Blood pressure after stroke

In 334 consecutive admissions for acute stroke, the blood pressure was elevated in 84% on the day of admission. The blood pressure decreased spontaneously an average of 20 mm Hg systolic and 10 mm Hg diastolic in the ten days following the acute event without specific antihypertensive therapy and was elevated in only one third of the cases on the tenth hospital day. The early elevation in blood pressure is likely a physiological response to brain ischemia, and blood pressure falls as recovery of brain function occurs.

On-line statistical detection of average evoked potentials: application to evoked response audiometry (ERA)

An objective method of EP detection in averaged EEG epochs is described which is based on the statistical properties of the averaged EEG in the absence of time-locked EP activity. The statistical properties of the subject's averaged background EEG are summarized by making a set of comparisons between two consecutive EEG epochs immediately preceding each stimulus presentation. After every stimulus presentation, a second set of comparisons is made between the post-stimulus EEG epoch and the immediately preceding pre-stimulus EEG epoch. These two sets of comparisons are then examined to determine whether the latter differ significantly from the former. The technique has been programmed for on-line use on a 12-bit minicomputer, validated on cooperative adult subjects and used for ERA threshold determinations in young children. Using response detection criteria yielding an empirically determined false positive error rate of between 1 and 4%, threshold estimates averaged about 10 dB higher than psychophysical thresholds. The efficiency with which such ERA thresholds may be obtained with this method is substantially greater than that of conventional ERA procedures employing subjective evaluation of averages. Further, the technique allows variation of detection criteria to suit non-audiometric needs and empirical determination of the false-positive error rate under any set of conditions.

Analysis of clinically occult and mammographically occult breast tumors

Findings by xeromammography and clinical examination were compared in 16,000 self-selected women aged 45-64 who participated in a voluntary breast cancer screening program. A total of 138 malignancies were detected: 108 (78%) by mammography and 78 (57%) by clinical examination. Mammography was more effective for large breasts, fatty breasts, and in older women. Conversely, clinical examination was more effective for small breasts, dense breasts, and retroareolar lesions. Clinical detection decreased strikingly for lesions with negative lymph nodes, in situ and microinvasive lesions, deeply situated lesions, and lesions where microcalcifications were the sole mammographic finding.

Cerebral blood flow regulation. II. Vasodilator mechanisms

Rapid vasicular resistance adjustments in the brain and in the circle of Willis have been continuously measured and enhanced by signal averaging methods. Naftidrofuryl, a drug chemically similar to local anesthetics and to beta adrenergic blocking agents, increases local CBF by reducing resistance in brain and in extracerebral supply arteries. It has also been reported to affect brain metabolism. Other similar drugs merit study for potential effects on CBF and brain metabolism which may be useful in treatment.

Thermography, mammography, and clinical examination in breast cancer screening. Review of 16,000 studies

Breast cancer screening detected 139 biopsy-proved malignancies in 16,000 slef-selected women (8.7/1,000). In these, xeroradiography detected 78% (109), clinical examination 55% (76), and thermography 39% (54). In all 16,000 women, the thermogram was interpreted as positive in 17.9% (2,864). The greatest effectiveness of mammography vs. clinical examination was seen in detection of early breast cancers (small lesions with negative axillary lymph nodes). In this group, thermography was less effective than it was in patients with larger lesions and lymph node metastases.

Thermography in breast cancer screening: progress and prospects

The use of thermography in breast cancer detection is reviewed. Although advantageous in its total lack of radiation exposure to the patient, thermography has limitations in that significant false-positive and false-negative cancer detection rates have been demonstrated. The potential use of thermography in evaluation of the pathogenesis of breast cancer and in identifying women at high risk is discussed.

Mass screening for breast disease. Results, problems, and expectations

The first 18 months' experience of the Breast Diagnostic Center of Jefferson Medical College have been reviewed. Almost 14,000 patients were screened for breast disease, using a combination of clinical examination. Xeroradiography, and thermography. In this group of 14,000 women, 106 cases of cancer were discovered, in incidence of almost 8 per 1000 women screened. Of these 106 cases of cancer, 45.3% were clinically occult or not recognized by clinical examination, and within this group at the time of mastectomy only a small percent had any evidence of axillary lymph node metastases. The combination of several technics of examination is proving to be more reliable for the early detection of breast cancer than any of the technics alone, and programs such as these may make a significant difference in the death rate from breast cancer.

Cerebral blood flow regulation: vascular resistance adjustments in the circle of Willis

Continuous measurements of systemic blood pressure (BP), cerebral perfusion pressure and CBF were accomplished in the cat during transient hypertension, hypercapnia and bilateral carotid artery occlusion. From these measurements resistance values in the circle of Willis and in the cerebral arteries distal to the circle were calculated. The results indicate that the arteries of the circle of Willis and the arteries distal to the circle of Willis dilate and contract independently.

Editorial: It makes my day when a letter like this comes to the association

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Editorial: Pulling the plug: who decides?

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Projections for health care for 1976 and beyond

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Canadian medicine has already provided the patient with a bill of rights

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Serving our patients individually remains basic concept of medicine

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Our future influence depends on expertise in management

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Toronto's sick kids' hospital is 100 years young this year

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The old home town's suffered progress but the squirrels are just the same

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The moral duty of the profession in the tranquillizer-on-demand syndrome

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How one Canadian medical school seeks those who will practise art and science

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Guard against these four factors if you want to see another summer

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Medical care by number

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The way I see it organized medicine can make a point short of using the ultimate labour tactic

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The way I see it: things may go better with COLA, but let's just make things equitable

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