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Biomedical subjects

B H Harris

Publications and source records attributed to B H Harris.

At least 55 records · Page 3Linked to original sources
PubMed1989

The development of pyloric stenosis during transpyloric feedings.

Three infants, ages 3 to 4 months, had nasojejunal feeding tubes placed for recurrent aspiration and/or feeding intolerance after upper gastrointestinal cineradiographs (ugi) had documented gastroesophageal reflux (GER) with normal pyloric channels and prompt gastric emptying. The tubes had been in place for 3 and 4 weeks, respectively, in the first two infants when classic hypertrophic pyloric stenosis (HPS) was found during fundoplication and gastrostomy tube placement. The last child had a failed attempt at nasogastric tube feedings following 3 months of nasojejunal tube feedings. A repeat ugi suggested HPS, which was confirmed by pyloric ultrasound. This infant underwent pyloromyotomy alone. The late presentation of HPS in these infants suggests that transpyloric tubes might cause the development of HPS and exacerbate the symptoms of preexisting GER. In infants who are expected to eat by mouth, pyloromyotomy alone might allow the reinstitution of orogastric feedings without the perioperative morbidity of fundoplication and gastrostomy tube placement.

Enteral Nutrition↗
PubMed1988

Pregnancy following repair of vaginal atresia.

The abdomino-perineal-vaginal pull-through operation offers the most anatomically correct reconstruction for patients with vaginal atresia. A 14-year-old girl with vaginal atresia and a persistent urogenital sinus underwent genitourinary reconstruction using this technique. Years later, two planned pregnancies were carried to term and completed by elective cesarean delivery. This is the first case that demonstrates normal vaginal function following abdomino-perineal-vaginal pull-through.

Adolescent↗
PubMed1988

Arteriovenous pH difference--a new index of perfusion.

Measurement of the pH of arterial blood may not reflect early stages of anaerobic metabolism. Since a relationship exists between pH and cellular utilization of oxygen, this study sought to determine whether the difference between arterial and venous pH might serve as a more useful index for estimating the adequacy of tissue perfusion. Dogs were made hypovolemic, and hemodynamic profiles including thermodilution cardiac output were obtained while simultaneous arterial and central venous blood samples were analyzed for pH. Arteriovenous pH difference increased as cardiac index fell. Whenever the arteriovenous pH difference became greater than 0.05 pH units, the cardiac index had fallen below 65% of the baseline values. A difference of 0.05 pH units between arterial and venous blood predicted hypoperfusion in 90% of the animals. With deepening shock the gradient widened, and when resuscitation was effective the arteriovenous pH difference returned toward normal. These data suggest that arteriovenous pH difference may reliably predict clinically significant reductions in cardiac output and cellular perfusion. This finding could be useful in pediatric trauma and critical care settings in which invasive monitoring and direct determination of cardiac output are technically difficult.

Acidosis, Lactic↗
PubMed1988

A pediatric trauma model of continuous hemorrhage.

This report describes a new experimental model of hemorrhage in immature animals. Puppies were subjected to continuous hemorrhage equivalent to 1% of calculated blood volume per minute. In the control group there was no change in mean arterial pressure, central venous pressure, cardiac output, hematocrit, pH, or core temperature. In the experimental group the response to hemorrhage was gradual and in proportion to blood loss until 25% to 30% blood volume reduction. At this critical point, the fall in mean arterial pressure and cardiac output accelerated and death occurred. These observations suggest that the response to blood loss has break points beyond which sudden deterioration is rapid and dramatic. This model of hemorrhage should be useful for future study of the effects of treatment of hemorrhagic shock in immature subjects.

Animals↗
PubMed1988

Evolution of the care of the injured child.

Pediatric trauma care has become an art form practiced by pediatric surgeons who regard it as their field of special interest. The emotional and physiologic differences of young patients and the need to cope with pediatric trauma as a syndrome require special techniques and organization best provided by pediatric trauma centers. Improved outcome in trauma centers, both adult and pediatric, has been documented beyond reasonable doubt, and the trauma center movement has matured to the point where legislative and regulatory bodies and insurance carriers are directing seriously injured patients to specialized facilities. We hear so much about rare diseases that it is possible to forget that trauma kills more children than all other diseases combined. Seventy years after Dr. Ladd's vision the day may finally be at hand in which every pediatric hospital and children's service has a pediatric trauma program. The essential ingredient of pediatric trauma care is commitment to the special needs of injured children--personal, institutional, and community commitment. The future belongs to those who understand the past.

Abdominal Injuries↗
PubMed1987

Pediatric trauma.

