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Biomedical subjects

A D Mayer

Publications and source records attributed to A D Mayer.

At least 127 records · Page 7Linked to original sources
PubMed1985

The diagnostic and prognostic value of peritoneal lavage in patients with acute pancreatitis.

Diagnostic peritoneal lavage was performed upon 247 patients referred with a clinical diagnosis of acute pancreatitis at a median time of five hours after admission to the hospital and was associated with 0.8 per cent morbidity. The procedure enabled an erroneous clinical diagnosis to be corrected in seven patients and confirmed a tentative clinical diagnosis in two other patients. Criteria for the prediction of severe pancreatitis by peritoneal lavage are described. This enabled 90 per cent of the patients who died of fulminant pancreatitis or of the later effects of pancreatic necrosis to be identified. Diagnostic lavage appeared to be most useful for the identification of severe attacks of pancreatitis which were associated with a shock-like systemic illness.

Acute Disease↗
PubMed1984

A simple screening test for acute pancreatitis.

A urinary test strip for amylase (Rapignost-Amylase) was compared with plasma amylase assay in samples of urine and plasma collected on the day of admission to hospital from 23 patients with acute pancreatitis and 38 patients with other causes of acute abdominal pain. Plasma amylase was greater than 1200 IU/l in 24 patients (23 with pancreatitis and 1 with a perforated duodenal ulcer) and all were Rapignost-Amylase positive. Twenty-nine of the remaining patients were Rapignost-Amylase negative, but there were eight "false positives' with plasma amylase levels of 86-474 IU/l. The Rapignost-Amylase test is of potential value to screen for clinically occult acute pancreatitis.

Acute Disease↗
PubMed1984

Relation of alpha 2-macroglobulin and other antiproteases to the clinical features of acute pancreatitis.

alpha 2-macroglobulin is probably the most important of the antiproteases in plasma. In this study, the relationships of plasma alpha 2-macroglobulin to the clinical features of acute pancreatitis as well as to plasma levels of other antiproteases, immunoglobulins, and immunoreactive trypsin, were investigated in 55 patients with acute pancreatitis. The mean level of alpha 2-macroglobulin in 395 plasma samples from the patients was 2.12 g/liter compared with 2.41 g/liter in 29 healthy subjects and 2.93 g/liter in 17 patients with septicemia. Plasma levels were lower in 12 patients with severe pancreatitis than in 43 with mild attacks, and the lowest levels in three fatal attacks were less than half the mean of the normal range. Lowest levels were recorded at a mean time of 3 days after admission in the patients with mild attacks, at 5 days after admission in the patients with severe attacks, and 9 days after admission in those with fatal attacks. In contrast, plasma levels of the alpha 1-proteinase inhibitor antichymotrypsin and C-reactive protein increased to above normal levels during the attack, significantly more so in severe compared with mild attacks. Plasma levels of IgA, IgG, and IgM remained within the normal range or were increased. In patients with severe pancreatitis, plasma levels of immunoreactive trypsin remained elevated for longer than in those with mild attacks although there was little initial difference in the levels. These data suggest that decreasing levels of alpha 2-macroglobulin during the course of acute pancreatitis are due to a specific mechanism and unrelated, for the most part, to any generalized effect of pancreatitis on protein synthesis. The formation of rapidly cleared complexes between alpha 2-macroglobulin and active proteases is the most tenable explanation for the depletion of plasma levels, but the clinical significance of the changes remains unclear.

Acute Disease↗
PubMed1984

C reactive protein: an aid to assessment and monitoring of acute pancreatitis.

An evaluation of C reactive protein as an indicator of the progress of acute pancreatitis has been made, and the data have been compared with the information given by the white cell count, erythrocyte sedimentation rate, and temperature and by two antiproteases--alpha 1 protease inhibitor and alpha 1 antichymotrypsin. The main value of C reactive protein is to provide a guide to the severity of the inflammation and to increase clinicians' awareness of the patient's enhanced risk of developing pancreatic collections when the C reactive protein concentration remains high (greater than 100 mg/l) at the end of the first week of the illness. In this respect C reactive protein concentrations are superior to white cell count, erythrocyte sedimentation rate, and temperature and the concentrations of antiproteases.

Acute Disease↗
PubMed1984

Operations upon the biliary tract in patients with acute pancreatitis: aims, indications and timing.

