Evaluation of lithium-tetracycline interaction.
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Adult↗
Biomedical subjects
B Connolly
Publications and source records attributed to B Connolly.
CSF/shunt infections--the bane of our lives!
Thirty one patients were treated for 43 laboratory proven shunt or CSF infections, between 1980 to 1986 inclusive. They required 63 separate treatments. Infective episodes were grouped retrospectively according to method of treatment employed i.e. 1) placement of external drainage system or 2) reservoir and tapping, 3) intravenous or intraventricular antibiotics alone, 4) total change of shunt prosthesis, 5) partial change of prosthesis or 6) removal of all the prosthesis. See Table II. The single most important factor in eradication of shunt infection was the entire removal of the total shunt system and achieved success in 80% of instances. Conversely utilization of any of the existing infected system failed in 77% of cases. Route of administration of antibiotics, choice or change of side, or method of treatment chosen did not appear to influence success greatly.
Bacterial Infections↗
Trends in tracheoesophageal fistula.
The changing trends in the management of patients with esophageal atresia, with or without tracheoesophageal fistula during 1974 to 1983, and its effect on survival and morbidity rates are analyzed herein. Of 139 patients in this series, 44 per cent were in Waterston group C. The over-all mortality rate was 25.5 per cent but this decreased consistently after 1980 to 11.0 per cent in 1983. The incidence of infants in the series who weighed less than 1.8 kilograms at birth increased from 7 per cent before 1979 to 18 per cent after 1979 and the survival rate increased from zero to 50 per cent. All six infants who were 30 to 34 weeks gestation and referred after 1979 survived. Severe pneumonia at admission decreased from 24 to 11 per cent in two five year periods. Delayed primary anastomosis and Livaditis circular myotomy overcame many problems of the "long gap" associated with pure esophageal atresia, resulting in successful anastomosis in all eight patients treated in the latter years. Of six patients who presented before 1979, three patients died and three required interposition grafts. Significant anastomotic leaks decreased from 14.7 to 3.2 per cent and the mortality rate decreased from 70 to zero per cent, reflecting many factors, such as extrapleural repair, use of total parenteral nutrition and improved neonatal, ventilatory and intensive care.
Abnormalities, Multiple↗
An operative technique to reduce valve colonisation.
Using a multiple skin preparation technique, drape edges soaked in chlorhexidine and valves primed with gentamicin solution CSF shunt (VP) colonisation rate has been reduced to 2.4% of 82 operations.
C-Reactive Protein↗
Effects of osmolality of liquid nutrient diets on plasma equilibration of water and carbohydrate in Yucatan miniature swine.
Osmolality of a liquid diet was varied from 250 to 700 mOsm/kg by altering the amount of sucrose and corn syrup solids, while maintaining the same level of calories, protein, and electrolytes. The appearance of 3H and 14C in blood plasma were monitored during a 4-h period after pigs voluntarily consumed one of five diets labeled with 3H2O and U-14C-sucrose. Plasma osmolality and sodium and potassium concentrations in plasma did not differ among the diets. Postprandial plasma glucose concentration response to the diets varied both between and within treatments. The rates of radioactive tracer appearance in plasma suggest that water and carbohydrate absorption were accelerated with increasing osmolality of diet up to 700 mOsm/kg.
Absorption↗
Early intervention with Down syndrome children: follow-up report.
This report compares developmental milestones and current intellectual and adaptive functioning of 20 children with Down syndrome who participated in an early intervention program with those of 53 noninstitutionalized children with Down syndrome who did not experience such a program. The children in the former group generally showed earlier acquisition of motor and self-help skills and significantly higher intelligence quotients and social quotients at three to six years of age. Because of certain variables that could not be rigorously controlled in this type of program, the higher functioning cannot be clearly attributed to early intervention. These findings nevertheless are consistent with the hypothesis that early intervention has a beneficial effect and should provide encouragement for further studies.
Child↗
Interdisciplinary early intervention program.
Developmental data were obtained on 40 children with Down's syndrome by an interdisciplinary team during an ongoing early intervention program. Interventive methods are described. Results are compared with available data on children with Down's syndrome who were not in early intervention programs. Comparisons of developmental progress are also made of children begun in the early intervention program before six months of age with those begun after six months of age. Conclusions from the study indicate that early intervention helps the child in earlier attainment of many developmental tasks and enhances functioning of the family unit.
Counseling↗
Communications to the editor.