Explore the source record for details and available documents.

Pediatrics↗
PubMed1987

Abdominal abscesses in adolescents with Crohn's disease.

Little information is available about the development of abdominal abscesses in adolescents with Crohn's disease. We report the clinical presentation of five adolescents with Crohn's disease who developed this complication. The mean time from diagnosis until development of an abdominal abscess was 1.7 years. The admitting diagnosis was an acute abdomen in two patients and recurrent Crohn's disease in the other three. No features of the clinical presentation or laboratory data distinguished this group from other adolescents with Crohn's disease. The use of ultrasound and CT scanning was helpful in making this diagnosis preoperatively. Those patients with active Crohn's disease who do not respond promptly to medical therapy should be evaluated for the development of this complication.

Abdomen↗
PubMed1987

The crucial hour.

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Airway Obstruction↗
PubMed1986

Performance of aeromedical crewmembers: training or experience?

In a clinical trial testing delivery of cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC) in a medical helicopter, 40-45% of physicians, nurses, and paramedics certified in advanced cardiac life support (ACLS) performed below standard as compared with full-time flight nurses and paramedics. Personnel regularly engaged in aeromedical activities perform far better than those similarly qualified but less familiar with the aviation environment. Because regular ACLS techniques apply during air transport, training, comfort, experience, and confidence are critical factors in crew performance and may affect outcome. The ideal crew should include regular partners who train and work together. The temptation to assign personnel to aeromedical duties without adequate preparation, testing, and commitment must be resisted. Those responsible for the medical direction of hospital-based helicopter services should insist on full-time crew members and provide them with liberal training opportunities and opportunities for skill maintenance.

Aircraft↗
PubMed1986

Oriental cholangitis.

Oriental cholangitis is a progressive hepatic disease characterized by episodic biliary obstruction and sepsis. This is the report of a case of Oriental cholangitis in a nine-year-old girl. Oriental cholangitis should be considered in the differential diagnosis of upper abdominal pain in the susceptible population.

Child↗
PubMed1985

Management of multiple trauma.

The first 20 minutes of medical treatment are crucial in determining the outcome for the multiple injured child. The author chronicles management procedures and their sequence, emphasizing the systemic approach and preparation as important tools.

Child↗
PubMed1985

In vitro activity of cefbuperazone against anaerobic bacteria.

The in vitro activity of cefbuperazone was compared with that of cefoxitin, moxalactam, and piperacillin against 305 strains of anaerobic bacteria. Piperacillin was the most active overall, inhibiting 97% of all anaerobes tested at 128 micrograms/ml. Cefbuperazone had poor activity against the Bacteroides fragilis group and Clostridium difficile (43 and 0% susceptible, respectively) but good activity (90.5%) against all other anaerobic bacterial species tested.

Anti-Bacterial Agents↗
PubMed1982

Mycobacterial lymphadenitis.

The plan for cervical lymph node biopsy should include special maneuvers for recognition of patients with lymphadenitis due to atypical mycobacteria, since these children need extensive operations. The diagnosis should be suspected in children less than 3 yr old with lymphadenopathy present for several months and no exposure to cats (or with negative cat scratch skin tests). Wide local excision of all visibly involved nodes is recommended; acid-fast touch preparations should be done and interpreted during operation in any suspicious case. Limited operations should be avoided in children with mycobacterial lymphadenitis. The illness may be more common than previously suspected.

Cat-Scratch Disease↗
PubMed1982

Protection of the solitary testis.

In 15 negative explorations for unilateral cryptorchidism, inspection of the contralateral scrotum revealed a "bell-clapper" deformity in 13 patients. Since the descent of the testis is influenced by the gubernaculum and gubernacular abnormalities are usually bilateral, the data suggest that an inadequate gubernaculum is associated with most instances of antenatal and postnatal torsion. Unilateral absence of the testis is a form of this syndrome; congenital monorchidism is probably due to antenatal torsion rather than hypoplasia or agenesis. When monorchidism is confirmed at operation, exploration and suture fixation of the contralateral testis at the same procedure is recommended to protect the solitary testis from future torsion.

Adolescent↗
PubMed1977

Radioisotope diagnosis of splenic trauma.

Multiple injury or delay in seeking medical attention may prevent confident clinical diagnosis of splenic trauma. The spleen scan is a rapid, simple, noninvasive test useful in such circumstances. When peritoneal lavage is contraindicated, unrevealing, or inapproapriate, radioisotope imaging of the spleen can help confirm a suspicion of splenic injury.

Adolescent↗