The management of gallstones in patients with acute pancreatitis (AP) is controversial. This paper reports an analysis of 171 attacks of AP associated with gallstones. Whilst awaiting elective cholecystectomy 56% of patients had further symptoms and 1 died. Non-urgent operations during the same admission as the pancreatitis (n = 34) resulted in 2 deaths and 7 septic complications, but prediction of complications may be possible. Urgent surgery (n = 5) was followed by 3 deaths. This study suggests that in most patients, cholecystectomy should be performed as soon as the patient is adequately fit. Urgent removal of an impacted ampullary stone (preferably by endoscopic papillotomy) may be required in a small minority if severe pancreatitis fails to respond to medical treatment, or if cholangitis supervenes .

Acute Disease↗
PubMed1984

Prepartum changes in maternal responsiveness and nest defense in Rattus norvegicus.

Changes in maternal responsiveness during late pregnancy were traced by exposing females to foster pups (15-30-min tests) under conditions favoring the rapid initiation of maternal behavior. Groups were tested when nonpregnant or on Days 17, 20, 21, or 22 of pregnancy (Day 22 = parturition). Nulliparous females were compared with primiparous and with "experienced breeders." Nest defense was observed by introducing unfamiliar males (2-min tests) on Day 22. Results focused attention on three periods: (a) Days 17-20, when maternal responsiveness was lower than in the nonpregnant condition, (b) Day 21, when maternal responsiveness returned to or rose above nonpregnant levels, and (c) on Day 22, the 3.5 hr prior to delivery, during which 90% of females almost immediately retrieved, gathered, and tended foster pups and during which 92% attacked the unfamiliar intruders. (Attacks were rare earlier.) Maternally experienced females were more responsive to pups than nulliparous females when nonpregnant and throughout late pregnancy, but both groups were equally likely to show prepartum aggression.

Aggression↗
PubMed1981

Compression suture of the abdominal wall: a controlled trial in 302 major laparotomies.

Monofilament nylon suture material undergoes both plastic and elastic elongation when stretched. Nylon inserted as a continuous suture for approximation of the abdominal musculo-aponeurosis may, therefore, allow early separation of the cut edges, which may predispose to the later development of an incisional hernia. This hypothesis was tested in a consecutive series of 302 major laparotomies randomized to be sutured with continuous mass nylon either to approximate or to compress the deep layers. The incidence of incisional hernia at 6 months in the group sutured with normal tension was 10.0 per cent, compared with 5.5 per cent in those tightly sutured. There was, however, an increased rate of minor wound infection in the latter group.

Abdominal Muscles↗
PubMed1980

Hormonal interaction with stimulus and situational factors in the initiation of maternal behavior in nonpregnant rats.

Previous hormonal studies have identified the hormonal and stimulus factors mediating the initiation of maternal behavior but have failed to reduce hormone-induced latencies of nonpregnant females to less than 1-2 days of continuous pup exposure. For the purpose of testing whether this delay is due to an olfactory-vomeronasal-mediated aversive reaction to pups like that found in untreated virgins, estrogen-injected hysterectomized-ovariectomized (HO-EB) nonpregnant females were subjected to olfactory-vomeronasal deafferentation. Median latencies were reduced to 0 and 1.5 hr compared with 72 hr for HO-EB nondeafferented females, which indicates that normally after HO-EB treatment, tendencies to initially avoid pup contact remain strong. Next, the hypothesis was explored that experiences during late pregnancy and/or parturition interact with hormonal priming to modify pup avoidance. Nonpregnant HO-EB females that had been exposed to pregnant-parturient females for 2 wk were tested under conditions simulating parturition. A high percentage rapidly initiated maternal behavior, but conditions during testing proved more important than prior exposure to pregnancy/parturition. The contributions of three stimulus/situation factors were analyzed: pup age--newborn versus 3-8 day; method of pup presentation--four at once versus staggered introduction; and time of day--lights versus dark phase. Hormonally treated but not sham-treated females initiated maternal behavior most rapidly when first exposed to one newborn in the nest during the light phase (76% within 1.5 hr). Prepartum caesarean-delivered females, however, responded maternally to four 3-8-day-old pups outside the nest, which indicates that additional factors operate at parturition.

Animals↗
PubMed1979

Ontogeny of maternal behavior in the laboratory rat: early origins in 18- to 27-day-old young.

The responses of unweaned juveniles, 18 to 27 days of age, in brief tests with pups younger than 10 days were observed during initial exposure and at 4-6-day intervals. They showed no aversive responses and actively sought contact with the pups until 24 days when contact-seeking declined sharply. Young exposed to pups before 24 days continued to seek contact with them after 24 days showing an effect of the prior experience. Juveniles given a choice between young pups and a warm bowl chose the pups; given a choice between young pups and age mates, they chose the young pups until day 23, but chose the age mates after then. When housed continuously with young pups at 22 days of age, 5 of 9 retrieved and grouped pups with a latency of 1 day. Our results indicate that timidity or fear of novelty develops in rats in this situation about Day 24 and thereafter is a factor inhibiting the expression of positive social behavior toward pups.

