: suppressed (< 0.1 mU/L, group I); low (0.1 to 0.4 mU/L, group II); normal (0.5 to 5.0 mU/L, group III); and high (> 5.0 mU/L, group IV). Thyroxine (T4), resin uptake (RU). and free thyroxine index (FTI) tests on groups I, Il, and IV revealed that T4 and RU were normal for most patients in all groups and FTI was normal in 80% of group 1, 93.4 % of group ll, and 93.3% of …

Measurement Of Left Ventricular Ejection Fraction Using Gated 99mtc-Sestamibi Myocardial Planar Images: Comparison To Contrast Ventriculography, David A. Parker, Ramon L. Lloret, Francesco Barilla, Lori Douthat, Mihai Gheorghiade

Henry Ford Hospital Medical Journal

Using the new myocardial perfusion agent 99mTc-sestamibi and multigated acquisition on a nuclear medicine gamma camera, the left ventricular ejection fraction (LVEF) was derived in 13 patients with coronary artery disease (CAD). Cross-sectional activity profiles were used to measure the left ventricle from end-diastolic and end-.systolic images. Several different geometric methods were then utilized to derive ejection fractions from the nuclear data. Comparison of the resultant ejection fractions to those obtained from contrast ventriculography showed significant correlation for all geometric methods (P < 0.01,S y X x = 6.2 to 9.6). We conclude that in patients with CAD one or more of these simple geometric methods can provide a useful estimate of the LVEF when performing 99mTc-sestamibi multigated myocardial perfusion imaging.

Cushing's Disease: Dilemmas Of Diagnosis And Management, M. Saeed-Uz-Zafar, Raymond C. Mellinger, Max Wisgerhof

Henry Ford Hospital Medical Journal

Determining the cause of Cushing's disease and correcting the abnormality presents a continuing challenge to the clinician despite remarkable advances in diagnostic and therapeutic techniques. We present seven cases to illustrate 1) the classic disorder cured by pituitary adenomectomy: 2) persistence of the disease after adenomectomy: 3) Cushing's disease manifesting in the puerperium and remitting with dopamine agonist therapy: 4) a patient whose disease relapsed at least five times during 20 years of treatment by adrenalectomy, pituitary radiation, mitotane, and pituitary adenomectomy; 5) the Nelson syndrome; 6) the ectopic adrenocorticotropic hormone (ACTH) syndrome in a patient with dexamethasone suppressible urinary …

Contemporary Approach To Thyroid Disease Emphasizing Use Of High-Sensitivity Thyrotropin Assays, Carolyn S. Feldkamp, Malachi J. Mckenna

Henry Ford Hospital Medical Journal

Capabilities of new high-sensitivity immunoradiometric assays for thyroid-stimulating hormone (TSH-IRMA) to distinguish among hypothyroid, euthyroid, and hyperthyroid subjects and patient groups with low TSH for nonthyroidal causes suggested an algorithmic approach (directed TSH) to the evaluation of patients with suspected thyroid disease. Utilizing the algorithm, a TSH-IRMA result outside normal limits (0.5 to 5.0 mUlL) generates follow-up tests on the same sample. The interpretation of thyroid function tests (TSH-IRMA, thyroxine, resin uptake, free thyroxine index) and associated studies in the context of different clinical settings is reviewed. The approach is a cost-effective and efficient utilization of laboratory services.

An Ambulatory Approach To Self-Care Of Diabetes, Fred W. Whitehouse, Iris J. Whitehouse, Mary Sue Cox, Dorothy M. Kahkonen

Henry Ford Hospital Medical Journal

Managing the insulin-requiring diabetic patient in an ambulatory selling includes metabolic regulation of the diabetes and education in its self-care. Means of achieving these goals include structured group or one-on-one individualized sessions. Third party policies relating to ambulatory care are challenged and their need for fiscal support emphasized. During the coming decade, diabetic patients should 1) have access to ambulatory care programs for metabolic regulation and education in self-care. 2) expect third party support of these programs, and 3) heighten their own priorities on diabetes care to ensure quality management of their diabetes.

Chloramphenicol Therapy Of Typhoid Fever, Z A. Bhutta, S H. Naqvi, S Durrani, A Suria

Department of Paediatrics and Child Health

In a prospective study we compared two different dosage regimens of IV chloramphenicol succinate (100 mg/kg/day and 75 mg/kg/day) in children with culture proven typhoid. Trough and peak blood samples, obtained at 48 hrs, were analysed for free chloramphenicol by high pressure liquid chromatography (HPLC). Although the mean trough (8.8 +/- 7.7 versus 5.4 +/- 2.6 mcg/ml) and peak (19.9 +/- 12.2 versus 15.4 +/- 6.1 mcg/ml) chloramphenicol concentrations were comparable in both groups, a significantly wider range was found in the group receiving 100 mg/kg/day. Potentially toxic levels (greater than 30 mcg/ml) developed in two patients with liver dysfunction. …

Regulation Vs. The Market: The Case Of Bicycle Safety (Part I), Ross D. Petty

RISK: Health, Safety & Environment (1990-2002)