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Journal Article↗
Acetylcholinesterase and ATPases in motor neuron degenerative diseases.
Acetylcholinesterase (AChE) activity was measured in the presence of the specific inhibitor of pseudocholinesterase, iso-OMPA, in plasma from patients with amyotrophic lateral sclerosis (ALS), progressive muscular atrophy (PMA), neuromuscular disease controls, and normal controls. Both AChE and Na-K ATPase activities were measured in erythrocyte ghost membranes from ALS and normal controls. Activities of erythrocyte ghost AChE and Na-K ATPase did not differ between ALS and control patients, suggesting that erythrocyte membranes were normal in ALS. However, the activity of plasma AChE in patients with ALS and PMA was increased significantly over plasma activity in disease controls and normal controls. In addition, in an animal model of human PMA, the Wobbler mouse, plasma AChE activity was increased significantly over littermate controls. The explanation for the increase in plasma acetylcholinesterase was not clear; however, a number of potentially useful clinical points followed from this study. First, there was no relationship between a specific subtype of motor neuron disease and the level of AChE activity. Second, AChE activity appeared to vary directly with the duration of PMA but not with the severity of PMA. This did not correlate with either the duration or severity of ALS. Last, plasma AChE activity was normal in about 30% of patients who had motor neuron disease; therefore, AChE assay had limited use in the diagnosis of ALS or PMA.
Acetylcholinesterase↗
Imaging of abdominal complications following cardiac surgery.
Ten thousand seven hundred fifty-six patients underwent cardiac bypass surgery at the Mater Hospital national cardiac unit between September 1979 and April 1993. Of this group, 49 patients were identified who had developed postoperative gastrointestinal complications leading to 16 deaths. Twenty-five patients developed gastrointestinal hemorrhage, eight patients developed gallbladder disease, five patients developed phlegmonous pancreatitis, eight patients developed bowel perforations, and three patients developed intestinal pseudoobstruction. The particular radiological features that lead to diagnosis in each case are discussed and relevant literature is briefly reviewed.
Abdomen↗
MRI in acute hemiplegia of childhood.
OBJECTIVE: Acute hemiplegia in childhood is rare, the underlying etiology frequently obscured and the pathological site unidentified. MATERIALS AND METHODS: Magnetic resonance imaging (1.5 T Magnetom) was performed in two cases with hemiplegia followed by repeated studies at 3 and 16 months, respectively, after the initial examinations, including CT and angiography, were negative. RESULTS: MRI demonstrated otherwise occult lesions in the brain stem and showed the subsequent partial resolution consistent with infarction. CONCLUSION: MRI should be employed in those children with acute hemiplegia in whom no underlying cause is elicited.
Acute Disease↗
Pichinde virus-induced respiratory failure due to obstruction of the small airways: structure and function.
Respiratory distress that leads to death is seen in patients with Lassa fever. The development of this respiratory problem was studied using a Pichinde virus model (10(4) plaque forming units, IP, survival time 20 +/- 1 days) in strain 13 guinea pigs (n = 35, 229-353 g) of this lethal human contagious infectious disease. Extravascular lung water to bloodless dry lung weight (EVLW/BDLW) ratio showed a modest yet significant increase in animals 13 and 18-21 days postinoculation (PI). In contrast, residual lung blood and lung radioactive 125I-labeled human serum albumin activity index were elevated only in the 18- to 21-day group. These data are consistent with the progressive severity of perivascular edema, lymphocytic pneumonitis, and some alveolar protein between days 13 and 18-21 PI. Lymphocytic pneumonitis appeared to be distributed near most airways and was proportional to the degree of Pichinde virus antigen staining of alveolar macrophages, large mononuclear cells within the pulmonary vascular and extravascular spaces, and alveolar-capillary membranes. These findings suggest that lymphocyte recruitment to the lung reflects the Pichinde virus-induced cell-mediated immune response. Obstructed small bronchi with some lumenal cell debris and hypertrophied epithelial cells were found associated with the areas of marked pneumonitis. The severe hypoxemia and modest anaerobic metabolism in association with marked tachypnea and normocapnia are consistent with small airway obstruction and wasted ventilation, since no change in arterial blood pressure, heart rate, hematocrit, hemoglobin, or blood volume was noted. These data suggest that Pichinde virus-induced respiratory failure was due to obstruction of the small airways with wasted ventilation in association with lymphocytic pneumonitis.
Airway Obstruction↗