Aging↗
PubMed1979

Ontogeny of maternal behavior in the laboratory rat: factors underlying changes in responsiveness from 30 to 90 days.

Male and female rats that were nonhandled or that were handled from weaning, and that had intact or impaired olfaction (intranasal zinc sulfate), were sensitized through continuous pup exposure commencing at 30, 45, 60, or 90 days of age. Nonhandled males and females were alike in latencies to become maternal at Day 30 but thereafter latencies of females became shorter and latencies of males lengthened; by 90 days males had markedly longer latencies than females and only 1/3 became maternal. Handling facilitated sensitization at 30 days among males and females but only among males at 45 and 60 days. Intranasal zinc sulfate reduced latencies of both males and females at all ages tested, but appeared most effective after 45 days of age. Gender differences in latencies persisted in adult animals even after combined treatments. Results indicate that both timidity and olfaction inhibit the onset of maternal responses to pups in virgin males and females, but they differ in relative importance by age and gender.

Aging↗
PubMed1975

Olfactory basis for the delayed onset of maternal behavior in virgin female rats: experimential effects.

A previous study showed that intranasal zinc sulfate (ZnSO4) treatment shortens the latencies for the onset of maternal behavior in nonpregnant rats. The aim of this study was to see whether after recovery from the effects of ZnSO4 treatment, the latencies for maternal behavior increased. In Experiment 1 nonpregnant females were intranasally infused with ZnSO4 or air or were left untreated and exposed to pups starting 48 hr later. Olfactory discrimination tests using chocolate bits were done simultaneously. The ZnSO4 treatment resulted in short latency maternal behavior (1.1 days) compared with latencies of control females (3.8 days), but neither group showed any loss of olfactory discrimination. Three weeks later- ZnSO4-treated females showed increased latencies for all but retrieving, while control groups showed decreased latencies for all maternal behaviors. In Experiment 2, intranasal ZnSO4- and air-treated females were given olfactory discrimination tests under food deprivation, using chocolate bits and guinea pigs pellets. Choice of guinea pig pellets was more severely affected than choice of chocolate bits, but recovery of the discriminations was complete in 4-5 days. The effects of ZnSO4 on maternal behavior and on olfactory discrimination in nonpregnant females were discussed.

Animals↗
PubMed1975

Decline of maternal behavior in the virgin and lactating rat.

Sensitized virgins and postpartum lactating mothers, both exhibiting maternal behavior, were given donor litters that increased in age by 1 day, for 28 days, starting at the onset of maternal behavior. Each day females were tested for maternal behavior with pups 4-8 days old: Maternal care (i.e., nursing/crouching, retrieving, nest building and licking) and maternal withdrawal, rejection, and prevention of nursing were recorded. After the ninth day, females were also tested with the progressively older pups from 10 to 28 days of age with which they were living. Virgins and lactating mothers showed generally similar patterns of maternal care although some differences were found, and they declined in maternal behavior toward the older pups in a similar manner. Maternal behavior did not decline in tests with younger pups. The results are interpreted as supporting the hypothesis that the decline as well as the maintenance of maternal behavior postpartum is nonhormonally mediated.

Age Factors↗
PubMedDate not supplied

Is serum gentamicin level a good predictor of graft injury in intestinal transplantation?

INTRODUCTION: Following intestinal transplant (SBT), the early diagnosis and treatment of rejection is a major management aim. The diagnosis of rejection is based on histology of stomal biopsies. Oral gentamycin (2.5 mg/kg) was used for selective decontamination of the digestive system. Our hypothesis was that gentamycin might be absorbed in the presence of graft dysfunction. AIM: Our goal was to assess the correlation between serum gentamycin level and the health of the intestinal graft. SUBJECTS AND METHODS: Among 33 SBT performed from 1993 to 2005, serum gentamycin levels were performed once weekly or more often when there was a suspicion of rejection. All data were analyzed retrospectively. RESULTS: Adequate trough levels were achieved for only 23 patients, six of whom had histologically proven rejection and only one did not have a raised gentamycin content. Five patients with raised levels but no rejection included two with severe intestinal ischemia and three with bowel obstruction/ileus. Four of the five patients required laparotomies. CONCLUSION: We concluded that in our study raised serum gentamycin levels were a good predictor of rejection or significant injury to the graft.

Biomarkers↗