This part of the article describes events leading to the creation of the Consumer Product Safety Commission - and the on-going debate between those who believe safety regulation is necessary and those who believe that market forces can achieve acceptable levels of Risk. The author also sets the stage for a detailed examination of bicycle Risk. In the next issue, he compares the accomplishments of the CPSC's bicycle standard with, e.g., the development and use of hard-shell bicycle helmets. Moreover, he discusses the role of tort liability in managing Risk and ultimately concludes that, in the case of bicycle safety, …

Oncolog, Volume 36, Issue 02, April-June 1991, Gilbert H. Fletcher M.D., James M. Bowen Phd

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Redefining the risks of chemotherapy during pregnancy Renewing the assault on pancreatic cancer
• Significance of cancer volume in radiotherapy

Oncolog, Volume 36, Issue 01, January-March 1991, Michael S. Ewer Md, Mph, T. C. Hsu Ph.D., John R. Redman M.D.

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Decision making in critical illness: Who knows best?
• Successful Hodgkin's disease treatment can also preserve reproductive function
• Chromosomes and cancer

The Undrained Brain: The Other Side Of The Foreign Medical Graduate Resident Issue, C M. Smythe

Section of Neurology

No abstract provided.

Neuropsychological Sequelae Of Brain Tumors, John L. Fisk, Jerel E. Del Dotto

Henry Ford Hospital Medical Journal

Investigation of the neuropsychological sequelae of brain tumors is extremely complex largely because the neurobehavioral consequences of brain tumors depend upon complex interactions among disease and treatment variables as well as patient characteristics. To illustrate some of these complexities, we present case studies of two patients in whom the behavioral outcome was not easily predictable on the basis of our current understanding of brain-behavior relationships in tumor patients. The case studies do illustrate how neuropsychological evaluation aids in identifying cognitive deficits which have implications for subsequent quality of life. Recommendations for future experiments and statistical analyses of neurobehavioral data of …

Response To Cpap And Uppp In Apnea, Frank J. Zorick, Timothy Roehrs, William Conway, George Potts, Thomas Roth

Henry Ford Hospital Medical Journal

Ninety-two consecutive patients with obstructive sleep apnea syndrome (OSAS) were studied before and six weeks after treatment with either nasal continuous positive airway pressure (CPAP) or uvulopalatopharyngoplasty (UPPP) (n = 46 per group). Assignment of patients to treatment was based on clinical considerations and patient preference. Patients were assessed by nocturnal polysomnography and performance on the Multiple Sleep Latency Test (MSLT) the following day. Before treatment, the CPAP and UPPP groups did not differ in sleep-related respiratory disturbance, oxygenation during sleep, fragmentation of sleep, or the level of excessive daytime sleepiness indicated by the MSLT. Both treatments produced significant improvement …

Perioperative Management Of Diabetes, Gary W. Edelson, J. David Fachnie, Fred W. Whitehouse

Henry Ford Hospital Medical Journal

No abstract provided.

The Physiologic Basis For Nutritional Support In Hepatic Failure, John J. Fath

Henry Ford Hospital Medical Journal

Hepatic failure is often perceived as a unidimensional progression from near normal clinical function (Child's class A) to overt clinical failure (Child's class C). As this view fails to distinguish between patients who are capable of using exogenous protein and those who cannot, it hinders the nutritional support team in determining protein supplementation. This report addresses the physiologic basis for variable findings in hepatic failure and proposes a simple definition of hepatic faliure based upon ability to utilize amino acids.

Psychometric Profiles Of Patient Populations With Excessive Daytime Sleepiness, Edward J. Stepanski, Jon J. Markey, Frank J. Zorick, Thomas Roth

Henry Ford Hospital Medical Journal

Patients with narcolepsy have more psychiatric symptoms than normal controls as measured by psychometric tests. However, it is unclear whether these findings are specific to narcolepsy, as some studies have suggested, or related to excessive daytime sleepiness (EDS) or to chronic illness. We compared a group of 56 narcoleptics to age- and sex-matched controls with EDS. A group of 48 individuals with normal sleep architecture was also used as an additional control group. Both the narcoleptic group and the EDS-control group had significantly greater scores on Minnesota Multiphasic Personality Inventory scales hut were not different from each other. Our data …

Vital Signs, December 1990, Boonshoft School Of Medicine

Vital Signs

A fifteen page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, alumni profiles, class notes, and more.

The Role Of Group Health Cooperative In The Development Of Washington State's Basic Health Plan, Aubrey Davis

Henry Ford Hospital Medical Journal

No abstract provided.

Future Directions For Urban Health Care, Symond R. Gottlieb, Gail L. Warden, Iris R. Shannon, Seth L. Foldy, David M. Kinzer

Henry Ford Hospital Medical Journal

No abstract provided.

Urban Health: Challenges And Opportunities, Iris R. Shannon

Henry Ford Hospital Medical Journal

No abstract provided.

Countycare Summary, Edward H. Mcnamara, Vernice Davis-Anthony, Deborah L. Scott

Henry Ford Hospital Medical Journal

No abstract provided.